Laser therapy for recurrent aphthous stomatitis: an overview

  • Juliana Amorim dos Santos
  • Ana Gabriela Costa Normando
  • Isabela Porto de Toledo
  • Gilberto Melo
  • Graziela De Luca Canto
  • Alan Roger Santos-Silva
  • Eliete Neves Silva GuerraEmail author



To evaluate therapeutic effects of laser therapy on patients with recurrent aphthous stomatitis assessing evidences from previously published systematic reviews.

Materials and methods

An overview of systematic reviews was conducted based on PRISMA checklist. Search strategies were developed and adapted for six different electronic databases and a gray literature search was also performed. The methodology quality of the included systematic reviews was assessed by the Measurement Tool to Assess the Methodological Quality of Systematic Reviews 2 (AMSTAR 2).


After a two-step selection, five systematic reviews were included. Methodology quality was considered as a high risk of bias in two systematic reviews, while in the other three were graded as moderate. The systematic reviews’ conclusions demonstrated that all included systematics reviews showed positive effects of laser therapy for pain relief, and most of them demonstrated healing improvement. A meta-analysis was not feasible due to heterogeneity in treatments parameters.


Evidence suggested that laser therapy is an effective tool to treat recurrent aphthous stomatitis; nevertheless, more randomized clinical trials should be conducted to compare different lasers parameters.

Clinical relevance

The present overview evaluated recent evidence about laser therapy for recurrent aphthous stomatitis management in order to contribute for evidence-based dentistry and decision-making. This overview suggests that laser therapy is a safe and promising alternative to treat recurrent aphthous stomatitis, since it promotes wound healing and pain relief.


Lasers Oral ulcer Oral medicine Systematic review Evidence-based medicine Overview 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.

Supplementary material

784_2019_3144_MOESM1_ESM.docx (42 kb)
ESM 1 (DOCX 42 kb)


  1. 1.
    Scully C, Porter S (2008) Oral mucosal disease: recurrent aphthous stomatitis. Br J Oral Maxillofac Surg 46(3):198–206. CrossRefPubMedGoogle Scholar
  2. 2.
    Al-Omiri MK, Karasneh J, Alhijawi MM, Zwiri AM, Scully C, Lynch E (2015) Recurrent aphthous stomatitis (RAS): a preliminary within-subject study of quality of life, oral health impacts and personality profiles. J Oral Pathol Med 44(4):278–283. CrossRefPubMedGoogle Scholar
  3. 3.
    Stanley HR (1972) Aphthous lesions. Oral Surg Oral Med Oral Pathol 33(3):407–416CrossRefGoogle Scholar
  4. 4.
    Preeti L, Magesh K, Rajkumar K, Karthik R (2011) Recurrent aphthous stomatitis. J Oral Maxillofac Pathol 15(3):252–256. CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Suter VGA, Sjölund S, Bornstein MM (2017) Effect of laser on pain relief and wound healing of recurrent aphthous stomatitis: a systematic review. Lasers Med Sci 32(4):953–963. CrossRefPubMedGoogle Scholar
  6. 6.
    Jurge S, Kuffer R, Scully C, Porter SR (2006) Mucosal disease series. Number VI. Recurrent aphthous stomatitis. Oral Dis 12(1):1–21. CrossRefGoogle Scholar
  7. 7.
    Brocklehurst P, Tickle M, Glenny AM, Lewis MA, Pemberton MN, Taylor J, Walsh T, Riley P, Yates JM (2012) Systemic interventions for recurrent aphthous stomatitis (mouth ulcers). Cochrane Database Syst Rev 9:CD005411. CrossRefGoogle Scholar
  8. 8.
    González-Moles MA (2010) The use of topical corticoids in oral pathology. Med Oral Patol Oral Cir Bucal 15(6):e827–e831. CrossRefPubMedGoogle Scholar
  9. 9.
    da Silva JP, da Silva MA, Almeida AP, Lombardi Junior I, Matos AP (2010) Laser therapy in the tissue repair process: a literature review. Photomed Laser Surg 28(1):17–21. CrossRefPubMedGoogle Scholar
  10. 10.
    Arany PR (2016) Craniofacial wound healing with photobiomodulation therapy: new insights and current challenges. J Dent Res 95(9):977–984. CrossRefPubMedGoogle Scholar
  11. 11.
    Chung H, Dai T, Sharma SK, Huang YY, Carroll JD, Hamblin MR (2012) The nuts and bolts of low-level laser (light) therapy. Ann Biomed Eng 40(2):516–533. CrossRefPubMedGoogle Scholar
  12. 12.
    Smith KC (2005) Laser (and LED) therapy is phototherapy. Photomed Laser Surg 23(1):78–80CrossRefGoogle Scholar
  13. 13.
    Pandeshwar P, Roa MD, Das R, Shastry SP, Kaul R, Srinivasreddy MB (2016) Photobiomodulation in oral medicine: a review. J Investig Clin Dent 7(2):114–126. CrossRefPubMedGoogle Scholar
  14. 14.
    Zand N, Fateh M, Ataie-Fashtami L, Djavid GE, Fatemi SM, Shirkavand A (2012) Promoting wound healing in minor recurrent aphthous stomatitis by non-thermal, non-ablative CO2 laser therapy: a pilot study. Photomed Laser Surg 30(12):719–723. CrossRefPubMedGoogle Scholar
  15. 15.
    Pavlić V, Vujić-Aleksić V, Aoki A, Nežić L (2015) Treatment of recurrent aphthous stomatitis by laser therapy: a systematic review of the literature. Vojnosanit Pregl 72(8):722–728. CrossRefPubMedGoogle Scholar
  16. 16.
    Najeeb S, Khurshid Z, Zohaib S, Najeeb B, Qasim SB, Zafar MS (2016) Management of recurrent aphthous ulcers using low-level lasers: a systematic review. Medicina(Kaunas) 52(5):263–268. CrossRefGoogle Scholar
  17. 17.
    Han M, Fang H, Li QL, Cao Y, Xia R, Zhang ZH (2016) Effectiveness of laser therapy in the management of recurrent aphthous stomatitis: a systematic review. Scientifica (Cairo) 2016:9062430. CrossRefGoogle Scholar
  18. 18.
    Vale FA, Moreira MS, de Almeida FC, Ramalho KM (2015) Low-level laser therapy in the treatment of recurrent aphthous ulcers: a systematic review. ScientificWorldJournal 2015:150412. CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e1000097. CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Amorim dos Santos JA, Normando AGC, de Toledo IP, Melo G, Guerra ENS (2018) Laser therapy on aphthous stomatitis: an overview of systematic reviews. PROSPERO 2018:CRD42018102772Google Scholar
  21. 21.
    Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, Moher D, Tugwell P, Welch V, Kristjansson E, Henry DA (2017) AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 358:j4008. CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Zand N, Ataie-Fashtami L, Djavid GE, Fatch M, Alinaghizadeh MR, Fatemi AM, Arbabi-Kalati F (2009) Relieving pain in minor aphthous stomatitis by a single session of non-thermal carbon dioxide laser irradiation. Lasers Med Sci 24:515–520. CrossRefPubMedGoogle Scholar
  23. 23.
    Prasad RS, Pai A (2013) Assessment of immediate pain relief with laser treatment in recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol Oral Radiol 116(2):189–193. CrossRefGoogle Scholar
  24. 24.
    Hazeem MI, Rajab MS, Badeia RA (2013) Treatment of recurrent aphthous stomatitis with 940nm diode laser. Tikrit J Dent Sci 1(2013):77–82Google Scholar
  25. 25.
    Sattayut S, Trivibulwanich J, Pipithirunkarn N, Danvirutai N (2013) A clinical efficacy of using CO2 laser irradiating to transparent gel on aphthous stomatitis patients. Laser Ther 22(4):283–289. CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Aggarwal H, Singh MP, Nahar P, Mathur H, Gv S (2014) Efficacy of low-level laser therapy in treatment of recurrent aphthous ulcers - a sham controlled, split mouth follow up study. J Clin Diagn Res 8(2):218–221. CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Tezel A, Kara C, Balkaya V, Orbak R (2009) An evaluation of different treatments for recurrent aphthous stomatitis and patient perceptions: Nd:YAG laser versus medication. Photomed Laser Surg 27(1):101–106. CrossRefPubMedGoogle Scholar
  28. 28.
    Albrektson M, Hedström L, Bergh H (2014) Recurrent aphthous stomatitis and pain management with low-level laser therapy: a randomized controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol 117(5):590–594. CrossRefPubMedGoogle Scholar
  29. 29.
    Jijin MJ, Rakaraddi M, Pai J, Jaishankar HP, Krupashankar R, Kavitha AP, Anjana R, Shobha R (2016) Low-level laser therapy versus 5% amlexanox: a comparison of treatment effects in a cohort of patients with minor aphthous ulcers. Oral Surg Oral Med Oral Pathol Oral Radiol 3:269–273. CrossRefGoogle Scholar
  30. 30.
    Grant MJ, Booth A (2009) A typology of reviews: an analysis of 14 review types and associated methodologies. Health Inf Libr J 26(2):91–108. CrossRefGoogle Scholar
  31. 31.
    Aromataris E, Fernandez R, Godfrey CM, Holly C, Khalil H, Tungpunkom P (2015) Summarizing systematic reviews: methodological development, conduct and reporting of an umbrella review approach. Int J Evid Based Healthc 13(3):132–140. CrossRefPubMedGoogle Scholar
  32. 32.
    Hunt H, Pollock A, Campbell P, Estcourt L, Brunton G (2018) An introduction to overviews of reviews: planning a relevant research question and objective for an overview. Syst Rev 7:39. CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Lins RDAU, Lucena KCR, Granville-Garcia AF, Dantas EM, Catão MHCV, Neto LGC (2018) Efeitos bioestimulantes do laser de baixa potência no processo de reparo. An Bras Dermatol 85(6):849–855CrossRefGoogle Scholar
  34. 34.
    Jahromi NZ, Ghapanchi J, Pourshahidi S, Zahed M, Ebrahimi H (2017) Clinical evaluation of high and low-level laser treatment (CO2vsInGaAlP diode laser) for recurrent aphthous stomatitis. J Dent Shiraz Univ Med Sci 18(1):17–23Google Scholar
  35. 35.
    Lalabonova H, Daskalov H (2014) Clinical assessment of the therapeutic effect of low-level laser therapy on chronic recurrent aphthous stomatitis. Biotechnol Biotechnol Equip 28(5):929–933. CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Arabaci T, Kara C, Ciçek Y (2009) Relationship between periodontal parameters and Behçet’s disease and evaluation of different treatments for oral recurrent aphthous stomatitis. J Periodontal Res 44(6):718–725. CrossRefPubMedGoogle Scholar
  37. 37.
    Salman H, Kashmoola MA, Al-Waiz MM, Al-Sandooq TA (2008) Differences between low level laser therapy and triamcinolone acetonide kenalog on healing of recurrent aphthous ulceration. Ann Coll Med Mosul 34(1):35–41CrossRefGoogle Scholar
  38. 38.
    De Souza TO, Martins MA, Bussadori SK, Fernandes KP, Tanji EY, Mesquita-Ferrari RA, Martins MD (2010) Clinical evaluation of low-level laser treatment for recurring aphthous stomatitis. Photomed Laser Surg 28(Suppl 2):S85–S88. CrossRefPubMedGoogle Scholar
  39. 39.
    Rudralingam M, Randall C, Mighell AJ (2017) The use of topical steroid preparations in oral medicine in the UK. Br Dent J 223(9):633–638. CrossRefPubMedGoogle Scholar
  40. 40.
    Verma SK, Maheshwari S, Singh RK, Chaudhari PK (2012) Laser in dentistry: an innovative tool in modern dental practice. Natl J Maxillofac Surg 3(2):124–132. CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Juliana Amorim dos Santos
    • 1
  • Ana Gabriela Costa Normando
    • 1
  • Isabela Porto de Toledo
    • 1
    • 2
  • Gilberto Melo
    • 2
  • Graziela De Luca Canto
    • 2
  • Alan Roger Santos-Silva
    • 3
  • Eliete Neves Silva Guerra
    • 1
    Email author
  1. 1.Laboratory of Oral Histopathology, Health Sciences FacultyUniversity of BrasiliaBrasiliaBrazil
  2. 2.Brazilian Centre for Evidence-Based Research, Department of DentistryFederal University of Santa CatarinaFlorianópolisBrazil
  3. 3.Oral Diagnosis, Piracicaba Dental SchoolUniversity of Campinas (UNICAMP)São PauloBrazil

Personalised recommendations