Non-Cochrane · intervention · PM41422215
Effects of photobiomodulation therapy on orthodontically induced inflammatory root resorption: a systematic review and meta-analysis.
Zhang Guanning, Li Zhuoying, McGrath Colman, et al. · BMC oral health · 2025 · PubMed · doi:10.1186/s12903-025-07512-y
Findings
Population Patients undergoing fixed orthodontic treatment with buccal tipping of maxillary first premolars (split-mouth RCTs)
8 findings
| Photobiomodulation (low-level laser or LED) | No PBM or sham (control side) | Root resorption crater volume (mm3) on the distal root surface 28 days · Orthodontic clinics; maxillary first premolars extracted and scanned ex vivo by micro-CT · Root surface: Distal Unresolved: the two extractors disagree on this row. | MD -0.03 [-0.06, 0.01] Low 4 studies · 82 participants |
| Photobiomodulation (low-level laser or LED) | No PBM or sham (control side) | Total root resorption crater volume (mm3) 28 days · Orthodontic clinics; maxillary first premolars extracted and scanned ex vivo by micro-CT · Sensitivity analysis: within-person correlation R=0.30 | MD -0.13 [-0.17, -0.08] GRADE not reported 4 studies · 82 participants |
| Photobiomodulation (low-level laser or LED) | No PBM or sham (control side) | Total root resorption crater volume (mm3) 28 days · Orthodontic clinics; maxillary first premolars extracted and scanned ex vivo by micro-CT Unresolved: the two extractors disagree on this row. | MD -0.13 [-0.17, -0.09] Low 4 studies · 82 participants |
| Photobiomodulation (low-level laser or LED) | No PBM or sham (control side) | Total root resorption crater volume (mm3) 28 days · Orthodontic clinics; maxillary first premolars extracted and scanned ex vivo by micro-CT · Sensitivity analysis: within-person correlation R=0.70 | MD -0.13 [-0.16, -0.09] GRADE not reported 4 studies · 82 participants |
| Photobiomodulation (low-level laser or LED) | No PBM or sham (control side) | Root resorption crater volume (mm3) on the palatal root surface 28 days · Orthodontic clinics; maxillary first premolars extracted and scanned ex vivo by micro-CT · Root surface: Palatal Unresolved: the two extractors disagree on this row. | MD -0.03 [-0.04, -0.02] Low 4 studies · 82 participants |
| Photobiomodulation (low-level laser or LED) | No PBM or sham (control side) | Root resorption crater volume (mm3) across all four root surfaces combined 28 days · Orthodontic clinics; maxillary first premolars extracted and scanned ex vivo by micro-CT · All root surfaces combined | MD -0.03 [-0.04, -0.02] GRADE not reported 4 studies · 82 participants |
| Photobiomodulation (low-level laser or LED) | No PBM or sham (control side) | Root resorption crater volume (mm3) on the buccal root surface 28 days · Orthodontic clinics; maxillary first premolars extracted and scanned ex vivo by micro-CT · Root surface: Buccal Unresolved: the two extractors disagree on this row. | MD -0.03 [-0.05, -0.01] Low 4 studies · 82 participants |
| Photobiomodulation (low-level laser or LED) | No PBM or sham (control side) | Root resorption crater volume (mm3) on the mesial root surface 28 days · Orthodontic clinics; maxillary first premolars extracted and scanned ex vivo by micro-CT · Root surface: Mesial Unresolved: the two extractors disagree on this row. | MD -0.03 [-0.05, -0.02] Low 4 studies · 82 participants |
Included primary studies 13
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Al Okla 2018 Effect of Photobiomodulation on Maxillary Decrowding and Root Resorption: A Randomized Clinical Trial DOI:10.4103/apos.apos_46_18 | 2018 | 2 other reviews | not stated | not extracted yet |
| Abellan 2021 Effects of Photobiomodulation on the Upper First Molar Intrusion Movement Using Mini-Screws Anchorage: A Randomized Controlled Trial DOI:10.1089/photob.2020.4979 | 2021 | 1 other review | not stated | not extracted yet |
| Ang Khaw 2018 Physical properties of root cementum: Part 27. Effect of low-level laser therapy on the repair of orthodontically induced inflammatory… DOI:10.1016/j.ajodo.2018.04.022 | 2018 | 1 other review | Total root resorption crater volume (mm3) | not extracted yet |
| Goymen 2020 Effect of photobiomodulation therapies on the root resorption associated with orthodontic forces: a pilot study using micro computed… DOI:10.1007/s00784-019-03155-w | 2019 | 1 other review | not stated | not extracted yet |
| Nayyer 2021 Effect of photobiomodulation on external root resorption during orthodontic tooth movement – a randomized controlled trial DOI:10.1016/j.ortho.2021.01.007 | 2021 | 1 other review | Total root resorption crater volume (mm3) | not extracted yet |
| Ng 2018 The effect of low-level laser therapy on orthodontically induced root resorption: a pilot double blind randomized controlled trial DOI:10.1093/ejo/cjx065 | 2017 | 1 other review | Total root resorption crater volume (mm3) | not extracted yet |
| Sambevski 2022 Physical properties of root cementum: Part 29. The effects of LED-mediated photobiomodulation on orthodontically induced root resorption… DOI:10.1093/ejo/cjac022 | 2022 | 1 other review | Total root resorption crater volume (mm3) | not extracted yet |
| Dehis 2024 Effect of low-level laser therapy on en masse retraction in females with bimaxillary dentoalveolar protrusion DOI:10.1007/s00056-024-00525-2 | 2024 | this review only | not stated | not extracted yet |
| Eid 2022 The influence of two photobiomodulation protocols on orthodontically induced inflammatory root resorption (a randomized controlled… DOI:10.1186/s12903-022-02251-w | 2022 | this review only | not stated | not extracted yet |
| Manoghna Subramanya 2024 Effectiveness of a customized intraoral photobiomodulator for accelerating orthodontic tooth movement DOI:10.18231/j.jco.2024.077 | 2024 | this review only | not stated | not extracted yet |
| Nasser 2023 Investigating the Effectiveness of Low-Level Laser in Reducing Root Resorption of the Upper Incisors During Intrusion Movement Using… PMID:36846638 | 2023 | this review only | not stated | not extracted yet |
| Saifeldin 2021 Three Dimensional evaluation of low-level laser therapy on orthodontically induced root resorption: a randomized split mouth trial DOI:10.21608/asdj.2022.141450.1123 | 2021 | this review only | not stated | not extracted yet |
| Shahid 2023 Effects of Low-Level Laser Therapy and Bracket Systems on Root Resorption during Orthodontic Treatment: A Randomized Clinical Trial DOI:10.3390/healthcare11060864 | 2023 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients of any age, sex or ethnicity undergoing fixed orthodontic treatment for any tooth movement; excluded systemic disease/medication, surgery, replanted or previously treated teeth, existing root resorption | 13 RCTs, 10 to 32 participants each, ages 13 to 60; meta-analysis of 4 studies on maxillary first premolar buccal tipping (n=82 teeth per arm) |
| Intervention | Photobiomodulation therapy with low-level laser or LED | Diode laser or LED PBM, 660 to 980 nm, output 50 mW to 2.5 W (n=13) |
| Comparison | Orthodontic treatment without PBM (no treatment or sham) | No PBM or placebo/sham (n=13) |
| Outcomes | Quantitative measurement of OIIRR (crater volume by micro-CT pooled; other 2D/3D and Levander-Malmgren grading narrative); PBM parameters as secondary outcome | Total and surface crater volume (mm3, micro-CT) pooled (n=4); root length, volume or Levander-Malmgren grade narrative (n=9) |
| Study designs | Randomized controlled trials, parallel or split-mouth | 13 RCTs (7 split-mouth, 6 parallel) |
| Timing | Minimum follow-up 28 days | 4 weeks to 6 months; pooled studies 4 weeks |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Low | yes |