{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:51:32Z","timestamp":1790362292107,"version":"4.1.0"},"reference-count":94,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Photobiomodulation (PBM) therapy has shown potential in managing orofacial neuropathic pain (ONP); however, inconsistent PBM dosimetry and methodological variability limit its clinical application. This World Association for Photobiomodulation Therapy (WALT) Position Paper aims to critically appraise current evidence and provide recommendations for Clinical Practice Guidelines (CPG) and Expert Consensus Opinion (ECO) where appropriate. Methods: Evidence evaluation was guided by the HANNA (Holistic Analysis &amp; Novel Normative Actions) Framework, a structured multi-step methodology integrating systematic review, quality appraisal, and expert consensus. A systematic review was conducted in accordance with PRISMA 2020 guidelines. Methodological quality was assessed using validated tools: AMSTAR 2 for systematic reviews, RoB2 for randomized controlled trials (RCTs), and ROBINS-I for non-randomized studies (NRCTs). The AGREE II Reporting Checklist was applied to ensure transparency and rigor in the development of WALT recommendations. The Somerfield Criteria were used to rate the level of evidence (LoE) for each included ONP condition, where deemed appropriate. Results: WALT CPG were established for primary burning mouth syndrome (BMS), supported by robust evidence (LoE I) from 204 patients across six \u201cLow RoB\u201d RCTs and NRCTs, and 557 patients included in a \u201cHigh-Confidence\u201d systematic review and meta-analysis of \u201clow RoB\u201d RCTs. WALT ECO were developed for idiopathic trigeminal neuralgia (TN) and post-herpetic neuralgia (PHN), both supported by LoE II. Insufficient evidence precluded formal recommendations for post-traumatic trigeminal neuralgia, glossopharyngeal neuralgia, and occipital neuralgia. Conclusions: This Position Paper introduces the HANNA Framework, for the first time, as a robust and transparent methodology for developing WALT recommendations by delivering evidence-based CPG for PBM in the management of neuropathic pain associated with primary BMS, along with ECO for both TN and PHN. These recommendations support PBM as a safe and effective therapeutic approach, and provide a structured roadmap for future research and periodic guidelines updates.<\/jats:p>","DOI":"10.3390\/jcm15031304","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T13:33:50Z","timestamp":1770384830000},"page":"1304","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Photobiomodulation Therapy in the Management of Orofacial Neuropathic Pain\u2014WALT Position Paper 2026"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2882-2156","authenticated-orcid":false,"given":"Reem","family":"Hanna","sequence":"first","affiliation":[{"name":"Department of Restorative Dental Sciences, Eastman Dental Institute, Medical Faculty, University College London, London WC1E 6DE, UK"},{"name":"Head and Neck Academic Centre, Integrated Research, Division of Surgery and Interventional Science, Medical Faculty, University College London, London W1W 7TY, UK"},{"name":"Dental Faculty, Royal College of Surgeons Ireland, 21-122 St Stephen\u2019s Green, Dublin 2, D02 H903 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2695-9290","authenticated-orcid":false,"given":"Roberta","family":"Chow","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, University of Sydney, NSW, Brain and Mind Centre, 94 Mallett Street, Camperdown, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6601-8551","authenticated-orcid":false,"given":"Snehal","family":"Dalvi","sequence":"additional","affiliation":[{"name":"Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur 440001, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6116-2340","authenticated-orcid":false,"given":"Praveen R","family":"Arany","sequence":"additional","affiliation":[{"name":"Department of Oral Biology, School of Dental Medicine, University of Buffalo, Buffalo, NY 14215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1290-7497","authenticated-orcid":false,"given":"Ren\u00e9-Jean","family":"Bensadoun","sequence":"additional","affiliation":[{"name":"Centre de Haute \u00c9nergie, 10 Bd Pasteur, 06000 Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2040-6617","authenticated-orcid":false,"given":"Alan Roger","family":"Santos-Silva","sequence":"additional","affiliation":[{"name":"Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas, 901 Limeira Avenue, Bairro Are\u00e3o, Piracicaba, S\u00e3o Paolo P.O. Box 52, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8144-2295","authenticated-orcid":false,"given":"Jan","family":"Tun\u00e9r","sequence":"additional","affiliation":[{"name":"Private Dental Practice, Sollentuna, 19162 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9205-1061","authenticated-orcid":false,"given":"James D","family":"Carroll","sequence":"additional","affiliation":[{"name":"Thor Photomedicine, Units 1, Anglo Office Park, White Lion Rd., Amersham HP7 9FB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6431-4605","authenticated-orcid":false,"given":"Michael R","family":"Hamblin","sequence":"additional","affiliation":[{"name":"Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2092, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6696-4860","authenticated-orcid":false,"given":"Juanita","family":"Anders","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Physiology and Genetics, Uniformed University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9590-9764","authenticated-orcid":false,"given":"Shimon","family":"Rochkind","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Peripheral Nerve Reconstruction Division, Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, Tel Aviv 6423906, Israel"},{"name":"Microsurgical Center for Peripheral Nerve Reconstruction, Assuta Medical Center, 20 HaBarzel Street, Ramat HaHayal, Tel Aviv 6971020, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Heiskanen","sequence":"additional","affiliation":[{"name":"Private Dental Practice, Spider Med Hammasklinikka Manse, 3300 Tampere, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1500-8390","authenticated-orcid":false,"given":"Judith E.","family":"Raber-Durlacher","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, 1081 Amsterdam, The Netherlands"},{"name":"Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, 1105 Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4820-1090","authenticated-orcid":false,"given":"E-Liisa","family":"Laakso","sequence":"additional","affiliation":[{"name":"Mater Research Institute, University of Queensland, Level 2 Aubigny Place, Raymond Terrace, South Brisbane, QLD 4101, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2204","DOI":"10.1016\/j.pain.2011.06.017","article-title":"A new definition of neuropathic pain","volume":"152","author":"Jensen","year":"2011","journal-title":"Pain"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.pain.2007.08.013","article-title":"Prevalence of chronic pain with neuropathic characteristics in the general population","volume":"136","author":"Bouhassira","year":"2008","journal-title":"Pain"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/S1474-4422(14)70251-0","article-title":"Pharmacotherapy for neuropathic pain in adults: A systematic review and meta-analysis","volume":"14","author":"Finnerup","year":"2015","journal-title":"Lancet Neurol."},{"key":"ref_4","first-page":"e769","article-title":"The opioid epidemic and the need for pain medicine","volume":"4","author":"Petzke","year":"2019","journal-title":"Pain Rep."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Hanna, R., Dalvi, S., Bensadoun, R.J., and Benedicenti, S. 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