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.

Schemes for Drug-Induced Treatment of Osteonecrosis of Jaws with Particular Emphasis on the Influence of Vitamin D on Therapeutic Effects.

Drugs that inhibit bone resorption are prescribed most often by orthopedists, hematologists, or oncologists. Dental practice rarely draws attention to their importance and the effects they carry. The problem concerns mainly older people owing to oncological problems or postmenopausal consequences, but everyone can be at risk. Carefully conducted interviews and analysis of history and disease should always be performed before any action is taken by patients taking this type of medicine. Further action should consider possible complications and, above all, the risk of their occurrence. In this article, the most important issues related to the treatment of drug-induced osteonecrosis of the jaws (ONJ) are raised, including medication-related osteonecrosis of the jaw (MRONJ); conservative treatment, including the use of laser; and the impact of vitamin D supplementation on the overall treatment, prognosis, and prevention before complication, which is osteonecrosis of the jaw in the course of treatment with bisphosphonates and other drugs predisposing to MRONJ, such as denosumab and angiogenesis inhibitors. The degree of osteonecrosis is also critical, as it is possible to avoid surgical procedures for only conservative methods that sometimes bring good results. Surgical treatment of advanced stages is complicated and carries a high risk of error and complications. MRONJ is a disease that is easy to avoid, but it is difficult to treat and treatment sometimes leads only to a partial remission of the disease, not a complete cure.

Effect of ozone and diode laser (635 nm) in reducing orthodontic pain in the maxillary arch-a randomized clinical controlled trial.

The effect of ozone, diode laser irradiation, and presence of teeth crowding/spacing on pain perception in orthodontic patient was tested. Overall, 76 patients [55 women and 21 men; age 35.1(6.4) years] who met the inclusion criteria participated in the study. Immediately after fixed orthodontic appliance placement, the patients were exposed to a pain relief treatment (one single session) using either 635-nm diode laser (SmartM, Lasotronix, Warsaw, Poland) or ozone therapy (OzoneDTA, Apoza, New Taipei City, Taiwan) by placing the handpieces in the area of each teeth apex and interdental papillae, from the maxillary right first molar to the maxillary left first molar. Subjects were divided into three groups: control group (G1, n = 26), ozone (G2, n = 26, exposed to ozone therapy, generator probe type 3, working time per point 5 s, 23 points, application time 1 min and 55 s), and laser group (G3, n = 25, exposed to continuous mode diode laser, 400 mW, handpiece diameter 8 mm, spot area 0.5024 cm2, power density per second 1.59 W/cm2, dose 2 J per point, time: 5 s per point, 23 points, total energy per session 46 J, application time 1 min and 55 s). The level of teeth crowding was assessed using the Lundstrom indicator. The patients received a questionnaire for pain assessment (the Numeric Rating Scale, NRS-11, grade level 0-10) and recorded at 7 time points (1 h, 6 h, and 1, 2, 3, 4, and 5 days ) after the fixed orthodontic appliance placement. The mean pain values for the diode laser, ozone, and control group were 3.6 (1.31) (95% CI, 2.95-4.25), 5.25 (3.37) (95% CI, 3.52-6.98), and 5.75 (2.40) (95% CI, 4.69-6.81), respectively. We observed lower pain values in the diode laser group compared to the control group (p = 0.0237). The use of ozone in this study did not result in significant pain reduction in comparison to control (p = 0.8040) and laser groups (p = 0.1029). There were no differences in pain perception between patients with crowded teeth and non-crowded teeth in each group (G1, p = 0.66, G2, p = 0.86, G3, p = 0.24). The use of 635-nm diode laser led to decreased pain perception; however, ozone and presence of teeth crowding/spacing did not affect the pain perception in orthodontic patients during the first 5 days after the fixed orthodontic appliance placement.

Photobiomodulation by a 635nm Diode Laser on Peri-Implant Bone: Primary and Secondary Stability and Bone Density Analysis-A Randomized Clinical Trial.

INTRODUCTION: Various procedures in dental implantology are performed to enhance the bone healing process and implant stability. One of these methods can be a low-level laser therapy (LLLT). OBJECTIVES: The aim of our study was to evaluate the stabilization (primary and secondary) and bone density in peri-implant zone after LLLT protocol using a 635 nm diode laser. MATERIAL AND METHODS: The research included 40 implants placed in the posterior region of a mandible in 24 patients (8 women and 16 man; age: 46.7 ± 8.7 years). The patients were randomly divided into 2 groups G1 (n=12, 18 implants) and G2 (n=12, 22 implants) according to the treatment procedure; G1 (test): 635 nm laser, with handpiece diameter: 8mm, output power: 100mW, spot area: 0.5024cm2, average power density: 199.04mW/cm2, continuous mode, dose: 4J per point (8J/cm2), time: 40 sec per point, 2 points (irradiation on a buccal and a lingual side of the alveolus/implant), and total energy per session 8J; G2 (control): no laser irradiation. The G1 (test) group's implants were irradiated according to the following protocol: 1 day before surgery, immediately after the surgery and 2, 4, 7, and 14 days after. The total energy after all therapeutic sessions was 48J. The implants stability was measured employing a Periotest device (Periotest Test Value: PTV) (measured immediately after the surgery, 7 days, 2 weeks, 4 weeks, and 2 and 3 months after the surgery) and the bone density using cone-beam computed tomography (grayscale value) (measured immediately after the surgery, 4 weeks and 12 weeks after the treatment). RESULTS: The average implant stability at different time points showed lower PTV value (higher stability) at 2nd and 4th week after 635 nm laser irradiation (G1) compared with a control (G2) group (p<0.01). The secondary stability of the implants after 12 weeks observation was not significantly higher for the laser group in contrast to none-irradiated implants (p>0.05). The mean grayscale value at the apical, middle, and cervical level of the titanium implants showed the reduction of pixel grayscale value after 2 weeks and was lower for the G1 group in contrast to the G2 group (p<0.01). The value of grayscale after 12 weeks was significantly higher at the middle and apical level of the implants in the G1group in contrast to the G2 group (p<0.01). CONCLUSION: The application of the 635 nm diode laser enhanced secondary implant stability and bone density. However, to assess the impact of the LLLT on peri-implant bone with different bone densities, further well-controlled long-term trials on larger study groups are needed.

[The influence of selected plants on the tobacco smoking-induced effects in the oral cavity--review]. / Wplyw wybranych zwiazków roslinnych na ograniczenie skutków palenia tytoniu w jamie ustnej--przeglad literatury.

Tobacco smoking is a culprit of many pathological lesions on the oral mucosa. In this literature review we focused on various therapeutic options for tobacco induced mucosal pathologies. Many active ingredients of Aloe vera, Chamomile, Curcuma longa and Calendula show potent anti-inflammatory and regenerative activity, making plant derived drugs a reasonable option for traditional pharmaceuticals.