Comparison of the low level laser therapy effects on cultured human gingival fibroblasts proliferation using different irradiance and same fluence

Effects of a single near-infrared laser treatment on cutaneous wound healing: Biometrical and histological study in rats

BACKGROUND

Low intensity laser therapy has been recommended to support the cutaneous repair; however, so far studies do not have evaluated the tissue response following a single laser treatment. This study investigated the effect of a single laser irradiation on the healing of full-thickness skin lesions in rats.

METHODS

Forty-eight male rats were randomly divided into three groups. One surgical lesion was created on the back of rats using a punch of 8mm in diameter. One group was not submitted to any treatment after surgery and it was used as control. Two energy doses from an 830-nm near-infrared diode laser were used immediately post-wounding: 1.3 J cm(-2) and 3 J cm(-2). The laser intensity 53 m W cm(-2) was kept for both groups. Biometrical and histological analyses were accomplished at days 3, 7 and 14 post-wounding.

RESULTS

Irradiated lesions presented a more advanced healing process than control group. The dose of 1.3 J cm(-2) leaded to better results. Lesions of the group irradiated with 1.3 J cm(-2) presented faster lesion contraction showing quicker re-epithelization and reformed connective tissue with more organized collagen fibers.

CONCLUSIONS

Low-intensity laser therapy may accelerate cutaneous wound healing in a rat model even if a single laser treatment is performed. This finding might broaden current treatment regimens.

Influence of Broad-Spectrum and Infrared Light in Combination with Laser Irradiation on the Proliferation of Wounded Skin Fibroblasts

OBJECTIVE

This study aimed to establish if broad-spectrum or infrared (IR) light in combination with laser therapy can assist phototherapy and accelerate cell proliferation to improve the rate of wound healing.

BACKGROUND DATA

The effect of laser light may be partly or completely reduced by broad-spectrum light. There are few studies that investigate the benefit or detriment of combining laser irradiation with broad-spectrum or IR light.

METHODS

Wounded human skin fibroblasts were irradiated with a dose of 5 J/cm(2) using a heliumneon laser, a diode laser, or a Nd:YAG laser in the dark, in the light, or in IR. Changes in cell proliferation were evaluated using optical density at 540 nm, alkaline phosphatase (ALP) enzyme activity, cytokine expression, and basic fibroblast growth factor (bFGF) expression.

RESULTS

The optical density and ALP enzyme activity indicate that 5 J/cm(2) using 1064 nm in the light is more effective in increasing cell proliferation or cell growth than 830 nm in the light, but not as effective as 632.8 nm in the light. bFGF expression shows that the response of wounded cells exposed to 5 J/cm(2) in IR light is far less than the biological response of wounded cells exposed to 5 J/cm(2) in the dark or light. The results indicate that wounded cells exposed to 5 J/cm(2) using 632.8 nm in the dark results in a greater increase in IL-6 when compared to cells exposed to 5 J/cm(2) in the light or in IR.

CONCLUSION

Results indicate that 5 J/cm(2) (using 632.8 nm in the dark or 830 nm in the light) is the most effective dose to stimulate cell proliferation, which may ultimately accelerate or improve the rate of wound healing.

A phase III randomized double-blind placebo-controlled clinical trial to determine the efficacy of low level laser therapy for the prevention of oral mucositis in patients undergoing hematopoietic cell transplantation

INTRODUCTION

Oral mucositis (OM) is a significant early complication of hematopoietic cell transplantation (HCT). This phase III randomized double-blind placebo-controlled study was designed to compare the ability of 2 different low level GaAlAs diode lasers (650 nm and 780 nm) to prevent oral mucositis in HCT patients conditioned with chemotherapy or chemoradiotherapy.

MATERIALS AND METHODS

Seventy patients were enrolled and randomized into 1 of 3 treatment groups: 650 nm laser, 780 nm laser or placebo. All active laser treatment patients received daily direct laser treatment to the lower labial mucosa, right and left buccal mucosa, lateral and ventral surfaces of the tongue, and floor of mouth with energy densities of 2 J/cm2. Study treatment began on the first day of conditioning and continued through day +2 post HCT. Mucositis and oral pain was measured on days 0, 4, 7, 11, 14, 18, and 21 post HCT.

RESULTS

The 650 nm wavelength reduced the severity of oral mucositis and pain scores. Low level laser therapy was well-tolerated and no adverse events were noted.

DISCUSSION

While these results are encouraging, further study is needed to truly establish the efficacy of this mucositis prevention strategy. Future research needs to determine the effects of modification of laser parameters (e.g., wavelength, fluence, repetition rate of energy delivery, etc.) on the effectiveness of LLE laser to prevent OM.

Laser light influences cellular viability and proliferation in diabetic-wounded fibroblast cells in a dose- and wavelength-dependent manner

Phototherapy stimulates metabolic processes in healing wounds. Despite worldwide interest, phototherapy is not firmly established or practiced in South Africa. This study aimed to determine which dose and wavelength would better induce healing in vitro. Diabetic-induced wounded fibroblasts were irradiated with 5 or 16 J/cm(2) at 632.8, 830, or 1,064 nm. Cellular morphology, viability (Trypan blue and apoptosis), and proliferation (basic fibroblast growth factor) were then determined. Cells irradiated with 5 J/cm(2) at 632.8 nm showed complete wound closure and an increase in viability and basic fibroblast growth factor (bFGF) expression. Cells irradiated at 830 nm showed incomplete wound closure and an increase in bFGF expression. Cells irradiated at 1,064 nm showed incomplete closure and increased apoptosis. All cells irradiated with 16 J/cm(2) at all three wavelengths showed incomplete wound closure, increased apoptosis, and decreased bFGF expression. This study showed that diabetic-wounded cells respond in a dose- and a wavelength-dependent manner to laser light. Cells responded the best when irradiated with a fluence of 5 J/cm(2) at a wavelength of 632.8 nm.

The importance of coherence length in laser phototherapy of gingival inflammation—a pilot study

The aim of this study was to investigate if coherence length is of importance in laser phototherapy. Twenty patients with moderate periodontitis were selected. After oral hygiene instructions, scaling and root planing (SRP), one side of the upper jaw was randomly selected for HeNe (632.8 nm, 3 mW) or InGaAlP (650 nm, 3 mW) laser irradiation. One week after SRP, the following parameters were measured: pocket depth, gingival index, plaque index, gingival crevicular fluid volume, matrix metalloproteinase (MMP-8), interleukin (IL-8) and subgingival microflora. The irradiation (180 s per point, energy 0.54 J) was then performed once a week for 6 weeks. At the follow up examination, all clinical parameters had improved significantly in both groups. A more pronounced decrease of clinical inflammation was observed after HeNe treatment. MMP-8 levels were considerably reduced on the HeNe side, while there was no difference for IL-8 or microflora. Coherence length appears to be an important factor in laser phototherapy.

Influence of Photodynamic Therapy on the Development of Ligature-Induced Periodontitis in Rats

BACKGROUND

The purpose of this study was to evaluate, histologically and radiographically, the effect of photodynamic therapy on the progression of experimentally induced periodontal disease in rats.

METHODS

Ligatures were placed at the first mandibular molar in rats. The animals were divided into four groups: group 1 (C) received no treatment; group 2 was treated topically with methylene blue (MB; 100 microg/ml); group 3 was treated with low-level laser therapy (LLLT); and group 4 was treated topically with methylene blue followed by LLLT (4.5 J/cm(2)) (photodynamic therapy; PDT). Rats were sacrificed 5, 15, or 30 days postoperatively. Standardized radiographs were taken to measure bone loss around the mesial root surface of the first molar. Data were analyzed statistically (analysis of variance and Tukey test; P <0.05). A scoring system was used to evaluate the connective tissue, periodontal ligament, and alveolar bone histologically. Data were analyzed statistically (Kruskal-Wallis test; P <0.05).

RESULTS

Radiographic examination showed that there was significantly less bone loss in Group PDT compared to Group C at 5 and 15 days postoperatively. There was no significant difference in bone loss at 30 days. At 15 days, the histologic results showed significant differences in the extent of inflammatory reaction in the gingival tissue, with a greater extent of chronic inflammatory reaction in Group LLLT.

CONCLUSION

PDT transiently reduced the periodontal tissue destruction.

Comparative Study Using 685-nm and 830-nm Lasers in the Tissue Repair of Tenotomized Tendons in the Mouse

OBJECTIVE

The objective of this study was to evaluate the effects of 685- and 830-nm laser irradiations, at different fluences on the healing process of Achilles tendon (Tendon calcaneo) of mice after tenotomy.

BACKGROUND DATA

Some authors have shown that low-level laser therapy (LLLT) is able to accelerate the healing process of tendinuos tissue after an injury, increasing fibroblast cell proliferation and collagen synthesis. However, the mechanism by which LLLT acts on healing process is not fully understood.

METHODS

Forty-eight male mice were divided into six experimental groups: group A, tenomized animals, treated with 685 nm laser, at the dosage of 3 J/cm(2); group B, tenomized animals, treated with 685-nm laser, at the dosage of 10 J/cm(2); group C, tenomized animals, treated with 830-nm laser, at dosage of 3 J/cm(2); group D, tenomized animals, treated with 830-nm laser, at the dosage of 10 J/cm(2); group E, injured control (placebo treatment); and group F, non-injured standard control. Animals were killed on day 13 post-tenotomy, and their tendons were surgically removed for a quantitative analysis using polarization microscopy, with the purpose of measuring collagen fibers organization through the birefringence (optical retardation [OR]).

RESULTS

All treated groups showed higher values of OR when compared to injured control group. The best organization and aggregation of the collagen bundles were shown by the animals of group A (685 nm, 3 J/cm(2)), followed by the animals of group C and B, and finally, the animals of group D.

CONCLUSION

All wavelengths and fluences used in this study were efficient at accelerating the healing process of Achilles tendon post-tenotomy, particularly after the 685-nm laser irradiation, at 3 J/cm(2). It suggests the existence of wavelength tissue specificity and dose dependency. Further studies are required to investigate the physiological mechanisms responsible for the effects of laser on tendinuos repair.

Comparison between Wound Healing in Induced Diabetic and Nondiabetic Rats after Low-Level Laser Therapy

OBJECTIVE

The aim of this work was to compare the effect of low-level laser therapy (LLLT) on the wound healing process in nondiabetic and diabetic rats.

BACKGROUND DATA

Among the clinical symptoms caused by diabetes mellitus, a delay in wound healing is a potential risk for patients. It is suggested that LLLT can improve wound healing.

METHODS

The tissue used for this study was extracted from animals suffering from diabetes, which was induced by Streptozotocin, and from nondiabetic rats. Animals were assembled into two groups of 25 rats each (treated and control) and further subdivided into two groups: diabetic (n = 15) and nondiabetic (n = 10). A full-thickness skin wound was made on the dorsum area, with a round 8-mm holepunch. The treated group was irradiated by a HeNe laser at 632.8 nm, with the following parameters: 15 mW, exposition time of 17 sec, 0.025 cm2 irradiated area, and energy density of 10 J/cm2. Square full-thickness skin samples (18 mm each side, including both injured and noninjured tissues) were obtained at 4, 7, and 15 days after surgery and analyzed by qualitative and quantitative histological methods.

RESULTS

Quantitative histopathological analysis confirmed the results of the qualitative analysis through histological microscope slides. When comparing tissue components (inflammatory cells, vessels and fibroblast/area), we found that treated animals had a less intense inflammatory process than controls.

CONCLUSION

Results obtained by both qualitative and quantitative analyses suggested that irradiation of rats with HeNe (632.8 nm), at the tested dose, promoted efficient wound healing in both nondiabetic and diabetic rats as, compared to the control group.

Irradiation at 780 nm increases proliferation rate of osteoblasts independently of dexamethasone presence

BACKGROUND AND OBJECTIVES

We have previously shown that phototherapy increases cell growth and impairs protein secretion of fibroblasts. Our objective was to study the effect of phototherapy on osteoblast-like cells in culture treated with dexamethasone.

STUDY DESIGN/MATERIALS AND METHODS

Rat calvaria osteoblast-like cells were previously treated or not with dexamethasone and then, they were irradiated or not with a GaAlAs diode laser (wavelength of 780 nm, 10 mW, 3 J/cm2). Adhesion, proliferation, and osteonectin synthesis were analyzed.

RESULTS

Phototherapy increased the proliferation rate of cells independently of dexamethasone presence. Adhesion and osteonectin synthesis were not significantly influenced by laser and/or dexamethasone.

CONCLUSIONS

Based on the conditions of this study we concluded that phototherapy acts as a proliferative stimulus on osteoblast-like cells, even under the influence of dexamethasone. Thus, we suggest that phototherapy can be of importance as co-adjuvant in bone clinical manipulation in order to accelerate bone regeneration.

Influence of different power densities of LILT on cultured human fibroblast growth

The aim of this in vitro study was to analyze the influence of different power densities of low-intensity laser therapy (LILT) on the biomodulation of human gingival fibroblasts. The cells were cultured in nutritional deficit. Laser irradiation was carried out with a GaAlAs diode laser (lambda-660 nm, 2 J/cm2). The irradiation was done twice with 12-h interval using the punctual technique, at continuous mode and in contact. The experimental groups were: I, control, nonirradiated; II, power of 10 mW and intensity approximately or equal to 142.85 mW/cm2; III, 29 mW and 428.57 mW/cm2. Growth curves were obtained by using the trypan blue dye exclusion assay. The cell growth of the irradiated groups was significantly higher than control group (P<or=0.05). The cultures of Group II presented cell growth superior to that of Group III. Based on the conditions of this study, we concluded that the power density influences cell growth in an inversely proportional manner.

Photoradiation and Orthodontic Movement: Experimental Study with Canines

OBJECTIVE

The aim of this study was to evaluate, through a double-blind study, the effect of gallinium-aluminium- arsenic (GaAlAs) laser irradiation on the speed of orthodontic movement in canine premolars.

METHODS

Eighteen dogs were divided into two groups, and their third molars were extracted. An orthodontic device was placed between the first molar and the second premolar for stabilization purpose. Group I was irradiated with a dosage of 5.25 J/cm(2) on the right side, whereas the left side was used as the control group. Group II was submitted to the same procedure, but was irradiated with a dosage of 35.0 J/cm(2). Irradiations were done every 7 days, for a total of nine irradiations. The orthodontic space was measured every 21 days.

RESULTS

The 5.25 J/cm(2) dosage accelerated orthodontic movement during the first observation period, from 0 to 21 days (p < 0.05), whereas the 35.0 J/cm(2) dosage retarded the orthodontic movement in the treated group when compared with the control group, during both the first and second observation periods, from 0 to 42 days (p < 0.05).

CONCLUSION

The results suggets that photoradiation may accelerate orthodontic movement at a dosage of 5.25 J/cm(2), whereas a higher dosage, 35.0 J/cm(2), may retard it.

Low-Level Laser Therapy for Wound Healing: Mechanism and Efficacy

BACKGROUND

Given the recent interest in light-emitting diode (LED) photomodulation and minimally invasive nonablative laser therapies, it is timely to investigate reports that low-level laser therapy (LLLT) may have utility in wound healing.

OBJECTIVES

To critically evaluate reported in vitro models and in vivo animal and human studies and to assess the qualitative and quantitative sufficiency of evidence for the efficacy of LLLT in promoting wound healing.

METHOD

Literature review, 1965 to 2003.

RESULTS

In examining the effects of LLLT on cell cultures in vitro, some articles report an increase in cell proliferation and collagen production using specific and somewhat arbitrary laser settings with the helium neon (HeNe) and gallium arsenide lasers, but none of the available studies address the mechanism, whether photothermal, photochemical, or photomechanical, whereby LLLT may be exerting its effect. Some studies, especially those using HeNe lasers, report improvements in surgical wound healing in a rodent model; however, these results have not been duplicated in animals such as pigs, which have skin that more closely resembles that of humans. In humans, beneficial effects on superficial wound healing found in small case series have not been replicated in larger studies.

CONCLUSION

To better understand the utility of LLLT in cutaneous wound healing, good clinical studies that correlate cellular effects and biologic processes are needed. Future studies should be well-controlled investigations with rational selection of lasers and treatment parameters. In the absence of such studies, the literature does not appear to support widespread use of LLLT in wound healing at this time. Although applications of high-energy (10-100 W) lasers are well established with significant supportive literature and widespread use, conflicting studies in the literature have limited low-level laser therapy (LLLT) use in the United States to investigational use only. Yet LLLT is used clinically in many other areas, including Canada, Europe, and Asia, for the treatment of various neurologic, chiropractic, dental, and dermatologic disorders. To understand this discrepancy, it is useful to review the studies on LLLT that have, to date, precluded Food and Drug Administration approval of many such technologies in the United States. The fundamental question is whether there is sufficient evidence to support the use of LLLT.

A randomised, placebo controlled trial of low level laser therapy for activated Achilles tendinitis with microdialysis measurement of peritendinous prostaglandin E2 concentrations

BACKGROUND

Low level laser therapy (LLLT) has gained increasing popularity in the management of tendinopathy and arthritis. Results from in vitro and in vivo studies have suggested that inflammatory modulation is one of several possible biological mechanisms of LLLT action.

OBJECTIVE

To investigate in situ if LLLT has an anti-inflammatory effect on activated tendinitis of the human Achilles tendon.

SUBJECTS

Seven patients with bilateral Achilles tendinitis (14 tendons) who had aggravated symptoms produced by pain inducing activity immediately before the study.

METHOD

Infrared (904 nm wavelength) LLLT (5.4 J per point, power density 20 mW/cm2) and placebo LLLT (0 J) were administered to both Achilles tendons in random blinded order.

RESULTS

Ultrasonography Doppler measurements at baseline showed minor inflammation through increased intratendinous blood flow in all 14 tendons and measurable resistive index in eight tendons of 0.91 (95% confidence interval 0.87 to 0.95). Prostaglandin E2 concentrations were significantly reduced 75, 90, and 105 minutes after active LLLT compared with concentrations before treatment (p = 0.026) and after placebo LLLT (p = 0.009). Pressure pain threshold had increased significantly (p = 0.012) after active LLLT compared with placebo LLLT: the mean difference in the change between the groups was 0.40 kg/cm2 (95% confidence interval 0.10 to 0.70).

CONCLUSION

LLLT at a dose of 5.4 J per point can reduce inflammation and pain in activated Achilles tendinitis. LLLT may therefore have potential in the management of diseases with an inflammatory component.

Probing the differential effects of infrared light sources IR1072 and IR880 on human lymphocytes: evidence of selective cytoprotection by IR1072

Light therapy, both laser and LED, have been shown to provide clinical benefit in many therapeutic arenas. The effects of IR1072 and IR880 were investigated, using a range of single and multiple irradiation protocols, for their effect on freshly prepared human lymphocytes stimulated with phytohemagglutinin. Viable cell numbers remained significantly higher after irradiation with IR1072 and were significantly lower after IR880 irradiation compared to untreated controls, following a daily single irradiation over a 5-day period. Cell numbers were significantly higher after pre-treatment with IR1072 and exposure to UVA, compared to cells treated with UVA only. Cells irradiated twice on Day 3 post-harvest with various wavebands confirm on Day 5, an increase in % cell viability after IR1072, and IR1072 alternating with IR1268 irradiation, and a decrease in % cell viability after IR880 irradiation alone. Further, wavebands tested displayed no significant differences compared to the control. Cells were collected after exposure on Days 3 and 5 with IR1072 and IR880 treatments and protein levels were compared using quantitative immunoblotting probed with an anti-iNOS antibody. Following IR1072, but not IR880, treatment there was a 4.9+/-2.1-fold higher iNOS protein expression in treated cells compared to the control on Day 5 post-treatment.

Spontaneous effects of low-level laser therapy (650 nm) in acute inflammatory mouse pleurisy induced by carrageenan

OBJECTIVE

Our aim was to investigate the effect of low-level laser therapy (LLLT), 650-nm wavelength, on acute inflammatory pleurisy.

BACKGROUND DATA

There is only scattered evidence of anti-inflammatory effects from LLLT and dosage characteristics, and the effect on pleurisy inflammation has yet to be investigated.

METHODS

A classical experimental model of pleurisy was used in a sample of 40 Balb male mice, randomly divided into five groups. Inflammation was induced by carrageenan (0.5 mg/cavity) administered by intrathoracic injections. Four groups received the inflammatory agent, and one received injections of sterile saline solution. At 1, 2, and 3 h after injections, LLLT irradiation was performed, with the same power (2.5 mW), but different irradiation times. The energy densities at each of the three treatment sessions were 0 J/cm(2) (placebo), 3 J/cm(2), 7.5 J/cm(2), and 15 J/cm(2), respectively.

RESULTS

Total and differential cell analysis at 4 h after induction of pleurisy showed a significant reduction of inflammatory cell migration for all groups treated with active laser. However, at 4 h after injection, the most significant (p < 0.001) reduction of leukocyte cell migration was seen in the 7.5 J/cm(2) group, at 2.7 (95% CI: 2.5-2.9) x 10(6), versus 7.9 (95% CI: 6.7-9.1) x 10(6) in the placebo control group. The greatest reduction of inflammatory cells was registered for neutrophils.

CONCLUSIONS

LLLT administered at 1-3 h after the induction of inflammatory pleurisy significantly reduces the inflammatory cell migration measured. Under these conditions and at 2.5 mW, 7.5 J/cm(2) was more effective than 3 J/cm(2) and 15 J/cm(2).

Long-term effect of pulsed Nd:YAG laser irradiation on cultured human periodontal fibroblasts

BACKGROUND AND OBJECTIVES

The purpose of this study was to investigate the long-term effect of Nd:YAG laser irradiation on cultured human periodontal fibroblasts (hPF).

STUDY DESIGN/MATERIALS AND METHODS

The cultured hPF were irradiated by pulsed Nd:YAG laser. The power delivery was 50 mJ x 10 pps (pulse per second) with irradiation duration 60, 120, 180, or 240 seconds. The viability and collagen content of laser-irradiated hPF were assessed on day 5 after laser treatment. Light microscope and transmission electron microscope (TEM) were used to observe cytomorphological change. The irradiated hPF cultured in mineralizing medium for 28 days were examined by alizarin red S and Von Kossa stain.

RESULTS

The cellular viability and collagen content of hPF decreased after Nd:YAG laser irradiation. Cell damage was noted with retraction of cellular processes, loss of normal architecture, and lysis of some cells. However, survived hPF proliferated and migrated to the cell-debris-associated deposits. The electron-dense cytoplasm and amorphous organelles in laser-damaged cells was revealed by TEM. In vitro mineralization was demonstrated in the long-term laser-irradiated hPF cultured in mineralizing medium.

CONCLUSION

Nd:YAG laser irradiation induced partial loss of cellular viability and collagen content. The co-existence of viable cells and progressive degeneration of laser-damaged cells was associated with the in vitro mineralization of hPF.

The clinical effect of LLLT in endodontic surgery: A prospective study on 72 cases

OBJECTIVES

The purpose of this prospective study was to evaluate a possible clinical benefit of LLLT in endodontic surgery.

STUDY DESIGN

Seventy-two endosurgery cases on incisors and premolars were included to the study and were split randomly into an LLLT test group, a placebo group, and a control group. In the LLLT group, irradiation was performed intraoperatively and postoperatively 1, 3, and 7 days after surgery. In the placebo group, irradiation was performed without laser activation. In the control group, neither LLLT nor placebo therapy was used. Swelling, wound healing, and pain were evaluated by a blinded investigator 1, 3, and 7 days postoperatively.

RESULTS

No statistically relevant differences between the LLLT and the placebo groups were found. Patients in the control group reported on statistically relevant stronger pain.

CONCLUSION

In routine endodontic surgery cases, LLLT does not achieve a significant clinical benefit. Further, the results indicate a prominent placebo effect of the soft laser therapy.

Low power laser radiation at 685nm stimulates stem-cell proliferation rate in Dugesia tigrina during regeneration

Today's scientific interest in tissue engineering for organ transplantations and regeneration from stem cells, allied with recent observations on biostimulation of tissues and cells by laser radiation, stands as a strong motivation for the present work, in which we examine the effects of the low power laser radiation onto planarians under regenerative process. To investigate those effects, a number of 60 amputated worms were divided in three study groups: a control group and two other groups submitted to daily 1 and 3 min long laser treatment sections at approximately 910 W/m2 power density. A 685 nm diode laser with 35 mW optical power was used. Samples were sent to histological analysis at the 4th, the 7th and the 15th days after amputation. A remarkable increase in stem cells counts for the fourth day of regeneration was observed when the regenerating worms was stimulated by the laser radiation. Our findings encourage further research works on the influence of optical radiation onto stem cells and tissue regeneration.

The short-term effects of low-level lasers as adjunct therapy in the treatment of periodontal inflammation

OBJECTIVES

The aim of this split-mouth, double-blind controlled clinical trial was to study the effects of irradiation with low-level lasers as an adjunctive treatment of inflamed gingival tissue.

MATERIALS AND METHODS

Seventeen patients with moderate periodontitis were included. After clinical examination, all teeth were scaled and root planed (SRP). One week after SRP, we took samples of gingival crevicular fluid (GCF) and subgingival plaque. The laser therapy was started 1 week later and continued once a week for 6 weeks. One side of the upper jaw was treated with active laser and the other with a placebo. The test side was treated with two low-level lasers having wavelengths of 635 and 830 nm. The patients then underwent another clinical examination with sampling of GCF and plaque. The GCF samples were analysed for elastase activity, interleukin-1beta (IL-1beta) and metalloproteinase-8 (MMP-8). We examined the subgingival plaque for 12 bacteria using DNA probes.

RESULTS

The clinical variables i.e. probing pocket depth, plaque and gingival indices were reduced more on the laser side than on the placebo one (p<0.01). The decrease in GCF volume was also greater on the laser side, 0, 12 microl, than on the placebo side, 0.05 microl (p=0.01). The total amount of MMP-8 increased on the placebo side but was slightly lower on the laser side (p=0.052). Elastase activity, IL-1beta concentration and the microbiological analyses showed no significant differences between the laser and placebo sides.

CONCLUSION

Additional treatment with low-level lasers reduced periodontal gingival inflammation.

Laser Light Is Capable of Inducing Proliferation of Carcinoma Cells in Culture: A Spectroscopicin VitroStudy

OBJECTIVE

The objective of this work was to evaluate the influence of time, treatment, and wavelength, through the assessment of the cellular viability with MTT, on the proliferation of H.Ep.2 cells subjected to laser irradiation or not (lambda685 and lambda830 nm) with the same energy density (4 J/cm2).

BACKGROUND DATA

Although malignant lesions have been studied for some time, there is not yet a definitive cure. Mortality could be reduced if lesions were diagnosed on initial phases of development.

MATERIALS AND METHODS

H.Ep.2 cells were cultured in flasks and maintained in DMEN medium (10% FBS, 1% L-glutamine, and 1% antibiotic solution). For irradiation, cells were kept in 24 wells of the 96-well plaques containing DMEM medium (5% FBS, 1% L-glutamine, and 1% antibiotic solution), irradiated with lasers at lambda685- and lambda830-nm wavelength, and stained at 0, 6, 12, 24, and 48 h after irradiation.

RESULTS

There was significant differences when the three groups were compared (p = 0.0087). There was significant difference for both irradiated groups, lambda685 nm (p = 0.0202) and lambda830 nm (p = 0.0324). Time of irradiation significantly influenced only the lambda685-nm group (p = 0.04). The wavelength had a significant influence (p = 0.013).

CONCLUSION

Time, treatment, and wavelength significantly influenced the proliferation process of H.Ep.2 cells.

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.

Effect of 655-nm diode laser on dog sperm motility

Sperm motility depends on energy consumption. Low-level laser irradiation increases adenosin triphosphate (ATP) production and energy supply to the cell. The aim of this study is to analyse whether the irradiation affects the parameters that characterise dog sperm motility. Fresh dog sperm samples were divided into four groups and irradiated with a 655-nm continuous-wave diode laser with varying doses: 0 (control), 4, 6 and 10 J/cm(2). At 0, 15 and 45 min following irradiation, pictures were taken of all the groups in order to study motility with computer-aided sperm analysis (CASA). Functional tests were also performed. Average path velocity (VAP), linear coefficient (Lin) and beat cross frequency (BCF) were statistically and significantly different when compared to the control. The functional tests also showed a significant difference. At these parameters, the 655-nm continuous-wave diode laser improves the speed and linear coefficient of the sperm.

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.

Effect of Low-Level Er:YAG Laser Irradiation on Cultured Human Gingival Fibroblasts

BACKGROUND

Low-level laser irradiation has been reported to enhance wound healing. Activation of gingival fibroblasts (GF) has a potential for early wound healing in periodontal treatment. The present study aimed to investigate the direct effect of low-level Er:YAG laser irradiation on gingival fibroblasts proliferation in order to clarify the laser effect on healing.

METHODS

Cultured human gingival fibroblasts (hGF) were exposed to low-power, pulsed Er:YAG laser irradiation with different energy densities ranging from 1.68 to 5.0 J/cm(2). The cultures were analyzed by means of trypan blue staining and counted under a light microscope. The effect of Er:YAG laser on hGF was also evaluated using a transmission electron microscope (TEM).

RESULTS

Cultures irradiated with Er:YAG laser presented faster cell growth when compared with untreated controls. This difference was statistically significant. Transmission electron microscopy revealed rough endoplasmic reticulum, prominent Golgi complexes, and mitochondria after laser irradiation.

CONCLUSIONS

Our results showed that the low-level Er:YAG laser irradiation stimulates the proliferation of cultured gingival fibroblasts. The optimal stimulative energy density was found to be 3.37 J/cm(2). This result suggests that Er:YAG laser irradiation may be of therapeutic benefit for wound healing.

Low power laser irradiation alters gene expression of olfactory ensheathing cells in vitro

BACKGROUND AND OBJECTIVES

Both photobiomodulation (PBM) and olfactory ensheathing cells (OECs) transplantation improve recovery following spinal cord injury. However, neither the combination of these two therapies nor the effect of light on OECs has been reported. The purpose of this study was to determine the effect of light on OEC activity in vitro.

MATERIALS AND METHODS

OECs were purified from adult rat olfactory bulbs and exposed to 810 nm light (150 mW; 0, 0.2, or 68 J/cm(2)). After 7-21 days in vitro, cells underwent immunocytochemistry or RNA extraction and RT-PCR.

RESULTS

Analysis of immunolabeling revealed a significant decrease in fibronectin expression in the cultures receiving 68 J/cm(2). Analysis of gene expression revealed a significant (P < 0.05) increase in brain derived neurotrophic factor (BDNF), glial derived neurotrophic factor (GDNF), and collagen expression in the 0.2 J/cm(2) group in comparison to the non-irradiated and 68 J/cm(2) groups. OEC proliferation was also found to significantly increase in both light treated groups in comparison to the control group (P < 0.001).

CONCLUSIONS

These results demonstrate that low and high dosages of PBM alter OEC activity, including upregulation of a number of neurotrophic growth factors and extracellular matrix proteins known to support neurite outgrowth. Therefore, the application of PBM in conjunction with OEC transplantation warrants consideration as a potential combination therapy for spinal cord injury.

Evaluation of the use of low level laser and photosensitizer drugs in healing

BACKGROUND AND OBJECTIVES

In the last decade, many different kinds of therapies have emerged as a consequence of advances in the field of applied technology. It is known that low level laser therapy contributes to tissue healing; however, the use of photodynamic therapy (PDT) in healing and the scar formation processes has not been fully explored. The present study analyses the effect of low level laser InGaAIP (685 nm), radiation, either alone or combined with a phthalocyanine-derived photosensitizer (PS) in a gel base delivery (GB) system, on the healing process of cutaneous wounds in rats.

STUDY DESIGN/MATERIALS AND METHODS

The rats were divided into six groups: control (untreated) (CG), gel base (GB), photosensitizer (PS), laser (LG), laser+photosensitizer (LPS), and laser+photosensitizer in a GB (LPSG). Standardized circular wounds were made on the dorsum of each rat with a skin punch biopsy instrument. After wounding, treatment was performed once daily and the animals were killed at day 8. Tissue specimens containing the whole wound area were removed and processed for histological analysis using conventional techniques. Serial cross-sections were analyzed to evaluate the organization of the dermis and epidermis as well as collagen deposition.

RESULTS

The animals of groups LG, PS, LPS, and LPSG presented higher collagen content and enhanced re-epithelialization as compared to CG (control) and GB rats. Connective tissue remodeling was more evident in groups LPS and LPSG.

CONCLUSIONS

The results clearly indicated a synergetic effect of light+photosensitizer+delivery drug on tissue healing. PDT did not cause any healing inhibition or tissue damage during the healing process.

The efficacy of laser therapy in wound repair: a meta-analysis of the literature

OBJECTIVE

We determined the overall effects of laser therapy on tissue healing by aggregating the literature and subjecting studies meeting the inclusion and exclusion criteria to statistical meta-analysis.

BACKGROUND DATA

Low-level laser therapy (LLLT) devices have been in use since the mid sixties, but their therapeutic value remains doubtful, as the literature seems replete with conflicting findings.

MATERIALS AND METHODS

Pertinent original research papers were gathered from library sources, online databases and secondary sources. The papers were screened and coded; those meeting every inclusion and exclusion criterion were subjected to meta-analysis, using Cohen's d. statistic to determine the treatment effect size of each study.

RESULTS

Twenty-four studies with 31 effect sizes met the stringent inclusion and exclusion criteria. The overall mean effect of laser therapy on wound healing was highly significant (d = +2.22). Sub-analyses of the data revealed significant positive effects on wound healing in animal experiments (d = +1.97) as well as human clinical studies (d = +0.54). The analysis further revealed significant positive effects on specific indices of healing, for example, acceleration of inflammation (d = +4.45); augmentation of collagen synthesis (d = +1.80); increased tensile strength (d = +2.37), reduced healing time (d = +3.24); and diminution of wound size (d = +0.55). The Fail-Safe number associated with the overall effect of laser therapy was 509; a high number representing the number of additional studies-in which laser therapy has negative or no effect on wound healing-required to negate the overall large effect size of +2.22. The corresponding Fail-Safe number for clinical studies was 22.

CONCLUSION

We conclude that laser therapy is an effective tool for promoting wound repair.

Low-level laser therapy in dentistry

Low-level laser therapy (LLLT) is a newly developing technique in dentistry, although it has been used among medical, dental, physiotherapy, and veterinary professions in some parts of the world for decades. LLLT can offer tremendous therapeutic benefits to patients, such as accelerated wound healing and pain relief. There is much to be learned about the mechanisms, recognition of the therapeutic window, and how to properly use these cellular phenomena to reach the treatment goals.

Photobiomodulation Improves Cutaneous Wound Healing in an Animal Model of Type II Diabetes

OBJECTIVE

We investigated the effects of photobiomodulation (PBM) on cutaneous wound healing in an animal model of type II diabetes, Psammomys obesus (Sand Rats).

BACKGROUND DATA

632-nm light has been established as the most effective wavelength for treatment of cutaneous wounds; however, the inconsistent efficacy of PBM may be due to inadequate treatment parameter selection.

METHODS

Using 632-nm light, an initial series of experiments were done to establish optimal treatment parameters for this model. Following creation of bilateral full-thickness skin wounds, non-diabetic Sand Rats were treated with PBM of differing dosages. Wound healing was assessed according to wound closure and histological characteristics of healing. Optimal treatment parameters were then used to treat type II diabetic Sand Rats while a diabetic control group received no irradiation. In order to elucidate the mechanism behind an improvement in wound healing, expression of basic fibroblast growth factor (bFGF) was assessed.

RESULTS

Significant improvement in wound healing histology and wound closure were found following treatment with 4 J/cm(2) (16 mW, 250-sec treatments for 4 consecutive days; p < 0.05). The 4 J/cm(2) dosage significantly improved histology and closure of wounds in the diabetic group in comparison to the non-irradiated diabetic group. Quantitative analysis of bFGF expression at 36 h post-injury revealed a threefold increase in the diabetic and non-diabetic Sand Rats after PBM.

CONCLUSIONS

The results demonstrate that PBM at an energy density of 4 J/cm(2) is effective in improving the healing of cutaneous wounds in an animal model of type II diabetes, suggesting that PBM (632 nm, 4 J/cm(2)) would be effective in treating chronic cutaneous wounds in diabetic patients.

Effect of low-power laser irradiation on protein synthesis and ultrastructure of human gingival fibroblasts

BACKGROUND AND OBJECTIVES

Low-power lasers improve wound healing. Cell proliferation and protein secretion are important steps of this process. The aim of this study was to analyze both protein synthesis and ultrastructural morphology of human gingival fibroblasts irradiated by a low-power laser.

STUDY DESIGN/MATERIALS AND METHODS

The cell line FMM1 was grown in nutritional deficit. Laser irradiation was carried out with a gallium-aluminum-arsenate (Ga-Al-As) diode laser (904 nm, 120 mW, energy density of 3 J/cm(2)). The protein synthesis analysis and ultrastructural morphology of control (non-irradiated) and irradiated cultures were obtained.

RESULTS

There were changes in the structure of cytoplasm organelles of treated cells. The procollagen was not altered by the laser irradiation; however, there were a significant reduction of the amount of protein in the DMEM conditioned by irradiated cells.

CONCLUSIONS

Low-power laser irradiation causes ultrastructural changes in cultured fibroblasts. We suggest that these alterations may lead to disturbances in the collagen metabolism.

Photobiological Basis and Clinical Role of Low-Intensity Lasers in Biology and Medicine

The purpose of this article is to provide a comprehensive review on the clinical role of low intensity laser therapy (laser photostimulation) in biology and medicine. Studies on wound healing and pain relief are highlighted to show the clinical efficacy of laser therapy. Controversies about the use of low intensity laser as a therapeutic modality for wound healing and pain relief are presented and a brief explanation is provided to overcome these controversies. The importance of standard parameters is emphasized for the applications of low intensity lasers in biology and medicine. A justification has been made to warrant further research on the use of low intensity laser as a therapeutic modality. Although the therapeutic applications of low intensity laser are imminent, the heterogeneity in treatment protocols and study design calls for a vigilant interpretation of the findings.

Usefulness of low-level laser for control of painful stomatitis in patients with hand-foot-and-mouth disease

OBJECTIVE

The aim of this study was to evaluate the usefulness of low-level laser therapy (LLLT) for the control of painful stomatitis in patients with hand-foot-and-mouth disease (HFMD).

BACKGROUND DATA

LLLT has been successfully applied to various painful oral mucosal diseases, although there have been few reports on LLLT for HFMD patients.

MATERIALS AND METHODS

Through a randomized double-blind placebo controlled trial, the painful period of HFMD stomatitis was compared between the LLLT group (n=11) and the placebo LLLT one (n=9), which had similar clinical backgrounds. The LLLT parameters supplied were as follows: wavelength of 830 nm, power of 30 mW, frequency of 30 Hz, and energy output of 1.1 J/cm2. Acceptability and safety of the treatment were also evaluated.

RESULTS

The painful period was shorter in the LLLT group (4.0 +/- 1.3 days) than in the placebo LLLT one (6.7 +/- 1.6 days) with a statistically significant difference (p<0.005). The treatment was judged acceptable for 90.0% (18 of 20) of patients. No adverse events were observed in any cases.

CONCLUSION

LLLT is a useful method to control HFMD stomatitis by shortening the painful period, with its high acceptability and lack of adverse events.

Influence of low level laser therapy on wound healing and its biological action upon myofibroblasts

BACKGROUND AND OBJECTIVE

In re-evaluating the effects of laser therapy in wound healing, the role of extracellular matrix elements and myofibroblasts, was analyzed.

STUDY DESIGN/MATERIALS AND METHODS

Cutaneous wounds were inflicted on the back of 72 Wistar rats. Low level laser was locally applied with different energy densities. Lesions were analyzed after 24, 48, 72 hours and 5, 7, and 14 days. Tissues were studied by histology, immunohistochemistry, and electron microscopy.

RESULTS

In treated animals, the extent of edema and the number of inflammatory cells were reduced (P < 0.05), but the amount of collagen and elastic fibers appeared slightly increased. Desmin/smooth muscle alpha-actin-phenotype myofibroblasts were statistically more prominent on the 3rd day after surgery (P < 0.05) in treated wounds than in controls. Treatment with a dosage of 4 J/cm(2) was superior to that with 8 J/cm(2).

CONCLUSIONS

Laser therapy reduced the inflammatory reaction, induced increased collagen deposition and a greater proliferation of myofibroblasts in experimental cutaneous wounds.

Does LLLT stimulate laryngeal carcinoma cells? An in vitro study

Low level laser therapy (LLLT) has been used successfully in biomedicine and some of the results are thought to be related to cell proliferation. The effects of LLLT on cell proliferation is debatable because studies have found both an increase and a decrease in proliferation of cell cultures. Cell culture is an excellent method to assess both effects and dose of treatment. The aim of this study was to assess the effect of 635nm and 670 nm laser irradiation of H.Ep.2 cells in vitro using MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide). The cells were obtained from squamous cell carcinoma (SCC) of the larynx and were routinely processed from defrost to the experimental condition. Twenty-four hours after transplantation the cells were irradiated with doses ranging from 0.04 to 0.48J/cm2 for seven consecutive days (5 mW diode lasers: 635nm or 670 nm, beam cross-section approximately 1 mm) at local light doses between 0.04 and 0.48 J/cm2. The results showed that 635nm laser light did not significantly stimulate the proliferation of H.Ep.2 cells at doses of 0.04 J/cm2 to 0.48 J/cm2, However, 670nm laser irradiation led to an increased cell proliferation when compared to both control and 635nm irradiated cells. The best cell proliferation was found with 670nm laser irradiated cultures exposed to doses of doses of 0.04 to 0.48 J/cm2. We conclude that both dose and wavelength are factors that may affect cell proliferation of H.Ep.2 cells.

Effect of low-power laser irradiation on cell growth and procollagen synthesis of cultured fibroblasts

BACKGROUND AND OBJECTIVES

In dentistry, low-power lasers have been used in the treatment of dentin hypersensitivity, gingivitis, periodontitis, and different forms of oral ulcers. This in vitro study focuses on the biostimulation of NIH-3T3 fibroblasts by a low-power Ga-As-pulsed laser.

STUDY DESIGN/MATERIALS AND METHODS

We have studied cell growth and procollagen synthesis of cultured fibroblasts submitted to low-power laser irradiation with energy densities varying from 3 to 5 J/cm(2) over a period of 1-6 days. The light source was a 120 mW Ga-As diode laser (lambda = 904 nm). Growth curves and procollagen immunoprecipitation were obtained.

RESULTS

Irradiation of 3 and 4 J/cm(2) increased the cell numbers about threefold to sixfold comparing to control cultures. However, this effect was restricted to a small range of energy densities since 5 J/cm(2) had no effect on cell growth. The energy density of 3 J/cm(2) remarkably increased cell growth, with no effect on procollagen synthesis, as demonstrated by the immunoprecipitation analysis.

CONCLUSIONS

Our results showed that a particular laser irradiation stimulates fibroblast proliferation, without impairing procollagen synthesis.

Effects of low-level laser therapy on malignant cells: in vitro study

The aim of this study was to assess the effect of 635- and 670-nm laser irradiation on H.Ep.2 cells in vitro using MTT. In addition to our previous report on the effects of LLLT on the proliferation of laryngeal carcinoma cells in which it was found that irradiaton H.Ep.2 cells with 670-nm laser results in increased cell proliferation, it was decided to evaluate the effect of increased doses of laser light on these cells. The cells, obtained from SCC of the larynx, were routinely processed from defrost to the experimental condition. The cultures were kept either at 5% or 10% of FBS. Twenty-four hours after transplantation, the cells were irradiated with laser light (5-mW diode lasers; 635 and 670-nm; beam cross section approximately 1 mm) at local light doses between 0.04 and 4.8.10(4) Jm(-2). For 670 nm, significant differences in the proliferation were observed between the two concentrations of FBS (p = 0.002) and between irradiated cultures and controls (p = 0.000). Although the results were not significant, 635-nm irradiated cells also proliferated more than nonirradiated ones. This occurred under both conditions of nutrition. It is concluded, that irradiation with 670-nm laser light applied at doses between 0.04 and 4.810(4) Jm(-2) could significantly increase proliferation of laryngeal cancer cells.