Management of recurrent aphthous ulcers using low-level lasers: A systematic review

Background and objective The exact etiology of recurrent aphthous ulcers (RAS) is unknown. The management of RAS is not always straightforward. The aim of this review is to critically analyze and summarize the clinical literature focusing on the management of aphthous ulcers using low-level lasers. Materials and methods The Medline (PubMed), Web of Knowledge (ISI), Cochrane Central Register of Controlled Trials (CENTRAL) and Embase databases were searched electronically for studies published in last 20 years (1995–2015) using the keywords “recurrent aphthous stomatitis,” “aphthous ulcers,” and “laser.” Results A total of 85 articles were found during the initial search; 76 studies were excluded for not fulfilling the criteria whereas nine studies were deemed suitable for this review. Among the included studies, two articles were case reports and seven were randomized clinical trials. Study design, sample size, type of intervention and control of each study were critically analyzed and summarized according to the CONSORT protocol. In majority of the patients, immediate pain relief and accelerated ulcer healing was observed following irradiation with lasers. Conclusions Although various types of lasers have succeeded in providing immediate pain relief to patients, carbon dioxide (CO₂) lasers have the unique advantage of requiring a short exposure time (5–10 s). In order to ascertain the efficacy of laser for treating ulcers in the clinical setting, more clinical trials are required.