The effect of post-extraction socket preservation laser treatment on bone density 4 months after extraction: Randomized controlled trial

Successful Intentional Replantation of a Severely Compromised Tooth Using 3 Types of Phototherapy: A Case Report

Background: Intentional replantation (IR) is an emerging and cost-effective last-resort treatment for persistent apical periodontitis. Adjunctive phototherapy for IR aims to improve the management of challenging cases by enhancing disinfection, stimulating healing and promoting regeneration. Objective: We report a novel phototherapy-assisted IR protocol conducted on a compromised lateral incisor with an extensive periapical infection (Ø > 10 mm) in a 68-year-old diabetic male. Methods: The IR protocol involved pre- and postoperative photobiomodulation (660 nm, 0.2 J/cm2, 60 sec/site), antimicrobial photodynamic therapy of the root surface (660 nm, 0.6 J/cm2, 30 sec, methylene blue photosensitizer), and Er:YAG root and socket debridement (2940 nm, 21 J/cm2, 30 sec). The total time from extraction to replantation was 14 min 35 sec. Results: The tooth at 3.5-year follow-up remained clinically functional with radiographic resolution of the infection indicating a successful reimplantation. Conclusions: This case report demonstrated that an adjunctive phototherapy IR protocol can effectively treat a compromised tooth with extensive periapical infection.

The effect of bone remodeling with photobiomodulation in dentistry: a review study

Photobiomodulation (PBM) has been emerging as a promising alternative therapy in dentistry. However, various parameters of PBM are used in different studies, and there is limited cumulative data on PBM for improving bone formation in clinical trials. The aim of this review was to evaluate the effectiveness of PBM in the process of bone remodeling in dentistry using randomized controlled trials. Initially, a total of 1,011 articles published from January 2008 to December 2021 were retrieved from five electronic databases (PubMed, Scopus, Cochrane Library, EMBASE, and CINAHL). After a two-step review, nine articles met the inclusion criteria. The parameter of PBM, group, treatment sessions, assessment times and outcomes of the included studies were reviewed. Eighty-nine percent of the studies revealed positive effects on bone formation between the laser group and the control group. Only one article reported that light-emitting diode did not significantly enhance osteogenesis. Additionally, the present study shows that Gallium aluminum arsenide of near infrared (NIR) laser with continuous mode is the most commonly used form of PBM. The biostimulatory effects are dependent on several parameters, with wavelength and dose being more important than others. Based on this review, it is suggested that the NIR range and an appropriate dose of PBM could be used to increase the efficiency of stimulating bone healing and remodeling. However, standardization of treatment protocols is needed to clarify therapeutic strategies in dentistry.

Nd:YAG laser therapy on postoperative pain, swelling, and trismus after mandibular third molar surgery: a randomized double-blinded clinical study

This study aims to evaluate the effect of Nd:YAG laser therapy (NdLT) on postoperative pain, swelling, and trismus after mandibular third molar (M3) surgery. Three hundred patients were randomly divided into the Nd group (n = 100), medication group (n = 100), and Nd+medication (Nd+m) group (n = 100). The WHARFE classification system was used to assess surgical difficulty. After surgery, the Nd group was irradiated by the Nd:YAG laser in very long-pulsed mode (VLP, pulse duration 1 ms, 20 Hz, 4 W, R21-C3) in 6 regions of the extraction socket with a total energy of 300 J. For the medication group, dexamethasone 0.75 mg and loxoprofen 60 mg were prescribed immediately and every 12 h thereafter for 3 days. The Nd+m group received both treatments mentioned above. Pain assessment was performed at 6, 24, 48, and 72 h postoperatively using the visual analog scale (VAS). Swelling was evaluated by changes in the distance from (1) the tragus to the labial commissure, (2) the tragus to the pogonion, and (3) the mandibular angle to the lateral canthus preoperatively and 72 h postoperatively. Trismus was assessed by the change in maximum mouth opening. Groups Nd and Nd+m had lower VAS scores at 6 h, 24 h, and 48 h (F = 13.80, p = 0.00), but the difference between the two groups was not significant (F = 1.34, p = 0.11). However, no significant difference was observed at 72 h (p = 0.10). There was no significant difference in swelling or trismus among the three groups (p > 0.05). NdLT is an effective approach to improve complications after M3 surgery.

Influence of Er:YAG laser irradiation on the outcomes of alveolar ridge preservation at the infected molar sites: a randomized controlled trial

BACKGROUND

The purpose of this study was to investigate the socket healing outcome after alveolar ridge preservation at infected molar sites using an erbium-doped yttrium aluminium garnet (Er:YAG) laser.

METHODS

Eighteen patients who needed molar extraction and exhibited signs of infection were included and allocated into either the laser group or the control group. Er:YAG laser irradiation for degranulation and disinfection was performed with alveolar ridge preservation (ARP) in the laser group. Traditional debridement with a curette was performed in the control group. Two months after ARP, bone tissue samples were harvested at the time of implant placement for histological analysis. Assessment of dimension changes in alveolar bone was conducted by superimposing two cone-beam computed tomography (CBCT) scans taken at baseline and two months after extraction.

RESULTS

Histologically, after two months of healing, Er:YAG laser treatment resulted in more newly formed bone (laser: 17.75 ± 8.75, control: 12.52 ± 4.99, p = 0.232). Moreover, greater osteocalcin (OCN) positive expression and lower runt-related transcription factor 2 (RUNX-2) positive expression were detected in the laser group. However, no statistically significant difference was observed between the two groups. The difference in the vertical resorption of the buccal bone plate was statistically significant between groups (laser: -0.31 ± 0.26 mm, control: -0.97 ± 0.32 mm, p < 0.05). Major changes in ridge width were observed at 1 mm below the bone crest. However, the differences between groups were not significant (laser: -0.36 ± 0.31 mm, control: -1.14 ± 1.24 mm, p = 0.171).

CONCLUSIONS

ARP with Er:YAG laser irradiation seemed to improve bone healing by regulating osteogenesis-related factor expression in the early stage at infected sites.

TRIAL REGISTRATION

The trial was registered on the Chinese Clinical Trial Registry Platform ( https://www.chictr.org.cn/ ) (registration number: ChiCTR2300068671; registration date: 27/02/2023).

A Scoping Review of the Efficacy of Diode Lasers Used for Minimally Invasive Exposure of Impacted Teeth or Teeth with Delayed Eruption

Background: The use of diode lasers for oral surgery soft tissue procedures is associated with less pain and bleeding, quick recovery, and better surgical site visibility. Objectives: This scoping review identifies and analyses the evidence evaluating the efficacy of the diode laser surgical exposure of impacted teeth or teeth with delayed eruption (both with no overlaying bone) vs. conventional scalpel surgical exposure. Materials and Methods: The PubMed/Medline, SCOPUS, and Google Scholar databases were searched up to January 2022 for randomized clinical trials and case-control studies comparing diode laser impacted-tooth surgical exposure vs. conventional surgical methods. Furthermore, the surgical exposure of an impacted mandibular canine or premolars with a 940 nm (InGaAsP) diode laser was presented. Results: The literature search revealed no high-quality evidence. However, four prospective studies were identified. Diode laser application was associated with less pain or analgesic need, minimal/no bleeding, and no need for suturing after surgery. The laser wavelengths used were 808, 810, 935, and 980 nm. A comparison of the study outcomes was not possible; all the studies had methodological issues and their funding sources were not mentioned. Conclusions: Adequately powered clinical trials are needed for comparing outcomes from diode laser surgical exposure vs. conventional methods, identifying the ideal laser characteristics, and assessing the long-term periodontal health of laser-exposed teeth and any potential risks.

Influence of low-level laser therapy on implant stability in implants placed in healed sites: a randomized controlled trial

Background

The present study aims to assess the influence of low-level laser therapy (LLLT) on stability in implants placed in healed sites.

Material and methods

The present study followed the SPIRIT statement and is reported according to CONSORT. Patients were randomly allocated to LLLT or control groups. LLLT consisted in the application of 808-nm GaAlA laser applied before the preparation of the implant bed and after suturing (80 seconds; 11J/cm²). Implant stability quotient (ISQ) and the distance between the implant platform to the alveolar bone crest (millimeters) were assessed at implant placement (T₀) and the abutment selection phase (4–6 months, T_a).

Results

A total of 64 implants were placed in 33 patients. The insertion torque ranged from 10 to 70 N.cm (mean 43.23; SD ±16.82). The T₀ ISQ ranged from 18 to 95.5 (mean 61.7; SD ±18.23) and the crestal bone radiographic distance was 2.03 mm (SD±1.27). At T_a, the ISQ ranged from 39 to 90 (mean 64.2; SD±9.84), and the mean crestal bone radiographic loss was 1.70mm (SD±1.65). However, no differences were observed when LLLT and control groups were compared with ISQ difference (T_a–T₀; p=0.598) or radiographical peri-implant alterations (p=0.531).

Conclusion

LLLT did not influence the implant stability in implants placed in healed sites compared to a control group.

Trial registration

ReBEC, RBR-35TNJ7. Registered May 23, 2018

The effect of post-extraction socket preservation laser treatment on bone density 4 months after extraction: Randomized controlled trial

Background

Post‐extraction bone resorption may affect the outcome of ensuing restorations.

Purpose

This study aimed to evaluate a comprehensive laser post‐extraction protocol by comparing resulting alveolar bone regeneration with that obtained after standard extraction procedure.

Materials and Methods

About 53 simple extractions were randomized to either laser or control group. In the laser group, erbium (Er:YAG; 2940 nm) and neodymium (Nd:YAG; 1064 nm) lasers were used for degranulation, disinfection, de‐epithelialization of the surrounding gingiva, clot stabilization, and photobiomodulation. The primary outcome measure was change in bone density in the extraction area between day 1 and 4 months after extraction. Patients were monitored for potential side effects.

Results

Increase in bone density at the follow‐up CBCT was significantly higher in laser than in control group (p < 0.001). No post‐operative pain, bleeding, or swelling was present in the laser group. In the control group, one patient had bleeding 3–5 days after extraction, two patients had swelling and three patients reported post‐operative pain rated 3–5 on a 0–10 pain scale up to 3 days after extraction.

Conclusions

The proposed laser post‐extraction procedure is a safe and effective method to improve post‐extraction bone healing.