Photobiomodulation, photomedicine, and laser surgery最新文献

Background and Objective: Breast cancer (BC) is one of the most common cancers among women, with a high potential for metastasis. The epithelial-mesenchymal transition (EMT) is crucial in the invasion and metastasis of cancer cells. This research was designed to examine the efficacy of photobiomodulation therapy in combination with celecoxib in inhibiting the EMT process. We also analyzed the changes in the expression of E-cadherin, N-cadherin, and α-SMA genes in BC cell lines MCF-7 and MDA-MB-231. Material and Methods: In this study, the IC₅₀ of celecoxib was first determined using the 3-(4,5-dimethylthiazol-2-yl)2,5-diphenyltetrazolium bromide assay for both cell lines. The cells were then treated with celecoxib, laser irradiation, and their combination. A migration assay was performed to evaluate the cell migration. Real-time polymerase chain reaction also assessed the changes in the expression of the abovementioned genes. Results: A combination of celecoxib and laser therapy significantly reduced the migration of cancer cells. Additionally, the potentiated effect of the combined therapy altered the expression levels of the aforementioned genes, indicating the potential role of the combination treatment in regulating EMT. Conclusions: Our research discloses that combining laser therapy with celecoxib could serve as an effective therapeutic approach to inhibit BC invasion and metastasis by targeting the EMT process and decelerating disease progression. Further investigations are essential to validate these results in clinical environments.

Objective: This interventional prospective double-blind randomized study investigated the adjunctive inflammation-modulatory effects of photobiomodulation therapy on the periodontal clinical parameters of patients undergoing chemotherapy. Methods: Twenty diagnosed patients with cancer were enrolled in this split-mouth trial. Patients were randomized to implantation with either SRP alone in one quadrant or with five sessions of adjunctive photobiomodulation using a diode laser (density of energy = 2 J/cm² | wavelength = 635 nm | power = 50 mW | spot diameter = 4 mm | exposure time = 5 s | continuous mode) on the other quadrant. The gingiva was radiated buccally and lingually. The laser beam was positioned 3 mm vertically away from the gingival surface and at a right angle to it. Before chemotherapy, all participants were given oral hygiene training and received SRP. In the same session, the patient's baseline clinical measures were taken immediately after the beginning of one chemotherapy session, interventions for each side were started and clinical parameters including gingival index (GI), plaque index (PI), clinical attachment level (CAL), and pain/burning sensation after one chemotherapy session were obtained. Results: Regarding GI and PI, both control and test groups showed favorable results compared with baseline. However, the adjunctive photobiomodulation group outperformed the control group in one chemotherapy session regarding both abovementioned indices (p < 0.05). The photobiomodulation+scaling and root planing (SRP) group showed promising results in terms of gingival discomfort reduction and SRP alone was not effective. No significant effect was observed regarding CAL in both groups (p > 0.05). Conclusion: Based on the results of this study, it can be concluded that photobiomodulation promotes gingival health and reduces PI and GI indices. Photobiomodulation also alleviates pain or burning in the gingiva. Accordingly, adjunctive photobiomodulation therapy may be suggested as a supplementary treatment in patients with cancer.

Objectives: This split-mouth randomized controlled clinical trial aimed to evaluate the efficacy of diode laser therapy as an adjunct to scaling and root planning (SRP) in the management of patients with stage II grade A periodontitis. Methods: Thirty participants were randomly assigned to receive either SRP alone (control group) or SRP and diode laser application (study group) on the contralateral side. Clinical parameters (plaque index, gingival index, probing depth, and clinical attachment level) and microbiological markers; Aggregatibacter actinomycetemcomitans (A actinomycetemcomitans), Porphyromonas gingivalis (P gingivalis), and Fusobacterium nucleatum (F nucleatum) were evaluated at baseline and at 4, 8, and 12 weeks post-treatment. Results: Both groups reported significant improvements in all clinical parameters over the follow-up period. The study group reported a significantly higher reduction in probing depth at 12 weeks than the SRP-alone group. Microbiological evaluation revealed significantly greater reductions in P gingivalis and F. nucleatum levels in the study group at later time points, whereas no significant alterations were observed for A actinomycetemcomitans. Conclusions: Our results suggest that the adjunctive use of diode laser therapy may improve the clinical and microbiological findings of nonsurgical periodontal management in patients with stage II grade A periodontitis.

Purpose: The study's main objective was to assess the efficacy and safety of TANIT, a platform combining functional dermal stimulation with damped bioactive current and mechanical stimulation to reduce adipose tissue (AT) in patients with stage I (SI) or II (SII) lipedema. Methods: A single-center, before-after clinical trial without a control group was conducted on adult women diagnosed with SI or SII lipedema. Patients underwent a treatment protocol for 5 weeks, with weekly sessions. Blood tests, AT thickness, pain threshold, and anthropometric measurements were assessed at baseline and the end of the study, and a satisfaction survey was conducted after treatment. Results: Twenty-three women were enrolled with a mean age of 44.91 (standard deviation 11.58) and a median of 46.00 (Q25 = 36.50, Q75 = 51.50). Seven (30.4%) patients had SI lipedema and 16 (69.6%) had SII. The pain threshold increased in 78.3% of patients at the knee level and 80.0% at the ankle level. Lower limb volume decreased in 78.3% of patients. AT thickness decreased in all treated areas, with a mean decrease of 26.1% at the ankles, 14.5% at the knees, and 17.4% at the trochanter level. Patients reported high satisfaction with the results obtained after the treatment sessions, and no unexpected adverse effects were found. Conclusions: The TANIT platform provided an effective and safe conservative treatment option for patients with S and SII lipedema, reducing leg volume, AT thickness, and pain. However, additional randomized clinical trials and standardized assessment tools would be necessary.

Background: Melasma therapy can be difficult and requires employing different treatment approaches. Laser therapy is a good alternative for treating melasma, especially for patients with refractory cases. Objective: To evaluate the efficacy and safety of newcomer wavelength 675 nm diode laser in treating melasma in darker skin types. Methods: Nineteen female patients with facial melasma were recruited. They received four sessions of 675 nm laser at one-month intervals using the following parameters: power 5-6 W, pulse duration 100-150 ms, spacing 2000 mm, and stack one up to 4 passes. One month after the last treatment session, the evaluation was done subjectively through the modified melasma area and severity index (mMASI) score and objectively using the Antera 3D camera. Results: After treatment, there was a highly statistically significant reduction in mMASI scores. In addition, the scores on the Antera camera recorded highly statistically significant differences in the treated areas' melanin and hemoglobin average levels. Conclusion: The novel 675 nm laser represents a safe and efficient approach in treating melasma in darker phototype patients.

Background: The evaluation of the effect of laser in disinfection of root canal in pulp regenerative therapy, if found effective laser can be used for root canal disinfection in cases of regenerative endodontic therapy. Objective: This study includes a systematic review addressing the question of whether laser is effective in root canal treatment in regenerative endodontic therapy. Methods: Randomized controlled trials (RCTs), case series, and animal studies evaluating the effect of laser-assisted endodontic irrigation in pulp regenerative therapy were included. Review articles, case reports, and in vitro studies were excluded. The data search covers all publications without limitation by year. The last search was conducted on December 31, 2023. An electronic search was performed using the following databases: PubMed, Cochrane Library, and Google Scholar. The result of this review was in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Assessment of risk of bias was done using the modified Cochrane Risk of Bias Tool. Results: The initial search resulted in 749 articles. Eleven duplicate articles were removed. Following the titles and abstracts screening, 11 articles were identified to form the basis of this systematic review. Three articles were excluded as full text was unavailable. Overall, eight studies evaluated the laser effect in root canal disinfection in pulp regenerative therapy, which were included in this systematic review. Of the included studies, a low risk of bias was shown by 7/8 studies, and a moderate risk of bias was shown by 1/8 studies. Conclusion: Laser can be used for root canal disinfection in cases of regenerative endodontic therapy. There is a need for further RCTs about individual laser groups and their disinfection effect on regenerative endodontic therapy for obtaining a higher level of evidence.

Background: Total knee arthroplasty (TKA) is commonly performed for severe osteoarthritis but often results in significant postoperative swelling and discomfort, impacting early rehabilitation. Photobiomodulation therapy (PBMT), utilizing low-level laser therapy (LLLT), has emerged as a potential adjunctive treatment to alleviate these symptoms. Methods: In this single-center, nonblinded prospective randomized clinical trial, conducted from May to July 2024, 30 patients undergoing primary TKA were enrolled and divided into two groups. Fifteen patients formed the control group receiving standard postoperative care, while the intervention group consisted of another 15 patients who received additional PBMT from the first to the fifth postoperative day (POD). The swelling was assessed using bioimpedance analysis, which offers a noninvasive, safe, and efficient method for assessing postoperative swelling by measuring tissue impedance, and functional outcomes were measured using the 2-min walk test (2MWT) and active range of motion (aROM). The study was registered with ClinicalTrials.gov (NCT06426251). Results: The PBMT group demonstrated significantly lower impedance, reactance, and phase angle ratios by POD6, suggesting reduced swelling compared to the control group. In the 2MWT, the PBMT group achieved a longer walking distance of 27 m, compared to 16 m in the control group. However, there were no significant differences in aROM or Visual Analogue Scale (VAS) pain scores between the groups. Conclusions: The findings indicate that PBMT effectively reduces postoperative swelling and enhances early mobility post-TKA. These benefits suggest that PBMT can be a valuable addition to conventional postoperative care, potentially accelerating functional recovery, and reducing rehabilitation time.

Background: Photobiomodulation (PBM) is a technology that has gained much attention in recent years regarding its potential application for stimulating wound healing, alleviating pain, reducing inflammation, and aiding in the restoration of function. Due to a scarcity of evidence in the literature regarding PBM for the treatment of burns, our objective of this study was to test whether treatment with PBM in hospitalized patients with second-degree burns accelerated recovery. Methods: A double-blind controlled study was conducted on nine patients with up to 15% second-degree burns who were hospitalized at Hadassah-Hebrew University Medical Center, Ein Kerem Campus, Jerusalem Israel, between July 2022 and November 2022. Each patient recruited for the study received PBM treatment on part of the burn area (approximately 10%-20% of the burn area), while the control group was the burn area of the same patient treated only with the usual non-PBM. Treatment parameters were light emitting diode surface including continuous and/or pulsed red (660 nm) and near-infrared (840 nm), 5-16 mW/cm², 2.4-7.7 J/cm² per treatment session. Results: Patients received three to five treatments with a mean epithelization time of 16 days (±2.89 standard deviation [SD]) in the control area, while only 7.56 (±2.29 SD) in the treatment area. The mean percent reduction in healing time was 46.22% (±4.24 SD), which was found to be statistically significant (p = 0.004). Conclusion: Our study demonstrated a statistically significant acceleration of healing in second-degree burns following treatment with PBM for the treatment of burns in patients. However, further studies are needed to determine if these results translate to a reduction in hospitalization time and medical care costs.

Background: Previous case reports hint ultraviolet A1 (UVA1) phototherapy as a novel adjunct treatment for acute cutaneous inflammations and neuralgia of herpes zoster, but its clinical effectiveness and safety in this condition are not yet proven by clinical trials. Objectives: To determine the efficacy and safety of UVA1 phototherapy as an adjunct treatment for acute inflammation and neuralgia in herpes zoster. Methods: A total of 60 patients with moderate-to-severe acute herpes zoster were randomly divided into two parallel groups. Group I received regular treatment and UVA1, and Group II received regular treatment alone. Time of blister crusting and acute erythema subside, assessment of pain, sleep, anxiety, and quality of life were recorded accordingly. Results: In Groups I and II, 28 and 29 patients completed the treatment and follow-up, respectively, with no significant demographic or baseline differences. UVA1 therapy notably reduced blister crusting time and acute erythema subside time and achieved more rapid pain relief within the first 2 weeks. However, it did not significantly alter the rate of postherpetic neuralgia occurrence. Additionally, UVA1 therapy significantly improved anxiety and quality of life scores at the 2-week mark. The primary adverse effects were mild burning and hyperpigmentation at the treatment site. Conclusions: UVA1 phototherapy as an adjunct treatment can expedite the resolution of acute inflammatory cutaneous lesions and neuralgia associated with herpes zoster, providing swifter relief from anxiety and enhancing patient quality of life during the acute phase, with demonstrated good tolerability and safety.

Objective: This study was conducted to investigate whether the addition of photobiomodulation therapy (PBMT) to pelvic floor exercises (PFEs) is more effective in treating postpartum coccydynia compared with either modality alone. Background: Postpartum coccydynia is a widespread condition that significantly affects the quality of life. Inflammation as a response to childbirth trauma and weakening of the muscles and ligaments attached to the coccyx are presumed causes of postpartum coccydynia. Finding effective modalities to manage this condition will help the quality of life for most women. Methods: Sixty women aged 25-35 years with postpartum coccydynia ≥6 weeks were randomly allocated to Group A (PBMT + hot pack + PFEs), Group B (PBMT + hot pack), and Group C (placebo PBMT + hot pack + PFEs). All groups received 12 sessions over 4 weeks of hot packs plus their allocated active treatment (PBMT and/or PFEs). Outcomes were pain intensity (visual analog scale), lumbar flexion range of motion (ROM) (modified Schober test), and self-reported disability (Oswestry Disability Index). The assessors were blinded to group allocation. Results: All the measured outcomes showed significant differences (p < 0.001), with the superiority of Group A over the other groups (p < 0.001). Within groups, all groups showed statistically significant improvement from baseline across outcomes (p < 0.05). Conclusions: Adding PBMT to PFEs is recommended in the management of postpartum coccydynia as this combination resulted in greater reductions in pain and disability, along with improved lumbar flexion ROM.