Red, infrared, and simultaneous laser-wavelengths irradiation effects on 5-fluorouracil-induced oral mucositis in hamsters.

The association of more than one wavelength for photobiomodulation therapy (PBMT) to treat oral mucositis (OM) is unusual in the literature. Thus, this study aims to compare the simultaneous irradiation effects with their isolated application to treat OM. In order of that, 48 male Syrian hamsters were divided into 4 groups: Chemotherapy (Ch), which received only a OM induction protocol (5-fluorouracil chemotherapy and superficial oral mucosa scratches); red laser (RL), which received the OM induction and a PBMT protocol at 660 nm; infrared laser (IRL), which received the OM induction, and a PBMT protocol at 808 nm; and the RL + IRL group, which received the simultaneous application, of 660 and 808 nm wavelengths. Clinical (OM grade classification), histological (light microscopy analysis with H&E and collagen staining), immunohistochemical (TNF-α expression), and biochemical (TNF-α and hydroxyproline concentration) analyzes were performed after 7 and 10 days. Mainly on the 10th day, the RL and IRL groups showed lower OM grades and faster microscopic repair process, with greater expression of collagen fibers and lower TNF-α levels, besides the higher hydroxyproline concentrations, mainly in comparison with the Ch group. In conclusion, in this study, the simultaneous protocol did not present superior results than the isolated irradiations.

Management of orofacial lesions with antimicrobial photodynamic therapy and photobiomodulation protocols in patients with COVID-19: A multicenter case series.

Several oral lesions related to COVID-19 have been described in the scientific literature. The COVID-19 pandemic highlighs importance of supportive protocols, which can reduce the inflammation and aid in tissue repair in severe cases. Photobiomodulation therapy (PBMT) alone or in combination with antimicrobial photodynamic therapy (aPDT) can be used to manage orofacial lesions in confirmed cases of COVID-19. Here, we sought to describe the clinical presentation and specificities of three cases in which aPDT and PBMT were used to manage orofacial lesions in patients with COVID-19. The laser protocols were effective with improvement of the orofacial lesions within a few days.

Wound healing process with different photobiomodulation therapy protocols to treat 5-FU-induced oral mucositis in hamsters.

OBJECTIVES: The aim of this study was to analyze the effects of three different Photobiomodulation Therapy (PBMT) protocols in the treatment of 5-fluorouracil-induced oral mucositis in hamsters. DESIGN: 60 hamsters were divided into five groups: group "C", which did not receive oral mucosa scratching, 5-fluorouracil (5-FU) or PBMT; group "Ch", which received anesthesia, superficial oral mucosa scratching and 5-FU (oral mucositis induction); and three groups that received oral mucositis induction and a PBMT protocol: groups ChLI, ChLII and ChLIII that received 0.24 J (one point), 1 J (one point) and 1.2 J (five points of 0.24 J) of energy, respectively. The laser equipment used had λ = 660 nm and 0.04 cm2 of spot area (0.226 cm diameter). The animals were euthanized on days 7 and 10 of the experiment, and their oral mucosas were removed for histological (light microscopy and collagen staining), immunohistochemical (NF-kB and TNF-α), and biochemical (TNF-α, NF-kB and hydroxyproline) analysis. RESULTS: Group ChLI (less energy), showed the most accelerated repair rates and a lower concentration of inflammatory biomarkers than group Ch. Comparing the three PBMT protocols for treatment of 5-FU-induced oral mucositis in hamsters, the one with low energy (0.24 J) showed better results, regarding reduction of inflammatory biomarkers and tissue repair, than the ones with higher energy (1 and 1.2 J).

Early effect of laser irradiation in signaling pathways of diabetic rat submandibular salivary glands.

Low-power laser irradiation (LPLI) is clinically used to modulate inflammation, proliferation and apoptosis. However, its molecular mechanisms are still not fully understood. This study aimed to describe the effects of LPLI upon inflammatory, apoptotic and proliferation markers in submandibular salivary glands (SMGs) in an experimental model of chronic disorder, 24h after one time irradiation. Diabetes was induced in rats by the injection of streptozotocin. After 29 days, these animals were treated with LPLI in the SMG area, and euthanized 24h after this irradiation. Treatment with LPLI significantly decreased diabetes-induced high mobility group box 1 (HMGB1) and tumor necrosis factor alpha (TNF-α) expression, while enhancing the activation of the transcriptional factor cAMP response element binding (CREB) protein. LPLI also reduced the expression of bax, a mitochondrial apoptotic marker, favoring the cell survival. These findings suggest that LPLI can hamper the state of chronic inflammation and favor homeostasis in diabetic rats SMGs.

Phototherapy With LED as an Effective Treatment for Chemotherapy-Induced Oral Mucositis in Hamsters.

Introduction: Oral mucositis (OM) has been considered one of the most feared collateral effects of oncological treatments. Some therapies have been used, such as light-emitting diode (LED), with promising results, but with no sufficient evidence in the literature. Objective: Our study aimed to evaluate, by clinical and histological analysis, the effect of LED on the treatment of chemotherapy-induced OM (CIOM) in an animal model. Methods: Twenty male hamsters were equally distributed to two groups: control (C), which received anesthesia and CIOM induction; and LED (L), which received anesthesia, CIOM induction, and LED treatment (635 nm, 120 mW, 0.48 J). The clinical analysis was performed through two specific scales for OM analysis on days 5, 7 and 10 of the experiment. In addition, the injured area of all hamsters check pouch mucosa was removed and processed for histological analysis on the last experimental day. Results: After statistical analysis, group L showed less severity of OM when compared with the C group (P <0.05); beyond that, both healed completely on day 10. Conclusion: Our results suggested that the phototherapy with LED had a positive effect on accelerating repair, reducing the severity of CIOM.

Treating Acute Cervical Radiodermatitis with Photobiomodulation Therapy: A Report of Two Cases.

Objective: The objective of this study was to report the application of photobiomodulation therapy (PBMT) in the treatment of two patients diagnosed with acute cervical radiodermatitis (RD) induced by radiotherapy. Background data: An undesirable effect of radiotherapy, RD often poses a limitation to the continuity of treatment that can negatively affect the control and prognosis of the disease. RD is frequently associated with pain and aesthetic impairment and can significantly influence quality of life. Many agents used to prevent and treat RD do not have sufficient scientific evidence to support its use. Materials and methods: In both clinical cases, the patients presented RD degree 3 and were in drug treatment, with no satisfactory response, and PBMT was started. Two diode lasers were used, with a dose of 35.71 J/cm2, 10 sec/point, 100 mW of power, and a beam area of 0.028 cm2 and dose of 27.77 J/cm2, 25 sec/point, 40 mW, and 0.036 cm2 beam area. Both lasers were applied at the wavelength of red, daily, in contact and perpendicular to the skin, to deliver 1 J/point/1.5 cm, which covered the entire area affected with RD. Results: The PBMT made possible an expressive improvement in the healing process and reduction of painful symptoms associated with RD. Conclusions: Although PBMT facilitated healing and reduced pain experienced with RD, randomized controlled trials are needed to evaluate all of its possible benefits.

Phototherapy is unable to exert beneficial effects on orthodontic tooth movement in rat molars.

OBJECTIVES: To investigate the effects of irradiation lasers and light-emitting diode (LED) light on root resorption in rat molars during orthodontic tooth movement (OTM). MATERIALS AND METHODS: Twenty-one 12-week-old Wistar male rats were divided into three groups: OTM only (control [CG]), OTM and LED irradiation (DG), and OTM and low laser irradiation therapy (LG). The distance between the first and second molars was used to evaluate the amount of tooth movement. The mesial surfaces of the distopalatal roots were analyzed by scanning electron microscopy, and the area of the resorption was calculated. RESULTS: Statistical analysis showed a decreased amount of tooth movement in the exposed DG or LG compared with CG, which was statistically significant (P = .031 and P = .004, respectively). However, when the DG and LG groups were compared, no statistically significant differences were found (P = .504). The root resorption areas were similar between CG and DG. However, statistically significant differences were found between LG and CG (P = .014) and LG and DG (P = .038). CONCLUSIONS: Phototherapy did not enhance tooth movement, while infrared laser irradiation did increase root resorption.

Terapia de fotobiomodulação no tratamento das lesões orais da síndrome de Stevens-Johnson: relato de caso / Photobiomodulation therapy in the treatment of Stevens-Johnson syndro-me oral lesions: case report

Introdução: A Síndrome de Stevens-Johnson é uma reação rara que se manifesta por exantema que evolui para um extenso deslocamento epidérmico. Na maioria dos casos, há o surgimento de lesões dolorosas em mucosa oral, que podem reduzir a ingestão de nutrientes e dificultar a higiene bucal. A terapia de fotobiomodulação pode ter um importante papel antálgico, na modulação da inflamação e na cicatrização dessas lesões. Objetivo: Relatar um caso clínico no qual as lesões orais da Síndrome de Stevens-Johnson foram tratadas com o auxílio da terapia de fotobiomodulação. Relato de caso: Paciente de 17 anos, do sexo feminino, com diagnóstico de síndrome de Stevens-Johnson, apresentava-se com edema labial, úlceras orais, febre e odinofagia intensa, com tolerância apenas para dieta líquida. Encontrava-se com redução da ingestão alimentar, sem comunicação oral eficiente e com interrupção da higiene bucal devido a dor intensa. A terapia de fotobiomodulação foi utilizada no tratamento das lesões orais. Conclusão: A terapia de fotobiomodulação auxiliou na redução da dor, favoreceu a ingestão de alimentos por via oral e reduziu o tempo de cicatrização das lesões.

Introduction: Stevens-Johnson Syndrome is a rare reaction manifested by a rash that evolves into extensive epidermal dislocation. In most cases there are painful oral mucosal lesions that can reduce nutrient intake and make oral hygiene difficult. Photobiomodulation therapy can play an important antalgic role in modulating inflammation and healing these lesions. Objective: To report a clinical case in which Stevens-Johnson Syndrome oral lesions were treated with the aid of photobiomodulation therapy. Case Report: A 17-year-old female patient diagnosed with Stevens-Johnson syndrome presented with lip edema, oral ulcers, fever, and severe odynophagia, tolerating only a liquid diet. She experienced reduced food intake, no efficient oral communication, and an interruption of oral hygiene due to intense pain. Photobiomodulation therapy was requested to treat the oral lesions. Conclusion: Photobiomodulation therapy helped reduce pain, favored oral food intake, and reduced lesion healing time.

Osteoradionecrosis of the jaws: case series treated with adjuvant low-level laser therapy and antimicrobial photodynamic therapy.

BACKGROUND: Osteoradionecrosis of the jaw (ORNJ) is the most severe and complex sequel of head and neck radiotherapy (RT) because of the bone involved, it may cause pain, paresthesia, foul odor, fistulae with suppuration, need for extra oral communication and pathological fracture. We treated twenty lesions of ORNJ using low-level laser therapy (LLLT) and antimicrobial photodynamic therapy (aPDT). The objective of this study was to stimulate the affected area to homeostasis and to promote the healing of the oral mucosa. METHODS: We performed aPDT on the exposed bone, while LLLT was performed around the bone exposure (red spectrum) and on the affected jaw (infrared spectrum). Monitoring and clinical intervention occurred weekly or biweekly for 2 years. RESULTS: 100% of the sample presented clinical improvement, and 80% presented complete covering of the bone exposure by intact oral mucosa. CONCLUSION: LLLT and aPDT showed positive results as an adjuvant therapy to treat ORNJ.

Low-power laser irradiation decreases lipid droplet accumulation in the parotid glands of diabetic rats.

Lipid droplet accumulation has been related to salivary gland hypofunction in diabetes. In this study, the effect of laser irradiation on the parotid glands (PGs) of diabetic rats was analyzed with regard to its effect on lipid droplet accumulation, intracellular calcium concentration and calmodulin expression. The animals were distributed into 6 groups: D0, D5, D20 and C0, C5, C20, for diabetic (D) and control animals (C), respectively. Twenty-nine days following diabetes induction, PGs of groups D5 and C5; D20 and C20 were irradiated with 5 and 20 J/cm2 of a red diode laser at 100 mW, respectively. After 24 hours, PGs were removed for histological, biochemical, and western blotting analysis. The diabetic animals showed lipid droplet accumulation, which was decreased after irradiation. Ultrastructurally, the droplets were nonmembrane bound and appeared irregularly located in the cytoplasm. Moreover, diabetic animals showed an increased intracellular calcium concentration. In contrast, after laser irradiation a progressive decrease in the concentration of this ion was observed, which would be in agreement with the results found in the increased expression of calmodulin in D20. These data are promising for using laser to decrease lipid droplet accumulation in PGs, however, more studies are necessary to better understand its mechanisms. Micrographs showing decreased lipid accumulation after laser irradiation in light micrographs (LM), and morphology of lipid droplet in transmission electron microscopic (TEM). LM: (A) PGs from nondiabetic rats that did not receive Laser irradiation (LI), (B) PGs from nondiabetic rats that received a dose of 20 J/cm2 , (C) lipid accumulation (arrows) in the secretory cells from diabetic rats that did not receive irradiation, (D) reduction of lipid accumulation in the secretory cells from diabetic rats that received a dose of 20 J/cm2 and TEM: (E) scale bar = 5 µm, (F) scale bar = 1 µm, and (G) scale bar = 0.5 µm.

Osteoradionecrosis of the jaws: case series treated with adjuvant low-level laser therapy and antimicrobial photodynamic therapy

Abstract Background: Osteoradionecrosis of the jaw (ORNJ) is the most severe and complex sequel of head and neck radiotherapy (RT) because of the bone involved, it may cause pain, paresthesia, foul odor, fistulae with suppuration, need for extra oral communication and pathological fracture. We treated twenty lesions of ORNJ using low-level laser therapy (LLLT) and antimicrobial photodynamic therapy (aPDT). The objective of this study was to stimulate the affected area to homeostasis and to promote the healing of the oral mucosa. Methods: We performed aPDT on the exposed bone, while LLLT was performed around the bone exposure (red spectrum) and on the affected jaw (infrared spectrum). Monitoring and clinical intervention occurred weekly or biweekly for 2 years. Results: 100% of the sample presented clinical improvement, and 80% presented complete covering of the bone exposure by intact oral mucosa. Conclusion: LLLT and aPDT showed positive results as an adjuvant therapy to treat ORNJ.

The Effects of Low-Power Laser Irradiation on Inflammation and Apoptosis in Submandibular Glands of Diabetes-Induced Rats.

Diabetes can lead to dysfunction of the secretory capacity in salivary glands. Activation of the receptor for advanced glycation end products (RAGE) and its ligands has been suggested to participate in chronic disorders such as diabetes and its complications. In this study, the expression of RAGE, high mobility group box 1 (HMGB1) and advanced glycation end products (AGE), as well as the effects of low-power laser irradiation (LPLI) in salivary glands of diabetic rats were evaluated, and the mechanisms involved were characterized. The expression of RAGE and HMGB1 at the protein and mRNA levels was observed in submandibular glands (SMGs) of streptozotocin-induced diabetic rats. A diode laser was applied at 660 nm, 70 mW, 20 J/cm2, 0.56 J/point, with a spot area of 0.028 cm2 and its in vivo effects and the pathways involved were evaluated. Immunohistochemistry and western blotting analysis were performed for inflammatory and apoptosis markers. Diabetes up-regulates HMGB1/AGE/RAGE axis gene expression in SMGs that is associated with activation of the nuclear factor kappa B (NF-κB) pathway. Interestingly, LPLI suppresses NF-κB activation induced by inflammation. LPLI also reduces diabetes-induced apoptosis. That effect was accompanied by decreased levels of Bax, and cleaved caspase 3, which were up-regulated in diabetes. Taken together, our data suggest that LPLI reduces diabetes-induced inflammation by reducing the induction of HMGB1, ultimately leading to inhibition of apoptosis in submandibular glands of diabetic rats.

Dosimetric study of photobiomodulation therapy in 5-FU-induced oral mucositis in hamsters.

Oral mucositis (OM) is a debilitating consequence of cancer treatment that could be treated with photobiomodulation therapy (PBMT); however, there is no consensus about its dosimetric parameters for OM healing. The aim of this study was to compare different PBMT protocols on OM treatment, through clinical and histological analysis. Thirty hamsters were used, in an induced model of OM by 5-fluorouracil (5-FU) and superficial scratching, in seven days of follow-up. The animals were divided into five groups: control (C), which received only anesthesia and chemotherapeutic vehicle; chemotherapy (Ch), which received anesthesia, 5-FU, and scratches; laser 1 (L1), the same as Ch group, PBMT 6 ?? J / c m 2 and 0.24 J (one point); laser 2 (L2), the same as Ch group, PBMT 25 ?? J / c m 2 and 1 J (one point); and laser 3 (L3), the same as Ch group, PBMT 4 points of 0.24 J and 6 ?? J / c m 2 each. The laser used has ? = 660 ?? nm , 0.04 ?? c m 2 of spot area, and 40 mW. The best PBMT protocol to maintain lowest OM levels compared to Ch group was L1, followed by L2 and L3. Our results suggest that the application mode of PBMT and the energy delivered per area could interfere with the OM healing.

Low-power laser irradiation in salivary glands reduces glycemia in streptozotocin-induced diabetic female rats.

Low-power laser irradiation (LPLI) has been extensively employed to modulate inflammation in vitro and in vivo. Previous reports from our group indicated that LPLI might regulate glycemia in diabetic animals. Diabetes results in chronic hyperglycemia and therefore chronic inflammation by upregulation of inflammatory markers such as the high mobility group box 1 (HMGB1) protein. Thus this study aimed to analyze the LPLI effects upon blood glucose levels, plasma insulin and HMGB1 concentrations in a diabetes experimental rat model. Streptozotocin-induced diabetic rats were irradiated in the salivary glands area with a diode laser applied at 660 nm, 70 mW, 20 J/cm2 , 22.4 J, with a spot area of 0.028 cm2 and its effects were evaluated. LPLI significantly reduced diabetic rat hyperglycemia, without changing insulin or HMGB1 plasma levels, but possibly by ameliorating the insulin resistance in these animals. These findings suggest that LPLI might have a systemic effect, but more studies are necessary to better understand its mechanisms. Fasting blood glucose measured by peroxidase-glucose oxidase (PGO) method (A), showing a reduction of diabetic animals glycemia after LPLI. LPLI probably reduced the hyperglycemia in diabetes by improving the insulin resistance in these animals (B). C n = 10, CL n = 10, D n = 7 and DL n = 8. Data are expressed as mean ± SD; * P < 0.05 vs. respective control group; # P < 0.05 vs. D group.

Comparative study among three different phototherapy protocols to treat chemotherapy-induced oral mucositis in hamsters.

In this study, clinical, biochemical and histological analysis were used to compare different phototherapies, including LED, low and high-power laser (HPL) for the treatment of chemotherapy (CT)-induced oral mucositis (OM). One-hundred-fifty hamsters were divided into five groups: C: control; CH: CT/OM induction; L: CT/OM induction and treatment with LED (635 nm, 1.2 J), HL: CT/OM induction and treatment with HPL (808 nm, 10 J), LL: CT/OM induction and treatment with low-level laser therapy (LLLT) (660 nm, 1.2 J). OM was induced by scratches performed on check pouch mucosa after two injections of 5-Fluorouracil. The experiment lasted 10 days and OM was analyzed by specific clinical scales on days 5, 7 and 10. The animals were euthanized and the cheek pouch mucosa removed for biochemical (TNF-α concentration) and histological (light microscopy) analysis. After statistical analysis, the authors' results showed LED and LLLT therapies were efficient treatments for OM, decreasing TNF-α concentration on day 7 (p < 0.05) and completely healing the mucosa on day 10. HPL showed no interference in final healing of OM. According to the methodology used and the results obtained in the present study, LLLT and LED therapies were the best choices to decrease the severity of OM, accelerating tissue repair and decreasing the inflammatory process. Clinical evaluation of OM in Groups CH, LL, L and HL and their respective arrangement of phototherapy treatments at different time intervals (5, 7 and 10 days).

Diabetes: noções gerais para o Cirurgião-Dentista / Diabetes: general characteristics for dentists

Diabetes mellitus é uma enfermidade crônica de origem endocrinológica e que afeta mais de 170 milhões de pessoas no mundo e possui como principal característica a hiperglicemia. Na Odontologia, alguns estudos mostram que os pacientes diabéticos descompensados reportam algumas alterações na cavidade oral, relacionadas com o estado hiperglicêmico, como por exemplo, xerostomia e hipossalivação, aumento nos índices de cárie e doença periodontal e alteração na reparação tecidual. Com isto, este trabalho tem o objetivo de levar aos cirurgiões dentistas conceitos, características da doença, complicações orais relacionadas com o Diabetes mellitus e algumas opções de terapias para estas complicações orais, como a laserterapia e a terapia fotodinâmica antimicrobiana.

Diabetes mellitus consists of a group of metabolic diseases characterized by hyperglycemia, resulting from disorders in insulin secretion, insulin action or both. A higher incidence of oral diseases, related to poorly controlled diabetes, can be observed in diabetic patients, such as xerostomia, hyposalivation, higher risk of infection, carious lesions, taste alterations, in addition to inadequate preparation of food for digestion. Thus, the aim of this study was to get some important information about this disease, for dentistis, as well as some therapeutic options for oral complications, suh as lasertherapy and antimicrobial photodynamic therapy.

Laser Therapy in the Treatment of Paresthesia: A Retrospective Study of 125 Clinical Cases.

OBJECTIVE: The aim of this retrospective study was to evaluate the effectiveness of laser therapy for acceleration and recovery of nerve sensitivity after orthognathic or minor oral surgeries, by analysis of clinical records of patients treated at the Special Laboratory of Lasers in Dentistry (LELO, School of Dentistry, University of São Paulo), throughout the period 2007-2013. BACKGROUND DATA: Nerve tissue lesions may occur during various dental and routine surgical procedures, resulting in paresthesia. Laser therapy has been shown to be able to accelerate and enhance the regeneration of the affected nerve tissue; however, there are few studies in the literature that evaluate the effects of treatment with low-power laser on neural changes after orthognathic or minor oral surgeries. METHODS: A total of 125 clinical records were included, and the data on gender, age, origin of the lesion, nerve, interval between surgery and onset of laser therapy, frequency of laser irradiation (one or two times per week), final evolution, and if there was a need to change the irradiation protocol, were all recorded. These data were related to the recovery of sensitivity in the affected nerve area. Descriptive analyses and modeling for analysis of categorical data (α=5%) were performed. RESULTS: The results from both analyses showed that the recovery of sensitivity was correlated with patient age (p=0.015) and interval between surgery and onset of laser therapy (p=0.002). CONCLUSIONS: Within the limits of this retrospective study, it was found that low- power laser therapy with beam emission band in the infrared spectrum (808 nm) can positively affect the recovery of sensitivity after orthognathic or minor oral surgeries.

Clinical, biochemical and histological study of the effect of antimicrobial photodynamic therapy on oral mucositis induced by 5-fluorouracil in hamsters.

Oral mucositis (OM) is a debilitating side effect of chemotherapy, which can be relieved by phototherapy. Antimicrobial photodynamic therapy (aPDT) may be used for the treatment of OM, when infection is present. However, there are no studies showing that aPDT affects tissue repair process when used in the treatment of lesions caused by OM. This work aims to evaluate the effect of aPDT in healing OM induced by 5-Fluorouracil (5-FU). Two hundred forty-five hamsters were divided into two groups, control (C) and experimental, which were subdivided into 4 subgroups (Ch, ChP, ChL, aPDT). C group received only the vehicle of chemotherapy and anesthesia, whereas all animals of the experimental groups received anesthesia and chemotherapy agent 5-FU to induce OM. Ch group received no OM treatment; ChP group received an application of methylene blue (MB) 0.01%; ChL received irradiation with low-power-laser (LPL-660 nm/120 J /cm(2)/40 mW/4.4 J per point); and aPDT received MB and LPL irradiation. OM Clinical severity were daily assessed by a blinded examiner. The animals were sacrificed after 5, 7 and 10 days of experiment and their oral mucosa were removed for biochemical (enzymatic activity of SOD and catalase) and histological analyzes (light microscopy). After statistical analysis was performed, results showed that aPDT reduced the severity of OM on the tenth day of the experiment, when compared to the initial OM score (p < 0.05), as well as increased keratinization with organized collagen deposition in the lamina propria. In conclusion, aPDT can be safely used in animals with infected OM because it does not affect lesion-repairing processes.

Low-level laser irradiation promotes the proliferation and maturation of keratinocytes during epithelial wound repair.

Low-level laser therapy (LLLT) has been extensively employed to improve epithelial wound healing, though the exact response of epithelium maturation and stratification after LLLT is unknown. Thus, this study aimed to assess the in vitro growth and differentiation of keratinocytes (KCs) and in vivo wound healing response when treated with LLLT. Human KCs (HaCaT cells) showed an enhanced proliferation with all the employed laser energy densities (3, 6 and 12 J/cm(2) , 660 nm, 100 mW), together with an increased expression of Cyclin D1. Moreover, the immunoexpression of proteins related to epithelial proliferation and maturation (p63, CK10, CK14) all indicated a faster maturation of the migrating KCs in the LLLT-treated wounds. In that way, an improved epithelial healing was promoted by LLLT with the employed parameters; this improvement was confirmed by changes in the expression of several proteins related to epithelial proliferation and maturation. Immunofluorescent expression of cytokeratin 10 (red) and Cyclin D1 (green) in (A) Control keratinocytes and (B) Low-level laser irradiated cells. Blue color illustrates the nuclei of the cells (DAPI staining).