Photobiomodulation, photomedicine, and laser surgery最新文献

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.

Background: Oral mucositis (OM) is a frequent and debilitating adverse effect of cancer treatments, primarily mediated by oxidative stress and inflammatory pathways involving reactive oxygen species (ROS) and nitric oxide. Photobiomodulation (PBM) therapy has emerged as a potential intervention to mitigate OM severity by regulating these mechanisms. This review examines the influence of PBM on salivary nitrite concentrations-a key biomarker of oxidative stress-in patients with OM. Methods: A systematic literature search was conducted across PubMed and the Cochrane Library, encompassing clinical trials published up to June 2025. Included studies investigated the effects of PBM on salivary nitrite levels in patients receiving anticancer therapy. Methodological quality was assessed using the Revised Cochrane Risk of Bias tool (RoB 2.0). Results: Three studies satisfied the inclusion criteria. Although variations existed among the studies regarding anticancer treatment modalities and PBM irradiation parameters, all consistently reported a reduction in salivary nitrite levels following PBM therapy. Conclusion: PBM therapy appears effective in alleviating OM severity, potentially attributable to its capacity to decrease salivary nitrite concentrations. Additional research is warranted to validate these preliminary findings and optimize PBM protocols for clinical implementation.

Background: Diabetes mellitus (DM) is a global health concern, with 90% of cases diagnosed as type 2 DM (DM2). Objective: We evaluated the effects of photobiomodulation (PBM) plus adipose-derived stem (ADS) cells, alone and together, during the inflammation (day 4) and proliferation (day 8) stages of the wound healing process (WHP) in an infected ischemic wound model in DM2 rats. Stereological parameters and immunohistological assessments of M1 and M2 macrophage phenotypes, as well as mRNA expression levels of four genes, were assessed. Materials and Methods: We assigned 48 rats to 4 groups: control, PBM, ADS, and PBM+ADS. Results: On day 4, the treatment groups had significantly reduced neutrophil, macrophage, and M1 counts compared to the control group (all p < 0.001). PBM+ADS showed the greatest reduction (p < 0.001). The treatment groups had higher fibroblast and M2 counts (p < 0.001), with PBM+ADS showing the largest increase (p < 0.01). Vascular length was significantly greater in the PBM+ADS and PBM groups (p < 0.001), with PBM+ADS showing the highest increase (p < 0.001). New epidermis and dermis volumes were significantly higher in all treatment groups (p < 0.001), with PBM+ADS showing the greatest improvements (p < 0.001). On day 8, neutrophil, macrophage, and M1 counts remained significantly lower in all treated groups (p < 0.001), with PBM+ADS showing the most reduction. Fibroblasts and M2 counts remained elevated, with PBM+ADS having the highest values (p < 0.001). Vascular length, epidermis, and dermis volumes increased significantly in the PBM+ADS group (all p < 0.001). There were significant increases in basic fibroblast growth factor, vascular endothelial growth factor A, stromal cell-derived factor-1α, and hypoxia-inducible factor 1-alpha in all treatment groups (all p < 0.001), especially the PBM+ADS and PBM groups. Conclusion: Although PBM outperformed ADS in enhancing WHP in a DM2 rat model, the combination of PBM+ADS showed the best results.

Objective: The current study sought to explore the impact of a novel noninvasive treatment called transcranial photobiomodulation (PBM) on resting-state functional connectivity (rsFC) of the cerebellum in individuals with a history of repetitive head acceleration events (RHAEs). Background: RHAEs are associated with cumulative neurological compromise, including chronic alterations in rsFC; however, few treatments have been investigated to mitigate these effects. A recent study by our team demonstrated that PBM treatment led to improvements in measures of balance and motor function in adults with RHAE exposure. Due to the cerebellum's role in motor functioning and its connectivity with cerebral regions targeted by PBM, we sought to examine changes in the rsFC of the cerebellum following PBM treatment. Methods: Thirty individuals with RHAE used an at-home PBM headset with an intranasal cannula for 20 min every other day for a period of 8-10 weeks. A total of 240 J/cm² of red and near-infrared light was administered to cortical nodes of the default mode network (DMN) and subcortical structures in each session. Using resting-state functional magnetic resonance imaging, rsFC was measured before and after treatment in 11 cerebellar seed regions associated with the DMN, salience network (SN), and frontoparietal network (FPN). Results: We observed an overall decrease in between-network connectivity and an increase in within-network connectivity after PBM treatment, particularly in the SN and FPN. Conclusions: These results suggest that PBM may improve network efficiency of the cerebellum by regulating overactive connections and increasing network segregation.

Background: Photobiomodulation (PBM) therapy involves the use of low-dose, nonionizing light to reduce pain and inflammation, promote wound healing, and enhance tissue regeneration. PBM-based therapy of various dental conditions is associated with improved treatment outcomes. This study aims to critically review the literature to highlight the underlying molecular biological mechanisms and clinical applications of PBM in modern dental practice. Methods: This critical review employed literature search in PubMed/Medline, Google Scholar, and ScienceDirect databases to determine biological basis of PBM with a particular focus on its clinical dental applications. English literature published in the past 25 years were eligible for inclusion. Selected studies were analyzed to evaluate the therapeutic biochemical effects of PBM, with a focus on its dental applications. Results: PBM exerts its biological effects by influencing cytochrome c oxidase, increasing adenosine triphosphate, and improving DNA replication and RNA transcription. Various transcription factors and signaling pathways are involved through the activation of secondary messengers such as reactive oxygen species, nitric oxide, and cyclic adenosine monophosphate. The favorable biological effects of PBM can be beneficial for various dental applications in pulp therapy, management of postsurgical complications, and temporomandibular joint disorders. Conclusions: PBM represents a promising and effective treatment modality for the management of several challenging dental problems in the pediatric and adult populations, offering improved treatment outcomes, namely enhanced wound healing and reduced inflammation. Further research is recommended to optimize technical settings and standardize current protocols in the aim of enhancing clinical outcomes, exploring more applications, and improving patient satisfaction.

Introduction: Cisplatin (Cis), a key cancer chemotherapy drug, faces limitations such as dose-dependent side effects and resistance. Photobiomodulation therapy (PBMT) shows promise as an adjuvant therapy to enhance Cis efficacy and reduce side effects. Methods: A systematic review was conducted to evaluate the combined effects of PBMT and Cis on various cancers. After searching five databases using relevant keywords, nine studies were included, encompassing both in vitro and in vivo models. Results: Most in vitro studies showed a synergistic effect, with enhanced cancer cell inhibition, apoptosis induction, and reduced cell viability compared with Cis alone. The animal model confirmed these findings, showing PBMT mitigated Cis-induced acute renal failure. Conclusion: Mechanistically, PBMT may increase reactive oxygen species generation, cytochrome c release, modulate cellular metabolism, and involve the miR-124/STAT3 signaling pathway. Combining PBMT with Cis appears to be a safe and effective cancer treatment strategy, synergistically inhibiting cancer cell growth and reducing side effects. Further clinical trials are needed to validate these findings.

Background: Photodynamic therapy (PDT) combined with biliary stenting reportedly has better efficacy and safety in the treatment of extrahepatic cholangiocarcinoma (EHC). Considering the shortcomings of traditional PDT methods, we proposed a novel modified approach, defined as initial biliary stent placement followed by PDT, for the treatment of EHC. The study aimed to evaluate the effect and safety of biliary stent placement prior to PDT versus only stent placement on the treatment of EHC. Methods: A total of 30 patients diagnosed with EHC between January 2017 and December 2024 were included in the retrospective study. Ten patients underwent biliary stent placement, followed by PDT (Stenting with PDT group). Survival time, surgical success rate, and postoperative adverse events were compared to 20 patients receiving biliary stent placement alone (Stenting only group). Results: The success rate of all operations in both groups was 100%. After 96 months of follow-up, the stenting with PDT group had significantly longer median survival after stent placement than the stenting only group (10.5 vs. 4.0 months, p = 0.028). There were no statistically significant differences in the rates of postoperative total adverse events (5 [25%] vs. 2 [20%], p = 1.000), asymptomatic hyperamylasemia (1 [5%] vs. 1 [10%], p = 1.000), acute pancreatitis (4 [20%] vs. 1 [10%], p = 0.272), and postoperative acute cholangitis (0 vs. 1 [10%], p = 0.333) between the two groups. Conclusions: Compared with stenting alone, modified stenting combined with PDT resulted in longer survival in patients with unresectable EHC without significant adverse events.

Background: Depression is a prevalent mental disorder characterized by mental suffering and emotional distress. Its pathogenesis involves the concurrent action of multiple factors, including genetic predisposition, stress exposure, hypothalamic-pituitary-adrenal axis dysregulation, imbalances in neurotransmitters and their receptors, inflammatory responses, and mitochondrial malfunction. Photobiomodulation (PBM), a noninvasive therapeutic approach, has shown potential in treating mood disorders such as depression and has emerged as a promising intervention for various pathologies; however, unified standards for PBM irradiation parameters (e.g., based on species, gender, age) are currently lacking. Objective: This review aims to introduce the potential mechanisms underlying depression and summarize the latest pre-clinical and clinical progress of PBM in the treatment of this mood disorder. Materials and Methods: As a narrative review, this work synthesizes and analyzes existing literature on the pathological mechanisms of depression and the application of PBM in depression treatment. Results Polytherapy with PBM targeting multiple biological pathways exerts beneficial effects on depression. Specifically, PBM enhances mitochondrial function in the brain, promotes neurogenesis and synaptogenesis, regulates neurotransmitter homeostasis, and provides neuroprotection through anti-inflammatory and antioxidant actions, while simultaneously supplying energy to brain tissues. Additionally, the curative effect of PBM is found to be associated with multiple factors, including irradiation parameters, species, gender, and age, highlighting the lack of unified parameter standards in current research. Conclusions: PBM exhibits therapeutic potential for depression by modulating key pathological pathways (e.g., mitochondrial function, neurogenesis, inflammation). The latest pre-clinical and clinical evidence supports its role as a promising noninvasive intervention. However, the establishment of unified PBM irradiation parameters is essential for standardizing its clinical application in depression treatment. Future research should focus on optimizing parameter standards to enhance the efficacy and reproducibility of PBM therapy.

Objective: This in vitro study aimed to compare the antibacterial properties of 2% chlorhexidine (CHX) and 0.2% nano chitosan, with and without Er:YAG laser activation using a side-firing tip, against Enterococcus faecalis. It evaluates their potential to improve disinfection in endodontic treatments and assesses the impact of laser activation on antimicrobial efficacy. Background: Successful endodontic treatment relies on effective root canal disinfection, often hindered by E. faecalis, which invades dentinal tubules. While sodium hypochlorite is effective, it can cause cytotoxicity and dentin damage. CHX is a biocompatible alternative, and nanochitosan offers promising antimicrobial properties with low toxicity. However, conventional irrigation methods are often insufficient. Er:YAG laser activation enhances irrigant penetration into dentinal tubules, improving antimicrobial effects. Method: Extracted human premolars were inoculated with E. faecalis and divided into four groups: Group A (2% CHX), Group B (0.2% nano chitosan), Group C (2% CHX + Er:YAG laser), and Group D (0.2% nano chitosan + Er:YAG laser). Bacterial counts were measured using colony-forming units on Mueller Hinton agar. Results: CHX showed superior antibacterial efficacy compared with nanochitosan. Laser activation significantly enhanced the antimicrobial effect of both irrigants, with Group C (CHX + laser) showing the greatest reduction in bacterial colonies. Conclusion: Er:YAG laser activation improves the antimicrobial effectiveness of both CHX and nano chitosan, particularly in combination, offering a promising approach for root canal disinfection. Furthermore, clinical studies are needed to confirm these findings in vivo.