Journal of lasers in medical sciences最新文献

Introduction: Trastuzumab is now increasingly being used as a potent HER2 inhibitor in treating breast cancer, while acneiform rashes sometimes arise as skin-related side effects in patients undergoing treatment with HER2 inhibitors, and their specificity as drug-induced eruptions makes their management quite challenging. Pulsed dye laser (PDL) therapy has been utilized to treat a wide variety of vascular lesions, achieving excellent outcomes. Case Report: A 595 nm PDL was used to treat a 38-year-old woman suffering from an acneiform rash induced by trastuzumab as neoadjuvant therapy for breast cancer. One-half of the face received PDL treatment, while the other half served as the control. Conclusion: After just one PDL treatment, the skin lesion demonstrated a remarkable improvement, with a significant reduction in erythematous papules and inflammatory pustules, as well as an improvement in skin thickening. PDL therapy might offer an effective alternative for managing acneiform rashes induced by trastuzumab.

Introduction: Genitourinary syndrome of menopause (GSM) is a common complication secondary to estrogen depletion which leads to tissue changes in the female genitourinary tract. Here, we sought to investigate the short- and long-term effects of CO₂ laser therapy on symptoms of GSM in postmenopausal women. Methods: In this clinical trial, 47 postmenopausal women with symptoms of GSM were included. Participants underwent vaginal and extra-vaginal CO₂ fractional laser treatment in three sessions, with intervals of one month between each session. Symptom severity, including itching, dyspareunia, vaginal discharge, and dryness, was assessed at each session using a modified Vaginal Health Index (VHI), where the intensity was rated on a Visual Analog Scale (VAS) from 1 to 10 (1 indicating minimal symptoms and 10 representing maximum severity). Additionally, the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) was administered. Patients were followed for one to three years after the final laser treatment session. Results: The scores of all subscales, including itching, dyspareunia, urinary incontinence, vaginal discharge, and dryness, improved significantly following three sessions of CO₂ fractional laser (P values<0.001). However, except for the urinary incontinence domain (P=0.058), none of the symptoms maintained improved after one to three years from the last intervention. Conclusion: CO₂ fractional laser treatment is appropriate for treating symptoms related to GSM. But it seems that it needs to be used continuously for the maintenance effect on itching, dyspareunia, urinary incontinence, vaginal discharge, and dryness. The exact timing of laser sessions should be identified in further studies since the beneficial outcomes of the intervention seem temporary.

Introduction: Nowadays, antimicrobial photodynamic therapy (aPDT) has been introduced as one of the minimally invasive methods for disinfection of the surfaces of dental implants. Being derived from seaweed, Chlorella has been used as a photosensitizer in this study. This study aimed to investigate the impacts of aPDT with Chlorella on the rate of reduction of Streptococcus salivarius in vitro. Methods: The minimum inhibitory concentration of Chlorella, the sublethal exposure to 660 nm diode laser irradiation, and the minimum sublethal dose of aPDT utilizing Chlorella against S. salivarius were determined. Finally, the CFU/mL value of each plate was calculated. Then, Tukey HSD and one-way ANOVA tests were utilized for comparison the number of colonies after the interventions. Results: A concentration of 250 µg/mL of Chlorella at an irradiation time of 3 minutes, was identified as a sublethal dose of aPDT for the reduction of S. salivarius. In contrast, the application of aPDT utilizing a 660 nm diode laser for 4 minutes in combination with Chlorella at a final concentration of 500 µg/mL, demonstrated significantly greater efficacy in reducing S. salivarius compared to the other experimental groups (P<0.001). Conclusion: Chlorella 500 µg/mL mediated aPDT (660 nm, 4 minutes) has a significant effect on reducing S. salivarius count.

Introduction: In recent years, various methods such as lasers and different solutions have been investigated to eliminate microorganisms in the root canal. This investigation was aimed at comparing the bactericidal effect on Enterococcus faecalis between a diode laser with a wavelength of 940 nm and a mixture of a tetracycline isomer, an acid, and a detergent (MTAD). Methods: Forty single-rooted human lower premolar teeth were prepared for inoculation with E. faecalis and incubated for a period of 3 weeks. The 40 samples were randomly divided into 4 groups: the 940 nm diode laser group with irradiation through a 200 µm optical fiber with parameters of (1 W/CW,4 cycles, 20s interval); the MTAD group irrigated with 5 mL for 5 minutes; also, a positive group with 3% NaOCl and a negative group with 0.9% saline solution, both irrigated with 5 mL for 5 minutes. For statistical analysis, the Mann-Whitney U and Wilcoxon tests were used. Results: The 3% NaOCl positive control group had greater bacterial reduction after treatment (99.99%) compared to the 940nm diode laser (98.96%) and MTAD (99.34%) groups. Statistically, we found a significant difference between all groups regarding the reduction in the colony count (P<0.05). Conclusion: It was found that there was a significant difference in the percentage of reduction for the bacterial colonies between all the groups evaluated, with the greatest antibacterial effectiveness observed with 3% sodium hypochlorite.

Introduction: Striae distensae (SD) are a skin disorder characterized by linear atrophic depression of the dermis due to stretching of the skin. There are various SD therapy modalities, namely topical therapy, peeling, microneedling, platelet-rich plasma, and laser. Until now, there has been no standard therapy for SD, but several therapeutic modalities can reduce clinical symptoms, so knowledge about the current management of SD is needed. Methods: The research method used an experimental research design with consecutive sampling technique in SD patients at the Dermatology, Venereology and Aesthetics clinic of Mohammad Hoesin Hospital, Palembang, during the research period. This study aimed to determine the effectiveness of combination therapy with fractional CO₂ laser and Centella asiatica in SD. Results: This study included 22 SD patients who met the inclusion criteria and received combination therapy with fractional CO₂ laser and Centella asiatica. The results of the analysis of differences in the Index of Striae Distensae Assessment (INA) score, Dermatology Life Quality Index (DLQI) score and VAS score revealed that there was a significant difference in the mean decrease in the INA score between the baseline and week 12 (P=0.014), as well as in the DLQI score between the baseline and week 12 (P=0.000). There was a significant difference in the mean VAS score between the baseline and week 4 (P=0.000). Conclusion: These findings indicate that the combination of fractional CO₂ laser and topical Centella asiatica effectively reduces the severity of SD, improves patients' quality of life, and decreases associated pain. Further studies could explore long-term effects and optimize treatment protocols for even better outcomes.

Introduction: Chondrocytes are the major cell in hyaline cartilage playing a crucial role in maintaining the mechanical resilience of the tissue. We assessed the effect of an 808nm diode laser on the proliferation of human chondrocytes. Methods: This study was conducted on human chondrocytes in vitro. The cells were divided into 5 cases and one control group. The cells were irradiated by low-level laser 808 nm, with energy levels of 1, 2, 3 J/cm² (0.2 W, for 5, 10, and 15 seconds), 4 J/cm² (0.3 W,13 s), and 5 J/cm² (0.4 W,12 s). The culture was incubated for 24 hours. The MTT assay was performed to determine the cell viability. After 72 hours of incubation, the procedure was reperformed to assess the effect of incubation duration. The cell viability in terms of incubation duration and irradiation parameters were investigated by a two-way ANOVA test. Pairwise comparisons were performed using the Bonferroni test. Results: In the 72-hour incubation group, cell viability in the group that received 5 J/cm² energy was significantly lower than that in the groups receiving 1 J/cm², 2 J/cm² and 4 J/cm² irradiation. The variables of time (P=0.001) and energy level (P=0.024) had significant effects on the cell viability of the samples. In the 24-hour incubation groups, no significant difference in cell viability was observed. Conclusion: The diode 808 nm Low-level laser irradiation (LLLI) at doses of 5 J/cm² and less did not show a significant increase in the proliferation of chondrocytes (regardless of incubation time). However, the best survival rate of chondrocytes was observed in the group of 4 J/cm² with 72-hour incubation.

Introduction: This study aimed to evaluate the efficacy of the orifice-level passive ultrasonic activation (OL-PUA) technique in removing debris from the mesial root canals of mandibular molars, besides comparing it with other approaches, including manual dynamic agitation (MDA), EndoActivator, and laser-activated irrigation (LAI). Methods: Ninety mesial roots of mandibular molars were prepared up to 25.06 using the Race rotary system, filled with 3% sodium hypochlorite (NaOCl), and then they were randomly assigned to 5 groups (n=15) based on the activation protocol: MDA, EndoActivator, OL-PUA, LAI (using a diode laser), and needle irrigation (no activation). Moreover, one group served as the negative control using normal saline as the final irrigant. The roots were decalcified and sectioned into coronal, middle, and apical cross-sections. After histological staining, the remaining debris was assessed with an optical microscope and measured in the canals and isthmuses using histomorphometric analysis. Statistical analyses were performed by using one-way ANOVA and Tukey's HSD post hoc test (P=0.05). Results: Although less residual debris was observed after OL-PUA/LAI than using the EndoActivator/MDA methods, no significant difference was found between the four activation techniques at any root third (P>0.05). The OL-PUA/LAI group harbored significantly less remaining debris than the needle-irrigated samples at all root thirds (P<0.05). Debris accumulation increased from the coronal to the apical root thirds. Conclusion: No statistical difference was detected between the four activation techniques in terms of debris-removal performance, and none of them resulted in completely debris-free canals. Orifice-level PUA proved to be a promising approach with significant efficacy in removing debris compared to control groups.

Introduction: Photobiomodulation (PBM) is considered a promising adjunctive approach in regenerative medicine. This study aimed to investigate the proliferation and adhesion of human gingival fibroblast (HGF) cells to a collagen membrane following PBM. Methods: Cultured HGF cells on a collagen membrane received PBM at wavelengths of 808 nm, 915 nm (2 and 4 J/cm²), and 660 nm (2.1 and 4.2 J/cm²) in interventional groups, while non-irradiated cells served as the control. On days 1 and 3 post-irradiation, cell proliferation was measured by MTT assay, and adhesion to the membrane was assessed under the scanning electron microscope (SEM). Results: Cell proliferation significantly increased in interventional groups compared to the control, with the most significant increase at 915 nm (4 J/cm²) in both time points. On the first day, the 808 nm and 660 nm lasers demonstrated similar results, significantly lower than the 915 nm laser (2 J/cm²). On day 3, the 660 nm, 808 nm, and 915 nm (2 J/cm²) groups showed comparable results. Qualitative analysis by the SEM identified spindle-shaped cells with multiple extended projections in 915 nm groups, especially at an energy density of 4 J/cm². Groups of 660 nm and 808 nm (4 J/cm²) showed spindle-shaped cell morphology. No distinct cellular morphology indicative of enhanced adhesion was observed at 808 nm (2 J/cm²). Conclusion: The most effective PBM setup for promoting HGF proliferation and adhesion to a collagen membrane was identified at 915 nm (4 J/cm²).

Introduction: Photobiomodulation (PBM) is beneficial to biological tissues; depending on the optical dose that is absorbed by tissues, it can function as a biostimulative, analgesic, and anti-inflammatory mediator. Thus, the current research aimed to assess the impacts of PBM and Calcium aluminosilicate-based material on direct pulp capping (DPC) of dogs' permanent teeth through histological analysis. Methods: To study DPC of dogs' teeth, we separated 24 canines and premolars obtained from mature, healthy mongrel dogs into four equal groups: group 1, which served as the control (exposed pulp was covered with a sterile polytetrafluoroethylene, Teflon tape); group 2, which received PBM treatment using a 980 nm diode laser with a 100 mw output power for one minute; group 3: Calcium aluminosilicate-based material; group 4: Calcium aluminosilicate+PBM. In accordance with the assessment period, each group was divided into three equal subcategories: (A) 1 week; (B) 2 months; (C) 3 months. The teeth were evaluated histologically for inflammatory response and dentine bridge formation. Results: Statistical analysis detected that there was a significant difference between PBM, Calcium aluminosilicate cement, and the combination group of PBM and Calcium aluminosilicate related to the control group in variant evaluation periods regarding the inflammatory response and dentine bridge thickness through the histological analysis. In relation to the inflammatory response after one week, the combined group (Calcium silicate cement+PBM) exhibited a significantly decreased intensity of inflammation compared to other groups at an identical time. As for dentin bridge creation, the PBM+calcium aluminosilicate group detected thicker dentine bridge creation at three months than other studied groups. Conclusion: Combined with calcium aluminosilicate-based material, PBM using a 980 nm diode laser with output power of 100 mw for one minute decreased the initial inflammatory response and enhanced a complete thick dentine bridge formation.

Introduction: Anal fissures (AFs) are a prevalent pathology. Although internal lateral sphincterotomy is still the gold-standard surgery for treating chronic AFs, this procedure is associated with a considerable risk of anal incontinence. This study describes an alternative and minimally invasive technique for treating AFs using photobiomodulation and a high-power diode laser-fissure treatment (LFT) and highlights initial results pertaining to pain. Methods: This retrospective study focused on 38 patients treated with LFT on an outpatient basis at three different hospitals in different states of Brazil (Santa Catarina, Paraná, and São Paulo). The objective was to evaluate the effects of LFT treatment on AF patient pain following the procedure. The Friedman test was used to identify the effects of LFT treatment over time (D0, D7, D15, D30, and D60) on postoperative pain intensity using the visual analogue scale (VAS). Complications and incontinence rates were also analyzed. Results: Roughly two-thirds of the patients (66%; n=25) were male. The median age of the cohort was 49. Constipation was described by 32% of the patients, 13% were smokers, and 21% had recently used opioids. In 92% of the cases, the AF was localized posteriorly. Skin tags were present in 27% of the cases, and 26% had recently undergone a previous orificial surgery. A significant reduction in pain was observed over time in the intensity of postoperative pain measured by the VAS. Prior to surgery (D0), the patients' mean VAS score was 4.1; it progressively decreased to 0.1 on the 60^th postoperative day (P<0.05). There was no significant change in fecal continence at the end of the 60-day follow-up period. Minor complications occurred in 7.9% of the patients (2.6% hemorrhoidal thrombosis, 2.6% skin tag, and 2.6% "failure"). Conclusion: Our results suggest that treating AFs with laser therapy results in a significant reduction in pain intensity over time without interfering with anal continence.