Full operating parameter recording as an essential component of the reproducibility of laser-tissue interaction and treatments.

BACKGROUND: The number and diversity of published peer-reviewed studies in the discipline of laser dentistry have grown considerably during the past 10 years. OBJECTIVES: Within primary research, the development of protocols to guide and formulate clinical practice demands precision and ease of reproducibility. Errors in data acquisition and management may become amplified as the applied randomized clinical trials (RCTs) forge new levels of clinical diversity and predictability in the use of laser photonic energy in both ablative (surgical) and sub-ablative (photobiomodulation (PBM) or photodynamic therapy (PDT)) applications. MATERIAL AND METHODS: A comprehensive range of empirical and computational operating parameters must be included in published studies to facilitate the uniformity of powerand time-related values of laser irradiation. RESULTS: Choosing the correct "tissue irradiation parameters" is difficult and depends on the pathology and symptoms, the surface area to be treated, laser wavelength, the thermal relaxation time of each targeted tissue, and controlling penetration depth of the light into tissues. Therefore, to allow the reproducibility of the results, it is recommended that authors mention with the greatest care and clarity the irradiation parameters used in their study. CONCLUSION: This paper outlines the concerns felt regarding the general shortfalls and proposes a minimum range of laser operating parameters that should be represented in future peer-reviewed publications.

Enhanced Recovery of Local Anesthesia in Pediatric Patients: The Impact of Photobiomodulation on Reversing Anesthesia Effects.

BACKGROUND The split-mouth study design is used in oral health research and usually consists of 2 treatments randomly assigned to either the right or left side. This split-mouth study aimed to evaluate the efficacy of photobiomodulation on reversal of local anesthesia in 50 children aged 8-10 years. MATERIAL AND METHODS The study was conducted among 50 children: 27 girls and 23 boys, aged 8-10 years (mean age 9.38±1.15 years), who presented 2 carious maxillary permanent molars. One side was randomly assigned to the laser group (50 teeth), and the contralateral side to the control group (50 teeth). At the end of the treatment, photobiomodulation (PBM) was performed in the area of infiltration at 6 points, with 635 nm (25 children) (250 mW, 500 mW/cm², 15J) and 808 nm (25 children) (200 mW, 400 mW/cm², 12J) (SmartM PRO, Lasotronix, Poland). On the contralateral side, the laser's off-mode applicator was used. Anesthetic effect was evaluated by palpation test (soft tissues) and electrical test (dental pulp). RESULTS After 15 minutes, in the laser group the return to normal sensations in the palpation test showed 88% (808 nm) and 68% (635 nm), and only 20% in the control group (P=0.04123). After 45 minutes, all the participants from the PBM group returned to normal sensations (P=0.21458). Dental pulp's excitability threshold was lower for both wavelengths compared to the control group (P=0.000001). CONCLUSIONS The identification of factors accelerating the recovery time to normal function, such as PBM, can be used as important data to eliminate self-injury secondary to local anesthesia (LA) in children.

A Molecular Approach for Detecting Bacteria and Fungi in Healthcare Environment Aerosols: A Systematic Review.

Molecular methods have become integral to microbiological research for microbial identification. This literature review focuses on the application of molecular methods in examining airborne bacteria and fungi in healthcare facilities. In January 2024, a comprehensive electronic search was carried out in esteemed databases including PubMed, Web of Science, and Scopus, employing carefully selected keywords such as ((bacteria) OR (virus) OR (fungi)) AND (aerosol) AND ((hospital) OR (healthcare) OR (dental office)) AND ((molecular) OR (PCR) OR (NGS) OR (RNA) OR (DNA) OR (metagenomic) OR (microarray)), following the PRISMA protocol. The review specifically targets healthcare environments with elevated concentrations of pathogenic bacteria. A total of 487 articles were initially identified, but only 13 met the inclusion criteria and were included in the review. The study disclosed that the prevalent molecular methodology for appraising aerosol quality encompassed the utilization of the PCR method, incorporating either 16S rRNA (bacteria) or 18S rRNA (fungi) amplification techniques. Notably, five diverse molecular techniques, specifically PFGE, DGGE, SBT, LAMP, and DNA hybridization methods, were implemented in five distinct studies. These molecular tests exhibited superior capabilities compared to traditional bacterial and fungal cultures, providing precise strain identification. Additionally, the molecular methods allowed the detection of gene sequences associated with antibiotic resistance. In conclusion, molecular testing offers significant advantages over classical microbiological culture, providing more comprehensive information.

The Influence of Fluoride Gels on the Physicochemical Properties of Tooth Tissues and Dental Materials-A Systematic Review.

The aim of the presented systematic review is to update the state of knowledge and relate the properties and composition of fluoride gels to their potential application. This article aims to explore the effect of fluoride gel application on changes in the properties of dental biomaterials and tooth tissues. The review includes articles assessing studies on the effects of fluoride gel on dental tissues and materials. Employing the PRISMA protocol, a meticulous search was conducted across the PubMed, Scopus, and Web of Science databases, utilizing keywords such as fluoride, gel, and properties. The publications were selected without limitation by the year of publication, and then Cohen's κ test was used to assess the agreement of the respondents. Exclusion criteria included non-English studies, opinion pieces, editorial papers, letters to the editor, review articles and meta-analyses, clinical reports, studies lacking full-text accessibility, and duplicates. The quality of the chosen papers was assessed by two independent reviewers. A total of 2385 were located in databases, of which only 17 met the inclusion criteria. All publications showed increased surface mineralization, and seven studies showed the effect of fluoride gel on the surface of dental tissues. Three articles stated a negative effect of fluoride gels on titanium and stainless steel alloys and glass ionomer fillings. The effects on shear bond strength and plaque deposition require further investigation because the study results are contradictory.

Surface Functionalization of Titanium-Based Implants with a Nanohydroxyapatite Layer and Its Impact on Osteoblasts: A Systematic Review.

This study aims to evaluate the influence of a nanohydroxyapatite layer applied to the surface of titanium or titanium alloy implants on the intricate process of osseointegration and its effect on osteoblast cell lines, compared to uncoated implants. Additionally, the investigation scrutinizes various modifications of the coating and their consequential effects on bone and cell line biocompatibility. On the specific date of November 2023, an exhaustive electronic search was conducted in esteemed databases such as PubMed, Web of Science, and Scopus, utilizing the meticulously chosen keywords ((titanium) AND ((osteoblasts) and hydroxyapatite)). Methodologically, the systematic review meticulously adhered to the PRISMA protocol. Initially, a total of 1739 studies underwent scrutiny, with the elimination of 741 duplicate records. A further 972 articles were excluded on account of their incongruence with the predefined subjects. The ultimate compilation embraced 26 studies, with a predominant focus on the effects of nanohydroxyapatite coating in isolation. However, a subset of nine papers delved into the nuanced realm of its modifiers, encompassing materials such as chitosan, collagen, silver particles, or gelatine. Across many of the selected studies, the application of nanohydroxyapatite coating exhibited a proclivity to enhance the osseointegration process. The modifications thereof showcased a positive influence on cell lines, manifesting in increased cellular spread or the attenuation of bacterial activity. In clinical applications, this augmentation potentially translates into heightened implant stability, thereby amplifying the overall procedural success rate. This, in turn, renders nanohydroxyapatite-coated implants a viable and potentially advantageous option in clinical scenarios where non-modified implants may not suffice.

Analysis of aerosol generation during Er:YAG laser-assisted caries treatment: A randomized clinical trial.

BACKGROUND: Maintaining biosafety in dental practice involves the effective elimination of aerosols produced during dental treatment. OBJECTIVES: To assess the quantity of aerosols and aerobic bacteria in the air during the treatment of caries. MATERIAL AND METHODS: The study involved 60 patients with a total of 60 molar teeth (n = 60) in the mandible who were divided into 2 groups based on caries treatment method. Group 1 (G1, n = 30) received treatment with a conventional dental turbine (W&H Synea TA-98LC; W&H, Burmoos, Austria), while group 2 (G2, n = 30) underwent treatment with an Er:YAG (erbium-doped yttrium aluminium garnet) laser (LightWalker, Fotona, Slovenia). Measurements of aerosol particles between 0.3 Em and 10.0 Em near the operatorfs mouth were taken using the PC200 laser particle counter (Trotec GmbH, Schwerin, Germany). The number of aerobic bacteria in the air was determined using 60 Petri plates with a microbiological medium (Columbia agar with 5% sheep blood) and the sedimentation method. A control group (G3) was established to measure initial aerosol levels and initial total number of bacteria colony-forming units (CFUs) before each treatment. RESULTS: In G1 (dental turbine), the median value of aerosol particles was 57,021 (42,564.67,568), while in G2 (Er:YAG laser), it was significantly lower at 33,318 (28,463.35,484) (p < 0.001). The median total bacteria count per cubic meter of air in G1 (conventional dental turbine + high volume evacuator (HVE)), G2 (Er:YAG laser + HVE) and G3 (control group before caries treatment) were 734 (420.988), 158 (96.288) and 48 (32.74), respectively, with a statistically significant difference between the groups (p < 0.001). CONCLUSIONS: The use of Er:YAG laser during caries treatment resulted in a 41.6% reduction in aerosol amounts and a 78.5% decrease in the total bacterial count (TBC) compared to treatment with a dental turbine.

The Impact of Hydrogen Peroxide (H2O2) Fumigation on Bacterial Levels in Dental Office Environments: A Randomized Clinical Trial Investigation.

BACKGROUND: Fumigation with hydrogen peroxide has proven to be a highly effective approach to maintaining biological safety within dental offices. The main purpose of this research was to investigate the efficacy of hydrogen peroxide (H2O2) fumigation in reducing bacterial levels in dental office environments. METHODS: The study involved 30 participants diagnosed with moderate caries decay (ICDAS 3 and 4) in their mandibular molars. Sixty Petri dishes (two per patient) with Columbia Agar and 5% Sheep Blood were opened at the beginning of the caries treatment. After the completion of caries treatment and tooth restoration, 30 plates (G1 group) were closed. Following this, a 20 min fumigation procedure with 6% hydrogen peroxide biosanitizer using a compressed air device was conducted. After the fumigation, the remaining plates were closed (G2 group). The total number of bacteria CFUs (colony-forming units) in the dental office air was determined using the Koch sedimentation method. RESULTS: The total bacterial colony (TBC) level, measured in cfu/m3, demonstrated a significant decrease in the number of bacteria following room environment fumigation (163.1 ± 145.7; G2 group) compared to non-fumigated samples (817.2 ± 208.2; G1 group) (p < 0.001). The predominant bacteria observed in the microbiological plates before fumigation were Micrococcus and Bacillus species, found in 80% (24/30) and 60% (18/30) of the plates, respectively. Application of H2O2 room fumigation resulted in a significant reduction in bacterial numbers: 79.2% (5/30) for Micrococcus species (p < 0.001), 83.3% (3/30) for Bacillus species (p < 0.001), and 100% (0/30) for Staphylococcus arlettae (p < 0.05). CONCLUSION: Fumigation with 6% H2O2 is an effective method for reducing bacterial counts in a dental office environment.

The Use of Graphene Oxide in Orthodontics-A Systematic Review.

BACKGROUND: Graphene-based materials have great prospects for application in dentistry and medicine due to their unique properties and biocompatibility with tissues. The literature on the use of graphene oxide in orthodontic treatment was reviewed. METHODS: This systematic review followed the PRISMA protocol and was conducted by searching the following databases: PubMed, Scopus, Web of Science, and Cochrane. The following search criteria were used to review the data on the topic under study: (Graphene oxide) AND (orthodontic) ALL FIELDS. For the Scopus database, results were narrowed to titles, authors, and keywords. A basic search structure was adopted for each database. Initially, a total of 74 articles were found in the considered databases. Twelve articles met the inclusion criteria and were included in the review. RESULTS: Nine studies demonstrated the antibacterial properties of graphene oxide, which can reduce the demineralization of enamel during orthodontic treatment. Seven studies showed that it is biocompatible with oral tissues. Three studies presented that graphene oxide can reduce friction in the arch-bracket system. Two studies showed that it can improve the mechanical properties of orthodontic adhesives by reducing ARI (Adhesive Remnant Index). Three studies demonstrated that the use of graphene oxide in the appropriate concentration can also increase the SBS (shear bond strength) parameter. One research study showed that it can increase corrosion resistance. One research study suggested that it can be used to accelerate orthodontic tooth movement. CONCLUSION: The studies included in the systematic review showed that graphene oxide has numerous applications in orthodontic treatment due to its properties.

Evaluation of photobiomodulation for postoperative discomfort following laser-assisted vital pulp therapy in immature teeth: A preliminary retrospective study.

BACKGROUND: Minimally invasive endodontics is recommended for young, immature teeth to preserve healthy pulp and dentin tissue. OBJECTIVES: The aim of the study was to examine the cold sensitivity of immature teeth that received photobiomodulation (PBM) after vital pulp therapy (VPT). MATERIAL AND METHODS: The study followed the STROBE guidelines and included 123 healthy patients aged 8-13. The immature teeth (incisors, premolars and molars) that qualified for VPT received the bioceramic material - Biodentine. In this experiment, teeth were treated immediately and at 24 h post-VPT with a 635-nm diode laser using a power of 100 mW, a power density of 200 mW/cm2 and a total energy of 4 J (PBM group, n = 43), while those not treated were the control group (n = 43). The tooth sensitivity to cold was measured using a visual analogue scale (VAS) before and at 6 h, 1 day, 7, 30, and 90 days after treatment. The predictor variable was PBM skills regarding the ability to decrease cold sensitivity after VPT. The primary endpoint was the time to reverse hypersensitivity to cold, and the secondary endpoint was the occurrence of possible side effects. The Mann-Whitney U test, Friedman test along with Dunn's post hoc test, and the χ2 test were used to investigate tooth sensitivity. RESULTS: Eighty-six immature permanent teeth of 86 children were included in the study. It was shown that the difference was significant for sensitivity to a cold stimulus between the groups at 6 h, 24 h, 7 days, and 30 days, but no difference was found preoperatively and at 90 days (6 h, 24 h, 7 days, and 30 days, p < 0.001, and 90 days, p = 0.079). However, patients in both groups reported a decrease in discomfort provoked by cold stimuli throughout the follow-up period. CONCLUSIONS: Photobiomodulation decreased postoperative sensitivity and was more acceptable for patients. Further randomized clinical studies with placebo-controlled groups are needed.

Comparison of Diagnostic Validity of Cephalometric Analyses of the ANB Angle and Tau Angle for Assessment of the Sagittal Relationship of Jaw and Mandible.

BACKGROUND: Cephalometric analysis is an essential tool used in orthodontic diagnosis and treatment planning. The aim of this study was to evaluate the reliability and repeatability of new cephalometric points introduced in Tau angle analysis, in contrast to the gold standard, which is the analysis of the ANB angle. For this purpose, an attempt was made to assess the repeatability and reliability of the introduction of anthropometric points by evaluating both inter- and intraobserver parameters, as well as the agreement among the orthodontists participating in the study. METHODS: Repeatability and reliability assessments for all six anthropometric points (N, A, B, T, M, G) used in the analysis of the ANB and Tau angles were conducted individually by 29 orthodontists. This assessment was performed in triplicate on the day of the study, on the day following the first study, and on the seventh day after the second study. Measurement errors for the ANB and Tau angles were evaluated using the Dahlberg formula and intraclass correlation coefficients (ICCs). RESULTS: The orthodontists in the study measured sagittal discrepancy significantly more accurately using the ANB angle compared to the Tau angle (p < 0.001). The Dahlberg error for measuring the Tau angle was three times greater than that for the ANB angle (p < 0.001). Additionally, the ICC for the Tau angle was more than 3.5 times smaller than that for the ANB angle, while the R&R error for Tau measurement was more than three times greater than that for the ANB angle (p < 0.001). CONCLUSIONS: The results of ANB angle measurements exhibit fewer errors in comparison to Tau angle measurements.

Quantitative Evaluation of Aerosols Produced in the Dental Office during Caries Treatment: A Randomized Clinical Trial.

BACKGROUND: Effective removal of aerosols generated during dental treatment is crucial for maintaining biosafety in dental practice. This study aimed to measure the aerosol amount and the number of aerobic bacteria in the air during caries treatment. METHODS: The study involved 50 molar teeth (n = 50) in the mandible in 50 patients divided into two groups based on the type of a high-volume evacuator (HVE); G1 (n = 25) conventional HVE (EM19 EVO, Monoart® Euronda, Vicenza, Italy) and G2 (n = 25) a new, wider, customized HVE. The PC200 laser particle counter (Trotec GmbH, Schwerin, Germany) was used to measure aerosol particles in a range of 0.3-10.0 µm near the operator's mouth. The study used 60 microbiological plates with a microbiological medium (Columbia Agar with 5% Sheep Blood) to check the number of aerobic bacteria in the air. RESULTS: The mean value of aerosol particles in the G1 group (conventional HVE) was 54,145 ± 7915, while in the G2 group (test, wider evacuator) was lower and amounted to 32,632 ± 1803. (p < 0.001). The median total bacteria count in the air per cubic meter in control, G1 (HVE), and G2 (NEW-HVE) groups were 50 [36-60]; 772 [643-881]; 120 [92-139], respectively. (p < 0.05). Gram-positive cocci were the predominant bacteria in the plates: Micrococcus sp. (50%), Bacillus species (36.4%), Staphylococcus epidermidis (3.8%), Staphylococcus saprophyticus (3.8%). CONCLUSIONS: the application of the wider high-volume evacuator increases the air purity during caries treatment as well as the biological safety of a dental office.

The Use of Lactide Polymers in Bone Tissue Regeneration in Dentistry-A Systematic Review.

(1) Background: Different compositions of biodegradable materials are being investigated to successfully replace non-resorbable ones in bone tissue regeneration in dental surgery. The systematic review tried to address the question, "Can biodegradable polymers act as a replacement for conventional materials in dental surgery procedures?" (2) Methods: An electronic search of the PubMed and Scopus databases was conducted in October 2022. The following keywords were used: (lactide polymers) and (hydroxyapatite or fluorapatite) and (dentistry) and (regeneration). Initially, 59 studies were found. Forty-one studies met the inclusion criteria and were included in the review. (3) Results: These usually improved the properties and induced osteogenesis, tissue mineralisation and bone regeneration by inducing osteoblast proliferation. Five studies showed higher induction of osteogenesis in the case of biomaterials, UV-HAp/PLLA, ALBO-OS, bioresorbable raw particulate hydroxyapatite/poly-L-lactide and PLGA/Hap, compared to conventional materials such as titanium. Four studies confirmed improvement in tissue mineralisation with the usage of biomaterials: hydroxyapatite/polylactic acid (HA/PLA) loaded with dog's dental pulp stem cells (DPSCs), Coll/HAp/PLCL, PDLLA/VACNT-O:nHAp, incorporation of hydroxyapatite and simvastatin. Three studies showed an acceleration in proliferation of osteoblasts for the use of biomaterials with additional factors such as collagen and UV light. (4) Conclusions: Lactide polymers present higher osteointegration and cell proliferation rate than the materials compared. They are superior to non-biodegradable materials in terms of the biocompability, bone remodelling and healing time tests. Moreover, because there is no need of reoperation, as the material automatically degrades, the chance of scars and skin sclerosis is lower. However, more studies involving greater numbers of biomaterial types and mixes need to be performed in order to find a perfect biodegradable material.

Effectiveness of lasers and aPDT in elimination of intraoral halitosis: a systematic review based on clinical trials.

In recent years, there has been increasing interest in research showing positive results in antimicrobial photodynamic therapy (aPDT) and laser therapy (LT) in dentistry. The authors of this review tried to answer the question: "Is the effectiveness of lasers and aPDT in the elimination of intraoral halitosis possible?" For this purpose, the electronic database of PubMed and Cochrane Library were searched until September 2021 using a combination of different keywords: (bad breath OR fetor ex ore OR halitosis OR oral malodor) AND (laser OR PDT OR PACT OR photodynamic inactivation OR photodynamic therapy OR photodynamic antimicrobial chemotherapy). Initially, 83 studies were identified. A total of 9 articles were qualified after the application of the eligibility criteria. Eight works concerned aPDT treatment, and only one dedicated to the Er,Cr:YSGG laser. A significant reduction in halitosis occurred immediately after both LT and aPDT. The review found the confirmation of the effectiveness of laser therapy in reducing the number of volatile sulfur compounds (VSC) and the amount of anaerobic bacteria responsible for VSC formation. In most studies, a positive effect was observed for a 1-week follow-up. Laser therapy (aPDT, Er,Cr:YSGG) effectively eliminates microorganisms that produce volatile compounds and can effectively eliminate bad breath for the longer period of time than traditional methods of combatting this ailment.

Erbium laser-assisted ceramic debonding: a scoping review.

PURPOSE: Removal of ceramic restorations and appliances can be time consuming, invasive, and inconvenient. Erbium lasers offer an alternative noninvasive method for debonding of ceramic appliances. This paper aims to provide a comprehensive review of current literature on the effectiveness of erbium lasers for removal of ceramic restorations and appliances from natural teeth and dental implants. METHODS: A comprehensive search of 7 databases, including Medline (Ovid), Embase, Dentistry and Oral Sciences Source (DOSS), Web of Science, Cochrane Library, and ProQuest Dissertations and Theses was performed. The inclusion and exclusion criteria were agreed prior to the literature search. Two reviewers independently screened the title and abstract. A third reviewer then broke the tie, if any. The selected articles then underwent full text review and the data was extracted. RESULTS: The search identified 4117 unique articles published through June 10, 2021. Studies were assessed and categorized based on the type of restoration/appliance, type of abutment, type of laser, laser settings, efficacy of debonding, and pulpal temperature rise. Thirty-eight full-text articles were reviewed for inclusion. Time for ceramic debonding varies depending on the type of restorations and materials. Removal of zirconia crowns from teeth and implant abutments requires a longer period of time compared to lithium disilicate crowns. Temperature increases were reported as 5.5 degrees or less. Laser setting and laser type affect the debonding time and the increase in temperature. Examinations of debonded ceramics demonstrated no known structural damages resulting from laser applications. CONCLUSIONS: Erbium lasers are effective noninvasive tools to remove all ceramic restorations/appliances from natural teeth and implant abutments without causing harm to abutments. Laser-assisted debonding should be considered as a viable alternative to rotary instrumentation for ceramic crowns; however, clinical studies of erbium-assisted ceramic retrieval are needed.

Sodium Hypochlorite and Diode Laser in Non-Surgical Treatment of Periodontitis: Clinical and Bacteriological Study with Real Time Polymerase Chain Reaction (PCR).

Increasing the disinfection during non-surgical treatment of periodontitis is primordial. This study assesses the effectiveness of sodium hypochlorite and a 980 nm diode laser in non-surgical treatment of periodontitis. Thirty sites of localized periodontitis with a probing pocket depth (PPD) of ≥ 6 mm were included. Fifteen underwent scaling root planing (SRP group) and 15 underwent SRP + 0.5% NaOCl and a 980 nm diode laser (study group). A biological molecular test and real time polymerase chain reaction (RT-PCR) were performed before (T0) and after intervention (T1). Total bacterial count and counts of Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Prevotella intermedia, Peptostreptococcus micros, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, Eubacterium nodatum, Capnocytophaga gingivalis were assessed. Plaque index (PI), bleeding on probing (BOP), gingival recession (GR), PPD and clinical attachment loss (CAL) were evaluated at T0, and 3 and 6 months after. Study group showed a statistically significant reduction of TBC (5.66 × 108 CFU/mL) compared to SRP (6.2 × 109 CFU/mL). Both groups showed a statistically significant reduction of Treponema denticola, Tannerella forsythia, Prevotella intermedia, Peptostrep. (micromonas) micros and Fusobacterium nucleatum; however, a significant reduction of Eubacterium nodatum and Capnocytophaga gingivalis was observed in the study group. At T6, both groups had a statistically significant reduction of PI, BOP, GR, PD and CAL. The study group showed more GR compared to SRP and a significant reduction of PD (4.03 mm ± 0.49) compared to SRP (5.28 mm ± 0.67). This study reveals that NaOCl and a diode laser are effective as an adjunctive to the non-surgical treatment of periodontitis.

Photobiomodulation Therapy in the Treatment of Oral Mucositis-A Case Report.

In 2021, our group published a laboratory study on the impact of PBM on human gingival fibroblasts. The in vitro results confirmed the fact that the appropriately selected wavelength and properly selected parameters of the laser settings can increase cell proliferation, modulate inflammatory markers, and decrease the susceptibility of human gingival fibroblasts to apoptosis. Therefore, this case report was aimed at the clinical evaluation of the proposed settings and treatment regimen in a very difficult situation of an immunocompromised patient with extensive changes and stagnation of symptoms for many weeks. A 65-year-old man, during his oncological treatment, was diagnosed with oral mucositis grade 3 according to the World Health Organization and National Cancer Institute scales. Due to pain sensation, long-lasting and not healing oral lesions, and problems with solid food intake, he was qualified for laser photobiomodulation therapy. For the management of oral lesions, a diode laser 635 nm (SmartMPro, Lasotronix, Poland) was intraorally applied at an energy density of 4 J/cm2, the 20 s of irradiation, the output power of 100 mW, and in continuous wave mode. Seven treatment procedures were performed two times a week using the spot technique in contact and non-contact mode. Within 21 days of monotherapy, all ailments disappeared. The patient was also able to reuse dental dentures and return to a solid diet. The obtained results confirm the efficiency of at least 3 PBM protocols. Our case shows that the use of PMB therapy contributes to faster healing of painful oral lesions in oncological patients, and thus the treatment time and return to the appropriate quality of life is shorter.

Efficacy of Various Laser Wavelengths in the Surgical Treatment of Ankyloglossia: A Systematic Review.

Ankyloglossia, commonly known as tongue-tie, is the most common disorder of tongue morphology characterized by aberrant attachment of the lingual frenum. This study aimed to provide a comprehensive literature review and evaluate the effectiveness of various laser wavelengths in the surgical treatment of patients with ankyloglossia. An electronic screening of PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted on 8 November 2021. The following search terms were used to review the available data on the subject of interest: (ankyloglossia OR tongue tie OR short lingual frenulum OR lingual frenectomy OR lingual frenulectomy OR lingual frenotomy OR lingual frenulotomy) AND laser. The use of lasers in ankyloglossia treatment resulted in shorter procedure time, reduced indications for general anesthesia, reduced administration of postoperative analgesics, fewer sutures or none needed, reduced postoperative bleeding, and improved healing. Despite many advantages, this method has its clinical limitations: it requires the use of expensive equipment; well-trained personnel familiar with lasers; and personal protective equipment for the patient, caregiver, operator, and assistant. The laser procedure does not eliminate the need for myofunctional exercises and work with a speech therapist.

Fibroblasts Adhesion to Laser-Modified Titanium Surfaces-A Systematic Review.

OBJECTIVE: Laser treatment has been recently introduced in many fields of implant dentistry. The systematic review tried to address the question: "How does laser modification of titanium surface influence fibroblast adhesion?". METHODS: An electronic search of the PubMed and Scopus databases was performed. The following keywords were used: (laser) AND (fibroblast) AND (titanium) AND (implant OR disc) AND (proliferation OR adhesion). Initially, 136 studies were found. Ten studies met the inclusion criteria and were included in the review. All studies chosen to be included in the review were considered to have a low risk of bias. RESULTS: Studies included in the review varied with laser parameters or ways of observing fibroblast behavior. Studies showed that fibroblasts tend to take different shapes and create extensions on modified surfaces and that their metabolic activity is more intense. One study concentrated on laser application and showed that three-directional laser application is the most successful in terms of fibroblast adhesion. Studies which concentrated more on laser parameters showed that too low energy density (lower or equal to 0.75 J/cm2) does not influence fibroblast adhesion. Increasing the energy density over 0.75 J/cm2 causes better cell adhesion of fibroblasts to the laser-modified sample. One included study focused on increasing titanium surface wettability, which also positively influenced cell adhesion. CONCLUSION: The studies included in the review proved a positive effect of laser-modified titanium surfaces on fibroblast adhesion. However, the application of an appropriate laser energy dose is crucial.

SEM Evaluation of Tooth Surface after a Composite Filling Removal Using Er:YAG Laser, Drills with and without Curettes, and Optional EDTA or NaOCl Conditioning.

(1) Background: This study aimed to evaluate the microporosity of the tooth surface structure adjacent to the cemento-enamel junction (CEJ) after the removal of composite fillings with a drill in comparison with removal by an Er:YAG laser and after cleaning with a periodontal curette, chemical EDTA and NaOCl (sodium hypochlorite) conditioning. (2) Methods: The research material consisted of 30 extracted premolars with cervical composite fillings. The teeth were divided into six groups according to the method of tooth preparation: group G1 (n = 5)-a diamond drill; group G2 (n = 5)-a diamond drill + curette; group G3 (n = 5)-a diamond drill + 24% EDTA (PrefGel, Straumann, Switzerland); group G4 (n = 5)-an Er:YAG laser (LightWalker, Fotona, Ljubljana, Slovenia) set with the following parameters: power: 1.65 W (composite removal, CR), 1.2 (tooth conditioning, TC), energy: 110 mJ (CR), 80 mJ (TC), frequency: 15 Hz, pulse duration: 50 µs, tip diameter: 1 mm, air/fluid cooling: 4, distance 1.5 mm, energy density: 14.01 J/cm2 (CR), 10.19 J/cm2 (TC); group G5 (n = 5)-an Er:YAG laser + 2% sodium hypochlorite (NaOCl); group G6 (n = 5)-an Er:YAG laser + 5.25% NaOCl. In each tooth, three cavities were made and subjected to analysis. The dentin surface was evaluated using a scanning electron microscope (SEM). (3) Results: Groups G1 and G2 exhibited mechanical damage to the tooth surface structure caused by the rotary motion of a diamond drill. The SEM image showed a smear layer that could only be removed chemically using 24% EDTA gel (group G3). The tooth surfaces prepared with the Er:YAG laser (groups G4-G6) revealed a homogeneous structure without damage along with open dentinal tubules (without smear layer) and visible denaturation of collagen fibers. The sodium hypochlorite (NaOCl) conditioning did not increase the visibility of dentinal tubules. (4) Conclusions: Dentin surfaces have open dentinal tubules after removal of the composite filling using the Er:YAG laser and therefore do not require additional NaOCl conditioning.

Photobiomodulation with Red and Near-Infrared Light Improves Viability and Modulates Expression of Mesenchymal and Apoptotic-Related Markers in Human Gingival Fibroblasts.

Photobiomodulation (PBM), also called low-level laser treatment (LLLT), has been considered a promising tool in periodontal treatment due to its anti-inflammatory and wound healing properties. However, photobiomodulation's effectiveness depends on a combination of parameters, such as energy density, the duration and frequency of the irradiation sessions, and wavelength, which has been shown to play a key role in laser-tissue interaction. The objective of the study was to compare the in vitro effects of two different wavelengths-635 nm and 808 nm-on the human primary gingival fibroblasts in terms of viability, oxidative stress, inflammation markers, and specific gene expression during the four treatment sessions at power and energy density widely used in dental practice (100 mW, 4 J/cm2). PBM with both 635 and 808 nm at 4 J/cm2 increased the cell number, modulated extracellular oxidative stress and inflammation markers and decreased the susceptibility of human primary gingival fibroblasts to apoptosis through the downregulation of apoptotic-related genes (P53, CASP9, BAX). Moreover, modulation of mesenchymal markers expression (CD90, CD105) can reflect the possible changes in the differentiation status of irradiated fibroblasts. The most pronounced results were observed following the third irradiation session. They should be considered for the possible optimization of existing low-level laser irradiation protocols used in periodontal therapies.