Photobiomodulation, photomedicine, and laser surgery最新文献

Background: Rheumatoid arthritis (RA) is a persistent inflammatory condition that results in joint deterioration and impairment. A noninvasive treatment option that has shown promise is photobiomodulation therapy (PBMT), but the optimal energy density for RA management is not well established.

Objective: This study aims to assess the therapeutic efficacy of PBMT utilizing varying energy densities on RA in male rats, in comparison with methotrexate treatment.

Methods: A case-control study was conducted on 48 male rats randomly assigned to six groups: Group I is the negative control, Group II is the RA positive control, Group III is the RA + PBMT 36 J/cm², Group IV is the RA + PBMT 54 J/cm², Group V is the RA + PBMT 72 J/cm², and Group VI is the RA plus methotrexate. RA was induced in all groups except Group I. Treatments were applied over a defined period. Outcomes included paw thickness and biochemical markers: superoxide dismutase (SOD), interleukin-6 (IL-6), interleukin-1β (IL-1β), malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-α), and rheumatoid factor.

Results: All PBMT-treated groups showed significant reductions in paw thickness, and pro-inflammatory indicators were compared with the RA positive control (p < 0.05). PBMT at 54 J/cm² (Group IV) demonstrated the most pronounced anti-inflammatory effect, comparable with methotrexate. Oxidative stress marker MDA decreased significantly, while SOD levels increased in all PBMT groups, particularly in Group IV.

Conclusion: PBMT at an energy density of 54 J/cm² appears optimal in mitigating inflammation and oxidative stress in RA, providing a potential non-pharmacologic adjunct to conventional therapy.

Aim: To investigate the impact of different post space sterilants, namely methylene blue (MB) photosensitizer (PS)-loaded chitosan nanoparticles (CHNPs), sepiolite nanoparticles (SepNPs), and Er, Cr: YSGG laser (ECL), on the smear layer (SL) removal and push-out bond strength (PBS) of glass fiber posts (GFPs) to canal dentin.

Methods: A total of 52 single-rooted premolars were carefully selected, crowns were decoronated, and endodontic therapy was performed; subsequently, the samples were prepared for post space utilizing Gates-Glidden instruments. The specimens were categorized into four cohorts based on the disinfection regime (n = 13): Group 1: 2.5% NaOCl + ethylenediamine tetraacetic acid (EDTA), Group 2: MB-CHNPs-PDT + EDTA, Group 3: MB-SepNPs-PDT + EDTA, and Group 4: ECL + EDTA. SL removal analysis and PS-loaded nanoparticle characterization were executed using scanning electron microscopy. Self-cure resin cement was used for bonding GFP, followed by thermocycling. The evaluation of bond strength and the analysis of the fracture mode were conducted utilizing a universal testing machine and stereomicroscope, respectively. Data analysis was conducted using Analysis of Variance (ANOVA) and a post hoc test (p < 0.05).

Result: The cervical section of Group 2 (MB-CHNPs-PDT + EDTA) test specimens displayed the maximum cleaning of SL (1.22 ± 0.23) and the highest PBS (11.23 ± 0.12 MPa). However, the apical third of Group 1 (MB-SepNPs-PDT + EDTA) reported minimum SL removal (4.53 ± 0.17) and the lowest bond strength (6.65 ± 0.13 MP). Group 1 (2.5% NaOCl + EDTA) and Group 4 (ECL + EDTA) presented no significant variation in SL elimination and PBS of GFP.

Conclusion: Using EDTA co-application, the MB-loaded CHNP protocol was associated with lower smear layer scores and higher PBS compared with the other tested groups.

Background: Laser-assisted irrigation may enhance chemomechanical debridement and improve the sealing of root canals during endodontic treatment.

Objective: This study aimed to address the scientific deficit in understanding the laser-assisted sequential versus continuous chelation in root canal irrigation.

Methods: One hundred and twenty single-rooted teeth were prepared using Reciproc R40 instruments and randomly divided into six groups (n = 20) based on the irrigation protocol. In the sequential chelation groups, canals were irrigated with NaOCl during instrumentation, followed by 17% ethylenediaminetetraacetic acid using a needle, ultrasound, or erbium-doped yttrium aluminum garnet laser activation. In the continuous chelation groups, canals were irrigated with a mixture of 2% sodium hypochlorite and 9% hydroxyethylidene diphosphonic acid during and after instrumentation, followed by final activation using the same three techniques. Ten samples per group were used to evaluate sealer penetration with Fluo-3 dye, while the remaining samples underwent push-out bond strength testing. Statistical analyses were conducted using the Kruskal-Wallis and Friedman tests (p < 0.05).

Results: No significant differences in sealer penetration were found between sequential and continuous protocols in the apical third when needle or ultrasonic activation was used. However, laser activation combined with continuous chelation resulted in significantly higher sealer penetration and bond strength (p < 0.001). Sealer penetration followed the trend: coronal > middle > apical (p < 0.05) with all irrigation techniques.

Conclusions: Continuous chelation protocols, especially when combined with laser activation, were as effective or superior to conventional methods in improving sealer penetration and bond strength. Continuous chelation with laser-assisted irrigation may improve clinical efficiency and shorten treatment time in root canal procedures.

Background and aim: Hypertrophic scars (HTs) pose challenges in aesthetic management and patient satisfaction. Conventional treatments such as corticosteroid injections and silicone gels often show limited efficacy on the vascular component. Rhodamine-based intense pulsed light (IPL) targets vascular tissues selectively, offering a potential noninvasive solution. The study aims to evaluate the efficacy and safety of rhodamine-based IPL in treating HTs with a prominent vascular component, using clinical photography, dynamic optical coherence tomography (D-OCT), and patient-reported outcomes.

Methods: A retrospective analysis was conducted on 12 patients with persistent HTs characterized by a prominent vascular component. Each patient received two IPL treatments at 20-day intervals using a rhodamine-based IPL device. Outcomes were assessed through digital photography and D-OCT imaging to quantify changes in vascular and structural characteristics. The Vancouver Scar Scale was used for clinical assessment. Patient satisfaction was evaluated using the Aesthetic Numeric Analogue (ANA) scale, and adverse effects were documented at each visit.

Results: Most patients demonstrated clinical and instrumental improvements. Digital photography and D-OCT data indicated significant reductions in erythema, vessel diameter, and vessel density. Clinical observers reported good to excellent improvements in 10 out of 12 patients. ANA scores showed increased patient satisfaction. Mild, transient erythema was observed in some patients, with no severe adverse effects reported.

Conclusion: Rhodamine-based IPL therapy is a safe, effective treatment for HTs with prominent vascular components, reducing vascularization and improving scar texture and appearance. Despite the small sample size, these findings support further exploration of rhodamine-based IPL as a targeted noninvasive therapy in HT management.

Aim: Tumor-associated macrophages (TAMs) constitute a major component of the tumor microenvironment (TME) and are frequently skewed toward an M2-like phenotype that promotes immune suppression, angiogenesis, and tumor progression.

Objectives: Reprogramming these macrophages into an M1-like, pro-inflammatory state has emerged as a promising strategy to reinvigorate antitumor immunity and enhance the efficacy of immunotherapeutic interventions. Photobiomodulation (PBM), a non-invasive therapeutic modality utilizing low-intensity red to near-infrared light (600-1100 nm), has shown growing potential in immunomodulation through its effects on mitochondrial bioenergetics, redox signaling, and transcriptional regulation.

Materials and methods: This review presents a comprehensive analysis of the molecular mechanisms by which PBM influences macrophage polarization, including activation of cytochrome c oxidase, transient increases in reactive oxygen species (ROS) and adenosine triphosphate (ATP), and downstream activation of nuclear factor κB, signal transducer and activator of transcription 1, and hypoxia-inducible factor-1alpha pathways.

Results: Pre-clinical evidence demonstrates that PBM can effectively reprogram M2-polarized TAMs toward an M1 phenotype, characterized by increased expression of inducible nitric oxide synthase and interleukin (IL)-12 and reduced levels of CD206 and IL-10. When combined with immune checkpoint inhibitors, PBM further enhances CD8⁺ T cell infiltration and tumor clearance. Nanotechnology-based delivery platforms-such as TAM-targeted upconversion nanoparticles and ROS-sensitive polymeric carriers-have enabled precise, localized PBM activation within tumors, overcoming the limitations of light penetration and systemic exposure.

Conclusion: Collectively, PBM offers a spatiotemporally controlled, drug-free approach to modulate tumor immunity by reeducating TAMs and reshaping the TME. Its integration with existing immunotherapies and nanomedicine holds significant promise for next-generation precision oncology strategies.

Background: Type 2 diabetes mellitus (T2DM) and chronic periodontitis (CP) have a bidirectional association; scaling and root planing (SRP) alone has limited efficacy in their comorbidity, with controversial photobiomodulation therapy (PBMT) adjunctive efficacy. Objective: To quantify PBMT + SRP's effects on periodontal [probing depth (PD), clinical attachment level (CAL)], glycemic [fasting plasma glucose (FPG), glycated hemoglobin (HbA1c)], and inflammatory [high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α)] indices in patients with T2DM + CP and explore heterogeneity (PBMT parameters, study region) for clinical optimization. Methods: Following PRISMA 2020, we searched six databases (PubMed, Cochrane Library, etc.) from inception to August 24, 2025, for PBMT-adjuvanted SRP randomized controlled trials (RCTs). Bias was assessed via RoB 2.0, meta-analysis via RevMan 5.4, with preset subgroup analyses. Results: Six RCTs (n = 319) were included. At 3 months of follow-up, PBMT + SRP significantly improved key periodontal indices (PD: MD = -0.87 mm, 95% CI: [-1.00, -0.74]; CAL: MD = -0.47 mm, 95% CI: [-0.65, -0.29]; both p < 0.00001), glycemic control (FPG: MD = -0.79 mmol/L, 95% CI: [-1.41, -0.17], p = 0.01), and systemic inflammation (hs-CRP: MD = -0.99 mg/L, 95% CI: [-1.12, -0.86]; TNF-α: MD = -2.78 pg/mL, 95% CI: [-3.17, -2.39]; both p < 0.00001) versus SRP alone. HbA1c showed borderline significant reduction (MD = -0.81%, 95% CI: = [-1.62, -0.01], p = 0.05). Subgroup analyses suggested 808/810 nm + 0.8-1.5 W as potentially optimal PBMT parameters, though high-power efficacy relied on one small-sample study (n = 40). Notable limitations included high inter-study heterogeneity (most I² > 90%) and maximum 6-month follow-up. Conclusions: PBMT adjunctive to SRP significantly improves periodontal indices (PD, CAL), FPG, and hs-CRP in patients with T2DM and CP, with borderline HbA1c reduction and good safety. Subgroup analyses identify 808/810 nm + 0.8-1.5 W as potentially optimal PBMT parameters, though high-power efficacy relies on one small-sample study. Given high inter-study heterogeneity (most I² > 90%) and short follow-up (maximum 6 months), conclusions require validation by standardized, large-sample, long-term, high-quality RCTs.

Purpose: To systematically review and meta-analyze the efficacy of photobiomodulation therapy (PBMT) for temporomandibular disorders (TMDs), focusing on the influence of intensity, frequency, and duration on pain reduction and functional improvement. Methods: Through a systematic search of PubMed, Cochrane, and EMBASE, we identified randomized controlled trials (RCTs) involving adults with TMD who were treated with PBMT. Ultimately, 40 RCTs were included, and a meta-analysis was conducted using Review Manager 5.4. The primary outcomes included pain, pain-free opening (PFO), maximum-unassisted opening, and maximum-assisted opening (MAO). Results: PBMT significantly reduced pain at the third assessment (T2). The optimal parameters included wavelengths (951-1070 nm) and output power (below 100 mW). Additionally, PFO and MAO significantly improved at T2. Treatment durations exceeding 10 weeks were most effective for articular-muscular TMDs, whereas shorter durations were more beneficial for purely articular or muscular TMDs. Three to four sessions per week yielded the best outcomes. Conclusion: Effective pain reduction was achieved with high wavelengths (951-1070 nm), low power (<100 mW), and frequent, long-term treatment (3-4 times per week over 10 weeks). Avoiding high energy consumption over a short period was crucial. This approach is more effective for articular-muscular TMDs than for purely articular or muscular conditions.

Background: 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. Aim: 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. Methods: 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. Results: 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. Conclusions: Fractional picosecond laser can be considered a viable and safe option to treat acne scars in patients with dark skin type.

Background: Vitiligo is a chronic autoimmune skin disorder characterized by depigmented macules and patches due to melanocyte destruction. Traditional therapies include topical corticosteroids, calcineurin inhibitors, phototherapy, and systemic immunomodulators. Objective: There is growing interest in alternative and adjunctive light-based therapies, such as 308 nm excimer light and red light, for promoting repigmentation and modulating the immune response. Methods: We report the case of a 37-year-old male patient with non-segmental vitiligo, affecting the arm and hands, who demonstrated significant repigmentation following treatment with 308 nm excimer light and 635 nm red light therapy. Results: The patient had a 3-year history of vitiligo and had previously been unresponsive to topical treatment and 308 nm excimer light monotherapy. However, with the combination of 308 nm excimer light and red light, gradual repigmentation was observed over 3 months. The patient tolerated the therapy well with no adverse effects. Conclusion: This case suggests that the combination of 308 nm excimer light and red light therapy may offer a promising treatment option for vitiligo.

Background: Cultural beauty ideals in South Asia favor both lighter skin and hair pigmentation, creating demand for various lightening procedures. The skin- and hair-lightening products currently on the market carry substantial health risks, including cutaneous adverse effects and systemic toxicity. Given these safety concerns, there's a critical need for safer alternatives. Objective: This study sought to explore the deliberate application of the Q-switched 1064-nm neodymium-doped yttrium aluminum garnet (QS 1064-nm Nd:YAG) laser for hair bleaching and to evaluate its concurrent effects on pigmentary clearance and skin rejuvenation in Indian subjects. Methods: This retrospective study analyzed 25 Indian subjects treated with a 1064 nm QS Nd:YAG laser for purposes including hair bleaching, lentigo removal, and skin toning. Participants received 1-3 monthly sessions, with efficacy assessed via clinical photography and a five-point hair lightening scale. Adverse events were documented to monitor safety. Results: The cohort was predominantly female (96%) with higher skin phototypes. "Significant" hair lightening was achieved in 68% of cases, with "maximum" lightening in 8%. Larger spot sizes correlated with greater hair lightening. Beyond hair bleaching, 84% achieved "good" or "excellent" pigmentary clearance, and all saw at least "good" skin rejuvenation. Adverse events were mild and transient, with no significant hypo- or hyperpigmentation. Retinol/tretinoin use was linked to increased post-treatment erythema. All participants reported treatment satisfaction, with 69% achieving moderate to excellent satisfaction levels and no subjects reporting dissatisfaction. Conclusion: This study demonstrates that 1064 nm QS laser treatment effectively bleaches hair with an acceptable safety profile, offering a medically supervised alternative to hazardous chemical products. Its additional benefits for pigmentary clearance and skin rejuvenation position it as a promising aesthetic therapeutic modality.