Use of photobiomodulation in guided bone regeneration protocols with biomaterials: from integrative review to experimentation in animal models

• Ano de defesa: 2025
• Autor(a) principal: Moscatel, Matheus Bento Medeiros
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: eng
• Instituição de defesa: Biblioteca Digitais de Teses e Dissertações da USP
• Palavras-chave em Português: Biocompatible materials; Bone regeneration; Low-level light therapy; Materiais biocompatíveis; Regeneração óssea; Terapia com luz de baixa intensidade
• Link de acesso: https://www.teses.usp.br/teses/disponiveis/25/25149/tde-25032026-103602/

The repair of critical bone defects still represents a significant challenge for clinical practice in dentistry and medicine, since bone tissue, despite its intrinsic regenerative capacity, is unable to restore itself completely in more complex situations without the aid of additional therapeutic strategies. In this context, the search for biomaterials and adjuvant therapies has intensified, especially with regard to the use of heterologous fibrin biopolymer, biological membranes derived from bovine cortical bone, and photobiomodulation (PBM). These resources, alone or in combination, have the potential to promote tissue regeneration, promoting both early mineralized matrix deposition and bone architecture organization over time. The first study consisted of a literature review aimed at gathering and analyzing the available evidence on the application of PBM in association with biomaterials in guided bone regeneration protocols. The review indicated that PBM can accelerate the formation of immature bone trabeculae, modulate the inflammatory response, and induce the maturation of collagen fibers. These effects have been reported mainly in animal models, in which the association with biological membranes or sealants resulted in more organized and stable repair. However, the literature still lacks standardization of application parameters, since variables such as wavelength, energy density, and power show great heterogeneity between studies. Furthermore, the few clinical trials available are limited in sample size and follow-up time, which reinforces the need for more translational and multicenter research. The second study, which was experimental research, involved 60 Wistar rats that had 5.0 mm critical defects created in their skulls, which were treated with different combinations of fibrin biopolymer, biological membrane, and PBM. The animals were evaluated after 14 and 42 days by histomorphometric analysis using hematoxylin-eosin, Masson\'s trichrome, and picrosirius red stains. The results showed that combined therapies, especially in groups treated with biological membrane associated with PBM, presented greater immature bone deposition, greater collagen fiber density, and better trabecular organization when compared to control groups or groups treated in isolation. Although no group achieved complete closure of the defects, the combination of biomaterials and PBM showed a synergistic effect, suggesting that such combinations may enhance the processes of osteoconduction and osteoinduction. To summarize, both studies converge on the idea that the integration of biomaterials with photobiomodulation is a promising approach for guided bone regeneration. Although the experimental and review results indicate clear benefits, studies with longer followup periods and controlled clinical trials are still needed to confirm effectiveness and establish safe and standardized application protocols.