Photobiomodulation,Photomedicine,and Laser Surgery

To assess the clinical application of intravascular laser irradiation of blood (ILIB), photodynamic therapy (PDT), and photobiomodulation therapy (PBM-T) in mucositis in cancer patients.

PBM-T and PDT are used for the management of oral mucositis (OM) and there are no studies associating intravascular laser irradiation of blood (ILIB) for this purpose.

Thirty-six patients were allocated by convenience into three groups according to the established therapy: PDT+PBM-T (n = 10); PDT+PBM-T+ILIB (n = 10), and ILIB (n = 16). PDT was performed with the photosensitizer curcumin and irradiation of the oral cavity with blue light-emitting diode (LED) (power 1200 mW and wavelength 468 nm). PBM-T was performed using low-intensity laser (power 100 mW, wavelength 660 nm, and spot energy 1 J) at 26 points of the oral cavity. ILIB was applied with a bracelet on the radial artery using the low-intensity laser (100 mW of power, 660 nm wavelength, and 30 J of total energy). All therapies were performed weekly for 5 weeks. The results of the OM degrees were analyzed using the Wilcoxon test.

There was a significant reduction in the degrees of OM after treatment with PDT+PBM-T (p = 0.0117), PDT+PBM-T+ILIB (p = 0.0277), and ILIB (p = 0.0277).

It was concluded that ILIB, PDT, and PBM-T reduced the severity of mucositis and prevented its onset.

Clinical Trial Registration number: RBR-54XS25.

The prognosis of replanted teeth is depended on the vitality of periodontal ligament cells residual on the root surface. Photobiomodulation has photobiological effects that can promote cell vitality. The study aimed to explore the effect of photobiomodulation on the periodontal ligament cells under inflamed or starved conditions mimicking clinically damaged periodontal ligament cells of avulsed teeth and provide the adjuvant procedure for tooth replantation.

Normal, starved, or inflamed periodontal ligament cells were irradiated with an 808 nm laser at densities of 0, 1, 3, 5, or 10 J/cm². The cell counting kit-8 (CCK-8) assay and scratch test were applied to determine the effects on the proliferation and migration of cells. Anti-inflammatory effects were assessed according to the mRNA expression of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) measured by reverse-transcription polymerase chain reaction. Osteogenic capacity was evaluated by alkaline phosphatase (ALP) staining, ALP activity assay, Alizarin Red S staining, and ALP and osteocalcin (OCN) mRNA expression.

The CCK-8 assay and scratch test demonstrated that the 808 nm laser significantly promoted proliferation and migration of normal condition periodontal ligament cells at a density of 3 J/cm² versus 5 J/cm² under the starved and inflamed conditions. Moreover, the 808 nm laser had anti-inflammatory effects and promoted osteogenesis of periodontal ligament cells at 3 J/cm² under normal conditions, while photobiomodulation at 5 J/cm² upregulated the osteogenesis of periodontal ligament cells under starved and inflamed conditions.

The photobiomodulation of 808 nm laser reduced inflammation and improved the proliferation, migration, and osteogenesis of normal, starved, and inflamed periodontal ligament cells. These effects required a higher energy density under starved or inflamed conditions compared with normal conditions. The photobiomodulation of 808 nm has a potential application in root surface treatment for replanted teeth.

The aim of this study was to evaluate the therapies of low-level green laser and chemical desensitizer in the treatment of dentin hypersensitivity (DH).

Forty-eight patients with 96 sensitive teeth were invited to participate in this clinical trial and were randomly divided into three groups. One group was treated with low-level green laser, the second group was treated with desensitizer [sodium fluoride (NaF)], and the third group acted as the placebo group and was treated with distilled water and placebo laser. The wavelength of green laser was 532 nm and the irradiance was 15 J/cm² per treatment site. Hypersensitivity was assessed by visual analogue scale (VAS) according to cold test and probing at baseline. Immediately, 2 weeks, and 3 months after the application of green laser, NaF, and placebo, the participants' sensitivity level was accessed by new VAS analysis.

Forty-five patients with 90 teeth (n = 15 patients/group; 30 teeth/group) were followed up for 2 weeks and 3 months after treatment. There were significant differences in VAS scores between the placebo group and intervention group (green laser group and NaF group; analysis of variance, p < 0.05) at all three time points. The mean pain scores in DH reduced significantly immediately after treatment in the green laser group and NaF group when stimulated by cold and probing, whereas no significant difference was observed with these two therapies after 2 weeks (p > 0.05). After 3 months, mean VAS scores of the NaF group were higher than those of the green laser group (p < 0.01).

Therefore, the green laser displayed similar effectiveness as NaF in treatment of DH and could be a promising new therapy to reduce DH.

Tranexamic acid has been reported to benefit the treatment of postinflammatory hyperpigmentation (PIH). Laser-assisted drug delivery (LADD) could facilitate the efficacy of topically applied drugs into the dermis. This split-area randomized prospective study aims to assess whether early utilization of the LADD procedure with tranexamic acid delivery followed by picosecond lasers can attenuate the PIH better than the utilization of picosecond lasers alone.

Ten post-traumatic cases of PIH in 10 patients (8 female and 2 male) with an average age of 34.2 ± 11.2 years were included in this clinical trial. Using block randomization to determine the treatment side, one side of each area of the PIH was separated from the midline into two halves belonging to the control and tranexamic acid groups. The half area of the tranexamic acid group was further topically applied with 10% tranexamic acid solution. This procedure was repeated every 6 weeks, four times in total.

The self-assessment of the hyperpigmentation and overall satisfaction of the treatment outcome were not significantly different between the treatment and control sides.

This split-area study revealed that, compared with picosecond alone, there was no significant difference adopting tranexamic acid in LADD after nonablative fractional picosecond laser for PIH.

We aimed to evaluate real-world data for the use of fractional CO₂ laser therapy for treating symptoms of vulvovaginal atrophy (VVA).

VVA is widespread and can reduce the patients' quality of life. There is a lack of data regarding its therapy with laser, especially for daily practice (i.e., real-world data).

Thirty-six patients were treated in a single medical center. They consisted of pre- and postmenopausal women and received three fractional CO₂ laser therapy treatments with 3–6 weeks between each treatment. Each patient financed the treatment privately. The symptoms pain, pruritus, dyspareunia, burning, dryness, and dysuria were recorded with a visual analog scale (1–10) before the first, second, and third laser treatment. The data were examined retrospectively.

Pain was reduced from a mean of 2.5 points (minimum 0, maximum 9 points) to 1.1 (minimum 0, maximum 8 points) before the third laser treatment. Pruritus showed a mean score of 3.8 (minimum 0, maximum 10 points). This decreased to 1.4 (minimum 0, maximum 8 points). Dyspareunia scored a mean of 6.8 (minimum 0, maximum 10 points). After two laser therapies, the score was 3.3 (minimum 0, maximum 8 points). Burning showed 4.2 points (minimum 0, maximum 10 points). Having experienced two laser therapy sessions, the patients scored 1.5 (minimum 0, maximum 9 points) points. The severity of dryness dropped from 6.5 (minimum 0, maximum 10 points) to 3.3 (minimum 0, maximum 9 points). Dysuria was stated with 1.8 points (minimum 0, maximum 10 points) before the first and 0.5 points (minimum 0, maximum 6 points) before the third laser therapy. All changes showed statistical significance (p < 0.002).

This real-world data propose fractional CO₂ laser to reduce VVA-associated genital discomfort, thus being a valuable therapy option for pre- and postmenopausal women.

The purpose of this review is to systematically assess the existing literature and summarize the evidence regarding the effect of erbium-doped yttrium aluminum garnet (Er:YAG) laser on enamel surface roughness and pulp health compared with the conventional orthodontic debonding techniques.

Following the preferred reporting items for systematic reviews (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement, the electronic database, PubMed, Scopus, Web of Science, Google scholar, and Saudi Digital Library were searched for relevant published records. Data were collected following specific keywords: “debonding” “Er:YAG laser” etc. In vitro studies, and clinical randomized- and nonrandomized-controlled studies limited to the English language and published in peer-reviewed journals were included.

A total of 564 articles were identified as relevant to the topic. Duplicates were excluded resulting in 382 articles, out of which 374 articles were discarded upon screening titles and abstracts. The remaining eight articles were read to their entirety and included in the current qualitative review after fulfilling the eligibility criteria. In all the included studies, a total of 480 sound posterior teeth were used to evaluate the effect of Er:YAG laser on debonding of orthodontic brackets from the enamel surface.

Er:YAG laser debonding has demonstrated a reduced risk of enamel damage (fracture or cracks) but resulted in increased enamel surface roughness and was time-consuming for adhesive removal procedures compared with the conventional debonding methods. Further, within the applied laser settings, Er:YAG lasers have found to exhibit low thermal exhaustion in relation to the pulp. The laser source with a wavelength of 2940 nm has been used with different setting ranges (power of 2.5–5 W, energy 125–600 mJ, frequency 4–30 Hz, and pulse duration 50–350 μsec) for debonding of orthodontic brackets.

The aim of this clinical trial was to evaluate the efficacy of photobiomodulation (PBM) to reduce oral pain initiated by capsaicin. Background: PBM has been used for pain reduction in oral regions; however, its clinical efficacy to alleviate burning sensations is still unknown.

This clinical study was divided into two phases. There were 10 subjects in each phase. In Phase I, the burning sensation was stimulated using 0.05% in 95% ethanol capsaicin (prepared by the Faculty of Pharmaceutical Sciences, Khon Kaen University, Thailand) on filter paper and recorded with a 10-cm horizontal visual analog scale (VAS) every 1 min until the subject experienced no more pain. The area under the curve (AUC) of the graph between VAS and time was calculated. The washout period was 24 h. In Phase II, a crossover clinical trial was conducted in subjects who received the pain model as stated. Four interventions were included: (1) PBM before & after pain stimulation, (2) PBM before pain stimulation, (3) PBM after pain stimulation, and (4) Placebo. For PBM intervention, a single exposure of 850 nm Laser (AsGaAl; TOP 250 Soft Laser, Berkmed Medikal, distributed by Medical Innovation-MI, Istanbul, Turkey) with 0.10 cm² spot size laser probe continuous wave at 1 W/cm² and 30 J/cm² for 30 sec was used.

In Phase I, there was no statistically significant difference (p = 0.09) between the average AUC of day 1 [55.63 (23.38)] and day 2 [48.99 (27.20)]. In phase II, there was no statistical difference (p = 0.20) of the average AUC among the interventions and the placebo; group 1 [56.24 (30.11)], group 2 [45.46 (45.46)], group 3 [64.15 (32.89)], and group 4 [58.59 (30.16)].

The human capsaicin model was suitable for a crossover design clinical trial. The PBM used in this study did not reduce oral burning sensations from capsaicin.