Photobiomodulation,Photomedicine,and Laser Surgery

To evaluate the effects of photobiomodulation (PBM) on glycemic control in individuals with type 2 diabetes mellitus (T2DM). Persistent hyperglycemia in T2DM disrupts mitochondrial metabolism, increases oxidative stress, and contributes to metabolic and vascular complications. PBM has emerged as a potential nonpharmacological strategy to modulate mitochondrial function and improve metabolic homeostasis.

Recent clinical trials investigating PBM in T2DM were systematically synthesized. Methodological quality was assessed using the Physiotherapy Evidence Database scale, and certainty of evidence was evaluated with the Grading of Recommendations, Assessment, Development, and Evaluation approach.

PBM, predominantly using red and near-infrared wavelengths, was associated with reductions in fasting glucose, postprandial glucose, and glycated hemoglobin, as well as modulation of hemodynamic and metabolic parameters. Methodological quality ranged from moderate to high, while certainty of evidence was very low to low.

PBM shows potential as an adjunctive therapy for glycemic control in T2DM, although further well-designed trials are required to strengthen evidence and standardize protocols.

Patients of Asian descent with Fitzpatrick skin types III–V who experience facial acne scars are a relatively under-researched demographic in medical literature, with limited studies specifically addressing their unique skin characteristics and treatment responses. Traditional treatments have variable efficacy and risk of complications. A novel technique that has shown potential in managing scars is the Q-Switched, 1064 nm neodymium-doped yttrium aluminum garnet laser with a fractional beam profile. Picosecond lasers, with extremely short pulse durations, minimize thermal damage and induce tissue remodeling, reducing post-inflammatory hyperpigmentation risk.

This prospective study was proposed to judge the efficacy of 1064 nm fractional picosecond laser for treating atrophic acne scars in the Indian skin type.

Twenty-two patients completed the study; all were treated at monthly intervals for three sessions. Evaluation based on Investigator’s Global assessment along with patient satisfaction scores was carried out for all patients. The safety of the laser was evaluated by noting down adverse effects.

Fourteen patients showed improvement of 26–50% by Investigator’s Global Assessment, which was similar to the patient satisfaction scores. Post-treatment edema, pinpoint bleeding, and mild erythema were the only side effects noted. Postinflammatory hyperpigmentation was not noted in any of the patients.

Fractional picosecond laser can be considered a viable and safe option to treat acne scars in patients with dark skin type.

To investigate the effectiveness of the acai photosensitizer (Euterpe oleracea Martius), combined or not with low-intensity laser, in reducing Streptococcus mutans in carious dentin.

Due to its high penetration power and coloring ability, acai presents a promising and unexplored option for use as a photosensitizer in antimicrobial photodynamic therapy.

We selected 60 permanent third molars and exposed their coronal dentin. After producing dentin carious lesions, we randomly divided the teeth into four groups (n = 15 each): C (control)—no disinfection; AC (acai)—acai photosensitizer application; AC + BL (acai + laser)—acai photosensitizer application and irradiation with low-intensity blue laser diode (Therapy); and BL (laser)—low-intensity blue laser diode (Therapy) application. All carious tissue was collected post-protocol application. Total viable bacterial count was determined after 2 days of incubation. Micro-computed tomography was used for qualitative analysis of carious lesions through observation of a carious tooth (control group). Scanning electron microscopy (SEM) was used for qualitative analysis of carious tissue disinfection using different protocols. Results were analyzed using the Kruskal–Wallis test (Student–Newman–Keuls).

The cariogenic challenge produced a carious lesion measuring 17.14875 mm³, located in deep dentin close to the pulp. The AC + BL group showed the most significant reduction in S. mutans count (p < 0.0001), followed by the AC group (p = 0.0055). The BL group showed no significant reduction in S. mutans count (p = 0.2122). SEM analysis showed that AC + BL promoted dentin disinfection, with exposed dentinal tubules. The percentage reduction in S. mutans count was: BL (35.75%), AC (63.41%), and AC + BL (92.68%).

The AC + BL group showed significantly better results than the AC group alone. The acai photosensitizer, with or without antimicrobial photodynamic therapy, is indicated for carious dentin disinfection.

Assess clinical efficacy of photodynamic therapy (PDT) combined with periodontal regenerative surgery (PTR) in severe periodontitis, focusing on gingival thickness (GT), inflammatory markers, and bone repair.

Sixty patients were randomized to Combination (PDT + PTR) or Control (PTR alone) groups. PDT utilized 660 nm laser with methylene blue. Outcomes included probing depth (PD), clinical attachment loss (CAL), bleeding on probing (BOP), keratinized tissue width (KTW), GT, cone-beam computed tomography bone parameters, and gingival crevicular fluid cytokines (IL-1β, TNF-α, PGE2, MMP-8) at 3/6/12 months.

At 12 months, Combination group showed superior PD reduction (p < 0.05), CAL gain (p < 0.05), lower BOP (16.67% vs. 43.33%, p < 0.05), increased KTW/GT, and enhanced bone density/defect filling versus Control. Inflammatory markers were significantly reduced at 3 months (p < 0.05). Three-wall defects exhibited better CAL/GT outcomes than two-wall defects (p < 0.05).

The combined PDT and PTR therapy demonstrated significant improvements in key clinical parameters, reduced inflammatory biomarkers, and enhanced radiographic bone fill in severe periodontitis patients.

An in vitro study to evaluate the efficacy of indocyanine green (ICG) encapsulated in chitosan (CHNPs) and titanium dioxide nanoparticles (TiO₂NPs) activated by 810-nm diode laser on smear layer (SL) removal and shear bond strength (SBS) to caries-affected dentin (CAD).

Sixty extracted human mandibular molars with CAD were randomly assigned to four groups (n = 15). Group 1: 2% chlorhexidine (CHX), Group 2: free ICG-activated PDT (ICG-PDT), Group 3: ICG-loaded TiO₂NPs-activated PDT (ICG-TiO₂NPs-PDT), and Group 4: ICG-loaded CHNPs-activated PDT (ICG-CHNPs-PDT). CHNPs and TiO₂NPs were characterized by scanning electron microscopy (SEM) energy-dispersive X-ray spectroscopy. SL removal was assessed qualitatively via SEM using the Hülsmann scale. A fifth-generation etch-and-rinse adhesive was applied with active scrubbing, and nanohybrid composite buildups were fabricated. Following thermocycling, SBS was measured using notched-edge shear testing machine. Failure modes were assessed stereoscopically. Data were analyzed using one-way ANOVA and Tukey post hoc tests (α = 0.05).

ICG-CHNPs-PDT yielded the lowest SL score (1.04 ± 0.14) and highest SBS (9.79 ± 0.62 MPa), significantly outperforming all groups (p < 0.05). CHX exhibited intermediate performance (SL: 2.16 ± 0.48; SBS: 7.59 ± 0.46 MPa). ICG-PDT (SL: 2.75 ± 0.29; SBS: 6.12 ± 0.43 MPa) and ICG-TiO₂NPs-PDT (SL: 2.81 ± 0.35; SBS: 5.97 ± 0.35 MPa) showed comparable, inferior results (p > 0.05). ICG-CHNPs-PDT demonstrated predominantly cohesive failures (60%), while ICG-PDT and ICG-TiO₂NPs-PDT showed mainly adhesive failures (50%).

Near-infrared antimicrobial photodynamic therapy using chitosan-encapsulated ICG activated at 810 nm significantly enhanced both SL removal and resin–dentin bond strength compared with conventional CHX. The dual chelating and photosensitizing properties of the chitosan-ICG system offer a promising alternative for CAD surface conditioning before adhesive bonding.

Radiation-induced oral mucositis (RIOM) may cause severe pain and impaired quality of life during head and neck radiotherapy (RT). Preventive photobiomodulation (PBM) has shown promising clinical benefits.

Eligible patients had oropharyngeal or oral cavity cancer and were opioid-naïve at the start of curative-intent RT. Patients in the PBM group were treated between 2020 and 2023. PBM was applied to the entire oral mucosa at 2.25 J/cm² (λ = 660 nm). Extraoral PBM was delivered using an LED cluster device at 6 J/cm² (λ = 810 nm) to target the pharyngolaryngeal mucosa. PBM was administered three times per week by trained radiation therapists. A historical control cohort treated between 2012 and 2019 was matched 1:1 based on tumor site, concurrent systemic therapy, and prior surgery. The primary objective was to evaluate differences in daily morphine consumption at the end of RT according to the preventive use of thrice-weekly oral PBM in patients receiving curative-intent RT for head and neck cancer.

A total of 280 patients were included: 45% had oral cavity cancers, 43% were treated postoperatively, and 42% received RT without systemic therapy. Morphine use was significantly lower in the PBM group at the end of RT (22.9 vs. 37.4 mg/day; p = 0.002) and 1 month post-RT (10.3 vs. 27.2 mg/day; p = 0.0001). No morphine was required in 60% of PBM patients compared with 47% of controls. PBM appeared particularly beneficial in oropharyngeal cancer, in patients receiving definitive RT, and with concurrent treatment. In contrast, rates of grade 3–4 RIOM at the end of RT were identical (63% in both groups), and grade 3–4 mucositis-free survival did not differ (p = 0.99).

In this large matched cohort, preventive PBM reduced morphine consumption during and after RT, supporting its use to alleviate RIOM-related pain in head and neck cancer patients.