Uso do laser de baixa potência para o tratamento de parestesia: uma revisão de literatura / Use of low-level laser to treat paresthesia: a literature review

Introdução: A parestesia é uma neuropatia que afeta a função sensorial. O Laser de Baixa Potência (LBP), por sua vez, apresenta propriedades analgésicas, bioestimuladoras e reparadoras. Objetivo: Realizar um levantamento na literatura científica sobre os aspectos gerais e benefícios do LBP no manejo terapêutico da parestesia, além de identificar a classificação e métodos de obtenção do diagnóstico desta condição. Materiais e Métodos: Tratou-se de uma revisão narrativa da literatura através da busca nas plataformas PubMed, SciELO, LILACS e Google Schoolar. Após o cruzamento dos descritores com os operadores booleanos e aplicação dos critérios de inclusão/exclusão, 26 estudos foram incluídos. Resultados: A parestesia pode ser classificada em neuropraxia, axonotmese e neurotmese, subdivididas em Grau I ao V. Seu diagnóstico pode ser executado através de testes subjetivos e objetivos. O LBP compreende em um dispositivo tecnológico com efeitos analgésico, anti-inflamatório e fotobiomodulador, que estimula o reparo neural. Os estudos mostram que a dosimetria nos comprimentos de onda vermelho e infravermelho, aplicação intra e extra oral, e com mais de uma sessão semanal exerce efeito modulatório positivo do reparo neural, com retorno progressivo da atividade sensitiva. Além disso, os estudos trazem uma ampla variação no número de pontos de aplicação, bem como no tempo de irradiação e quantidade de sessões, em virtude da extensão e tempo de diagnóstico da parestesia. Considerações finais: Apesar da alta complexidade da parestesia, o LBP exerce efeitos benéficos através do retorno da sensibilidade parcial ou total, além de ser um dispositivo bem tolerado pelo organismo e minimamente invasivo.

Introduction: Paresthesia is a neuropathy that affects sensory function. The Low-Level Laser (LLL), in turn, has analgesic, biostimulating and reparative properties. Purpose: Carry out a survey at the scientific literature on the general aspects and benefits of LLL in the therapeutic management of paresthesia in addition to identifying the classification and methods for obtaining a diagnosis of this condition. Materials and Methods: It was a narrative literature review through search in platforms PubMed, SciELO, LILACS and Google Schoolar. After crossing the descriptors with boolean operators and applying the inclusion/exclusion criteria, 26 articles were included in this study. Results: Paresthesia can be classified into neuropraxia, axonotmesis and neurotmesis, subdivided into Grades I to V. Its diagnostic can be carried out through subjective and objective tests. The LLL consists in a technological device with analgesic, anti-inflammatory and photobiomodulatory effects, which stimulates neural repair. Studies show that LLL in dosimetry at red and infrared wavelengths with intra and extra oral application and with more than one-week use exerts a positive modulatory effect on neural repair, with a progressive return of sensory activity. Furthermore, the studies show a wide variation in the number of application points, as well as the irradiation time and number of sessions, due to the extent and time of diagnosis of paresthesia. Final Considerations: Despite the high complexity of paresthesia, the LLL has beneficial effects through the return of partial or total sensitivity in addition being a device well tolerated by the body and minimally invasive.

Photobiomodulation Therapy for the Treatment of Chronic Oral Ulcers: A Report of Two Cases.

Oral ulcers are a very frequent complaint of patients reporting to dental professionals, of which traumatic ulcers are the most common They are very painful and troublesome while the patient speaks, masticates, or brushes. Various treatment modalities, such as topical analgesics and topical or systemic antibiotics, are used conventionally. However, long-term non-healing painful conditions and drug resistance have boosted the rapid raising of an alternative wound healing method. In the presented cases, low-dose biophotonics, also called photobiomodulation (PBM) therapy by low-level laser, was used with the aim of alleviating pain and inflammation, modulating the immune response, and promoting wound healing and tissue regeneration.

The effects of fulvic acids and low-level laser therapy on orthodontic retention in rats.

BACKGROUND: Shortening retention time and minimizing relapse rates are ongoing challenges in orthodontics. This study investigated the effects of natural fulvic acids (FAs) and low-level laser therapy (LLLT) on orthodontic retention in rats. METHODS: Seventy-two male Sprague-Dawley rats underwent mesial movement of the left maxillary first molar using a 50 g force via a nickel-titanium tension spring. After three weeks of movement, the rats entered the retention phase with retainer wires and were divided into four groups: Control (no intervention), FAs (80 mg/kg orally daily), LLLT (808 nm laser twice weekly), and FAs + LLLT (both treatments). Retainers were removed on days 7, 14, and 21 for a 3-day relapse assessment. Maxillary impressions were analyzed for relapse rates using 3Shape software, alongside histological and immunohistochemical evaluations of bone morphogenetic protein-2 (BMP-2) expression in periodontal tissues, with differences among groups analyzed using an ordinary two-way analysis of variance (ANOVA). RESULTS: The relapse rate decreased over time, particularly at 10, 17, and 24 days (p < 0.001). The FAs group did not significantly affect relapse rates compared to the control group (p = 0.084). In contrast, both the LLLT and FAs + LLLT groups significantly reduced relapse rate (p < 0.001), with no significant difference between these groups (p = 0.555). Histological examination revealed active osteoclasts on day 10, decreasing by days 17 and 24. The LLLT and FAs + LLLT groups showed less local cementum resorption and better periodontal fiber arrangement. All treatment groups significantly increased BMP-2 expression (P < 0.05) compared to controls. with LLLT and FAs + LLLT differing significantly from FAs (P < 0.001), though no difference was observed between LLLT and FAs + LLLT (P = 0.578). CONCLUSIONS: FAs did not significantly reduce relapse rate with retainers, while LLLT effectively reduced relapse rates, showing no additional benefit from combining FAs with LLLT. Both FAs and LLLT increased BMP-2 expression in PDL fibroblasts but with no synergistic effect.

The efficacy of light-guiding microneedle patch for stimulating hair growth in androgenetic alopecia.

Androgenetic alopecia (AGA) is the most common form of hair loss characterized by miniaturization of hair follicles. Low-level light therapy (LLLT) and microneedling have shown potential in promoting hair regrowth. This study aims to evaluate the efficacy of an innovative light-emitting diode (LED) helmet cooperated with a novel light-guiding microneedle patch (LMNP) for stimulating hair growth in AGA. In this randomized clinical trial, 16 AGA patients received treatments using light-guiding microneedle patches (LMNPs) illuminated by a LED helmet equipped with green (522 nm) and red (633 nm) LEDs, delivering 50 mW/cm2 power and 40 J/cm2 energy. Treatments were applied weekly for 24 weeks, targeting the frontal recession area. The right side of the scalp was treated with green light and the left with red light, each combined with a LMNP featuring 900 µm height needles at a density of 105 per square centimeter. Hair density and diameter, along with patient and physician satisfaction scores, were assessed monthly. Both red and green LED treatments with LMNP, significantly enhanced hair density and diameter. Satisfaction scores, as reported by both physicians and participants, increased over time. Comparative analyses revealed no statistically significant differences in average satisfaction scores or in changes in hair density and diameter between the groups by the end of the study. Additionally, no serious adverse effects were reported, highlighting the safety of the treatments. The combined Light sources which is portable LED helmet and LMNPs shows promise as a non-invasive, effective treatment for AGA, with similar efficacy between red and green wavelengths.

The impact of photobiomodulation on angiogenic differentiation of two different dental derived stem cells using two irradiation protocols: an in vitro investigation.

The present study aimed to compare the effect of photobiomodulation with different energy densities on the angiogenic differentiation of human periodontal ligament stem cells (hPDLSCs) and stem cells from human exfoliated deciduous teeth (SHED). Photobiomodulation therapy with a 660 nm diode laser (2.4 J/cm2 and 3.9 J/cm2) on two consecutive days post-culture was applied to two types of stem cells (hPDLSCs and SHED). The Quantitative Real-time Polymerase Chain Reaction (RT-qPCR) test was undertaken to investigate Vascular Endothelial Growth Factor-A (VEGF-A) and Angiopoietin I (ANG-I) genes on days 1, 3, 5, 7, and 10 after the first session of laser application. The 4',6-diamidino-2-phenylindole (DAPI) staining and Methyl Thiazolyl Tetrazolium (MTT) test were conducted on days 1, 3, and 5 after the first session of laser application, to assess the cell viability. The Two-way ANOVA with Tukey post hoc test was used to analyze the outcomes of the MTT and RT-qPCR tests. The results of the MTT and DAPI convergently illustrated that the groups receiving photobiomodulation with 2.4 J/cm2 had higher cell viability compared to 3.9 J/cm2. All experimental groups showed an upregulation of VEGF-A and ANG-I gene expression from day 1 to 5, followed by a downregulation from day 5 to 10. The groups with cultured hPDLSCs and SHED receiving photobiomodulation using 2.4 J/cm2 had the most amounts of VEGF-A and ANG-I gene expression on day 5, respectively. In conclusion, the 660 nm mediated photobiomodulation therapy of cultured SHED and hPDLSCs with 2.4 J/cm2 energy density may be associated with higher angiogenic differentiation (the expression of VEGF-A and ANG-I) as well as higher cell viability compared to the photobiomodulation therapy with 3.9 J/cm2.

Impact of Photobiomodulation on the Quality of Life of Men and Women With Androgenetic Alopecia.

OBJECTIVES: Androgenetic alopecia (AGA) is the most common cause of hair loss in men and women, and it can affect the psychological and social activities of individuals, thus reducing their quality of life. Photobiomodulation (PBM) is a recent adjuvant treatment for this condition with promising results for hair regrowth. We aimed to assess the health-related quality of life of men and women with AGA before and after PBM sessions. METHODS: This is a single-center prospective observational study conducted with 42 men and 43 women with AGA. All participants answered a sociodemographic questionnaire in an interview and individually answered the Brazilian version of Skindex-29 (self-application). After 24 PBM sessions, two 20-minute sessions per week, with 48 to 72 hours of interval between sessions, participants answered the Skindex-29 again. RESULTS: Women had a large reduction in Skindex-29 total score after PBM (p<0.01; d=0.82) and lower scores in the emotions (p<0.01; d=0.89), psychosocial functioning (p<0.01; d=0.60), and symptoms domains (p=0.03; d=0.38). Men presented a moderate reduction in Skindex-29 total score after PBM (p<0.01; d=0.68), largely lower scores in the emotions domain (p<0.01; d=0.82) and a small reduction in the psychosocial functioning domain (p<0.01; d=0.47). CONCLUSIONS: The use of PBM in AGA is associated with improving the quality of life of men and women. This enhancement was higher regarding emotions, the major domain affected in the AGA population. Women had larger impacts on all domains of Skindex-29 after the use of PBM.

Safety, Tolerability, and Short-Term Efficacy of Low-Level Light Therapy for Dry Age-Related Macular Degeneration.

INTRODUCTION: Photobiomodulation (PBM) has become a promising approach for slowing the progression of early and intermediate dry age-related macular degeneration (dAMD) to advanced AMD. This technique uses light to penetrate tissues and activate molecules that influence biochemical reactions and cellular metabolism. This preliminary analysis is aimed at assessing the safety, tolerability, and short-term effectiveness of the EYE-LIGHT®PBM treatment device in patients with dAMD. METHODS: The EYE-LIGHT® device employs two wavelengths, 590 nm (yellow) and 630 nm (red), in both continuous and pulsed modes. Patients over 50 years of age with a diagnosis of dAMD in any AREDS (Age-Related Eye Disease Study) category were randomly assigned to either the treatment group or the sham group. The treatment plan consisted of an initial cycle of two sessions per week for 4 weeks. Safety, tolerability, and compliance outcomes, along with functional and anatomical outcomes, were assessed at the end of the fourth month. RESULTS: This preliminary analysis included data from 76 patients (152 eyes). All patients were fully compliant with treatment sessions, and only one fifth of patients treated with PBM reported mild ocular adverse events, highlighting exceptional results in terms of tolerability and adherence. Changes in best-corrected visual acuity (BCVA) from baseline to month 4 differed significantly between the sham and PBM-treated groups, favoring the latter, with a higher proportion achieving a gain of five or more letters post-treatment (8.9% vs. 20.3%, respectively; p = 0.043). No significant differences in central subfield thickness (CST) were observed between the two groups over the 4-month period. The study also found a statistically significant disparity in mean drusen volume changes from baseline to month 4 between the groups in favor of patients treated with PBM (p = 0.013). CONCLUSION: These preliminary results indicate that PBM treatment using the EYE-LIGHT® system is safe and well tolerated among patients with dAMD. Furthermore, both functional and anatomical data support the treatment's short-term efficacy. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT06046118.

Low level laser therapy alleviates mechanical allodynia in a postoperative and neuropathic pain model and alters the levels of inflammatory factors in rats.

Background: This study aimed to investigate the analgesic and preventive effect of low-level laser therapy (LLLT) on the incisional pain model and spinal nerve ligation (SNL) model in rats and identify the possible mechanisms of action. Methods: Male Sprague-Dawley rats were used, divided into different treatment groups. The single application group received LLLT before or after skin incision or SNL. The consecutive application group received LLLT for six consecutive days post-incision, three days pre-incision, or three consecutive days pre-SNL. The control group underwent skin incision or SNL without LLLT. The von Frey test was used to quantify the pain associated with mechanical allodynia. Pro-inflammatory cytokine level and alterations in nerve growth factor (NGF) expression were measured by using ELISA and immunohistochemistry, respectively in the skin, muscle of the paw, and spinal cord dorsal horn (SCDH). Results: In the incisional pain model, LLLT showed significant analgesic and preventive effect. LLLT ameliorated SNL-induced mechanical allodynia but LLLT had no preventive effect. LLLT decreased interleukin-1ß (IL-1ß) expression levels in the skin, muscle, and SCDH and reduced the optical density of skin and spinal cord NGF in the incisional pain model. Conclusions: LLLT alleviated incisional pain and neuropathic pain caused by SNL in rats, and reduced the levels of IL-1ß and NGF in the peripheral tissue and SCDH in the incisional pain model. LLLT might be effective in patients with post-operative pain and peripheral neuropathic pain.

Aplicação clínica da laserterapia de baixa potência na atenção primária à saúde / Clinical praxis of low-level laser therapy in primary health care

LASER é um acrônimo que sumariza a amplificação da luz por emissão estimulada de radiação (eletromagnética). O Programa Saúde em Ação equipou diversas Unidades Básicas de Saúde com aparelhos de laser diodo. Cirurgiões Dentistas têm aplicado a laserterapia de baixa potência para acelerar a remissão de várias condições clínicas, sem necessidade de encaminhamento imediato para Atenção Secundária. O objetivo deste artigo é apresentar protocolos de laserterapia de baixa potência empregados por Cirurgiões Dentistas da Atenção Primária à Saúde de Campinas-SP, por meio da ilustração com casos clínicos atendidos em consultas de urgência. Aplicações para ulceração traumática e desordem temporomandibular foram realizadas em uma senhora de 60 anos de idade, que aguardava a substituição das próteses totais. Irradiou-se por laser vermelho (660nm) com energia de 1J as margens da ulceração. Após palpação da articulação e dos músculos mastigatórios para mapeamento, os pontos álgicos foram irradiados por laser infravermelho (808nm) com energia de 4J. Um homem de 50 anos de idade queixava-se de paralisia hemifacial havia 10 dias. A tentativa de recuperação do nervo facial ocorreu com irradiação por laser infravermelho com energia de 8J por ponto, em 22 pontos dos ramos do nervo facial. Em ambos os casos, a regressão do quadro clínico desconfortável foi observada. Os Profissionais do Sistema Único de Saúde (SUS) que são aptos ao uso dos equipamentos para laserterapia de baixa potência podem utilizar este recurso de modo seguro e bem sucedido, observando comprimento de onda do laser e doses protocolares para cada alteração a ser tratada.

LASER is an acronym which means light amplification by stimulated emission of radiation (electromagnetic). Many Primary Health Care Units received diode laser devices from the Brazilian Health in Action Program. Dental practitioners have applied low-level laser therapy for accelerating the resolution of several clinical problems, without the need to prompt referral for Secondary Attention. This manuscript aimed at presenting low-level laser therapy protocols, used by Dentists in Primary Health Care Units from Campinas-SP, illustrated with case reports of urgency consultations. Applications for traumatic ulcers and temporomandibular disorder were performed in a 60-year-old woman who was waiting for dental prosthesis replacement. Red laser irradiation (660nm) with 1J energy was delivered at the margins of the ulcer. Upon articular and masticatory muscles palpation for mapping, trigger points were irradiated with infrared laser (808nm), 4J energy. A 50-year-old man complained of hemifacial paresis for 10 days. The recovery attempt of the facial nerve was carried out by infrared laser irradiation with 8J energy per point in 22 points of the facial nerve branches. In both case reports, regression of the uncomfortable clinical problem was noted. Professionals from the Unified Health System (SUS) who are able to use a low-level laser device may safe and successfully operate this equipment, selecting the appropriate laser wavelength and protocol doses for managing each clinical problem.

Photobiomodulation with laser and led on mesenchymal stem cells viability and wound closure in vitro.

Mesenchymal stem cells can differentiate into specific cell lineages in the tissue repair process. Photobiomodulation with laser and LED is used to treat several comorbidities, can interfere in cell proliferation and viability, in addition to promoting responses related to the physical parameters adopted. Evaluate and compare the effects of laser and LED on mesenchymal cells, with different energy doses and different wavelengths, in addition to viability and wound closure. Mesenchymal stem cells derived from human adipocytes were irradiated with laser (energy of 0.5 J, 2 J and 4 J, wavelength of 660 nm and 830 nm), and LED (energy of 0.5 J, 2 J and 4 J, where lengths are 630 nm and 850 nm). The wound closure process was evaluated through monitoring the reduction of the lesion area in vitro. Viability was determined by analysis with Hoechst and Propidium Iodide markers, and quantification of viable and non-viable cells respectively Data distributions were analyzed using the Shapiro-Wilk test. Homogeneity was analyzed using Levene's test. The comparison between the parameters used was analyzed using the Two-way ANOVA test. The T test was applied to data relating to viability and lesion area. For LED photobiomodulation, only the 630 nm wavelength obtained a significant result in 24, 48 and 72 h (p = 0,027; p = 0,024; p = 0,009). The results related to the in vitro wound closure test indicate that both photobiomodulation with laser and LED demonstrated significant results considering the time it takes to approach the edges (p < 0.05). Considering the in vitro experimental conditions of the study, it is possible to conclude that the physical parameters of photobiomodulation, such as energy and wavelength, with laser or LED in mesenchymal stem cells, can play a potential role in cell viability and wound closure.

Effect of low-level light therapy in individuals with dry eye disease.

INTRODUCTION: Low-level light therapy (LLLT) or photobiomodulation, the application of red light to the eye, is used for the treatment of dry eye. Limited studies have investigated the efficacy of LLLT as a stand-alone treatment. The investigation aimed to evaluate the effect of LLLT on signs and symptoms of dry eye. METHODS: Participants with mild to moderate dry eye were recruited for this three-visit study. Visits were 7 (±3) days apart and all participants received 633 nm LLLT (eye-light®) for 15 min at each visit. Clinical measures including first and average non-invasive keratograph tear break-up time (NIKBUT), tear meniscus height (TMH), meibomian gland (MG) loss for upper and lower eyelids, ocular surface disease index (OSDI) score, tear film lipid layer thickness, meibum quality score, Schirmer's test, corneal fluorescein staining and eyelid temperature for external upper (EUL) and external lower (ELL) eyelids were measured from the right eye of participants before and after treatment. RESULTS: Thirty participants (mean [SD] age: 31.1 [9.5] years) completed the study. Treatment with LLLT resulted in significant differences in first and average NIKBUT, TMH, tear film lipid layer thickness, OSDI score, Schirmer's test, meibum quality score and eyelid temperature over time (all p < 0.05). Compared to baseline, TMH, tear film lipid layer thickness and eyelid temperature significantly increased by 0.06 mm (95% CI: 0.01-0.11), 12.9 nm (95% CI: 1.18-24.55), and 7.0°C, respectively, for both EUL (95% CI: 6.17-7.84) and ELL (95% CI: 6.17-7.73). The respective decrease in the OSDI score and Schirmer's test was 10.2 (95% CI: -15.15 to -5.26) and 4.4 mm (95% CI: -7.31 to -1.42; all p < 0.05). There was no significant difference in corneal fluorescein staining and MG loss after LLLT. CONCLUSION: Low-level light therapy treatment significantly improved signs and symptoms of dry eye in the early phases of treatment, suggesting its efficacy for dry eye management.

Photobiomodulation with near-infrared laser for tinnitus management: preliminary animal experiments and randomized clinical trials.

This study investigates the effectiveness of photobiomodulation therapy (PBMT) in treating chronic high-frequency tinnitus with the TINI device, a near-infrared (830 nm) laser. The study includes preliminary animal experiments with 28 mice and a randomized controlled trial with 56 participants to examine the functional and molecular changes in the auditory system that PBMT may cause. The animal model used sodium salicylate to induce tinnitus, followed by PBMT, which showed promising reductions in the behavioral evidence of tinnitus and a reversal of tinnitus-associated upregulation of vesicular glutamate transporters 2 expression in the ipsilateral dorsal cochlear nucleus (p < 0.05). In the clinical trial, participants with chronic high-frequency tinnitus received trans-tympanic application of the TINI device. The results did not show a significant difference in tinnitus score at the final time point when compared to the sham group. However, questionnaires revealed significant improvements in tinnitus symptoms and psychological outcomes following treatment with the TINI device compared to before treatment (p < 0.05). These findings suggest that while PBMT has potential benefits, its clinical effectiveness may be unclear due to its complex nature and interaction with other conditions. Further research is required to optimize treatment parameters and gain a complete understanding of the therapeutic potential of PBMT in managing tinnitus.

The synergistic effect of phototherapy and active substances on hair growth.

Androgenic alopecia (AGA) typically manifests post-puberty, resulting in decreases in hair density, disruptions in the hair growth cycle, and alterations in hair follicle micro structure. Dihydrotestosterone (DHT) is a key hormone implicated in hair loss, especially on male. In this study, we found that each of arginine (Arg), arterial extract (AE) or biotin tripeptide-1 (BT-1), when combined with low level light therapy (LLLT, at 630 nm, 2 J/cm2), showed the efficacy in enhancing mitochondrial functions, cell proliferation and collagen synthesis in fibroblasts. Additionally, CARRIPOWER (the complexes of AE, BT-1, Arg, and Diaminopyrimidine derivatives), in conjunction with LLLT (630 nm, 2 J/cm2), showed promising results in dermal papilla cells (DPCs). The promising results contained not also inflammatory cytokines (IL-1ß and IL-6) and cell pro apoptotic factor (TGF-ß2) reduction, but also Wnt pathway inhibition by decreasing DKK1 level, and pro-hair growth factors (vascular endothelial growth factor (VEGF) and ß-catenin) increase. This innovative combination therapy offers a potential solution for the treatment of AGA, addressing both hormonal and cellular factors involved in hair loss.

The role of light emitting diode in wound healing: A systematic review of experimental studies.

Wounds represent a growing global issue demanding increased attention. To expedite wound healing, technologies are under development, and light emitting diode (LED) devices of varying wavelengths are being explored for their stimulating influence on the healing process. This article presents a systematic literature review aiming to compile, organize, and analyze the impacts of LED devices on wound healing. This review is registered on the PROSPERO platform [CRD42023403870]. Two blinded authors conducted searches in the Pubmed, Web of Science, Scopus, Embase, and ScienceDirect databases. In vitro and in vivo experimental studies assessing LED utilization in the wound healing process were included. The search yielded 1010 studies, of which 27 were included in the review. It was identified that LED stimulates different healing pathways, promoting enhanced cell proliferation and migration, angiogenesis stimulation, increased collagen deposition, and modulation of the inflammatory response. Thus, it can be concluded that the LED stimulates cellular and molecular processes contingent on the utilized parameters. The effects depend on the standards used. Cell migration and proliferation were better influenced by green and red LED. The extracellular matrix components and angiogenesis were regulated by all wavelengths and the modulation of inflammation was mediated by green, red, and infrared LEDs.

Comparative evaluation of the effectiveness of concentrated growth factor alone and in combination with diode laser application in the treatment of intrabony periodontal defects: A clinical and radiographic split-mouth study.

Background: Applying autologous growth factors and diode laser in periodontal therapy enhances fibroblast-mediated new attachment and osteoblastic differentiation. Hence, this study compared and evaluated the effectiveness of concentrated growth factor (CGF) alone and with diode laser application in managing intrabony periodontal defects. Methods: Ten patients with stage III periodontitis were included in this study. All the patients underwent an open flap debridement (OFD) procedure followed by CGF membrane placement in the intrabony defect in site A, whereas, in site B, after OFD, all the patients underwent diode laser irradiation before CGF membrane placement. Plaque and gingival bleeding index (PI & GBI), PPD, and clinical attachment level (CAL) were evaluated at baseline and 3 and 6 months later. Bone fill (BF), BF%, bone crest changes (BCC), and BCC% were assessed radiographically at six months postoperatively. Results: Significant reductions in PI and GBI scores, probing pocket depth (PPD), and CAL gain were observed at both sites 3 and 6 months from baseline. A significant reduction in PPD and CAL gain was noted between sites, which were higher in site B than in site A with a mean difference of 0.70±0.05 mm and 1.30±0.18 mm, 0.90±1.89 mm at 3 and 6 months, respectively. Radiographic measurement showed better BF, BF%, BCC, and BCC% at both sites at six months, which were higher at site B than at site A but statistically insignificant. Conclusion: The combination of CGF and diode laser application has demonstrated successful and promising results in terms of regeneration, improving the clinical and radiographic parameters.

Long-Term Benefits of Photobiomodulation Therapy on Health-Related Quality of Life in Burning Mouth Syndrome Patients: A Prospective Study.

Background/Objectives: Burning Mouth Syndrome (BMS) patients experience a reduction in health-related quality of life and an increased intake of medication. Photobiomodulation with low-level laser therapy has been demonstrated to be an efficacious treatment for BMS. However, its long-term benefits remain relatively unknown. This study aimed to evaluate the impact of prolonged Photobiomodulation with low-level laser therapy on BMS patients by examining the efficacy of an outpatient protocol in a real-world setting. Methods: A prospective study was designed to address the research question. Photobiomodulation was performed, irradiating the affected areas once every two weeks for 12 months. Health-related quality of life was assessed using the EQ-5D-5L questionnaire at the initial consultation and after 6 months and 12 months of treatment. Additionally, the patients' pharmacological profile was also monitored. Nonparametric statistical analysis was performed (p < 0.05 was considered statistically significant). Results: The study was completed by 15 individuals, comprising 14 females and 1 male. The results indicated a statistically significant improvement (p < 0.001) in four of the five dimensions of the health-related quality of life questionnaire, namely self-care, usual activities, pain/discomfort, and anxiety/depression, along with the patients' perceived health level. A total of 13 participants reported suspending or reducing their intake of medications for Burning Mouth Syndrome. Conclusions: Therefore, Photobiomodulation with low-level laser therapy has a positive effect on improving patients' quality of life and reducing BMS symptoms, contributing to a subsequent reduction or suspension of previous medications. These findings support the efficacy of the applied protocol. Given the innovative methodology and promising results, further research is warranted.

Effect of Low-Level Laser Therapy on the Osseointegration of Immediately Loaded Implants with a Connective Tissue Graft: A Randomized Clinical Trial.

Introduction: This study assessed the effect of low-level laser therapy (LLLT) on the osseointegration of immediately loaded implants with a connective tissue graft (CTG). Methods: This clinical trial was conducted on patients with buccal bone dehiscence requiring dental implants. A CTG was harvested from the palate and placed in the labial side by considering the 2 mm distance between the implant thread and bone. Autogenous bone was harvested from the tuberosity, mixed with the allograft, and implanted at the site. After sufficient torquing of the implant, a customized abutment was fabricated and placed. The patients were randomly assigned to two groups (n=5) of intervention and control. The patients in the intervention group received LLLT with a 940 nm gallium-aluminum-arsenide laser while those in the control group received placebo irradiation. The primary implant stability was measured before the delivery of customized abutment while the secondary implant stability was measured after 12 weeks by Osstell® and reported as the implant stability quotient (ISQ). Results: No significant difference was found in secondary ISQ between the laser and control groups (P>0.05). In the intervention group, a significant difference was found between the primary and secondary ISQ in the buccolingual dimension (P<0.05) but not in the mesiodistal dimension (P>0.05). The two groups had no significant difference in gingival thickness or vertical bone gain (P>0.05). All implants were successful with no complications. Conclusion: LLLT had a significant positive efficacy for the enhancement of secondary stability of implants in the buccolingual dimension. CTG showed optimal efficacy for the treatment of buccal bone dehiscence.

Multimodal therapeutic intervention program associated with photobiomodulation therapy for individuals with chronic nonspecific neck pain: protocol for a clinical trial.

BACKGROUND: Neck pain is a prevalent global musculoskeletal issue, significantly contributing to the loss of years of healthy life due to disability. Chronic nonspecific neck pain (CNNP) involves diverse symptoms impacting mobility and quality of life. While therapeutic exercises demonstrate efficacy, the role of photobiomodulation therapy (PBMT) remains uncertain. This study aims to assess the additional effects of PBMT within a multimodal therapeutic intervention for CNNP. METHODS: A randomized, two-arm, controlled, blind clinical trial follows CONSORT and SPIRIT guidelines. Participants diagnosed with CNNP will receive a stand-alone multimodal therapeutic intervention or the same program with additional PBMT. The primary outcomes will be assessed by the functional disability identified through applying the NDI (Neck Disability Index). Secondary outcomes will be pain intensity during rest and active neck movement, catastrophizing and kinesiophobia, functionality, and disability assessed at baseline, after 8 weeks, and at a 4-week follow-up. Both groups receive pain education before personalized interventions, including resistance exercises, neuromuscular activities, mobility, and body balance. The PBMT group undergoes low-level light therapy. Intention-to-treat analysis, using linear mixed models, employs data presented as mean, standard deviation, and differences with a 95% confidence interval. Non-normally distributed variables transform. Statistical significance is set at 5%. DISCUSSION: This study addresses a critical gap in understanding the combined effects of PBMT and therapeutic exercises for CNNP. The findings aim to guide clinicians, researchers, and CNNP sufferers through rigorous methodology and diverse outcome assessments, offering valuable insights into evidence-based practices for CNNP management. Data confidentiality is maintained throughout, ensuring participant privacy during statistical analysis. TRIAL REGISTRATION: Effects of adding photobiomodulation to a specific therapeutic exercise program for the treatment of individuals with chronic nonspecific neck pain, registration number: NCT05400473, on 2022-05-27.

Efficacy of photobiomodulation following L-PRF application for recovery of mental nerve neurosensory disturbances caused by genioplasty: A randomized triple-blind clinical trial.

The present study assessed the efficacy of photobiomodulation (PBM) following leukocyte-platelet rich fibrin (L-PRF) application for recovery of mental nerve neurosensory disturbances (NSDs) caused by genioplasty. This randomized triple-blind split-mouth clinical trial was conducted on 20 female patients (40 quadrants) requiring genioplasty. In each patient, one random side of the mandible served as the intervention (laser), and the other side as the control group. After genioplasty and L-PRF application, the intervention side underwent GaAIAs diode laser irradiation (880 nm, 500 mW, 15 J/cm2, 0.5 cm2 spot size, continuous-wave). Each point was laser irradiated for 15 s. Unilateral extraoral PBM was performed at 1, 3, 7, 14, 21, and 28 days, postoperatively. Laser in off mode (sham laser) was used for the control side. A visual analog scale (VAS) was used for general sensitivity, and 2-point discrimination, directional discrimination, pain discrimination, and thermal discrimination tests were used to assess the neurosensory recovery at 2 days, 2 weeks, 4 weeks, and 2 months, postoperatively. Statistical analyses were performed using two-way repeated measures ANOVA, Bonferroni test, and generalized estimating equation (alpha = 0.05). Time had a significant effect on improvement of all sensory variables (P < 0.05). Neurosensory recovery was significantly better in the intervention than the control group at all time points according to the two-point discrimination test (P = 0.0135) and brush test (P = 0.025) results. The interaction effect of time and intervention was not significant on any dependent variable (P > 0.05). Application of L-PRF + PBM resulted in significantly greater sensorineural recovery according to the two-point discrimination and brush test results.

Management of androgenic alopecia: a systematic review of the literature.

We aimed to determine the efficacy of the various available oral, topical, and procedural treatment options for hair loss in individuals with androgenic alopecia. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review of the National Library of Medicine was performed. Overall, 141 unique studies met our inclusion criteria. We demonstrate that many over the counter (e.g. topical minoxidil, supplements, low-level light treatment), prescription (e.g. oral minoxidil, finasteride, dutasteride), and procedural (e.g. platelet-rich plasma, fractionated lasers, hair transplantation) treatments successfully promote hair growth, highlighting the superiority of a multifaceted and individualized approach to management.