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BACKGROUND: The number and diversity of published peer-reviewed studies in the discipline of laser dentistry have grown considerably during the past 10 years. OBJECTIVES: Within primary research, the development of protocols to guide and formulate clinical practice demands precision and ease of reproducibility. Errors in data acquisition and management may become amplified as the applied randomized clinical trials (RCTs) forge new levels of clinical diversity and predictability in the use of laser photonic energy in both ablative (surgical) and sub-ablative (photobiomodulation (PBM) or photodynamic therapy (PDT)) applications. MATERIAL AND METHODS: A comprehensive range of empirical and computational operating parameters must be included in published studies to facilitate the uniformity of powerand time-related values of laser irradiation. RESULTS: Choosing the correct "tissue irradiation parameters" is difficult and depends on the pathology and symptoms, the surface area to be treated, laser wavelength, the thermal relaxation time of each targeted tissue, and controlling penetration depth of the light into tissues. Therefore, to allow the reproducibility of the results, it is recommended that authors mention with the greatest care and clarity the irradiation parameters used in their study. CONCLUSION: This paper outlines the concerns felt regarding the general shortfalls and proposes a minimum range of laser operating parameters that should be represented in future peer-reviewed publications.
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Terapia por Láser , Humanos , Terapia por Láser/métodos , Rayos Láser , Reproducibilidad de los ResultadosRESUMEN
BACKGROUND: Oral squamous cell carcinoma (OSCC) is a type of cancer that is responsible for a significant amount of morbidity and mortality worldwide. Researchers are searching for promising therapeutic methods to manage this cancer. In this study, an in silico approach was used to evaluate the activity of sonodynamic therapy (SDT) based on the use of Kojic acid as a sonosensitizer to inhibit matrix metalloprotease-9 (MMP-9) in OSCC. MATERIALS AND METHODS: The three-dimensional structure of MMP-9 was predicted and validated by computational approaches. The possible functional role of MMP-9 was determined in terms of Gene Ontology (GO) enrichment analysis. In silico, molecular docking was then performed to evaluate the binding energies of Kojic acid with MMP-9, and ADME parameters and toxicity risks were predicted. The pharmacokinetics and drug-likeness properties of Kojic acid were assessed. Moreover, after the determination of the cytotoxicity effect of Kojic acid-mediated SDT, the change of mmp-9 gene expression was assessed on OSCC cells. RESULTS: The results of the study showed that Kojic acid could efficiently interact with MMP-9 protein with a strong binding affinity. Kojic acid obeyed Lipinski's rule of five without violation and exhibited drug-likeness. The cytotoxic effects of Kojic acid and ultrasound waves on the OSCC cells were dose-dependent, and the lowest expression level of the mmp-9 gene was observed in SDT. CONCLUSIONS: Overall, Kojic acid-mediated SDT as an MMP-9 inhibitor can be a promising adjuvant treatment for OSCC. The study highlights the potential of in silico approaches to evaluate therapeutic methods for cancer treatment.
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The purpose of this study was to investigate photothermal aspects of photobiomodulation therapies (PBMT) in vitro to assist in the development of safe clinical parameters with respect to higher-power devices with large surface applicators. Laser wavelengths in the range of 650 nm-1064 nm were investigated using a thermal camera. Thermographic measures of surface and sub-surface temperature variations of similar lean porcine muscle tissue samples were recorded for a series of calibrated experiments. A thermal comparison was then made between Flat-top and Gaussian beam spatial distribution devices. Outcome data were subjected to statistical analysis using an ANOVA model. Results acquired at similar parameters of irradiance indicated that the application of the 980 nm wavelength was associated with the highest rise in temperature, which decreased with other wavelengths in the order 980 > 1064 ≈ 650 >>> 810 nm (p < 5 × 10-20). All wavelengths assessed were associated with a significant temperature increase, and with the exception of 810 nm, all exceeded the threshold of a 6 °C rise within the prescribed parameter limits. Optical scanning by movement of the applied source over a relevant area was found to offer effective mitigation of these temperature increases. An extended discussion is presented, analysing the clinical significance of the study outcomes. Recommendations are made within the limits of this in vitro study in order to assist future clinical investigations.
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BACKGROUND: Streptococcus mutans is considered a major significant contributor to dental caries and its effective removal is difficult due to the formation of biofilm. Therefore, the development of adjuvant therapeutic strategies with anti-biofilm properties is a promising approach. In the present study, we examined the effect of dermcidin-derived peptide DCD-1 L on the antibacterial activity of hypericin nanoparticle (HypNP)-mediated antimicrobial sonodynamic therapy (aSDT) against persister cells growing- and biofilm cultures of S. mutans. MATERIALS AND METHODS: Following synthesis and confirmation of HypNP, the fractional inhibitory concentration (FIC) index of HypNP and DCD-1 L was determined by checkerboard assay. Cellular uptake of HypNP-DCD-1 L and generation of endogenous reactive oxygen species (ROS) were assessed and followed by the determination of antimicrobial sonoactivity of HypNP-DCD-1 L against persister cells growing- and biofilm cultures of S. mutans. The water-insoluble extracellular polysaccharide (EPS) and expression of the gtfD, comDE, and smuT genes were then evaluated in persister cells growing- and biofilm cultures of S. mutans. RESULTS: There was a synergistic activity in the combination of HypNP and DCD-1 L against S. mutans with an FIC index value of 0.37. The HypNP-DCD-1L-mediated aSDT also displayed the highest cellular uptake and endogenous ROS generation by bacterial cells. When biofilm and persister cells of S. mutans were treated with HypNP-DCD-1 L and subsequently exposed to ultrasound waves, 5.1 log and 3.8 log reductions, respectively, in bacterial numbers were observed (P<0.05). According to the data, EPS in both persister cells growing- and biofilm cultures of S. mutans were significantly decreased after exposure to the HypNP-DCD-1L-mediated aSDT (P<0.05). In addition, the quantitative real-time PCR data illustrated the high level of similarities in very low-expression profiles of the gtfD before and after all treated groups for persister cells. While, following HypNP-DCD-1L-mediated aSDT treatment, the expression levels of gtfD, comDE, and smuT were significantly lower in treated persister cells growing- and biofilm cultures of S. mutans in comparison with control groups (P<0.05). CONCLUSIONS: Combined, the results of this study indicate that ultrasound waves-activated HypNP-DCD-1 L can sonoinactivate S. mutans biofilms and persister cells, as well as reduce effectively pathogenicity potency of S. mutans. Hence, HypNP-DCD-1L-mediated aSDT may be proposed as a promising adjunctive therapeutic approach for dental caries.
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Antiinfecciosos , Caries Dental , Dermcidinas , Fotoquimioterapia , Humanos , Streptococcus mutans , Dermcidinas/metabolismo , Dermcidinas/farmacología , Especies Reactivas de Oxígeno/metabolismo , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/farmacología , Biopelículas , Antiinfecciosos/farmacologíaRESUMEN
BACKGROUND: The present study evaluated the anti-biofilm and bystander effects of antimicrobial photo-sonodynamic therapy (aPSDT) on the polymicrobial periopathogenic biofilms formed on mini-screws coated with zinc oxide nanoparticles (ZnONPs). MATERIALS AND METHODS: Thirty orthodontic identical mini-screws were divided into 6 groups (n = 5) as follows: 1. negative control: uncoated mini-screw + phosphate-buffered saline (PBS), 2. positive control: uncoated mini-screw + 0.2% CHX, 3. coating control: coated mini-screw + PBS, 4. antimicrobial photodynamic therapy (aPDT): coated mini-screw+light emitting diode (LED), 5. Antimicrobial sonodynamic therapy (aSDT): coated mini-screw+ultrasound waves, and 6. aPSDT: coated mini-screw+LED+ultrasound waves. Electrostatic spray-assisted vapor deposition was employed to coat ZnONPs on titanium mini-screws. The biofilm inhibition test was used to assess the anti-biofilm efficacy against polymicrobial periopathogenic biofilms including Porphyromonas gingivitis, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans, and the results were shown as the percent reduction of Log10 colony-forming unit (CFU)/mL. Following each treatment, the gene expression levels of TNF-α, IL-1ß, and IL-6 were evaluated on human gingival fibroblast (HGF) cells via quantitative real-time polymerase chain reaction (qRT-PCR) to reveal the bystander effects of aPSDT on HGF cells. RESULTS: A significant reduction in log10 CFU/mL of periopathogens was observed in groups treated with aPDT, aSDT, aPSDT, and 0.2% CHX up to 6.81, 6.63, 5.02, and 4.83 log, respectively, when compared with control groups (P<0.05). 0.2% CHX and aPSDT groups demonstrated significantly higher capacity in eliminating the periopathogen biofilm compared with other groups (P<0.05). The qRT-PCR showed that the expression level of inflammatory cytokines was significantly down regulated in aPDT, aSDT, and aPSDT groups (P<0.05). CONCLUSION: It was found that the ZnONPs-mediated aPSDT could significantly reduce periopathogen biofilm as well as the expression level of inflammatory cytokines.
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Antiinfecciosos , Nanopartículas , Fotoquimioterapia , Óxido de Zinc , Humanos , Fotoquimioterapia/métodos , Óxido de Zinc/farmacología , Fármacos Fotosensibilizantes/farmacología , Efecto Espectador , Antiinfecciosos/farmacología , Citocinas , BiopelículasRESUMEN
The Muraenolepididae family of fishes, known as eel cods, inhabits continental slopes and shelves in the Southern Hemisphere. This family belongs to the Gadiformes order, which constitutes one of the most important commercial fish resources worldwide, but the classification of the fish species in this order is ambiguous because it is only based on the morphological and habitat characteristics of the fishes. Here, the genome of Patagonian moray cod was sequenced using the Illumina HiSeq platform, and screened for microsatellite motifs. The genome was predicted to be 748.97 Mb, with a heterozygosity rate of 0.768%, via K-mer analysis (K = 25). The genome assembly showed that the total size of scaffolds was 711.92 Mb and the N50 scaffold length was 1522 bp. Additionally, 4,447,517 microsatellite motifs were identified from the genome survey assembly, and the most abundant motif type was found to be AC/GT. In summary, these data may facilitate the identification of molecular markers in Patagonian moray cod, which would be a good basis for further whole-genome sequencing with long read sequencing technology and chromosome conformation capture technology, as well as population genetics.
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BACKGROUND: Despite the positive effect of the photobiomodulation therapy (PBMT) application on animals, the primary role of this technique on the human condyle is still unclear. Several experimental reports have shown the efficacy of PBMT in inducing cellular changes in the temporomandibular joint (TMJ) region during functional treatment of patients with skeletal deformities. Still, the lack of information about its effects on human condyles requires further studies. OBJECTIVES: This study aimed to evaluate the effect of PBMT on the TMJ components following Class III treatment with the reversed twin block (RTB) appliance in growing patients. Materials and Method: Forty children (12 females, 28 males) between the age of nine and eleven years with skeletal Class III were assigned randomly to the RTB group with photobiomodulation (RTB+PBMT) or the control group (RTB). The PBMT was applied to the TMJ region using an 808-nm wavelength Ga-Al-As semiconductor laser device with 5 Joules/cm2 energydensity on days 1, 3, 7, and 14 of the first month. Afterwards, the irradiation was conducted every 15 days until the end of the treatment. Cone-beam computerized tomography (CBCT) images were taken before (T1) treatment and following the end of treatment (T2) to assess TMJ and skeletal changes. RESULTS: Condylar volume was significantly increased in the RTB group only by a mean of 287.97 mm3 (p<0.001). The significantly backward and upward condylar movement was observed in the RTB and RTB+PBMT groups (superior joint space (SJS): 0.26 mm, 0.15 mm; posterior joint space (PJS): 0.42mm, 0.11mm, respectively). The RTB group showed the most remarkable changes. Significant improvement of the sagittal maxilla-mandibular relationship was greater in the RTB+PBMT group compared to the RTB group (p=0.02). CONCLUSION: There were no considerable differences in the condylar position after Class III treatment between the RTB and the RTB+PBMT groups. But a difference in the condylar volume was noticed between the two group.
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The development of protocols for laser-assisted therapy demands strict compliance with comprehensive operating parametry. The purpose of this investigation was to examine the accuracy of correlation between laser control panel and fibre emission power values in a selection of diode dental lasers. Through retrospective analysis using successive systematic review and meta-analysis, it is clear that there is inconsistency in the details, and possible inaccuracies in laser power applied and associated computed data. Through a multi-centre investigation, 38 semi-conductor ("diode") dental laser units were chosen, with emission wavelengths ranging from 445 to 1064 nm. Each unit had been recently serviced according to manufacturer's recommendations, and delivery fibre assembly checked for patency and correct alignment with the parent laser unit. Subject to the output capacity of each laser, four average power values were chosen using the laser control panel-100 mW, 500 mW, 1.0 W, and 2.0 W. Using a calibrated power meter, the post-fibre emission power value was measured, and a percentage power loss calculated. For each emission, a series of six measurements were made and analysed to investigate sources of power losses along the delivery fibre, and to evaluate the precision of power loss determinations. Statistical analysis of a dataset comprising % deviations from power setting levels was performed using a factorial ANOVA model, and this demonstrated very highly significant differences between devices tested and emission power levels applied (p < 10-142 and < 10-52 respectively). The devices × emission power interaction effect was also markedly significant (p < 10-66), and this confirmed that differences observed in these deviations for each prior power setting parameter were dependent on the device employed for delivery. Power losses were found to be negatively related to power settings applied. Significant differences have emerged to recommend the need to standardize a minimum set of parameters that should form the basis of comparative research into laser-tissue interactions, both in vitro and in vivo.
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Terapia por Láser , Terapia por Luz de Baja Intensidad , Odontología , Terapia por Láser/métodos , Rayos Láser , Terapia por Luz de Baja Intensidad/métodos , Metaanálisis como Asunto , Estudios Multicéntricos como Asunto , Estudios RetrospectivosRESUMEN
Background: Dosimetry at a level of 2-8 J/cm2 at target cellular level has been accepted to represent the optimum range for the stimulatory benefits associated with photobiomodulation therapies. However, it has been proposed that a higher bracket of 10-30 J/cm2 at target tissue level may represent a good and effective range for analgesia, accompanied by at-distance regional anti-inflammatory effects. However, although this provides a useful guideline, transforming recommendations into a translatable and repeatable clinical skill have to date proven elusive. Methods: Based on prior publications of systematic reviews by the authors, key factors have been identified, associated with reported clinical and in vitro and in vivo animal studies that can support outcome success or null responses. Drawn from five recently published systematic reviews, an analysis of an extended published evidence base indicates that research methodology should embrace a mature understanding of terminology, a requirement for consistent metered energy delivery, and an appreciation of optical transport techniques. Results: Using models derived from orthodontics and oncology, evidence-based optimal delivery parameters and techniques are presented. Within the confines of the accepted inclusion criteria, a modified Cochrane risk of bias tool has been applied and the parameters extracted from the included studies were subjected to a meta-analysis. This demonstrated a low risk of bias from the studies included with a multivariate and/or univariate statistical analysis that supports the author's evidence-based determinations. The adoption of a surface optical spot size of >1 cm2 demonstrated a high degree of success in managing both superficial as well as subsurface pathologies in oral care. Also, the timing of the intervention with conditioning before or at the same time as a potentially traumatic cellular event was found to be a significant signal of outcome success. An extended commentary explores the benefits and disadvantages of scanning techniques. Conclusions: The extracted clinical data are cross-referenced to the mechanisms suggested for photobiomodulation therapies from the authors' own current in vitro research, and proposals are made for some possible lines of approach in future research and clinical trials.
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Analgesia , Terapia por Luz de Baja Intensidad , Ortodoncia , Revisiones Sistemáticas como AsuntoRESUMEN
There are inconclusive results regarding etching and bonding protocol to achieve optimal bond strength and marginal integrity of adhesive composite resin restorations in erbium laser prepared cavities. This systematic review aimed to consider which adhesive system protocol may be optimal in achieving the bond strength and marginal integrity in erbium laser-prepared cavities, comparable to that obtained with conventional method of cavity preparation. This review was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement with literature search based on all publications during the period January1, 2000-October 10, 2020, in three databases: MEDLINE, Google Scholar and ScienceDirect. The necessary information was extracted by two independent authors. The search resulted in 139 articles from all databases, and a total of thirty-one articles met the inclusion criteria. The results indicated that the selection of adhesives depending on their pH and composition and the laser pulse duration and pulse energy used plays an important role in predicting the adhesion and marginal integrity. The 10-MDP containing moderate self-etch adhesives has demonstrated predictable outcomes. Longer pulse durations used for cavity preparations may indicate the use of etch-and-rinse (EnR) or moderate self-etch adhesives (SEA) to allow better resin infiltration in deep craters formed due to laser irradiation. However, further studies with more standardizations in relation to adhesives and laser parameters are needed.
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Recubrimiento Dental Adhesivo , Recubrimientos Dentinarios , Adhesivos , Resinas Compuestas , Erbio , Rayos Láser , Ensayo de Materiales , Cementos de ResinaRESUMEN
Trematomus loennbergii Regan, 1913, is an evolutionarily important marine fish species distributed in the Antarctic Ocean. However, its genome has not been studied to date. In the present study, whole genome sequencing was performed using next-generation sequencing (NGS) technology to characterize its genome and develop genomic microsatellite markers. The 25-mer frequency distribution was estimated to be the best, and the genome size was predicted to be 815,042,992 bp. The heterozygosity, average rate of read duplication, and sequencing error rates were 0.536%, 0.724%, and 0.292%, respectively. These data were used to analyze microsatellite markers, and a total of 2,264,647 repeat motifs were identified. The most frequent repeat motif was di-nucleotide with 87.00% frequency, followed by tri-nucleotide (10.45%), tetra-nucleotide (1.94%), penta-nucleotide (0.34%), and hexa-nucleotide (0.27%). The AC repeat motif was the most abundant motif among di-nucleotides and among all repeat motifs. Among microsatellite markers, 181 markers were selected and PCR technology was used to validate several markers. A total of 15 markers produced only one band. In summary, these results provide a good basis for further studies, including evolutionary biology studies and population genetics of Antarctic fish species.
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Introduction: The aim of this article was to evaluate reports in the scientific literature that used antimicrobial photodynamic therapy (aPDT) with a blue light source and curcumin and riboflavin as photosensitizers in the management of periodontitis. Methods: The search was conducted in electronic databases, including PubMed, Web of Science, and Scopus, with the keywords "photodynamic therapy", "antimicrobial photodynamic therapy", "laser activated disinfection", "photoactivated disinfection", "light activated disinfection" "LED", "Periodontitis", "Curcumin", "Riboflavin", and "periodontitis" from 2012 to 2020. Results: After evaluating a total of 24 relevant articles, 13 articles were selected, full texts were read, and the data were extracted and placed in a table. Conclusion: Reviewing articles showed that curcumin as a photosensitizer activated by a blue wavelength is effective in the elimination of the various bacterial species involved in periodontal disease, and to the best of our knowledge, there is no study that has shown this substance does not reduce bacteria. According to the result of the articles, riboflavin as a photosensitizer activated by blue light can reduce bacteria that are involved in periodontitis, but other studies have reported that blue light alone can also reduce bacteria significantly. Therefore, more in-vitro and clinical trial studies are needed to give a more conclusive opinion on the effectiveness of riboflavin as a photosensitizer in the treatment of periodontitis.
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The ability to engineer biological systems, whether to introduce novel functionality or improved performance, is a cornerstone of biotechnology and synthetic biology. Typically, this requires the generation of genetic diversity to explore variations in phenotype, a process that can be performed at many levels, from single molecule targets (i.e., in directed evolution of enzymes) to whole organisms (e.g., in chassis engineering). Recent advances in DNA synthesis technology and automation have enhanced our ability to create variant libraries with greater control and throughput. This review highlights the latest developments in approaches to create such a hierarchy of diversity from the enzyme level to entire pathways in vitro, with a focus on the creation of combinatorial libraries that are required to navigate a target's vast design space successfully to uncover significant improvements in function.
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Evolución Molecular Dirigida , Biología Sintética , Biotecnología , Variación Genética/genética , FenotipoRESUMEN
Non-coding RNAs (ncRNAs), including the more recently identified Stable Unannotated Transcripts (SUTs) and Cryptic Unstable Transcripts (CUTs), are increasingly being shown to play pivotal roles in the transcriptional and post-transcriptional regulation of genes in eukaryotes. Here, we carried out a large-scale screening of ncRNAs in Saccharomyces cerevisiae, and provide evidence for SUT and CUT function. Phenotypic data on 372 ncRNA deletion strains in 23 different growth conditions were collected, identifying ncRNAs responsible for significant cellular fitness changes. Transcriptome profiles were assembled for 18 haploid ncRNA deletion mutants and 2 essential ncRNA heterozygous deletants. Guided by the resulting RNA-seq data we analysed the genome-wide dysregulation of protein coding genes and non-coding transcripts. Novel functional ncRNAs, SUT125, SUT126, SUT035 and SUT532 that act in trans by modulating transcription factors were identified. Furthermore, we described the impact of SUTs and CUTs in modulating coding gene expression in response to different environmental conditions, regulating important biological process such as respiration (SUT125, SUT126, SUT035, SUT432), steroid biosynthesis (CUT494, SUT053, SUT468) or rRNA processing (SUT075 and snR30). Overall, these data capture and integrate the regulatory and phenotypic network of ncRNAs and protein-coding genes, providing genome-wide evidence of the impact of ncRNAs on cellular homeostasis.
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Redes Reguladoras de Genes/genética , ARN no Traducido/genética , Transcripción Genética , Transcriptoma/genética , Regulación Fúngica de la Expresión Génica/genética , Genoma Fúngico , Haploidia , Fenotipo , Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae/genética , Factores de Transcripción/genéticaRESUMEN
AIMS: Definition of sense and antisense microRNA matches in 3'utr. BACKGROUND: Matches of mature microRNAs (m-miRs) in human 3'utr could be traced to mutations producing fragments of original m-miR sequences without physical separation. (The m-miR matches in 5'utr and cds should be by far fewer, but could follow similar patterns). OBJECTIVE: To ascertain if the sense and antisense m-miR fragments in 3'utr occur at similar or different levels. METHODS: Frequency of sense and antisense m-miR matches in 3'utr was examined in the range of 7-22 nucleotides. RESULTS: The fragmentation occurs at gene level by mutation within one of the paired m-miRs, which upon transcription results in increased interactive capability for both former pre-micro (premir) RNA stem partners. The non-mutated stem partner can persist in 3'utr sequences, as is apparent from significant presence of miR-619-5p and miR-5096 and some conservation of 20 other simian- specific m-miR sequences. However, most of m-mir sequences in 3'utr are extensively fragmented, with low preservation of long matches. In flanks of individual m-miR embeds the mutated pre-mir positions are to a degree defined specifically. CONCLUSION: The m-mir matches of various sizes in 3'utr apparently reflect accumulation, on a phylogenetic time scale, of in-sequence point mutations. Across human 3'utr this fragmentation is significantly less for evolutionarily recent human m-miRs that originate in simians compared to human m-miRs first appearing in lower primates, and especially to human m-miRs introduced in nonprimates.
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Biología Computacional/métodos , MicroARNs/genética , ARN Mensajero/genética , Regiones no Traducidas 3' , Composición de Base , HumanosRESUMEN
BACKGROUND: During in-office bleaching, appropriate light sources are applied in order to enhance the activity of the bleaching gels applied onto teeth. For this method to be effective, a high absorption of light within the gel is necessary. Variation in the light attenuation capability of the gel, the duration of application and light activation can contribute towards safety hazards associated with this procedure. METHODS: In this study, seven different gels and hydrogen peroxide have been evaluated for their optical properties by means of spectrophotometry (440-1000 nm). The transmitted light spectrum was used to estimate the intensity loss for each gel. The mean intensity decreases observed were statistically analysed using an analysis of variance (ANOVA). RESULTS: The five more-pigmented gels tested indicated a very similar intensity loss of around 80%, whereas the remaining two gels showed significantly less attenuation (predominantly, p < 10-6). CONCLUSIONS: Throughout the spectrum of wavelengths examined, and according to the underlying studies evaluated, five of the gels assessed demonstrated an attenuation high enough to possibly avoid overheating of the underlying enamel dentine and pulp. An evaluation of appropriate irradiation parameters is proposed.
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It is a common experience amongst laser dentists and patients that mid-IR wavelength application in cavity preparation may be achieved without causing any associated pain. The erbium family of lasers (Er,Cr:YSGG 2780 nm and Er:YAG 2940 nm) are frequently used without employing injectable local anesthesia as an adjunct: the phenomenon arising from the application of these devices is known as laser analgesia. This review seeks to apply a systematic approach to the examination of appropriate published studies but also to highlight the need for much more structured clinical investigations that consolidate photonic dose and methodology. A search of published data using PRISMA criteria was carried out to examine clinical trials into laser analgesia in conjunction with restorative dentistry, applying inclusion and exclusion criteria. From this, 10 published articles were selected for analysis. Suitability assessment was carried out, using a modified Cochrane risk of bias methodology. In 8/10 of the included studies, laser-induced analgesia is claimed to be better and effective, while in 2/10 of the studies, no difference was exhibited compared to the control group. Statistical analysis of three split mouth studies concluded that only one of these investigations reviewed demonstrated a significant analgesic effect for laser treatment while the other two did not support this observation. From this data, it is inconclusive to assess the predictability of laser analgesia in cavity preparation. A possible rationale and laser operating parametry has been discussed. Successful implementation of this treatment modality remains technique sensitive and subject to further investigation.
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OBJECTIVE: This systematic review and meta-analysis of published randomized controlled trials examines a possible relationship between optical spot size at surface tissue, irradiance, radiant exposure, total energy delivered, operator technique and reported clinical outcomes. BACKGROUND: Clinical photobiomodulation (PBM) therapy has achieved a high level of evidence-based acceptance in the mitigation of oral mucositis associated with cancer radiotherapy and chemotherapy, and supportive clinical research in relation to orthodontic tooth movement, oral medical conditions, including burning mouth syndrome, xerostomia and lichen planus. Inconsistent outcomes have been reported not withstanding a substantial body of primary supportive research from clinical, in vitro and animal studies. MATERIALS AND METHODS: PubMed, Cochrane Database of Reviews and Google Scholar search engines were applied to identify human clinical trials of PBM therapy in clinical dentistry. A total of 766 articles between February 2009 and June 2020 were identified and following a full text evaluation, 38 papers with sufficient data to permit analyses are included in this investigation. RESULTS: Following a detailed assessment of potential factors that may have an influence in clinical outcome, a clear trend is apparent associating optical spot size to a positive or negative effect. Furthermore, there is a clear difference in the reported results in relation to total energy applied, delivery techniques and optical parameters, which merits further investigation. Factorial statistical analyses identified an association between smaller optical surface applications and an overall lower level of reported clinical success in treating superficial and deeper targets, and correspondingly sub-surface larger target tissues were found to be more responsive to therapy by use of a larger optical surface spot size. Moreover, use of multiple small diameter probe applications was found to provide inconsistent results. CONCLUSIONS: Many factors can confound clinical success including variations in anatomy, site location, clinical condition and subject individuality. To achieve higher levels of predictable outcome, a mature appreciation of these factors, plus an expanded understanding of laser parametry, tissue volume and target depth to deliver an adequate dose within current recommended guidelines, is essential.
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Objective: To explore via systematic review the validation of uneventful post-surgical healing, associated with shorter and longer laser wavelength applications in minor oral surgery procedures. Methods: From April 28 to May 11, 2020, PubMed, Cochrane Database of Systemic Reviews, and Google Scholar search engines were applied to identify human clinical trials of photobiomodulation (PBM) therapy in clinical dentistry. The searches were carried out with reference to (1) dental laser wavelengths shorter than 650 nm; (2) wavelengths localized within the 2780-2940 nm; and (3) the 9300-10,600 nm range. Selected articles were further assessed by three independent reviewers for strict compliance with PRISMA guidelines and modified Cochrane Risk of Bias to determine eligibility. Results: Using selection filters of randomized clinical trials, moderate/low risk of bias, and the applied period, and following PRISMA guidelines, 25 articles were selected and examined. A risk of bias was completed, where 11 out of 25 publications were classified as low risk of bias, and 14 out of 25 were classified as medium risk status. In total, 6 out of 13 (46% of) studies comparing the examined laser wavelengths with scalpel-based treatment showed positive results, whereas 6 out of 13 (46%) showed no difference, and only 1 out of 13 (7.7%) presented a negative outcome. In addition, 5 out of 6 (83% of) studies comparing the examined laser wavelengths with other diodes (808-980 nm) showed positive results, whereas 1 out of 6 (17%) had negative outcomes. Conclusions: A detailed and blinded examination of published studies has been undertaken, applying strict criteria to demonstrate research outcome data, which suggests positive or at worst neutral comparatives when a given laser wavelength system is used against an alternative control therapy. As such, substantiated evidence for laser surgery in delivering uneventful healing and analgesic effects, as an expression of a PBM-like (quasi-PBM) influence, has been shown.
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Terapia por Luz de Baja Intensidad , Humanos , Cicatrización de HeridasRESUMEN
BACKGROUND: Antimicrobial photodynamic therapy (aPDT) has been proposed as an effective alternative method for the adjunctive treatment of all classes of oral infections. The multifactorial nature of its mechanism of action correlates with various influencing factors, involving parameters concerning both the photosensitizer and the light delivery system. This study aims to critically evaluate the recorded parameters of aPDT applications that use lasers as the light source in randomized clinical trials in dentistry. METHODS: PubMed and Cochrane search engines were used to identify human clinical trials of aPDT therapy in dentistry. After applying specific keywords, additional filters, inclusion and exclusion criteria, the initial number of 7744 articles was reduced to 38. RESULTS: Almost one-half of the articles presented incomplete parameters, whilst the others had different protocols, even with the same photosensitizer and for the same field of application. CONCLUSIONS: No safe recommendation for aPDT protocols can be extrapolated for clinical use. Further research investigations should be performed with clear protocols, so that standardization for their potential dental applications can be achieved.