J Craniomaxillofac Surg. 2026 Aug 4;54(10):109849. doi: 10.1016/j.jcms.2026.109849. Online ahead of print.
ABSTRACT
This study aimed to evaluate the influence of local photobiomodulation (LPBM) and vascular photobiomodulation (VPBM) on early bone healing after alveolar bone grafting (ABG) in patients with cleft lip and palate (CLP). Eighty-seven CLP patients (104 cleft areas) underwent secondary ABG with autogenous bone from the mandibular symphysis or iliac crest. Eighty-seven patients with CLP, corresponding to 104 grafted alveolar cleft sites, were included from two independent clinical protocols conducted at the same craniofacial rehabilitation center. LPBM was evaluated in patients with unilateral cleft lip and palate (UCLP), whereas VPBM was evaluated in patients with bilateral cleft lip and palate (BCLP). In each protocol, the PBM group was compared with the corresponding control group, which received simulated laser application. All patients underwent secondary ABG with autogenous bone harvested from the mandibular symphysis or anterior iliac crest, according to the established surgical protocol of the hospital. LPBM was performed using a GaAlAs laser (880 ± 10 nm, 100 mW, 4 J per point) applied in continuous mode at 14 standardized extraoral points. VPBM was performed using a red-spectrum laser (660 ± 10 nm, 100 mW), applied over the radial artery for 10 min in patients aged 9-17 years and 15 min in adults, corresponding to total energies of 60 J and 90 J, respectively. Irradiation was performed immediately after surgery (T0) and 24 h postoperatively (T1). Standardized periapical radiographs were obtained preoperatively and 2 months after ABG (T2). Cleft morphology was assessed by measuring height and width using digital calipers. Bone bridge formation was evaluated at T2 using the Chelsea scale. Statistical analysis included one-way ANOVA, Kruskal-Wallis, and logistic regression tests (α = 0.05). LPBM showed a higher proportion of favorable Chelsea classes (80%) than control (45%) and VPBM (37.5%) groups (p < 0.05). No differences were found between donor sites or baseline cleft dimensions. VPBM results were similar to control values. LPBM enhanced bone bridge formation after ABG, suggesting a stimulatory effect on bone repair. VPBM, under the tested parameters, did not improve outcomes.
PMID:42551061 | DOI:10.1016/j.jcms.2026.109849
