Lasers in Medical Science最新文献

Comparative data regarding the effectiveness of the 1064-nm Nd: YAG picosecond laser with fractional micro-lens array (P-MLA) versus traditional electro-optical synergy (ELOS) for treating post-acne erythema (PAE) are limited. Therefore, we aimed to compare the efficacy and safety of P-MLA and ELOS in the treatment of PAE. This prospective, randomized, split-face trial enrolled 20 patients with PAE, primarily of darker skin tones (Fitzpatrick skin types III-VI). Patients were randomly assigned to receive P-MLA treatment on one side of the face, and ELOS treatment on the other side. Three treatments were administered at 4-week intervals, with follow-up conducted at weeks 0, 4, 8, and 12. Standardized photographs were obtained using the VISIA system. Efficacy was assessed based on improvements in PAE lesion counts, clinical erythema assessment, VISIA skin analysis data, and patient-reported satisfaction. Adverse events were recorded. Both the P-MLA and ELOS groups showed significant reductions in erythema, with the P-MLA group demonstrating a notably greater decrease in PAE lesion counts and a higher clinical response rate at week 12 than the ELOS group. VISIA analysis revealed a greater reduction in red zone scores for the P-MLA group, alongside significant improvements in wrinkles and pigmentation. Patient satisfaction scores were comparable between the two groups, with an overall satisfaction rate of 94.74%. Adverse events, including erythema duration, edema, and pain, were similar across both groups, with no serious complications observed. P-MLA demonstrates superior efficacy and lower risk of adverse effects than ELOS in PAE treatment among Asian patients.

One of the formidable challenges that may emerge in patients with breast cancer is drug resistance which is highly correlated with failure in cancer therapy and, as a result, poorer prognosis. Thus, developing novel approaches to overcome this undesirable event has always been a hot topic in the field of cancer. Photobiomodulation (PBM), also known as low-level laser therapy, is one such approach that has recently been introduced as a promising modality in clinical settings with interesting anti-tumor properties. Moreover, PBM has been considered a possible candidate to be employed in conjunction with conventional modalities such as chemotherapy. The present study investigated the potential effects of PBM at two wavelengths of 630 nm and 980 nm on chemoresistance in breast cancer MDA-MB-231 cells, which previously acquired resistance to doxorubicin (DOX) through 12 passages. Findings proposed that PBM, in conjunction with DOX, led to a reduction in the viability of resistant MDA-MB 231 cells as was evidenced by decreased IC₅₀ values of DOX across different groups. Furthermore, gene expression studies demonstrated that PBM inhibited the overexpression of some of the important resistance-related genes, including SOX9, MDR1, NRF2, TGF-β, and ABCC1. Although both wavelengths had considerable efficiency, at 630 nm, PBM performed better in overcoming DOX resistance. Overall, the present study suggests that PBM might play a promising role against breast cancer via reducing chemoresistance which, indeed, necessitates further research to better understand its mechanisms and clinical potential for translation.

The gut microbiota is known to interact with various organs in the body, including the central nervous system, through the gut-brain axis. Intestinal dysbiosis can lead to increased peripheral inflammation and, consequently, affect the brain, resulting in neuroinflammation. Photobiomodulation (PBM) has demonstrated positive regulatory effects on the imbalance of certain body functions, including pain, inflammation, immunity, wound healing, and gut microbiota dysbiosis. Therefore, PBM at the intestinal level could help improve intestinal dysbiosis and reestablish cerebral homeostasis. In this context, this study aimed to conduct a narrative review of the literature on the effects of PBM at the intestinal level on intestinal dysbiosis and neuroinflammation. Overall, the findings highlight that PBM modulates the gut microbiota, suggesting it could serve as a therapy for neurological conditions affecting the gut-brain axis. Future research should focus on further elucidating the molecular mechanisms underlying this therapy.

This randomized clinical trial aimed to evaluate the effect of selective caries removal in deep Class I cavities in posterior teeth followed or not by photobiomodulation (PBM) therapy at two different wavelengths on postoperative sensitivity. Baseline spontaneous and stimulated sensitivity scores of 33 vital permanent molars were determined by the participants using a numeric rating scale. The teeth had their affected dentine preserved and were randomly allocated into three groups (n = 11): selective removal of infected dentine (control), selective removal of infected dentine followed by infrared (IR; 810 nm) or red (R; 660 nm) laser irradiation. The teeth were restored with a two-step self-etch adhesive and nanoparticle composite layers, and followed by laser irradiation only for IR and R groups. Both spontaneous and stimulated sensitivity were recorded after 12 h, 7 days, and 14 days. Data were statistically analyzed by Kruskal-Wallis, Friedman, and Wilcoxon tests (p < 0.05). The pulp of all teeth positively responded to cold a stimulus. The control group presented a significant increase in spontaneous sensitivity at 12 h (p < 0.05), which decreased to the preoperative level after 14 days. In both IR and R groups, the sensitivity levels remained stable over time (p > 0.05). At both 7- and 14-day follow-ups, the spontaneous sensitivity for the IR group was significantly lower than the other groups (p < 0.05). In addition to preserving tooth sensitivity, selective deep caries removal can be associated with R or IR to respectively attenuate or completely resolve postoperative sensitivity within one week.

The aim of this study is to evaluate the safety parameters of diode laser (DL) therapy on treating recurrent aphthous ulcer (RAU). We conducted a systematic review in accordance with the PRISMA guidelines. Studies from PubMed, Embase, WOS, Cochrane, Google Scholar, CNKI, Wanfang Data and VIP were searched by hand. The search terms encompassed both Medical Subject Headings terms (Stomatitis, aphthous; Lasers, semiconductor) and their corresponding text words. The meta-analysis was performed using Review Manager 5.4. 16 studies were included in this review with no high-risk studies and no significant publication bias. In this review, we found DL therapy was more effective than medication or placebo in reducing Visual Analog Scale (MD = 2.79, 95% CI: 1.40 to 4.17, P < 0.0001), shrinking ulcer size (MD = 2.62, 95% CI: 1.15 to 4.09, P = 0.0005) and accelerating healing time (MD = -3.72, 95% CI: -4.86 to -2.59, P < 0.00001). Moreover, subgroup analyses demonstrated that DL therapy effectively alleviated immediate pain in patients (MD = 2.88, 95% CI: 1.53 to 4.23, P < 0.0001), and a single exposure significantly shortened the healing time of RAU (MD = -4.20, 95% CI: -5.76 to -2.64, P < 0.00001). DL therapy is an effective treatment for RAU without any adverse effects. A single session (or two) with low-energy density irradiation significantly alleviates RAU symptoms. Consequently, there is no need to pursue longer durations and higher parameters of DL therapy, which also aligns with the economic interests of patients. RAU is typically painful and can impair quality of life. Suitable DL therapy represents a promising strategy.

Verrucous venous malformation (VVM) is a rare vascular malformation with hyperkeratosis. Concomitant laser and surgery are first line treatments, but evidence establishing efficacy is limited. We assess the efficacy of laser alone for VVM. Retrospective analysis of patients receiving laser treatment for VVM between 1994-2023. Of 83 patients, 29 were excluded due to missing data, 7 due to concomitant surgical excision and 47 were evaluated. Pulse dye laser (PDL) and combined dual PDL-neodymium-doped yttrium aluminium garnet (PDL-Nd:YAG) lasers were used. Outcomes were difference in percentage surface area (SA) reduction and colour improvement after laser treatment. Two blinded healthcare professionals independently graded the VVMs. Tools used included a numerically graded colour chart, and a 10 × 10 surface area grid to assess pre/post photos printed to the same scale. Mean Joules delivered with PDL; 9.29 and PDL-Nd:YAG; 9.16. Spot size (mm) for PDL; 8.58 and PDL-Nd:YAG; 9.63. Mean number of treatments was 5.27 and 3.68 in red and purple lesions respectively. Mean SA reduction for red and purple lesions; PDL; 71.11% and 6.67%, and PDL-Nd:YAG; 54.30% and 32.35%. Mean colour improvement in red and purple; PDL; 53.13% and 8.59%, and PDL-Nd:YAG; 46.88% and 40.81%. Red responded better than purple (p = 0.0014 and p = 0.024), for SA and colour respectively. There was no statistical significance in better outcomes; age at first treatment or number of treatments. Laser alone is an effective non-invasive method for improvement of colour and SA. Red lesions responded better to laser. PDL-Nd:YAG laser is preferred in purple lesions.

In this study, we aimed to investigate the efficacy and safety of combined fractional carbon dioxide laser and topical timolol maleate 0.5% solution versus topical timolol maleate 0.5% solution alone in inflammatory acne. Thirty adult patients with inflammatory facial acne were randomized in this study. The patients received 3 biweekly sessions of fractional CO2 laser on one side of the face followed by topical timolol maleate ophthalmic solution 0.5% once daily for 7 days on both sides. Outcome was evaluated 2 weeks after the first session, 2 weeks after the last session, and 1 month after the last session by lesion count, erythema, hyperpigmentation, qualitative global scarring grading, and patients' satisfaction. Side effects were also evaluated. Trial registration (IRB No. 417, 30/10/2023). At 2 weeks after the first session, there were insignificant differences between both sides regarding lesion count, erythema, hyperpigmentation, and qualitative global scarring grading (p value = 0.8, 0.05, 0.7, 0.1 respectively). At 2 weeks after the last session, the erythema on the combined side was reduced by a mean of 0.2 ± 0.4 SD compared to timolol only side with significant difference between both sides (p value = 0.03), while there were insignificant differences between both sides regarding lesion count, hyperpigmentation, qualitative global scarring grading, and patients' satisfaction (p value = 0.1, 0.5, 0.8, 0.3 respectively). Recurrence was detected at one month after the last session. No side effects were reported. Combined fractional CO2 laser and topical timolol maleate 0.5% solution were significantly more effective than topical timolol maleate 0.5% solution alone in reduction of erythema of inflammatory facial acne in adolescent men with Fitzpatrick's skin type III-IV at 2 weeks after 3 biweekly sessions with insignificant differences between both sides regarding lesion count, hyperpigmentation, qualitative global scarring grading, and patients' satisfaction. Further and larger studies are still needed.

The purpose of this study was to compare the penetration of methylene blue (MB) dye after laser irradiation using PIPS (photon-induced photoacoustic streaming) and SWEEPS (shockwave enhanced emission photoacoustic streaming) methods compared to Passive ultrasonic irrigation (PUI) and to study their effect on dentin microhardness. A total of 44 single-rooted human teeth which were extracted for orthodontic or periodontal reasons were used. The teeth were decapitated to standardize roots to 12 mm in length. Canals were prepared up to size #30.6% and divided randomly into four groups (n = 11/group) according to the method of NaOCl activation: Group I: Er: YAG laser activation with PIPS tip; Group II: Er: YAG laser activation with SWEEPS tip; Group III: passive ultrasonic irrigation (PUI) and Group IV: conventional needle irrigation (CI). MB dye was injected then teeth were sectioned horizontally into coronal, middle and apical sections. Penetration depth/area percentages were measured using stereomicroscopy. Coronal specimens were further subjected to Vickers microhardness testing. Data were statistically analyzed. SWEEPS and PIPS activation methods provided higher dye penetration depth and area percentages compared to PUI with no statistically significant differences between all test groups. However, all test groups showed statistically significant differences with the CI (control) group. SWEEPS activation provided higher microhardness values with statistically significant differences with the other groups. Laser irrigant activation using PIPS and SWEEPS is comparable to PUI concerning MB dye penetration. However, SWEEPS preserved dentin microhardness significantly which can be beneficial for the long-term prognosis of root canal treated teeth.

The photobiomodulation therapy (PBMT) is promising additional therapy in the treatment of temporomandibular disorder (TMD). In this regard, the purpose of this narrative review is to give a wide-ranging, objective, and judicious view of the current knowledge on PBMT as an additional TMD treatment modality, with summarised updated information. Although the results of most research studies report improvement of pain in TMD patients, some state that sustainability of absence of pain after PBMT of TMD is of concern. There has been a recent surge in research around the application of lasers for the management of TMD. Nonetheless, the scarcity of scientific clinical studies with structured laser parameters makes it difficult to draw a more concrete conclusion whether lasers in the treatment of TMD are more effective than traditional TMD treatments. In conclusion, since PBMT is becoming an additional treatment of choice for the management of TMD there is a need for more research especially involving clinical studies with better structured laser parameters.