Journal of Lasers in Medical Sciences

The coronavirus disease 2019 (COVID-19) pandemic has forced numerous changes in our lives. Many of us lost our loved ones in this tragedy. Serendipitously, there were some good changes for patients and surgeons too. For example, telemedicine has been extensively integrated into patient care visits for the benefit of both the patients and the care providers.
In the Journal of Lasers in Medical Sciences (JLMS) , we are also undergoing a significant change. From now on, the publication routine of the journal changes from quarterly to continuous. This means that once an article is accepted for publication, there will be no need to wait for the next issue to be published, and the article will be displayed on the journal site immediately and indexed in global references. This significantly reduces the waiting time for authors to see the results of their work and efforts.
As a result, one of the main concerns of the authors, which was the long queue for the publication of the accepted article, is resolved. Another point is that we intend to publish a volume of the journal every year without separate issues so the citation method to the articles will change a little.
Over the past several years, JLMS has experienced a substantial increase in the number and quality of submissions and the depth and breadth of Laser science in these submissions. This welcome growth in volume and complexity, however, has challenged the review capacity of the co-editors and laid bare an insufficient organizational structure. We are extremely fortunate to have an excellent editorial board loaded with talented individuals with extensive expertise and a considerable depth of knowledge. Because of the riches of our editorial board, following a highly competitive search, we are introducing a new organizational structure that will include section editors.
We are excited to introduce these new editors, who bring expertise, energy, and networks of respected, knowledgeable colleagues in their respective specialties to JLMS. We are grateful for their unwavering commitment to the peer review process that will help us to upgrade the level of our journal. Please join us, and feel free to share your thoughts with us!

DOI:10.34172/jlms.2021.01

This article is in Editorial form and doesn't need the abstract.

DOI: 10.34172/jlms.2021.66.

Introduction: The clinical and economic burden of kidney stones is a challenge for the healthcare system. There is a limited bibliometric project exploring the literature trends on ‘urolithiasis’ and its related management.
Methods: A review was conducted to discover the related abstracts regarding each specific issue, investigated year by year from May 2000 to May 2020. To make an effective comparison, the statistics resulting from every single study were allocated to two 10-year periods: period 1 (2000 to 2010) and period 2 (2010 to 2020). We included all English language articles, all non-English articles with English abstracts, and studies in which interventions were used for stone removal, including laser technology.
Results: These articles are about ureteroscopy (URS) (n=10360, 33.45%), percutaneous nephrolithotomy (PCN) (n =10790, 34.84%) and extracorporeal shockwave lithotripsy (ESWL) (n=9846, 31.76%). When evaluating the two time periods, there were 9912 studies available in period one, which increased by ×2.12 times (112.71% rise) to 21 084 studies in period two (P=0.001). The increase was 133%, 103.51%, and 70.4% for URS, PCN, and SWL respectively. A total of 855 studies on Laser application via URS were published on PubMed over a 20-year period. There was an increasing trend toward using laser applications via URS over the study period. Also, there were 230 articles published in period one, which increased by nearly 2.71 times to 625 papers in period two (P< 0.001). There was an increasing trend toward using laser application via PCN; 126 papers were published in period one, which increased by nearly 3.05 times (rise of 205.5%) to 385 papers in period two (P = 0.002).
Conclusion: The minimal invasive interventions for stone removal, including URS and PCN, increased dramatically in the last decade, and the use of lasers in stone treatment increased significantly in the last decade.

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.

Introduction: This systematic review was conducted to evaluate the effectiveness of low-level laser therapy (LLLT) in orthodontic separator pain.
Methods: This article was written according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Electronically and manually 3 databases, namely PubMed, Scopus, and Google Scholar, were searched by the keywords that were selected based on population, intervention, comparison, and outcome (PICO) on October 10, 2020. Studies were appraised by Cochrane version 5.2.0 with 7 domains and were checked by these inclusion criteria: 1. Randomized clinical trial (RCT) that examined the efficacy of LLLT in separator pain, 2. Splitmouth design, 3. LLLT application in the first hours after separator placement, 4. LLLT application to both sides of the teeth, 5. Patients receiving elastomeric separators between the premolars and
molars, 6. Lasers with a wavelength of 800-899 nm, 7. Studies conducted from 2010 to 2020, and 8. Participants who went through orthodontic treatment without limitation in gender, age, and socialeconomic status.
Results: 299 studies were screened. 34 full-text papers were read by 2 authors independently. In the end, 4 articles met the inclusion criteria. All 4 articles showed LLLT has a significant impact on pain reduction.
Conclusion: The exact protocol for laser therapy is still not clear. Therefore, more studies with a meticulously designed method are needed.

DOI: 10.34172/jlms.2021.29

Introduction: Blue and blue-violet diode lasers (450 and 405 nm) seem to represent an interesting approach for several clinical treatments today. The aim of this narrative review is to describe and comment on the literature regarding the utilization of blue and blue-violet lasers in dentistry.
Methods: A search for “blue laser AND dentistry” was conducted using the PubMed database, and all the papers referring to this topic, ranging from 1990 to April 2020, were analyzed in the review. All the original in vivo and in vitro studies using 450 nm or 405 nm lasers were included in this study. All the articles on the LED light, laser wavelengths other than 405 and 450 nm, and using lasers in specialties other than dentistry, as well as case reports, guideline papers, and reviews were excluded.
Results: From a total of 519 results, 47 articles met the inclusion criteria and were divided into 8 groups based on their fields of application: disinfection (10), photobiomodulation (PBM) (4), bleaching (1), resin curing (20), surgery (7), periodontics (1), endodontics (1) and orthodontics (3).
Conclusion: Blue and blue-violet diode lasers may represent new and effective devices to be used in a large number of applications in dentistry, even if further studies will be necessary to fully clarify the potentialities of these laser wavelengths

DOI:10.34172/jlms.2021.31

Introduction: Herpesvirus infection has a variety of clinical forms and is extremely widespread in the world while existing treatment methods are not always quite effective. The search for new treatment modalities is a relevant problem and numerous studies show the therapeutic effect of low level laser therapy (LLLT) on different herpesvirus types.
Methods: The mechanisms of laser light action and the impact of LLLT on the pathological pathways of herpes infections are described. A narrative review of the relevant papers is conducted.
Results: The reviewed studies confirm that LLLT is a potential prospective treatment method for patients infected with the herpes virus. However, it is necessary to improve the methodology and optimize the combination of laser action with antiviral medications.
Conclusion: The review shows that it is most effective to combine laser impact on skin lesions with the application of topical antiviral gels or creams, additionally using a combined procedure of laser ultraviolet blood illumination (LUVBI, 365-405 nm) + intravenous laser blood irradiation (ILBI, 525nm).

Doi:10.34172/jlms.2021.38.

Introduction: Laser therapy has attracted experts’ attention in medical sciences. Many benefits of laser therapy are presented besides some complications. The present study, it is tried to present a new perspective of laser therapy in the various fields of medicine.
Methods: Laser therapy-related articles which are combined with regenerative medicine, cosmetic, dentistry, neurodegenerative diseases, kidney, bone fracture, and vaginal function in the English language were searched through the google scholar search engine in the range of 2000-2021. After title screening, the abstracts were evaluated to access the full texts.
Results: Basic concepts and various kinds of lasers that are applied in medicine were explained. Applications of laser therapy in various fields of medicine such as pain reduction, wound healing, regenerative medicine, dentistry, and several other body organs were highlighted and some complications were pointed.
Conclusion: High potential of laser therapy for application in medicine implies a reconsideration of the laser properties and also styles of laser applications to improve the treatment and prevention of its side effects.

DOI:10.34172/jlms.2021.42

Introduction: Currently, lasers are used to treat many diseases and their complications. However, the use of lasers in pregnant patients is still controversial.
Methods: In this review, the application of lasers in the fields of urology, surgery, obstetrics, dermatology, and musculoskeletal disorders is evaluated. The following keywords were used to search through PubMed, Google Scholar, and Scopus: pregnancy, laser, urolithiasis, endovenous laser ablation (EVLA) or treatment, leg edema, varicose vein, venous insufficiencies, hair removal, pigmentation, telangiectasia, vascular lesions, Q switch laser, diode laser, holmium, holmium-YAG laser, erbium laser and Pulsed dye laser, low-level laser therapy, high-intensity laser therapy, pain, musculoskeletal disorders, twin to twin transfusion syndrome (TTTS), amnioreduction, and safety.
Results: Totally, 147 articles were found, and their abstracts were evaluated; out of 53 articles extracted, 14 articles were about dermatology, 24 articles were about urology, 12 articles were about obstetrics and gynecology, 10 articles were about musculoskeletal disorders and three articles were related to surgery.
Conclusion: Laser therapy can be used as a safe treatment for urolithiasis, skin diseases, TTTS, and varicose veins of the lower extremities. However, the use of laser therapy for musculoskeletal disorders during pregnancy is not recommended due to lack of evidence, and also we cannot recommend endovenous ablation.

DOI: 10.34172/jlms.2021.50

Introduction: In recent years, there has been a rise in laser therapy for the treatment of cardiovascular diseases.
Methods: This paper attempted to represent recent advances in laser therapy in cardiovascular tissue repairs. Three standard techniques have been explicitly described herein cardiovascular tissue repairs by laser.
Results: One of the advantages of using laser therapy in cardiovascular diseases is its non-invasiveness. It also reduces the treatment process pain and prevents massive surgical incisions and bleeding throughout the operation. Laser therapy can ensure an alternative method to treat the ischemic region of the heart and creating anastomosis of vessels.
Conclusion: With professional technologies and endoscopic surgery method development, the role of using lasers has become much more precise and more transparent in cardiovascular diseases.

DOI: 10.34172/jlms.2021.52.

Introduction: The most important side effect after non-surgery cancer treatment (NSCT) is oral mucositis (OM) which degrades the quality of life. Using photobiomodulation (PBM), formerly known as low-level laser therapy (LLLT), in the prevention of NSCT-induced OM was widely studied. Hence, this review evaluates the efficacy of optical treatment parameters behind the working process of PBM in preventing NSCT-induced OM in preclinical studies.
Methods: Using the PubMed, Scopus, and Embase databases, the present study systematically reviewed existing preclinical studies for optical treatment parameters of PBM in preventing NSCTinduced OM in experimental models without restriction on the year of publication.
Results: In total, 51 articles were recognized during the search of the literature, and only 16 research papers were included in this review, taking into consideration the inclusion as well as exclusion benchmarks. The reviewed studies showed that a consensus has yet to be reached on the optimal PBM treatment parameters in preventing NSCT-induced OM. However, a wavelength of 660 nm, a power density of 40 mW as well as fluence which ranged between 2 and 6 J/cm2 were mostly utilized in the included studies. Furthermore, the severity of NSCT-induced OM was reduced following PBM application with no reported severe side effects.
Conclusion: The efficacy of PBM with the associated optical parameters is a promising strategy in preventing NSCT-induced OM. However, the optimal parameters of PBM need to be investigated.

DOI: doi:10.34172/jlms.2021.54

Introduction: Photobiomodulation or low-level laser therapy (LLLT;<0.5 W) has been used as a non-invasive treatment for various medical indications. Short (visible; 635-650 nm) and longer (invisible; 810-850 nm and 915-980 nm) near-infrared wavelengths have been commonly used, but power setting deficiencies or incorrect wavelength settings can cause negative outcomes. The 1064 nm wavelength as the longest wavelength is a relative newcomer in high-powered (>0.5 W) laser photobiomodulation therapy (HPL-PBMT) with unique biophysical characteristics.
Methods: A comprehensive search of 2016-2021 PubMed, Google Scholar, and Cochrane databases for “photobiomodulation” restricted to clinical trials for patients with a medical diagnosis was done. “1064 nm” content was identified and restricted to high-powered lasers (>0.5 watts). Cohen’s d was calculated for the effect size and the difference was determined as a measure of relative 1064 nm HPL-PBMT efficacy.
Results: The 22 independent studies meeting inclusion criteria focused on knee arthropathies, spine, shoulder/elbow, wound, gynecological, or osteoporosis with the evaluation of pain, function, quality of life, range of motion (ROM), and anatomy. Pain was reduced with statistical significance (P<0.05) in 90% of study assessments (n=20) and 100% of studies focused on the knee (n=6). Of 18 studies assessing functional outcome measures, 100% demonstrated statistically significant improvements. Follow-up assessments up to 6 months in 5 knee arthritis studies revealed long-term pain reduction after cessation of treatment. Improvements in wound healing, bone mineral density, and knee cartilage thickness were demonstrated. The largest effect sizes observed were pain reduction in knee arthritis (average Cohen’s d effect size=2.46).
Conclusion: These studies have established that 1064 nm HPL-PBMT can effectively reduce pain, increase ROM, increase functional scores, and increase the quality of life for knee osteoarthritis and spinal disorders, with limitations. More studies are needed for clinical validation of single-trial data detecting changes in musculoskeletal conditions, cartilage thickness, and bone density.

Introduction: Multiple sclerosis (MS) is an autoimmune disease. Inflammatory cells, cytokines, and chemokines play a major role in the pathogenesis of the disease. Low-level laser therapy (LLLT) as a photobiostimulation approach could affect a wide range of cellular responses. LLLT inhibits the inflammatory signaling pathway, improves cell viability, inhibits apoptosis, modulates immune responses, and induces the production of growth factors.
Methods: In this review, we discuss the effect of LLLT on cellular responses and its application in the treatment of MS. Such keywords as “low-level laser therapy”, “photobiomodulation” and “multiple sclerosis” were used to find studies related to laser therapy in MS in Google scholar, PubMed, and Medline databases.
Results: LLLT reduced the inflammatory immune cells and mediators. It also enhanced the regeneration of neurons.
Conclusion: Investigations showed that besides current treatment strategies, LLLT could be a promising therapeutic approach for the treatment of MS.

DOI:10.34172/jlms.2021.88

Introduction: Terahertz (THz) waves with frequencies in the range of 0.1 to 10 THz are electromagnetic radiation with growing applications in various fields of science and technology. Attractive features of this radiation have brought out many novel possibilities for medical diagnostics and treatments with considerable advantages compared to other conventional methods.
Methods: In this paper, we present a review of more recent reports on practical applications of THz radiation for diagnostic, biosensing, and clinical treatments. The review includes the diagnosis of breast, skin, mouth, cervical, lungs, small intestine, prostate, colon, and stomach cancers, the evaluation of biomolecules, the detection of genetic mutations, the determination of burn depth, the diagnosis of tooth decay, diabetes, and emotional-psychological states, the evaluation of corneal water to diagnose visual diseases, and wound healing monitoring. Further, it embraces the use of THz therapy in reducing the size of the tumor, treating skin cancer, and healing burn wounds, cardiovascular disease, corneal epithelium, angina, and THz heating.
Results: This review has emphasized the capabilities of THz waves as a novel tool for future clinical diagnostics and treatments.
Conclusion: The paper provides a comprehensive understanding of the feasible potential application of THz waves for clinical purposes and their advantages in comparison with other conventional tools.

DOI: 10.34172/jlms.2021.92

Introduction: This study was performed to compare the effect of Fractional CO2 laser or Q switched Nd: YAG laser of surface treatment on the shear bond strength of zirconia-porcelain interface.
Methods: Fractional CO2 laser at 30 W, 2 ms, time interval 1 ms, the distance between spots 0.3 mm, and the number of scans is (4) or Q switched Nd: YAG laser at 30 J/mm2 and 10 Hz were used to assess the shear bond strength of zirconia to porcelain. pre-sintered zirconia specimens were divided into three groups (n = 10) according to the surface treatment technique used: (a) untreated (Control) group; (b) CO2 group; (c) Nd: YAG group. All samples were then sintered and veneered with porcelain according to the manufacturer’s instructions. Surface morphology was examined using a light microscope, the surface roughness test was done by the atomic force microscope (AFM), and the shear bond strength (SBS) test was done by a universal testing machine. After debonding following the shear bond test, zirconia surfaces were examined under a light microscope to determine their fracture mode.
Results: The Results of this study showed that the lowest SBS was recorded in the control group, and the highest SBS recorded in the Fractional CO2 group, followed by the Q switched Nd: YAG laser group, as well as an increase in surface roughness and change in the morphology and mode of failure in the experimental groups.
Conclusion: This study shows that Fractional CO2 laser and Q switched Nd: YAG laser treatments significantly increase the bond strength than untreated zirconia.

Introduction: Skin cancer is one of the most common types of malignancy worldwide. Human skin naturally contains several endogenous fluorophores, as potential sources that can emit inherent fluorescence, called intrinsic autofluorescence (AF). The melanin endogenous fluorophore in the basal cell layer of the epidermis seems to have a strong autofluorescence signal among other ones in the skin. This pilot study aimed to investigate the feasibility of the detection of autofluorescence signals in the A375 human melanoma cell line in the cell culture stage using the FluoVision optical imaging system.
Methods: The human skin melanoma cell line (A375) donated as a gift from Switzerland (University Hospital Basel) was cultured. For the imaging of the A375 human melanoma cell sample in this pilot study, the FluoVision optical imaging device (Tajhiz Afarinan Noori Parseh Co) was applied. The proposed clustering image processing code was developed based on the K-mean segmentation method, using MATLAB software (version 16).
Results: The quantification of color pixels in the color bar along with the intensity score of the autofluorescence signal ranged between 0 and 70 was written in the image processing code execution and a threshold higher than 40%, proportional to the ratio of autofluorescent cells. The percentage of the signal of A375 autofluorescent melanoma cells in the 3 studied cell samples was calculated as 3.11%±0.6.
Conclusion: This imaging method has the advantage of no need for fluorophore labels over the existing fluorescence imaging methods, and it can be regarded as one of the important choices of label-free imaging for this A375 melanoma cell line containing the intrinsic endogenous fluorophore in cell studies.

Introduction: This study investigated the effect of various laser powers on the shear bond strength (SBS) of resin cement to the zirconia surface.
Methods: Seventy-five zirconia disks were prepared and assigned to five groups including no surface treatment (control group), sandblasting with 50 µ Al2O3 particles (second group), and Nd: YAG laser treatments with 2 W, 2.5 W, and 3 W powers respectively (third, fourth and fifth groups). Afterward, composite resin cylinders were cemented on zirconia disks using dual-curing resin cement. Before thermocycling (2000 cycles, 5-55°C), all samples were placed in distilled water at 37°C for 24 hours. Using a universal testing machine at the crosshead speed of 0.5 mm/min, the SBS was examined. Also, using a stereomicroscope, the failure type was determined. Data analyses were performed using Welch and Games-Howell tests (P< 0.05).
Results: The mean bond strength difference between the control group and the other groups was significant. The respective bond strength from the highest to the lowest was observed in the sandblast group, the laser group with 2.5 W power, the laser group with 3 W power, the laser group with 2 W power, and finally the control group. However, no significant difference was observed between different laser groups (P< 0.05). Also, there was no significant difference between the sandblast and laser groups with 2.5 W and 3 W power (P< 0.05). Most of the failures in the sandblasting and laser groups with powers of 2.5 W and 3 W were mixed, but in the control and 2 W laser groups, most of the failures were of adhesive nature.
Conclusion: The highest bond strength was achieved by sandblasting with Al2 O3 particles and then using an Nd: YAG laser with a power of 2.5 W.

Introduction: Erbium laser ablation as a method of tooth preparation and conditioning has shown promising results. Although previous studies have adopted various combinations of different laser parameters and several dentin adhesive systems, very few have investigated combining high-level and low-level Er: YAG lasers with Universal adhesives. This study aimed to assess the impact of using low-energy irradiation on the surface micro-topography and shear bond strength (SBS) of universal adhesive (UA) to the erbium:yttrium-aluminum-garnet (Er: YAG) laser-ablated dentin substrate, bonded in etch-and-rinse or self-etch adhesive mode.
Methods: Eighty-seven extracted molars were sectioned to expose flat occlusal dentin surface; 60 teeth were divided equally into three groups according to the surface treatment; bur-cutting (B), Er: YAG high-energy laser cutting, or L1 followed by low-energy laser modification. Then each group was equally divided into two groups (n=10) according to the mode of application of the universal adhesive; either etch-and-rinse (ER) or self-etching (SE). The samples were subjected to thermocycling (5000 cycles between 5°C and 55°C), and SBS was tested. Two-way ANOVA and Tukey post hoc test was used to analyze the results. The remaining 27 samples were used to investigate the effect of the treatment on the topography of the treated dentin surfaces using a scanning electron microscope (SEM).
Results: B/SE recorded the highest SBS (25.48 ± 2.6 MPa) followed by B/ER and L1/L2/SE (22.94 ± 4.1 MPa) and with no statistically significant difference between these groups (P >0.05). The lowest SBS results (P<0.05) were recorded for L1/SE (12.22 ± 3 MPa). No statistical differences were found between the SBS of L1/L2/ER and L1/ER groups or between the SBS of L1/L2/ER and L1/L2/SE groups.
Conclusion: A subsequent treatment of the Er: YAG laser-ablated dentin with low-energy laser modification mode (LMM) enhances the SBS of the tested UA when applied in SE mode.

DOI:10.34172/jlms.2021.07

Introduction: Controlling pain in orthodontic patients has gained special attention. This study assessed the efficacy of photobiomodulation therapy (PBMT) for pain control following the placement of elastomeric separators.
Methods: This split-mouth single-blind randomized clinical trial evaluated 30 orthodontic patients who required posterior elastomeric separators. The two maxillary quadrants were randomized into the laser and control groups. In the laser quadrant, an 808 nm diode laser (400 mW, 15.60 J/cm2,11 seconds, continuous-wave, contact mode) was irradiated to the cervical third of the maxillary first molar roots 24 hours prior to the placement of separators. The control quadrant received placebo radiation by a light-curing unit. The patients received the second laser cycle right before the placement of separators 24 hours later. The level of self-perceived pain was recorded at 0, 2, 6, 24, and 72 hours and 5 days after the intervention in the laser and control quadrants using a visual analog scale (VAS). Data were analyzed using the analysis of variance (ANOVA) and paired-samples t-test.
Results: The trend of change in the pain score was similar in both groups. The pain score was significantly lower in the laser group than the control group at all-time points (P<0.05) except at time 0. The pain score increased in the first 6 hours and reached its maximum level in 24 hours in both groups.
Conclusion: PBMT by an 808 nm diode laser can effectively decrease pain following the placement of elastomeric separators

Introduction: Abnormal wound repair is a cause for a considerable expense, as well as patient morbidity and mortality. Here, we investigated the combined impact of photobiomodulation (PBM) and curcumin on a rat experimental model of an acute skin wound.
Methods: A round full-thickness wound was created on the back of each rat. We divided the rats into the following four groups. Group one was the control group. Group two received pulse wave (PW) PBM at a dose of 890 nm, 80 Hz, and 0.2 J/cm2. Group 3 received 40 mg/kg curcumin by gastric gavage and group 4 was treated with PWPBM + curcumin. We measured the wound area on days 4, 7, and 15, and performed microbiologically and tensiometry examinations.
Results: There was markedly improved wound contraction in the curcumin (7.5 ± 0.57; P=0.000), PBM (8.5 ± 1.2; P=0.000), and PBM + curcumin (14.5 ± 4.3; P=0.002) groups relative to the control group (25 ± 6). PBM (100 ± 7.3; P=0.005), and PBM + curcumin (98 ± 6; P=0.005) groups meaningfully improved tensile strength relative to the control group (61 ± 8.2). On day 15, the PBM (10 ± 5; P=0.000), curcumin (14 ± 4.5, P=0.000), and PBM + curcumin (27.3 ± 8.3; P=0.000) groups meaningfully decreased microbial flora relative to the control group (95 ± 6).
Conclusion: We concluded that the PBM and PBM + curcumin groups meaningfully accelerated wound healing of the acute skin wound in the rats. The results of the PBM group were statistically more effective than the curcumin alone and PBM + curcumin-treated groups.

DOI:10.34172/jlms.2021.09

Introduction: The laser-induced fluorescence (LIF) method as molecular emission spectroscopy is used to diagnose cancerous tissues. According to the previous reports, the red-shift in the fluorescence spectrum from Rhodamine 6G (Rd6G)-stained cancerous tissues compared to healthy ones impregnated with the same dye provides the feasibility for diagnosis. In this paper, we have employed the LIF emissions as a diagnostic method to distinguish between cancerous and healthy tissues infiltrated by a body-compatible fluorophore to avoid the toxicity and hazard of Rd6G dye.
Methods: Biological tissue specimens are stained with sodium fluorescein (NaFl) dye and then irradiated by the blue CW diode laser (405 nm) to examine the spectral properties that are effective in detecting cancerous tissues.
Results: The spectral shift and the intensity difference of fluorescence are keys to diagnosing in vitro cancerous breast, colon, and thyroid tissues for clinical applications. The notable tubular densities in the breast and colon tissues and the space between the papillae in the thyroid ones cause the cancerous tissues to be prominently heterogeneous, providing numerous micro-cavities and thus more room for dye molecules.
Conclusion: Here, we have assessed the spectral shift and intensity difference of fluorescence as a diagnostic method to distinguish between cancerous and healthy tissues for clinical applications.

Introduction: Ceramic brackets have gained increasing popularity among dental clinicians and orthodontic patients but friction is a major concern when using them. This study sought to assess the effects of diode and Nd: YAG (neodymium-doped yttrium aluminum garnet) laser irradiation on friction forces between two types of ceramic brackets and rhodium-coated esthetic archwires.
Methods: Thirty polycrystalline and 30 poly-sapphire brackets were divided into 6 groups (n=10) as follows: (I) control polycrystalline brackets (no laser irradiation), (II) polycrystalline brackets subjected to diode laser irradiation, (III) polycrystalline brackets subjected to Nd: YAG laser irradiation, (IV) control poly-sapphire brackets (no laser irradiation), (V) poly-sapphire brackets subjected to diode laser irradiation, and (VI) poly-sapphire brackets subjected to Nd: YAG laser irradiation. The bracket slots were laser-irradiated on a custom-made table. Sixty 5-cm pieces of rhodium-coated archwires were used for the friction test in a universal testing machine at a speed of 10 mm/min. Ten brackets from the six groups underwent scanning electron microscopy (SEM), X-ray diffraction (XRD), and energy-dispersive X-ray spectroscopy (EDX).
Results: The frictional resistance value of polycrystalline brackets was significantly higher than that of poly-sapphire brackets, irrespective of laser type (P < 0.05). Irradiation of diode and Nd: YAG lasers, compared with the control group, had no significant effect on friction, irrespective of bracket type (P> 0.05).
Conclusion: It appears that diode and Nd: YAG laser irradiation cannot significantly decrease friction. Future studies are warranted on different laser types with variable exposure.

DOI: 10.34172/jlms.2021.13

Introduction: Phototherapy with a light-emitting diode (LED) is used in medicine due to its potential bio-stimulatory effects on the human body. However, controversy still exists regarding the efficacy of low-level laser therapy (LLLT) and phototherapy with LED. This in vivo study aimed to quantitatively and qualitatively assess the newly formed bone following LED phototherapy of the human maxillary sinuses.
Methods: This randomized clinical trial (concurrent parallel) was conducted on 44 patients in two groups (n=22) at the Implant Department of Tehran University of Medical Sciences. Randomization was done by a random sequence generator program. The inclusion criteria were the absence of chronic sinusitis and chronic bone marrow conditions, no history of surgery at the site, absence of diabetes mellitus, no history of chemotherapy or radiotherapy, maxillary premolar edentulism, and signing informed consent forms. Group A underwent LED phototherapy with 620 ± 2 nm wavelength for 20 minutes daily for a total of 21 days after sinus lift surgery. Group B served as the control group and did not receive phototherapy. After 6 months, the grafted sites were re-opened for implant placement, and bone biopsy samples were obtained using a trephine bur. The samples were stained with hematoxylin and eosin and inspected under a light microscope. The results were statistically analyzed using the Mann-Whitney U test. Both the surgeon and pathologist were blinded to the group allocation of patients.
Results: Forty tissue specimens were analyzed. Insignificant differences existed between the two groups in terms of the degree of inflammation, bone quality, and maturity of collagen. Histological analyses revealed no significant difference in the mineralized areas of bone between the two groups (P>0.05).
Conclusion: The results indicated that LED phototherapy cannot significantly enhance osteogenesis after sinus lift surgery. No side effects were observed in the experimental group.

DOI: 10.34172/jlms.2021.16

Introduction: Cancer is one of the most important problems in the world. Low-level laser therapy (LLLT) has been emerged as a new approach, having both stimulation and inhibition effects on cellular function. The goal of this study was to analyze and compare the different concentrations of cisplatin and wavelengths of laser therapy on the LnCap cell lines.
Methods: LnCap cells were cultured and treated with different concentrations of cisplatin (0.1, 0.4, 0.8, 1.2 and 2 µg/mL for 24 hours) and wavelengths of laser therapy (610, 630, and 810 nm) (0.45J/cm2) separately. The viability of cells was examined by MTT assay and IC50 was also calculated. Furthermore, a combination of cisplatin IC50 (24 hours) and different wavelengths of the laser was examined.
Results: The results of this study showed that 2 µg/mL of cisplatin has the most significant reduction effect on the cell viability of the LnCap cell line. Cisplatin decreased the viability of cells in a dose-dependent manner. Moreover, IC50 of cisplatin was 1.24 µg/mL. On the other hand, LLLT with wavelengths of 610, 630, and 810 nm did not show notable biological effects on cell viability.
Conclusion: As known, cisplatin has the capability to reduce the viability of LnCap cell lines. However, LLLT cannot be a remarkable option for the treatment of prostate cancer. Therefore, although laser therapy showed praiseful therapeutic activity against some cancer cell lines, in this study the results indicated that defined laser wavelengths had no inhibitory effects against the prostate cancer cell line.

DOI:10.34172/jlms.2021.17

Introduction: The efficiency of stem cell isolation, culture, and biological characterization techniques for treatment is facing serious challenges. The purpose of this study was to provide a protocol for isolation and culture of three types of mesenchymal stem cells (MSCs) derived from the human placenta, amniotic membrane, and umbilical cord with high efficiency used for cell therapy.
Methods: During this experimental laboratory study, 10 complete placenta samples were prepared from cesarean section mothers. The protocol for isolation and culture of mesenchymal cells from the placenta tissue, umbilical cord, and amniotic membrane was enzymatically optimized. The morphological features of mesenchymal cells were investigated using an inverted microscope and their biological features were measured using flow cytometry. The differentiation potential of the cells was evaluated by measuring their differentiation capacity into osteocytes and adipocytes. The absorption and reflectance features of the cells were recorded by optical spectroscopy. Finally, the data were statistically analyzed.
Results: The expression of CD44, CD73, CD90, and CD29 markers in human placenta tissue-derived cells was significant. CD14, CD34, and CD45 markers were not expressed or were slightly expressed. These cells were highly viable and successfully differentiated into osteocytes and adipocytes. MSCs absorbed more light than visible light by showing light absorption peaks at wavelengths of about 435 and 550 nm.
Conclusion: The protocol used in this study for isolation and culture of human placenta tissue-derived MSCs had significant efficiency for the production of MSCs for use in cell therapy and tissue engineering.

DOI: 10.34172/jlms.2021.18

Introduction: Chronic neck pain is a common complaint among office workers. The aim of the present study was to compare the efficacy of a high-intensity laser and physiotherapy in office workers who were diagnosed with chronic non-specific neck pain.
Methods: This study was a single-blind randomized controlled trial, with parallel allocation. Sixty office workers with chronic neck pain, aged between 25 and 55 years, participated in the study. The participants were randomly divided into two groups: photobiomodulation (by a high-level laser) and physiotherapy. Visual analog scale (VAS), Neck Disability Index (NDI), Neck Pain and Disability Scale (NPDS), and Bournemouth Questionnaire (BQN) were completed on three occasions (before, immediately, and 2 weeks after the intervention) to assess and compare the efficacy of the high-intensity laser and physiotherapy in neck pain. Data were analyzed by SPSS 23 software using the chi-square test, Student’s t-test, multivariate tests, and Fisher’s exact test.
Results: The mean age of the participants was 37.53±9.52 and 41.16±7.85 years in physiotherapy and laser therapy respectively. The VAS score and NDI scores decreased after both kinds of interventions, and the effect of photobiomodulation was significantly higher than physiotherapy (P<0.001). Both treatment modalities significantly affect different aspects of chronic neck pain assessed by NDPS and BQN questionnaires and the effect of photobiomodulation was more prominent than physiotherapy.
Conclusion: The findings of this study showed that photobiomodulation and physiotherapy can reduce chronic neck pain and its different aspects and the effect of laser therapy was significantly higher than physiotherapy

DOI: 10.34172/jlms.2021.20

Introduction: Laser-assisted hair removal is widely used by a large number of patients complaining of unwanted hair. However, little is known about the effect of varying the pulse duration on clinical results and side effects. This study aimed to investigate the effectiveness of hair removal using an alexandrite laser with different pulse durations.
Methods: Fifty female patients with facial hirsutism were subjected to a hair removal procedure with an alexandrite laser, using 3 and 10 milliseconds pulse durations on each side of the face every 5 weeks for three sessions. Photographs were taken and hair counts were checked before the treatment and one month postoperatively.
Results: one month after the laser treatment, the clearance rate was 56% with both 3 and 10 milliseconds pulse durations. There was not any significant difference in clinical efficacy or the side effect profile.
Conclusion: Using a 755 nm alexandrite laser for hair removal is an effective and safe method for delaying hair regrowth and this delay is not markedly different by increasing the pulse duration from
3 to 10 milliseconds.

DOI: 10.34172/jlms.2021.21

Introduction: The conventional chemomechanical procedures are ineffective incomplete disinfection of the pulp space due to the complexities of the root canal architecture. The present study aims to compare the efficacy of erbium: YAG laser-activated irrigation, sonic irrigation, and manual dynamic irrigation in the removal of the smear layer through a scanning electron microscope study.
Methods: Fifty extracted single-rooted mandibular premolars with a single canal were used and instrumented until F3 ProTaper rotary file reached the working length. Upon the completion of the canal preparation, each specimen was irrigated with 3 mL of 4% NaOCl for 3 minutes, 3 mL saline for 1 minute, and 3 mL of 17% EDTA for 3 minutes. The teeth were assigned to three experimental groups (n=15 each): manual dynamic irrigation, sonic irrigation (EndoActivator), and Er: YAG laser using an X pulse tip. Root canals were sectioned longitudinally and the smear layer at the apical, middle, and coronal third was examined under a scanning electron microscope. Smear layer scores were analyzed by Kruskal-Wallis and Mann-Whitney U tests at P=0.05.
Results: The Er: YAG laser group showed significantly lower smear layer scores in the apical third as compared to all other groups. EndoActivator resulted in better cleaning efficacy at the apical area compared to manual dynamic agitation.
Conclusion: This study showed results in favor of Er:YAG with an X-pulse tip followed by EndoActivator activation.

DOI: 10.34172/jlms.2021.22

Introduction: A substantial amount of evidence supports the positive effect of photobiomodulation on the proliferation and differentiation of various cell types. Several laser wavelengths have been used for wound healing improvement, and their actual outcome depends on the settings utilized during irradiation. However, the heterogeneous wavelengths and laser settings applied in the existing literature make it difficult to draw solid conclusions and comparison of different studies. The aim of the present study is to evaluate and compare the effects of various doses of laser energy, provided by an 810 nm diode, on human gingival fibroblasts in terms of proliferation and expression of growth factors with a pivotal role in wound healing.
Methods: Human gingival fibroblasts were cultured on plastic tissue culture and irradiated with 2, 4, 6 or 12 J/cm2. The effects of the low-level laser therapy (LLLT) using an 810 nm diode laser on growth factor expression (EGF, TGF and VEGF) were evaluated by qPCR at 72 hours and 7 days after irradiation. Cell proliferation was evaluated at 24, 48 and 72 hours after LLLT using MTT assay.
Results: Energy density of 12 J/cm2 provoked irradiated gingival fibroblasts to demonstrate significantly higher proliferation as well as higher gene expression of Col1, VEGF and EGF. LLLT positive effects were obvious up to 7 days post-irradiation.
Conclusion: LLLT with 810 nm presents beneficial effects on proliferation, collagen production and growth factor expression in human gingival fibroblast cells. The application of 12 J/cm2 can be suggested as the optimal energy density for the enhancement of the wound healing process.

DOI: 10.34172/jlms.2021.25

Introduction: The cytotoxicity of chemotherapy drugs is a significant challenge in the way of surmounting cancer. Liposomal drug delivery has proven to be efficacious in increasing the function of the drugs. Its potential to accumulate drugs in the target site and enhance the efficiency of anticancer agents with lower doses hinders their cytotoxicity on normal healthy cells. Since the release of drugs from liposomes is not generally on a controlled basis, several studies have suggested that external stimuli including lasers could be used to induce controlled release and boost the efficiency of liposomal drug delivery systems (LDDSs).
Methods: The A375 cancer cell line was used and exposed to the liposomes containing doxorubicin in the presence of a low-level laser beam to investigate its effect on the liposomal stimuliresponsiveness release and its toxicity on cancer cells. So as to achieve that goal, Annexin V/PI was employed to analyze the number of cells that underwent apoptosis and necrosis.
Results: Here, we report the effect of laser irradiation on LDDSs. According to the results obtained from the annexin V/PI assay, the pattern of viability status has shifted, so that the number of preapoptotic cells treated with liposomal doxorubicin and a laser beam was more than that of cells treated with only liposomal doxorubicin.
Conclusion: The use of stimuli-responsive LDDSs, in this case, laser-responsive, has led to favorable circumstances in the treatment of cancer, offering enhanced cancer cell cytotoxicity

DOI:10.34172/jlms.2021.28

Introduction: Periodontal disease and tongue coatings are among the major factors associated with oral malodor. The present study, comparatively evaluated the effects of the Er,Cr:YSGG laser and Halita mouthwash as adjunctive treatments to nonsurgical periodontal debridement on oral malodor reduction in chronic periodontitis patients.
Methods: Sixty patients with stage II and III chronic periodontitis and bad breath. The patients were randomly divided into two groups (n=30). After conventional scaling and root planing, patients in group 1 underwent Er,Cr:YSGG laser (Waterlase; Biolase, San Clemente, CA, USA) irradiation of the internal surface of the pockets ( 1.5 W, 30 Hz, 20% A, 40% W) and the dorsum of the tongue (1 W, 30 Hz, 20%A, 40% W) immediately after SRP and on the third and seventh days. Group 2 patients were asked to use Halita mouthwash twice daily for one week. Baseline, 1 and 3-month post-treatment measurements of plaque index (PI), probing pocket depth (PPD), clinical attachment level (CAL), gingival index (GI), bleeding on probing (BOP) and organoleptic assessment of Halitosis severity were performed.
Results: Significant improvement in all parameters was noted in both groups after 1 and 3 months, compared with baseline (P<0.05). The two groups had significant reductions which occurred in PPD, CAL, and BOP levels and the organoleptic score in 1 and 3 months after the intervention (P<0.05).
Conclusion: Er,Cr:YSGG laser irradiation and Halita mouthwash as adjuncts to non-surgical periodontal therapy are both effective in the treatment of oral malodor and improvement of periodontal parameters.

DOI:10.34172/jlms.2021.26

Introduction: Photomodulation is a promising strategy for optimizing tissue healing, but its photomodulatory effects on the synergistic cellular metabolism of gingival and bony tissues remain largely unknown. The aim of the present study was to evaluate the photomodulatory effects of a diode laser (810 nm) on osteoblasts, HGFs, and their co-cultures in vitro.
Methods: Primary cultures of HGFs, cultures of immature osteoblastic cells (MG63), and their cocultures were irradiated with a diode laser (810 nm), 15 J/cm2. Cell cultures were examined for cellular proliferation (MTT assay), viability (FDA/PI staining) after 24, 48, and 72 hours, and cell differentiation (qPCR of collagen type 1a – COL1a and alkaline phosphatase expressions - ALP) after 7 days.
Results: Photomodulation with an 810-nm diode laser increased cell proliferation at all time points. COL1a gene expression increased both in HGF and co-cultures. ALP expression was up-regulated in osteoblastic cultures, but co-cultures with fibroblasts negated this response.
Conclusion: The 810-nm diode laser positively affected cell proliferation and viability in all experimental groups. The statistically significant increased COL1a gene expression at 7 days after irradiation both in the irradiated HGF and co-cultures suggests that low-level laser therapy (LLLT) stimulated extracellular matrix (ECM) formation signaling in both cell types.

DOI: 10.34172/jlms.2021.33

Introduction: Genital condylomatosis is a highly contagious disease caused by the human papillomavirus (HPV). The aim of this prospective multicentre study was to evaluate the safety and efficacy of the Holmium: YAG (yttrium-aluminum-garnet) laser in the treatment of genital and intra-urethral warts; the secondary aim was to assess the patients’ postoperative satisfaction and cosmetic results.
Methods: From December 2016 to March 2019, patients with genital warts were prospectively enrolled in three hospitals. The inclusion criteria were male gender, age over 18 years old, and treatment-naïve. External and urethral genitalia warts were treated by the Holmium YAG laser. The follow-up analysis consisted of physical examination, flexible urethra-cystoscopy in case of meatal lesions, and administration of Dermatology Quality of Life Index (DLQI) and Patient Global Impression of Improvement (PGI-I) questionnaires at 1, 3, 6, and 12 months after surgery and subsequently yearly.
Results: Sixty patients were enrolled. The single treatment was effective in 57/60 patients (95%). At a mean follow-up of 26 months, recurrences occurred in 8 patients (13.3%). No peri- or postoperative complication occurred. An improvement in pre-operative condition was highlighted with PGI-I and DLQI questionnaires.
Conclusion: Our prospective multicentre study showed that holmium laser surgery seems to be a safe and effective treatment for external genital and urethral warts. Good dermatological outcomes aid to further improve patient satisfaction.

DOI: 10.34172/jlms.2021.34

Introduction: our study aimed to assess the safety and efficacy of Holmium: YAG laser internal urethrotomy compared to the cold knife internal urethrotomy.
Methods: Eighty adult male patients presented with a urethral stricture less than 1.5 cm were included in our study; they were randomly allocated into 2 groups representing Holmium and cold knife internal urethrotomy. A careful evaluation with ascending cystourethrogram and uroflowmetry were done on all patients, and they were followed up for 1 year with uroflowmetry.
Results: Each group included 40 patients sharing the same demographic data. The most common cause of a urethral stricture in both groups was iatrogenic injury. The mean operative time of the cold knife urethrotomy procedure was 10.98 ± 2.40 minutes compared to 15.43 ± 2.48 minutes in the holmium laser urethrotomy group with a highly significant difference. The results showed success rates of 90% and 80% for the holmium laser and cold knife internal urethrotomy groups respectively. The perioperative complication according to the Clavien-Dindo classification, showed no statistically significant difference in grade 1 and 2 complications. A recurrence rate with the need for redo surgery representing grade 3B complication was seen in 4 cases in the Holmium group compared to 8 cases in the cold knife group with a statistically significant difference.
Conclusion: Both Holmium Laser and cold knife internal urethrotomy are effective surgical options for the treatment of a urethral stricture less than 1.5 cm with a promising outcome after 1-year follow-up with a better success rate using the Holmium laser.

Doi:10.34172/jlms.2021.35

Introduction: Considering the recent trend to use mineral trioxide aggregate (MTA) and Biodentine and resin cements, more conservative approaches concurrent with adequate bond strength have always been requested. The present study aimed to evaluate the effect of pretreatment with Er: YAG laser etching versus acid-etching for 5 and 15 seconds on the micro shear bond strength of selfadhesive resin cement (SRC) to MTA and Biodentine.
Materials and Methods: Forty-eight samples of each cement (MTA and Biodentine) were prepared and distributed into four groups based on surface pretreatment: 1) control, no treatment; 2) Er: YAG laser etching with the energy of 60 mJ; 3) 5-second acid-etching; 4) 15-second acid-etching. All specimens were cemented using SRC. Microshear bond strengths were tested following 24-hour water storage. Debonded specimens were examined and surface topography was assessed using an atomic force machine (AFM). Data analysis was performed using the two-way ANOVA and Tukey multiple comparisons test.
Results: The three testing groups of laser etch and 5-s and 15-s acid-etch demonstrated a significantly higher SBS than the control group (P<0.05) with negligible differences among them (P > 0.05). Furthermore, Biodentine showed better adhesive bonding than MTA in all groups.
Conclusion: Laser etching of 60 mJ and 5-s acid-etching were as beneficial as 15-s acid-etching in terms of bond strength of SRC to MTA and Bodentine.

Doi:10.34172/jlms.2021.36

Introduction: This study evaluated the effectiveness of an 810-nm diode laser as an adjunct to scaling and root planning (SRP) in improving periodontal parameters in patients with chronic periodontitis.
Methods: This randomized clinical trial consisted of 36 patients (16 females and 20 males) with chronic periodontitis and pocket depths of 4-6 mm. The quadrants were randomly divided into two sides; one side of each patient was selected as the laser group (SRP + laser) and the other side served as the control group (SRP alone). An 810-nm diode laser was applied in the laser side to remove the outer gingival epithelium (1.5 W, CW) as well as the inner epithelium of the periodontal pockets (1 W, CW). The clinical parameters including bleeding on probing (BOP), probing depth (PD), plaque index (PI), and clinical attachment level (CAL) were measured at baseline and 6 and 18 weeks after therapy.
Results: In both groups, there was a significant improvement in BOP, PD, PI and CAL over the course of the experiment (P<0.001). Significantly lower BOP was found in the SRP + laser group than the SRP alone group after 6 and 18 weeks of intervention (P<0.05). The difference in other parameters was not significant between the two groups, neither at 6 nor at 18 weeks after the treatment (P>0.05).
Conclusion: Within the limitations of this study, the association of the diode laser with standard nonsurgical periodontal therapy (SRP) provided minimal additional benefits for patients with moderate chronic periodontitis

Doi:10.34172/jlms.2021.37

Introduction: Obesity is the major pathogenesis of non-alcoholic fatty liver disease (NAFLD). The combination of low-level laser therapy (LLLT) and Mediterranean diet (MD) is a new approach for improving liver function.
Methods: 60 obese older adults (65-75 years old) with NAFLD were randomly assigned equally to two groups: a study group and a control group. The study group received LLLT and MD, while the control group followed MD only. These findings evaluated the changes in the level of liver enzymes, serum lipid profile, and anthropometric measurements (body mass index [BMI] and waist circumference [WC]) after 12 weeks of intervention.
Results: Both study and control groups showed a significant reduction in the levels of liver enzymes, serum lipid profile, BMI, and WC (P<0.001 and P <0.01 respectively); however, the study group showed more significant results compared to the control group (P<0.01).
Conclusion: LLLT and MD may be considered as a treatment approach for NAFLD in older adults to improve their liver function, control dyslipidemia, and help in losing weight.

Doi:10.34172/jlms.2021.39.

Introduction: Herein, the individual and combined effects of photobiomodulation (PBM) and arginine (ARG) on the wound healing course of an experimental model of a slow healing wound (ulcer) in rats were assessed.

Methods: A total of 108 male rats were divided into 6 groups: control; lower energy density (low)-PBM; arginine ointment (ARG); low-PBM+ARG; high energy density (high)-PBM; and highPBM+ARG. In each rat, one ischemic wound in the center of a bipedicle flap and one non-ischemic wound out of the flap was created. Both wounds were treated in the experimental groups. Microbial growth wound area and wound strength were assessed on days 0, 5, 10, 15, and 20 after the wound.
infliction

Results: All non-ischemic wounds closed before day 15. High-PBM+ARG and ARG significantly increased wound closure rates compared to the control group (LSD test, P=0.000, and P=0.001, respectively) on day 10. All slow healing wounds were open on day 15 but closed completely before day 20. Low-PBM+ARG and high-PBM significantly increased wound strength (stress high load, SHL) on day 10 compared to the control group (LSD test, P=0.001, and P=0.000, respectively). ARG, high-PBM, and low-PBM+ARG significantly increased wound closure rates on day 15 relative to the control group (LSD test, P=0.000, P=0.000, and P=0.001, respectively).

Conclusions: High-PBM and low-PBM+ARG have biostimulatory and antibacterial effects on slow-healing wounds, which were shown by significant increases in wound closure rates, wound strength, and inhibition of Staphylococcus aureus growth.

Doi:10.34172/jlms.2021.40.

Introduction: The ability of simultaneous treatment of critical-sized femoral defects (CSFDs) with photobiomodulation (PBM) and demineralized bone matrix (DBM) with or without seeded adipose-derived stem cells (ASCs) to induce bone reconstruction in ovariectomized induced osteoporotic (OVX) rats was investigated.
Methods: The OVX rats with CSFD were arbitrarily separated into 6 groups: control, scaffold (S, DBM), S + PBM, S + alendronate (ALN), S + ASCs, and S + PBM + ASCs. Each group was assessed by cone-beam computed tomography (CBCT) and histological examinations. Results: In the fourth week, CBCT and histological analyses revealed that the largest volume of new bone formed in the S + PBM and S + PBM + ASC groups. The S + PBM treatment relative to the S and S + ALN treatments remarkably reduced the CSFD (Mann-Whitney test, P = 0.009 and P = 0.01). Furthermore, S + PBM + ASCs treatment compared to the S and S + ALN treatments significantly decreased CSFD (Mann Whitney test, P = 0.01). In the eighth week, CBCT analysis showed that extremely enhanced bone regeneration occurred in the CSFD of the S + PBM group. Moreover, the CSFD in the S + PBM group was substantially smaller than S, S + ALN, and S + ASCs groups (Mann Whitney test, P = 0.01, P = 0.02 and P = 0.009). Histological observations showed more new bone formation in the treated CSFD of S + PBM + ASCs and S + PBM groups.
Conclusion: The PBM plus DBM with or without ASCs significantly enhanced bone healing in the CSFD in OVX rats compared to control, DBM alone, and ALN plus DBM groups. The PBM plus DBM with or without ASCs significantly decreased the CSFD area compared to either the solo DBM or ALN plus DBM treatments.

DOI:10.34172/jlms.2021.41

Introduction: There is a morphological assessment of the damaged area and the inflammatory response of periodontal tissues after therapy. It seems relevant to evaluate the reaction of the periapical tissues of the teeth of experimental animals after the treatment of simulated apical periodontitis using laser photodynamic therapy (PDT) and non-pigment laser transcanal microablation using morphological research.
Methods: The lower incisors of 15 rabbits were used to simulate acute apical periodontitis of pulpal origin. Subsequently, the traditional treatment of teeth canals using mechanical cleaning and irrigation with antiseptic solution started. Then, three groups underwent different therapies - using PDT (n = 5; photosensitizer chlorin e6, [l = 660 nm, 60 mW/cm2 ] for 2 minutes), using a new technology of transcanal laser ablation (n = 5; diode laser [l = 1265 nm, 180 mW/cm2] for 3 minutes), and without additional treatment (n = 5). Laser therapy in two groups was carried out for 10 days once in 2 days. The animals were euthanized 10 days after the treatment started, decapitation was performed, and morphological specimens were studied under a microscope. Descriptive analysis (study of inflammatory apical infiltrate, bone regeneration of the alveoli and periodontal ligament) and quantitative analysis were performed. The data were statistically processed using the KruskalWallis test.
Results: The group treated with the new laser technology showed the best results with moderate lymph-macrophage infiltration and congested vessels, moderate neoangiogenesis, and fibrogenesis. The size of the lesion was 506.4 mm2, compared with the PDT group - 872.0 mm2 (P≤0.05).
Conclusion: A decrease in the focus of inflammation, moderate neoangiogenesis, and fibrogenesis in the periapical region when using transcanal laser microablation indicates the prospects of using the new technology in clinical practice in the complex therapy of apical periodontitis.

DOI:10.34172/jlms.2021.43

Introduction: The regeneration of dental pulp tissue using human dental pulp stem cells (HDPSCs) has attracted increasing attention in recent years. Recent studies have suggested that several factors such as photobiomodulation (PBM) and vitamin D affect the proliferation and differentiation of HDPSCs. Therefore, the present study evaluated the effects of PBM and vitamin D on odontogenic differentiation of HDPSCs for dentin-like tissue formation.

Methods: HDPSCs were collected, isolated, and characterized and then divided into six groups: group I, control; group II, vitamin D (10-7 Mol); group III, irradiation at 1 J/cm2 of 810 nm diode laser; group IV, irradiation at 1 J/cm2 and culture with vitamin D; group V, irradiation at 2 J/cm2, and group VI, irradiation at 2 J/cm2 and culture with vitamin D, cell viability assay was measured through MTT. Alkaline phosphatase (ALP) enzyme activity and mRNA levels of vascular endothelial growth factor (VEGF), bone morphogenic protein-2 (BMP-2), and dentin sialophosphoprotein (DSPP) were also assessed.

Results: PBM at 1 and 2 J/cm2 combined with vitamin D significantly promoted HDPSCs proliferation through MTT assay and odontogenic differentiation through gene expression of VEGF, BMP-2, and DSPP levels (P<0.0001).

Conclusion: PBM at 2 J/cm2 combined with vitamin D enhanced the HDPSCs proliferation and odontogenic differentiation and thus could be a novel strategy for dentin regeneration in dentistry.

DOI: 10.34172/jlms.2021.30

Introduction: Knee osteoarthritis is a common degenerative joint disease, causing deformity, pain and a limited joint range of motion. Modification of the lifestyle and an exercise training program is the cornerstone of treatment. Alternative therapies such as laser or ozone are commonly used, but there is not any comparative study of low-level laser therapy versus ozone therapy. The aim of the study was to compare the efficacy and safety of the LLLT versus ozone in patients with KOA.

Methods: In this single-blinded randomized clinical trial, 60 patients with KOA were assigned to LLLT or ozone groups (n=30). The First basic pain severity, the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, and physical function were determined. Then in the LLLT group, the patients were provided with 12 sessions of LLLT. In the ozone group, 6 sessions of intra-articular injection of ozone were organized (in each session a mixture of 10 mL of bupivacaine 0.25% with 15 mL of ozone 30 μg/mL). In the middle and at the end of the intervention period, we reassessed the joint pain and physical function and the degree of improvement compared between the two groups. 

Result: In the middle and at end of the treatment period in both groups, the joint pain decreased significantly. The same as pain, the self-administrated WOMAC score and the range of joint motion improved significantly in both groups. All of these variables exposed more improvement in the ozone group patients.

Conclusion: The study showed that both LLLT and ozone are acceptable non-invasive methods in the non-surgical treatment of KOA. Compared to LLLT, the ozone was more effective. These methods must be considered in any patient who is not suitable for surgical interventions or does not experience enough improvement in symptoms following long periods of common exercise training programs.

DOI:10.34172/jlms.2021.44

Introduction: This study aimed to investigate the effect of low-level laser therapy (LLLT) on the blood cell count when applied to parotid glands of rats irradiated by volumetric modular arc therapy (VMAT).
Methods: Thirty-two adult male Wistar rats were used in this study. Samples were randomly assigned to three groups: control group (CG, n = 8), immediate laser group (24 hours) (ILG, n=12), and late laser group (120 hours) (LLG, n=12). The two laser groups were previously subjected to VMAT radiotherapy in a single dose of 12 Gy. LLLT with an AsGaAl laser (660 nm, 100 mW) was applied at three points in the region of the parotid glands, right side, with the energy of 2 J per point (20s, 70 J/cm2) and a spot size of 0.0028 cm2 for 10 consecutive days. In euthanasia, blood samples were obtained by cardiac puncture. The samples from each group were processed by an automatic method and analyzed for erythrogram, leukogram, and platelet count values. The data were analyzed by ANOVA and each LLLT time point was analyzed in relation to the control group,
with a significance level less than 0.05.
Results: Groups using LLLT had higher red blood cell counts, being higher in the LLG (p = 0.000). The hematimetric indices MCV (P=0.002) and MCH (P=0.009) were lower than the control group, especially when compared to the group using LLLT 120h after radiotherapy (LLG). White blood cell counts were lower in the groups with radiotherapy and immediate use of LLLT (ILG) (P=0.011), mainly at the expense of lymphocytes (P=0.002).
Conclusion: The results suggest a potential systemic effect of LLLT, especially on circulating red blood cell counts, regardless of their time of immediate or late use of radiotherapy.

ِDOI: 10.34172/jlms.2021.45

Introduction: Plasmonic biosensors provide high sensitivity in detecting the low amount of biomarkers and pharmaceutical drugs. We studied the mesenchyme cell activity under the treatment of common sedative drugs of methadone and tramadol using the integrated plasmonic-ellipsometry technique.
Methods: Mesenchymal stem cells were cultured on patterned plasmonic chips under the treatment of methadone and tramadol drugs. Three cultured chips were kept non-treated as the control ones. The plasmonic-ellipsometry technique was applied to study the signaling characteristic of the cells affected by these two drugs. In this technique, optical information regarding the amplitude ratio and phase change between p- and s-polarized light was recorded.
Results: This drug treatment could affect the spectral plasmonic resonance and subsequently the phase shift (Δ) and the amplitude ratio (Ψ) values under p- and s-polarized impinging light. A more significant Δ value for tramadol treatment meant that the phase split was larger between p- and s-polarized light. Tramadol also had more prominent absolute Δeff and Ψeff values in comparison with methadone.
Conclusion: We showed that tramadol caused more contrast in phase shift (Δ) and amplitude ratio (Ψ) between p- and s-polarized impinging light for cultured stem cells in comparison with methadone. It means that tramadol differentiated more the optical responses for p- and s-polarized lights compared to methadone. Our proposed technique possesses the potential of quantitative and qualitative analysis of drugs on humans even on a cell scale.

DOI:10.34172/jlms.2021.46

Introduction: This study aimed to compare the effects of root biomodification by citric acid and antimicrobial photodynamic therapy (aPDT) with LED and laser on the proliferation of human gingival fibroblasts (HGFs).
Methods: This in vitro experimental study evaluated 60 single-rooted teeth extracted due to periodontal disease. The teeth underwent scaling and root planing (SRP), and then 5 × 5 mm blocks were prepared from the cervical area of the teeth 1 mm apical to the cementoenamel junction. The blocks were divided into 4 groups (n=15 blocks): SRP alone (control), SRP + citric acid, SRP + toluidine blue (TBO) + LED light, and SRP + TBO + laser. HGFs were seeded on the surface of the samples, and the methyl thiazolyl tetrazolium (MTT) assay was
performed after 24, 48, and 72 hours. Group comparisons were performed using repeated-measures ANOVA, while pairwise comparisons of the time points were performed by an LSD test.
Results: Cell proliferation was higher in all experimental groups at 48 and 72 hours, compared with 24 hours (P<0.05). Cell proliferation was significantly different in the citric acid group at 24 hours (P=0.016) and 48 hours (P=0.015), compared with other groups. However, cell proliferation was not significantly different in the aPDT group with LED Photosan and a diode laser at 24 and 48 hours (P>0.05).
Conclusion: aPDT and citric acid can enhance the proliferation of HGFs on dentin blocks. Further studies can pave the way for their future use in the clinical setting.

DOI: 10.34172/jlms.2021.47

Introduction: An increase in dentine thickness could result in an inadequate depth of laser energy penetration. This study aimed to evaluate the effect of a 940 nm laser on Enterococcus faecalis through varying thicknesses of human root dentin slices.
Methods: Thirty-five dentin slices of root dentin with thicknesses ranging between 500 and 3000 µm were produced. Six experimental groups (500, 1000, 1500, 2000, 2500, and 3000 µm (n=5 each) were lased and the seventh, non-lased group served as the positive control with a dentine thickness of 2000 µm. The slices were inoculated with 2 µL of E. faecalis suspension of 1.5 × 108 E. faecalis cells/mL. All the lased slices were lased from the opposing side of the inoculation. A non-initiated 200 μm bare end fiber at the power of 1 W, in a continuous wave, was used. Four doses of laser irradiation of 5 seconds with a side-to-side movement with the tip held at a 5º angle to the dentine slice were performed. The colony-forming units of E. faecalis were determined and the bacterial photobiomodulation effect analysed using one-way ANOVA with a Bonferroni and Holm post hoc test at a significance level of P>0.05.
Results: There were statistical differences between the dentin slices of 500, 1000, and 1500 μm treated with the laser compared to the positive control (P<0.01). However, there were no statistical differences between the lased 2000 and 2500 μm slices compared to the positive control. There was significantly more photobiomodulation of the E. faecalis for the dentine slices of 3000 μm than the positive control (P<0.01).
Conclusion: Laser treatment through dentine slices of 2000 μm and thinner significantly reduced bacterial growth. The photobiomodulation effects started to occur in dentine slices thicker than 2500 μm compared to the positive control.

DOI: 10.34172/jlms.2021.48

Introduction: Although intravascular laser irradiation of blood (ILIB) is deemed an innocuous and a useful technique for laser therapy, particularly when systemic effects are required, no study, to our knowledge, has been conducted on the effectiveness and innocuousness of ILIB in treating acute kidney injury (AKI).
Objective: This study aimed to assess the feasibility and outcomes of ILIB in the management of patients with AKI and comparing them with the Sham-laser group. Materials and Methods: Twenty-six patients with intra-renal AKI (24-95 years old) at Tajrish Hospitals were evaluated for enrollment eligibility in this clinical trial study. This study was conducted at the nephrology department of Shahid Beheshti University of Medical Science, Tehran, Iran, between 2018 and 2019. Based on the treatment method, the patients’ assignment to two groups (ILIB or Sham-laser) was randomly done. Demographic characteristics need for dialysis, hemoglobin and
serum biochemistry changes, serum, and urine neutrophil gelatinase-associated lipocalin (NGAL) changes, laser complications, and the hospitalization period were recorded.
Results: In terms of the baseline characteristics and biochemistry serum level, no differences were seen between the two groups. All post-treatment parameters, except the hemoglobin value, significantly improved in both groups. Urine NGAL and serum NGAL show decline from the baseline in both groups; however, the reduction slope of these parameters occurred faster in the laser group in a statistically significant manner.
Conclusion: A decline in NGAL levels in the laser group during the treatment may suggest that the ILIB can help patients with AKI recover better.

DOI:10.34172/jlms.2021.49.

Introduction: Spectroscopic properties of Xeloda chemodrug have been studied over varying concentrations ranging between 0.001 and 10 mg/mL, using laser-induced fluorescence (LIF) spectroscopy. The alternative photoluminescence (PL) and near infrared (NIR) measurements are carried out to authenticate the obtained results by the LIF method.
Methods: The XeCl laser as the excitation coherent source with 160 mJ/pulse at 308 nm is employed for LIF measurements of the fluorophore of interest in the modular spectroscopic set-up.
Results: Xeloda as a significant chemodrug acts as a notable fluorophore. LIF, PL and NIR spectroscopy techniques are employed to investigate the spectral properties of the chemodrug in terms of concentration. The maximum LIF peak intensity of Xeloda is achieved at λmax=410.5 nm and the characteristic concentration of CP1=0.05 mg/mL. PL signals are in good agreement with the data given by the LIF measurements. The characteristic NIR spectra of Xeloda as solid evidence of chemical bonding formation attest to fluorescence quenching at the fluorophore concentration of ~ 0.2 mg/mL. Besides, the spectral shift of fluorescence signals which is obtained in terms of fluorophore concentration- demonstrating as a diagnostic marker for the purpose of optimized chemotherapy.
Conclusion: Xeloda exhibits outstanding fluorescence properties over the allowable concentration in human serum (Cmax). These characteristics could benefit the potential advantage of simultaneous laser-based imaging of cell-chemodrug interaction over in-vivo studies.

DOI: 10.34172/jlms.2021.51

Introduction: Photobiomodulation therapy (PBM) appears to induce osteogenesis and stimulate fracture repair. This paper aims to analyze the effects of the PBM at different doses on the repair of critical bone defects through histological and histomorphometric analyses.
Methods: Sixty 90-day-old adult rats (Rattus norvegicus, Albinus, Wistar) weighing approximately 300 g were used. Critical bone defects of 5 mm in diameter were performed in their calvaria. The animals were randomly separated into 5 groups: C-Blood clot, L15-PBM 15J/cm2, L30-PBM 30 J/cm2, L45-PBM 45 J/cm2, L60-PBM 60 J/cm2. Each group was subdivided according to observation periods of 30 and 60 days with 6 rats in each subgroup. Low-level gallium aluminum arsenide (GaAlAs) lasers were used at a 660 nm wavelength, 30 mW, and 0.04 cm2 in area. The PBM was applied over 5 points; 4 points of application were distributed on the edges while one point of application was located in the center of the bone defect. PBM occurred right after the procedure. In 30 and 60 days, the animals were euthanized by anesthesia overdose and the analyses were performed. The data were analyzed statistically by the ANOVA, together with the Tukey test, whose significance level was 5%.
Results: As regards the treatment factor, the highest percentage of bone neoformation was achieved by group L45-60. The group with the highest closure, despite not having a statistically significant difference with the other doses, was 45 J with only 0.49 mm between edges.
Conclusion: Thus, the present study allowed concluding that the highest percentage of bone neoformation area was achieved at 45 J/cm2 in 60 days; that is, it was significantly effective in comparison with other doses.

DOI: 10.34172/jlms.2021.53.

Introduction: Obesity is a global problem because it causes various complications. Methods for reducing fat for a healthy life are being studied. In this study, we developed a minimally invasive and non-invasive lipolysis laser system for effective fat reduction.
Methods: The laser had the wavelengths of 1980 nm and 2300 nm which have very good absorption of fat and water. We developed a minimally invasive laser system that breaks down fat by direct irradiation of fat tissue. This minimally invasive laser system uses an 808 nm diode laser and Nd: YVO4 to generate the 1064 nm wavelength, which is the pumping source of the nonlinear crystals. It is a mid-infrared lipolysis laser system having two wavelengths of 1980 nm and 2300 nm by controlling the temperature of nonlinear crystals. We also developed a non-invasive laser system that reduces fat with hyperthermia treatment by raising the temperature of adipocytes with a 1060 nm penetrating depth into the skin. In this non-invasive laser system, the In gallium arsenide (GaAs) diode laser is irradiated on the skin with an area of 4 × 8 cm2
through the handpiece. The cooling system in the handpiece protects the skin from burns. We studied the effectiveness and safety of each system through animal experiments. We studied the effects of lipolysis when these two systems were combined.
Results: This research uses new wavelengths (1980 nm, 2300 nm) to increase the fat reduction effect with low energy (1.3 W). After using the 1060 nm (1.1 W/cm2) wavelength laser, when the 1980 nm and 2300 nm (1.3 W) laser were used, a lipolysis effect of about 35 % was obtained.
Conclusion: We have developed a 1.3 W mid-infrared (1980 nm, 2300 nm) laser with a good lipolysis effect with low power.

Introduction: Radiofrequency (RF)-based stress urinary incontinence (SUI) treatment, which has quickly attracted attention, is administered in an office setting. This pilot-safety study assessed the efficacy of transvaginal RF treatment in the quality of life (QOL) and frequency of incontinence episodes in women with SUI.
Methods: Twenty-eight women suffering from SUI were treated with an intravaginal quadric applicator while a grounding pad was attached in front of their pubes. The first phase is thermic, which will heat up the vaginal wall up to 40°C for 10 minutes. The second step is contraction to stimulate an aerobic exercise of pelvic floor muscles for 20 minutes (pulsed contractile RF at 20-40 watts and 1000-300 kHz with modulation of 1 to 300 Hz for muscle exercise). It was scheduled for one session per week for 3 sessions. Patients had follow-up visits before and 1, 6, and 12 months following the treatment for a one-day voiding diary, the Persian version of urinary incontinence QOL questionnaire (I-QOL), Q-tip test, 24 hours-pad test, and daily incontinence episodes’ number.
Results: The patients’ mean age, duration of incontinence, and median vesical leak point pressure were 41.6±9.6 years, 5.48±6.84 years, and 140 cm H2 O respectively. Significant changes were observed in the mean I-QOL total score and the pad test. Also, a notable reduction was observed in the number of daily leakage episodes and the Q-tip test at any follow-up visit (P=0.001).
Conclusion: Preliminary results suggest that transvaginal RF is a convenient method of SUI treatment. Significant changes were observed in the mean I-QOL total score and the pad test. Also, a notable reduction was observed in the number of daily leakage episodes.

DOI: 10.34172/jlms.2021.56

Introduction: Stretch marks, or striae distensae (SD), are the lesions of the dermis caused by its linear atrophy at the sites of stretching. They occur in more than 70% of pregnant women and adolescents as a result of cutaneous stretching. This study aimed at evaluating and comparing the clinical and histological efficacy of the fractional CO2 laser versus the long-pulsed (LP) Nd: YAG laser in the treatment of striae alba.
Methods: Thirty female subjects having bilateral symmetrical stretch marks were managed by the LP Nd: YAG laser on the right side and the fractional CO2 laser on the left side. The laser treatment course consisted of 3 sessions with an interval of 3 weeks. The patient satisfaction score and the Global Aesthetic Improvement Scale (GAIS) were employed in the study in order to assess the improvement 3 months after therapy. Punch biopsies measuring 4 mm were extracted from one lesion on each side at baseline and after the last treatment session by 3 months to evaluate the thickness of both collagen and epidermis
Results: Clinical improvement was more significant in the lesions treated with the LP Nd: YAG laser than those treated with the fractional CO2 laser. The patient satisfaction score and the GAIS were higher with a statistically significant value in the side treated by the LP Nd: YAG laser. Collagen and epidermal thickness increased more in the LP Nd: YAG laser-treated lesions in comparison to their thickness in the fractional CO2 laser-managed lesions, but this difference did not have a statistical significance.
Conclusion: The clinical efficacy of the LP Nd-YAG laser exceeded that of the fractional CO2 laser in the treatment of striae alba without severe side effects in spite of the insignificant histological difference between the two lasers.

DOI: 10.34172/jlms.2021.57

Introduction: This study assessed the effect of apical size and taper on the efficacy of root canal disinfection with LED photodynamic therapy (PDT) as an adjunct to irrigation with sodium hypochlorite.
Methods: A total of 126 extracted human mandibular molars were divided into 4 groups. The mesiobuccal canal was prepared to size 25/4% in group 1, 25/6% in group 2, 30/4% in group 3, and 30/6% in group 4 using the iRaCe rotary system. A 21-day Enterococcus faecalis biofilm was prepared and used for inoculation of the canals. Each group was randomly divided into 3 subgroups for canal disinfection with 2.5% sodium hypochlorite, sodium hypochlorite plus LED PDT, and saline (positive control). Samples from the root canals were obtained with rotary files and cultured. Microbiologic data were analyzed using the Poisson regression test.
Results: The bacterial count significantly decreased following disinfection with sodium hypochlorite with/without PDT in all sizes and tapers of preparation compared with the control group (P<0.05). Increasing the apical taper or apical size and the use of PDT as an adjunct did not have a significant effect on the reduction of the bacterial count (P>0.05). However, the apical size and PDT had a significant effect on the number of residual bacteria (P<0.05) and increasing the apical size and conduction of PDT significantly decreased the number of residual bacteria.
Conclusion: The apical size and taper and the use of PDT as an adjunct did not have a significant effect on the reduction of the bacterial count. However, increasing the apical size and conduction of PDT as an adjunct to sodium hypochlorite irrigation significantly decreased the number of residual bacteria in the root canal system.

DOI: 10.34172/jlms.2021.58

Introduction: There are many documents about the significant role of low-level laser therapy (LLLT) in different processes such as regenerator medicine and bone formation. The aim of this study is to assess the role of LLLT in blood hemostasis in rats via bioinformatic investigation.
Methods: The differentially expressed plasma proteins of treated rats via LLLT from the literature and the added 50 first neighbors were investigated via network analysis to find the critical dysregulated proteins and biological processes by using Cytoscape software, the STRING database, and ClueGO.
Results: A scale-free network including 55 nodes was constructed from queried and added first neighbor proteins. Fibrinogen gamma, fibrinogen alpha, and plasminogen were highlighted as the central genes of the analyzed network. Fibrinolysis was determined as the main group of biological processes that were affected by LLLT.
Conclusion: Findings indicate that LLLT affects blood hemostasis which is an important point in
approving the therapeutic application of LLLT and also preventing its possible complication.

DOI: 10.34172/jlms.2021.59

Introduction: Rheumatoid arthritis (RA) causes inflammation, pain, edema, and articular degradation and its treatment can be based on anti-inflammatory drugs, photobiomodulation (PBM) and/or platelet-rich plasma (PRP) that can decrease cell flow and promote local healing. In the present study, we evaluate the effects of PBM and PRP on acute arthritis in Wistar rats through inflammatory and oxidative stress parameters.
Methods: Thirty female Wistar rats were assigned to five groups (n=6, each group): Control, Sham, PRP, Laser, and PRP+Laser. For arthritis induction, all animals of groups Sham, PRP, Laser and PRP+Laser received an intraarticular injection of Zymosan® (200µg) in the right knee. Twenty-four hours post-arthritis induction, PRP was prepared and injected (8 × 105 of platelets) in animals of PRP and PRP+Laser groups. PBM was performed in Laser and PRP+Laser groups by single-dose therapy with the GaAlAs laser (λ=808 nm, P=25 mW, fluence=30 J/cm2, beam area=0.02 mm2, t=33 seconds, E=0.825 J, punctual application). After seven days of induction, serum samples
were collected and thiobarbituric acid reactive substances (TBARS), nitric oxide (NO), and catalase activity were analyzed. Morphological parameters were measured for inflammation areas, cartilage thickness, and C3 protein expression in knee samples. Statistical analysis was performed with an ANOVA test and Tukey’s posthoc test with a significance level of 5% (P<0.05).
Results: NO was lower in the treated groups compared to the Sham group, and TBARS did not show any differences, while catalase showed greater activity between PRP+Laser versus PRP (P<0.05). Inflammatory areas and cartilage thickness were lower in the treated groups compared to Sham (P<0.05), while no differences in C3 protein expression were observed.
Conclusion: PBM associated with PRP is better for anti-inflammatory and joint preservation by morphological aspects and NO levels that concern a potential clinical application.

DOI: 10.34172/jlms.2021.60

Introduction: Dentin hypersensitivity (DH) is one of the most common complaints of patients referred to a dental office, so this study aimed to compare the effectiveness of combined diode laser and GLUMA bonding therapy with combined diode laser and 5% sodium fluoride varnish in patients with DH.
Methods: Sixty patients were divided into three groups (bonding, laser-bonding, laser-varnish), and before the intervention, the amount of DH was measured with the visual analog scale (VAS) scale. In the bonding group, GLUMA Desensitizer solution was applied and then air-dried. In the bonding laser group, first bonding was used, and then the affected tooth was irradiated with a diode laser. In the varnish-laser group, 5% sodium fluoride varnish was coated and then the laser was irradiated with the said method. DH was measured immediately after the treatment and then 2, 7 and 30 days after the treatment.
Results: Laser-varnish treatment was not different from laser-bonding treatment at all measurement times (P=1). Laser-varnish and bonding treatment were not significantly different up to one week after the intervention, but on the 30th day after the intervention, the difference in pain was significant (P=0.01). There was no significant difference in laser-bonding treatment up to one week after the intervention, but on the 30th day after the intervention, the difference in pain was significant (P=0.003).
Conclusion: The combined treatment with GLUMA bonding and the 660 nm diode laser is effective in reducing DH and this is more effective than GLUMA bonding alone in the long term. However, it does not have a significant advantage over the combined varnish-laser method, but it seems that due to its ease of use, it can be a suitable alternative to the varnish-laser method.

DOI:10.34172/jlms.2021.62

Introduction: Recently, the management of dentin hypersensitivity by lasers has gained special attention. This study aimed to assess and compare the efficacy of the 980 nm diode, Nd: YAG, and Er: YAG lasers accompanied by fluoride in dentinal tubule obstruction.
Methods: Twenty sound single-rooted human teeth were used for this in-vitro study. Forty dentinal discs were prepared of the roots and etched with 6% citric acid. One layer of fluoride varnish was applied over their surface. The sections were randomly allocated into 4 groups. The control group received no laser irradiation. Group 2 underwent 980 nm diode laser irradiation with 0.5 W power. Group 3 underwent Nd: YAG laser irradiation with 0.5 W power and group 4 underwent Er: YAG laser irradiation with 0.5 W power. All samples were then inspected under a scanning electron microscope, and the number of obstructed dentinal tubules and the diameter of open dentinal tubules in the field were determined. One-way ANOVA and Tukey’s test were used for data analysis at a significance level of 0.05.
Results: All three laser types decreased the number of open dentinal tubules significantly compared to the control group (P<0.05). No significant difference was noted in dentinal tubule obstruction between the three laser groups (P>0.05). The diameter of open tubules in the three laser groups did not show a significant difference from that in the control group.
Conclusion: All three types of lasers evaluated in this study can effectively obstruct the dentinal tubules.

DOI:10.34172/jlms.2021.63

Introduction: Hyperoxygenation is linked to numerous effects in a variety of organ systems. It can cause tissue damage by generating reactive oxygen species (ROS), increasing oxidative stress, and inducing cell death by apoptosis. The present study aimed to evaluate the effects of low-level laser therapy on the retina in response to acute hyperoxia in animals.
Methods: A total of 70 Wistar albino rats were evaluated in the present study: 10 rats were designated as a control group, and the rest were exposed to hyperoxia (O2, 90%) for 3 days, 1 week, and 2 weeks (20 rats each). Each group was divided into two subgroups (n=10), one of which was designated as hyperoxia only. The other was treated with a 670 nm light-emitting diode laser (2 sessions/one week, ~ 9.0 J/cm2) in each eye. The animals were euthanized, and their retinas were dissected for analysis of protein content, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), total antioxidant capacity (TAC), hydrogen peroxide (H2O2), malondialdehyde (MDA), and histological examination.
Results: We found that two weeks of hyperoxia-induced an increase in retinal protein content (P<0.001), an alteration in the intensities and molecular weights of protein fractions, a significant decrease in the TAC level (P<0.01), and a noticeable increase in H2 O2 and MDA levels (P<0.001). Histological examination revealed fragmentation of the photoreceptors and neovascularization in the outer and inner plexiform layers. Furthermore, the data showed remarkable improvement in the retinal protein contents, oxidative state, and retinal structure after light-emitting diode laser therapy.
Conclusion: Light-emitting diode laser therapy was found to be a useful treatment paradigm for reducing hyperoxia-induced retinal damage.

DOI: 10.34172/jlms.2021.64

Introduction: One of the chemoradiotherapy (CRT) side effects is oral mucositis (OM). Since photobiomodulation therapy (PBMT) is a public method for the repair process, in the present study the mechanism of PBMT in the prevention of OM is investigated via the bioinformatics approach.
Methods: Six validated and significant differentially expressed genes (DEGs) associated with the prevention of OM in head and neck cancer (HNC) patients who had experienced CRT were extracted from the literature. After adding 50 neighbors from STRING, the network was constructed and analyzed. The results of the action map and network analysis were compared and discussed.
Results: HLA gene families were identified as central nodes of the analyzed network. Based on action map finding, activation is prominent action and IRF9 was the potent activator. The role of the IRF gene family was highlighted by action map analysis.
Conclusion: Regulation of the immune system by HLA and IRF genes family is a crucial factor in the prevention of OM in the studied patients.

DOI: 10.34172/jlms.2021.65

Introduction: Peri-implantitis is a common complication of dental implant treatment. A cause-and effect relationship has been previously documented between microbial plaque and peri-implantitis and implant failure. A difference has been reported in the disinfection efficacy of erbium laser irradiation and air-flow abrasion for contaminated titanium surfaces. Also, the surface changes caused by lasers and air-flow abrasion have not been well studied. Thus, the purpose of this study was to compare the surface changes of contaminated titanium discs following decontamination by erbium-doped yttrium aluminum garnet (Er: YAG) laser irradiation and air-flow abrasion.
Methods: Twenty-eight intact, sandblasted, and acid-etched (SLA) titanium discs were used. Twentyfour titanium discs were contaminated with Escherichia coli. Then, they were decontaminated by using Er: YAG laser irradiation and air-flow abrasion. Four discs remained intact. The mean and standard deviation of the contact angle and the weight percentage of aluminum, titanium, oxygen, carbon, phosphorus, and calcium were measured. Qualitative changes in surface topography of titanium discs were assessed by scanning electron microscopy (SEM).
Results: The mean weight percentage of carbon in the air-flow abrasion group (4.98%) experienced a significant reduction compared with the contaminated (positive control) group (P=0.035). The contact angles were 46.54° and 38.67° in the laser and air-flow abrasion groups respectively, which were significantly lower than the value in the positive control group (75.15°) (P ≤0.001). SEM micrographs showed no significant change in the surface area in either technique.
Conclusion: Air-flow abrasion was more successful in improving the surface characteristics of titanium discs with no alteration in surface topography or elements, compared with Er: YAG laser irradiation. Further studies regarding the safety of the Er: YAG laser for the decontamination of titanium surfaces are recommended.

DOI:10.34172/jlms.2021.67

Introduction: The basis of periodontal treatments is the mechanical removal of bacterial biofilm, which is often not sufficient. Therefore, laser therapy can be effective as an adjunct treatment. The aim of the present study was to evaluate the clinical efficacy of the 940-nm diode laser in the treatment of recurrent pockets of patients in the periodontal maintenance phase.
Methods: The present clinical trial study was performed on 20 patients. Clinical indices, including bleeding index (BI), probing pocket depth (PPD), and clinical attachment level (CAL) of the studied teeth were recorded before the test. The different quadrants were randomly divided into two experimental (scaling and root planing (SRP)+Laser) and control groups (SRP alone). Both groups were matched in terms of plaque index (PI). Clinical indices were re-recorded using therapeutic methods 30 and 90 days after the treatment and data analysis was carried out using the t-test and LSD.
Results: There were no significant differences in PI, PPD, CAL, and BI in both groups before the treatment (P>0.05). However, there were significant differences in PPD, CAL, and BI in the two groups one month after the treatment (P<0.05); it means that improvements were more significant in the experimental group than in the control group. Comparing experimental and control groups, we found that there were no significant differences in PPD and CAL indices three months after the treatment (P>0.05); however, there were significant improvements in the BI index in both groups (P<0.05), so that the improvement was better in the experimental group than the control group.
Conclusion: Both SRP+Laser and SRP alone improved clinical indices in patients. In short-term follow-up, the effect of SRP+Laser treatment on BI, CAL, PPD was significantly superior to SRP treatment alone, but in long-term follow-up, SRP+laser was more effective than SRP alone in improving the BI index.

DOI:10.34172/jlms.2021.68

Introduction: This study was to assess the effect of various output parameters of laser treatment on roughening the surface of a commercial nickel-chromium (Ni-Cr) alloy as compared to the sandblasting technique.
Materials and Methods: Ninety-six disk-shaped (5 mm diameter and 2 mm thickness) specimens in the total were made of a nickel-chromium alloy by using the lost-wax technique. Air-abrasion surface treatment was used for sixteen specimens. Specimens were divided into six groups; one of them was sandblasted and the rest were irradiated by different Nd: YAG laser output parameters as follows: Group A: energy: 122 mJ, frequency: 20 Hz, irradiation duration: 20 seconds, spot size: 1.5 mm; Group B: energy: 122 mJ, frequency: 20 Hz, irradiation duration: 20 seconds, spot size: 3.5 mm; Group C: energy: 122 mJ, frequency: 10 Hz, irradiation duration: 20 seconds, spot size: 3.5 mm; Group D: energy: 102 mJ, frequency: 10 Hz, irradiation duration: 20 seconds, spot size: 3 mm; Group E: energy: 102 mJ, frequency: 20 Hz, irradiation duration: 20 seconds, spot size: 3 mm. The
surface roughness of all surface-treated specimens was evaluated by using a profilometer, and their average roughness (Ra) was calculated. The average value of each group was analyzed by t-test and one-way ANOVA (SPSS 17).
Results: Significant differences (P<0.05) were observed between the study groups. The highest Ra was achieved for the sandblasted group. The Ra value in group C was the highest value among the laser-etched groups.
Conclusion: Based on the results, Nd: YAG laser irradiation increases surface roughness, but it is not as efficient as the sandblasting method as a gold standard.

DOI:10.34172/jlms.2021.69.

Introduction: Inadequate recovery from Bell’s palsy exists in a third of patients and results in physical and social impairments. The controversial nature of existing medical treatment options means that novel, alternative approaches are needed. In basic and clinical studies, low-level laser therapy (LLLT) has proven successful in regenerating peripheral nerves. Laser acupuncture therapy (LAT) is a rapidly growing treatment modality; however, its effectiveness for treating chronic Bell’s palsy is unknown. The feasibility of this innovative approach is the focus of this pilot study.
Methods: A two-armed, parallel, randomized, investigator-subject-assessor-blinded, shamcontrolled pilot study was conducted, and 17 eligible subjects were randomly allocated to either LAT (n=8) or sham LAT (n=9). The LAT group received three treatments each week for six weeks (18 sessions), while the sham LAT group received the same procedure but with a sham laser device. The change from baseline to week 6 in the social subscale of the Facial Disability Index (FDI) was the primary outcome. Secondary outcomes were changes in the House-Brackmann facial paralysis scale (HB), the Sunnybrook facial grading system (SB) and a stiffness scale at weeks 3 and 6.
Results: A significant difference was shown in the HB score (P=0.0438) between baseline and week 3 and borderline significance was observed in both SB and stiffness scores from baseline to week 6 (P=0.0598 and P=0.0980 respectively). There was no significant difference in the FDI score between baseline and week 6.
Conclusion: To the best of our knowledge, this clinical trial is the first such investigation on this topic. Our findings suggest that using LAT may have clinical effects on long-term complications of Bell’s palsy and justify further large-scale studies.

DOI: 10.34172/jlms.2021.70

Introduction: This study was conducted to assess the impact of nanosecond and femtosecond lasers on shear bond strength at the zirconia-veneering ceramic juncture.
Materials and Methods: The first 60 samples of partially sintered zirconia cylindrical discs measuring 7 mm diameter and 4 mm height were milled and sintered. Then they were randomly divided into three groups namely group C (control, n=10), group N (Nd: YAG laser, n=10), and group T (Ti: sapphire laser n=40) which was further divided based on the duration of laser irradiation, into 4 subgroups (n=10 each) which were 30 seconds, 1 minute, 2 minutes and 3 minutes. Surface treatment was done on sintered zirconia discs based on the group. Following the treatment, the discs were ultrasonically cleaned followed by liner application (IPS Emax Zirliner, Ivoclar-Vivadent) and veneer ceramic layering (IPS e.max Ceram, Ivoclar-Vivadent) of 1.5 mm height. Each sample underwent shear stress in the universal test machine on the mounting jig, and bond strength was evaluated. Data were assessed using ANOVA followed by Tukey’s post hoc multiple comparison analyses.
Results: According to one-way ANOVA, there was a significant difference in shear bond strength between the groups. Tukey’s post hoc pairwise comparison test showed a significant difference (P value=0.001) in shear bond strength of all pairs except group C and group N. The results of repeated measures, ANOVA (related and dependent groups), and Tukey’s multiple pairwise comparison test showed that there was a significant difference (P value=0.001) in shear bond strength at 30 seconds and all other groups.
Conclusion: Ti: sapphire laser irradiation for 30 seconds can be used as a potential surface treatment to increase shear bond strength at the zirconia-veneering ceramic juncture.

DOI: 10.34172/jlms.2021.71.

Introduction: The final goal of root canal therapy is to remove most bacteria from the root canal. This study aimed at comparing the antibacterial effects of a diode laser with a wavelength of 940nm and silver nanoparticles and the synergic effects of both techniques on Enterococcus faecalis.
Methods: Ninety single-rooted human teeth were decoronated and prepared with rotary files. The samples were irrigated with sodium hypochlorite and EDTA17%. Then they were autoclaved and contaminated with E. faecalis suspension (1.5 × 108 CFU/mL) for 21 days. The samples were fixed in a microtube and were randomly divided into 4 experimental (n=20) groups and a negative control group (n=10) as follows: Group 1: hypochlorite sodium 5%, Group 2: silver nanoparticle, Group 3: diode laser, and Group 4: diode laser and silver nanoparticle. The samples were obtained from dentin chips before and after the intervention. The data were analysed using the Kruskal-Wallis nonparametric test. Furthermore, alterations in bacterial colonies were entered using the Wilcoxon signed ranks test (α=0.05).
Results: There was a significant decrease in colony counts for all groups after interventions (P value<0.05). Also, all groups showed more reductions in colony counts compared with the negative control group (P-value <0.004). There was a significant reduction for group 1 in comparison with other groups (P-value <0.001) and this group had an extreme decrease of colony counts (RCC=100%). There was an important differential between silver nanoparticles and diode laser groups in bacterial counts (P value<0.001) and silver nanoparticles (RCC=83.15%) had more efficiency than the diode laser (RCC=41/33%). RCC of group 4 was 68/52%.
Conclusion: Followed by sodium hypochlorite 5%, silver nanoparticles were the most effective antibacterial substances. The 940 nm laser diode had less antibacterial effect compared to its use with silver nanoparticles.

DOI:10.34172/jlms.2021.73

Introduction: This study was conducted to assess the microleakage in Er: YAG laser-ablated and burprepared root and coronal dentin cavities using self-etch and total-etch adhesive systems.
Methods: Sixty extracted caries-free human third molars were sectioned for dentin exposure. Then, two standard class V cavities were prepared in the root and coronal dentin of each tooth and allocated to one of the following conditioning groups randomly (n=12/Group): G1: Diamond bur for cavity preparation and single bond (BESB) etch-and-rinse adhesive for bonding, G2: Er: YAG laser (160 MJ, 20 Hz, 29.88 J/cm2) and SB (LESB), G3: Er: YAG laser and SB without acid etching (LSB), G4: Diamond bur and Clearfil SE Bond (BCSE) self-etch system, and G5: Er: YAG laser and Clearfil SE Bond (LCSE). The cavities were filled with Z100 composite resin. Dye penetration was assessed after thermocycling. Data analysis was done by Kruskal–Wallis and Mann–Whitney U tests. Statistical significance was set at P<0.05.
Results: The results showed there were no statistically significant differences in microleakage between the two preparation methods (bur and laser) or the bonding agents applied (P>0.05). Regardless of the cavity preparation method, dye penetration was significantly higher in coronal dentin than in root dentin (P<0.05).
Conclusion: The Er: YAG laser had the same efficacy as the conventional method for cavity preparation, and microleakage did not depend on the bonding agent. Microleakage was significantly higher in coronal restorations than in root restorations.

Doi:10.34172/jlms.2021.74.

Introduction: Low-level laser therapy (LLLT) has been reported to improve cell proliferation and differentiation. The stem cells derived from dental apical papilla (SCAPs) are a promising therapy because they are easily obtained from immature human teeth. The effect of LLLT over SCAPs is still unknown. This study aimed to evaluate the proliferation and osteogenic potential of the SCAPs stimulated with LLLT.
Methods: SCAPs were isolated from the third molars of a healthy donor and characterized according to the minimum established criteria. SCAPs were cultured for 24 hours before being exposed to LLLT. Cells were exposed to different doses, energy, and wavelengths for selecting the irradiation parameters. SCAPs proliferation was evaluated with the MTT assay at 24 hours and 7-day post-laser exposure. VEGF and TGFβ2 expression were assessed with a specific enzyme-linked immunosorbent assay (ELISA). The osteogenic differentiation potential was analyzed with alizarin red staining, and the nodule quantification was performed by the relative optical density (ROD) analysis using Image software.
Results: The cells isolated from the apical papilla showed phenotype and stem cell properties. SCAPs irradiated with one dose at 6 J/m2 and 650 nm exhibited significantly higher proliferation (P>0.05) than the controls nonirradiated. LLLT stimulated SCAPs’ expression of factors VEGF and TGFβ2. Also, SCAPs irradiated showed higher osteogenic activity (P<0.05).
Conclusion: LLLT promotes proliferation, osteogenic differentiation, and VEGF and TGFβ2 the expression on SCAPs. LLLT is a practical approach for the preconditioning of SCAPs in vitro for future regenerative therapies. More studies are needed to determine the underlying molecular processes that determine the mechanism of the LLLT.

DOI: 10.34172/jlms.2021.75

Introduction: Radiotherapy as the first-line nasopharyngeal carcinoma (NPC) treatment provides different responses including radioresistant and radiosensitive states. In order to investigate the molecular basis of radioresistancy, protein-protein interaction network analysis of proteome data prior to therapy was performed.
Methods: 20 dysregulated proteins of the patients who were radioresistant were extracted from the literature. Cytoscape and its plug-ins were used for the resistant network construction and its centrality analysis. Furthermore, ClueGO+ CluePedia application determined the most statistically significant biological processes (BP) related to the hubs.
Results: Fourteen hubs were concluded and no differentially expressed protein (DEP) was among these agents. Among the hubs, albumin (ALB) and fibronectin (FN1) were the hub-bottlenecks, and the Serpin family was present. What is more, SERPIND1 was the highest degree-valued DEP in the network.
Conclusion: It can be concluded that the central elements of the NPC network could be noteworthy for improving the radiotherapy outcome and overcoming its limitations. However, complementary studies are required for a better understanding of their major role.

DOI: doi:10.34172/jlms.2021.76

Introduction: Wound healing can have a very important impact on the patients’ quality of life. For its treatment, wound dressings have vital and effective uses. Indeed, the use of a proper wound dressing can improve the healing process and duration. Recently, wound dressings with unique properties have been prepared using natural hydrogels. In addition to the general wound characteristics, new generations of wound dressings, such as those lasting longer on the wound, can have specific properties such as transferring allogeneic cells to enhance the healing effect and speed up the healing process. The present study aimed to prepare a gelatin-based hydrogel and to characterize it for therapeutic purposes.
Methods: In this experimental-laboratory study, a gelatin hydrogel was made using a microbial transglutaminase (mTG) enzyme. The prepared hydrogel was evaluated in terms of appearance, physical, and chemical properties. To investigate the biological properties of the hydrogel, cells were cultured on it and the toxicity of the hydrogel for the cells was investigated. The location of the cells on the hydrogel was imaged via an electron microscope. The absorption and reflectance characteristics of the hydrogel were recorded by optical spectroscopy. Data were collected and statistical analysis was performed.
Results: The results showed that the mTG gelatin hydrogel had a uniform pore size and good physical, chemical, and mechanical properties for use in wound healing. Cell experiments showed evident cell proliferation and high viability. The results also revealed that the cells grew vigorously and adhered tightly to the hydrogel.
Conclusion: The preparation of a gelatin hydrogel under GMP conditions can be considered in the healing of diabetic wounds and burns.

Doi:10.34172/jlms.2021.77.

Introduction: The clinical effect of low-level laser therapy (LLLT) on canine wounds is still under debate. The aim of this pilot study was to evaluate the potential influence of LLLT on the bacterial loads of wounds, using two different energy densities or doses of laser light as adjuvant therapy for traumatic contaminated wound management.
Methods: A prospective, randomized, blinded, placebo-controlled pilot clinical trial was used to evaluate the effect of two different doses of LLLT as an adjuvant treatment of contaminated traumatic wounds on the bacterial load and wound scoring in dogs. Fourteen dogs with traumatic bites or laceration wounds were randomly assigned to one of the three groups. Animals in groups A and B received a dose of LLLT of 6 and 2 J/cm2 respectively. Four wavelengths were used simultaneously:
660 nm, 800 nm, 905 nm, and 970 nm. Animals in group C received placebo LLLT. Bacterial burden and clinical wound scores were evaluated.
Results: A statistically significant reduction in the average count of colony-forming units was observed in group B (2 J/cm2) when compared to placebo group C. Group B also showed improved wound scores. No clinically adverse effects were observed in the patients treated with LLLT.
Conclusion: LLLT, with the parameters used in this pilot trial, decreased bacterial loads of contaminated wounds in dogs and improved wound scores, especially when using a dose of 2 J/cm2. This is the first time the effect of LLLT on bacterial load has been investigated in a clinical setting using traumatic wounds in canine patients.

DOI: 10.34172/jlms.2021.78

Introduction: Enterococcus faecalis is a gram-positive, facultative anaerobic bacterium associated with persistent endodontic infections. Conventional disinfection methods may not completely eradicate the bacteria within the root canal system. Therefore, novel modalities have been suggested to optimize root canal disinfection. The aim of this study was to evaluate and compare the antibacterial effect of photodynamic therapy (PDT), passive ultrasonic irrigation (PUI) and their combination in addition to conventional endodontic irrigation against E. faecalis biofilms in root canals.
Methods: Root canals of 50 single-rooted extracted human teeth were prepared and incubated with E. faecalis for 21 days. They were then divided into 4 treatment groups and a control group as follows: (1) NaOCl—Syringe irrigation with 2.5% NaOCl, (2) PUI—Passive ultrasonic irrigation with NaOCl, (3) NaOCl+PDT—Photodynamic therapy following syringe irrigation with NaOCl, (4) PUI+PDT, (5) Control—Syringe irrigation with saline. Colony-forming units were counted and bacterial reduction was calculated for each treatment group.
Results: All treatments led to significant reductions in the bacterial load compared to the control group. PUI and PUI+PDT led to the complete elimination of the bacteria from the root canals. NaOCl and NaOCl+PDT treatments reduced the bacteria by 99.9% and 99.5% respectively. NaOCl+PDT was significantly less effective in reducing the bacteria compared to other treatment groups. There were no significant differences between the NaOCl, PUI, and PUI+PDT groups.
Conclusion: Passive ultrasonic irrigation with or without the combination of Photodynamic therapy completely eradicated the bacteria. The use of PDT as an adjunction to NaOCl syringe irrigation and PUI did not enhance their antibacterial effect.

DOI: 10.34172/jlms.2021.81

Introduction: Dental decay is caused by the fermentation of carbohydrates and the production of acids that demineralize teeth. The fermented food debris lowers the pH under 5.5, resulting in the mineral loss of teeth. Anti-decay factors are used to reduce decay rates and increase dental protection.
Methods: Fifteen sectioned teeth samples were immersed in Ag NPs solution and then irradiated with laser pulses. Structures, morphologies, chemical compositions and microhardness were studied using the Vickers micro-hardness tester, energy dispersive x-ray machine, atomic force microscope and scanning electron microscopes.
Results: Nine mature extracted human third molars, cleaned and placed in plastic molds then filled with a warm epoxy resin, were sectioned longitudinally and polished. The samples were then cleaned ultrasonically and stored in distilled water and taken immediately one by one for laser treatment. Sharper, overlapping, interconnected rods, and higher resistance against enamel decay were demonstrated with little alterations of the mineral percentages of the teeth samples.
Conclusion: The combination of laser light and silver annoparticles improved the decay resistance;
where regular inter-connected chain-like merged grains were formed. These laser-induced modifications in enamel components have reduced the lattice stress and enamel solubility and improved resistance against decay. The computer model indicated a possible prediction of the laser-treated profile prior to laser treatment.

DOI: 10.34172/jlms.2021.82.

Introduction: Investigating the molecular mechanism of cellular response to light radiation has attracted many researchers’ attention. In the present study, the critically affected gene by 1-hour blue light radiation in human keratinocytes was investigated via network analysis.
Methods: Gene expression profiles of human keratinocytes exposed to 1-hour blue light radiation plus controls were extracted from Gene Expression Omnibus (GEO). The significantly dysregulated genes plus 100 first neighbors were investigated by Cytoscape software and its applications. The central nodes of the network based on four centrality parameters were determined and discussed.
Results: Among 6 significant dysregulated genes, 4 individuals were recognized by the STRING database. The network was constructed by using the 4 queried genes and 100 first neighbors. EGR1, STAT1, and ISG15 were identified as central nodes; however, the prominent role of EGR1 was highlighted.
Conclusion: EGR1 appeared as a critically affected gene after blue light irradiation. It seems that this upregulated gene is responsible for protecting human keratinocytes against stress and cancer. Therefore, the application of blue light may be accompanied by antistress effects in the human body.

DOI: 10.34172/jlms.2021.83.

Introduction: Cervical and ovarian cancers are well-known causes of death among women in developing countries. There are various technologies to treat cancer cells, but the polyphenolic compound is a natural one and has an anti-cancer effect. In this study, we investigated combination therapy using sinensetin and low-level laser therapy (LLLT) to enhance treatment.
Methods: The cancer cells purchased from Pasteur Institute, Iran, were cultured. The cells were treated with various concentrations of sinensetin, wavelengths of laser therapy (660 nm), and power density (3 J/cm2) for different times separately. Furthermore, the sensitivity of cells to sinensetin, LLLT, and combined therapy was determined by clonogenic assays. To measure DNA damage and repair at individual cell level used comet assay. To examine the intracellular generation of reactive oxygen species used 2′,7′-dichlorodihydrofluorescein (DCFH) as an intracellular probe. To analyze data we used SPSS software and comparison between groups was used (ANOVA) and t-test statistical analyses were performed using SPSS 17 software. The level of statistical significance was set at a two-tailed P value of 0.05.
Results: Our results demonstrated that the doubling time for CHO is more than Hella cells, with 20.7 and 27.7 h for each cell respectively. The pretreatments can decrease the viability of both cell lines more than the first treatment. In the clonogenic assay, the pretreatment of cells with LLLT and Sinensetin significantly reduced the surviving fraction of both cell lines. MTT results showed that pretreatment with LLLT and Sinensetin can increase cell death compared to Sinensetin and LLLT alone.
Conclusion: Our result indicated that combined therapy with LLLT and Sinensetin can treat CHO and Hela cells better than the other groups. Combination treatment with sinensetin-LLLT and the other treatment means, sinensetin and LLLT alone, did not change the cell viability significantly.

DOI: 10.34172/jlms.2021.85.

Introduction: Currently, infertility is the main concern, and it is estimated that 15% of couples are considered infertile. Conventional therapies such as vitamins, antioxidants, and supplements have been used widely, but they may not be sufficiently effective. This study evaluated the effect of laser acupuncture on semen parameters in infertile patients with oligospermia.
Methods: This study is a clinical trial with a double-blind control group. 35 patients in the intervention group underwent laser acupuncture twice a week for consecutive 5-weeks. In the control group, sham laser acupuncture was performed. The two groups were compared in terms of semen parameters including semen volume, sperm concentration, sperm motility and sperm morphology as the primary outcome. The secondary outcome was a successful pregnancy rate. After data collection, statistical analysis was performed with SPSS version 20.
Results: The mean age of all patients was 27.46±2.88 years; in the intervention group, their age was 27.82±2.6 years, and in the control group, it was 27.11±2.96 years, and there was no significant difference (P=0.396). During the study, 4 patients (5.4%) reported adverse effects; three patients in the control group complained of mild weakness and itching, and one patient in the intervention group reported dizziness. The volume of semen and sperm morphology did not differ significantly in both control and intervention groups (P ˃ 0.05), while sperm motility and sperm concentration had a significant difference (P=0.0001).
Conclusion: Laser acupuncture as a non-invasive procedure is effective in improving sperm mobility and concentration in infertile patients with oligospermia. Due to the surface contact of the laser probe with the skin and the lack of need to insert needles in the skin, laser acupuncture is more convenient and better tolerated by patients.

DOI: 10.34172/jlms.2021.84

Introduction: Excessive exposure to ultraviolet (UV) radiation may cause a variety of skin cancers and damage to the eye lens. The assessment of different aspects of UV damage has attracted researchers’ interest. UV radiation to simple biological models such as Saccharomyces cerevisiae of yeast family could help to find out different molecular changes resulting from radiation. The assessment and network analysis of gene expression data about yeast cells radiated by the UV laser was the aim of this study.
Methods: The gene expression profiles of S. cerevisiae samples in the presence of the UV laser at 30 seconds radiation and 15 minutes’ post-radiation time are compared with the control profiles. The significantly expressed genes interacted and the central nodes and related biological terms were identified.
Results: The main connected component of the network including 427 nodes was analyzed and 11 central differentially expressed genes (DEGs) were determined. RPN11, UBI4, HSP82, and HSC82 as critical DEGs and “positive regulation of telomere maintenance” as a related biological term was introduced.
Conclusion: The finding has provided a new perspective on laser application in the rejuvenation process. It seems that the laser can be used as a suitable agent against the aging process which is a limiting factor in human life.

DOI:10.34172/jlms.2021.87

Introduction: The reversibility of biological processes is an important challenge in the study of environmental pollutants and also natural and artificial radiation. There are many pieces of evidence about the reversible and irreversible effects of UV radiation on the human body. Assessment of the reversibility of UV laser effects on Saccharomyces cerevisiae was the aim of this study.
Methods: Gene expression alteration in S. cerevisiae samples radiated by a 30s UV laser for 15, 30, and 60 minutes post-radiation times were investigated via network analysis to explore time-dependent reversible alteration in the gene expression profiles of the samples.
Results: 19 differentially expressed genes (DEGs) were identified as targeted genes for the samples which were harvested 60 minutes after radiation; network analysis revealed no significant alteration in biological processes.
Conclusion: It can be concluded that the gross effects of the UV laser on S. cerevisiae samples disappear after 60 minutes of radiation.

DOI:10.34172/jlms.2021.90.

Introduction: Widespread application of lasers in different fields of medicine implies more investigations into the molecular mechanism of laser effects on the human body. Network analysis of the dysregulated genes of Saccharomyces cerevisiae samples are irradiated by a UV laser and harvested 30 minutes after radiation compared with a 15-minute group is the aim of this research.
Methods: The significantly dysregulated genes interacted via the STRING database, and the central nodes were determined by “Networkanalyzer” application of Cytoscape software. The critical genes and the related biological terms were identified via action map analysis and gene ontology assessment.
Results: The gene expression profiles of the samples with 30-minute post-radiation time were different from the samples with 15 minutes of post-radiation time. 9 potent central genes, 50% of which were similar to the nodes of the 15-minute group, were identified. The terms “positive regulation of telomere maintenance” were targeted in the two sample groups.
Conclusion: In spite of large alterations in the gene expression profiles of the samples, the results indicated that the main affected biological term for the 15-minute and 30-minute groups was similar.

DOI:10.34172/jlms.2021.91.

Introduction: Fourier domain Optical coherence tomography (OCT) is a widely used highresolution optical imaging technique. It is useful for various applications in medical imaging, such as ophthalmology (e.g. retinal imaging for diagnosing complications like glaucoma or macular degeneration), dermatology, oncology, and cardiology. The ability to noninvasively measure both the refractive index and thickness of biological tissues could have various medical applications and enable earlier disease detection. For example, observing changes in the refractive index can help distinguish between tissues with normal or abnormal function.
Methods: In this study, the theoretical framework for simultaneous measurement of the refractive index and physical thickness of multilayer systems is proposed and tested for two different samples, each having three layers, a glass/NaCl solution/glass sample and a glass/sugar solution/glass sample. The whole signal processing procedure and the experimental setup are described.
Results: The refractive index and thickness of saltwater and sugar water samples in the Fourierdomain OCT (FD-OCT) system were obtained. The resulting data were compared with reference measurements and showed a deviation of about 1% for the samples.
Conclusion: We tested the proposed framework for the simultaneous extraction of the refractive index and thickness of multilayer systems of salt water and sugar water from its FD-OCT data. We showed that the measured parameters were in agreement with reference amounts.

DOI: 10.34172/jlms.2021.89

Introduction: The golden standard of the treatment of radicular cysts is mainly root canal therapy or surgical excision with apicectomy. The root canals are usually disinfected by the mechanical and chemical actions of instruments and chemical irrigating solutions respectively. To improve the efficacy of the root canal disinfection process, many techniques have been used and many researchers are still trying to reach the quickest and most convenient way to achieve this goal. Diode lasers have shown antibacterial activity on dentinal tubules, and they can penetrate more than 1000 μm into the dentin.
Case Presentation: Our patient was a 25-year-old female with an infraorbital abscess caused by a non-vital maxillary canine with periapical radiolucency. After completing the conventional treatment, the optical fiber was inserted into the canal according to the working length previously measured. An 810 nm diode laser at the output power of 4 W was used to irradiate the root canals, with a 300 μm fiber.The lesion was resolved in radiographic follow-ups, 3 and 6 months after the root canal treatment.
Conclusion: A combination of conventional root canal therapy and an 810 nm diode laser is an effective treatment for non-vital teeth with periapical lesions.

DOI: 10.34172/jlms.2021.03

Introduction: The aim of this article was to evaluate the efficacy of photobiomodulation therapy (PBMT) in the alveolar tissue healing process post-extraction using infrared thermography (IT).
Case Presentation: A 36-year-old male patient had teeth extractions (18 and 28). Four PBMT sessions (660 nm; 2 J per tooth) were performed in the region of tooth 28 and recorded with thermographic images to compare the healing process, bilaterally. In the first two postoperative sessions, the temperature was higher (hyperradiant) on the left side (treated). After the third laser application, the left side was hyporradiant. In a later session, the treated side became hyperradiant compared to the control side. The alveolus of tooth 28 showed more rapid healing than tooth 18 over a period of 60 days.
Conclusion: IT can be used to detect the favorable effect of PBMT on accelerating the healing process in the alveolus within 60 days after the tooth extraction.

Introduction: Medication-related osteonecrosis of the jaws (MRONJ) corresponds to an adverse effect of the use of drugs such as Bisphosphonates and Denusomab. The management of MRONJ tends to be conservative, through the guidance of oral hygiene, antibiotic therapy and mouthwashes. However, the use of antimicrobial photodynamic therapy (aPDT) has shown promise in the treatment of these injuries. The purpose of this article is to report a case of MRONJ treatment associated with aPDT.

Case report: A 75-year-old patient, with a history of breast cancer and use of intravenous Zoledronic Acid, presented with bilateral MRONJ lesions in tuberosity on the right and left sides. Treatment was conservatively instituted with the use of aPDT as an adjuvant. After 12 aPDT sessions, complete regression of the lesion was observed. However, after two weeks, the presence of a new lesion was noted, this time in the anterior region of the maxilla. The same protocol previously established was followed and after two aPDT sessions, the patient returned with complete lesion regression.

Conclusion: The use of aPDT may represent an important adjuvant within a set of clinical protocols in the treatment of MRONJ.

Introduction: Salivary stones inside the Wharton’s duct adjacent to the mylohyoid muscle are often removed by a little incision of the mouth floor under local anesthesia. However, in the case of relatively large salivary stones, a large incision is required, which is commonly accompanied by hemorrhage and the need for surgical hemostasis, resulting in prolonged surgery. Furthermore, troublesome sequelae such as ranula and lingual nerve paralysis can occur after surgical procedures.
Methods: Two patients who had relatively large salivary stones (>1 cm diameter) in the Wharton’s duct was underwent incision of the mouth floor soft tissues with a CO2 laser.
Results: In both patients, the stone was removed in a few minutes without causing abnormal bleeding, nerve injury, or sublingual gland disorders and was completely healed.
Conclusion: We report the usefulness and safety of the CO2 laser in two patients with relatively large salivary stones, who underwent successful surgical removal.

DOI: 10.34172/jlms.2021.19

Introduction: Tuberous sclerosis complex (TSC) is a rare, genetic disease that leads to neurological, cardiological, nephrological, ophthalmic, pulmonary, and skin disorders.
Case Presentation: Here, we describe a case of a 64-year-old man with the presence of giant angiofibromas located on his chin and nasolabial folds which caused inconvenience and unaesthetic appearance. All angiofibromas were removed with the use of a CO2 laser. The patient was extremely satisfied with the obtained result. No side effects were observed after a 6-month follow-up.
Conclusion: Despite the fact that giant facial angiofibromas may be troublesome not only for patients but also for medical doctors, adequate CO2 laser usage with local anesthesia and control of massive bleeding is a promising treatment option for patients with TSC.

 DOI: 10.34172/jlms.2021.24

Introduction: The glands of Blandin–Nuhn are mucous and serous salivary glands situated on both
sides of the midline of the ventral surface of the tongue. In this area, a mucocele generally results
from trauma. The diagnosis of mucoceles is based on clinical and histopathological examinations
and the recommended treatment is surgical excision.

Case report: This report describes a case of mucocele of the glands of Blandin-Nuhn (MGBN) affecting a 20-year-old male. Oval-shaped swelling with a smooth and bright surface of soft consistency was observed on the ventral surface of the individual’s tongue. The diagnostic hypothesis was mucocele. Surgical excision was performed in a single session with a diode laser. A histopathological examination revealed mucus extravasating into connective tissue, with foamy macrophages and granulation tissue.

Conclusion: The high-intensity laser was a safe and effective tool for treating MGBN. No need for a suture, minimal or no intraoperative bleeding, and a minimal report of pain and edema by the patient were observed. A diode laser may be a helpful tool because it is less invasive and it is safe and effective.

DOI:10.34172/jlms.2021.27

Introduction: Topical steroids remain the first-line therapy to treat lichen sclerosis (LS), but circumcision may be curative in most cases. Positive results have been obtained by using a fractional micro-ablative CO2 laser to treat genital LS. This study aims to assess the safety and efficacy of the fractional micro-ablative CO2 laser in the treatment of penile LS.
Case Presentation: Five treatments with the fractional CO2 laser were performed on one 69-year old man affected by penile LS. A significant improvement in symptomatology was noted after the first treatment session. Complete clinical remission was achieved 14 weeks after the last treatment.
Conclusion: The fractional micro-ablative CO2 laser may represent a practical therapeutic approach in penile LS.

DOI: 10.34172/jlms.2021.61

Introduction: Behçet’s disease (BD) is a debilitating and chronic vasculitis that can affect multiple organs. Recurrent oral aphthosis is the most common clinical feature of BD. The remarkable pain associated with painful oral ulcers can exert a major impact on the patients’ quality of life. Non-thermal CO2 laser therapy (NTCLT) as a novel photobiomodulative approach has recently been used for significant and immediate pain reduction of some types of painful oral lesions such as recurrent aphthous stomatitis, pemphigus Vulgaris, and so on. In this procedure by some considerations, the conventional CO2 laser is used as a non-surgical, non-thermal, photobiomodulative laser without any visible thermal adverse effects. In this article, we report our
experiences about the analgesic effects of NTCLT on painful oral aphthous ulcers of BD.
Case Presentation: We report four cases of BD, whose painful oral aphthous ulcers were irradiated with NTCLT. Immediately after NTCLT, the pain of the lesions was significantly relieved with no visible complications.
Conclusion: The results of this study suggest that NTCLT could be proposed as a hopeful procedure for significant and instant pain relief of oral aphthous ulcers of BD without any visible thermal adverse effects.

DOI:10.34172/jlms.2021.72.

Introduction: Acute lymphoid leukemia (ALL) is a malignant disease, the prognosis of which depends on the age of the patient and the treatment. The aim of this article was to report the treatment of this rare and interesting case of alveolar osteitis with antimicrobial photodynamic therapy (aPDT) in a patient with ALL that was resolved efficiently and quickly.
Case Presentation: A 33-year-old male diagnosed with ALL attended the public service, complaining of pain in the region of tooth 48, without function. Extraction was performed, and the patient returned for postoperative follow-up, complaining of severe pain in the area of the alveolus. Clinical examination revealed osteitis. The alveolus was treated using aPDT with 0.005% methylene blue photosensitizer, followed by the application of a low-level red laser at a wavelength of 660 nm (321J/cm2– site). After 15 days, soft tissue closure was observed and complete filling of the alveolus was observed radiographically with a 7-month follow-up.
Conclusion: The authors suggest that aPDT can be an effective treatment of alveolar osteitis in a
patient with ALL.

DOI: 10.34172/jlms.2021.79.

Introduction: Prostatic abscess is an infrequent but serious pathology that could be treated by
ultrasound-guided puncture, transurethral resection, or open surgery.
Case Report: We present a case of a 72-year-old male with a 3x5 cm prostatic abscess in the right lobe shown in abdominal computed tomography (CT). In the blood test, he presented coagulopathy. Urgent transurethral drainage by holmium laser was decided to be performed. It started with incision and opening of the right prostatic lobe with an energy of 1.2 J and a frequency of 20 Hz with a total power of 24 W. A 550-micron fiber was used for this technique. Coagulation of the area was performed with a power of 20 W. The postoperative course was uneventful.
Conclusion: The holmium laser appears to be an effective alternative in the treatment of this pathology in patients with coagulation disorders by providing adequate hemostatic control.

DOI:10.34172/jlms.2021.80

Introduction: Congenital melanocytic nevus (CMN) is a severe challenge for dermatology. This pigmented skin lesion is undesirable for patients because of its localization in open areas of the body. Various visible and near-infrared laser systems and intense pulsed light (IPL) sources have been applied for CMN treatment. However, post-traumatic hyperpigmentation, structural changes, atrophy, and scarring due to non-specific thermal damage have been observed. Many patients have shown recurrence after treatment. Therefore, it highlights the need for testing new laser modalities for the management of CMN.
Methods: Two adult II Fitzpatrick phototype patients (a 55-year-old male and a 30-year-old female) with middle-sized facial CMN (on the forehead and lower eyelid) are presented. All patients were treated with dual-wavelength copper vapor laser (CVL) radiation at 511 nm and 578 nm wavelengths with a power ratio of 3:2. The average power was 0.7-0.85 W with an exposure time of 0.3 seconds. The spot size amounted to 1 mm.
Results: Both patients showed complete resolution of CMN after CVL treatments. CMN became crusted within a few days after the laser treatment and peeled off within seven days. No recurrences were observed during the follow-up period up to 24 months.
Conclusion: The middle-sized CMN can be successfully treated with dual-wavelength CVL radiation.

DOI: 10.34172/jlms.2021.05

Introduction: Surgical methods for removing eyelid nevus are associated with a risk of developing such side effects as scarring or loss of eyelashes. Although current laser modalities have shown promising results, eyelid laser surgery may cause skin discoloration and noticeable scarring. This study aims at evaluating the efficacy and safety of the dual-wavelengths copper vapor laser (CVL) treatment of eyelid intradermal nevus of Miescher (NM).
Patients and Methods: We present three adult female patients with eyelid intradermal nevus treated with CVL. CVL settings were as follows: the average power of 0.6-0.8 W, under a power ratio of 3:2 at wavelengths of 511 nm and 578 nm, exposure time of 0.3 seconds, the light spot diameter of 1 mm.
Results: The dual-wavelength CVL treatment of medium- and large-sized NM provides the complete removal of eyelid dome-like NM after one and two sessions with a month interval correspondingly. The duration of skin healing accounted for two weeks.
Conclusion: The complete removal of eyelid NM lesions without side effects demonstrates the safety and efficacy of dual-wavelengths CVL in treating such skin lesions. This laser treatment mode of benign skin neoplasms seems promising for dermatologists and cosmetologists’ clinical practice.

DOI: 10.34172/jlms.2021.23

Introduction: Non-clinical cardiovascular drug safety assessment is the main step in the progress of new pharmaceutical products. Cardiac drug safety testing focuses on a delayed rectifier potassium channel block and QT interval prolongation, whereas optogenetics is a powerful technology for modulating the electrophysiological properties of excitable cells.
Methods: For this purpose, the blue light-gated ion channel, channelrhodopsin-2 (ChR2), has been introduced into isolated primary neonatal cardiomyocytes via a lentiviral vector. After being subjected to optical stimulation, transmembrane potential and intracellular calcium were assessed.
Results: Here, we generated cardiomyocytes expressing ChR2 (light-sensitive protein), that upon optical stimulation, the cardiomyocytes depolarized result from alterations of membrane voltage and intracellular calcium.
Conclusion: This cell model was easily adapted to a cell culture system in a laboratory, making this method very attractive for therapeutic research on cardiac optogenetics.

DOI: 10.34172/jlms.2021.32