Beyond Protocol Selection: A Mechanism-Based Clinical Decision Framework for Individualized Photobiomodulation in Oral Medicine.

Authors

Sahar Mafi, Aryan Tabibnia, Arash Bahari Bandari, Pooya Omidi

Published in

Journal of oral rehabilitation. Nov 11, 2026. Epub Nov 11, 2026.

Abstract

Photobiomodulation (PBM) is increasingly used as an adjunctive therapy across oral medicine conditions. However, clinical translation remains protocol-driven and disease-oriented, while biological and clinical heterogeneity is often viewed as a limitation rather than a basis for individualized decision-making.
To propose a mechanism-based framework that shifts PBM implementation toward biology-driven patient selection and rehabilitation-oriented reasoning.
This evidence-informed narrative review synthesized biological knowledge, clinical evidence, guidelines, systematic reviews, meta-analyses, randomized trials and mechanistic studies across major oral medicine conditions. Evidence was mapped using shared domains, including disease biology, PBM-responsive therapeutic target, biological suitability, therapeutic objectives, evidence maturity and clinical applicability.
Most studies, reviews, meta-analyses and guidelines evaluated PBM by disease category, efficacy, outcomes and irradiation parameters. Across conditions, they commonly reported protocol heterogeneity, variable responses and differences in evidence strength. Comparative evidence mapping identified recurring biological decision domains across otherwise heterogeneous oral medicine conditions, suggesting that variability in PBM outcomes reflects biological diversity as well as methodological differences.
This review proposes the principle that patient selection should precede protocol selection because PBM acts on biologically responsive targets, not on diagnostic labels alone. Rather than seeking a universally optimal laser regimen, clinicians may first consider whether the individual patient presents a biologically plausible and potentially recoverable therapeutic target. Heterogeneity may therefore be reframed as an opportunity for personalized PBM implementation. Prospective studies are needed to evaluate the framework's clinical utility.

PMID:
43012381
Bibliographic data and abstract were imported from PubMed on 11 Nov 2026.

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