Leopoldo Mauriello, Vitolante Pezzella, Andrea Blasi, Giuseppe Trapanese, Elio Ramaglia, Vincenzo Iorio-Siciliano, Luca Ramaglia
The initial search yielded 1,901 results after 62 duplicates were removed. 40 papers were eligible. Following title/abstract and full-text screening, 11 studies met the inclusion criteria. Full-text articles were excluded because they did not meet the target population criteria (n = 5), lacked focus on group support models (n = 12), were irrelevant to study outcomes (n = 10), or were not behavioural/health-related studies (n = 2). Group-based HIV prevention models commonly included peer-led support, HIV and sexual and reproductive health education, psychosocial support, mentorship or buddy systems, communication and negotiation skills-building, and PrEP adherence discussions. Across studies, these interventions were reportedly associated with improved HIV prevention knowledge, increased PrEP uptake and early adherence, stronger motivation to remain engaged in care, reduced stigma, improved social support, and greater confidence in sexual health decision-making. The findings suggest that group support models may help address social, cultural, and gender-related barriers to HIV prevention by creating supportive and empowering spaces for AGYW. However, evidence on long-term PrEP adherence, retention in care, scalability, sustainability, cost-effectiveness, and comparative effectiveness of different approaches was limited. Few studies reported objective adherence outcomes or longer-term HIV prevention impacts.
Background/Objectives: Postoperative pain following impacted mandibular third molar extraction is a common complication that negatively affects patients' quality of life. Photobiomodulation (PBM) therapy has been proposed as a non-pharmacological adjunctive approach to reduce postoperative pain. This study aimed to evaluate the effectiveness of intraoral PBM in reducing postoperative pain after impacted mandibular third molar extraction compared with placebo, sham treatment, or standard postoperative care. Methods: A systematic review was conducted according to the PRISMA 2020 guidelines. PubMed and Embase were searched through January 2025 for randomized controlled trials (RCTs) investigating intraoral PBM after impacted mandibular third molar extraction. Only studies reporting postoperative pain using the Visual Analog Scale (VAS) were included. Risk of bias was assessed using the Cochrane RoB 2 tool, and the certainty of evidence was evaluated using the GRADE approach. Random-effects meta-analyses were performed at 24, 48, and 72 h postoperatively using standardized mean differences (SMDs). Results: Eight RCTs met the inclusion criteria for qualitative synthesis, whereas only two provided extractable data for quantitative analysis. Meta-analysis demonstrated a significant reduction in postoperative pain in the PBM group at 24 h (SMD = -0.64; 95% CI: -0.90 to -0.38; p < 0.001), 48 h (SMD = -0.82; 95% CI: -1.64 to -0.01; p = 0.047), and 72 h (SMD = -1.11; 95% CI: -1.38 to -0.84; p < 0.001). Conclusions: Intraoral PBM appears to reduce postoperative pain during the first 72 h. However, the available evidence is limited by the small number of studies included in the meta-analysis, heterogeneity in PBM protocols, and inconsistent outcome reporting. Additional well-designed RCTs are needed to strengthen the current evidence.