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Published in: Lasers in Medical Science 8/2018

01-11-2018 | Original Article

Treatment of mucositis with combined 660- and 808-nm-wavelength low-level laser therapy reduced mucositis grade, pain, and use of analgesics: a parallel, single-blind, two-arm controlled study

Authors: Raquel Gusmão Soares, Lucyana Conceição Farias, Agna Soares da Silva Menezes, Carla Silvana de Oliveira e Silva, Angeliny Tamiarana Lima Tabosa, Pablo Vinicyus Ferreira Chagas, Laís Santiago, Sérgio Henrique Sousa Santos, Alfredo Maurício Batista de Paula, André Luiz Sena Guimarães

Published in: Lasers in Medical Science | Issue 8/2018

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Abstract

Oral squamous cell carcinoma (OSCC) is the most frequent oral malignant neoplasia. As consequence of OSCC treatment, oral mucositis (OM) is one of the most common adverse effects of OSCC treatment. Currently, there is no consensus for OM treatment. The purpose of the current study was to test the combination of red and infrared low-level laser therapy (LLLT) for OM treatment. Primary culture of human fibroblast was performed to identify LLLT dose. After laboratory tests, a two-arm parallel, single-blind, controlled study was conducted. The two arms were group 1, both 660- and 808-nm wavelengths (300 J/cm2, 9 J of total energy, 100 mW, spot size 3 mm2), and group 2, only 660-nm wavelength (300 J/cm2, 9 J of total energy, 100 mW, spot size 3 mm2). Both treatments were performed twice a week. Group 1 presented a reduction of mucositis grade in comparison to group 2. Group 1 also presented reduction of analgesics prescription. But no significant differences between groups 1 and 2 were observed according to the pain scale. In conclusion, the current study demonstrated that a combination of red and infrared at a higher dose (300 J/cm2) reduced both oral mucositis grade and analgesics prescription. The effects of the combination of RT and LLLT are unclear and need more studies.
Literature
1.
go back to reference Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):E359–E386CrossRef Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):E359–E386CrossRef
2.
go back to reference Warnakulasuriya S (2009) Global epidemiology of oral and oropharyngeal cancer. Oral Oncol 45(4–5):309–316CrossRef Warnakulasuriya S (2009) Global epidemiology of oral and oropharyngeal cancer. Oral Oncol 45(4–5):309–316CrossRef
3.
go back to reference Stelzle F, Knipfer C, Schuster M, Bocklet T, Noth E, Adler W et al (2013) Factors influencing relative speech intelligibility in patients with oral squamous cell carcinoma: a prospective study using automatic, computer-based speech analysis. Int J Oral Maxillofac Surg 42(11):1377–1384CrossRef Stelzle F, Knipfer C, Schuster M, Bocklet T, Noth E, Adler W et al (2013) Factors influencing relative speech intelligibility in patients with oral squamous cell carcinoma: a prospective study using automatic, computer-based speech analysis. Int J Oral Maxillofac Surg 42(11):1377–1384CrossRef
4.
go back to reference Speksnijder CM, van der Glas HW, van der Bilt A, van Es RJ, van der Rijt E, Koole R (2010) Oral function after oncological intervention in the oral cavity: a retrospective study. J Oral Maxillofac Surg 68(6):1231–1237CrossRef Speksnijder CM, van der Glas HW, van der Bilt A, van Es RJ, van der Rijt E, Koole R (2010) Oral function after oncological intervention in the oral cavity: a retrospective study. J Oral Maxillofac Surg 68(6):1231–1237CrossRef
5.
go back to reference Maria OM, Eliopoulos N, Muanza T (2017) Radiation-induced oral mucositis. Front Oncol 7:89CrossRef Maria OM, Eliopoulos N, Muanza T (2017) Radiation-induced oral mucositis. Front Oncol 7:89CrossRef
6.
go back to reference Sonis ST, Elting LS, Keefe D, Peterson DE, Schubert M, Hauer-Jensen M et al (2004) Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 100(9 Suppl):1995–2025CrossRef Sonis ST, Elting LS, Keefe D, Peterson DE, Schubert M, Hauer-Jensen M et al (2004) Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 100(9 Suppl):1995–2025CrossRef
7.
go back to reference Riley P, Glenny AM, Worthington HV, Littlewood A, Clarkson JE, McCabe MG (2015) Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy. Cochrane Database Syst Rev (12):CD011552 Riley P, Glenny AM, Worthington HV, Littlewood A, Clarkson JE, McCabe MG (2015) Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy. Cochrane Database Syst Rev (12):CD011552
8.
go back to reference von Bultzingslowen I, Brennan MT, Spijkervet FK, Logan R, Stringer A, Raber-Durlacher JE et al (2006) Growth factors and cytokines in the prevention and treatment of oral and gastrointestinal mucositis. Support Care Cancer 14(6):519–527CrossRef von Bultzingslowen I, Brennan MT, Spijkervet FK, Logan R, Stringer A, Raber-Durlacher JE et al (2006) Growth factors and cytokines in the prevention and treatment of oral and gastrointestinal mucositis. Support Care Cancer 14(6):519–527CrossRef
9.
go back to reference Rastogi M, Khurana R, Revannasiddaiah S, Jaiswal I, Nanda SS, Gupta P et al (2017) Role of benzydamine hydrochloride in the prevention of oral mucositis in head and neck cancer patients treated with radiotherapy (>50 Gy) with or without chemotherapy. Support Care Cancer 25(5):1439–1443CrossRef Rastogi M, Khurana R, Revannasiddaiah S, Jaiswal I, Nanda SS, Gupta P et al (2017) Role of benzydamine hydrochloride in the prevention of oral mucositis in head and neck cancer patients treated with radiotherapy (>50 Gy) with or without chemotherapy. Support Care Cancer 25(5):1439–1443CrossRef
10.
go back to reference Peterson DE, Boers-Doets CB, Bensadoun RJ, Herrstedt J, Committee EG (2015) Management of oral and gastrointestinal mucosal injury: ESMO Clinical Practice Guidelines for diagnosis, treatment, and follow-up. Ann Oncol 26(Suppl 5):v139–v151CrossRef Peterson DE, Boers-Doets CB, Bensadoun RJ, Herrstedt J, Committee EG (2015) Management of oral and gastrointestinal mucosal injury: ESMO Clinical Practice Guidelines for diagnosis, treatment, and follow-up. Ann Oncol 26(Suppl 5):v139–v151CrossRef
11.
go back to reference Carvalho PA, Jaguar GC, Pellizzon AC, Prado JD, Lopes RN, Alves FA (2011) Evaluation of low-level laser therapy in the prevention and treatment of radiation-induced mucositis: a double-blind randomized study in head and neck cancer patients. Oral Oncol 47(12):1176–1181CrossRef Carvalho PA, Jaguar GC, Pellizzon AC, Prado JD, Lopes RN, Alves FA (2011) Evaluation of low-level laser therapy in the prevention and treatment of radiation-induced mucositis: a double-blind randomized study in head and neck cancer patients. Oral Oncol 47(12):1176–1181CrossRef
12.
go back to reference Elad S, Zadik Y (2016) Chronic oral mucositis after radiotherapy to the head and neck: a new insight. Support Care Cancer 24(11):4825–4830CrossRef Elad S, Zadik Y (2016) Chronic oral mucositis after radiotherapy to the head and neck: a new insight. Support Care Cancer 24(11):4825–4830CrossRef
13.
go back to reference Calderhead RG, Vasily DB (2016) Low level light therapy with light-emitting diodes for the aging face. Clin Plast Surg 43(3):541–550CrossRef Calderhead RG, Vasily DB (2016) Low level light therapy with light-emitting diodes for the aging face. Clin Plast Surg 43(3):541–550CrossRef
14.
go back to reference Kim WS, Calderhead RG (2011) Is light-emitting diode phototherapy (LED-LLLT) really effective? Laser Ther 20(3):205–215CrossRef Kim WS, Calderhead RG (2011) Is light-emitting diode phototherapy (LED-LLLT) really effective? Laser Ther 20(3):205–215CrossRef
15.
go back to reference Huang YY, Sharma SK, Carroll J, Hamblin MR (2011) Biphasic dose response in low level light therapy—an update. Dose-Response 9(4):602–618CrossRef Huang YY, Sharma SK, Carroll J, Hamblin MR (2011) Biphasic dose response in low level light therapy—an update. Dose-Response 9(4):602–618CrossRef
16.
go back to reference Buravlev EA, Zhidkova TV, Osipov AN, Vladimirov YA (2015) Are the mitochondrial respiratory complexes blocked by NO the targets for the laser and LED therapy? Lasers Med Sci 30(1):173–180CrossRef Buravlev EA, Zhidkova TV, Osipov AN, Vladimirov YA (2015) Are the mitochondrial respiratory complexes blocked by NO the targets for the laser and LED therapy? Lasers Med Sci 30(1):173–180CrossRef
17.
go back to reference Hahm E, Kulhari S, Arany Praveen R (2012) Targeting the pain, inflammation and immune (PII) axis: plausible rationale for LLLT. Photonics Lasers Med 241 Hahm E, Kulhari S, Arany Praveen R (2012) Targeting the pain, inflammation and immune (PII) axis: plausible rationale for LLLT. Photonics Lasers Med 241
18.
go back to reference Niemz MH (2007) Laser-Tissue Interactions. 308 p Niemz MH (2007) Laser-Tissue Interactions. 308 p
19.
go back to reference Karu T (1999) Primary and secondary mechanisms of action of visible to near-IR radiation on cells. J Photochem Photobiol B 49(1):1–17CrossRef Karu T (1999) Primary and secondary mechanisms of action of visible to near-IR radiation on cells. J Photochem Photobiol B 49(1):1–17CrossRef
20.
go back to reference Gouvea de Lima A, Villar RC, de Castro G Jr, Antequera R, Gil E, Rosalmeida MC et al (2012) Oral mucositis prevention by low-level laser therapy in head-and-neck cancer patients undergoing concurrent chemoradiotherapy: a phase III randomized study. Int J Radiat Oncol Biol Phys 82(1):270–275CrossRef Gouvea de Lima A, Villar RC, de Castro G Jr, Antequera R, Gil E, Rosalmeida MC et al (2012) Oral mucositis prevention by low-level laser therapy in head-and-neck cancer patients undergoing concurrent chemoradiotherapy: a phase III randomized study. Int J Radiat Oncol Biol Phys 82(1):270–275CrossRef
21.
go back to reference Simoes A, Eduardo FP, Luiz AC, Campos L, Sa PH, Cristofaro M et al (2009) Laser phototherapy as topical prophylaxis against head and neck cancer radiotherapy-induced oral mucositis: comparison between low and high/low power lasers. Lasers Surg Med 41(4):264–270CrossRef Simoes A, Eduardo FP, Luiz AC, Campos L, Sa PH, Cristofaro M et al (2009) Laser phototherapy as topical prophylaxis against head and neck cancer radiotherapy-induced oral mucositis: comparison between low and high/low power lasers. Lasers Surg Med 41(4):264–270CrossRef
22.
go back to reference Campos L, Simoes A, Sa PH, Eduardo Cde P (2009) Improvement in quality of life of an oncological patient by laser phototherapy. Photomed Laser Surg 27(2):371–374CrossRef Campos L, Simoes A, Sa PH, Eduardo Cde P (2009) Improvement in quality of life of an oncological patient by laser phototherapy. Photomed Laser Surg 27(2):371–374CrossRef
23.
go back to reference Migliorati C, Hewson I, Lalla RV, Antunes HS, Estilo CL, Hodgson B et al (2013) Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients. Support Care Cancer 21(1):333–341CrossRef Migliorati C, Hewson I, Lalla RV, Antunes HS, Estilo CL, Hodgson B et al (2013) Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients. Support Care Cancer 21(1):333–341CrossRef
24.
go back to reference Bjordal JM, Bensadoun RJ, Tuner J, Frigo L, Gjerde K, Lopes-Martins RA (2011) A systematic review with meta-analysis of the effect of low-level laser therapy (LLLT) in cancer therapy-induced oral mucositis. Support Care Cancer 19(8):1069–1077CrossRef Bjordal JM, Bensadoun RJ, Tuner J, Frigo L, Gjerde K, Lopes-Martins RA (2011) A systematic review with meta-analysis of the effect of low-level laser therapy (LLLT) in cancer therapy-induced oral mucositis. Support Care Cancer 19(8):1069–1077CrossRef
25.
go back to reference Coluzzi DJ, Parker SPA (2017) Lasers in dentistry current concepts. 400 p Coluzzi DJ, Parker SPA (2017) Lasers in dentistry current concepts. 400 p
26.
go back to reference Zhou Y, Fan W, Xiao Y (2014) The effect of hypoxia on the stemness and differentiation capacity of PDLC and DPC. Biomed Res Int 2014:890675PubMedPubMedCentral Zhou Y, Fan W, Xiao Y (2014) The effect of hypoxia on the stemness and differentiation capacity of PDLC and DPC. Biomed Res Int 2014:890675PubMedPubMedCentral
27.
go back to reference Schneider CA, Rasband WS, Eliceiri KW (2012) NIH image to ImageJ: 25 years of image analysis. Nat Methods 9(7):671–675CrossRef Schneider CA, Rasband WS, Eliceiri KW (2012) NIH image to ImageJ: 25 years of image analysis. Nat Methods 9(7):671–675CrossRef
28.
go back to reference Rosner B (2011) Fundamentals of biostatistics. Brooks/Cole, Cengage Learning, Boston Rosner B (2011) Fundamentals of biostatistics. Brooks/Cole, Cengage Learning, Boston
29.
go back to reference Rieger JM, Zalmanowitz JG, Wolfaardt JF (2006) Functional outcomes after organ preservation treatment in head and neck cancer: a critical review of the literature. Int J Oral Maxillofac Surg 35(7):581–587CrossRef Rieger JM, Zalmanowitz JG, Wolfaardt JF (2006) Functional outcomes after organ preservation treatment in head and neck cancer: a critical review of the literature. Int J Oral Maxillofac Surg 35(7):581–587CrossRef
30.
go back to reference Biswal BM (2008) Current trends in the management of oral mucositis related to cancer treatment. Malays J Med Sci 15(3):4–13PubMedPubMedCentral Biswal BM (2008) Current trends in the management of oral mucositis related to cancer treatment. Malays J Med Sci 15(3):4–13PubMedPubMedCentral
31.
go back to reference Cox JD, Pajak TF, Marcial VA, Coia L, Mohiuddin M, Fu KK et al (1992) Interruptions adversely affect local control and survival with hyperfractionated radiation therapy of carcinomas of the upper respiratory and digestive tracts. New evidence for accelerated proliferation from Radiation Therapy Oncology Group Protocol 8313. Cancer 69(11):2744–2748CrossRef Cox JD, Pajak TF, Marcial VA, Coia L, Mohiuddin M, Fu KK et al (1992) Interruptions adversely affect local control and survival with hyperfractionated radiation therapy of carcinomas of the upper respiratory and digestive tracts. New evidence for accelerated proliferation from Radiation Therapy Oncology Group Protocol 8313. Cancer 69(11):2744–2748CrossRef
32.
go back to reference Peters LJ, O'Sullivan B, Giralt J, Fitzgerald TJ, Trotti A, Bernier J et al (2010) Critical impact of radiotherapy protocol compliance and quality in the treatment of advanced head and neck cancer: results from TROG 02.02. J Clin Oncol 28(18):2996–3001CrossRef Peters LJ, O'Sullivan B, Giralt J, Fitzgerald TJ, Trotti A, Bernier J et al (2010) Critical impact of radiotherapy protocol compliance and quality in the treatment of advanced head and neck cancer: results from TROG 02.02. J Clin Oncol 28(18):2996–3001CrossRef
33.
go back to reference de Lima FJ, Barbosa FT, de Sousa-Rodrigues CF (2014) Use alone or in combination of red and infrared laser in skin wounds. J Lasers Med Sci 5(2):51–57PubMedPubMedCentral de Lima FJ, Barbosa FT, de Sousa-Rodrigues CF (2014) Use alone or in combination of red and infrared laser in skin wounds. J Lasers Med Sci 5(2):51–57PubMedPubMedCentral
34.
go back to reference Mendez TM, Pinheiro AL, Pacheco MT, Nascimento PM, Ramalho LM (2004) Dose and wavelength of laser light have influence on the repair of cutaneous wounds. J Clin Laser Med Surg 22(1):19–25CrossRef Mendez TM, Pinheiro AL, Pacheco MT, Nascimento PM, Ramalho LM (2004) Dose and wavelength of laser light have influence on the repair of cutaneous wounds. J Clin Laser Med Surg 22(1):19–25CrossRef
35.
go back to reference Enwemeka CS, Parker JC, Dowdy DS, Harkness EE, Sanford LE, Woodruff LD (2004) The efficacy of low-power lasers in tissue repair and pain control: a meta-analysis study. Photomed Laser Surg 22(4):323–329CrossRef Enwemeka CS, Parker JC, Dowdy DS, Harkness EE, Sanford LE, Woodruff LD (2004) The efficacy of low-power lasers in tissue repair and pain control: a meta-analysis study. Photomed Laser Surg 22(4):323–329CrossRef
36.
go back to reference Woodruff LD, Bounkeo JM, Brannon WM, Dawes KS, Barham CD, Waddell DL et al (2004) The efficacy of laser therapy in wound repair: a meta-analysis of the literature. Photomed Laser Surg 22(3):241–247CrossRef Woodruff LD, Bounkeo JM, Brannon WM, Dawes KS, Barham CD, Waddell DL et al (2004) The efficacy of laser therapy in wound repair: a meta-analysis of the literature. Photomed Laser Surg 22(3):241–247CrossRef
37.
go back to reference Zecha JA, Raber-Durlacher JE, Nair RG, Epstein JB, Sonis ST, Elad S et al (2016) Low level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 1: mechanisms of action, dosimetric, and safety considerations. Support Care Cancer 24(6):2781–2792CrossRef Zecha JA, Raber-Durlacher JE, Nair RG, Epstein JB, Sonis ST, Elad S et al (2016) Low level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 1: mechanisms of action, dosimetric, and safety considerations. Support Care Cancer 24(6):2781–2792CrossRef
38.
go back to reference Schartinger VH, Galvan O, Riechelmann H, Dudas J (2012) Differential responses of fibroblasts, non-neoplastic epithelial cells, and oral carcinoma cells to low-level laser therapy. Support Care Cancer 20(3):523–529CrossRef Schartinger VH, Galvan O, Riechelmann H, Dudas J (2012) Differential responses of fibroblasts, non-neoplastic epithelial cells, and oral carcinoma cells to low-level laser therapy. Support Care Cancer 20(3):523–529CrossRef
39.
go back to reference Zecha JA, Raber-Durlacher JE, Nair RG, Epstein JB, Elad S, Hamblin MR et al (2016) Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 2: proposed applications and treatment protocols. Support Care Cancer 24(6):2793–2805CrossRef Zecha JA, Raber-Durlacher JE, Nair RG, Epstein JB, Elad S, Hamblin MR et al (2016) Low-level laser therapy/photobiomodulation in the management of side effects of chemoradiation therapy in head and neck cancer: part 2: proposed applications and treatment protocols. Support Care Cancer 24(6):2793–2805CrossRef
40.
go back to reference Yeo R, Campbell T, Fairchild A (2012) Is weekend radiation therapy always justified? J Med Imaging Radiat Sci 43(1):38–42CrossRef Yeo R, Campbell T, Fairchild A (2012) Is weekend radiation therapy always justified? J Med Imaging Radiat Sci 43(1):38–42CrossRef
41.
go back to reference Kreisler M, Christoffers AB, Al-Haj H, Willershausen B, d'Hoedt B (2002) Low level 809-nm diode laser-induced in vitro stimulation of the proliferation of human gingival fibroblasts. Lasers Surg Med 30(5):365–369CrossRef Kreisler M, Christoffers AB, Al-Haj H, Willershausen B, d'Hoedt B (2002) Low level 809-nm diode laser-induced in vitro stimulation of the proliferation of human gingival fibroblasts. Lasers Surg Med 30(5):365–369CrossRef
42.
go back to reference Haubner F, Ohmann E, Pohl F, Strutz J, Gassner HG (2012) Wound healing after radiation therapy: review of the literature. Radiat Oncol 7:162CrossRef Haubner F, Ohmann E, Pohl F, Strutz J, Gassner HG (2012) Wound healing after radiation therapy: review of the literature. Radiat Oncol 7:162CrossRef
43.
go back to reference Sanguineti G, Endres EJ, Gunn BG, Parker B (2006) Is there a “mucosa-sparing” benefit of IMRT for head-and-neck cancer? Int J Radiat Oncol Biol Phys 66(3):931–938CrossRef Sanguineti G, Endres EJ, Gunn BG, Parker B (2006) Is there a “mucosa-sparing” benefit of IMRT for head-and-neck cancer? Int J Radiat Oncol Biol Phys 66(3):931–938CrossRef
44.
go back to reference Wewers ME, Lowe NK (1990) A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 13(4):227–236CrossRef Wewers ME, Lowe NK (1990) A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 13(4):227–236CrossRef
45.
go back to reference Schaller A, Dragioti E, Liedberg GM, Larsson B (2017) Quality of life during early radiotherapy in patients with head and neck cancer and pain. J Pain Res 10:1697–1704CrossRef Schaller A, Dragioti E, Liedberg GM, Larsson B (2017) Quality of life during early radiotherapy in patients with head and neck cancer and pain. J Pain Res 10:1697–1704CrossRef
46.
go back to reference Wan Leung S, Lee TF, Chien CY, Chao PJ, Tsai WL, Fang FM (2011) Health-related quality of life in 640 head and neck cancer survivors after radiotherapy using EORTC QLQ-C30 and QLQ-H&N35 questionnaires. BMC Cancer 11:128CrossRef Wan Leung S, Lee TF, Chien CY, Chao PJ, Tsai WL, Fang FM (2011) Health-related quality of life in 640 head and neck cancer survivors after radiotherapy using EORTC QLQ-C30 and QLQ-H&N35 questionnaires. BMC Cancer 11:128CrossRef
47.
go back to reference Lopatina EV, Yachnev IL, Penniyaynen VA, Plakhova VB, Podzorova SA, Shelykh TN et al (2012) Modulation of signal-transducing function of neuronal membrane Na+,K+-ATPase by endogenous ouabain and low-power infrared radiation leads to pain relief. Med Chem 8(1):33–39CrossRef Lopatina EV, Yachnev IL, Penniyaynen VA, Plakhova VB, Podzorova SA, Shelykh TN et al (2012) Modulation of signal-transducing function of neuronal membrane Na+,K+-ATPase by endogenous ouabain and low-power infrared radiation leads to pain relief. Med Chem 8(1):33–39CrossRef
48.
go back to reference Alves AC, Vieira R, Leal-Junior E, dos Santos S, Ligeiro AP, Albertini R et al (2013) Effect of low-level laser therapy on the expression of inflammatory mediators and on neutrophils and macrophages in acute joint inflammation. Arthritis Research & Therapy 15(5):R116CrossRef Alves AC, Vieira R, Leal-Junior E, dos Santos S, Ligeiro AP, Albertini R et al (2013) Effect of low-level laser therapy on the expression of inflammatory mediators and on neutrophils and macrophages in acute joint inflammation. Arthritis Research & Therapy 15(5):R116CrossRef
Metadata
Title
Treatment of mucositis with combined 660- and 808-nm-wavelength low-level laser therapy reduced mucositis grade, pain, and use of analgesics: a parallel, single-blind, two-arm controlled study
Authors
Raquel Gusmão Soares
Lucyana Conceição Farias
Agna Soares da Silva Menezes
Carla Silvana de Oliveira e Silva
Angeliny Tamiarana Lima Tabosa
Pablo Vinicyus Ferreira Chagas
Laís Santiago
Sérgio Henrique Sousa Santos
Alfredo Maurício Batista de Paula
André Luiz Sena Guimarães
Publication date
01-11-2018
Publisher
Springer London
Published in
Lasers in Medical Science / Issue 8/2018
Print ISSN: 0268-8921
Electronic ISSN: 1435-604X
DOI
https://doi.org/10.1007/s10103-018-2549-y

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