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Mohammadzadeh E, Amiri AH, Fekrazad R, Leitgeb RA, Mayr W, Ezzati K. The Effect of Photobiomodulation on Bone Mineral Density, Serum Vitamin D, and Bone Formation Markers in Individuals with Complete Spinal Cord Injuries with Osteoporosis. Photobiomodul Photomed Laser Surg 2024; 42:693-700. [PMID: 39358889 DOI: 10.1089/photob.2023.0195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2024] Open
Abstract
Study design: A quasi-experimental study utilized a matched-pair design, administering photobiomodulation at four-sites on one side of the body and assigning control to the other side at corresponding sites. Objectives: This study aimed to assess photobiomodulation treatment effects on bone mineral density (BMD) measurement using dual-energy X-ray-absorptiometry in individuals with complete spinal cord injury (C.SCI) and osteoporosis. Methods: Eight patients received treatment at four-sites: forearm-mid-distal (MID), proximal-femur, distal-femur, and proximal-tibia, totaling 32 sites. Using an 830 nm gallium-aluminum-arsenide semiconductor laser irradiation was administered three times weekly for 8 weeks. Different doses (energy density) were determined depending on bone depth from skin surface, as assessed by sonography and adjusted through irradiation time to be 8, 10, and 12 J/cm2 for depths <1 cm, between 1 and 1.5 cm, and >1.5 cm, respectively, using 200 mW power to deliver the optimal isodose of laser at each depth of bone within each therapeutic site. BMD was measured at baseline, week 8 of treatment, and week 15 of follow-up. Serum 25-(OH)-vitamin D and bone formation markers including osteocalcin and bone-alkaline-phosphatase (B-ALP) were also assessed at baseline and week 8 of treatment. Results: Significant increases in BMD were noted in proximal-femur and forearm-MID at both week 8 and week 15. Serum 25-(OH)-vitamin D levels significantly increased after treatment. However, no notable changes were observed in distal-femur and proximal-tibia BMD or in osteocalcin and B-ALP levels. Conclusions: Photobiomodulation (830 nm) laser demonstrated efficacy in improving BMD at proximal-femur and forearm-MID in individuals with C.SCI. Moreover, the observed positive influence on vitamin D levels suggests a potential photobiomodulation role, warranting further investigation.
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Affiliation(s)
- Esmaeil Mohammadzadeh
- Center for Medical Physics and Biomedical Engineering of Medical, University of Vienna, Vienna, Austria
| | - Aref Hosseinian Amiri
- Faculty of Medicine, Department of Rheumatology, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Fekrazad
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education, and Research Network (USERN), Tehran, Iran
| | - Rainer A Leitgeb
- Center for Medical Physics and Biomedical Engineering of Medical, University of Vienna, Vienna, Austria
| | - Winfried Mayr
- Center for Medical Physics and Biomedical Engineering of Medical, University of Vienna, Vienna, Austria
| | - Kamran Ezzati
- Poorsina Hospital, Neuroscience Research Center, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Abd-Elhaleem Othman MA, Zaky AA, Eltayeb EA, Khalil NM. A radiographic and histological study to compare red (650 nm) versus near infrared (810 nm) diode lasers photobiomodulation for alveolar socket preservation. Sci Rep 2024; 14:6871. [PMID: 38519552 PMCID: PMC10959980 DOI: 10.1038/s41598-024-57114-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/14/2024] [Indexed: 03/25/2024] Open
Abstract
Previous findings indicated that the laser photobiomodulation is more effective than the control or placebo in preserving the alveolar socket. This study aimed to compare two different lasers regarding their effectiveness in aiding alveolar socket preservation. Twenty extraction sockets were selected then divided into two equal groups. Group A was exposed to 650 nm Diode laser, and Group B to 810 nm Diode laser following the same protocol and parameters after a standard alveolar socket preservation procedure with collagen plug. Radiographic analysis with cone beam computed tomography was done to compare the alveolar bone surface area immediately after extraction and three months post-operatively, while bone samples collected before implant drilling were histologically examined for newly formed bone evaluation and histomorphometric analysis in terms of percentage of new bone surface area, percentage of unmineralized bone and finally, immunohistochemical analysis of Osteocalcin reaction surface area as well as optical density. Radiographically, infrared (810 nm) Diode effect on alveolar bone surface area has significantly exceeded the red laser, while histologically, red (650 nm) Diode has demonstrated statistical significance regarding all parameters; newly formed bone surface area percentage, unmineralized bone area percentage and finally Osteocalcin bone marker reaction surface area percentage and optical density. Under the specified conditions and laser parameters, photobiomodulation using the 810 nm Diode got the upper hand radiographically, yet histologically, the red 650 nm Diode managed to dominate all histological parameters when both employed as an adjunct to alveolar socket preservation procedures.
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Affiliation(s)
| | - Ahmed Abbas Zaky
- Medical Applications of Lasers Department, National Institute of Laser Enhanced Sciences, Cairo University, Cairo, Egypt
| | - Elsayed Abdullah Eltayeb
- Medical Applications of Lasers Department, National Institute of Laser Enhanced Sciences, Cairo University, Cairo, Egypt
| | - Nesma Mohamed Khalil
- Oral Biology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Berni M, Brancato AM, Torriani C, Bina V, Annunziata S, Cornella E, Trucchi M, Jannelli E, Mosconi M, Gastaldi G, Caliogna L, Grassi FA, Pasta G. The Role of Low-Level Laser Therapy in Bone Healing: Systematic Review. Int J Mol Sci 2023; 24:ijms24087094. [PMID: 37108257 PMCID: PMC10139216 DOI: 10.3390/ijms24087094] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
Low-level laser therapy (LLLT) is a treatment that is increasingly used in orthopedics practices. In vivo and in vitro studies have shown that low-level laser therapy (LLLT) promotes angiogenesis, fracture healing and osteogenic differentiation of stem cells. However, the underlying mechanisms during bone formation remain largely unknown. Factors such as wavelength, energy density, irradiation and frequency of LLLT can influence the cellular mechanisms. Moreover, the effects of LLLT are different according to cell types treated. This review aims to summarize the current knowledge of the molecular pathways activated by LLLT and its effects on the bone healing process. A better understanding of the cellular mechanisms activated by LLLT can improve its clinical application.
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Affiliation(s)
- Micaela Berni
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Alice Maria Brancato
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Camilla Torriani
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Valentina Bina
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
| | - Salvatore Annunziata
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Elena Cornella
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Michelangelo Trucchi
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Eugenio Jannelli
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Mario Mosconi
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Giulia Gastaldi
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
- Centre for Health Technologies, University of Pavia, 27100 Pavia, Italy
| | - Laura Caliogna
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
| | - Federico Alberto Grassi
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
- Centre for Health Technologies, University of Pavia, 27100 Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Gianluigi Pasta
- Orthopedics and Traumatology Clinic, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy
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Jana S, Datta P, Das H, Jaiswal S, Ghosh PR, Lahiri D, Kundu B, Nandi SK. Copper and cobalt doped bioactive glass-fish dermal collagen electrospun mat triggers key events of diabetic wound healing in full-thickness skin defect model. J Mech Behav Biomed Mater 2022; 134:105414. [PMID: 36037706 DOI: 10.1016/j.jmbbm.2022.105414] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/03/2022] [Accepted: 08/07/2022] [Indexed: 10/15/2022]
Abstract
The wounds arising out of underlying hyperglycemic conditions such as diabetic foot ulcers demand a multifunctional tissue regeneration approach owing to several deficiencies in the healing mechanisms. Herein, four different types of electrospun microfibers by combining Rohu fish skin-derived collagen (Fcol) with a bioactive glass (BAG)/ion-doped bioactive glass, namely, Fcol/BAG, Fcol/CuBAG, Fcol/CoBAG, and Fcol/CuCoBAG was developed to accelerate wound healing through stimulation of key events such as angiogenesis and ECM re-construction under diabetic conditions. SEM analysis shows the porous and microfibrous architecture, while the EDX mapping provides evidence of the incorporation of dopants inside various inorganic-organic composite mats. The viscoelastic properties of the microfibrous mats as measured by a nano-DMA test show a higher damping factor non-uniform tan-delta value. The maximum ultimate tensile strength and toughness are recorded for fish collagen with copper doped bioactive glass microfibers while the least values are demonstrated by microfibers with cobalt dopant. In vitro results demonstrate excellent cell-cell and cell-material interactions when human dermal fibroblasts (HDFs) were cultured over the microfibers for 48 h. When these mats were applied over full-thickness diabetic wounds in the rabbit model, early wound healing is attained with Fcol/CuBAG, Fcol/CoBAG, and Fcol/CuCoBAG microfibers. Notably, these microfibers-treated wounds demonstrate a significantly (p < 0.01) higher density of blood vessels by CD-31 immunostaining than control, Duoderm, and Fcol/BAG treated wounds. Mature collagen deposition and excellent ECM remodeling are also evident in wounds treated with fish collagen/ion-doped bioactive glass microfibers suggesting their positive role in diabetic wound healing.
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Affiliation(s)
- Sonali Jana
- Department of Veterinary Physiology, West Bengal University of Animal and Fishery Sciences, Kolkata, India
| | - Pradyot Datta
- Bioceramics and Coating Division, CSIR-Central Glass and Ceramic Research Institute, Kolkata, India
| | - Himanka Das
- Bioceramics and Coating Division, CSIR-Central Glass and Ceramic Research Institute, Kolkata, India
| | - Satish Jaiswal
- Department of Metallurgical and Materials Engineering, Indian Institute of Technology, Roorkee, Uttarakhand, India
| | - Prabal Ranjan Ghosh
- Department of Veterinary Physiology, West Bengal University of Animal and Fishery Sciences, Kolkata, India
| | - Debrupa Lahiri
- Department of Metallurgical and Materials Engineering, Indian Institute of Technology, Roorkee, Uttarakhand, India
| | - Biswanath Kundu
- Bioceramics and Coating Division, CSIR-Central Glass and Ceramic Research Institute, Kolkata, India.
| | - Samit Kumar Nandi
- Department of Veterinary Surgery and Radiology, West Bengal University of Animal and Fishery Sciences, Kolkata, India.
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Effectiveness of Photobiomodulation Therapy on Human Bone Healing in Dentistry: A Systematic Review. Photobiomodul Photomed Laser Surg 2022; 40:440-453. [DOI: 10.1089/photob.2021.0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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LED photobiomodulation therapy combined with biomaterial as a scaffold promotes better bone quality in the dental alveolus in an experimental extraction model. Lasers Med Sci 2021; 37:1583-1592. [PMID: 34767116 DOI: 10.1007/s10103-021-03407-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/20/2021] [Indexed: 10/19/2022]
Abstract
A bone scaffold added to the dental alveolus immediately after an extraction avoids bone atrophy and deformity at the tooth loss site, enabling rehabilitation with implants. Photobiomodulation accelerates bone healing by stimulating blood flow, activating osteoblasts, diminishing osteoclastic activity, and improving the integration of the biomaterial with the bone tissue. The aim of the present study was to evaluate the effect of photobiomodulation with LED at a wavelength of 850 nm on bone quality in Wistar rats submitted to molar extraction with and without a bone graft using hydroxyapatite biomaterial (Straumann® Cerabone®). Forty-eight rats were distributed among five groups (n = 12): basal (no interventions); control (extraction) (basal and control were the same animal, but at different sides); LED (extraction + LED λ = 850 nm); biomaterial (extraction + biomaterial), and biomaterial + LED (extraction + biomaterial + LED λ = 850 nm). Euthanasia occurred at 15 and 30 days after the induction of the extraction. The ALP analysis revealed an improvement in bone formation in the control and biomaterial + LED groups at 15 days (p = 0.0086 and p = 0.0379, Bonferroni). Moreover, the LED group had better bone formation compared to the other groups at 30 days (p = 0.0007, Bonferroni). In the analysis of AcP, all groups had less resorption compared to the basal group. Bone volume increased in the biomaterial, biomaterial + LED, and basal groups in comparison to the control group at 15 days (p < 0.05, t-test). At 30 days, the basal group had greater volume compared to the control and LED groups (p < 0.05, t-test). LED combined with the biomaterial improved bone formation in the histological analysis and diminished bone degeneration (demonstrated by the reduction in AcP), promoting an increase in bone density and volume. LED may be an important therapy to combine with biomaterials to promote bone formation, along with the other known benefits of this therapy, such as the control of pain and the inflammatory process.
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Theodoro LH, Marcantonio RAC, Wainwright M, Garcia VG. LASER in periodontal treatment: is it an effective treatment or science fiction? Braz Oral Res 2021; 35:e099. [PMID: 34586213 DOI: 10.1590/1807-3107bor-2021.vol35.0099] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 12/29/2022] Open
Abstract
There are several studies that evaluate the use of lasers in periodontal treatment in non-surgical or surgical therapy. However, while several studies showed clinically beneficial effects of some lasers in periodontal treatment, there are few clinical reports of additional advantages of lasers as adjunctive treatments in periodontology. The aim of this paper is to demonstrate and critically analyze the level of scientific evidence of effects of low-level lasers and high-power lasers in periodontology. A narrative review of the studies was carried out in each topic and type of laser or periodontal treatment. In nonsurgical periodontal therapy the results showed that there is an additional clinical benefit when using a diode laser (DL) associated with scaling and root planing (SRP) in patients with moderate to severe periodontitis. The Er:YAG laser seems to be the most suitable for nonsurgical periodontal therapy and promotes the same clinical effects as conventional therapy. In periodontal surgery vaporization of the gingival or mucosal tissue can be carried out with DL, CO2, Nd:YAG, Er:YAG and Er,Cr:YSGG lasers. Photobiomodulation (PBM), mediated by low-level lasers associated with non-surgical periodontal therapy, promotes additional benefits in the short term and accelerates the bone and gingival tissue repair process and also reduces postoperative symptoms of periodontal surgery. The effect of antimicrobial Photodynamic Therapy is relevant in the initial reevaluation periods. Studies have shown controversial results of the use of lasers in periodontics, and this fact may be due to the lack of standard parameters of irradiation in each clinical application.
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Affiliation(s)
- Letícia Helena Theodoro
- Universidade Estadual Paulista - Unesp, School of Dentistry, Department of Diagnostic and Surgery, Araçatuba, SP, Brazil
| | | | - Mark Wainwright
- Liverpool John Moores University, School of Pharmacy & Biomolecular Sciences, Liverpool, UK
| | - Valdir Gouveia Garcia
- Latin American Institute of Dental Research and Education - Ilapeo, Curitiba, PR, Brazil
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8
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Photobiomodulation as an adjunctive therapy for alveolar socket preservation: a preliminary study in humans. Lasers Med Sci 2020; 35:1711-1720. [PMID: 31970564 DOI: 10.1007/s10103-020-02962-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/10/2020] [Indexed: 12/21/2022]
Abstract
Bone remodeling results in loss of alveolar bone height and thickness. Photobiomodulation (PBM) based on photochemical stimulation by low-intensity lasers emerges as an adjunctive therapy for alveolar socket preservation. Our study aimed to evaluate the effects of PBM therapy on alveolar bone repair. Twenty healthy patients in need of bilateral extraction of lower molars were enrolled in this split-mouth randomized and blind clinical trial. The extraction sites were randomly selected to receive either the PBM therapy with a CW GaAIAs diode laser (808 nm; 0.028 mm2; 0.1 W; 3.6 W/cm2; 89 J/cm2; 2.5 J/point) or no treatment (Control). Bone biopsies were harvested 45 days after the dental extraction and evaluated using micro-computerized tomography (μCT), morphometric, and histological analysis. Data were compared using the paired t test, and the level of significance was set at 5%. Bone surface (p = 0.029), bone surface/total volume (p = 0.028), trabecular number (p = 0.025), and connectivity density (p = 0.029) were higher at the PBM group compared with Control. The histological observations confirmed the μCT findings. PBM samples exhibited higher number of organized and connected bone trabeculae along with higher density of blood vessels than Control. Control samples displayed a dense and highly cellular connective tissue at the central area accompanied by the presence of immature bone trabeculae at the periphery. Our results indicated that the PBM therapy improved the newly bone trabeculae formation and their connectivity which increased bone surface, indicating the positive effect of the laser on alveolar human socket repair.
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Gholami L, Asefi S, Hooshyarfard A, Sculean A, Romanos GE, Aoki A, Fekrazad R. Photobiomodulation in Periodontology and Implant Dentistry: Part 1. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:739-765. [PMID: 31750783 DOI: 10.1089/photob.2019.4710] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
(Part 2 of this article can be located at www.liebertpub.com/doi/10.1089/photob.2019.4731.) Objective: Finding evidence-based treatment strategies for low-level light therapy (LLLT) and the correct incorporation of these treatment methods in the clinical practice of periodontics. Background: Photobiomodulation has been shown to have biostimulatory, anti-inflammatory and analgesic effects that can be beneficial in periodontal and dental implant treatment procedures. Methods: In this review we have addressed some clinical questions regarding the potential clinical application of low-level light irradiation and its photobiomodulatory effects in periodontology and implantology. The literature was searched for in vivo (animal or clinical) articles written in English in four electronic databases of PubMed, Scopus, Google Scholar, and Cochrane Library until April 2019. Only studies with low irradiation doses without any thermal effects used only for their photobiomodulatory purposes were included. Results: We were able to find relevant studies for all of our questions, and positive effects for the application of light therapy were reported in most of the studies. However, there is still great deal of heterogeneity in terms of study designs and most importantly in light irradiation devices and the parameters used. Owing to this issue it was not possible to reach specific evidence-based irradiation protocols for the questions addressed in this review. Conclusions: Based on our search results, an obvious positive effect of LLLT on stimulation of healing of periodontal soft and hard tissues and reduction of inflammation can be seen. Future well-designed randomized control studies with the same irradiation settings and systematic reviews evaluating the studies found on the questions mentioned are necessary to reach evidence-based recommendations.
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Affiliation(s)
- Leila Gholami
- Dental Implants Research Center, Department of Periodontology, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sohrab Asefi
- Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirarsalan Hooshyarfard
- Dental Implants Research Center, Department of Periodontology, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Anton Sculean
- Department of Periodontology, School of Dentistry, University of Bern, Bern, Switzerland
| | - Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, New York
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran.,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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10
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Yussif NM, Hosny MM. Towards the targeted management of aggressive periodontitis. Med Hypotheses 2017; 103:124-127. [PMID: 28571797 DOI: 10.1016/j.mehy.2017.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 03/23/2017] [Accepted: 04/21/2017] [Indexed: 11/18/2022]
Affiliation(s)
- Nermin M Yussif
- Oral Diagnosis, Medicine & Periodontology Dept., Faculty of Oral & Dental Medicine, Cairo University, Giza, Egypt.
| | - Manal M Hosny
- Oral Diagnosis, Medicine & Periodontology Dept., Faculty of Oral & Dental Medicine, Cairo University, Giza, Egypt.
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11
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Santinoni CDS, Oliveira HFF, Batista VEDS, Lemos CAA, Verri FR. Influence of low-level laser therapy on the healing of human bone maxillofacial defects: A systematic review. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2017; 169:83-89. [PMID: 28292696 DOI: 10.1016/j.jphotobiol.2017.03.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 03/04/2017] [Accepted: 03/06/2017] [Indexed: 12/17/2022]
Abstract
PURPOSE This systematic review evaluates the effectiveness of low-level laser therapy (LLLT) to enhance maxillofacial area bone repair. METHODS A comprehensive search of studies published up to February 2017 and listed in PubMed/MEDLINE, Scopus, and Cochrane Library databases was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS The 15 selected studies evaluated a total of 374 patients (mean age, 28.5years) who were treated with LLLT. Gallium-arsenide (GaAs) and gallium aluminium arsenide (GaAlAs) were the most commonly used devices, and LLLT parameters varied greatly. Wavelengths varied from 500 to 1000nm. Tooth extraction, distraction osteogenesis, maxillary expansion, periodontal defects, orthodontic movement and maxillary cystic defects were evaluated. From the 15 selected studies, six evaluated bone repair (primary outcomes). Of these, four studies showed improvement in bone formation after using LLLT, two demonstrated improved results for only one follow up period, and one showed no additional benefits. The other 9 studies evaluated secondary parameters related to healing (secondary outcomes) in the maxillofacial area after applying LLLT, including anti-inflammatory, analgesic, and healing accelerator effects, and quality of life related to oral health. There were no adverse or negative effects of LLLT reported. CONCLUSION Within the limitation of this review, a possible improvement in bone density can be found when LLLT is applied postoperatively in maxillofacial bony defects. LLLT also seems to promote anti-inflammatory and analgesic effects and accelerate healing, as well as enhance quality of life related to oral health. However, LLLT use protocols need to be standardized before more specific conclusions can be drawn about this subject.
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Affiliation(s)
- Carolina Dos Santos Santinoni
- Dental School, Univ. Estadual Paulista - UNESP, Araçatuba, Brazil; Dental School, Univ. do Oeste Paulista - UNOESTE, Presidente Prudente, Brazil
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12
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Bosco AF, Faleiros PL, Carmona LR, Garcia VG, Theodoro LH, de Araujo NJ, Nagata MJH, de Almeida JM. Effects of low-level laser therapy on bone healing of critical-size defects treated with bovine bone graft. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2016; 163:303-10. [DOI: 10.1016/j.jphotobiol.2016.08.040] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 08/25/2016] [Indexed: 10/21/2022]
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Abstract
BACKGROUND The effectiveness of low power lasers on incisional wound healing, because of conflicting results of previous studies, is uncertain. Therefore, the aim of this study was to evaluate the effects of low-level helium-neon (He-Ne) laser irradiation on wound healing in rat's oral mucosa. MATERIALS AND METHODS Sixty-four standardized incisions were carried out on the buccal mucosa of 32 male Wistar divided into four groups of eight animals each. Each rat received two incisions on the opposite sides of the buccal mucosa by a steel scalpel. On the right side (test side), a He-Ne laser (632 nm) was employed on the incision for 40 s. Laser radiation was used just in 1(st) day, 1(st) and 2(nd) day, 1(st) and 3(rd) day, and continuous 3 days in groups of A, B, C, and D of rats, respectively. The left side (control side) did not receive any laser. Histological processing and hematoxylin and eosin staining were done on tissue samples after 5 days. Wilcoxon and Kruskal-Wallis tests were used for statistical analysis. RESULTS Histological analysis showed that the tissue healing after continuous 3 days on the laser irradiated side was better than the control side, but there was no difference between the two sides in each groups (P > 0.05). CONCLUSION This study showed that He-Ne laser had no beneficial effects on incisional oral wound healing particularly in 5 days after laser therapy. Future research in the field of laser effects on oral wound healing in human is recommended.
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Affiliation(s)
- Farimah Sardari
- Department of Oral Medicine, School of Dentistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Farzaneh Ahrari
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Bhardwaj S, George JP, Remigus D, Khanna D. Low Level Laser Therapy in the Treatment of Intra-Osseous Defect- A Case Report. J Clin Diagn Res 2016; 10:ZD06-8. [PMID: 27135012 DOI: 10.7860/jcdr/2016/15805.7466] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 12/08/2015] [Indexed: 11/24/2022]
Abstract
Low level laser has been documented in literature to promote wound healing by reducing postoperative inflammation, oedema and reduces pain. This case report demonstrates the safe and positive outcome of LLLT in conjunction with demineralised bone matrix of bovine origin in the surgical treatment of a periodontal infrabony defect. After surgical defect debridement, low level semiconductor diode laser (GaAlAr) was delivered for 5 minutes to the inner margins of flap in contact mode and the defect was irradiated with LLLT in a non-contact mode for 10 minutes. Demineralised bone matrix graft was used as a bone grafting material. Repeat irradiation was done for the next 5 days on the outer buccal and lingual flap surfaces. A CAL gain of 4 mm and 37% bone fill was noted radiographically at end of 12 months. LLLT can be used as an adjunct to periodontal regeneration.
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Affiliation(s)
- Smiti Bhardwaj
- Research Associate, Department of Implantology, Maulana Azad Institute of Dental Sciences , New Delhi, India
| | - Joann Pauline George
- Professor, Department of Periodontology, Krishnadevaraya College of Dental Sciences & Hospital , Bangalore, Karnataka, India
| | - Divakaran Remigus
- Post Graduate Student, Department of Periodontology, Krishnadevaraya College of Dental Sciences & Hospital , Bangalore, Karnataka, India
| | - Divya Khanna
- Post Graduate Student, Department of Periodontology, Krishnadevaraya College of Dental Sciences & Hospital , Bangalore, Karnataka, India
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Doğan GE, Aksoy H, Demir T, Laloğlu E, Özyıldırım E, Sağlam E, Akçay F. Clinical and biochemical comparison of guided tissue regeneration versus guided tissue regeneration plus low-level laser therapy in the treatment of class II furcation defects: A clinical study. J COSMET LASER THER 2016; 18:98-104. [PMID: 26734916 DOI: 10.3109/14764172.2015.1114637] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The present study was aimed to compare the clinical and biochemical effectiveness of guided tissue regeneration (GTR) alone and combined with low-level laser therapy (LLLT) application in the treatment of furcation II periodontal defects, over a period of 6 months. MATERIAL AND METHODS Thirty-three furcation defects were included in the study. Seventeen of these defects were treated with GTR plus LLLT, and sixteen of them were treated with GTR alone. Probing pocket depth (PPD), clinical attachment level (CAL), horizontal probing depth (HPD), and alkaline phosphatase (ALP) and osteocalcin (OC) levels in the gingival crevicular fluid (GCF) were recorded at baseline and at postoperative 3rd and 6th months. RESULTS Healing was uneventful in all cases. At the 3rd and 6th months, both treatment modalities-GTR and GTR plus LLLT--showed improved PPD, CAL, and HPD values compared to their baseline values. ALP and OC levels in GCF increased after the treatment in both groups (p < 0.05). When compared the two groups, at the 6th month, PPD, CAL, HPD, and ALP values showed significantly more improvement in laser group than non-laser group (p < 0.05). CONCLUSIONS The results of this study showed that both treatments led to significantly favorable clinical improvements in furcation periodontal defects. LLLT plus GTR may be a more effective treatment modality compared to GTR alone.
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Affiliation(s)
- Gülnihal Emrem Doğan
- a Department of Periodontology , Faculty of Dentistry, Ataturk University , Erzurum , Turkey
| | - Hülya Aksoy
- b Department of Biochemistry , Medical Faculty, Ataturk University , Erzurum , Turkey
| | - Turgut Demir
- a Department of Periodontology , Faculty of Dentistry, Ataturk University , Erzurum , Turkey
| | - Esra Laloğlu
- b Department of Biochemistry , Medical Faculty, Ataturk University , Erzurum , Turkey
| | - Ercan Özyıldırım
- c Department of Public Health , Medical Faculty, Ataturk University , Erzurum , Turkey
| | - Ebru Sağlam
- a Department of Periodontology , Faculty of Dentistry, Ataturk University , Erzurum , Turkey
| | - Fatih Akçay
- b Department of Biochemistry , Medical Faculty, Ataturk University , Erzurum , Turkey
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COMPARATIVE STUDY OF THE EFFECTS OF LOW-LEVEL LASER AND LOW-INTENSITY ULTRASOUND ASSOCIATED WITH BIOSILICATE(®) ON THE PROCESS OF BONE REPAIR IN THE RAT TIBIA. Rev Bras Ortop 2015; 47:102-7. [PMID: 27027088 PMCID: PMC4799344 DOI: 10.1016/s2255-4971(15)30352-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 07/13/2011] [Indexed: 12/20/2022] Open
Abstract
Objective: Verify the effects of the association between Biosilicate® and ultrasound and, Biosilicate® and laser in bone consolidation process of rats, through the biomechanical and histological analysis. Methods: Forthy male rats were used. The animals were randomized into four groups (n=10): control group fracture no treated (CGF); group treated with Biosilicate® (BG); group treated with Biosilicate® and laser (BLG); group treated with Biosilicate® and ultrasound (BUG). Results: The biomechanical analysis showed no significant difference among any groups after 14 days post-surgery. In the morphometric analysis, the control group showed moderate presence of new formed bone tissue inside the defects areas and the Biosilicate® group showed similar results. Despite those facts, the biomaterial osteogenic potential was demonstrated by the great amount of cells and bone tissue around the particles. Curiously, the Biosilicate® plus laser or ultrasound groups showed lower amounts of bone tissue deposition when compared with control fracture and Biosilicate® groups. Conclusion: The data from this study can conclude that Biosilicate® was able to accelerate and optimized the bone consolidation, through the modulation of the inflammatory process and the stimulation of new bone formation. However, when resources were associated, there are no positive results.
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Jones JR. Reprint of: Review of bioactive glass: From Hench to hybrids. Acta Biomater 2015; 23 Suppl:S53-82. [PMID: 26235346 DOI: 10.1016/j.actbio.2015.07.019] [Citation(s) in RCA: 243] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Revised: 08/10/2012] [Accepted: 08/14/2012] [Indexed: 02/07/2023]
Abstract
Bioactive glasses are reported to be able to stimulate more bone regeneration than other bioactive ceramics but they lag behind other bioactive ceramics in terms of commercial success. Bioactive glass has not yet reached its potential but research activity is growing. This paper reviews the current state of the art, starting with current products and moving onto recent developments. Larry Hench's 45S5 Bioglass® was the first artificial material that was found to form a chemical bond with bone, launching the field of bioactive ceramics. In vivo studies have shown that bioactive glasses bond with bone more rapidly than other bioceramics, and in vitro studies indicate that their osteogenic properties are due to their dissolution products stimulating osteoprogenitor cells at the genetic level. However, calcium phosphates such as tricalcium phosphate and synthetic hydroxyapatite are more widely used in the clinic. Some of the reasons are commercial, but others are due to the scientific limitations of the original Bioglass 45S5. An example is that it is difficult to produce porous bioactive glass templates (scaffolds) for bone regeneration from Bioglass 45S5 because it crystallizes during sintering. Recently, this has been overcome by understanding how the glass composition can be tailored to prevent crystallization. The sintering problems can also be avoided by synthesizing sol-gel glass, where the silica network is assembled at room temperature. Process developments in foaming, solid freeform fabrication and nanofibre spinning have now allowed the production of porous bioactive glass scaffolds from both melt- and sol-gel-derived glasses. An ideal scaffold for bone regeneration would share load with bone. Bioceramics cannot do this when the bone defect is subjected to cyclic loads, as they are brittle. To overcome this, bioactive glass polymer hybrids are being synthesized that have the potential to be tough, with congruent degradation of the bioactive inorganic and the polymer components. Key to this is creating nanoscale interpenetrating networks, the organic and inorganic components of which have covalent coupling between them, which involves careful control of the chemistry of the sol-gel process. Bioactive nanoparticles can also now be synthesized and their fate tracked as they are internalized in cells. This paper reviews the main developments in the field of bioactive glass and its variants, covering the importance of control of hierarchical structure, synthesis, processing and cellular response in the quest for new regenerative synthetic bone grafts. The paper takes the reader from Hench's Bioglass 45S5 to new hybrid materials that have tailorable mechanical properties and degradation rates.
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Affiliation(s)
- Julian R Jones
- Department of Materials, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.
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Singh N, Uppoor A, Naik D. Semilunar Coronally Advanced Flap with or without Low Level Laser Therapy in Treatment of Human Maxillary Multiple Adjacent Facial Gingival Recessions: A Clinical Study. J ESTHET RESTOR DENT 2015; 27:355-66. [DOI: 10.1111/jerd.12160] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Neelesh Singh
- Department of Periodontology; Manipal College of Dental Sciences; Manipal University; Light House Hill Road Mangalore Karnataka 575001 India
| | - Ashita Uppoor
- Department of Periodontology; Manipal College of Dental Sciences; Manipal University; Light House Hill Road Mangalore Karnataka 575001 India
| | - Dilip Naik
- Department of Periodontology; DEAN; Manipal College of Dental Sciences; Manipal University; Light House Hill Road Mangalore Karnataka 575001 India
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Effect of low-level laser on bone defects treated with bovine or autogenous bone grafts: in vivo study in rat calvaria. BIOMED RESEARCH INTERNATIONAL 2014; 2014:104230. [PMID: 24982858 PMCID: PMC4058460 DOI: 10.1155/2014/104230] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 04/17/2014] [Accepted: 05/12/2014] [Indexed: 11/17/2022]
Abstract
Objective. The purpose of this study was to histologically evaluate the effect of low-level laser (LLL) on the healing of critical size defects (CSD) in rat calvaria, filled with autogenous or inorganic bovine bone grafts. Methods. Sixty rats were divided into 6 groups (n = 10): C (control—filled with blood clot), LLL (low-level laser—GaAlAs, λ 780 nm, 100 mW, 210 J/cm2, Φ 0.05 cm2; 6 J/point), AB (autogenous bone), ABL (autogenous bone + low-level laser), OB (inorganic bovine bone), and OBL (inorganic bovine bone + LLL). Material and Methods. The animals were killed after 30 days. Histological and histometric analyses were performed by light microscopy. Results. The groups irradiated with laser, LLL (47.67% ± 8.66%), ABL (39.15% ± 16.72%), and OBL (48.57% ± 28.22%), presented greater area of new bone formation than groups C (9.96% ± 4.50%), AB (30.98% ± 16.59%), and OB (11.36% ± 7.89%), which were not irradiated. Moreover, they were significantly better than group C (Kruskal-Wallis test followed by Dunn test, P < 0.05). Conclusion. The laser accelerated the healing of bone defects and the resorption of particles of the graft material.
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Emrem Doğan G, Demir T, Orbak R. Effect of Low-Level Laser on Guided Tissue Regeneration Performed with Equine Bone and Membrane in the Treatment of İntrabony Defects: A Clinical Study. Photomed Laser Surg 2014; 32:226-31. [DOI: 10.1089/pho.2013.3664] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Gülnihal Emrem Doğan
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum Turkey
| | - Turgut Demir
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum Turkey
| | - Recep Orbak
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum Turkey
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Effects of laser therapy on the proliferation of human periodontal ligament stem cells. Lasers Med Sci 2013; 30:1171-4. [DOI: 10.1007/s10103-013-1436-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 08/28/2013] [Indexed: 12/23/2022]
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Nagata MJH, de Campos N, Messora MR, Pola NM, Santinoni CS, Bomfim SRM, Fucini SE, Ervolino E, de Almeida JM, Theodoro LH, Garcia VG. Platelet-rich plasma, low-level laser therapy, or their combination promotes periodontal regeneration in fenestration defects: a preliminary in vivo study. J Periodontol 2013; 85:770-8. [PMID: 24001046 DOI: 10.1902/jop.2013.130318] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND This study histomorphometrically analyzes the influence of platelet-rich plasma (PRP), low-level laser therapy (LLLT), or their combination on the healing of periodontal fenestration defects (PFDs) in rats. METHODS PFDs were surgically created in the mandibles of 80 rats. The animals were randomly divided into four groups: 1) C (control) and 2) PRP, defects were filled with blood clot or PRP, respectively; 3) LLLT and 4) PRP/LLLT, defects received laser irradiation, were filled with blood clot or PRP, respectively, and then irradiated again. Animals were euthanized at either 10 or 30 days post-surgery. Percentage of new bone (NB), density of newly formed bone (DNB), new cementum (NC), and extension of remaining defect (ERD) were histomorphometrically evaluated. Data were statistically analyzed (analysis of variance; Tukey test, P <0.05). RESULTS At 10 days, group PRP presented ERD significantly lower than group C. At 30 days, group PRP presented NB and DNB significantly greater than group C. Groups LLLT, PRP, and PRP/LLLT showed significant NC formation at 30 days, with collagen fibers inserted obliquely or perpendicularly to the root surface. NC formation was not observed in any group C specimen. CONCLUSIONS LLLT, PRP, or their combination all promoted NC formation with a functional periodontal ligament. The combination PRP/LLLT did not show additional positive effects compared to the use of either therapy alone.
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Affiliation(s)
- Maria J H Nagata
- Department of Surgery and Integrated Clinic, Dental School of Araçatuba, UNESP - São Paulo State University, Araçatuba, São Paulo, Brazil
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Systemic effects of LLLT on bone repair around PLLA–PGA screws in the rabbit tibia. Lasers Med Sci 2013; 29:703-8. [DOI: 10.1007/s10103-013-1384-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 06/24/2013] [Indexed: 10/26/2022]
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Amid R, Kadkhodazadeh M, Fekrazad R, Hajizadeh F, Ghafoori A. Comparison of the effect of hand instruments, an ultrasonic scaler, and an erbium-doped yttrium aluminium garnet laser on root surface roughness of teeth with periodontitis: a profilometer study. J Periodontal Implant Sci 2013; 43:101-5. [PMID: 23678394 PMCID: PMC3651935 DOI: 10.5051/jpis.2013.43.2.101] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 03/22/2013] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The present study aimed to measure root surface roughness in teeth with periodontitis by a profilometer following root planning with ultrasonic and hand instruments with and without erbium-doped yttrium aluminium garnet (Er:YAG) laser irradiation. METHODS Sixty single-rooted maxillary and mandibular teeth, extracted because of periodontal disease, were collected. The crowns and apices of the roots were cut off using a diamond bur and water coolant. The specimens were mounted in an acrylic resin block such that a plain root surface was accessible. After primary evaluation and setting a baseline, the samples were divided into 4 groups. In group 1, the samples were root planned using a manual curette. The group 2 samples were prepared with an ultrasonic scaler. In group 3, after scaling with hand instrumentation, the roots were treated with a Smart 1240D plus Er:YAG laser and in group 4, the roots were prepared with ultrasonic scaler and subsequently treated with an Er:YAG laser. Root surface roughness was then measured by a profilometer (MahrSurf M300+RD18C system) under controlled laboratory conditions at a temperature of 25℃ and 41% humidity. The data were analyzed statistically using analysis of variance and a t-test (P<0.05). RESULTS Significant differences were detected in terms of surface roughness and surface distortion before and after treatment. The average reduction of the surface roughness after treatment in groups 1, 2, 3, and 4 was 1.89, 1.88, 1.40, and 1.52, respectively. These findings revealed no significant differences among the four groups. CONCLUSIONS An Er:YAG laser as an adjunct to traditional scaling and root planning reduces root surface roughness. However, the surface ultrastructure is more irregular than when using conventional methods.
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Affiliation(s)
- Reza Amid
- Department of Periodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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25
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Fronza B, Somacal T, Mayer L, de Moraes J, de Oliveira M, Weber J. Assessment of the systemic effects of low-level laser therapy (LLLT) on thyroid hormone function in a rabbit model. Int J Oral Maxillofac Surg 2013; 42:26-30. [DOI: 10.1016/j.ijom.2012.06.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2012] [Revised: 06/11/2012] [Accepted: 06/22/2012] [Indexed: 11/30/2022]
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26
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Slezák R, Paulusová V. Use of the NovaBone augmentation material in the treatment of chronic periodontitis. Preliminary communication. ACTA MEDICA (HRADEC KRÁLOVÉ) 2013; 56:157-61. [PMID: 24693797 DOI: 10.14712/18059694.2014.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The pilot study deals with the clinical results of the regenerative therapeutical method in intraosseous periodontal defects done by surgical augmentation procedure using a material of a new generation prepared on the basis of a bioactive glass. A group of 10 individuals were treated properly for chronic periodontitis. Some of treated infraalveolar periodontal lesions, both periodontal pockets and interradicular defects, persisted or recurred in posterior teeth. In order to eliminate them they were indicated for advanced periodontal surgery or regenerative surgical therapy stimulating healing processes of supportive tissues, mostly alveolar bone around treated teeth. Relevant clinical parameters, i. e. values of the pocket depth, gingival recession, and loss of attachment were evaluated before and after the periodontal surgery and compared with each other. The therapy led to significant improvement of clinical parameters in terms of the reduction of pocket depth and loss of attachment values.
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27
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Jones JR. Review of bioactive glass: from Hench to hybrids. Acta Biomater 2013; 9:4457-86. [PMID: 22922331 DOI: 10.1016/j.actbio.2012.08.023] [Citation(s) in RCA: 1003] [Impact Index Per Article: 91.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Revised: 08/10/2012] [Accepted: 08/14/2012] [Indexed: 12/18/2022]
Abstract
Bioactive glasses are reported to be able to stimulate more bone regeneration than other bioactive ceramics but they lag behind other bioactive ceramics in terms of commercial success. Bioactive glass has not yet reached its potential but research activity is growing. This paper reviews the current state of the art, starting with current products and moving onto recent developments. Larry Hench's 45S5 Bioglass® was the first artificial material that was found to form a chemical bond with bone, launching the field of bioactive ceramics. In vivo studies have shown that bioactive glasses bond with bone more rapidly than other bioceramics, and in vitro studies indicate that their osteogenic properties are due to their dissolution products stimulating osteoprogenitor cells at the genetic level. However, calcium phosphates such as tricalcium phosphate and synthetic hydroxyapatite are more widely used in the clinic. Some of the reasons are commercial, but others are due to the scientific limitations of the original Bioglass 45S5. An example is that it is difficult to produce porous bioactive glass templates (scaffolds) for bone regeneration from Bioglass 45S5 because it crystallizes during sintering. Recently, this has been overcome by understanding how the glass composition can be tailored to prevent crystallization. The sintering problems can also be avoided by synthesizing sol-gel glass, where the silica network is assembled at room temperature. Process developments in foaming, solid freeform fabrication and nanofibre spinning have now allowed the production of porous bioactive glass scaffolds from both melt- and sol-gel-derived glasses. An ideal scaffold for bone regeneration would share load with bone. Bioceramics cannot do this when the bone defect is subjected to cyclic loads, as they are brittle. To overcome this, bioactive glass polymer hybrids are being synthesized that have the potential to be tough, with congruent degradation of the bioactive inorganic and the polymer components. Key to this is creating nanoscale interpenetrating networks, the organic and inorganic components of which have covalent coupling between them, which involves careful control of the chemistry of the sol-gel process. Bioactive nanoparticles can also now be synthesized and their fate tracked as they are internalized in cells. This paper reviews the main developments in the field of bioactive glass and its variants, covering the importance of control of hierarchical structure, synthesis, processing and cellular response in the quest for new regenerative synthetic bone grafts. The paper takes the reader from Hench's Bioglass 45S5 to new hybrid materials that have tailorable mechanical properties and degradation rates.
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Affiliation(s)
- Julian R Jones
- Department of Materials, Imperial College London, South Kensington Campus, London, UK.
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Anabolic Actions of the Regenerative Agent Enamel Matrix Derivative (EMD) in Oral Periosteal Fibroblasts and MG 63 Osteoblasts, Modulation by Nicotine and Glutathione in a Redox Environment. J Funct Biomater 2012; 3:143-62. [PMID: 24956521 PMCID: PMC4031020 DOI: 10.3390/jfb3010143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Revised: 12/20/2011] [Accepted: 02/22/2012] [Indexed: 11/24/2022] Open
Abstract
Our study seeks to explore anabolic effects of a periodontal regenerative agent enamel matrix derivative (EMD). Its modulation by nicotine and the anti-oxidant glutathione (GSH) are investigated in human periosteal fibroblasts (HPF) and MG63 osteoblasts. Androgen biomarkers of oxidative stress and healing, resulting from radiolabeled androgen substrates are assayed. This in vitro model simulates a redox environment relevant to the periodontal lesion. It aims to confirm the hypothesis that EMD is an effective regenerative agent in a typically redox environment of the periodontal lesion. Monolayer cultures of MG63 osteoblasts and HPF established in culture medium are incubated with androgen substrates, and optimal concentrations of EMD, nicotine and GSH, alone and in combination. EMD significantly enhances yields of 5α-dihydrotestosterone (DHT) an effective bioactive metabolite, alone and in combination with GSH, to overcome oxidative effects of nicotine across cultures. The ‘in vitro’ findings of this study could be extrapolated to “in vivo” applications of EMD as an adjunctive regenerative therapeutic agent in an environment of chronic inflammation and oxidative stress. Increased yields of DHT implicated in matrix synthesis and direct antioxidant capacity, confirm the potential applications for enamel matrix derivative in periodontal regenerative procedures.
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Low power laser efficacy in the therapy of inflamed gingive in diabetics with parodontopathy. VOJNOSANIT PREGL 2011; 68:684-9. [DOI: 10.2298/vsp1108684o] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background/Aim. There is clear evidence on direct relationship between
periodontal disease and diabetes mellitus. Many investigations point out
greater prevalence and severity of periodontal disease among diabetic
patients. During last decade, low level laser therapy has been used in
periodontal therapy. It has biostimulative effect, accelerates wound healing,
minimizes pain and swelling, and there is almost no contraindication for its
usage. The aim of the paper was to investigate the efficiency of low level
laser therapy as adjuvant tool in reduction of gingival inflammation in
diabetic patients. Methods. The study incuded 150 participants divided into
three groups: group I (50 participants with diabetes mellitus type 1 and
periodontal disease), group II (50 participants with diabetes mellitus type 2
and periodontal disease), group III (nondiabetic participants with
periodontal disease). Gingival health evaluation was done using gingival
index L?e-Silness. Soft and hard deposits were removed, periodontal pockets
cleaned and GaAlAs low level laser therapy (5 mW) applied five consecutive
days. In each patient, low level laser therapy was not applied on the left
side of the jaw in order to compare the effects of the applied therapy. After
the first, third and fifth therapy and one month after the last visit
gingival index was evaluated. Before the first and after the fifth therapy
exfoliative cytology of gingiva was done and nuclei areal was analyzed
morphometrically. Results. After all investigated periods, gingival index and
nuclei areal were significantly decreased comparing to values before the
therapy, at both jaw sides (p < 0.001). After the 1st, 3rd and 5th therapy,
the t-test showed a significantly decreased gingival index at the lased side
of jaw comparing to non-lased side. Conclusion. Low level laser therapy is
efficient in gingival inflammation elimination and can be proposed as an
adjuvant tool in basic periodontal therapy of diabetic patients.
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