Enhancement of bone formation in rat calvarial bone defects using low-level laser therapy

Mechanistic study of apoptosis induced by high-fluence low-power laser irradiation using fluorescence imaging techniques

Low-power laser irradiation (LPLI) can cause cell proliferation, differentiation, or death; however, the cellular mechanisms of these effects of LPLI, at high or low fluences, are not well known. To investigate the mechanism of high-fluence LPLI-induced apoptosis, both human lung adenocarcinoma cells (ASTC-a-1) and African green monkey SV40-transformed kidney fibroblast cells (COS-7) were irradiated with a He-Ne laser for 10 min under a fluence of 120 J/cm(2) and 80 J/cm(2), respectively. The dynamics of reactive oxygen species (ROS) generation was determined by measuring changes in fluorescence resulting from oxidation of intracellular dichlorodihydrofluorescein diacetate (H(2)DCFDA) to (DCF). The changes of mitochondrial membrane potential, DeltaPsim, were studied by measuring the reduction of cellular fluorescence of Rhodamine 123 dyes using confocal laser scanning microscopy. The activation of caspase-3 in cells transfected by [SCAT3] reporters was observed using fluorescence resonance energy transfer (FRET) imaging. The activity of caspase-8 during high-fluence LPLI-induced apoptosis was studied by monitoring the cellular distribution of [Bid-CFP] reporters using fluorescence imaging. The following temporal sequence of cellular events was observed during apoptosis induced by high-fluence LPLI (120 J/cm(2), ASTC-a-1 cells): (1) immediate generation of mitochondrial ROS following laser irradiation, reaching a maximum level 60 min after irradiation; (2) onset of DeltaPsim decrease 15 min after laser irradiation, reaching a minimum level 50 min after irradiation; and (3) activation of caspase-3 between 30 min and 180 min after laser irradiation. Our results also show that the high-fluence LPLI does not activate caspase-8, indicating that the induced apoptosis was initiated directly from mitochondrial ROS generation and DeltaPsim decrease, independent of the caspase-8 activation.

Influence of low-level laser treatment on bone regeneration and osseointegration of dental implants following sinus augmentation: An experimental study on sheep

OBJECTIVES

The aim of this experimental study was to evaluate if low-level laser treatment (LLLT) enhances bone regeneration and osseointegration of dental implants in a sinus graft model.

MATERIAL AND METHODS

Twelve sheep underwent a bilateral sinus floor elevation procedure with cancellous bone from the iliac crest. Implant insertion followed 4 weeks (six sheep) and 12 weeks (six sheep) later. Sixteen weeks after second-stage surgery, animals were sacrificed. Unilaterally, the grafted sinus and during the second-stage surgery the implant sites were irradiated intraoperatively and three times during the first postoperative week with a diode laser (75 mW, 680 nm). The overall energy density per irradiation was 3-4 J/cm(2). Biopsies of the augmented area were obtained during implant insertion and after scarification.

RESULTS

Bone regeneration within the grafted sinus histomorphometric analysis hardly differed between control and test side both 4 and 12 weeks after sinus grafting. Osseointegration measurements resulted in a significantly higher bone/implant contact (BIC) on the test side (P=0.045). Further evaluation of peri-implant bone tends to amount in significant higher percentage on the laser side (P=0.053).

CONCLUSION

The presented experimental study on sheep did not confirm a positive LLLT effect on bone regeneration within a cancellous sinus graft. Nevertheless, LLLT possibly has a positive effect on osseointegration of dental implants inserted after sinus augmentation.

A new technique for physiodesis using photodynamic therapy

Vascularization of developing growth plates is integral to the process of endochondral ossification. We hypothesized photodynamic therapy could be used to initiate premature vascularization and calcification of growth plates in mice on the induction of vascular endothelial growth factor. Three-week-old transgenic mice that emit bioluminescence on activation of the vascular endothelial growth factor gene were treated with different regimens of benzoporphyrin derivative mono-acid-mediated photodynamic therapy in the right, proximal tibial growth plate. We quantified changes in vascular endothelial growth factor-related bioluminescence at times after photodynamic therapy in vivo. The expression of vascular endothelial growth factor protein and CD31-labeled vasculature in growth plates also were examined with growth plate histology. Measurements of limb length were assessed in vivo using conventional radiography and confirmed on harvesting. Mice exposed to repeat treatments of 10 J x2 displayed enhanced bioluminescence 2 weeks after photodynamic therapy. Histology confirmed increased vasculature immediately adjacent to the growth plates with evidence of physeal closure. At 4 weeks posttreatment, limbs were shortened by an average of 9.5% +/- 4.4% without complication, confirming the potential application of photodynamic therapy for physiodesis.

Effects of laser irradiation on the release of basic fibroblast growth factor (bFGF), insulin like growth factor-1 (IGF-1), and receptor of IGF-1 (IGFBP3) from gingival fibroblasts

Various studies have shown biostimulation effects of laser irradiation by producing metabolic changes within the cells. Little is known about the biological effect of laser irradiation on the oral tissues. Among the many physiological effects, it is important to recognize that low-level laser therapy (LLLT) may affect release of growth factors from fibroblasts. Therefore, the aim of the present study was to determine whether the laser irradiation can enhance the release of basic fibroblast growth factor (bFGF), insulin-like growth factor-1 (IGF-1), and receptor of IGF-1 (IGFBP3) from human gingival fibroblasts (HGF). The number of all samples in the study were 30, and the samples were randomly divided into three equal groups; In the first group (single dose group), HGF were irradiated with laser energy of 685 nm, for 140 s, 2 J/cm(2) for one time, and in the second group, energy at the same dose was applied for two consecutive days (double dose group). The third group served as nonirradiated control group. Proliferation, viability, and bFGF, IGF-1, IGFBP3 analysis of control and irradiated cultures were compared with each other. Both of the irradiated groups revealed higher proliferation and viability in comparison to the control group. Comparison of the single-dose group with the control group revealed statistically significant increases in bFGF (p < 0.01) and IGF-1 (p < 0.01), but IGFBP3 increased insignificantly (p > 0.05). When the double dose group was compared with the control group, significant increases were determined in all of the parameters (p < 0.01). In the comparison of the differences between the two irradiated groups (one dose and two doses), none of the parameters displayed any statistically significant difference (p > 0.05). In both of the laser groups, LLLT increased the cell proliferation and cell viability. The results of this study showed that LLLT increased the proliferation of HGF cells and release of bFGF, IGF-1, and IGFBP3 from these cells. LLLT may play an important role in periodontal wound healing and regeneration by enhancing the production of the growth factors.

Clinical study of the gingiva healing after gingivectomy and low-level laser therapy

OBJECTIVE

The purpose of this study was to investigate gingival healing after gingivectomy and adjunctive use of low-level laser therapy (LLLT).

BACKGROUND DATA

LLLT has been used in animal experiments to examine the influence of laser radiation on the wound healing process since the 1960s. However, clinical trials in dentistry are scarce, and most of them refer to treatment after extraction of the third molars, with only a few reports in the area of periodontics.

METHODS

Twenty patients with periodontal disease were selected, and treatment was planned for gingivectomy to bilateral maxillary and mandibular premolar teeth. After surgery, one side was submitted to LLLT using a 685-nm wavelength, output power of 50 mW, and energy density of 4 J/cm(2). The other side was used as the control and did not receive laser irradiation. Healing was evaluated, clinically and biometrically, immediately post-surgery and at days 3, 7, 14, 21, 28, and 35. Results were submitted to statistical analysis.

RESULTS

Biometrical evaluation indicated a significant improvement in healing for the laser group at 21 and 28 days. Clinical evaluation showed better repair for the laser group, mainly after the third day.

CONCLUSION

LLLT was an effective adjunctive treatment that appeared to promote healing following gingivectomy.

Low-Level Laser Effect on Mandibular Distraction Osteogenesis

PURPOSE

The purpose of this study was to determine whether low-level laser (LLL) application during distraction osteogenesis could accelerate bone regeneration and decrease the length of the consolidation phase and thereby reduce potential patient morbidity.

MATERIALS AND METHODS

Nine adult female New Zealand white rabbits underwent bilateral mandibular corticotomies and placement of unidirectional distraction devices (KLS-Martin LP, Jacksonville, FL). Each rabbit served as its own internal control. After a latency of 1 day, distraction progressed bilaterally at 1 mm per day for 10 days. Immediately after each device activation, the experimental side, chosen randomly, was treated with real LLL (Laser Medical Systems, Hedehusene, Denmark) of 6.0 J x 6 transmucosal sites in the area of the distraction gap. Radiographs were taken presurgically, immediately postsurgically, and weekly until sacrifice, and the bone was analyzed using a semiquantitative 4-point scale (Bone Healing Score [BHS]). Three animals each were sacrificed at 2, 4, and 6 weeks postdistraction, and each hemimandible was prepared for histologic examination in a blinded fashion.

RESULTS

Ten millimeters of distraction was achieved in each rabbit bilaterally. Radiographically, the BHS was higher for the LLL-treated group at all time periods. Histologically, the area of new bone trabeculation and ossification was more advanced for the LLL-treated group, with less intervening fibrovascular intermediate zone in the bony regenerate, at all time periods. The formation of a complete inferior border occurred sooner in the treatment group than in the controls.

CONCLUSIONS

LLL accelerates the process of bone regeneration during the consolidation phase after distraction osteogenesis. The adjunctive use of LLL may allow a shortened period of consolidation and therefore permit earlier device removal, with the avoidance of morbidity associated with prolonged device retention.

Effect of 650 nm low-power laser on bone morphogenetic protein in bone defects induced in rat femors

PURPOSE:To investigate the influence of 650 nm GaAlAs laser on the action of bone morphogenetic protein (BMP) in bone defects produced in rat femurs. METHODS: The sample consisted of 12 male albino Wistar rats (Rattus norvegicus). The animals were randomly divided into four experimental groups. After undergoing anesthesia, the fur was removed from the lateral face of the right thigh and surgical dissection was performed to view the femur region. A bone defect was created using a spherical diamond-tipped drill bit. In groups 1 and 2, the defect was filled with a paste of Gen-Tech bone-inducing substance. The animals were treated with GaAlAs laser, at a predetermined dose of joules/cm² for 80 seconds, over an area of 1 cm². Groups 2 and 4 were used as controls. Bone samples were removed to perform histological procedures and morphometric analyses on the 7th, 14th and 21st days after the operation. The results obtained were subjected to statistical analysis using ANOVA variance according to two criteria, with four repetitions, followed by the post hoc t test. The rejection level for the nullity hypothesis was 0.05 or 5% (alpha <= 0.05). RESULTS: In comparisons between G1, G2, G3 and G4, p = 0.024 was observed. In statistical comparisons using the t test for paired samples, only G1 vs. G4 presented a statistically significant result (p = 0.021). CONCLUSION: The association of low-power laser application and Gen-Tech bone-inducing substance achieved a better result than laser application alone or BMP use alone.

Evidências da ação de agentes físicos sobre o metabolismo do tecido ósseo e seus potenciais usos clínicos

A ação de agentes físicos como o laser, o ultra-som pulsado e campos elétrico e eletromagnético (todos de baixa intensidade) no tecido ósseo tem sido muito estudada, revelando que estes são capazes de estimular a osteogênese, acelerar a consolidação de fraturas e aumentar a massa óssea. O uso destas modalidades terapêuticas foi primeiramente baseado na descoberta de que o tecido ósseo é um material piezoelétrico, isto é, que quando deformado torna-se capaz de gerar uma polarização e transformar energia mecânica em elétrica, o que ampliou as possibilidades terapêuticas sobre este tecido. O presente trabalho tem por objetivo apresentar as evidências dos efeitos fisiológicos e discorrer sobre os mecanismos de ação destes agentes físicos sobre o metabolismo ósseo, com base em artigos publicados na literatura científica internacional.

Effect of laser therapy on attachment, proliferation and differentiation of human osteoblast-like cells cultured on titanium implant material

The aim of this in vitro study was to investigate the effect of low-level laser therapy (LLLT) on the attachment, proliferation, differentiation and production of transforming growth factor-ss(1) (TGF-beta(1)) by human osteoblast-like cells (HOB). Cells derived from human mandibular bone were exposed to GaAlAs diode laser at dosages of 1.5 or 3 J/cm(2) and then seeded onto titanium discs. Non-irradiated cultures served as controls. After 1, 3 and 24h, cells were stained and the attached cells were counted under a light microscope. In order to investigate the effect of LLLT on cell proliferation after 48, 72 and 96 h, cells were cultured on titanium specimens for 24h and then exposed to laser irradiation for three consecutive days. Specific alkaline phosphatase activity and the ability of the cells to synthesize osteocalcin after 10 days were investigated using p-nitrophenylphosphate as a substrate and the ELSA-OST-NAT immunoradiometric kit, respectively. Cellular production of TGF-beta(1) was measured by an enzyme-linked immunosorbent assay (ELISA), using commercially available kits. LLLT significantly enhanced cellular attachment (P<0.05). Greater cell proliferation in the irradiated groups was observed first after 96 h. Osteocalcin synthesis and TGF-beta(1) production were significantly greater (P<0.05) on the samples exposed to 3 J/cm(2). However, alkaline phosphatase activity did not differ significantly among the three groups. These results showed that in response to LLLT, HOB cultured on titanium implant material had a tendency towards increased cellular attachment, proliferation, differentiation and production of TGF-beta(1), indicating that in vitro LLLT can modulate the activity of cells and tissues surrounding implant material.

Measuring dynamics of caspase-3 activity in living cells using FRET technique during apoptosis induced by high fluence low-power laser irradiation

BACKGROUND AND OBJECTIVES

Low-power laser irradiation (LPLI) has been used for therapies such as curing spinal cord injury, healing wound etc. Yet, the mechanism of LPLI remains unclear. In order to determine the effects of high fluence LPLI on cell growth and caspase-3 activity, we have measured the dynamics of caspase-3 activity during cell apoptosis induced by high fluence LPLI treatment.

STUDY DESIGN/MATERIALS AND METHODS

He-Ne laser was used to irradiate human lung adenocarcinoma cells (ASTC-a-1). Cell Counting Kit-8 was used for cytotoxicity assay. A fluorescent microscope was used to perform fluorescence resonance energy transfer (FRET) imaging. A luminescence spectrometer was used to acquire the fluorescent emission spectrum. Statistical analysis was performed with Student's paired t-test.

RESULTS

Cytotoxicity assay showed that when light irradiation fluence exceeded 60 J/cm2, LPLI treatment induced ASTC-a-1 cell apoptosis in a fluence-dependent manner. FRET imaging and spectrofluorometric analysis demonstrated that caspase-3 was activated during high fluence LPLI-induced cell apoptosis.

CONCLUSIONS

Using FRET technique, we have reported that high fluence LPLI can induce human lung adenocarcinoma cells (ASTC-a-1) apoptosis. The activation of caspase-3 plays an important role in the apoptotic process.

Laser therapy accelerates initial attachment and subsequent behaviour of human oral fibroblasts cultured on titanium implant material. A scanning electron microscope and histomorphometric analysis

The aim of the study was to investigate the effect of low-level laser therapy (LLLT) on attachment and proliferation of human gingival fibroblasts (HGF) cultured on titanium implant material. HGF were exposed to gallium-aluminum-arsenide diode laser at dosages of 1.5 or 3 J/cm(2) and then cultured on commercially pure titanium discs. Cell profile areas were measured after 1, 3 and 24 h, using scanning electron microscopy and an automatic image analyzer. The results were expressed as percentage of attachment. In order to investigate the effect of LLLT on cellular growth after 8 and 10 days, HGF were cultured on titanium discs for 24 h and then exposed to laser irradiation on 3 consecutive days. Colony-forming efficiency (CFE) and clonal growth rates (CGR) were measured. Cell viability was determined by Hoechst and prodidium iodide staining. Non-lased cultures served as controls. Morphologically, the cells spread well on all titanium surfaces, indicating good attachment by both irradiated and non-irradiated cells. Fibroblasts exposed to laser irradiation had significantly higher percentages of cell attachment than the non-exposed cells (P<0.05). CFE and CGR were also enhanced for the irradiated cells (P<0.05). Cell viability was high (>90%) in the irradiated and control groups, without significant differences. It is concluded that in vitro LLLT enhances the attachment and proliferation of HGF on titanium implant material.

Determining optimal dose of laser therapy for attachment and proliferation of human oral fibroblasts cultured on titanium implant material

The purpose of this study was to investigate the influence of single or multiple doses of low-level laser therapy (LLLT) on attachment and proliferation of human gingival fibroblasts in a standardized, reproducible in vitro model. Titanium discs were randomly allotted to one of three groups: group I served as a control, group II was exposed to a single laser dose of 3 J/cm2, and the three subgroups in group III were exposed to laser doses of 0.75, 1.5, and 3 J/cm2. To examine the possible thermal effects of laser exposure on the cell culture, the temperature in the Petri dish was measured for every dose used, before and during irradiation. For attachment assays, groups II and III were exposed to laser irradiation and then seeded onto titanium discs. In group III, the exposures were repeated after 3 and 6 h. Cells were cultured for 6 and 24 h and stained with Hoechst and Propidium. Attached cells were counted under a light microscope. To investigate the effect of LLLT on cell proliferation after 48 h, 72 h, and 7 days, cells were cultured on titanium discs for 24 h and then exposed to laser irradiation for 1 day and 3 consecutive days, respectively. Cell proliferation was determined by counting cells under the microscope and by a cell proliferation enzyme-linked immunosorbent assay system. No increase of temperature of the cell cultures occurred before or during laser exposure at any of the doses tested. Both single and multiple doses of LLLT significantly enhanced cellular attachment (p<0.05). The proliferation assays showed higher cell proliferation (p<0.05) in group III at doses of 1.5 and 3 J/cm2 after 72 h and 7 days, with agreement between staining and enzyme-linked immunosorbent assay. It is concluded that, in this cellular model, the attachment and proliferation of human gingival fibroblasts are enhanced by LLLT in a dose-dependent manner.