Photobiomodulation, photomedicine, and laser surgery最新文献

Background: There is strong evidence supporting the effectiveness of photobiomodulation therapy (PBMT) in improving neuronal damage and enhancing neuropsychological activities. However, there is limited research on the effects of this method on cognitive function and mood disorders. This project aimed to evaluate the potential benefits of PBMT in improving cognitive status and mood disorders in patients with dementia. Methods: In this randomized, double-blinded, controlled trial, 30 patients with mild-to-moderate dementia participated. The patients were divided into two groups: the first group (n = 15) received standard treatment along with PBMT, whereas the second group (n = 15) received standard treatment along with the use of an off-device on the head. Cognitive function, anxiety, and depression levels were assessed before, immediately after treatment, and 1 month later. Results: The comparison of cognitive functional score at baseline, after completing the therapeutic regimen, as well as one later showed no difference between the two groups (Table 1). Similarly, the two groups had similar mean scores for depression and anxiety at baseline and after treatment interventions. [Table: see text] Conclusion: The treatment likely has no significant impact on improving cognitive status or mood disorders in patients with mild-to-moderate dementia.

Background: Green light photobiomodulation (GPBM, 500-565 nm) promotes tissue healing, reduces inflammation, and alleviates pain, with emerging potential in bone repair. This review evaluates GPBM's therapeutic effects on bone-related cells (proliferation, differentiation, migration), inflammation, vascularization, and neuronal responses. Methods: We assessed the influence of different GPBM parameters, possible underlying molecular mechanisms, and prospects for in vivo applications based on available studies. Results: GPBM acts through mitochondria, opsins, and transient receptor potential vanilloid (TRPV) channels. The most effective irradiation method uses low irradiance (5.3-100 mW/cm²) with a single exposure of ∼5 J/cm². Excessively low irradiance is ineffective, while excessively high irradiance may cause inhibitory effects. GPBM enhances bone-related cell functions, suppresses inflammation, and promotes vascular and neuronal responses. Conclusions: GPBM shows promise for bone repair, but further research is needed to optimize parameters, clarify molecular mechanisms, and standardize clinical trial protocols to ensure reliable in vivo outcomes.

Background: The combination of lasers and acoustic shock waves has shown promising results in accelerating tattoo removal. Objective: To assess the effectiveness of treatments combining lasers and shock waves regarding the number of sessions required for successful tattoo removal. Methods: A prospective, observational, real-world, single-center study including adults (>18 years) with ≥one professional tattoo of any color on any body part, excluding the head, partially removed or not. Devices were the QS laser RevLite® SI (Cynosure Lutronic, USA), the picosecond laser PicoWay® (Candela, USA), the CO₂ laser DUOGlide® with a SCAR 3 scanner (DEKA M.E.L.A. srl, Italy), and the GENTLE Pro® shock waves system (Zimmer MedizinSysteme GmbH, Germany). Treatment protocols consisted of QS/picosecond laser passes alternated with shock wave passes (three each) (classic protocol) and one QS/picosecond laser and one shock wave pass, a QS/picosecond second laser pass, and a final fractional CO₂ laser pass (reinforced protocol). Sessions were performed at two-month intervals. Results: We included 22 patients (68.2% women and 68.2% Fitzpatrick phototype III) with a mean (range) age of 42 (22-68) years and 25 tattoos in total. Most tattoos were black (92.0%) and were removed using the picosecond laser (80.0%) and following the classic (40.0%) and the reinforced (60.0%) protocols in a total of 66 treatment sessions. In 22 tattoos undergoing more than one session, results were good or excellent in 68.2% of them after 2-4 sessions, with no adverse effects. Conclusion: Acoustic shock wave therapy constitutes a safe adjuvant treatment to accelerate laser-based tattoo removal.

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: Fractional carbon dioxide (CO₂) laser is the standard treatment in facial rejuvenation for light skin phototypes; nevertheless, in Latin America, it is one of the most performed procedures on phototypes III-V. Aim: The goal of this study is to evaluate the improvement in facial skin aging in Latin skins with fractional CO₂ laser and its side effects in a period of 3 months. Materials and Methods: Descriptive multicenter cross-sectional study including 165 patients from 2 medical centers in Latin America who attended from 2014 to 2021. Data were collected from medical records and assessment of facial aging was performed through photographic records by two independent investigators. An arithmetic mean was obtained for each variable and for each researcher, subsequently the obtained values were averaged to find the overall average improvement according to the intervention and skin phototype. A Cohen's Kappa Concordance Test was performed to determine the agreement between observers beyond chance. Results: Significant improvement in fine lines, mottled pigmentation, and overall skin appearance was observed in patients treated with fractional CO₂ laser with or without platelet-rich plasma. As for side effects, only one patient presented with herpes simplex. Conclusions: There are few studies to date that evaluate the use of fractional CO₂ laser in Latin skins, through this research, it is evident that this technology has good results for facial rejuvenation in this type of patients and few side effects.

This split-mouth randomized study evaluated the effect of in-office tooth whitening with violet Light-Emitting Diode (LED) on gingival inflammation, assessed by gingival crevicular fluid (GCF) interleukin-6 (IL-6) level, histomorphology, and immunohistochemical analysis of Tumor Necrosis Factor (TNF-α) and Cluster of Differentiation 8 (CD8) expression, with and without gingival barrier protection. Thirteen volunteers requiring gingivoplasty were included. The whitening procedure was performed with parameters of 400 nm, 134J/cm², and 20 cycles of 30 sec with 60 sec of standby. Gingival surgery was performed 48 h post-whitening for histomorphology analysis, while GCF IL-6 levels were quantified using an Enzyme-Linked Immunosorbent Assay (ELISA). We also attempted immunohistochemical analysis of TNF-α and CD8 expression; however, the small gingival specimens, which were primarily epithelial tissue, limited the reliability of the results. No statistically significant differences were observed between sides for histomorphology or GCF IL-6. These findings suggest that LED whitening without a gingival barrier may not induce gingival inflammation. However, further studies with larger and gender-balanced samples, extended time points, and additional cytokine markers are needed to confirm these results.

Background: Photobiomodulation therapy has been widely used in various branches of regenerative medicine because it has the advantages of noninvasive, drug-free, and safe form of light therapy. However, the complexity of the parameters of low-level laser (LLL) hinders its wider clinical application. Materials and Methods: Mouse fibroblasts (L929) were cultured in vitro using an 810-nm diode laser with low-level mode (E1C 0.1 W, continuous; E1R 0.1 W, intermittent; E2C 0.5 W, continuous; E2R 0.5 W, intermittent). Cell migration ability was detected by in vitro scratch test. Cell proliferation ability was detected by cell counting kit-8 (CCK-8) assay. Reactive oxygen species (ROS) fluorescence intensity was detected by an inverted fluorescence microscope. Production of ROS was detected by flow cytometry. Results: Scratch results show that E1C and E2R significantly increased the cell migration rate compared with the E0 group (p < 0.001). E1R also enhanced cell migration (p < 0.01). CCK-8 results show that the increase in the optical density of E1R, E1C, and E2R was higher than that of E0 (p < 0.001). The E2C group did not facilitate cell proliferation. The results of ROS fluorescence analysis and flow cytometry analysis showed that the ROS produced by L929 cells irradiated with different modes of LLL were different. The ROS production of E2C cells was the highest, followed by E2R, E1C, and E1R, and the E0 group was the lowest, with a significant difference (p < 0.01). Conclusions: An 810-nm diode laser of 0.1 W with continuous pulse mode and 2 cm away from the wound can maintain the appropriate level of ROS, as well as effectively promote cell proliferation and migration.

Objective: Prolonged soft tissue anesthesia (STA) after dental treatments in children poses a risk of soft tissue injury (STI). This study aimed to systematically review the role of photobiomodulation therapy (PBMT) in reducing the duration of STA and incidence of STI after dental procedures. Methods: This systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration code: CRD42024622981). Results: Five eligible studies were included, involving 32-60 participants between 4 and 10 years, utilizing a diode laser with various wavelengths (635, 660, 808, and 810 nm), energy densities (6-11.5 J/cm²), irradiation times (12-30 sec), and irradiation points (6-12). The results demonstrated a significant reduction in duration of STA in all studies (p < 0.05); however, the reduction in the incidence of STI remained inconclusive. Conclusions: PBMT may serve as a painless and acceptable method to reduce the duration of STA in pediatric dentistry; however, its positive role in preventing STI remains inconclusive in patients with normal intellectual abilities supervised by alert caregivers.

Background: Keloids and hypertrophic scars appear more frequently in people with darker skin tones, such as those of African, Asian, or Hispanic descent. The combination of CO₂ laser, pulsed dye laser (PDL), and triamcinolone was successful in treating a keloid. Aim: The purpose of this research was to assess the clinical efficacy of a multi-modal treatment protocol comprising a 595 nm PDL, fractional ablative CO₂ laser, 1540 nm nonablative laser, and intralesional corticosteroid injections for keloid management in Indian patients. Methods: A total of 30 patients with keloids were treated with a combination of two different lasers (595 nm pulsed/10,600 nm and 1540 nm fractional laser) and intralesional steroids injections. Clinical images were collected before treatment and at 9 months after the last treatment, and adverse effects were monitored throughout the study. Patients were assessed with the Detroit Keloid Scale before treatment and at follow-up. Results: After completing treatments, almost all patients showed improvement; in particular, a decrease in redness was noted, and the keloids appeared flatter. This improvement was also recorded through the Detroit Keloid Scale, where a significant 6-point decrease on the scale was recorded between baseline and follow-up (p < 0.01). Conclusions: This combined therapy is a good option for people with darker skin tones since it has been proven as an effective tool for managing keloid, especially for enhancing texture and decreasing redness with a lower risk of postinflammatory hyperpigmentation.

Background: Low-level laser therapy has gained increasing attention in the field of dentistry as a promising modality due to its photobiomodulatory effects that facilitate tissue regeneration. Accumulating evidence suggests that neodymium-doped yttrium aluminum garnet (Nd:YAG) and erbium-doped yttrium aluminum garnet (Er:YAG) lasers, when applied at low-energy settings, can enhance cellular proliferation and promote mineralization in osteoblasts and mesenchymal stem cells. Objectives: This study aimed to investigate the photobiomodulation effects of low-level Nd:YAG and Er:YAG laser irradiation on rat odontoblast-like cells, with a particular focus on cellular proliferation, differentiation, and mineralization in vitro. Methods: Rat odontoblast-like cells (MDPC-23) were subjected to Nd:YAG and Er:YAG laser irradiation at a frequency of 10 Hz, with energy settings of 60, 80, 100, and 120 mJ for exposure durations of 0, 2, 5, 10, and 15 sec, respectively. The effects of low-level laser irradiation on cellular proliferation, differentiation, and mineralization were systematically evaluated. In addition, intracellular reactive oxygen species (ROS) levels were quantified, and an NF-κB inhibitor was employed to investigate its involvement in the regulation of cell proliferation and differentiation. Statistical analysis was conducted using one-way analysis of variance followed by post hoc Tukey's HSD tests. Results: Both Nd:YAG and Er:YAG laser irradiation at the energy of 80 mJ for 10 or 15 sec enhanced cell proliferation, differentiation, and mineralization in MDPC-23 cells. An elevation in cellular ROS levels was observed after laser irradiation, and the laser irradiation in the presence of the NF-κB inhibitor resulted in decreased cell proliferation and ALPase activity. Conclusions: Low-level Nd:YAG and Er:YAG laser irradiation enhanced the proliferation, differentiation, and mineralization of odontoblast-like cells in vitro. These effects appear to be mediated by the activation of the NF-κB signaling pathway through ROS, thereby promoting cellular proliferation followed by differentiation and mineralization.