Lasers in Medical Science最新文献

Eyelid laxity is a visible sign of aging that can significantly affect appearance and comfort; however, many patients remain reluctant to undergo surgical blepharoplasty. Monopolar radiofrequency (RF) offers a non-invasive alternative. This study evaluated the efficacy and safety of a 0.25 cm² monopolar RF tip for upper eyelid tightening in Asians. Fourteen subjects received a single session of treatment with a 0.25 cm² tip monopolar RF device. Multiple passes were applied to the upper eyelid and lateral orbital regions. Topical anesthesia was applied 30 min before treatment, and a protective plastic contact lens was used during the procedure. Standardized digital photography, physician assessments, and patient-reported outcomes were obtained at each visit. All subjects demonstrated clinical improvement. At 2 months, 73% of patients reported more than 50% improvement in eyelid tightening, increasing to 86% at 6 months. Physician Global Aesthetic Improvement Scale (GAIS) ratings corresponded to "much improved" at both time-points. Mid-pupillary brow elevation increased by 1.18 mm at 2 months and 1.45 mm at 6 months. Lateral canthal brow elevation increased by 1.23 mm and 1.21 mm, respectively. Superior palpebral crease elevation improved by 0.54 mm and 0.41 mm, while the eyebrow angle decreased by - 4.12° and - 5.67°, indicating a more elevated brow contour. No adverse events were observed. In conclusion, monopolar RF treatment with a 0.25 cm² tip appears to be a safe and effective non-surgical option for upper eyelid tightening in Asians.

To evaluate the efficacy and safety of the combination of the long-pulse 1064 nm neodymium-doped yttrium aluminum garnet (LP1064 nm) laser and picosecond 755 nm alexandrite (P755 nm) laser with a diffractive lens array (DLA) in improving skin photoaging. This prospective, randomized, split-face trial was conducted between April 2024 and February 2025 at two centers. A total of 22 healthy volunteers with facial photoaging symptoms aged 30-65 years were enrolled. The full face was treated with the LP1064 nm laser, and one side was treated with the P755 nm laser with DLA for three sessions at 1-month intervals. Efficacy and safety were assessed before each treatment and 1, 3, and 6 months after treatment. The primary outcome was the Global Aesthetic Improvement Scale (GAIS) score. A total of 21 patients completed the study. The combined treatment side demonstrated further improvement in GAIS scores compared with the monotherapy side at 3 (85.7% vs. 66.7%) and 6 months (66.7% vs. 57.1%). Significant changes in the facial regions were observed. Volumetric analysis using 3D assessment revealed that the combined treatment had a more pronounced effect on the nasolabial folds and suborbital areas. VISIA analysis found significantly improved pigmentation and pore size at 1 and 3 months after treatment. No adverse events were observed on either side during or after treatment period. The combination of the LP1064 nm and P755 nm lasers with DLA can enhance skin rejuvenation by addressing the structural and pigmentary aspects of photoaging. These preliminary findings support the safety and efficacy of this combination approach. Further studies are needed to optimize this approach.

To evaluate and compare the effect of 15, 20, 45 and 60 s of diode laser irradiation on the In Ovo Chick Embryo Yolk Sac Membrane (YSM) for Angiogenic differentiation. 15 fertile White Leghorn eggs incubated under controlled conditions were used in the study. Eggs were randomly assigned to five groups (n = 3) and exposed to 980 nm diode laser (0.7 W) for 15, 20, 45 and 60 s, with a control group receiving no irradiation. On day 10, the chorioallantoic membrane (CAM) vasculature was imaged and analysed using IKOSA CAM assay software to quantify blood vessel branching. Statistical analysis was performed using one-way ANOVA followed by Tukey's post hoc test. The mean values of vascular branching points, total vessel length, and vessel area showed statistically significant differences across all groups (p < 0.02, < 0.001, and < 0.04, respectively). Intergroup comparisons revealed significant increases in branching points for the 45-seconds (p < 0.04) and 60-seconds (p < 0.003) groups versus control, and between 15- and 60-seconds (p < 0.006), and 20- and 60-seconds (p < 0.02) groups. Total vessel length differed significantly between control and the 15-second (p < 0.02), 45-seconds (p < 0.001), and 60-second (p < 0.04) groups. For vessel area, a significant increase was noted in the 45-seconds group compared to control (p < 0.04). These results suggest that diode laser irradiation significantly enhances angiogenesis, with 45 s producing the most pronounced effect across all parameters. Diode laser irradiation enhances angiogenesis, with 45 s being the optimal exposure time for angiogenic differentiation. These findings suggest that highlight LLLT may accelerate healing and tissue repair, warranting further research for clinical applications.

The 808-nm wavelength laser has emerged as a promising non-invasive tool with significant therapeutic potential in various medical fields. This review highlights its biological mechanisms, including anti-inflammatory effects, tissue repair, and pain modulation. The laser inhibits the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway, reducing pro-inflammatory cytokines (e.g., tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6)) and increasing interleukin-10 (IL-10), an anti-inflammatory mediator that accelerates healing. The laser also activates the transforming growth factor-beta (TGF-β) pathway to stimulate collagen synthesis and fibroblast activity, enhancing tissue regeneration. Additionally, by promoting vascular endothelial growth factor (VEGF) expression, and improves neovascularization and tissue oxygenation as well. The modulation of transient receptor potential vanilloid 1 (TRPV1) channels, increased adenosine triphosphate (ATP) production, and activation of the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) and the brain-derived neurotrophic factor (BDNF) pathways further support neuroprotection and cellular recovery. Importantly, recent insights suggest the laser's interaction with glial cells particularly astrocytes and microglia plays a critical role in managing neuro-inflammation and improving outcomes in neurological disorders such as hydrocephalus. The ability to influence cerebrospinal fluid regulation and enhance brain barrier permeability positions the 808-nm laser as a potential therapeutic option for improving life quality in affected individuals. Despite its potential, further clinical studies are required to validate and standardize its application across medical protocols.

This study compared conventional needle irrigation (CNI), shock wave-enhanced emission photoacoustic streaming (SWEEPS), EDDY sonic-powered irrigation, and the XP-endo Finisher for organic tissue removal in simulated internal root resorption (IRR) cavities using 2.5% and 5% NaOCl. One hundred and twenty single-rooted mandibular first premolars were instrumented, split longitudinally, and standardized semicircular IRR cavities were prepared in the canal walls. Bovine muscle tissue samples were weighed and adapted into the cavities. The reassembled root segments were divided into three irrigant groups (distilled water, 2.5% NaOCl, or 5% NaOCl) and four activation subgroups (CNI, SWEEPS, EDDY, and XP-endo Finisher) (n = 10 per group). A total of 7 mL of irrigant (3 mL NaOCl + 1 mL EDTA + 3 mL NaOCl) was applied with a total activation time of 2 min, the roots were disassembled, and tissue dissolution was assessed by calculating the difference between the initial and final tissue weights. The data were analyzed using Kruskal-Wallis and Mann-Whitney U tests with Bonferroni Correction. Under laboratory conditions, the use of SWEEPS and XP-endo Finisher with 2.5% and 5% NaOCl resulted in higher tissue weight loss compared to CNI and EDDY (p < 0.001), with no significant difference between them (p > 0.05). No significant difference was observed between 2.5% and 5% NaOCl, with or without activation methods (p > 0.05). Complete removal of organic tissue could not be achieved with any of the techniques. SWEEPS technology and XP-endo Finisher demonstrated higher efficiency in removing organic tissue from IRR cavities compared with the CNI and EDDY systems.

Medication-related osteonecrosis of the jaw (MRONJ) are localized aggressive necrotic bone complications occurring post-tooth avulsion in patients receiving bone antiresorptive agents. Photobiomodulation is used in the medical field for its ability to accelerate wound healing. This study aimed to evaluate the efficacy of photobiomodulation in the prevention or management of MRONJ. A systematic review following the PRISMA guidelines was performed across the databases PubMed, Science Direct, Scopus, Cochrane, Lilacs, and Google Scholar. The review was registered on Prospero under the number CRD42024581951. A total of 947 articles were screened, from which 10 were included in this systematic review. For Group A, the 5 cohorts found a MRONJ incidence of 0,93% (IC[1,3%-3,4%]) at a mean follow-up of 15 months. For Group B, the 3 cohorts identified clinical improvement for all lesions, with complete healing rates reaching up to 91.67% (IC[54.57%-68.34%]). The 3 non-randomized studies found a significant difference favoring photobiomodulation for clinical improvement, but only 2 studies reported a significant difference for complete healing. The studies presented various clinical application protocols, yet converged on the use of a laser with a wavelength greater than 980 nanometers, continuous emission, single-point application, over 8 sessions, with a session duration of 5 min. No adverse effects were reported. Photobiomodulation may reduce the incidence of MRONJ following tooth avulsions, and could improve their treatment (decreasing treatment time and improving prognosis). Further randomized, double-blind, studies are necessary to consolidate these results.

Onychomycosis is a persistent nail infection often caused by dermatophytes or yeasts, with conventional treatments limited by long durations, poor compliance, and resistance. The long-pulsed Nd: YAG 1064 nm laser (NDYL) has emerged as a potential adjunct; however, its effects in combination with antifungals against yeast-related cases are unclear. This study examined the in vitro synergistic effect of NDYL with four antifungal agents-Ketoconazole (KET), Itraconazole (ITK), Voriconazole (VRC), and Terbinafine(TRB)-on clinical yeasts isolates from patients with onychomycosis. Yeast isolates were identified through ITS PCR sequencing. Susceptibility testing was conducted using the CLSI disk diffusion method (document M44-A2). Two experimental series-vital nail scrapings and cultured colonies-were exposed to standardized NDYL laser parameters. Antifungal activity was assessed by measuring inhibition zone diameters, and statistical comparisons were performed using paired t-tests. NDYL significantly enhanced antifungal activity, with the most pronounced effects observed for KET and ITC (p < 0.05). KET achieved up to 100% sensitivity improvement in nail scraping samples. VRC and TRB demonstrated moderate but consistent enhancements. Recorded irradiation temperatures remained below 42 °C, suggesting primarily non-thermal mechanisms. The relative frequencies of increased inhibition zone diameters in nail scrapings, yeast colonies, and combined datasets were: ITC (83.3%, 50.0%, 66.7%), VRC (66.7%, 50.0%, 58.3%), TRB (33.3%, 16.7%, 25.0%), and KET (100%, 66.7%, 83.3%). These findings support NDYL as a potential adjunctive tool for enhancing antifungal efficacy in yeast-associated onychomycosis. Further in vivo research is warranted to confirm clinical applicability and refine treatment protocols.

Objective: This in vitro study compared the efficacy of Er, Cr: YSGG laser (2780 nm), diode laser (976 nm), passive ultrasonic irrigation (PUI), and conventional syringe-needle (CSN) irrigation in smear layer removal, evaluating irrigant chemistry and root canal level.

Methods: 160 single-rooted premolars were instrumented and divided into four irrigation groups (n = 40/group): Er, Cr: YSGG (25 mJ, 50 Hz, radial-firing tip), diode laser (Pulsed 50%, 1.5 W), PUI, and CSN (side-vented needle). Groups were subdivided by irrigant (NaOCl + EDTA, EDTA, NaOCl, saline; n = 10/subgroup). Activation involved four 15-second cycles. Smear layer was scored (1-5) via SEM by blinded evaluators. Data were analyzed with Kruskal-Wallis and Mann-Whitney tests (p ≤ 0.05).

Results: Er, Cr: YSGG achieved the lowest scores (best cleaning) across all thirds, outperforming diode laser, PUI, and CSN. NaOCl + EDTA was the most effective irrigant (p < 0.05). Remarkably, saline with Er, Cr: YSGG surpassed NaOCl alone. Apical thirds showed consistently poorer removal.

Conclusion: Er, Cr: YSGG laser activation with NaOCl + EDTA is the most effective protocol for smear layer removal. The powerful mechanical effects of Er, Cr: YSGG dominated when using saline. Diode laser activation also surpassed PUI.

Background and aims: Primary localized cutaneous amyloidosis (PLCA) is a persistent dermatological disorder characterized by the accumulation of amyloid deposits within the dermal papillae, resulting in pigmentation alterations, pruritus, and textural modifications of the skin. Given the lack of a standardized treatment for this condition, this review aims to evaluate the efficacy and safety of various procedural modalities for PLCA management.

Methods: PubMed/Medline, Scopus, and Web of Science were systematically searched until August 25th, 2024. The study selection was restricted to English-language clinical studies, excluding case reports and case series. Our study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews and meta-analyses.

Results: Based on our inclusion criteria, 16 studies with 432 patients were included, assessing fractional CO₂ laser, Nd: YAG laser, Er: YAG laser, microneedling, and phototherapy for PLCA treatment. Fractional CO₂ laser effectively improved pigmentation and pruritus, especially when combined with corticosteroids or vitamin C. Nd: YAG and Er: YAG lasers demonstrated favorable outcomes, with combination therapies enhancing efficacy. Microneedling and phototherapy (PUVA/UVB) also showed benefits, with PUVA being superior for pruritus.

Conclusion: Fractional CO₂ laser, especially with corticosteroids or vitamin C, showed the most effective results for pigmentation, pruritus, and amyloid reduction in PLCA. Nd: YAG and Erbium lasers, microneedling, and phototherapy also demonstrated benefits. However, further comparative clinical trials are needed to determine the most effective approach and establish standardized treatment protocols.

Frozen shoulder (adhesive capsulitis) is a debilitating condition characterized by progressive shoulder pain and restricted range of motion. Photobiomodulation (PBM) therapy, using a 650 nm diode laser, has emerged as a promising non-invasive treatment modality. To investigate the physiological mechanisms and therapeutic efficacy of 650 nm diode laser photobiomodulation in treating frozen shoulder. A comprehensive review of the current literature on PBM mechanisms, cellular responses, and clinical applications in the treatment of frozen shoulder was conducted. Focus was placed on 650 nm wavelength therapeutic protocols and outcomes. PBM at 650 nm wavelength demonstrates significant therapeutic effects through mitochondrial cytochrome c oxidase activation, leading to increased ATP production, reduced inflammatory mediators, enhanced collagen synthesis, and improved tissue repair mechanisms. Clinical studies have shown significant pain reduction, improved range of motion, and accelerated functional recovery in patients with frozen shoulder. 650 nm diode laser PBM therapy represents an effective, non-invasive treatment option for frozen shoulder through well-established cellular and molecular mechanisms that promote tissue healing and pain resolution.