Veterinary Dental Photobiomodulation: Assessing Post-Treatment Gingival Inflammation in Canines

Objective: This research aims to determine the effect photobiomodulation treatment has on oral inflammation after routine dental prophylaxis in canines. Background: Photobiomodulation therapy after dental procedures has been documented to reduce inflammation in human and animal models. Methods: Canines were randomly assigned into three groups: control group (CG; n = 15), left side treated group (LTG; n = 15), and right side treated group (RTG; n = 15). The canines in the treatment groups received four points of irradiation [GaAlInP-650 nm, continuous wave (CW), 0.1 W, 0.2 W/cm2, 100 sec, 10 J, 20 J/cm2]. The gingiva was evaluated by a veterinary investigator blinded to the treatment groups for erythema and edema on the day following treatment. Student's t-test and Student's paired t-test were used for data analysis. Results: Reductions in composite inflammation (p = 0.008) and erythema (p = 0.030) were observed in the LTG relative to the CG at the location of the left dental arcade. Reductions in composite inflammation (p = 0.025) and erythema (p = 0.013) were also observed in the combined treated arcades of the LTG and RTG when compared to the CG. Conclusions: The results indicate that the canines who received a single photobiomodulation treatment on the left dental arcade demonstrated a decrease in inflammation and erythema.

Influence of Three Laser Wavelengths with Different Power Densities on the Mitochondrial Activity of Human Gingival Fibroblasts in Cell Culture

Phototherapy plays a key role in wound healing and tissue regeneration. The use of lasers has the potential to become an effective and minimally invasive treatment in periodontal and peri-implant disease. The aim of this study was to evaluate the influence of three laser wavelengths with the combination of parameters such as power density and energy density on human gingival fibroblasts (hGFs) in vitro culture. Isolated cells were seeded in 96-well plates with culture medium (DMEM, Dulbecco's modified Eagle's medium) supplemented with 10% fetal bovine serum (FBS). After 24 h cells were irradiated (1064, 980 and 635 nm, various energy density value). After 24, 48 and 72 h, cells were evaluated for viability. Data were analyzed by ANOVA followed by Tukey's HSD test. We found the best outcomes for hGFs irradiated with laser 1064 nm for all combinations of power output (50/400/1000 mW) and energy dose (3/25/64 J/cm²) after 48 h and 72 h compared with control group. Cell viability increase ranged from 0.6× (3 J/cm², 50 mW) to 1.3× (64 J/cm², 1000 mW). Our findings indicate that the appropriate use of low-level laser irradiation (LLLI) can increase the proliferation rate of cultured cells. The use of LLLI can be extremely useful in tissue engineering and regenerative medicine.

Neuroinflammation mechanisms of neuromodulation therapies for anxiety and depression

Mood disorders are associated with elevated inflammation, and the reduction of symptoms after multiple treatments is often accompanied by pro-inflammation restoration. A variety of neuromodulation techniques that regulate regional brain activities have been used to treat refractory mood disorders. However, their efficacy varies from person to person and lack reliable indicator. This review summarizes clinical and animal studies on inflammation in neural circuits related to anxiety and depression and the evidence that neuromodulation therapies regulate neuroinflammation in the treatment of neurological diseases. Neuromodulation therapies, including transcranial magnetic stimulation (TMS), transcranial electrical stimulation (TES), electroconvulsive therapy (ECT), photobiomodulation (PBM), transcranial ultrasound stimulation (TUS), deep brain stimulation (DBS), and vagus nerve stimulation (VNS), all have been reported to attenuate neuroinflammation and reduce the release of pro-inflammatory factors, which may be one of the reasons for mood improvement. This review provides a better understanding of the effective mechanism of neuromodulation therapies and indicates that inflammatory biomarkers may serve as a reference for the assessment of pathological conditions and treatment options in anxiety and depression.

Vaginal laser therapy for gynecologic conditions: re-examining the controversy and where do we go from here

Despite significant controversy, vaginal laser therapy continues to be used for treatment of many gynecologic and pelvic conditions including vaginal atrophy, vaginal dryness, dyspareunia, urinary incontinence and pelvic pain. This commentary reviews the controversy surrounding vaginal laser therapy and summarizes the important distinction between ablative and non-ablative vaginal lasers. While much research is still needed, the article describes what is important for healthcare professionals to know before making the decision to integrate this technology into their clinical practice.

Comparative evaluation of low-level light therapy and ethinyl estradiol and desogestrel combined oral contraceptive for clinical efficacy and regulation of serum biochemical parameters in primary dysmenorrhoea: a prospective randomised multicentre trial

We aimed to compare low-level light therapy with oral contraceptive pills for pain relief and serum levels of nitric oxide and prostaglandin E₂ in patients with primary dysmenorrhoea. This was a randomised, active comparator-controlled, multicentre study. In total, 156 patients were randomised to receive either low-level light therapy with light-emitting diodes (LED) applying on two acupoints, namely, conception vessel 4 (CV4) and CV6 or conventional treatment with oral Marvelon, 30 µg of ethinyl estradiol and 150 µg of desogestrel (DSG/EE), for three consecutive menstrual cycles. The main outcome was the proportion of patients who achieved 33% or more decrease in pain scores measured using the visual analogue scale, which was deemed as efficient rate. Absolute changes in visual analogue scale scores, serum levels of nitric oxide (assessed by nitrites and nitrates reflecting nitric oxide metabolism) and prostaglandin E₂ (measured by enzyme-linked immunosorbent assay) were the secondary outcomes. A total of 135 patients completed the study (73 in the light therapy group and 62 in the DSG/EE group). The efficient rate at the end of treatment was comparable between the groups (73.6% vs. 85.7%, χ² = 2.994, p = 0.084). A more significant reduction in pain scores was observed in the DSG/EE group (39.25% vs. 59.52%, p < 0.001). Serum levels of prostaglandin E₂ significantly decreased from baseline but did not differ between groups (- 109.57 ± 3.99 pg/mL vs. - 118.11 ± 12.93 pg/mL, p = 0.51). Nitric oxide concentration remained stable in both groups. Low-level light therapy with LED-based device applied on acupuncture points CV4 and CV6 demonstrated a similar level of dysmenorrhoea pain reduction to DSG/EE combined contraceptive. Both treatment modalities achieved clinically meaningful levels of pain reduction. Registration on ClinicalTrials.gov: TRN: NCT03953716, Date: April 04, 2019.

Effect of Photobiomodulation on Periodontal Ligament Cells Under Inflamed and Nutrient-Deficient Conditions Simulating Damaged Cells of Avulsed Teeth: An In Vitro Study

Background: The prognosis of replanted teeth is depended on the vitality of periodontal ligament cells residual on the root surface. Photobiomodulation has photobiological effects that can promote cell vitality. The study aimed to explore the effect of photobiomodulation on the periodontal ligament cells under inflamed or starved conditions mimicking clinically damaged periodontal ligament cells of avulsed teeth and provide the adjuvant procedure for tooth replantation. Materials and methods: Normal, starved, or inflamed periodontal ligament cells were irradiated with an 808 nm laser at densities of 0, 1, 3, 5, or 10 J/cm². The cell counting kit-8 (CCK-8) assay and scratch test were applied to determine the effects on the proliferation and migration of cells. Anti-inflammatory effects were assessed according to the mRNA expression of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) measured by reverse-transcription polymerase chain reaction. Osteogenic capacity was evaluated by alkaline phosphatase (ALP) staining, ALP activity assay, Alizarin Red S staining, and ALP and osteocalcin (OCN) mRNA expression. Results: The CCK-8 assay and scratch test demonstrated that the 808 nm laser significantly promoted proliferation and migration of normal condition periodontal ligament cells at a density of 3 J/cm² versus 5 J/cm² under the starved and inflamed conditions. Moreover, the 808 nm laser had anti-inflammatory effects and promoted osteogenesis of periodontal ligament cells at 3 J/cm² under normal conditions, while photobiomodulation at 5 J/cm² upregulated the osteogenesis of periodontal ligament cells under starved and inflamed conditions. Conclusions: The photobiomodulation of 808 nm laser reduced inflammation and improved the proliferation, migration, and osteogenesis of normal, starved, and inflamed periodontal ligament cells. These effects required a higher energy density under starved or inflamed conditions compared with normal conditions. The photobiomodulation of 808 nm has a potential application in root surface treatment for replanted teeth.

Photobiomodulation Promotes Hippocampal CA1 NSC Differentiation Toward Neurons and Facilitates Cognitive Function Recovery Involving NLRP3 Inflammasome Mitigation Following Global Cerebral Ischemia

Our recent study revealed that photobiomodulation (PBM) inhibits delayed neuronal death by preserving mitochondrial dynamics and function following global cerebral ischemia (GCI). In the current study, we clarified whether PBM exerts effective roles in endogenous neurogenesis and long-lasting neurological recovery after GCI. Adult male rats were treated with 808 nm PBM at 20 mW/cm² irradiance for 2 min on cerebral cortex surface (irradiance ∼7.0 mW/cm², fluence ∼0.8 J/cm² on the hippocampus) beginning 3 days after GCI for five consecutive days. Cognitive function was evaluated using the Morris water maze. Neural stem cell (NSC) proliferation, immature neurons, and mature neurons were examined using bromodeoxyuridine (BrdU)-, doublecortin (DCX)-, and NeuN-staining, respectively. Protein expression, such as NLRP3, cleaved IL1β, GFAP, and Iba1 was detected using immunofluorescence staining, and ultrastructure of astrocyte and microglia was observed by transmission electron microscopy. The results revealed that PBM exerted a markedly neuroprotective role and improved spatial learning and memory ability at 58 days of ischemia/reperfusion (I/R) but not at 7 days of reperfusion. Mechanistic studies revealed that PBM suppressed reactive astrocytes and maintained astrocyte regeneration at 7 days of reperfusion, as well as elevated neurogenesis at 58 days of reperfusion, as evidenced by a significant decrease in the fluorescence intensity of GFAP (astrocyte marker) but unchanged the number of BrdU-GFAP colabeled cells at the early timepoint, and a robust elevation in the number of DCX-NeuN colabeled cells at the later timepoint in the PBM-treated group compared to the GCI group. Notably, PBM treatment protected the ultrastructure of astrocyte and microglia cells at 58 days but not 7 days of reperfusion in the hippocampal CA1 region. Furthermore, PBM treatment significantly attenuated the GCI-induced immunofluorescence intensity of NLRP3 (an inflammasome component), cleaved IL1β (reflecting inflammasome activation) and Iba1, as well as the colocalization of NLRP3/GFAP or cleaved IL-1β/GFAP, especially in animals subjected to I/R at 58 days. Taken together, PBM treatment performed postischemia exerted a long-lasting protective effect on astrocytes and promoted endogenous neurogenesis in the hippocampal CA1 region, which might contribute to neurological recovery after GCI.

Role of E2F1/SPHK1 and HSP27 During Irradiation in a PMA-Induced Inflammatory Model

Background: Sphingosine kinase 1 (SPHK1) and heat shock protein 27 (HSP27) are important for antioxidant and anti-inflammatory effects after red light irradiation in an inflammatory model. Objective: The purpose of the present study was to evaluate whether SPHK1 and HSP27 work independently or are dependent on some other regulator after 625 nm light-emitting diode irradiation in the human keratinocyte (HaCaT) cell line. Methods: Differentially expressed genes (DEGs) were identified between groups with or without 625 nm photobiomodulation (PBM) in the inflammatory model. Potential transcription factors (TFs) of key DEGs were predicted using the iRegulon plugin. The mechanism was investigated by analyzing mRNA and protein expression levels, prostaglandin E2 levels, and intracellular reactive oxygen species (ROS) in phorbol 12-myristate 13-acetate (PMA)-induced HaCaT cells after 625 nm PBM. Results: A total of 6 TFs (e.g., E2F1) and 51 key DEGs (e.g., SPHK1) were identified after 625 nm PBM in PMA-stimulated HaCaT cells. E2F1 worked as a regulator of SPHK1; however, it did not affect HSP27. E2F1 knockdown drastically decreased the SPHK1 expression level and increased the intracellular ROS, as well as the expression levels of inflammation-related proteins in PMA-induced HaCaT cells. In addition, the inhibition of HSP27 decreased the anti-inflammatory effect of 625 nm PBM. Conclusions: E2F1 worked as a TF of SPHK1 and exhibited anti-inflammatory and antioxidative effects through SPHK1 in PMA-induced HaCaT cells after 625 nm PBM. HSP27 is essential for the 625 nm PBM-induced anti-inflammatory function. Therefore, E2F1/SPHK1 and HSP27 could be used as potential biomarkers for anti-inflammatory therapy with 625 nm PBM.

Immunomodulatory activity seen as a result of photobiomodulation therapy in stimulated primary human fibroblasts

OBJECTIVE

Oral biofilms burden host responses by induction of inflammatory mediators, exacerbating periodontal inflammation. Photobiomodulation Therapy (PBMT) has been shown to decrease levels of pro-inflammatory cytokines and chemokines. However, optimal wavelengths and exposure doses have not been established. This study investigated the effects of PBMT on human periodontal ligament fibroblasts (hPDLFs) stimulated with inflammatory mediators (LPS, TNF-α, and IL-1β).

METHODS

Cytotoxic effects of laser wavelengths 660 nm and 810 nm were assessed by measuring their effects on cellular dehydrogenase activity. The study was expanded to include 980 nm, 660 nm + 810 nm, and 810 nm + 980 nm. P.g. LPS, TNF-α, and/or IL-1β were added one hour before irradiation, then exposed to laser irradiation to determine the most appropriate stimulus. The levels of INF-γ, IL-6, IL-8, IL-17A/F, and MCP-1 production in stimulated hPDLFs were measured and analyzed.

RESULTS

P.g. LPS was a poor stimulus for hPDLFs, while TNF-α and IL-1β significantly elevated the analytes. The 660 nm laser treatment induced pro-inflammatory cytokines when stimulated, while 810 nm exhibited significant suppression. IL-1β was the stimulus of choice and the 810 nm wavelength alone exhibited anti-inflammatory effects for all analytes except IL-8, while the 810 nm in combination with 660 nm and/or 980 nm exhibited effects similar to 810 nm alone.

CONCLUSIONS

The downregulation of inflammatory mediators by the combination or individual treatment with 810 nm wavelength shows promise for the management of periodontal inflammation. PBMT may lead to the development of a novel approach in the management of periodontal disease.

In Vitro Evidences of Different Fibroblast Morpho-Functional Responses to Red, Near-Infrared and Violet-Blue Photobiomodulation: Clues for Addressing Wound Healing

Although photobiomodulation (PBM) has proven promising to treat wounds, the lack of univocal guidelines and of a thorough understanding of light–tissue interactions hampers its mainstream adoption for wound healing promotion. This study compared murine and human fibroblast responses to PBM by red (635 ± 5 nm), near-infrared (NIR, 808 ± 1 nm), and violet-blue (405 ± 5 nm) light (0.4 J/cm2 energy density, 13 mW/cm2 power density). Cell viability was not altered by PBM treatments. Light and confocal laser scanning microscopy and biochemical analyses showed, in red PBM irradiated cells: F-actin assembly reduction, up-regulated expression of Ki67 proliferation marker and of vinculin in focal adhesions, type-1 collagen down-regulation, matrix metalloproteinase-2 and metalloproteinase-9 expression/functionality increase concomitant to their inhibitors (TIMP-1 and TIMP-2) decrease. Violet-blue and even more NIR PBM stimulated collagen expression/deposition and, likely, cell differentiation towards (proto)myofibroblast phenotype. Indeed, these cells exhibited a higher polygonal surface area, stress fiber-like structures, increased vinculin- and phospho-focal adhesion kinase-rich clusters and α-smooth muscle actin. This study may provide the experimental groundwork to support red, NIR, and violet-blue PBM as potential options to promote proliferative and matrix remodeling/maturation phases of wound healing, targeting fibroblasts, and to suggest the use of combined PBM treatments in the wound management setting.

Effect of ScLL and 15d-PGJ2 on viability and cytokine release in LPS-stimulated fibroblasts: an in vitro study

This study evaluated the effect of a cyclopentenone-type PG, 15-Deoxy-Δ12,14-PG J2 (15d-PGJ2), and lectin (ScLL) on the viability of human gingival fibroblasts (HGFs), and on IL-6 and TGFβ-1 release by these fibroblasts, stimulated with lipopolysaccharide (LPS). HGFs were stimulated with LPS 10 μg/ml and treated with 15d-PGJ2 1 and 2 μg/ml, and ScLL 2 and 5 μg/ml, for 1 and 3h, and then evaluated for viability by MTT assay. Supernatant was collected to detect IL-6 and TGFβ-1 release, by ELISA. Positive control was cells kept in Dulbecco's Modified Eagle's Medium, and negative control was those kept in LPS. Data were analyzed by ANOVA and Dunnett's test (α = 0.05). No significant difference was found in viability among experimental groups at 1h (p > 0.05). Percentage of ScLL 5 µg/ml viable cells was similar to that of positive control at evaluated periods (p > 0.05), whereas the other groups had lower levels than the positive control (p < 0.05). IL-6 release was statistically higher for ScLL 5 μg/ml and 15d-PGJ2 2 µg/ml at 1h, compared with the other treated groups and positive control (p < 0.05). No significant differences were found among the groups at 3h (p > 0.05), except for ScLL 2 µg/ml and 15d-PGJ2 1 µg/ml, which showed lower IL-6 release compared with that of negative control (p < 0.05). No significant difference was found among the groups for TGFβ-1 release (p > 0.05). Results indicated that ScLL 5 μg/ml did not interfere in viability, and ScLL 2 µg/ml and 15d-PGJ2 1 µg/ml demonstrated reduced IL-6 release. Tested substances had no effect on TGFβ-1 release.

Under the spotlight: mechanisms of photobiomodulation concentrating on blue and green light

Photobiomodulation (PBM) describes the application of light at wavelengths ranging from 400-1100 nm to promote tissue healing, reduce inflammation and promote analgesia. Traditionally, red and near-infra red (NIR) light have been used therapeutically, however recent studies indicate that other wavelengths within the visible spectrum could prove beneficial including blue and green light. This review aims to evaluate the literature surrounding the potential therapeutic effects of PBM with particular emphasis on the effects of blue and green light. In particular focus is on the possible primary and secondary molecular mechanisms of PBM and also evaluation of the potential effective parameters for application both in vitro and in vivo. Studies have reported that PBM affects an array of molecular targets, including chromophores such as signalling molecules containing flavins and porphyrins as well as components of the electron transport chain. However, secondary mechanisms tend to converge on pathways induced by increases in reactive oxygen species (ROS) production. Systematic evaluation of the literature indicated 72% of publications reported beneficial effects of blue light and 75% reported therapeutic effects of green light. However, of the publications evaluating the effects of green light, reporting of treatment parameters was uneven with 41% failing to report irradiance (mW cm-2) and 44% failing to report radiant exposure (J cm-2). This review highlights the potential of PBM to exert broad effects on a range of different chromophores within the body, dependent upon the wavelength of light applied. Emphasis still remains on the need to report exposure and treatment parameters, as this will enable direct comparison between different studies and hence enable the determination of the full potential of PBM.

Effect of photobiomodulation on the stability and displacement of orthodontic mini-implants submitted to immediate and delayed loading: a clinical study

The aim of this study was to evaluate the effect of photobiomodulation (PBM) on the stability and displacement of orthodontic mini-implants (MIs) submitted to loading. Forty-eight and 35 mini-implants (1.5 × 8 × 1 mm) were assessed for stability and displacement, respectively (19 patients). MIs were allocated according to the intervention in 1-PBM + immediate loading (IL), 2-PBM + delayed loading (DL) (four weeks after implantation), 3-IL only, and 4-DL only. PBM (Therapy XT, DCM) was implemented using a red emission (660 nm, 4 J/cm², 0.1 W, 20 s) immediately after implantation (day 0) and infrared emissions (808 nm; 8 J/cm², 0.1 W, 40 s) in the following appointments every 48-72 h during two weeks (days 2, 4, 7, 9, 11, and 14). Loading of 150 gF was applied during three months for all MIs. The stability was assessed by resonance frequency analysis (Osstell ISQ), and images from Cone beam computed tomography were evaluated to determine the amount of the displacement of the MI's head. MIs from the PBM groups presented lower loss of stability (P = 0.0372). When the analysis considered the loading protocol as an additional variable, group two showed the lowest loss of stability, being significantly different from groups that did not receive PBM (P = 0.0161). There was no difference between groups two and four during the period without loading (P > 0.05). DL groups presented lower loss when the effective period of loading was assessed, independently of the application of PBM (P < 0.0001). All groups showed displacement of the MIs head without significant differences (P > 0.05). DL potentiated the effect of PBM, decreasing the loss of stability.

Adjunctive antimicrobial photodynamic therapy using methylene blue/ethanol formulation in experimental periodontitis in diabetic rats: short-term results

The aim of this study was to evaluate the effect of an MB experimental formulation (ethanol 20%) in aPDT used as an adjuvant to scaling and root planing (SRP) in the periodontal treatment of diabetic rats. Forty male Wistar rats received streptozotocin-intraperitonial injections to induce diabetes. After 14 days, 5 animals were allocated in the non-ligate group (NLG), and 35 animals received ligature at the first right mandibular molar to induce periodontitis. After 7 days, the ligature was removed and the animals were randomized into 4 groups: LG (without treatment, n = 5), SRPG (SRP, n = 10), aPDTW (SRP+aPDT-MB/water, n = 10), and aPDTEt (SRP + aPDT-MB/water/ethanol/carboxymethylcellulose, n = 10). Animals were euthanized after 7 days. Data of bone loss (BL) area, degree of inflammatory cell response, and collagen fibers percentages were statistically analyzed (p < 0.05). Percentage of animals that presented mild and severe inflammatory infiltrate was 10% and 40% for SRPG, 20% and 30% for aPDTW, and 50% and 0% for aPDTEt, respectively. BL area (mm²) was statistically higher in the LG (0.39 ± 0.15) than NLG (0.05 ± 0.02). aPDTEt showed the lowest value of BL (0.08 ± 0.03), followed by aPDTW (0.21 ± 0.15) and SRPG (0.31 ± 0.18). Statistical differences were verified between aPDTEt and SRPG. In relation to the LG, aPDTEt, aPDTW, and SRPG recovered the equivalent 80%, 46%, and 20% of the BL. aPDTEt showed collagen content statistically higher than SRPG and LG, and presented higher mean values than NLG (p > 0.05). Our findings showed aPDTEt presented promising results. aPDT using MB/ethanol can have potential as an adjunctive periodontal treatment in diabetics.

Mechanisms and applications of the anti-inflammatory effects of photobiomodulation

Photobiomodulation (PBM) also known as low-level level laser therapy is the use of red and near-infrared light to stimulate healing, relieve pain, and reduce inflammation. The primary chromophores have been identified as cytochrome c oxidase in mitochondria, and calcium ion channels (possibly mediated by light absorption by opsins). Secondary effects of photon absorption include increases in ATP, a brief burst of reactive oxygen species, an increase in nitric oxide, and modulation of calcium levels. Tertiary effects include activation of a wide range of transcription factors leading to improved cell survival, increased proliferation and migration, and new protein synthesis. There is a pronounced biphasic dose response whereby low levels of light have stimulating effects, while high levels of light have inhibitory effects. It has been found that PBM can produce ROS in normal cells, but when used in oxidatively stressed cells or in animal models of disease, ROS levels are lowered. PBM is able to up-regulate anti-oxidant defenses and reduce oxidative stress. It was shown that PBM can activate NF-kB in normal quiescent cells, however in activated inflammatory cells, inflammatory markers were decreased. One of the most reproducible effects of PBM is an overall reduction in inflammation, which is particularly important for disorders of the joints, traumatic injuries, lung disorders, and in the brain. PBM has been shown to reduce markers of M1 phenotype in activated macrophages. Many reports have shown reductions in reactive nitrogen species and prostaglandins in various animal models. PBM can reduce inflammation in the brain, abdominal fat, wounds, lungs, spinal cord.

Effect of lectin (ScLL) on fibroblasts stimulated with LPS - an in vitro study

The lectin (ScLL) extracted from the Synadenium carinatum plant has been evaluated as an immunomodulator in diseases such as asthma, neosporosis and leishmaniasis. However, it has not yet been evaluated in the oral cavity. This study evaluated the effect of ScLL on viability, proliferation and release of IL-10 in human gingival fibroblasts (HGF) stimulated with lipopolysaccharide (LPS). HGF were stimulated with LPS 1 µg/ml and treated with ScLL in concentrations of 10, 5 and 2 µg/ml for 1 and 5 h, and evaluated by flow cytometry for viability, apoptosis (initial/advanced) and necrosis. The supernatant was collected to detect release of IL-10 by ELISA. The proliferation was assessed with the BrdU assay. Positive control consisted of cells maintained in Dulbecco's Modified Eagles Medium (DMEM), and the negative control, of those kept in tap water. Data were analyzed by ANOVA and Dunnett's test (α = 0.05). No significant difference was found for ScLL concentrations regarding viability or initial and advanced apoptosis (p=0.455). All the groups, including the positive control, had a significantly lower necrosis parameter than negative control at 5 h (p < 0.001). No difference was found for proliferation among the experimental groups (p = 0.832). ScLL at 5 and 2 µg/ml resulted in a lower release of IL-10 than positive and negative controls at 5 h (p = 0.047). The results indicated that ScLL concentrations tested were not cytotoxic, and had no effect on proliferation and release of IL-10 parameters. A thorough understanding of ScLL, regarding its immunomodulatory potential, may open the door to new perspectives for dentistry.

Low-level laser therapy stimulates the oxidative burst in human neutrophils and increases their fungicidal capacity

Low-level laser therapy (LLLT) is known to enhance mitochondrial electron transfer and ATP production; thus, this study asked whether LLLT could stimulate the oxidative burst in human neutrophils (PMN) and improve their ability to kill microorganisms. Blood from healthy human subjects was collected and PMN were isolated from the samples. PMN were treated in vitro with 660 nm or 780 nm CW laser light at 40 mW power and increasing energies up to 19.2 J and were subsequently incubated with Candida albicans cells. Generation of hydroxyl radicals, hypochlorite anions and superoxide anions by PMN were checked using fluorescent probes and chemiluminescence assays; a microbicidal activity assay against C. albicans was also performed. LLLT excited PMN to a higher functional profile, which was translated as superior production of reactive oxygen species (ROS) and increased fungicidal capacity. The most efficacious energy was 19.2 J and, interestingly, the 660 nm light was even more efficacious than 780 nm at increasing the respiratory burst of PMN and the fungicidal capacity. Human neutrophils (PMN) were stimulated in vitro with 660 nm or 780 nm CW laser light at 40 mW of power and a total energy of 19.2 J. Low-level laser therapy (LLLT) excited PMN to a higher functional profile, which was translated as a superior production of reactive oxygen species (ROS) such as hydroxyl radicals (HO^• ) and hypochlorite anions (ClO^- ) (Figure) and increased fungicidal capacity against Candida albicans cells.

Effectiveness of an aquatic exercise program and low-level laser therapy on articular cartilage in an experimental model of osteoarthritis in rats

OBJECTIVE

The aim of this study was to evaluate the effects of an aquatic exercise program and low-level laser therapy (LLLT) (associated or not) on degenerative modifications and inflammatory mediators on the articular cartilage using an experimental model of knee OA.

METHOD

Forty male Wistar rats were divided into 4 groups: knee OA - without treatment (OA); OA plus exercise program group (OAE); OA plus LLLT (OAL); OA plus exercise program associated with LLLT (OAEL). Trained rats performed a water-jumping program carrying a load equivalent to 50-80 % of their body mass strapped to their chest. The laser irradiation was used either as the only method or after the exercise training had been performed, at 2 points contact mode (medial and lateral side of the left joint). The treatments started 4 weeks after the surgery, 3 days/week for 8 weeks.

RESULTS

The results revealed that all treated groups (irradiated or not) exhibited a better pattern of tissue organization, with less fibrillation and irregularities along the articular surface and improved chondrocytes organization. Also, a lower cellular density and structural damage (OARSI score) and higher thickness values were observed in all treated groups. Additionally, OAE and OAEL showed a reduced expression in IL-1β and caspase-3 as compared with OA. Furthermore, a statistically lower MMP-13 expression was only observed in OAEL as compared with OA.

CONCLUSION

These results suggest that aquatic exercise program and LLLT were effective in preventing cartilage degeneration. Also, physical exercise program presented anti-inflammatory effects in the knees in OA rats.

The dark art of light measurement: accurate radiometry for low-level light therapy

Lasers and light-emitting diodes are used for a range of biomedical applications with many studies reporting their beneficial effects. However, three main concerns exist regarding much of the low-level light therapy (LLLT) or photobiomodulation literature; (1) incomplete, inaccurate and unverified irradiation parameters, (2) miscalculation of ‘dose,’ and (3) the misuse of appropriate light property terminology. The aim of this systematic review was to assess where, and to what extent, these inadequacies exist and to provide an overview of ‘best practice’ in light measurement methods and importance of correct light measurement. A review of recent relevant literature was performed in PubMed using the terms LLLT and photobiomodulation (March 2014–March 2015) to investigate the contemporary information available in LLLT and photobiomodulation literature in terms of reporting light properties and irradiation parameters. A total of 74 articles formed the basis of this systematic review. Although most articles reported beneficial effects following LLLT, the majority contained no information in terms of how light was measured (73 %) and relied on manufacturer-stated values. For all papers reviewed, missing information for specific light parameters included wavelength (3 %), light source type (8 %), power (41 %), pulse frequency (52 %), beam area (40 %), irradiance (43 %), exposure time (16 %), radiant energy (74 %) and fluence (16 %). Frequent use of incorrect terminology was also observed within the reviewed literature. A poor understanding of photophysics is evident as a significant number of papers neglected to report or misreported important radiometric data. These errors affect repeatability and reliability of studies shared between scientists, manufacturers and clinicians and could degrade efficacy of patient treatments. Researchers need a physicist or appropriately skilled engineer on the team, and manuscript reviewers should reject papers that do not report beam measurement methods and all ten key parameters: wavelength, power, irradiation time, beam area (at the skin or culture surface; this is not necessarily the same size as the aperture), radiant energy, radiant exposure, pulse parameters, number of treatments, interval between treatments and anatomical location. Inclusion of these parameters will improve the information available to compare and contrast study outcomes and improve repeatability, reliability of studies.

The effectiveness of low-level laser therapy as an adjunct to non-surgical periodontal treatment: a meta-analysis

Background and Objectives

Although low‐level laser therapy (LLLT) has been demonstrated to have a biomodulatory effect on periodontal tissue, no systematic review has exclusively addressed its effectiveness as an adjunct to non‐surgical periodontal treatment. This study aimed to evaluate whether an additional benefit exists for the application of LLLT compared with scaling and root planing (SRP) alone.

Material and Methods

An extensive search was conducted in the Cochrane Library (Issue 8, 2015), PubMed (1997) and EMBASE (1947) before August 2015 for randomized controlled trials (RCTs). The bias risk was assessed with the Cochrane tool for risk of bias evaluation. A meta‐analysis was performed using REVMAN 5.3.

Results

After independent screening of 354 initial records, eight publications (seven RCTs) were included. However, six were rated as ‘having a high risk of bias’ as a result of major methodological weakness in ‘allocation concealment’ and ‘blinding of key personnel’. Meta‐analysis showed that LLLT‐mediated SRP demonstrated significant short‐term benefits over SRP monotherapy in the improvement of the probing pocket depth (p = 0.0009 at 1 mo; p = 0.03 at 2 mo) and the level of interleukin‐1β in the gingival crevicular fluid (p = 0.01 at 1 mo). Nevertheless, LLLT failed to show significant additional intermediate‐term (3 and 6 mo) effects in terms of clinical parameters and alveolar bone density.

Conclusion

These findings indicated that LLLT showed only short‐term additional benefits after conventional SRP. Its long‐term effects remain unclear due to substantial methodological weaknesses and an insufficient number of current studies. Future RCTs with better designs and longer follow‐up periods are required to assess the effectiveness of LLLT as an adjunctive treatment strategy in patients with periodontal disease.

Laser Phototherapy (660 nm) Can Be Beneficial for Reducing Gingival Inflammation in Prosthodontics

Among the new technologies developed, low power lasers have enabled new approaches to provide conservative treatment. Low power lasers act at cellular level, resulting in reduced pain, modulating inflammation, and improved tissue healing. Clinical application of the low power laser requires specific knowledge concerning laser interaction with biological tissue so that the correct irradiation protocol can be established. The present case report describes the clinical steps involved in an indirect composite resin restoration performed in a 31-year-old patient, in whom low power laser was used for soft tissue biomodulation. Laser therapy was applied with a semiconductor laser 660 nm, spot size of 0.028 cm², energy density of 35.7 J/cm², mean power of 100 mW, and energy per point as 1 J, in contact mode, on a total of 2 points (mesial and distal), totaling 2 J of energy. The therapy with low power laser can contribute positively to the success of an indirect restorative treatment.

Photobiomodulation with low-level diode laser promotes osteoblast migration in an in vitro micro wound model

Laser photobiomodulation can improve bone healing, but well-defined treatment parameters are lacking. Saos-2 human osteoblast-like cells were subjected to an in vitro scratch-wound healing assay and irradiated by a 915-nm gallium-aluminum-arsenide diode laser for 0, 48, 96, and 144 s using doses of, respectively, 0, 5, 10, and 15 J/cm(2) . Wound area was measured after 4, 24, 48, and 72 h. Cell viability, DNA content, gene expression, and release of bone-related proteins were evaluated after 24, 48, and 72 h. Laser significantly improved wound healing compared with nonirradiated controls. Cells treated with laser doses of 5 and 10 J/cm(2) reached wound closure after 72 h, followed by 15 J/cm(2) after 96 h. With the cell proliferation inhibitor Mitomycin C, the doses of 10 and 15 J/cm(2) maintained an improved wound healing compared with controls. Laser increased collagen type 1 gene expression with higher doses inducing a longer-lasting effect, whereas transforming growth factor-beta 1 showed comparable or decreased levels in irradiated versus nonirradiated groups, with no effect on protein release. This study demonstrated that laser photobiomodulation at 915 nm promoted wound healing mainly through stimulation of cell migration and collagen deposition by osteoblasts.

Low-level laser therapy to the mouse femur enhances the fungicidal response of neutrophils against Paracoccidioides brasiliensis

Neutrophils (PMN) play a central role in host defense against the neglected fungal infection paracoccidioidomycosis (PCM), which is caused by the dimorphic fungus Paracoccidioides brasiliensis (Pb). PCM is of major importance, especially in Latin America, and its treatment relies on the use of antifungal drugs. However, the course of treatment is lengthy, leading to side effects and even development of fungal resistance. The goal of the study was to use low-level laser therapy (LLLT) to stimulate PMN to fight Pb in vivo. Swiss mice with subcutaneous air pouches were inoculated with a virulent strain of Pb or fungal cell wall components (Zymosan), and then received LLLT (780 nm; 50 mW; 12.5 J/cm2; 30 seconds per point, giving a total energy of 0.5 J per point) on alternate days at two points on each hind leg. The aim was to reach the bone marrow in the femur with light. Non-irradiated animals were used as controls. The number and viability of the PMN that migrated to the inoculation site was assessed, as well as their ability to synthesize proteins, produce reactive oxygen species (ROS) and their fungicidal activity. The highly pure PMN populations obtained after 10 days of infection were also subsequently cultured in the presence of Pb for trials of protein production, evaluation of mitochondrial activity, ROS production and quantification of viable fungi growth. PMN from mice that received LLLT were more active metabolically, had higher fungicidal activity against Pb in vivo and also in vitro. The kinetics of neutrophil protein production also correlated with a more activated state. LLLT may be a safe and non-invasive approach to deal with PCM infection.

PCM triggers a typical granulomatous inflammatory reaction with PMN playing a major role; these inflammatory cells are crucial in the initial stages of PCM, participating in the innate immune reaction and also directing the acquired immune response in the later stages. In some PCM patients, these immune mechanisms are insufficient to eradicate the infection, and need to be boosted with antifungal drugs that have to be administered for long periods and can show serious side-effects. We aimed to develop a novel and safe way to activate PMN through low-level laser irradiation of the bone marrow in the mouse femoral medulla. LLLT increased PMN viability and activation, shown by a significantly greater production of protein and ROS, as well as a higher fungicidal capacity; PMN even retained their higher metabolic activity and fungicidal ability after a second exposure to the pathogenic fungus in vitro. This is the first time that LLLT has been shown to increase the immune response against a fungal infection, and could be a promising and safe technique to be used with antifungal drugs in PCM.