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Oliveira SV, Batista JVF, Gutierres GG, Silva NP, Lino-Dos-Santos-Franco A, Rodrigues MFSD, Cecatto RB. The supportive use of photobiomodulation on salivary glands: a narrative review and meta-analysis. Eur Arch Otorhinolaryngol 2024; 281:2793-2805. [PMID: 38189964 DOI: 10.1007/s00405-023-08425-8] [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] [Received: 09/07/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024]
Abstract
PURPOSE Radiotherapy is one of the main strategies used in the treatment of cancer patients and it can cause early or late xerostomia and/or hyposalivation. Therapeutic management of xerostomia includes oral hygiene, sialogenic agents among others. METHODS This study reviews the use of extra-oral salivary glands photobiomodulation in treating xerostomia and/or hyposalivation after radiotherapy and performs a meta-analysis of this data. RESULTS After a broad search of the literature, eight clinical studies were selected. DISCUSSION In a safe way, the studies found that extra-oral stimulation of the salivary glands has benefits in the hyposalivation and changes in salivary flow resulting from lesions by radiotherapy. A meta-analysis found significant values in pain comparing the pre- and post-treatment moments (MD - 3.02, I2 95%, IC - 5.56; - 0.48) and for stimulated salivary flow at 30 days after the end of radiotherapy (MD 2.90, I2 95%, IC 1.96; 3.84). CONCLUSION The most promising parameters comprise wavelengths between 630 and 830 nm, radiant exposure from 2 to 10 J/cm2, two-to-three times a week, before the radiotherapy damage, and homogeneously in the glands. Therefore, Light-Emitting Diode (LED) stimulation of larger areas than the punctual stimulation of small millimeters of the Low-Level Laser Therapy (LLLT) appears to be promising.
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Affiliation(s)
- Susyane Vieira Oliveira
- Biophotonics-Medicine Post-Graduate Program, Universidade Nove de Julho/UNINOVE, 249 Vergueiro Street, Liberdade, São Paulo, SP, 01504-001, Brazil
| | - João Victor Falcão Batista
- School of Medicine of Universidade Nove de Julho UNINOVE, 249 Vergueiro Street, Liberdade, São Paulo, SP, 01504-001, Brazil
| | - Gabriela Godinho Gutierres
- School of Medicine of Universidade Nove de Julho UNINOVE, 249 Vergueiro Street, Liberdade, São Paulo, SP, 01504-001, Brazil
| | - Nicole Pantojo Silva
- School of Medicine of Universidade Nove de Julho UNINOVE, 249 Vergueiro Street, Liberdade, São Paulo, SP, 01504-001, Brazil
| | - Adriana Lino-Dos-Santos-Franco
- Biophotonics-Medicine Post-Graduate Program, Universidade Nove de Julho/UNINOVE, 249 Vergueiro Street, Liberdade, São Paulo, SP, 01504-001, Brazil
| | | | - Rebeca Boltes Cecatto
- Biophotonics-Medicine Post-Graduate Program, Universidade Nove de Julho/UNINOVE, 249 Vergueiro Street, Liberdade, São Paulo, SP, 01504-001, Brazil.
- School of Medicine of University of Sao Paulo, Instituto de Reabilitação Lucy Montoro HCFMUSP, IMREA Morumbi, R. Jandiatuba, 580 - Vila Andrade, São Paulo, SP, 05716-150, Brazil.
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Silva ARGDA, Cunha LDO, Silva DCC, Novaes VM, Mourão AM, Vicente LCC. Immediate effects of photobiomodulation on saliva production. Codas 2024; 36:e20230224. [PMID: 38808859 PMCID: PMC11166038 DOI: 10.1590/2317-1782/20242023224pt] [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] [Received: 09/04/2023] [Accepted: 09/28/2023] [Indexed: 05/30/2024] Open
Abstract
PURPOSE To verify the immediate effects of photobiomodulation on the production of salivary flow and the correlation of demographic, anthropometric and medication use data. METHODS The study included 100 healthy individuals, aged between 18 and 76 years (mean 27.2 years), randomly split into an experimental group and a placebo group. Assessments of anthropometric measurements, self-perception of saliva production and sialometry were performed. Next, LASER irradiation was carried out at an infrared wavelength (808 nanometers) with 100 milliwatts (mw) of power at five intraoral points: on the sublingual glands and bilaterally on the submandibular and parotid glands, at doses of 9, 18 and 24 joules (J). Sialometry was repeated after each application. The control group received the same procedures with placebo equipment. RESULTS There was a statistical association in the self-perception of reduced saliva in the experimental group for the 24J dose and in sialometry and in the reduction in salivary flow for the 18J and 24J doses and an increase to 9J, in both groups. There was no association when comparing the experimental and placebo groups. Multiple multinomial regression analysis revealed that the reduction or increase in salivary flow is independent of demographic, anthropometric and medication use variables. CONCLUSION The bioinhibitory action of photobiomodulation on healthy salivary glands occurred at a dose of 18J and 24J, while the biostimulant action happened at a dose of 9J, regardless of demographic, anthropometric variables and medication use. The self-perception of reduced salivary flow occurred at 24J.
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Affiliation(s)
| | - Lucas de Oliveira Cunha
- Departamento de Fonoaudiologia, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil
| | | | - Vanessa Mouffron Novaes
- Departamento de Fonoaudiologia, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil
| | - Aline Mansueto Mourão
- Departamento de Fonoaudiologia, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil
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Ribeiro LN, de Vasconcelos Carvalho M, de Oliveira Limirio JPJ, do Egito Vasconcelos BC, Moraes SLD, Pellizzer EP. Impact of low-level laser therapy on the quality of life of patients with xerostomia undergoing head and neck radiotherapy: a systematic review. Support Care Cancer 2024; 32:118. [PMID: 38244087 DOI: 10.1007/s00520-024-08325-5] [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] [Received: 10/02/2023] [Accepted: 01/11/2024] [Indexed: 01/22/2024]
Abstract
PURPOSE To carry out a systematic review to assess whether low-level laser therapy can improve the quality of life of patients with xerostomia undergoing head and neck radiotherapy. METHODS A systematic search was performed through Embase, Medline/PubMed, Cochrane, Scopus, Web of Science, nonpeer-reviewed clinicaltrials.gov and LILACS. The strategy included clinical studies were selected that prospectively followed or evaluated the quality of life by directly comparing the use of low-level laser therapy for xerostomia induced by head and neck radiotherapy with alternative therapies without the use of a laser. The risk of bias in the studies was assessed by RoB 2.0 and Robins I. RESULTS After all application of the predetermined criteria, four studies were included, dated between the years 2014 and 2023. Three studies described as randomized clinical trials were included, one of which was a randomized pilot study and only one was a prospective clinical trial. A total of 126 patients were evaluated, all four studies used the infrared wavelength, with two studies using the combination with the red wavelength. It was observed that low-level laser therapy can change the sensation of dry mouth, improving patients' quality of life. In addition, changes related to increased stimulated and unstimulated salivary flow were also identified. CONCLUSION The use of low-level laser therapy has promising results on xerostomia, consequently improving the quality of life of patients undergoing radiotherapy in the head and neck region.
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Affiliation(s)
- Lucas Nascimento Ribeiro
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Integrated Anatomic Pathology Center, University of Pernambuco (UPE), Oswaldo Cruz University Hospital, Arnóbio Marques Street, 310 - Santo Amaro, Recife, PE, 50100-130, Brazil
| | - Marianne de Vasconcelos Carvalho
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Integrated Anatomic Pathology Center, University of Pernambuco (UPE), Oswaldo Cruz University Hospital, Arnóbio Marques Street, 310 - Santo Amaro, Recife, PE, 50100-130, Brazil.
- Department of Oral and Maxillofacial Pathology, School of Dentistry, University of Pernambuco (UPE), Cícero Monteiro Street, s/n - São Cristóvão, Arcoverde, PE, 56503-146, Brazil.
| | - João Pedro Justino de Oliveira Limirio
- Department of Dental Materials and Prosthodontics, Dental School of Araçatuba, São Paulo State University (UNESP), José Bonifácio Street 1193, Araçatuba, São Paulo, 1605000, Brazil
| | - Belmiro Cavalcanti do Egito Vasconcelos
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Pernambuco (UPE), Oswaldo Cruz University Hospital, Arnóbio Marques Street, 310 - Santo Amaro, Recife, PE, 50100-130, Brazil
| | - Sandra Lúcia Dantas Moraes
- Department of Prosthodontics, School of Dentistry, University of Pernambuco (UPE), Oswaldo Cruz University Hospital, Arnóbio Marques Street, 310 - Santo Amaro, Recife, PE, 50100-130, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Dental School of Araçatuba, São Paulo State University (UNESP), José Bonifácio Street 1193, Araçatuba, São Paulo, 1605000, Brazil
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de Carvalho E Silva RM, Mendes FM, Degasperi GR, Pinheiro SL. Photobiomodulation for the management of xerostomia and oral mucositis in patients with cancer: a randomized clinical trial. Lasers Med Sci 2023; 38:101. [PMID: 37060370 DOI: 10.1007/s10103-023-03760-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 04/05/2023] [Indexed: 04/16/2023]
Abstract
To evaluate the applicability of photobiomodulation therapy (PBM-T) in the management of xerostomia and OM. Fifty-three patients with head and neck squamous cell carcinoma were randomized into two groups: Sham and PBM-T. The Sham group received artificial saliva and laser simulation, while the PBM-T group received artificial saliva and PBM-T. Xerostomia-related quality of life (QoL), the presence or absence of OM lesions, the decayed-missing-filled teeth (DMFT) index, and periodontal charts were evaluated. The results of the QoL questionnaire, DMFT index, and periodontal chart were analyzed with the Kruskal-Wallis test, followed by the Student-Newman-Keuls test, while OM findings were compared using the Mann-Whitney test. QoL scores significantly increased in the Sham group (p < 0.0001), denoting more severe xerostomia symptoms (p = 0.0074), and decreased in the PBM-T group, indicating no or very mild xerostomia. Higher grades of OM were found in the Sham group than the PBM-T group (p = 0.0001). There was no significant difference in DMFT index or periodontal charts between the groups (p > 0.05). PBM-T improved QoL in patients with head and neck cancer treated with radiotherapy, whether as radiation alone or as an adjunct to chemotherapy and surgery.
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Affiliation(s)
| | | | | | - Sérgio Luiz Pinheiro
- Center for Life Sciences, Graduate Program in Health Sciences, PUC Campinas, Av. John Boyd Dunlop, s/n, Campinas, SP, 13034-685, Brazil.
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Robijns J, Nair RG, Lodewijckx J, Arany P, Barasch A, Bjordal JM, Bossi P, Chilles A, Corby PM, Epstein JB, Elad S, Fekrazad R, Fregnani ER, Genot MT, Ibarra AMC, Hamblin MR, Heiskanen V, Hu K, Klastersky J, Lalla R, Latifian S, Maiya A, Mebis J, Migliorati CA, Milstein DMJ, Murphy B, Raber-Durlacher JE, Roseboom HJ, Sonis S, Treister N, Zadik Y, Bensadoun RJ. Photobiomodulation therapy in management of cancer therapy-induced side effects: WALT position paper 2022. Front Oncol 2022; 12:927685. [PMID: 36110957 PMCID: PMC9468822 DOI: 10.3389/fonc.2022.927685] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
DisclaimerThis article is based on recommendations from the 12th WALT Congress, Nice, October 3-6, 2018, and a follow-up review of the existing data and the clinical observations of an international multidisciplinary panel of clinicians and researchers with expertise in the area of supportive care in cancer and/or PBM clinical application and dosimetry. This article is informational in nature. As with all clinical materials, this paper should be used with a clear understanding that continued research and practice could result in new insights and recommendations. The review reflects the collective opinion and, as such, does not necessarily represent the opinion of any individual author. In no event shall the authors be liable for any decision made or action taken in reliance on the proposed protocols.ObjectiveThis position paper reviews the potential prophylactic and therapeutic effects of photobiomodulation (PBM) on side effects of cancer therapy, including chemotherapy (CT), radiation therapy (RT), and hematopoietic stem cell transplantation (HSCT).BackgroundThere is a considerable body of evidence supporting the efficacy of PBM for preventing oral mucositis (OM) in patients undergoing RT for head and neck cancer (HNC), CT, or HSCT. This could enhance patients’ quality of life, adherence to the prescribed cancer therapy, and treatment outcomes while reducing the cost of cancer care.MethodsA literature review on PBM effectiveness and dosimetry considerations for managing certain complications of cancer therapy were conducted. A systematic review was conducted when numerous randomized controlled trials were available. Results were presented and discussed at an international consensus meeting at the World Association of photobiomoduLation Therapy (WALT) meeting in 2018 that included world expert oncologists, radiation oncologists, oral oncologists, and oral medicine professionals, physicists, engineers, and oncology researchers. The potential mechanism of action of PBM and evidence of PBM efficacy through reported outcomes for individual indications were assessed.ResultsThere is a large body of evidence demonstrating the efficacy of PBM for preventing OM in certain cancer patient populations, as recently outlined by the Multinational Association for Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Building on these, the WALT group outlines evidence and prescribed PBM treatment parameters for prophylactic and therapeutic use in supportive care for radiodermatitis, dysphagia, xerostomia, dysgeusia, trismus, mucosal and bone necrosis, lymphedema, hand-foot syndrome, alopecia, oral and dermatologic chronic graft-versus-host disease, voice/speech alterations, peripheral neuropathy, and late fibrosis amongst cancer survivors.ConclusionsThere is robust evidence for using PBM to prevent and treat a broad range of complications in cancer care. Specific clinical practice guidelines or evidence-based expert consensus recommendations are provided. These recommendations are aimed at improving the clinical utilization of PBM therapy in supportive cancer care and promoting research in this field. It is anticipated these guidelines will be revised periodically.
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Affiliation(s)
- Jolien Robijns
- UHasselt, Faculty of Medicine and Life Sciences, Diepenbeek, Belgium
| | - Raj G. Nair
- Oral Medicine, Oral Pathology and Oral Oncology, Griffith University, Department of Haematology and Oncology, Gold Coast University Hospital, Gold Coast, QL, Australia
| | - Joy Lodewijckx
- UHasselt, Faculty of Medicine and Life Sciences, Diepenbeek, Belgium
| | - Praveen Arany
- School of Dental Medicine, Oral Biology and Biomedical Engineering, University at Buffalo, Buffalo, NY, United States
| | - Andrei Barasch
- Harvard School of Dental Medicine, Division of Oral Medicine and Dentistry, Boston, MA, United States
| | - Jan M. Bjordal
- Physiotherapy Research Group, IGS, University of Bergen, Bergen, Norway
| | - Paolo Bossi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Anne Chilles
- Radiotherapy Department, Institut Curie, Paris, France
| | - Patricia M. Corby
- New York University College of Dentistry, Bluestone Center for Clinical Research, New York, NY, United States
| | - Joel B. Epstein
- City of Hope Duarte, CA and Cedars-Sinai Health System, Los Angeles, CA, United States
| | - Sharon Elad
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, United States
| | - Reza Fekrazad
- Department of Periodontology, Dental Faculty – Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
| | | | - Marie-Thérèse Genot
- Laser Therapy Unit, Institut Jules Bordet, Centre des Tumeurs de l’Université Libre de Bruxelles, Brussels, Belgium
| | - Ana M. C. Ibarra
- Postgraduate Program on Biophotonics Applied to Health Sciences, Nove de Julho University, São Paulo, Brazil
| | - Michael R. Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Vladimir Heiskanen
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Ken Hu
- Department of Radiation Oncology, NYU Langone Health, New York, NY, United States
| | | | - Rajesh Lalla
- Section of Oral Medicine, University of Connecticut School of Dental Medicine, Farmington, CT, United States
| | - Sofia Latifian
- Department of Medicine, Institut Jules Bordet, Universiteí Libre de Bruxelles, Brussels, Belgium
| | - Arun Maiya
- Manipal College of Health Professions, MAHE, Manipal, India
| | - Jeroen Mebis
- UHasselt, Faculty of Medicine and Life Sciences, Diepenbeek, Belgium
| | - Cesar A. Migliorati
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, Florida, United States
| | - Dan M. J. Milstein
- Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Barbara Murphy
- Department of Oncology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Judith E. Raber-Durlacher
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Department of Oral Medicine, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Hendrik J. Roseboom
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, Department of Oral Medicine, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, Netherlands
| | - Stephen Sonis
- Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital; Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine; Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Nathaniel Treister
- Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital; Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine; Division of Oral Medicine and Dentistry, Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Yehuda Zadik
- Department of Military Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel, and Department of Oral Medicine, Sedation and Maxillofacial Imaging, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel
| | - René-Jean Bensadoun
- Department of Radiation Oncology, Centre de Haute Energie, Nice, France
- *Correspondence: René-Jean Bensadoun,
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Micro-CT analysis of the mandibular bone microarchitecture of rats after radiotherapy and low-power laser therapy. Lasers Med Sci 2022; 37:2645-2653. [PMID: 35257243 DOI: 10.1007/s10103-022-03532-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 02/21/2022] [Indexed: 10/18/2022]
Abstract
To investigate whether low-level laser therapy (LLLT), at different times of application (immediate and late) in the region of the parotid glands, has a distance effect on the microarchitecture of the trabecular bone in mandible of rats irradiated by volumetric modular arc therapy (VMAT). Thirty adult Wistar rats were randomly divided into placebo control groups (CG, n = 2), only radiotherapy (RG, n = 2), only LPLT (LG, n = 2), and two other groups using LLLT in the immediate time (24 h) (ILG, n = 12) and late (120 h) (LLG, n = 12) to radiotherapy by VMAT in a single dose of 12 Gy. LLLT with AsGaAl laser (660 nm, 100 mW), a spot size of 0.0028 cm2, was applied in three points in the region of the right parotid gland, with energy of 2 J/cm2, 20 s per point, for 10 consecutive days. After euthanasia, the right hemimandibles of each animal were dissected, prepared, and analyzed by computerized microtomography (micro-CT) and histomorphometry. The different groups were analyzed by the Tukey and Bonferroni multiple comparison tests. The micro-CT analysis found statistically significant differences between the groups, especially in the LLG, which had the highest average bone volume compared to the CG (p = 0.001) and ILG (p = 0.002) and a greater number of trabeculae than the CG (p = 0.000) and ILG (p = 0.031). The ILG also had a higher number of trabeculae than the CG (p = 0.005). Trabecula separation (Tb.Sp) was lower in the LLG (p = 0.000) and ILG (p = 0.002) when compared to the CG. In the histomorphometry, there was no statistical difference between the groups in relation to all the analyzed variables. Micro-CT analysis showed that the LLLT, even applied at a distance, both in the immediate and late VMAT times, has an effect on the mandibular bone microarchitecture by increasing the volume and number of trabeculae and decreasing the spaces between them.
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Park Y, Kim H, Kim S, Cho KJ. Effect of low-level light therapy in patients with dry eye: a prospective, randomized, observer-masked trial. Sci Rep 2022; 12:3575. [PMID: 35246565 PMCID: PMC8897458 DOI: 10.1038/s41598-022-07427-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 02/16/2022] [Indexed: 11/09/2022] Open
Abstract
To evaluate the efficacy of low-level light therapy (LLLT) with near-infrared light-emitting diodes (LED-LLLT) for the treatment of dry eye. 40 patients were randomly assigned with a 1:1 allocation ratio to receive LED-LLLT (LLLT group, n = 20) or placebo treatment (placebo group, n = 20). Patients in the LLLT group received LLLT twice a week for 3 weeks, for a total of 6 treatment sessions. The primary endpoint was the changes in the fluorescein corneal staining (FCS) score. The secondary endpoints were the changes in the ocular surface disease index (OSDI) score, lissamine green conjunctival staining (LGCS) scores, tear film break-up time (TBUT), Schirmer test, and the meibomian gland dysfunction (MGD) index. These were evaluated before treatment and 4 weeks after start of treatment. The mean difference of score change in primary endpoint revealed significant improvement in the LLLT group, compared to the placebo. Among secondary endpoints, LGCS, Schirmer's test, upper meibography scores showed significant improvements, while TBUT, lid debris, lid swelling, lid telangiectasia, meibomian gland secretion and expressibility scores had slight improvement without significant differences. No serious adverse events were observed. The use of LED-LLLT for the treatment of dry eye and MGD appears to be safe and beneficial.
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Affiliation(s)
- Yuli Park
- Department of Ophthalmology, Dankook University Hospital, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Hoon Kim
- Department of Ophthalmology, Dankook University Hospital, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Sehwan Kim
- Department of Biomedical Engineering, School of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Kyong Jin Cho
- Department of Ophthalmology, Dankook University Hospital, College of Medicine, Dankook University, Cheonan, Republic of Korea.
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Besegato JF, de Melo PBG, Tamae PE, Alves APAR, Rondón LF, Leanse LG, Dos Anjos C, Casarin HH, Chinelatti MA, Faria G, Dai T, Bagnato VS, Rastelli ANDS. How can biophotonics help dentistry to avoid or minimize cross infection by SARS-CoV-2? Photodiagnosis Photodyn Ther 2021; 37:102682. [PMID: 34910994 PMCID: PMC8666148 DOI: 10.1016/j.pdpdt.2021.102682] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 09/30/2021] [Accepted: 12/10/2021] [Indexed: 12/23/2022]
Abstract
Biophotonics is defined as the combination of biology and photonics (the physical science of the light). It is a general term for all techniques that deal with the interaction between biological tissues/cells and photons (light). Biophotonics offers a great variety of techniques that can facilitate the early detection of diseases and promote innovative theragnostic approaches. As the COVID-19 infection can be transmitted due to the face-to-face communication, droplets and aerosol inhalation and the exposure to saliva, blood, and other body fluids, as well as the handling of sharp instruments, dental practices are at increased risk of infection. In this paper, a literature review was performed to explore the application of Biophotonics approaches in Dentistry focusing on the COVID-19 pandemic and how they can contribute to avoid or minimize the risks of infection in a dental setting. For this, search-related papers were retrieved from PubMED, Scielo, Google Schoolar, and American Dental Association and Centers for Disease Control and Prevention databases. The body of evidence currently available showed that Biophotonics approaches can reduce microorganism load, decontaminate surfaces, air, tissues, and minimize the generation of aerosol and virus spreading by minimally invasive, time-saving, and alternative techniques in general. However, each clinical situation must be individually evaluated regarding the benefits and drawbacks of these approaches, but always pursuing less-invasive and less aerosol-generating procedures, especially during the COVID-19 pandemic.
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Affiliation(s)
- João Felipe Besegato
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Priscila Borges Gobbo de Melo
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Patrícia Eriko Tamae
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Ana Paula Aparecida Raimundo Alves
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Luis Felipe Rondón
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Leon G Leanse
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | - Carolina Dos Anjos
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | - Heitor Hussni Casarin
- Dentistry School, Central Paulista University Center - UNICEP, São Carlos 13563-470, SP, Brazil
| | | | - Gisele Faria
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil.
| | - Tianhong Dai
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | | | - Alessandra Nara de Souza Rastelli
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil.
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Impact of photobiomodulation therapy on the morphological aspects of submandibular gland submitted to excretory duct ligation and hypothyroidism: an animal study. Lasers Med Sci 2021; 37:2005-2015. [PMID: 34797432 DOI: 10.1007/s10103-021-03463-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/04/2021] [Indexed: 10/19/2022]
Abstract
The aim of this study was to evaluate the impact of photobiomodulation therapy (PBMT) on histomorphological aspects of submandibular gland (SMG) submitted to salivary gland duct obstruction in hypothyroid rats. Fifty-six male Wistar rats (250 to 300 g) were divided into 4 groups (n = 14): euthyroid (EU), EU + PBMT, hypothyroid (HYPO), and HYPO + PBMT. Duct obstruction of the left submandibular gland (LSMG) was performed in all animals by a ligature procedure. For the induction of hypothyroidism, total thyroidectomy was performed. PBMT groups received irradiation with AlGaInP diode laser (808 nm, 0.04 W, 0.04cm2 spot size, 60 s, 2.4 J per point, 60 J/cm2, 1 W/cm2). Irradiation was performed immediately, 24 h, and 48 h after the obstruction of the salivary gland duct, in one point, extra oral and perpendicular to the gland. Animals were sacrificed after 24 h and 72 h after duct ligature. Our results indicated that salivary duct obstruction and hypothyroidism caused negative modifications on the salivary glands' histomorphology, especially acinar atrophy, after 24 h and 72 h. HYPO + PBMT showed a significant reduction of the inflammatory infiltrate, congested blood vessels, and acinar atrophy in the SMG submandibular salivary gland in 72 h compared to 24 h (p < 0.05). In conclusion, obstruction of the salivary gland excretory duct and hypothyroidism causes severe sialoadenitis with expressive atrophy of the glandular parenchyma. However, PBMT was able to modulate the inflammatory process and delaying acinar atrophy. This study provided insights to better understand the role of the PBMT on the altered salivary gland by duct ligation and associate hypothyroidism.
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10
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Asan MF, Castelino RL, Babu SG, Rao K, Pandita V. Oral Immune-Related Adverse Events - Current Concepts and their Management. Asia Pac J Oncol Nurs 2021; 8:604-609. [PMID: 34790844 PMCID: PMC8522587 DOI: 10.4103/apjon.apjon-2136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/10/2021] [Indexed: 11/05/2022] Open
Abstract
Recent advent of immune checkpoint inhibitors (ICIs) have made significant improvement in the treatment outcome of cancer patients. They are also known to increase the overall survival in many malignancies. They target key immune checkpoints, acting on the cytotoxic T-lymphocyte antigen-4, programmed death-1 (PD-1), and PD-1 ligand 1 pathways. ICIs are effective in cancer therapy, but also possess various adverse effects that are termed together as immune-related adverse events (irAEs). Information focusing only on the oral reactions of irAEs is scanty in the literature. Therefore, we performed a computerized database search in PubMed and Google Scholar to identify and collect data regarding the oral adverse effects of ICIs. The early recognition of oral irAEs and appropriative intervention may help in improving the quality of life in patients. This paper presents a brief review of oral irAEs and their management.
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Affiliation(s)
- Mohamed Faizal Asan
- Department of Oral Medicine and Radiology, Nitte (Deemed to be University), AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Renita Lorina Castelino
- Department of Oral Medicine and Radiology, Nitte (Deemed to be University), AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Subhas G. Babu
- Department of Oral Medicine and Radiology, Nitte (Deemed to be University), AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Kumuda Rao
- Department of Oral Medicine and Radiology, Nitte (Deemed to be University), AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Vaibhav Pandita
- Department of Oral Medicine and Radiology, Nitte (Deemed to be University), AB Shetty Memorial Institute of Dental Sciences, Mangalore, Karnataka, India
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11
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Palma LF, Marcucci M, Remondes CM, Chambrone L. Antibiotic therapy for the prevention of osteoradionecrosis following tooth extraction in head-and-neck cancer patients postradiotherapy: An 11-year retrospective study. Natl J Maxillofac Surg 2021; 12:333-338. [PMID: 35153427 PMCID: PMC8820304 DOI: 10.4103/njms.njms_413_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/15/2021] [Accepted: 08/26/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction: One of the most important complications of radiotherapy (RT) for head-and-neck cancer (HNC) is osteoradionecrosis (ORN) of the jaws, which mostly arises from tooth extractions. The ORN treatment still represents a great challenge; therefore, the prevention is of paramount importance. Thus, the present study aimed to evaluate retrospectively a perioperative systemic antibiotic therapy protocol for the prevention of ORN following tooth extraction in head-and-neck patients post-3D conformal RT. Materials and Methods: A retrospective medical record review was performed considering HNC patients submitted to RT in the period between 2008 and 2019. They necessarily received oral antibiotic therapy with Clindamycin 300 mg every 8 h for 10 days, with the first dose 3 days before the tooth extraction. Results: Forty-nine patients met the study criteria, with a total of 107 teeth extracted. Regarding the 47 patients who did not develop ORN, 103 tooth extractions were identified (96.3%). Only two patients developed ORN at two adjacent teeth sites (3.7%). Conclusion: The proposed perioperative systemic antibiotic therapy protocol seems to be efficient to prevent ORN following tooth extraction in postirradiated HNC patients.
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Affiliation(s)
- Luiz Felipe Palma
- Graduate Dentistry Program, Ibirapuera University, São Paulo, Brazil
| | - Marcelo Marcucci
- Stomatology and Oral and Maxilofacial Surgery Center, Hospital Heliópolis, São Paulo, São Paulo, Brazil
| | - Cíntia Maria Remondes
- Stomatology and Oral and Maxilofacial Surgery Center, Hospital Heliópolis, São Paulo, São Paulo, Brazil
| | - Leandro Chambrone
- Graduate Dentistry Program, Ibirapuera University, São Paulo, Brazil.,Evidence-Based Hub - CiiEM, Egas Moniz - Cooperativa de Ensino Superior, Caparica, Almada, Portugal.,Unit of Basic Oral Investigation (UIBO), Faculty of Dentistry, Universidade El Bosque, Bogota, Colombia
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12
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Golež A, Frangež I, Cankar K, Frangež HB, Ovsenik M, Nemeth L. Effects of low-level light therapy on xerostomia related to hyposalivation: a systematic review and meta-analysis of clinical trials. Lasers Med Sci 2021; 37:745-758. [PMID: 34409539 DOI: 10.1007/s10103-021-03392-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 07/26/2021] [Indexed: 02/06/2023]
Abstract
Hyposalivation is a condition represented by a reduced salivary flow and may include symptoms such as mouth dryness (xerostomia), loss of taste, pain, dysphagia, and dysphonia, all of which greatly affect an individual's quality of life.The aim of the present study was to systematically review the effects of low-level light therapy irradiation (photobiomodulation) on salivary gland function in patients with hyposalivation.The main question of the systematic review was: "Does low-level light irradiation therapy of the salivary glands affect salivary flow rate or indicators of salivary function (ion and protein concentrations) in patients with xerostomia or hyposalivation?" The question was based on the PICO (participant, intervention, control, outcome) principle and followed the PRISMA guidelines. Databases were explored and papers published between the years 1997 and 2020 were reviewed for the following Mesh-term keywords and their corresponding entry terms in different combinations: "Low-level light therapy," "Xerostomia," "Saliva," "Salivary glands," "Salivation."The initial sample consisted of 220 articles. Of those, 47 articles were used for full-text analysis and 18 were used for a systematic review, 14 were used in meta-analysis. According to their individual quality, most articles were classified as high quality of evidence according to the GRADE score. Meta-analysis of the evidence observed increase of unstimulated salivary flow 0.51 SMD compared to placebo (95% CI: 0.16-0.86), I2 = 50%, p = 0.005.The findings of our review revealed evidence of a beneficial effect of photobiomodulation therapy on salivary gland function. The therapy alleviates xerostomia and hyposalivation. However, these effects are reported short term only and did not induce lasting effects of photobiomodulation therapy on patients' quality of life.
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Affiliation(s)
- Aljaž Golež
- Institute of Physiology, Faculty of Medicine, University of Ljubljana, Zaloska cesta 4, Ljubljana, Slovenia
| | - Igor Frangež
- Department for Surgical Infections, University Medical Center Ljubljana, Zaloska cesta 2, 1000, Ljubljana, Slovenia.,Department of Surgery, Faculty of Medicine, University of Ljubljana, Zaloska cesta 7, Ljubljana, Slovenia
| | - Ksenija Cankar
- Institute of Physiology, Faculty of Medicine, University of Ljubljana, Zaloska cesta 4, Ljubljana, Slovenia
| | - Helena Ban Frangež
- Department of Gynaecology and Obstetrics, Faculty of Medicine, University of Ljubljana, Slajmerjeva 3, 1000, Ljubljana, Slovenia.,Department of Obstetrics and Gynaecology, University Medical Center Ljubljana, Slajmerjeva 3, 1000, Ljubljana, Slovenia
| | - Maja Ovsenik
- Department of Orthodontics and Dentofacial Orthopaedics, Faculty of Medicine, University of Ljubljana, Hrvatski trg 6, Ljubljana, Slovenia
| | - Lidija Nemeth
- Department of Dental Diseases and Normal Dental Morphology, Faculty of Medicine, University of Ljubljana, Hrvatski trg 6, Ljubljana, Slovenia.,Division of Stomatology, University Medical Centre Ljubljana, Stomatoloska klinika, Hrvatski trg 6, 1000, Ljubljana, Slovenia
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13
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Ribeiro LN, Lima MH, Carvalho AT, Albuquerque RF, Leão JC, Silva IH. Evaluation of the salivary function of patients in treatment with radiotherapy for head and neck cancer submitted to photobiomodulation. Med Oral Patol Oral Cir Bucal 2021; 26:e14-e20. [PMID: 33247577 PMCID: PMC7806351 DOI: 10.4317/medoral.23912] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 11/02/2020] [Indexed: 11/05/2022] Open
Abstract
Background Head and neck radiotherapy is typically associated with toxicities that can have profound effects on the patient's quality of life. Xerostomia, which may or may not be related to hypofunction of the salivary gland, leading to negative consequences, mainly in quality of life, leaving patients more susceptible to the development of oral mucositis, dental caries, oral infection and difficulties in speech is one of the most common side effects of such treatment. The aim of the present study was to evaluate salivary function of patients in treatment with radiotherapy for head and neck cancer submitted to photobiomodulation.
Material and Methods A cross-sectional study with a quantitative approach was carried out in the Dentistry Department of the Hospital de Câncer de Pernambuco between February and September 2019.
Results The study sample comprised 23 patients of both genders, treated with radiotherapy for cancer in the head and neck region. The patients were submitted to photobiomodulation with infrared laser, as intraoral applications in order to prevent mucositis and extraoral applications to stimulate salivary glands. The applications were undertaken three times a week on alternate days throughout the radiotherapy period. The following parameters were used: Intraoral 15mW, 12J / cm2, 10s / point, 2.4 J / point, and extraoral 30mW, 7.5J / cm2, 10s / point, 0.3J / point, both with a wavelength of 830nm and area of 0.028cm². Subjective and objective symptoms were evaluated by measuring the unstimulated salivary flow (USF) using the spitting technique before, during and after radiotherapy treatment. For statistical analysis, a significance level of 5% was adopted. Most patients were male (70%) with 60 years of age on average. At the beginning of treatment, 22 patients had USF> 0.2 ml / min (grade 1), at the end of which 15 patients remained unchanged and only 3 patients progressed to grade 3. As for the subjective classification, most (52%) remained in grade 1 (absence of disability) throughout the treatment.
Conclusions Based upon the results of this study it was possible to conclude that the use of photobiomodulation did not significantly interfere with the xerostomia complaint of patients in treatment with radiotherapy, however, it does seem to prevent patients from reaching higher degrees of xerostomia taking into account salivary flow measures. Key words:Photobiomodulation, head and neck neoplasms, radiotherapy, xerostomia, saliva.
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Affiliation(s)
- L-N Ribeiro
- Hospital of Cancer of Pernambuco Avenida Cruz Cabugá 1597 - Santo Amaro 50040-000, Recife - PE. Brazil
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14
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Louzeiro GC, Teixeira DDS, Cherubini K, de Figueiredo MAZ, Salum FG. Does laser photobiomodulation prevent hyposalivation in patients undergoing head and neck radiotherapy? A systematic review and meta-analysis of controlled trials. Crit Rev Oncol Hematol 2020; 156:103115. [PMID: 33039721 DOI: 10.1016/j.critrevonc.2020.103115] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 08/07/2020] [Accepted: 09/25/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Head and neck radiotherapy can cause hypofunction of the salivary glands. Many studies report that laser photobiomodulation (PBM) is able to minimize radiation-induced hyposalivation, yet there is no consensus about its effects. OBJECTIVE To carry out a meta-analysis of controlled clinical trials that used PBM to prevent radiation-induced hyposalivation. METHODS A systematic search was performed through Embase, Medline/PubMed, Cochrane, EBSCO, Scopus, LILACS and Web of Science databases. The strategy included comparisons of the effect of PBM with placebo/clinical follow-up on unstimulated and/or stimulated salivary flow in patients undergoing head and neck radiotherapy. RESULTS Six clinical trials were included, five of which were used for meta-analysis. Evidence was observed between the use of PBM and increased unstimulated salivary flow (MD 0.20 mL/min, 95 % Cl 0.10-0.30, I² = 96 %, p < 0.00001) and in stimulated salivary flow (MD 0.27 mL/min, 95 % CI 0.08-0.46, I² = 95 %, p < 0.00001). CONCLUSION PBM appears to minimize radiation-induced hyposalivation.
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Affiliation(s)
- Gabriel Campos Louzeiro
- School of Health and Life Sciences, Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Dieni da Silveira Teixeira
- School of Health and Life Sciences, Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Karen Cherubini
- School of Health and Life Sciences, Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Antonia Zancanaro de Figueiredo
- School of Health and Life Sciences, Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernanda Gonçalves Salum
- School of Health and Life Sciences, Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Rio Grande do Sul, Brazil
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15
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Krueger GF, de Oliveira MC, Gassen HT, Sganzerla JT, Simon D, Grivicich I, Hernández PAG, Miguens-Jr SAQ. Evaluation of Aquaporins 1 and 5 Expression in Rat Parotid Glands After Volumetric Modulated Arc Radiotherapy and Use of Low-Level Laser Therapy at Different Times. J Lasers Med Sci 2020; 11:262-267. [PMID: 32802285 DOI: 10.34172/jlms.2020.44] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: This experimental study investigated the mRNA expression of aquaporins (AQPs) 1 and 5 in the parotid glands of rats irradiated with volumetric modulated arc therapy (VMAT) and subjected to low-level laser therapy (LLLT) at different time points. Methods: The sample consisted of 30 Wistar rats (Rattus norvegicus) divided into the following groups: control, LLLT alone (LG), radiotherapy alone (RG), and experimental groups that received LLLT at 24 hours (early experimental group [EEG], n=12) and 120 hours (late experimental group [LEG], n=12) after radiotherapy. VMAT was delivered at a single dose (12 Gy) and LLLT was performed with an aluminium-gallium-arsenide diode laser (660 nm, 100 mW), spot area of 0.0028 cm2, energy of 2 J/cm2 applied to 3 spots in the region corresponding to the right parotid gland, for 10 consecutive days. The right parotid gland was resected and prepared for RNA extraction. The gene expression of AQPs was evaluated by quantitative polymerase chain reaction (qPCR) using specific TaqMan probes, with the HPRT gene as an internal control. Results: The lowest AQP1 gene expression was 0.83 (0.27) with the use of LLLT 24 hours after radiotherapy (EEG), and the highest was 1.56 (0.80) with the use of LLLT alone (LG). Likewise, the lowest AQP5 gene expression was found in the EEG (mean = 0.88; SD = 0.49) and the highest in the LG (mean = 1.29; SD = 0.33). Conclusion: The use of LLLT after radiotherapy may contribute to the maintenance and an increase of these proteins, even when used at a later time point after radiotherapy.
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Affiliation(s)
- Gabriel Francisco Krueger
- Department of Oral Medicine, Graduate Program in Dentistry, Universidade Luterana do Brasil, Canoas, RS, Brazil
| | | | - Humberto Thomazi Gassen
- Department of Oral Medicine, Graduate Program in Dentistry, Universidade Luterana do Brasil, Canoas, RS, Brazil
| | - Juliana Tomaz Sganzerla
- Department of Oral Medicine, Graduate Program in Dentistry, Universidade Luterana do Brasil, Canoas, RS, Brazil
| | - Daniel Simon
- Graduate Program in Cellular and Molecular Biology Applied to Health, Universidade Luterana do Brasil, Canoas, RS, Brazil
| | - Ivana Grivicich
- Graduate Program in Cellular and Molecular Biology Applied to Health, Universidade Luterana do Brasil, Canoas, RS, Brazil
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Effect of photobiomodulation on salivary flow and composition, xerostomia and quality of life of patients during head and neck radiotherapy in short term follow-up: A randomized controlled clinical trial. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2020; 209:111933. [DOI: 10.1016/j.jphotobiol.2020.111933] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/01/2020] [Accepted: 06/10/2020] [Indexed: 11/23/2022]
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17
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Dantas JBDL, Martins GB, Lima HR, Carrera M, Reis SRDA, Medrado ARAP. Evaluation of preventive laser photobiomodulation in patients with head and neck cancer undergoing radiochemotherapy: Laser in patients with head and neck cancer. SPECIAL CARE IN DENTISTRY 2020; 40:364-373. [PMID: 32544269 DOI: 10.1111/scd.12486] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 05/20/2020] [Accepted: 05/23/2020] [Indexed: 01/16/2023]
Abstract
AIMS This study aimed to evaluate the effect of laser photobiomodulation in the prevention of oral mucositis (OM), salivary hypofunction and referred pain in patients with head and neck cancer. METHODS AND RESULTS This randomized clinical study divided patients into two groups: the laser group (LG, n = 30) and the control group (CG, n = 24). The LG (InGaAlP, 660 nm, 86.7 mW, 2 J/cm2 ) participated in the preventive protocol, while the CG underwent a simulated procedure without light emission. The degree of OM, salivary flow, and referred pain were evaluated at five different periods of radiotherapy. Both groups showed a significant increase in the degree of OM (P < .01). Regarding OM, salivary flow, and oral pain, there were no significant differences between the groups. CONCLUSIONS The laser photobiomodulation protocol used in this study was not effective in preventing radiochemotherapy-induced OM, salivary hypofunction, and referred pain in patients with head and neck cancer. Notably, although the development of OM did not differ significantly according to the use of laser therapy, the severity of oral mucositis was reduced in patients who underwent laser therapy compared to that in patients who did not.
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Affiliation(s)
- Juliana Borges de Lima Dantas
- Masters in Dentistry at Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.,Professor of Adventist College of Bahia, Department of Dentistry, Cachoeira, Bahia, Brazil
| | - Gabriela Botelho Martins
- Associate Professor of Health Sciences Institute of the Federal University of Bahia, Salvador, Bahia, Brazil
| | - Hayana Ramos Lima
- Adjunct Professor, Center of Health Sciences, Federal University of Southern Bahia, Teixeira de Freitas, Bahia, Brazil
| | - Manoela Carrera
- Adjunct Professor of Stomatology at the Federal University of Bahia, Salvador, Bahia, Brazil.,Adjunct Professor, Department of Life Sciences at the State University of Bahia, Salvador, Bahia, Brazil
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18
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Heiskanen V, Zadik Y, Elad S. Photobiomodulation Therapy for Cancer Treatment-Related Salivary Gland Dysfunction: A Systematic Review. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 38:340-347. [DOI: 10.1089/photob.2019.4767] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Vladimir Heiskanen
- Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Yehuda Zadik
- Department of Military Medicine, Hebrew University-Hadassah Faculty of Medicine, Jerusalem, Israel
| | - Sharon Elad
- Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
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Palma LF, Tateno RY, Remondes CM, Marcucci M, Cortes ARG. Impact of radiotherapy on mandibular bone: A retrospective study of digital panoramic radiographs. Imaging Sci Dent 2020; 50:31-36. [PMID: 32206618 PMCID: PMC7078405 DOI: 10.5624/isd.2020.50.1.31] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/31/2019] [Accepted: 01/22/2020] [Indexed: 11/19/2022] Open
Abstract
Purpose The purpose of this study was to investigate the impact of radiotherapy on mandibular bone tissue in head and neck cancer patients through an analysis of pixel intensity and fractal dimension values on digital panoramic radiographs. Materials and Methods Thirty patients with radiographic records from before and after 3-dimensional (3D) conformational radiotherapy were selected. A single examiner carried out digital analyses of pixel intensity values and fractal dimensions, with the areas of interest unilaterally located in the right angle medullary region of the mandible below the mandibular canal and posterior to the molar region. Results Statistically significant decreases were observed in the mean pixel intensity (P=0.0368) and fractal dimension (P=0.0495) values after radiotherapy. Conclusion The results suggest that 3D conformational radiotherapy for head and neck cancer negatively affected the trabecular microarchitecture and mandibular bone mass.
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Affiliation(s)
- Luiz Felipe Palma
- Discipline of Descriptive and Topographic Anatomy, Department of Morphology and Genetics, Federal University of São Paulo, São Paulo, Brazil.,MSc Dentistry Program, Ibirapuera University, São Paulo, Brazil
| | | | - Cíntia Maria Remondes
- Stomatology and Oral and Maxillofacial Surgery Center, Heliópolis Hospital, São Paulo, Brazil
| | - Marcelo Marcucci
- Stomatology and Oral and Maxillofacial Surgery Center, Heliópolis Hospital, São Paulo, Brazil
| | - Arthur Rodriguez Gonzalez Cortes
- MSc Dentistry Program, Ibirapuera University, São Paulo, Brazil.,Department of Dental Surgery, Faculty of Dental Surgery, University of Malta, Msida, Malta
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20
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Nascimento ML, Farias AB, Carvalho AT, Albuquerque RF, Ribeiro LN, Leao JC, Silva IH. Impact of xerostomia on the quality of life of patients submitted to head and neck radiotherapy. Med Oral Patol Oral Cir Bucal 2019; 24:e770-e775. [PMID: 31655838 PMCID: PMC6901149 DOI: 10.4317/medoral.23131] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 09/02/2019] [Indexed: 12/18/2022] Open
Abstract
Background The aim of the present work was to evaluate the impact of xerostomia on the quality of life of patients who underwent radiotherapy in the head and neck region.
Material and Methods This was a cross-sectional, quantitative study. The sample comprised 40 patients whose xerostomia was classified through the xerostomia inventory and the quality of life evaluated through the oral health impact profile questionnaire (OHIP).
Results The majority of participants were male (75%), mean age 58.7 years. According to the degree of severity of the xerostomia, the average score among the participants was 36 points, this being considered moderate xerostomia. A significant impact was observed, with the median score 11 points, with the highest scores in the domains related to functional limitation, physical pain and physical disability. The majority of the participants (97.5%) had reduced salivary flow after the end of radiotherapy. There was a significant positive correlation between the degree of xerostomia and reduced quality of life, Pearson correlation 0.5421, (p< 0.05).
Conclusions Based upon the results it is concluded that xerostomia has a negative impact on the quality of life of patients who undergo radiotherapy in the head and neck region. Key words:Head and neck neoplasms, radiotherapy, xerostomia, quality of life.
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Affiliation(s)
- M-L Nascimento
- Hospital of Cancer of Pernambuco Avenida Cruz Cabuga 1597 - Santo Amaro Recife - PE. Brazil, 50040-000
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21
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Biswas R, Ahn JC, Moon JH, Kim J, Choi YH, Park SY, Chung PS. Low-level laser therapy with 850 nm recovers salivary function via membrane redistribution of aquaporin 5 by reducing intracellular Ca 2+ overload and ER stress during hyperglycemia. Biochim Biophys Acta Gen Subj 2018; 1862:1770-1780. [PMID: 29751100 DOI: 10.1016/j.bbagen.2018.05.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 05/04/2018] [Accepted: 05/07/2018] [Indexed: 12/28/2022]
Abstract
The overall goal is to study the effect of low-level laser therapy (LLLT) on membrane distribution of major water channel protein aquaporin 5 (AQP5) in salivary gland during hyperglycemia. Par C10 cells treated with high glucose (50 mM) showed a reduced membrane distribution of AQP5. The functional expression of AQP5 was downregulated due to intracellular Ca2+ overload and ER stress. This reduction in AQP5 expression impairs water permeability and therefore results in hypo-salivation. A reduced salivary flow was also observed in streptozotocin (STZ)-induced diabetic mice model and the expression of AQP5 and phospho-AQP5 was downregulated. Low-level laser treatment with 850 nm (30 mW, 10 min = 18 J/cm2) reduced ER stress and recovered AQP5 membrane distribution via serine phosphorylation in the cells. In the STZ-induced diabetic mouse, LLLT with 850 nm (60 J/cm2) increased salivary flow and upregulated of AQP5 and p-AQP5. ER stress was also reduced via downregulation of caspase 12 and CHOP. In silico analysis confirmed that the serine 156 is one of the most favorable phosphorylation sites of AQP5 and may contribute to the stability of the protein. Therefore, this study suggests high glucose inhibits phosphorylation-dependent AQP5 membrane distribution. High glucose induces intracellular Ca2+ overload and ER stress that disrupt AQP5 functional expression. Low-level laser therapy with 850 nm improves salivary function by increasing AQP5 membrane distribution in hyperglycemia-induced hyposalivation.
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Affiliation(s)
- Raktim Biswas
- Laser Translational Clinical Trial Centre, Dankook University Hospital, Cheonan, Republic of Korea
| | - Jin Chul Ahn
- Department of Biomedical Science, College of Medicine, Dankook University, Cheonan, Republic of Korea
| | - Jeong Hwan Moon
- Laser Translational Clinical Trial Centre, Dankook University Hospital, Cheonan, Republic of Korea; Department of Otolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Jungbin Kim
- Laser Translational Clinical Trial Centre, Dankook University Hospital, Cheonan, Republic of Korea
| | - Young-Hoon Choi
- Laser Translational Clinical Trial Centre, Dankook University Hospital, Cheonan, Republic of Korea
| | - So Young Park
- Laser Translational Clinical Trial Centre, Dankook University Hospital, Cheonan, Republic of Korea
| | - Phil-Sang Chung
- Laser Translational Clinical Trial Centre, Dankook University Hospital, Cheonan, Republic of Korea; Department of Otolaryngology-Head and Neck Surgery, Dankook University College of Medicine, Cheonan, Republic of Korea.
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Palma LF, Gonnelli FAS, Marcucci M, Giordani AJ, Dias RS, Segreto RA, Segreto HRC. A novel method to evaluate salivary flow rates of head and neck cancer patients after radiotherapy: a pilot study. Braz J Otorhinolaryngol 2018; 84:227-231. [PMID: 28400176 PMCID: PMC9449237 DOI: 10.1016/j.bjorl.2017.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/09/2017] [Accepted: 03/04/2017] [Indexed: 11/15/2022] Open
Abstract
Introduction The procedure used to evaluate salivary flow rate is called sialometry. It can be performed through several techniques, but none appears to be really efficient for post-radiotherapy patients. Objective To adequate sialometry tests for head and neck cancer patients submitted to radiotherapy. Methods 22 xerostomic patients post-radiotherapy (total radiation dose ranging from 60 to 70 Gy) were included in this study. Ten patients were evaluated using sialometries originally proposed by the Radiation Therapy Oncology Group and twelve were assessed by our modified methods. Unstimulated and stimulated sialometries were performed and the results were classified according a grading scale and compared between both groups. Results There was no statistically significant difference between the salivary evaluations of both groups (p = 0.4487 and p = 0.5615). Also, most of these rates were classified as very low and low. Conclusion This novel method seems to be suitable for patients submitted to radiotherapy.
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23
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Low-level laser therapy for xerostomia in primary Sjögren’s syndrome: a randomized trial. Clin Rheumatol 2017; 37:729-736. [DOI: 10.1007/s10067-017-3898-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/19/2017] [Accepted: 10/27/2017] [Indexed: 10/18/2022]
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