Experience with 808-nm diode laser in the treatment of 47 cases of oral vascular anomalies.

Treatment of oral vascular anomalies (OVA) has focused on minimally invasive techniques rather than radical surgery. We investigated the efficacy and safety of diode laser using the photocoagulation technique in the management of OVA. Forty-seven subjects with OVA were treated with forced dehydration with induced photocoagulation (FDIP) using diode laser (808 nm/4.5 W). This series consisted mostly of male (63.8%) and non-white (63.8%) patients with a mean age of 57.4 years. Varices (91.5%), venous malformations (6.4%), and hemangiomas (2.1%) with a mean size of 7.1 (±4.9) mm were the conditions treated. OVA presented as a nodular lesion (63.8%) involving mainly the lower lip (46.8%). Pulsed laser mode was used as standard and the number of applications varied from one to four sessions, with the majority requiring only one (83%) FDIP session. Kaplan-Meier analysis revealed that complete clinical healing can occur on the 15th day (n=9/29.5%), followed by the 20th (n=6/45.5%), and 30th (n=7/70.5%) days. Postoperative edema was observed in 31 (66%) patients, and recurrence of the lesion occurred in two (4.2%). Based on the data on complete clinical healing, minimal patient discomfort, and satisfactory esthetic results, we can confirm that FDIP by diode laser is a promising candidate for the safe and efficacious treatment of OVA.

Exploring the association between a standardized extract of pequi peels (Caryocar brasiliense Cambess) and blue light as a photodynamic therapy for treating superficial wounds.

Natural products derived from plants can be used as photosensitizers for antimicrobial photodynamic therapy (aPDT) combining key therapeutic strategies for tissue repair while controlling microorganisms' growth. We investigated a standardized extract of pequi peels (Caryocar brasiliense Cambess) as a brownish natural photosensitizer for aPDT using blue light. Three concentrations of the pequi extract (PE; 10, 30, or 90 µg/mL) were tested solely or associated with blue laser (445 nm, 100 mW, 138 J/cm2 , 6 J, 60 s). In vitro, we quantified reactive oxygen species (ROS), assessed skin keratinocytes (HaCat) viability and migration, and aPDT antimicrobial activity on Streptococcus or Staphylococcus strains. In vivo, we assessed wound closure for the most active concentration disclosed by the in vitro assay (30 µg/mL). Upon aPDT treatments, ROS were significantly increased in cell monolayers regardless of PE concentration. PE at low doses stimulates epithelial cells. Although PE stimulated cellular migration, aPDT was moderately cytotoxic to skin keratinocytes, particularly at the highest concentration. The antimicrobial activity was observed for PE at the lowest concentration (10 µg/mL) and mostly at PE 10 µg/mL and 30 µg/mL when used as aPDT photosensitizers. aPDT with PE 30 µg/mL presents antimicrobial activity without compromising the initial phases of skin repair.

Proposal of a prophylactic photobiomodulation protocol for chemotherapy-induced oral and oropharyngeal mucositis: a randomized clinical trial.

Photobiomodulation therapy (PBMT) is widely used in oncology settings, but lack of assessment standardization is the main barrier to optimization of clinical protocols. This study analyzed three PBMT protocols for preventing oral and oropharyngeal mucositis (OM) in patients undergoing chemotherapy (CT) and/or hematopoietic stem cell transplantation (HSCT). This is a preliminary randomized blind clinical trial. Group 1 received intraoral prophylactic PBMT, Group 2 received intraoral and oropharyngeal PBMT, and Group 3 received intraoral, oropharyngeal, and extraoral PBMT. The applications were from the first day of CT to day + 10. Clinicodemographic data, CT regimens, types of HSCT, hematological exams, occurrence/severity of OM, odynophagia, and OM-related opportunistic infections were assessed. Sixty participants (age range: 18-74 years) were included; 70% of them underwent CT and 30% HSCT. About 43.3% of patients had OM, while odynophagia was reported by 23.3%. Both Groups 1 and 2 revealed better results. Multivariate analysis showed that HSCT directly influenced the occurrence of OM. Individuals who had undergone allogeneic HSCT were 1.93 times more likely to develop OM (p < 0.001). Group 3 exhibited a higher frequency of OM, albeit of lower grades. This group consisted of half the population who had undergone HSCT, had the highest percentage of melphalan use, and had the lowest mean leukocyte count. The three proposed protocols were effective in preventing and reducing OM, with good tolerance and no reported adverse effects. PBMT is a safe and effective approach to OM prophylaxis in adults undergoing CT/HSCT.

Management of oral leukoplakia with an 808-nm high-power diode laser: a single-center experience.

PURPOSE: High-power diode laser emerges as a promising approach to the treatment of oral leukoplakia (OL); however, its short- and long-term effects have been barely explored. This study evaluated the postoperative endpoints and the recurrence rate of high-power diode laser treatment in a well-defined series of patients with OL. METHODS: A prospective analysis was performed on 22 individuals comprising 31 OL. The lesions were irradiated using the following protocol: Indium-Gallium-Arsenide diode laser, 808 nm, continuous-wave mode, 1.5-2.0 W, 780.0 ± 225.1 J, and 477.1 ± 131.8 s. Postoperative pain was assessed with a visual analog scale at three endpoints. Clinical follow-up was performed on all patients and the Kaplan-Meier test was used to analyze the probability of recurrence. RESULTS: The series consisted mostly of women (72.7%) with a mean age of 62.8 years. A single laser session was performed in 77.4% of cases. The median score on the scale that assessed pain on the 1st, 14th and 42nd postoperative day was 4, 1, and 0, respectively. The mean follow-up period per lesion was 28.6 months (range: 2-53 months). A complete response was observed in 93.5% of OL cases, while 6.5% had recurrence. The probability of recurrence at 39 months was 6.7%. No patient experienced malignant transformation. CONCLUSION: High-power diode laser for the treatment of OL is safe and effective during the trans- and postoperative period. These findings represent an alternative approach to the management of OL, mainly because a low recurrence rate was observed.

Guided Tissue Regeneration in Class IV External Cervical Resorption: A Case Report.

External cervical resorption (ECR) is a type of dental resorption that originates from the loss of the cementum's protective layer. The direct exposure of dentin to the periodontal ligament may lead to the invasion of clastic cells through an entry point on the external root surface into the dentinal tissue, causing resorption. Depending on the extension of ECR, different treatments are proposed. Although the literature presents distinct materials and methods for restoring ECR areas, an existing gap is related to care in the treatment of the supporting periodontal tissue. Guided tissue regeneration (GTR)/guided bone regeneration includes the stimulation of bone formation in bone defects using different types of membranes (resorbable and nonresorbable), regardless of its association with bone substitutes or grafts. Despite the benefits of guided bone regeneration, the application of this method in cases of ECR is still under-explored in the literature. Thus, the present case report uses GTR with xenogenic material and polydioxanone membrane in a case of class IV ECR. The success of the present case is related to the correct diagnosis and treatment plan. Complete debridement of resorption areas and restoration with biodentine were effective in tooth repair. GTR contributed to the stabilization of supporting periodontal tissues. The association of the xenogeneic bone graft with the polydioxanone membrane proved to be a viable option for restoring the health of the periodontium.

Evaluation of periodontal parameters and gingival crevicular fluid cytokines in children with anterior open bite receiving passive orthodontic treatment with a spur.

Objective: To evaluate clinical parameters and gingival crevicular fluid (GCF) cytokines in children with anterior open bite receiving passive orthodontic treatment with spurs. Methods: Twenty children with indications for interceptive orthodontic treatment, an anterior open bite, and good oral hygiene and periodontal health were included in this study. GCF samples were collected from the mandibular and maxillary central incisors before (baseline) and 24 hours and 7 days after spur bonding. Clinical and periodontal examinations and cytokine analyses were performed. Results: At 7 days after spur attachment, gingival bleeding in the mandibular group was increased relative to that in the maxillary group. Visible plaque was correlated with gingival bleeding at 7 days and the GCF volume at 24 hours after spur attachment. Compared with those at baseline, interleukin (IL)-8 levels in the maxillary group and IL-1ß levels in both tooth groups increased at both 24 hours and 7 days and at 7 days, respectively. At 24 hours, IL-8, IL-1ß, and IL-6 levels were higher in the maxillary group than in the mandibular group. Cytokine production was positively correlated with increased GCF volume, but not with gingival bleeding, visible plaque, or probing depth. Conclusions: Although orthodontic treatment with spurs in children resulted in increased gingival bleeding around the mandibular incisors, IL levels were higher around the maxillary incisors and not correlated with periodontal parameters. Increased cytokine levels in GCF may be associated with the initial tooth movement during open bite correction with a passive orthodontic appliance in children.

The use of antimicrobial photodynamic therapy in the successful management of an invasive cervical resorption class 4: A case report with five years follow-up.

A 41-year-old male with a dental history of invasive cervical resorption (ICR) was initially treated with a surgical endodontics approach and secondly with antimicrobial photodynamic therapy (aPDT) along with endodontic retreatment. The use of aPDT was essential to promote bacterial reduction in the resorption defect. Combining these techniques allowed for clinical, radiographic, and tomographic success after five years of follow-up.

Antimicrobial photodynamic therapy and guided endodontics: A case report.

A 35-year-old woman with a history of pulp canal obliteration (PCO) and apical periodontitis was treated with guided endodontics combined with antimicrobial photodynamic therapy (aPDT). The use of aPDT was paramount to the approach performed, and its application should be encouraged in cases of severely calcified canals when apical patency is unachievable. The combination of these techniques ensured successful clinical, radiographic, and tomographic outcomes at the 1-year follow-up. Key Words: Antimicrobial PDT, guided endodonics, periodontitis, pulp canal obliteration.

Lingual Lymphangioma Ablation With High Power Diode Laser: A Case Report.

Introduction: Lymphangioma is a rare vascular anomaly that affects the lymphatic vessels. Its etiology is not yet clear and it usually occurs in the head and neck region. This pathology is commonly diagnosed in childhood and there is no consensus about the most effective treatment of it. Case Report: We report a case of lymphangioma located on the dorsum of the tongue in a 9-year-old boy, with the clinical appearance of small transparent vesicles similar to "frog-eggs". The diagnosis was defined according to the clinical aspect and ultrasound images. The treatment performed consisted of two sessions of ablation with a high-power diode laser. Conclusion: High-intensity diode laser ablation was a safe and effective tool for the treatment of this lesion in the tongue, which provided the patient with a faster, efficient transoperative period and a more comfortable postoperative period.

Use of a High-Power Laser for Wound Healing: A Case Report.

Introduction: The use of low-level laser therapy to treat wounds and accelerate tissue healing has extensively been studied in recent years. The aim of this article is to describe a clinical case using an unfocused high-power laser instead of a low-power laser for therapy. Case Report: In the present article, we present the use of a high-power diode laser to treat an extensive knee injury that occurred after surgical treatment for total prosthesis due to border ischemia resulting from prolonged use of autostatic retractors. Conclusion: It is possible to use an unfocused high-power laser at a decreased intensity to accelerate healing as an adjuvant in the treatment of complicated wounds. This procedure results in reduced application time and cost and an excellent tissue response pattern similar to that reported in the literature with low-power lasers.

Antimicrobial Photodynamic Therapy associated with long term success in endodontic treatment with separated instruments: A case report.

This paper describes a case with a 5- year follow-up of Antimicrobial Photodynamic Therapy (aPDT) associated with long-term success in endodontic treatment in a tooth with separated instruments. The patient presented with a tooth exhibiting a periapical lesion, slight swelling, and severe pain. A radiograph revealed the presence of two separated files in the middle and apical thirds of the mesial root on a lower first molar. Attempts at bypassing were not successful. In the mesial root, instrumentation was limited to the coronal ends of the separated instruments. The apical patency could not be achieved due to the blockage of the separated files. aPDT was performed in two visits, at a 660-nm wavelength and 100 mW of power, for 90 s to a total energy of 9.0 Joules. Methylene blue solution was used as photosensitizer at concentration of 0005%. A 300-µm light diffusor was coupled to the diode laser and was inserted into the root canal 2 mm short of WL, where it was set to allow better diffusion of light. Each root canal was sealed with gutta-percha by warm vertical compaction and Pulp Canal Sealer™. After 5 years of follow-up, clear evidence of remineralization of the radiolucency and bone healing was observed. This case report suggests that the addition of aPDT to conventional endodontic treatment improved microbial disinfection leading to a successful long-term outcome.

Use of Surgical Laser for Excision of a Neurofibroma Associated With Neurofibromatosis Type-1.

Introduction: Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder that affects approximately 1/3500 individuals. Various bone manifestations and peripheral nerves neoplastic lesions associated with NF1 are seen in the jaws. Several oral manifestations may occur in this disorder; therefore the dentist's knowledge and multidisciplinary management of these patients are extremely important. Case Presentation: In the present article, we present the use of a high-power surgical laser to excise a neurofibroma in a patient with several intraoral manifestations associated with NF1. Conclusion: The use of diode laser (808 nm) for excision biopsy of tongue nodules showed no thermal damage to the tissue, allowing an adequate histopathological analysis of the neurofibroma.

Evaluation of polymeric PLGA nanoparticles conjugated to curcumin for use in aPDT

ABSTRACT Antimicrobial photodynamic therapy (aPDT) involves the association of a photosensitizing agent with a light source with the goal of causing apoptosis or microbial lysing. The use of compounds with natural active principles is gaining prominence throughout the world. Several studies from groups that are linked to the development of innovations in the pharmaceutical market have used natural dyes, such as curcumin, the efficacy of which has been demonstrated in aPDT trials. Difficulties related to physicochemical stability, solubility and cell penetration are some of the challenges associated with this field. The present work aimed to prepare, investigate the characteristics and improve the photodynamic activity of PLGA-based nanoparticles loaded with curcumin for use in aPDT therapy. Using the simple technique of emulsion during the evaporation of a solvent, the particles were built, characterized and tested against microorganisms with importance for medicine and dentistry. The results revealed that the particles were able to protect the curcumin against degradation and eliminate some microorganism species at nanomolar concentrations.

Avaliação das superfícies de implantes dentários com tratamento a laser / Evaluation of dental implant surfaces with laser treatment

O objetivo deste trabalho foi apresentar uma revisão da literatura sobre superfícies de implantes dentários com tratamento a laser. O laser é uma amplificação da luz que, dependendo de sua intensidade e interação com a matéria, é capaz de gerar mudanças morfológicas e químicas em ligas de metais, como as de titânio, usadas em Odontologia. Diversos tipos de tratamentos a laser vêm sendo estudados para criar superfícies rugosas em implantes dentais osseointegráveis. Atualmente, as superfícies rugosas de implantes dentários, comparadas às superfícies usinadas, apresentam melhor resposta biológica do hospedeiro, diminuindo o período de osseointegração e permitindo ao profissional que realize reabilitações protéticas mais rápidas e seguras.

The aim of this work is to present a literature review regarding dental implants surfaces treated by lasers. Laser is a light amplifi cation that depending of the intensity and matter interaction, is capable to cause morphologic and chemical changes in metal alloys, such as, titanium alloy used in dentistry. Several types of surface laser treatments has been studied to create rough surfaces in osseointegrated dental implants. In the last few years, the rough surfaces of dental implants compared to machined surfaces, presented better biologic response of the host, reducing the osseointegration period, enabling professionals to have a possibility to perform faster and more secure prosthodontic rehabilitation.

Terapia fotodinâmica antimicrobiana no tratamento de candidíase em paciente com prótese total mucossuportada superior - relato de caso / Candidiasis treatment with antimicrobial photodynamic therapy in patient with upper complete denture - case report

As próteses totais mucossuportada têm por objetivo reabilitar o sistema estomatognótico de pacientes desdentados totais, restabelecendo a saúde das estruturas de suporte bucais. Apesar da constante busca pela perfeição na confecção de próteses totais, lesões como a Candidíase podem estar associadas ao seu uso. O objetivo deste trabalho foi apresentar um caso clínico de estomatite protética tratada por meio da Terapia Fotodinâmica Antimicrobiana (aPDT), associada ao tratamento protético. O presente estudo mostrou que a luz emitida pelo laser associada ao CHIMIOLUX© foi eficiente em reduzir o número de células de C. albicans e regredir as manifestações clínicas da candidíase atrófica crônica. Assim, aPDT pode ser considerada uma alternativa viável ao tratamento coadjuvante para as lesões fúngicas intraorais e alternativa terapêutica para desinfecção de PTM. Apesar da eficiência da aPDT, a necessidade de orientar o paciente quanto … mudança de hábitos de higiene bucal e utilização de próteses adaptadas são de grande importância na manutenção da saúde dos tecidos orais

Complete mucous membrane-supported dentures aim to rehabilitate the stomatognathic system of edentulous patients, restoring oral health. Even with a constant search to improve complete dentures’ manufacturing process some adverse effects such as candidiasis may still occur. The aim of this study was to present a clinical case of denture stomatitis treated by Antimicrobial Photodynamic Therapy (aPDT), associated with prosthetic treatment. This study showed that the laser light associated with CHIMIOLUX© is effective in reducing the number of cells of C. albicans and to reverse clinical manifestations of chronic atrophic candidiasis. Thus, the aPDT can be considered a viable alternative to adjuvant treatment for denture stomatitis caused by C. albicans and to reverse clinical manifestations of chronic atrophic candidiasis. The aPDT can also be used for disinfection of complete dentures. Despite the efficiency of the aPDT, counseling the patients about oral hygiene and the use of adapted prostheses has great importance in preserving the health of oral tissues

Photodynamic inhibition of Trichophyton rubrum: in vitro activity and the role of oxidative and nitrosative bursts in fungal death.

OBJECTIVES: Antimicrobial photodynamic inhibition (aPI) is based on the use of a light source and a photosensitizer to kill pathogens. Little is known about aPI of dermatophytic fungi and its mechanism of action. We aimed to evaluate aPI of Trichophyton rubrum. METHODS: We performed tests using toluidine blue (TBO) as a photosensitizer and a 630 nm light-emitting diode (LED) as a source of light to target 12 T. rubrum isolates. Susceptibility testing with cyclopiroxolamine, time-kill curves and quantification of reactive oxygen species (ROS), peroxynitrite (ONOO·) and nitric oxide (NO·) were performed. RESULTS: The optimal conditions for in vitro aPI were 10 mg/L for TBO and 48 J/cm(2) for LED; these conditions were fungicidal or inhibited >98% of fungal growth depending on the strain tested. LED or TBO treatment alone did not inhibit growth. The MICs of cyclopiroxolamine were 2.0 mg/L for 90% of the strains. Analysis of time-kill curves revealed that pathogen death occurred 24 h post-treatment. Quantification of ROS, ONOO· and NO· revealed improvement after aPI. CONCLUSIONS: Photodynamic inhibition was more efficient in promoting cell death than the antifungal cyclopiroxolamine against T. rubrum. ROS, ONOO· and NO· were important in the fungicidal activity of aPI. A suggested mechanism for this activity is that TBO is excited by LED light (630 nm), reacts with biomolecules and increases the availability of transition electrons and substrates for nitric oxide synthase, thereby increasing the oxidative and nitrosative bursts in the fungal cell.

Phototoxic action of light emitting diode in the in vitro viability of Trichophyton rubrum.

BACKGROUND: Trichophyton rubrum is the most common agent of superficial mycosis of the skin and nails causing long lasting infections and high recurrence rates. Current treatment drawbacks involve topical medications not being able to reach the nail bed at therapeutic concentrations, systemic antifungal drugs failing to eradicate the fungus before the nails are renewed, severe side effects and selection of resistant fungal isolates. Photodynamic therapy (PDT) has been a promising alternative to conventional treatments. OBJECTIVES: This study evaluated the in vitro effectiveness of toluidine blue O (TBO) irradiated by Light emitting diode (LED) in the reduction of T. rubrum viability. METHODS: The fungal inoculums' was prepared and exposed to different TBO concentrations and energy densities of Light emitting diode for evaluate the T. rubrum sensibility to PDT and production effect fungicidal after photodynamic treatment. In addition, the profiles of the area and volume of the irradiated fungal suspensions were also investigated. RESULTS: A small reduction, in vitro, of fungal cells was observed after exposition to 100 µM toluidine blue O irradiated by 18 J/cm² Light emitting diode. Fungicidal effect occurred after 25 µM toluidine blue O irradiation by Light emitting diode with energy density of 72 J/cm². The analysis showed that the area and volume irradiated by the Light emitting diode were 52.2 mm² and 413.70 mm³, respectively. CONCLUSION: The results allowed to conclude that Photodynamic therapy using Light emitting diode under these experimental conditions is a possible alternative approach to inhibit in vitro T. rubrum and may be a promising new treatment for dermatophytosis caused by this fungus.