Low-intensity laser irradiation stimulates mineralization via increased BMPs in MC3T3-E1 cells

Tailoring photobiomodulation to enhance tissue regeneration

Photobiomodulation (PBM), the use of biocompatible tissue-penetrating light to interact with intracellular chromophores to modulate the fates of cells and tissues, has emerged as a promising non-invasive approach to enhancing tissue regeneration. Unlike photodynamic or photothermal therapies that require the use of photothermal agents or photosensitizers, PBM treatment does not need external agents. With its non-harmful nature, PBM has demonstrated efficacy in enhancing molecular secretions and cellular functions relevant to tissue regeneration. The utilization of low-level light from various sources in PBM targets cytochrome c oxidase, leading to increased synthesis of adenosine triphosphate, induction of growth factor secretion, activation of signaling pathways, and promotion of direct or indirect gene expression. When integrated with stem cell populations, bioactive molecules or nanoparticles, or biomaterial scaffolds, PBM proves effective in significantly improving tissue regeneration. This review consolidates findings from in vitro, in vivo, and human clinical outcomes of both PBM alone and PBM-combined therapies in tissue regeneration applications. It encompasses the background of PBM invention, optimization of PBM parameters (such as wavelength, irradiation, and exposure time), and understanding of the mechanisms for PBM to enhance tissue regeneration. The comprehensive exploration concludes with insights into future directions and perspectives for the tissue regeneration applications of PBM.

Electromagnetic Modulation of Cell Behavior: Unraveling the Positive Impacts in a Comprehensive Review

There are numerous effective procedures for cell signaling, in which humans directly transmit detectable signals to cells to govern their essential behaviors. From a biomedical perspective, the cellular response to the combined influence of electrical and magnetic fields holds significant promise in various domains, such as cancer treatment, targeted drug delivery, gene therapy, and wound healing. Among these modern cell signaling methods, electromagnetic fields (EMFs) play a pivotal role; however, there remains a paucity of knowledge concerning the effects of EMFs across all wavelengths. It's worth noting that most wavelengths are incompatible with human cells, and as such, this study excludes them from consideration. In this review, we aim to comprehensively explore the most effective and current EMFs, along with their therapeutic impacts on various cell types. Specifically, we delve into the influence of alternating electromagnetic fields (AEMFs) on diverse cell behaviors, encompassing proliferation, differentiation, biomineralization, cell death, and cell migration. Our findings underscore the substantial potential of these pivotal cellular behaviors in advancing the treatment of numerous diseases. Moreover, AEMFs wield a significant role in the realms of biomaterials and tissue engineering, given their capacity to decisively influence biomaterials, facilitate non-invasive procedures, ensure biocompatibility, and exhibit substantial efficacy. It is worth mentioning that AEMFs often serve as a last-resort treatment option for various diseases. Much about electromagnetic fields remains a mystery to the scientific community, and we have yet to unravel the precise mechanisms through which wavelengths control cellular fate. Consequently, our understanding and knowledge in this domain predominantly stem from repeated experiments yielding similar effects. In the ensuing sections of this article, we delve deeper into our extended experiments and research.

A study of the biological effects of low-level light

Low-level light therapy (LLLT), also known as photo biomodulation (PBM), is a type of optical therapy that uses red or near-infrared lasers or light-emitting diodes (LEDs) for medical treatment. The laser wavelengths involved in PBM typically range between 600-700 nm and 780-1100 nm, with power densities ranging between 5 mW/cm2 and 5 W/cm2. PBM is a series of biochemical cascades exhibited by biological tissues after absorbing a certain amount of energy from light. PBM has been widely used in clinical practice in the past 20 years, and numerous clinical trials have demonstrated its biological efficacy. However, the underlying mechanisms have not yet been fully explored. In this paper, we have summarized the research into PBM over the past two decades, to identify the important mechanisms of the biological effects of PBM from the perspective of molecular mechanisms, cellular levels, and tissue changes. We hope our study provide a theoretical basis for future investigations into the underlying mechanisms.

Photobiomodulation therapy assisted orthodontic tooth movement: potential implications, challenges, and new perspectives

Over the past decade, dramatic progress has been made in dental research areas involving laser therapy. The photobiomodulatory effect of laser light regulates the behavior of periodontal tissues and promotes damaged tissues to heal faster. Additionally, photobiomodulation therapy (PBMT), a non-invasive treatment, when applied in orthodontics, contributes to alleviating pain and reducing inflammation induced by orthodontic forces, along with improving tissue healing processes. Moreover, PBMT is attracting more attention as a possible approach to prevent the incidence of orthodontically induced inflammatory root resorption (OIIRR) during orthodontic treatment (OT) due to its capacity to modulate inflammatory, apoptotic, and anti-antioxidant responses. However, a systematic review revealed that PBMT has only a moderate grade of evidence-based effectiveness during orthodontic tooth movement (OTM) in relation to OIIRR, casting doubt on its beneficial effects. In PBMT-assisted orthodontics, delivering sufficient energy to the tooth root to achieve optimal stimulation is challenging due to the exponential attenuation of light penetration in periodontal tissues. The penetration of light to the root surface is another crucial unknown factor. Both the penetration depth and distribution of light in periodontal tissues are unknown. Thus, advanced approaches specific to orthodontic application of PBMT need to be established to overcome these limitations. This review explores possibilities for improving the application and effectiveness of PBMT during OTM. The aim was to investigate the current evidence related to the underlying mechanisms of action of PBMT on various periodontal tissues and cells, with a special focus on immunomodulatory effects during OTM.

Effects of different physical factors on osteogenic differentiation

Osteoblasts are essential for bone formation and can perceive external mechanical stimuli, which are translated into biochemical responses that ultimately alter cell phenotypes and respond to environmental stimuli, described as mechanical transduction. These cells actively participate in osteogenesis and the formation and mineralisation of the extracellular bone matrix. This review summarises the basic physiological and biological mechanisms of five different physical stimuli, i.e. light, electricity, magnetism, force and sound, to induce osteogenesis; further, it summarises the effects of changing culture conditions on the morphology, structure and function of osteoblasts. These findings may provide a theoretical basis for further studies on bone physiology and pathology at the cytological level and will be useful in the clinical application of bone formation and bone regeneration technology.

The Influence of Low-Level Laser Therapy on CBCT Radiographic and Biochemical Profiles of Type II Controlled Diabetic Patients After Dental Implant Insertion: A Randomized Case-Control Study

Background Low-level laser treatment (LLLT) was thought to increase bone quality during osseointegration when combined with dental implants. However, there is no sufficient information on its impact on dental implants in diabetics. Osteoprotegerin (OPG) has been described as a marker for bone turnover to determine implant prognosis. The current research aims to evaluate the effect of low-level laser therapy (LLLT) on bone density (BD) and osteoprotegerin levels in peri-implant crevicular fluid (PICF) in type II diabetic patients. Methods This study comprised 40 individuals with type II diabetes mellitus (T2DM). Implants were randomly placed in 20 non-lasered T2DM patients (control) and 20 lasered T2DM patients (LLLT group). At the follow-up stages, BD and OPG levels in the PICF were evaluated in both groups. Results Significant variations were shown among control and LLLT groups concerning OPG level and BD (p≤0.001). OPG was significantly decreasing with follow-up points (p≤0.001). There was a significant decrease in OPG with time in both groups with a higher decrease in the control group. Conclusion LLLT is promising in controlled T2DM patients due to its outstanding influence on BD and estimated crevicular levels of OPG. Regarding its clinical significance, LLLT significantly improved bone quality during osseointegration on dental implants in T2DM. LLLT is considered potentially important for T2DM patients during implant placement. Trial registration The study was registered on ClinicalTrial.gov under registration number NCT05279911 (registration date: March 15, 2022) (https://clinicaltrials.gov/ct2/show/NCT05279911).

Low-level green laser promotes wound healing after carbon dioxide fractional laser therapy

BACKGROUND

The carbon dioxide (CO₂ ) fractional laser resurfacing has become one of the hottest therapies for dermatoses. However, complications such as skin swelling, prolonged erythema, post-inflammatory hyperpigmentation, and scar formation remain. Low-level laser (LLL) therapy is accepted to promote skin wound healing and regeneration, decrease inflammation and pain, and modulate immunoreaction with low-dose laser of different wavelength. 532 nm laser therapy is commonly used to remove pigmented spots and to tender skin, but not utilized in wound care.

OBJECTIVE

We aimed to determine the efficacy of the low-level 532 nm green laser in wound healing after CO₂ fractional laser.

METHODS

Six adult male mice (C57BL/6, 8 weeks old) were prepared for animal experiments. The dorsum of each mouse was divided into four parts that, respectively, received designed treatments, as controlled (group Ctrl), 532 nm LLL-treated (group GL), CO₂ fractional laser-treated (group FL), and CO₂ fractional laser followed by three times 532 nm LLL-treated (group FG). Hematoxylin-eosin staining (H&E), Masson-trichrome staining, CD31 immunohistochemical staining were performed to evaluate the efficacy of wound healing after treated by different irradiations. Western blotting was used to detect the expression of related proteins. Mouse skin fibroblasts (MSFs) were treated with LLL using a wavelength of 532 nm once. Cellular responses were observed and analyzed after 48 hours. Cell viability and migration of different groups were assessed by scratch and the Cell Counting Kit-8 (CCK8) assays, respectively.

RESULTS

Collagen remodeling and epidermis thickness were significantly enhanced in group FG than that in group FL in morphology. Besides, CD31 immunohistochemical staining indicated prominently increased angiogenesis in both groups FL and FG than non-irradiation group. The expression of extracellular matrix (ECM)-related protein (Col1, Col3 and MMP1) showed a remarkable improvement in wound healing in group FG than that in group FL. Irradiated MSFs showed a better migration ability compared with non-irradiated controls. LLL enhanced the secretion function of MSFs on Collagen I and III.

CONCLUSIONS

Low-level green laser promotes wound healing after CO₂ fractional laser by improving the integrity of skin barrier and allowing for scarless healing. Therefore, low-level green laser therapy might serve as a sequential therapy of invasive laser surgery to ensure a better wound care.

Low-level controllable blue LEDs irradiation enhances human dental pulp stem cells osteogenic differentiation via transient receptor potential vanilloid 1

Human dental pulp stem cells (hDPSCs) have attracted tremendous attention in tissue regeneration engineering due to their excellent multidirectional differentiation potential. Photobiomodulation (PBM) using low-level light-emitting diodes (LEDs) or lasers has been proved to promote the osteogenesis of mesenchymal stem cells. However, the effect of LEDs on osteogenic differentiation of hDPSCs has little published data. In this work, the effect of blue LEDs with different energy densities of 2, 4, 6, 8, 10 J/cm² on osteogenic differentiation of hDPSCs was examined by using in vitro ALP staining, ALP activity, mineralization, and real-time PCR. The results showed that compared with the control group, osteogenic differentiation was significantly enhanced in blue LEDs treated groups. As the energy density increased, the level of osteogenesis initially increased and then decreased reaching the highest level at 6 J/cm². Transient receptor potential vanilloid 1 (TRPV1), a Ca²⁺ ion channel, was believed to be a potential player in osteogenesis by photobiomodulation. By immunofluorescence assay, calcium influx assay, PCR, and ALP staining, it was shown that blue LEDs irradiation can increase the activity of TRPV1 and intracellular calcium levels similarly to the agonist of TRPV1 capsaicin. Additionally, pretreatment with capsazepine, a selective TRPV1 inhibitor, was able to abrogate the osteogenic effect of blue LEDs. In conclusion, these findings proposed that blue LEDs can promote the osteogenesis of hDPSCs within the appropriate range (4-8 J/cm²) during culture of osteogenic medium, and TRPV1/Ca²⁺ may be an essential signaling pathway involved in blue LEDs-induced osteogenesis, providing new insights for the use of hDPSCs in tissue regeneration engineering.

Effect of Photobiomodulation Therapy on Peri-Implant Bone Healing in Extra-Short Implants in a Rabbit Model: A Pilot Study

Objective: To evaluate the effects of photobiomodulation therapy (PBMT) at distinct energy levels on peri-implant bone healing in extra-short implants in a experimental rabbit model. Background: The effect of PBMT on peri-implant bone healing in short implants remains unclear. This explored the effect of PBMT on extra-short implants in terms of bone-implant contact (BIC) length and rate, and implant stability quotient (ISQ). Methods: Fifteen white New Zealand rabbits were randomly divided into five groups. In all groups, extra-short implants (3.5 × 4 mm; Nucleoss T6, İzmir/Turkey) were placed in both tibias of the rabbits. PBMT was performed in four groups (group 1, 5 J/cm2; group 2, 10 J/cm2; group 3, 20 J/cm2; and group 4, 25 J/cm2); no PBMT was performed in the control group. On the 30th day, the rabbits were sacrificed and peri-implant tissue samples were obtained to determine the BIC length and BIC rate. Implant stability levels were measured by resonance frequency analysis using the Osstell penguin device and were determined as ISQ values on the 1st and 30th days of the study. Results: PBMT significantly increased the BIC length and BIC rate in groups 3 and 4 (p < 0.001). For the ISQ values, there were significant differences between the 1st and 30th day (p < 0.001). On the 30th day, the ISQ values were significantly higher in groups 3 and 4 compared with the remaining groups (p < 0.001). Conclusions: In this study, PBMT improved peri-implant bone healing through increase in BIC length, BIC rate, and ISQ parameter values in extra-short implants.

Efficacy of concentrated growth factor with low-level laser for the regeneration of interdental papilla defects

Gingival "black triangle" is common in clinical which due to interdental papilla recession. The cause of the loss of papilla is multi-factorial and it may be caused by the absorption of interdental alveolar bone or abnormal tooth position. Besides, it is a common complication after orthodontics and implant surgery. Recession of gingival papilla influences interdental plaque control, increasing food impaction and alveolar bone absorption, causing aesthetic and pronunciation problems. Thus, the way of reducing or eliminating the gingival "black triangle" has become one of the most essential problems for dentists. Concentrated growth factor (CGF) and low-level-laser therapy have been widely used, respectively, and CGF was considered as the only self-substance which has soft tissue regeneration function. This study aims to evaluate the efficacy of regenerating interdental papilla by Liquid phase concentrated growth factor (LPCGF) injection with low-level-laser therapy (LLLT).

Laser-photobiomodulation on titanium implant bone healing in rat model: comparison between 660- and 808-nm wavelength

Laser-photobiomodulation (L-PBM) has been widely studied and its biomodulatory effects have been established on irradiated cells, increasing viability and proliferation and on damaged tissues. In addition, L-PBM may reduce and modulate the inflammatory process. The effect of 660-nm and 808-nm laser-photobiomodulation on bone repair around titanium dental implants placed in rat's femur was evaluated by histomorphometry. Twenty-seven Wistar rats were divided into 3 groups of nine animals: group C - non-irradiated control; group R - λ=660nm irradiated; and group IR - λ=808nm irradiated. Each group was further divided in 3 subgroups of three animals each, according to histomorphometry analysis in 3 days, 7 days, and 14 days after irradiation. Histological H.E.-stained slides were photographed, and bone matrix measured in new-formed bone area. Bone matrix histomorphometry analysis indicates that at 7 days in the irradiated groups (R and IR), a bigger area matrix was observed in relation to control group (C) (p=0.04 and p=0.048 respectively). On the other hand, at 14 days, control group (C) presented a bigger area than infrared irradiated (IR) (p=0.001) and red irradiated group (R) also showed a bigger area than infrared irradiated group (IR) (p=0.019). Histological analysis indicates that irradiated groups (R and IR) exhibited a faster bone tissue matrix production than control group.

Efficacy of Photobiomodulation and Vitamin D on Odontogenic Activity of Human Dental Pulp Stem Cells

Introduction: The regeneration of dental pulp tissue using human dental pulp stem cells (HDPSCs) has attracted increasing attention in recent years. Recent studies have suggested that several factors such as photobiomodulation (PBM) and vitamin D affect the proliferation and differentiation of HDPSCs. Therefore, the present study evaluated the effects of PBM and vitamin D on odontogenic differentiation of HDPSCs for dentin -like tissue formation. Methods: HDPSCs were collected, isolated, and characterized and then divided into six groups: group I, control; group II, vitamin D (10^-7 Mol); group III, irradiation at 1 J/cm² of 810 nm diode laser; group IV, irradiation at 1 J/cm² and culture with vitamin D; group V, irradiation at 2 J/cm², and group VI, irradiation at 2 J/cm² and culture with vitamin D, cell viability assay was measured through MTT. Alkaline phosphatase (ALP) enzyme activity and mRNA levels of vascular endothelial growth factor (VEGF), bone morphogenic protein-2 (BMP-2), and dentin sialophosphoprotein (DSPP) were also assessed. Results: PBM at 1 and 2 J/cm² combined with vitamin D significantly promoted HDPSCs proliferation through MTT assay and odontogenic differentiation through gene expression of VEGF, BMP-2, and DSPP levels (P < 0.0001). Conclusion: PBM at 2 J/cm² combined with vitamin D enhanced the HDPSCs proliferation and odontogenic differentiation and thus could be a novel strategy for dentin regeneration in dentistry.

Photobiomodulation by Near-Infrared 980-nm Wavelengths Regulates Pre-Osteoblast Proliferation and Viability through the PI3K/Akt/Bcl-2 Pathway

BACKGROUND

bone tissue regeneration remains a current challenge. A growing body of evidence shows that mitochondrial dysfunction impairs osteogenesis and that this organelle may be the target for new therapeutic options. Current literature illustrates that red and near-infrared light can affect the key cellular pathways of all life forms through interactions with photoacceptors within the cells' mitochondria. The current study aims to provide an understanding of the mechanisms by which photobiomodulation (PBM) by 900-nm wavelengths can induce in vitro molecular changes in pre-osteoblasts.

METHODS

The PubMed, Scopus, Cochrane, and Scholar databases were used. The manuscripts included in the narrative review were selected according to inclusion and exclusion criteria. The new experimental set-up was based on irradiation with a 980-nm laser and a hand-piece with a standard Gaussian and flat-top beam profile. MC3T3-E1 pre-osteoblasts were irradiated at 0.75, 0.45, and 0.20 W in continuous-wave emission mode for 60 s (spot-size 1 cm²) and allowed to generate a power density of 0.75, 0.45, and 0.20 W/cm² and a fluence of 45, 27, and 12 J/cm², respectively. The frequency of irradiation was once, three times (alternate days), or five times (every day) per week for two consecutive weeks. Differentiation, proliferation, and cell viability and their markers were investigated by immunoblotting, immunolabelling, fluorescein-FragELTM-DNA, Hoechst staining, and metabolic activity assays.

RESULTS AND CONCLUSIONS

The 980-nm wavelength can photobiomodulate the pre-osteoblasts, regulating their metabolic schedule. The cellular signal activated by 45 J/cm², 0.75 W and 0.75 W/cm² consist of the PI3K/Akt/Bcl-2 pathway; differentiation markers were not affected, nor do other parameters seem to stimulate the cells. Our previous and present data consistently support the window effect of 980 nm, which has also been described in extracted mitochondria, through activation of signalling PI3K/Akt/Bcl-2 and cyclin family, while the Wnt and Smads 2/3-β-catenin pathway was induced by 55 J/cm², 0.9 W and 0.9 W/cm².

In Vitro Cytological Responses against Laser Photobiomodulation for Periodontal Regeneration

Periodontal disease is a chronic inflammatory disease caused by periodontal bacteria. Recently, periodontal phototherapy, treatment using various types of lasers, has attracted attention. Photobiomodulation, the biological effect of low-power laser irradiation, has been widely studied. Although many types of lasers are applied in periodontal phototherapy, molecular biological effects of laser irradiation on cells in periodontal tissues are unclear. Here, we have summarized the molecular biological effects of diode, Nd:YAG, Er:YAG, Er,Cr:YSGG, and CO₂ lasers irradiation on cells in periodontal tissues. Photobiomodulation by laser irradiation enhanced cell proliferation and calcification in osteoblasts with altering gene expression. Positive effects were observed in fibroblasts on the proliferation, migration, and secretion of chemokines/cytokines. Laser irradiation suppressed gene expression related to inflammation in osteoblasts, fibroblasts, human periodontal ligament cells (hPDLCs), and endothelial cells. Furthermore, recent studies have revealed that laser irradiation affects cell differentiation in hPDLCs and stem cells. Additionally, some studies have also investigated the effects of laser irradiation on endothelial cells, cementoblasts, epithelial cells, osteoclasts, and osteocytes. The appropriate irradiation power was different for each laser apparatus and targeted cells. Thus, through this review, we tried to shed light on basic research that would ultimately lead to clinical application of periodontal phototherapy in the future.

Interaction between Laser Light and Osteoblasts: Photobiomodulation as a Trend in the Management of Socket Bone Preservation-A Review

Simple Summary

Dental implants are becoming an accepted tool, and thousands of implants are placed every year by specialists and general practitioners. However, more than 10% of bone surgeries and related procedures can show healing complications as a consequence of infections, tissue damage, or inadequate blood supply. In particular, a deficient blood supply impacts on the optimal healing process because of altered oxygen delivery to cells in the wound and a decrease in their energy supply. Researchers showed how red and infrared light affects key cellular pathways by interacting with specific photoacceptors located within the cell, particularly in mitochondria. Low-level laser therapy or photobiomodulation (PBM), as the recent medical subject heading defines it, is based on a light–cell interaction, which modifies cell metabolism by increasing oxygen consumption and ATP production through mitochondria. Although not all aspects of this interconnection are completely described, many in vitro and in vivo studies showed the benefit of PBM in wound defect management. For instance, treatment of bone with PBM results in a greater amount of new-formed osteoblasts and matrix, an increase in collagen synthesis, and microvascular reestablishment. In our review, we highlight the osteoblast–light interaction, and the in vivo therapeutic tool of PBM for socket preservation is discussed.

Abstract

Bone defects are the main reason for aesthetic and functional disability, which negatively affect patient’s quality of life. Particularly, after tooth extraction, the bone of the alveolar process resorbs, limiting the optimal prosthetic implant placement. One of the major pathophysiological events in slowly- or non-healing tissues is a blood supply deficiency, followed by a significant decrease in cellular energy amount. The literature shows that photons at the red and infrared wavelengths can interact with specific photoacceptors located within the cell. Through this mechanism, photobiomodulation (PBM) can modify cellular metabolism, by increasing mitochondrial ATP production. Here, we present a review of the literature on the effect of PBM on bone healing, for the management of socket preservation. A search strategy was developed in line with the PRISMA statement. The PubMed and Scholar electronic databases were consulted to search for in vivo studies, with restrictions on the year (<50 years-old), language (English), bone socket preservation, and PBM. Following the search strategy, we identified 269 records, which became 14, after duplicates were removed and titles, abstract and inclusion-, exclusion-criteria were screened. Additional articles identified were 3. Therefore, 17 articles were included in the synthesis. We highlight the osteoblast–light interaction, and the in vivo therapeutic tool of PBM is discussed.

Laser and LED photobiomodulation effects in osteogenic or regular medium on rat calvaria osteoblasts obtained by newly forming bone technique

The purposes of this study are to evaluate the effects of photobiomodulation (PBM) with laser and LED on rat calvaria osteoblasts (rGO lineage), cultured in osteogenic (OST) or regular (REG) medium, after induction of a quiescent state and to test if PBM is capable of osteogenic induction and if there is a sum of effects when combining OST medium with PBM. Before irradiation, the cells were put in a quiescent state (1% FBS) 24 h, when red (AlGaInP-660 nm) and infrared laser (GaAlAs-808 nm) and LED (637 ± 15 nm) were applied. The groups were as follows: red laser (RL3-5 J/cm², 3 s and RL5-8.3 J/cm², 5 s, 1.66 W/cm²); infrared laser (IrL3-5 J/cm², 3 s and IrL5-8.3 J/cm², 5 s); LED (LED3-3 s and LED5-5 s, 0.02 J/cm², 0.885 W/cm²); positive (C+, 10% FBS) and negative control (C-, 1% FBS). For alkaline phosphatase (ALP) and mineralization assays, the cells were cultured in REG (DMEM 10% FBS) and OST medium (DMEM 10% FBS, 50 μg/mL ascorbic acid, 10 mM β-glycerophosphate). Statistical analysis was performed using ANOVA and Tukey's tests (p < 0.05). RL5 and LED5 increased proliferation, in vitro wound closure, ALP, and mineralization in rGO cells (p < 0.05). PBM with red laser and LED induced mineralization by itself, without osteogenic medium, not observed for infrared laser (p < 0.05). A sum of effects was observed in osteogenic medium and PBM by infrared, red laser, and LED (5 s). Red laser and LED increased proliferation, migration, and secretory phases in rGO cells in a dose-dependent manner. PBM with red laser and LED promotes osteogenic induction by itself. PBM with infrared laser and osteogenic medium potentializes mineralization.

Progress in Photobiomodulation for Bone Fractures: A Narrative Review

Objective: The aim of this article is to examine current concepts and the future direction of implementing photobiomodulation (PBM) for fracture treatment. Background data: The effectiveness of PBM for bone regeneration has been demonstrated throughout in vitro studies and animal models. Yet, insufficient clinical trials have been reported on treating fractures with PBM. Materials and methods: A narrative review was composed on the basis of a literary search. Inclusion criteria consisted of studies between 2000 and 2019 using animal or human fracture models. Exclusion criteria consisted of studies that did not pertain to complete fractures or used other forms of intervention. Results: Ten animal studies on rats and rabbits and four clinical trials were found on using PBM for complete fractures. Conclusions: Based on positive outcomes in animal trials, parameter optimization of PBM for human fractures still requires extensive research on factors such as dosage, wavelength, penetration depth, treatment frequency, and the use of pulsed waves.

Utility of High-Intensity Laser Therapy Combined with Photobiomodulation Therapy for Socket Preservation After Tooth Extraction

Objective: High-intensity laser therapy (HILT) combined with photobiomodulation therapy (PBMT) using a diode or CO₂ laser was administered after extraction of the left first molar in rats. Effects on socket preservation (preservation of the alveolar bone and healing time after extraction) were evaluated histopathologically.

Background: Irradiation using a diode or CO₂ laser has been shown to hasten wound healing, but the effects remain controversial.

Methods: Five-week-old male Wistar rats that underwent extraction of the left maxillary first molar were divided into three groups: diode laser irradiation (diode group), CO₂ laser irradiation (CO₂ group), and no laser irradiation (control group). HILT (27 J) was performed immediately after tooth extraction to enhance blood coagulation, followed by PBMT (0.7 J) 1 day later to enhance healing. Tissues, including the extraction socket, were removed en bloc 3, 5, 7, 10, and 21 days postextraction to determine the morphological characteristics of wound healing and the distribution of myofibroblasts involved in scar formation.

Results: In the diode and CO₂ groups, new bone formation and cancellous bone maturation were observed at an early stage of wound healing. The number of myofibroblasts was significantly lower in the laser treatment groups than the control (p < 0.001), and both treatment groups had a significantly higher alveolar crest height (p < 0.01), with almost no concavity in the mucosa of the extraction wound.

Conclusions: Combined HILT and PBMT following tooth extraction hastened wound healing and preserved alveolar crest height, suggesting a role in socket preservation.

Gene Expression Analysis of Chondrogenic Markers in Hair Follicle Dermal Papillae Cells Under the Effect of Laser Photobiomodulation and the Synovial Fluid

Introduction: Regarding the limited ability of the damaged cartilage cells to self-renew, which is due to their specific tissue structure, subtle damages can usually cause diseases such as osteoarthritis. In this work, using laser photobiomodulation and an interesting source of growth factors cocktail called the synovial fluid, we analyzed the chondrogenic marker genes in treated hair follicle dermal papilla cells as an accessible source of cells with relatively high differentiation potential. Methods: Dermal papilla cells were isolated from rat whisker hair follicle (Rattus norvegicus) and established cell cultures were treated with a laser (gallium aluminum arsenide diode Laser (λ=780 nm, 30 mW) at 5 J/cm² ), the synovial fluid, and a combination of both. After 1, 4, 7, and 14 days, the morphological changes were evaluated and the expression levels of four chondrocyte marker genes (Col2a1, Sox-9, Col10a1, and Runx-2) were assessed by the quantitative real-time polymerase chain reaction. Results: It was monitored that treating cells with laser irradiation can accelerate the rate of proliferation of cells. The morphology of the cells treated with the synovial fluid altered considerably as in the fourth day they surprisingly looked like cultured articular chondrocytes. The gene expression analysis showed that all genes were up-regulated until the day 14 following the treatments although not equally in all the cell groups. Moreover, the cell groups treated with both irradiation and the synovial fluid had a significantly augmented expression in gene markers. Conclusion: Based on the gene expression levels and the morphological changes, we concluded that the synovial fluid can have the potential to make the dermal papilla cells to most likely mimic the chondrogenic and/or osteogenic differentiation, although this process seems to be augmented by the irradiation of the low-level laser.

Effect of low power laser in biomodulation of cultured osteoblastic cells of Wistar rats1

Purpose

To analyze aspects of the biomodulating effect of light in biological tissues, bone cells from surgical explants of the femur of rats were irradiated with low intensity laser.

Methods

Bone cells were cultured and irradiated with LASER light (GaAlAs). Growth, cell viability, mineralized matrix formation, total protein dosage, immunostimulatory properties, cytochemical analysis, gene expression of bone proteins were examined using live cell imaging and cell counting by colorimetric assay. The gene expression of: alkaline phosphatase (ALP), type 1 collagen, osteocalcin and osteopontin through the real-time polymerase chain reaction.

Results

At 8 days, the viability of the irradiated culture was 82.3% and 72.4% in non-irradiated cells. At 18 days, the cellular viability (with laser) was 77.42% and 47.62% without laser. At 8 days, the total protein concentration was 21.622 mg / mol in the irradiated group and 16, 604 mg / mol in the non-irradiated group and at 18 days the concentration was 37.25 mg / mol in the irradiated group and 24, 95 mg / mol in the non-irradiated group.

Conclusion

The laser interfered in the histochemical reaction, cell viability, matrix mineralization, and maintained the cellular expression of proteins

Astragalin Promotes Osteoblastic Differentiation in MC3T3-E1 Cells and Bone Formation in vivo

Astragalin (AG) is a biologically active flavonoid compound that can be extracted from a number of medicinal plants. However, the effects of AG on osteoblastic differentiation in mouse MC3T3-E1 cells and on bone formation in vivo have not been studied fully. In this study, we found that the activities of alkaline phosphatase (ALP) and mineralized nodules in MC3T3-E1 cells were both significantly increased after treatment with AG (5, 10, and 20 μM). Meanwhile, the mRNA and protein levels of osteoblastic marker genes in MC3T3-E1 cells after AG treatment were markedly increased compared with a control group. In addition, the levels of BMP-2, p-Smad1/5/9, and Runx2 were significantly elevated in AG-treated MC3T3-E1 cells. Moreover, we found that the protein levels of Erk1/2, p-Erk1/2, p38, p-p38, and p-JNK were also significantly increased in AG-treated MC3T3-E1 cells compared to those in the control group. Finally, in vivo experiments demonstrated that AG significantly promoted bone formation in an ovariectomized (OVX)-induced osteoporotic mouse model. This was evidenced by significant increases in the values of osteoblast-related parameters (BFR/BS, MAR, Ob.S/BS, and Ob.N/B.Pm) and bone histomorphometric parameters (BMD, BV/TV, Tb.Th, and Tb.N.) in OVX mice after AG treatment (5, 10, and 20 mg/kg). Collectively, these results demonstrated that AG may promote osteoblastic differentiation in MC3T3-E1 cells via the activation of the BMP and MAPK pathways and promote bone formation in vivo. These novel findings indicated that AG may be a useful bone anabolic agent for the prevention and treatment of osteoporosis.

Low-level ultrahigh-frequency and ultrashort-pulse blue laser irradiation enhances osteoblast extracellular calcification by upregulating proliferation and differentiation via transient receptor potential vanilloid 1

BACKGROUND AND OBJECTIVE

Low-level laser irradiation (LLLI) exerts various biostimulative effects, including promotion of wound healing and bone formation; however, few studies have examined biostimulation using blue lasers. The purpose of this study was to investigate the effects of low-level ultrahigh-frequency (UHF) and ultrashort-pulse (USP) blue laser irradiation on osteoblasts.

STUDY DESIGN/ MATERIALS AND METHODS

The MC3T3-E1 osteoblast cell line was used in this study. Following LLLI with a 405 nm newly developed UHF-USP blue laser (80 MHz, 100 fs), osteoblast proliferation, and alkaline phosphatase (ALP) activity were assessed. In addition, mRNA levels of the osteoblast differentiation markers, runt-related transcription factor 2 (Runx2), osterix (Osx), alkaline phosphatase (Alp), and osteopontin (Opn) was evaluated, and extracellular calcification was quantified. To clarify the involvement of transient receptor potential (TRP) channels in LLLI-induced biostimulation, cells were treated prior to LLLI with capsazepine (CPZ), a selective inhibitor of TRP vanilloid 1 (TRPV1), and subsequent proliferation and ALP activity were measured.

RESULTS

LLLI with the 405 nm UHF-USP blue laser significantly enhanced cell proliferation and ALP activity, compared with the non-irradiated control and LLLI using continuous-wave mode, without significant temperature elevation. LLLI promoted osteoblast proliferation in a dose-dependent manner up to 9.4 J/cm² and significantly accelerated cell proliferation in in vitro wound healing assay. ALP activity was significantly enhanced at doses up to 5.6 J/cm² , and expression of Osx and Alp mRNAs was significantly increased compared to that of the control on days 3 and 7 following LLLI at 5.6 J/cm² . The extent of extracellular calcification was also significantly higher as a result of LLLI 3 weeks after the treatment. Measurement of TRPV1 protein expression on 0, 3, and 7 days post-irradiation revealed no differences between the LLLI and control groups; however, promotion of cell proliferation and ALP activity by LLLI was significantly inhibited by CPZ.

CONCLUSION

LLLI with a 405 nm UHF-USP blue laser enhances extracellular calcification of osteoblasts by upregulating proliferation and differentiation via TRPV1. Lasers Surg. Med. 50:340-352, 2018. © 2017 Wiley Periodicals, Inc.

A new therapeutic proposal for inoperable osteosarcoma: Photodynamic therapy

BACKGROUND

Osteosarcoma, a malignant tumor characterized by bone or osteoid formation, is the second most common primary bone neoplasm. Clinical symptoms include local and surrounding pain, unrelieved by rest or anesthesia. Osteosarcoma has a poor chemotherapeutic response with prognosis dependent on complete tumor excision. Therefore, for inoperable osteosarcoma new therapeutic strategies are needed. The present study aimed to develop murine models of cranial and vertebral osteosarcoma that facilitate simple clinical monitoring and real-time imaging to evaluate the outcome of photodynamic therapy based on a previously developed photosensitizer.

METHODS

Balb/c nude mice were divided into two groups: the cranial and vertebral osteosarcoma groups. Each group was further subdivided into the photodynamic therapy-treated and untreated groups. Images were obtained by scintigraphy with ^99mTc-MIBI and radiography. Tumor growth, necrotic area, osteoid matrix area, and inflammatory infiltration were analyzed.

RESULTS

Cranial and vertebral tumors could be macroscopically observed and measured. Radiographic and scintigraphic images showed tumor cells present at the inoculation sites. After photodynamic therapy, scintigraphy showed lower tumoral radiopharmaceutical uptake, which correlated histologically with increased necrosis. Osteoid matrix volume increased, and tumor size decreased in all photodynamic therapy-treated animals.

CONCLUSION

Cranial and vertebral osteosarcoma models in athymic mice are feasible and facilitate in vivo monitoring for the development of new therapies. Photodynamic therapy is a potential antitumoral treatment for surgically inoperable osteosarcoma.

Evaluation of the effects of photobiomodulation on vertebras in two rat models of experimental osteoporosis

The aim of this study was to evaluate the effects of photobiomodulation (PBM) on cancellous bone in rat models of ovariectomized induced osteoporosis (OVX-D) and glucocorticoid-induced osteoporosis (GIOP). The experiment comprised of nine groups. A group of healthy rats was used for baseline evaluations. The OVX-D rats were further divided into groups as follows: control rats with osteoporosis, OVX-D rats that received alendronate (1 mg/kg 60 days), OVX-D rats treated with pulsed wave laser (890 nm, 80 Hz, 900 s, 0.0061 W/cm², 5.5 J/cm², three times a week, 60 days), and OVX-D rats treated with alendronate + pulsed laser. Dexamethasone was administered to the remaining rats that were split into four groups: control, alendronate-treated rats, laser-treated rats, and GIOP rats treated with alendronate + laser. T12, L1, L2, and L3 vertebrae were subjected to laser. Results of the current study demonstrated that OVX-D and GIOP significantly decreased some stereological parameters, and type 1 collagen gene expression compared to the healthy group. There was a significant increase in osteoclast number in both OVX-D and glucocorticoid administration compared to the healthy group. However, the detrimental effect of the OVX-D procedure on bone was more serious than glucocorticoid administration. Results showed that laser alone had a detrimental effect on trabecular bone volume, and cortical bone volume in groups GIOP and OVX-D compared to those in the healthy group. Alendronate significantly improved total vertebral bone volume, trabecular bone volume, and cortical bone volume, in GIOP and OVX-D groups compared to the laser-treated groups. Furthermore, the alendronate + laser in OVX-D rats and GIOP rats produced significantly increased osteoblast number and type 1 collagen gene expression and caused a significant decrease in osteoclast number compared to the controls.

Low level laser therapy modulates viability, alkaline phosphatase and matrix metalloproteinase-2 activities of osteoblasts

Low level laser therapy (LLLT) has been shown to stimulate bone cell metabolism but their impact on the matrix metalloproteinase (MMP) expression and activity is little explored. This study evaluated the influence of LLLT at two different wavelengths, red and infrared, on MC3T3-E1 preosteoblast viability, alkaline phosphatase (ALP) and MMP-2 and -9 activities. To accomplish this, MC3T3-E1 cells were irradiated with a punctual application of either red (660nm; InGaAIP active medium) or infrared (780nm; GaAlAs active medium) lasers both at a potency of 20mW, energy dose of 0.08 or 0.16J, and energy density of 1.9J/cm² or 3.8J/cm², respectively. The control group received no irradiation. Cellular viability, ALP and MMP-2 and -9 activities were assessed by MTT assay, enzymatic activity and zymography, respectively, at 24, 48 and 72h. The treatment of cells with both red and infrared lasers significantly increased the cellular viability compared to the non-irradiated control group at 24 and 48h. The ALP activity was also up modulated in infrared groups at 24 and 72h, depending on the energy densities. In addition, the irradiation with red laser at the energy density of 1.9J/cm² promoted an enhancement of MMP-2 activity at 48 and 72h. However, no differences were observed for the MMP-9 activity. In conclusion, when used at these specific parameters, LLL modulates both preosteoblast viability and differentiation highlighted by the increased ALP and MMP-2 activities induced by irradiation.

Periodontal and peri-implant wound healing following laser therapy

Laser irradiation has numerous favorable characteristics, such as ablation or vaporization, hemostasis, biostimulation (photobiomodulation) and microbial inhibition and destruction, which induce various beneficial therapeutic effects and biological responses. Therefore, the use of lasers is considered effective and suitable for treating a variety of inflammatory and infectious oral conditions. The CO2 , neodymium-doped yttrium-aluminium-garnet (Nd:YAG) and diode lasers have mainly been used for periodontal soft-tissue management. With development of the erbium-doped yttrium-aluminium-garnet (Er:YAG) and erbium, chromium-doped yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, which can be applied not only on soft tissues but also on dental hard tissues, the application of lasers dramatically expanded from periodontal soft-tissue management to hard-tissue treatment. Currently, various periodontal tissues (such as gingiva, tooth roots and bone tissue), as well as titanium implant surfaces, can be treated with lasers, and a variety of dental laser systems are being employed for the management of periodontal and peri-implant diseases. In periodontics, mechanical therapy has conventionally been the mainstream of treatment; however, complete bacterial eradication and/or optimal wound healing may not be necessarily achieved with conventional mechanical therapy alone. Consequently, in addition to chemotherapy consisting of antibiotics and anti-inflammatory agents, phototherapy using lasers and light-emitting diodes has been gradually integrated with mechanical therapy to enhance subsequent wound healing by achieving thorough debridement, decontamination and tissue stimulation. With increasing evidence of benefits, therapies with low- and high-level lasers play an important role in wound healing/tissue regeneration in the treatment of periodontal and peri-implant diseases. This article discusses the outcomes of laser therapy in soft-tissue management, periodontal nonsurgical and surgical treatment, osseous surgery and peri-implant treatment, focusing on postoperative wound healing of periodontal and peri-implant tissues, based on scientific evidence from currently available basic and clinical studies, as well as on case reports.

Effect of low-level laser therapy on bisphosphonate-treated osteoblasts

BACKGROUND

This study investigates the effect of alendronate-treated osteoblasts, as well as the effect of low-level laser therapy (LLLT) on the alendronate-treated osteoblasts. Bisphosphonate decreases the osteoblastic activity. Various treatment modalities are used to enhance the bisphosphonate-treated osteoblasts; however, there were no cell culture studies conducted using a low-level laser.

METHODS

Human fetal osteoblastic (hFOB 1.19) cells were treated with 50 μM alendronate. Then, they were irradiated with a 1.2 J/cm2 low-level Ga-Al-As laser (λ = 808 ± 3 nm, 80 mW, and 80 mA; spot size, 1 cm2; NDLux, Seoul, Korea). The cell survivability was measured with the MTT assay. The three cytokines of osteoblasts, receptor activator of nuclear factor κB ligand (RANKL), osteoprotegerin (OPG), and macrophage colony-stimulating factor (M-CSF) were analyzed.

RESULTS

In the cells treated with alendronate at concentrations of 50 μM and higher, cell survivability significantly decreased after 48 h (p < 0.05). After the applications of low-level laser on alendronate-treated cells, cell survivability significantly increased at 72 h (p < 0.05). The expressions of OPG, RANKL, and M-CSF have decreased via the alendronate. The RANKL and M-CSF expressions have increased, but the OPG was not significantly affected by the LLLT.

CONCLUSIONS

The LLLT does not affect the OPG expression in the hFOB cell line, but it may increase the RANKL and M-CSF expressions, thereby resulting in positive effects on osteoclastogenesis and bone remodeling.

Proposed Mechanisms of Photobiomodulation or Low-Level Light Therapy

Photobiomodulation (PBM) also known as low-level laser (or light) therapy (LLLT), has been known for almost 50 years but still has not gained widespread acceptance, largely due to uncertainty about the molecular, cellular, and tissular mechanisms of action. However, in recent years, much knowledge has been gained in this area, which will be summarized in this review. One of the most important chromophores is cytochrome c oxidase (unit IV in the mitochondrial respiratory chain), which contains both heme and copper centers and absorbs light into the near-infra-red region. The leading hypothesis is that the photons dissociate inhibitory nitric oxide from the enzyme, leading to an increase in electron transport, mitochondrial membrane potential and ATP production. Another hypothesis concerns light-sensitive ion channels that can be activated allowing calcium to enter the cell. After the initial photon absorption events, numerous signaling pathways are activated via reactive oxygen species, cyclic AMP, NO and Ca2+, leading to activation of transcription factors. These transcription factors can lead to increased expression of genes related to protein synthesis, cell migration and proliferation, anti-inflammatory signaling, anti-apoptotic proteins, antioxidant enzymes. Stem cells and progenitor cells appear to be particularly susceptible to LLLT.

Low-level laser irradiation promotes the proliferation and maturation of keratinocytes during epithelial wound repair

Low-level laser therapy (LLLT) has been extensively employed to improve epithelial wound healing, though the exact response of epithelium maturation and stratification after LLLT is unknown. Thus, this study aimed to assess the in vitro growth and differentiation of keratinocytes (KCs) and in vivo wound healing response when treated with LLLT. Human KCs (HaCaT cells) showed an enhanced proliferation with all the employed laser energy densities (3, 6 and 12 J/cm(2) , 660 nm, 100 mW), together with an increased expression of Cyclin D1. Moreover, the immunoexpression of proteins related to epithelial proliferation and maturation (p63, CK10, CK14) all indicated a faster maturation of the migrating KCs in the LLLT-treated wounds. In that way, an improved epithelial healing was promoted by LLLT with the employed parameters; this improvement was confirmed by changes in the expression of several proteins related to epithelial proliferation and maturation. Immunofluorescent expression of cytokeratin 10 (red) and Cyclin D1 (green) in (A) Control keratinocytes and (B) Low-level laser irradiated cells. Blue color illustrates the nuclei of the cells (DAPI staining).

High-magnitude mechanical strain inhibits the differentiation of bone-forming rat calvarial progenitor cells

PURPOSE

Orthodontic tooth movement occurs during the bone remodeling induced by therapeutic mechanical strain. It is important to investigate the relation between the strength of mechanical stress and bone formation activity. The aim of this study was to determine the effect of high-magnitude mechanical strain on bone formation in detail.

MATERIALS AND METHODS

Osteoblast-like cells isolated from fetal rat calvariae were loaded with 18% cyclic tension force (TF) for 48 h. To phenotypically investigate the effect of TF, we measured the number and the size of bone nodules stained by von Kossa technique on day 21 after cell seeding and determined the calcium content of bone nodules on day 14. Furthermore, we examined the gene expression of BMP-2, Runx2 and Msx2, which are important factors for bone nodule formation, on days 1, 4 and 7 after TF loading.

RESULTS

The maximum bone nodule size in the control group was 1620 and 719 μm in the TF group. Furthermore, the mean number of bone nodules sized over 360 μm in the TF group was significantly decreased compared to the control group. The calcium content was also significantly decreased to 42% by TF loading. The mRNA expression of BMP-2, Runx2 and Msx2 was decreased 1 and 4 days after TF loading.

CONCLUSION

The differentiation of bone forming progenitor cells into bone nodule forming cells was inhibited by TF due to the decreased expression of bone formation related factors such as BMP-2, Runx2 and Msx2.

Light-emitting diode irradiation promotes donor site wound healing of the free gingival graft

BACKGROUND

This study aims to evaluate the effect of light-emitting diode (LED) light irradiation on the donor wound site of the free gingival graft.

METHODS

Rat gingival fibroblasts were chosen to assess the cellular activities and in vitro wound healing with 0 to 20 J/cm(2) LED light irradiation. Seventy-two Sprague-Dawley rats received daily 0, 10 (low-dose [LD]), or 20 (high-dose [HD]) J/cm(2) LED light irradiation on the opened palatal wound and were euthanized after 4 to 28 days; the healing pattern was assessed by histology, histochemistry for collagen deposition, and immunohistochemistry for tumor necrosis factor (TNF)-α infiltration. The wound mRNA levels of heme oxygenase-1 (HO-1), TNF-α, the receptor for advanced glycation end products, vascular endothelial growth factor, periostin, Type I collagen, and fibronectin were also evaluated.

RESULTS

Cellular viability and wound closure were significantly promoted, and cytotoxicity was inhibited significantly using 5 J/cm(2) LED light irradiation in vitro. The wound closure, reepithelialization, and collagen deposition were accelerated, and sequestrum formation and inflammatory cell and TNF-α infiltration were significantly reduced in the LD group. HO-1 and TNF-α were significantly upregulated in the HD group, and most of the repair-associated genes were significantly upregulated in both the LD and HD groups at day 7. Persistent RAGE upregulation was noted in both the LD and HD groups until day 14.

CONCLUSION

LED light irradiation at 660 nm accelerated palatal wound healing, potentially via reducing reactive oxygen species production, facilitating angiogenesis, and promoting provisional matrix and wound reorganization.

Laser phototherapy at high energy densities do not stimulate pre-osteoblast growth and differentiation

OBJECTIVE

The aim of this study is to evaluate the effects of red and infrared lasers at high energy densities on pre-osteoblast MC3T3 proliferation and differentiation.

BACKGROUND DATA

The acceleration of bone regeneration by low intensity laser irradiation may hold potential benefits in clinical therapy in orthopedics and dentistry.

MATERIALS AND METHODS

Cells were irradiated with red (660 nm) and infrared (780 nm) lasers (90 and 150 J/cm2, 40 mW). The control group did not receive irradiation. Cell growth was assessed by a colorimetric test (MTT) (24, 48, 72, 96 h) and cell differentiation was evaluated by alkaline phosphatase (ALP) quantification after growth in osteogenic medium (72, 96 h; 7, 14 days).

RESULTS

None of the irradiation groups had an enhancement in cell growth (p<0.05). The production of ALP was not influenced by irradiation at any period of time (p>0.05).

CONCLUSIONS

The low intensity laser stimulated neither cell growth nor the production of alkaline phosphatase.

Five-day, low-level laser therapy for sports-related lower extremity periostitis in adult men: a randomized, controlled trial

Periostitis in the lower leg caused by overexercise is a universal problem in athletes and runners. The purpose of this study was to observe the functional improvement of the lower limbs upon rehabilitation low-level laser therapy (LLLT). All medical data were gathered from enrolled adults with sports-related lower leg pain. A total of 54 patients underwent triple-phase bone scans using skeletal nuclear scintigraphy, which confirmed periostitis in their lower limbs. The patients were then randomly divided into two groups: one group received laser therapy (N = 29) and the other group (N = 25) received an equivalent placebo treatment (a drug or physical therapy). Treatment protocol commenced with rehabilitation intervention and LLLT was performed three times daily for 5 days at a dosage of 1.4 J/cm(2). A Likert-type pain scale was used to evaluate the severity of pain. Balance function, including postural stability testing (PST) and limits of stability (LOS), was also performed to evaluate the function outcome. Patients experienced a significant improvement in pain by day 2 or day 5 after starting LLLT, but here was no significant difference in pain scale between the measurements before (baseline) and after LLLT. Comparing the PST, the group differences of dynamic vs. static testings ranged from -18.54 to -50.22 (compared 12, 8, 4, 3, 2, 1 to 0, all p < 0.0001), and the PST after LLLT were 3.73 units (p = 0.0258) lower than those of before LLLT. Comparing the LOS, the group differences of dynamic vs. static testing were similar to those in PST, and the relationship between LOS and groups only varied with the direction control during dynamic testing in direction at backward/right vs. right (p < 0.0001). LLLT had a positive effect on proprioception in patients with lower limb periostitis. Larger, better controlled studies are needed to determine what specific effects LLLT has on the function of proprioception.

Periodontal effects with self ligating appliances and laser biostimulation

Background:

Recently, various biostimulation's effects of low energy laser irradiation have been reported. The present study was designed to examine the effects of low-energy laser irradiation on alveolar bone remodelling during orthodontic tooth movement and finally on formation of new keratinized gingiva.

Materials and Methods:

22 patients and 27 teeth in vestibular mucosal without keratinized gingiva were selected. Every patient was treated with self ligating appliances. In every orthodontic session the patient was treated with Diode laser biostimulation. At the moment of debonding, 27 teeth involved in the research were evaluated in terms of quality and quantity of attached gingiva. BOP and CAL loss were investigated.

Results:

Every tooth considered at the end of orthodontic treatment showed an attached gingiva around the crown: The average of keratinized gingiva at the end of the study was 3.10 mm and the mean increasing at each month was 0,49 mm.

Conclusions:

The combination between self ligating appliances and laser's biostimulation could improve the differentiation of periodontal ligaments stem cells in fibroblasts, able to promote attached gingiva around the crown of the teeth erupted in oral vestibular mucosa.

A 635-nm light-emitting diode (LED) therapy inhibits bone resorptive osteoclast formation by regulating the actin cytoskeleton

Bone diseases such as osteoporosis are mainly caused by upregulated activity of osteoclasts. The present study was designed to examine the effects of light-emitting diode (LED) irradiation on the formation and activity of multinucleated osteoclasts, specifically "round-shaped" osteoclast cells (ROC) in different cell types derived from mouse. After 635-nm LED irradiation, the cell viability was evaluated by MTT assay. The amount of total tartrate-resistant acid phosphatase (TRAP) + osteoclast and the number of ROC cells were also estimated by TRAP solution assay and TRAP staining, respectively. Actin rings were stained with rhodamine-conjugated phalloidin, and resorption assay was performed by dentin slices. In addition, gene expression levels between the control and irradiation groups were evaluated by RT-PCR. In a morphological analysis, the formation of ROC was significantly inhibited by 635-nm LED irradiation in the different cell types. Actin rings were seen at cell peripheries in most ROC cells of the control group, but patches containing disorganized actin were found in the irradiation group. Both the number of ROCs and bone resorption activity were much lower in the irradiation group than in the control group. Also, the gene expression levels involved in actin ring formation such as integrin β3 and c-Src decreased in RT-PCR analysis. Overall, 635-nm LED therapy may play a pivotal role in regulating bone remodeling, and it may prove to be a valuable tool to prevent bone loss in osteoporosis and other resorptive bone diseases.

Regulation of miRNA expression by low-level laser therapy (LLLT) and photodynamic therapy (PDT)

Applications of laser therapy, including low-level laser therapy (LLLT), phototherapy and photodynamic therapy (PDT), have been proven to be beneficial and relatively less invasive therapeutic modalities for numerous diseases and disease conditions. Using specific types of laser irradiation, specific cellular activities can be induced. Because multiple cellular signaling cascades are simultaneously activated in cells exposed to lasers, understanding the molecular responses within cells will aid in the development of laser therapies. In order to understand in detail the molecular mechanisms of LLLT and PDT-related responses, it will be useful to characterize the specific expression of miRNAs and proteins. Such analyses will provide an important source for new applications of laser therapy, as well as for the development of individualized treatments. Although several miRNAs should be up- or down-regulated upon stimulation by LLLT, phototherapy and PDT, very few published studies address the effect of laser therapy on miRNA expression. In this review, we focus on LLLT, phototherapy and PDT as representative laser therapies and discuss the effects of these therapies on miRNA expression.

Laser and light-emitting diode effects on pre-osteoblast growth and differentiation

The acceleration of bone regeneration by low-intensity laser irradiation may hold potential benefits in clinical therapy in orthopedics and dentistry. The purpose of this study is to compare the effects of light-emitting diode (LED) and laser on pre-osteoblast MC3T3 proliferation and differentiation. Cells were irradiated with red, infrared, and LED (3 and 5 J/cm(2)). Lasers had a power density of 1 W/cm(2) and irradiation time of 2 and 5 s. LED had a power density of 60 mW/cm(2) and irradiation time of 50 and 83 s. Control group did not receive irradiation. Cell growth was assessed by a colorimetric test (MTT) (24, 48, 72, and 96 h), and cell differentiation was evaluated by alkaline phosphatase (ALP) quantification after growth in osteogenic medium (72 and 96 h and 7 and 14 days). At 24 h, the cell growth was enhanced 3.6 times by LED (5 J/cm(2)), 6.8 times by red laser (3 J/cm(2)), and 10.1 times by red laser (5 J/cm(2)) in relation to control group (p < 0.05). At the other periods, there was no influence of irradiation on cell growth (p > 0.05). The production of ALP was not influenced by irradiation at any period of time (p > 0.05). Low-intensity laser and LED have similar effects on stimulation of cell growth, but no effect on cell differentiation.

Assessment of the effect of low-energy diode laser irradiation on gamma irradiated rats' mandibles

OBJECTIVE

The purpose of the present study was to evaluate the biostimulative and regenerative effects of low intensity laser irradiation (LILT) (applied before or after initiation of radiotherapy) on gamma irradiated rats' jaw bones.

METHODS

Forty eight male Albino rats were equally divided into two groups: group 1, in which the left side of the mandible was subjected to three successive sessions of laser (LILT) prior to whole body gamma radiation (2Gy/3 fractions/week) and group 2, received whole body gamma radiation (2Gy/3 fractions/week) prior to three successive sessions of laser applied to left side. The right side of both groups was used as gamma irradiated non-lased control group. Each group was then subdivided into four equal subgroups (a, b, c, d) according to the time of scarification (3, 7, 14, 21 days respectively). Specimens were subjected to histological, histomorphometric and scanning electron microscopic examinations.

RESULTS

Thin irregular bone trabeculae and widened marrow spaces were identified in the control group. The lased sides of groups 1 and 2 demonstrated regular, thick and continuous bone trabeculae. Ultrastructurally, collagen fibres of the control group appeared irregularly arranged and more spaced compared to groups 1 and 2. Normal-sized osteocytic lacunae were seen in the lased groups, as compared to the wide lacunar spaces noted in the control group. Histomorphometric analysis showed a significant increase in the area of bone trabeculae, as well as the width of compact bone, for the lased groups.

CONCLUSIONS

LILT seemed to attenuate the radiation-related damage in alveolar bones.

DNA repair gene expression in biological tissues exposed to low-intensity infrared laser

Special properties of laser light have led to its usefulness in many applications in therapy. Excitation of endogenous chromophores in biotissues and generation of free radicals could be involved in its biological effects. DNA lesions induced by free radicals are repaired by base excision repair pathway. In this work, we evaluated the expression of APE1 and OGG1 genes related to repair of DNA lesions induced by free radicals. Skin and muscle tissues of Wistar rats were exposed to low-intensity infrared laser at different fluences and frequencies. After laser exposition of 1 and 24 h, tissue samples were withdrawn for total RNA extraction, cDNA synthesis, and evaluation of APE1 and OGG1 gene expression by quantitative polymerase chain reaction. Data obtained show that laser radiation alters the expression of APE1 and OGG1 mRNA differently in skin and muscle tissues of Wistar rats depending of the fluence, frequency, and time after exposure. Our study suggests that low-intensity infrared laser affects expression of genes involved in repair of DNA lesions by base excision repair pathway.