Review Article

Low-Level Laser Therapy in Russia: History, Science and Practice

Sergey Vladimirovich Moskvin

Journal of Lasers in Medical Sciences, Vol. 8 No. 2 (2017), 8 April 2017, Page 56-65

In Russia (formerly USSR) study of biomodulation action (BMA) mechanisms of low-intensity laser irradiation (LILI) began in 1964, immediately after the development of lasers. During the period from 1965 to 1972 several dozens of scientific conferences were held, hundreds of studies were published. Generally, secondary mechanisms and results of LILI effect on patients with various diseases were studied. This data was immediately implemented into practical medicine in the fields of oncology, surgery, dermatology and dentistry, and since 1974 low level laser therapy (LLLT) is included in the standard of state medical care. For 50 years no less than 1000 books were published (monographs, collections, methodical and clinical materials), thousands of researches were carried out. Primary mechanism and patterns of interaction of LILI with acceptors within cells can be represented in the following order: absorption of photon’s energy – emergence of a local temperature gradient – release of Ca2+ from intracellular stores – stimulating Ca2+–dependent processes. Understanding of this process allowed the explanation of all known secondary effects, optimized methods and extremely increased effectiveness of LLLT. Owing to the knowledge of BMA mechanisms of LILI, numerous associated and combined LLLT techniques were developed and are widely used nowadays: locally, on the projection of internal organs, laser acupuncture, reflexology, intracavitary, transdermal and intravenous laser blood illumination, magnetic-laser therapy, laser phoresis, laser-vacuum massage, biomodulation, etc. About 400 000 laser therapeutic devices are used in Russian practical healthcare. Unique, having no analogues in the world devices, are produced – red pulsed laser diodes (wavelength 635 nm, power 5-40 W, pulse duration 100 ns, frequency 10 000 Hz) are designed specially for effective laser therapy.

Original Article

Effects of Root Debridement With Hand Curettes and Er:YAG Laser on Chemical Properties and Ultrastructure of Periodontally-Diseased Root Surfaces Using Spectroscopy and Scanning Electron Microscopy

Reza Amid, Gholamali Gholami, Masoud Mojahedi, Maryam Aghalou, Mohsen Gholami, Mahdieh Mirakhori

Journal of Lasers in Medical Sciences, Vol. 8 No. 2 (2017), 8 April 2017, Page 66-71

Introduction: The efficacy of erbium-doped yttrium aluminum garnet (Er:YAG) laser for root debridement in comparison with curettes has been the subject of many recent investigations. Considering the possibility of chemical and ultra-structural changes in root surfaces following laser irradiation, this study sought to assess the effects of scaling and root planing (SRP) with curettes and Er:YAG laser on chemical properties and ultrastructure of root surfaces using spectroscopy and scanning electron microscopy (SEM).

Methods: In this in vitro experimental study, extracted sound human single-rooted teeth (n = 50) were randomly scaled using manual curettes alone or in conjunction with Er:YAG laser at 100 and 150 mJ/pulse output energies. The weight percentages of carbon, oxygen, phosphorous and calcium remaining on the root surfaces were calculated using spectroscopy and the surface morphology of specimens was assessed under SEM. Data were analyzed using one-way analysis of variance (ANOVA).

Results: No significant differences (P > 0.05) were noted in the mean carbon, oxygen, phosphorous and calcium weight percentages on root surfaces following SRP using manual curettes with and without laser irradiation at both output energies. Laser irradiation after SRP with curettes yielded rougher surfaces compared to the use of curettes alone.

Conclusion: Although laser irradiation yielded rougher surfaces, root surfaces were not significantly different in terms of chemical composition following SRP using manual curettes with and without Er:YAG laser irradiation. Er:YAG laser can be safely used as an adjunct to curettes for SRP.

Comparison of the Antimicrobial Efficacy of Calcium Hydroxide and Photodynamic Therapy Against Enterococcus faecalis and Candida albicans in Teeth With Periapical Lesions; An In Vivo Study

Zohreh Ahangari, Maryam Mojtahed Bidabadi, Mohammad Asnaashari, Afsaneh Rahmati, Fahimeh Sadat Tabatabaei

Journal of Lasers in Medical Sciences, Vol. 8 No. 2 (2017), 8 April 2017, Page 72-78

Introduction: Elimination of pathological microflora of root canal systems is a major goal in endodontic treatment. This study aimed to compare the antimicrobial efficacy of calcium hydroxide as an intracanal medication and antibacterial photodynamic therapy (aPDT) against Enterococcus faecalis and Candida albicans in teeth with periapical (PA) lesions.

Methods: This in vivo study was conducted on 20 patients with single-rooted mandibular premolar with previously failed endodontic treatment. This study was performed as a clinical trial (IRCTID: IRCT2016090429686N1). After conventional chemo-mechanical root canal preparation (hand and rotary instruments and 2.5% NaOCl), microbiological samples were obtained using sterile paper points, then stored in thioglycolate solution and transferred to a microbiology laboratory. Group 1 (n = 10) specimens underwent aPDT (diode laser 808 nm + 50 mg/mL methylene blue), while creamy calcium hydroxide paste was used in group 2 for a duration of 1 week. A control sample was taken with sterile paper points and F3 Protaper rotary file. The samples were dispersed in transport medium, serially diluted, and cultured on selective mediums to determine the number of colony forming units (CFUs). Data were analyzed by Mann-Whitney U test at 5% significance level. The significance level for all analyses was set at P<0.05.

Results: Number of CFU significantly decreased in both groups after the interventions (P<0.001); however, there was no significant difference in the colony count between the 2 groups.

Conclusion: aPDT and calcium hydroxide therapy showed the same antimicrobial efficacy on E. faecalis and C. albicans.

Proteomic Analysis of the Effect of Extremely Low-Frequency Electromagnetic Fields (ELF-EMF) With Different Intensities in SH-SY5Y Neuroblastoma Cell Line

Mostafa Rezaie-Tavirani, Hadi Hasanzadeh, Samaneh Seyyedi, Hakimeh Zali

Journal of Lasers in Medical Sciences, Vol. 8 No. 2 (2017), 8 April 2017, Page 79-83

 Introduction: During the last 3 decades, human is exposed to extremely low frequency electromagnetic fields (ELF-EMF) emitted by power lines and electronic devices. It is now well accepted that ELF-EMF are able to produce a variety of biological effects, although the molecular mechanism is unclear and controversial. Investigation of different intensities effects of 50 Hz ELF-EMF on cell morphology and protein expression is the aim of this study.

Methods: SH-SY5Y human neuroblastoma cell line was exposed to 0.5 and 1 mT 50 Hz (ELF-EMF) for 3 hours. Proteomics techniques were used to determine the effects of these fields on protein expression. Bioinformatic and statistical analysis of proteomes were performed using Progensis SameSpots software.

Results: Our results showed that exposure to ELF-EMF changes cell morphology and induces a dose-dependent decrease in the proliferation rate of the cells. The proteomic studies and bioinformatic analysis indicate that exposure to 50 Hz ELF-EMF leads to alteration of cell protein expression in both dose-dependent and intensity dependent manner, but the later is more pronounced.

Conclusion: Our data suggests that increased intensity of ELF-EMF may be associated with more alteration in cell protein expression, as well as effect on cell morphology and proliferation.

Efficacy and Safety of Laser Lithotripsy in Pregnancy

Amir Reza Abedi, Farzad Allameh, Mohammadreza Razzaghi, Behrouz Fadavi, Hamidreza Qashqai, Saman Najafi, Arash Ranjbar, Manouchehr Bashirian

Journal of Lasers in Medical Sciences, Vol. 8 No. 2 (2017), 8 April 2017, Page 84-87

Introduction: The aim of our study was to assess the efficacy and safety of laser lithotripsy in pregnant patients.

Methods: In this retrospective study, we reviewed the 15 pregnant women who have been treated for ureteral stones with semi-rigid ureteroscope and holmium laser at our center between Januarys 2007and April 2015.

Results: The mean age of patients and mean gestational age was 29.3 years old 27.3 weeks respectively. Mean size of stones was 7.84 mm. Twelve patients had renal colic, and hematuria was found in 3 cases. Irritative urinary symptoms such as frequency and urgency detected in 6 ones and 2 patients had fever. The stone of all patients were fragmented by using holmium laser lithotripter. In 5 patients stone residual fragments were removed by grasper while other 10 patients were left to pass fragments spontaneously. No intraoperative and postoperative urological or obstetric complication was seen.

Conclusion: Laser lithotripsy is safe and efficacious in pregnant patients who have ureteral stone that does not respond to conservative management.

Efficacy of Conventional Laser Irradiation Versus a New Method for Gingival Depigmentation (Sieve Method): A Clinical Trial

Behzad Houshmand, Noushin Janbakhsh, Fatemeh Khalilian, Mohammad Reza Talebi Ardakani

Journal of Lasers in Medical Sciences, Vol. 8 No. 2 (2017), 8 April 2017, Page 88-94

Introduction: Diode laser irradiation has recently shown promising results for treatment of gingival pigmentation. This study sought to compare the efficacy of 2 diode laser irradiation protocols for treatment of gingival pigmentations, namely the conventional method and the sieve method.

Methods: In this split-mouth clinical trial, 15 patients with gingival pigmentation were selected and their pigmentation intensity was determined using Dummett’s oral pigmentation index (DOPI) in different dental regions. Diode laser (980 nm wavelength and 2 W power) was irradiated through a stipple pattern (sieve method) and conventionally in the other side of the mouth. Level of pain and satisfaction with the outcome (both patient and periodontist) were measured using a 0-10 visual analog scale (VAS) for both methods. Patients were followed up at 2 weeks, one month and 3 months. Pigmentation levels were compared using repeated measures of analysis of variance (ANOVA). The difference in level of pain and satisfaction between the 2 groups was analyzed by sample t test and general estimate equation model.

Results: No significant differences were found regarding the reduction of pigmentation scores and pain and scores between the 2 groups. The difference in satisfaction with the results at the three time points was significant in both conventional and sieve methods in patients (P = 0.001) and periodontists (P = 0.015).

Conclusion: Diode laser irradiation in both methods successfully eliminated gingival pigmentations. The sieve method was comparable to conventional technique, offering no additional advantage.

Case Report

Complete Clearance of Resistant Granuloma Faciale With Pulsed Dye Laser After Pre-treatment With Mometasone and Tacrolimus

Daniel Micallef, Michael J Boffa

Journal of Lasers in Medical Sciences, Vol. 8 No. 2 (2017), 8 April 2017, Page 95-97

Introduction: Granuloma faciale is an uncommon inflammatory dermatosis which usually affects the face and is often resistant to treatment.

Case Report: A 39-year-old English lady with Fitzpatrick skin phototype II presented with typical lesions of granuloma faciale, confirmed on biopsy, on her cheeks and nose. Treatment with ScleroPlus pulsed dye laser (Candela Corporation, Wayland, Mass) produced no visible improvement. The patient re-presented 5 years later with the same lesions, now more prominent. No improvement was noted with topical mometasone, however addition of topical tacrolimus caused significant flattening. Since the erythema and telangiectases persisted, treatment with ScleroPlus pulsed dye laser was re-attempted. Treatments were performed with a wavelength of 595 nm, pulse duration of 1.5 ms and 7 mm spot at a fluence of 8.5 J/cm2 in the first session and 9.5 J/cm2 in the subsequent 2 sessions. This resulted in complete resolution without scarring or pigmentary change. There was no recurrence at follow-up one year later.

Conclusion: Our observation supports the use of combination therapy in resistant cases of granuloma faciale. One such combination would be the application of a topical corticosteroid and tacrolimus followed by pulsed dye laser.

Successful Treatment of Unilateral Klippel-Trenaunay Syndrome With Pulsed-Dye Laser in a 2-Week Old Infant

Hoda Rahimi, Habib Hassannejad, Hamideh Moravvej

Journal of Lasers in Medical Sciences, Vol. 8 No. 2 (2017), 8 April 2017, Page 98-100

Introduction: Klippel–Trenaunay syndrome (KTS) is a rare congenital mesodermal abnormality characterized by varicose veins, cutaneous capillary malformation, as well as bone and soft tissue hypertrophy.

Case Report: A 2-week-old female infant presented to our clinic because of vascular nevus and progressive enlargement of her right extremities and trunk since birth. The patient was treated with 595-nm pulsed-dye laser (PDL). Her port-wine stain (PWS) disappeared completely after third PDL session and the soft tissue hypertrophy stopped. The patient experienced neither recurrence nor any change in size after 7 years of follow up.

Conclusion: PDL can treat KTS completely with no reccurence if it is used in “early stage” of disease.