Vol. 13 (2022)


Original Article

Effects of Two Protocols of Low-Level Laser Therapy on the Proliferation and Differentiation of Human Dental Pulp Stem Cells on Sandblasted Titanium Discs: An In Vitro Study

Reza Amid, Mahdi Kadkhodazadeh, Maedeh Gilvari Sarshari, Ardavan Parhizkar , Massoud Mojahedi

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e1

Introduction: Stem cell activities have different effects on tissue response and its outcomes. Low-level laser therapy (LLLT) can be considered a trigger to modify stem cell activities. The objective of the present experimental investigation was to study the effects of two protocols of LLLT on the proliferation and differentiation of human dental pulp stem cells (hDPSCs) cultured on sandblasted titanium discs.
Methods: Cells obtained from human dental pulp were seeded/cultured on titanium discs and were set in 2 main groups: (i) Radiated cells using the gallium-aluminium-arsenide (GaAlAs) diode laser at a continuous wavelength of 808 nm at 3 J/cm2 for 12 sec or 5 J/cm2 for 20 seconds, and (ii) Nonirradiated cells serving as control groups. The impact of LLLTs on hDPSC proliferation and viability
was investigated using the MTT assay after 24, 72, and 96 hours. The alkaline phosphatase activity was studied with p-nitrophenylphosphate after 14 and 28 days. The ability of hDPSCs to express osteocalcin was investigated using real-time polymerase chain reaction after 28 days, while their attachment was observed under a scanning electron microscope (SEM) after 14 and 28 days.
Results: Our study showed that LLLTs caused maximum cell proliferation in 96 hours (P<0.001) with 3 J/cm2 resulting in a higher proliferation rate. The highest activity of alkaline phosphatase and osteocalcin expression was observed in the laser radiation groups after 28 days.
Conclusion: The outcomes of the current study showed that cultured hDPSCs on sandblasted titanium discs had a tendency towards increased cellular activity in response to LLLTs. Thus, LLLTs could regulate the activities of hDPSCs on bone repair surrounding the sandblasted titanium discs.


Efficacy of the Er,Cr:YSGG Laser Application Versus the Conventional Method in Periodontal Flap Surgery: A Split-Mouth Randomized Control Trial

Parviz Torkzaban, Iman Barati, Javad Faradmal, Somayeh Ansari-moghadam, Leila Gholami

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e4

Introduction: The Er,Cr: YSGG laser has a suitable wavelength for the ablation of both hard and soft tissues of the periodontium and can be considered a potential tool in periodontal surgeries. The current study aimed at evaluating the application of this laser versus conventional instruments in periodontal pocket reduction flap surgery.
Methods: Eight patients requiring periodontal surgery were included. Using a split-mouth study design, two posterior sextants of a dental arch were randomly allocated into either a test group, open flap debridement periodontal surgery using the Er,Cr:YSGG laser, or a control group using the conventional method. Laser parameter settings of a 2780 nm wavelength, H mode (60 µs pulse duration), 25-50 Hz, 2-3.5 W output powers, and Air-20%, Water-60-80% were applied and adjusted individually for each step of the flap surgery procedure. Baseline, 1-3 month measurements of plaque index, Gingival Index, gingival recession, probing depth, and clinical attachment level were recorded for comparisons. Data were analyzed by a linear model for correlated data using the generalized estimating equations method and the least significant difference.
Results: In both treatment groups, reductions in PI and GI were observed in the 3-month follow-up period. These indices were significantly lower in the laser-treated sides compared to the conventional group (P<0.05). The Mean PD and CAL were lower at 1 month and 3 months compared to the baseline in both groups (P<0.05). However, these parameters were not statistically different in the treatment groups during these follow-up timelines. An increase in GR was observed from the baseline to 1 month and 3 months with less recession in the laser-treated sides (P=0.016).
Conclusion: Based on the results of the present study, the Er,Cr:YSGG laser-assisted periodontal flap surgery resulted in similar treatment outcomes to the conventional method and may be considered a safe and effective treatment modality


Photobiomodulation and Antimicrobial Photodynamic Influence of a 650 nm Wavelength on Staphylocoagulase and Viability of Staphylococcus aurous

Noor Abduljabar Jadah, Imad Abdulabbass Shamkhi, Jinan Abdulabbass Shamkhi

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e5

Introduction: Staphylococcus aureus is one of the critical pathological bacteria. This bacterium had developed a variety of genetic mutations that made it resistant to drugs and more harmful to humans. In addition, all attempts to design a specific vaccine against S. aureus have failed. Therefore, this experiment was designed as a trial for vaccine production, by using a photodynamic treatment (PDT) through partial biological inhibition. This study also aimed to evaluate the inhibitory effect of PDT on the total bacterial account (viability) simultaneously with SC assay.
Methods: A 650nm wavelength diode laser was used with 100 mW output power and 2 minutes of exposure time. Dye dilutions were 50, 100, 150 and 200 μg/mL. The viability of bacteria after and before laser treatment was calculated using single plate-serial dilution spotting methods. The activity of SC was detected by using human plasma for 4 hours incubation of crude-substrate interaction.
Results: The results revealed a significant decrease in enzyme activity and colony-forming units (CFU) after irradiating bacterial suspension with 150 g/mL MB, as well as a decline in CFU. However, irradiation with a laser alone showed a significant increase in SC activity and CFU for the same exposure time.
Conclusion: Besides reducing the production of SC activity, PDT significantly inhibited the viability of S. aureus. The application of MB photosensitizer at a concentration of 150 g/mL in combination with a laser wavelength of 650 nm resulted in a complete decrease in the SC activity value as well as the viability of bacteria.


Comparison of the Effectiveness of CO2 and Diode Lasers for Gingival Melanin Depigmentation: A Randomized Clinical Trial

Amir Moeintaghavi, Farzaneh Ahrari, Amir Fallahrastegar, Asma Salehnia

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e8

Introduction: Gingival hyperpigmentation is an esthetic concern for some individuals. This study compared the effectiveness of CO2 and diode lasers for gingival depigmentation.
Methods: This randomized, split-mouth, clinical trial consisted of 12 patients with the chief complaint of hyperpigmented gingival areas. The upper right and left anterior segments and the mandibular anterior  segment were randomly allocated to one of the treatment groups. The segments in group 1 underwent gingival depigmentation with a diode laser (810 nm) at 6 W and pulsed mode, whereas group 2 was ablated with a diode laser at 3 W and continuous mode. The removal of gingival pigments in group 3 was contemplated with a CO2
laser (10600 nm, 3 W, continuous mode). The operation chair time, bleeding during the procedure and post-operative pain were recorded. The gingival color and esthetic appearance were measured before the operation and at 1 week and 6 months later.
Results: There was no significant difference in the bleeding scores, pain level, and color alteration values between the groups (P>0.05). The operation chair time was significantly shorter when the diode laser was applied at pulsed mode (P<0.05). The segments treated with the diode laser (pulsed or continuous mode) showed a higher esthetic appearance at the 6-month follow-up compared to those ablated with the CO2
laser (P<0.05).
Conclusions: Higher esthetic appearance is expected when using the diode laser for gingival depigmentation compared to the CO2 laser. The application of the diode laser at pulsed mode could be recommended for gingival depigmentation, as it produced pleasing esthetic outcomes at reduced chair time.


Effects of Radiotherapy in Combination With Irinotecan and 17-AAG on Bcl-2 and Caspase 3 Gene Expression in Colorectal Cancer Cells

Mahnaz Ebrahimpour, Mahshid Mohammadian, Bagher Pourheydar, Zhino Moradi, Zhaleh Behrouzkia

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e9

Introduction: In this study, the cytotoxic and anti-cancer effects of Irinotecan as a conventional chemotherapeutic agent compared to 17-(allyl amino)-17-demethoxygeldanamycin (17-AAG) as possible radiosensitizers in the HCT-116 cell line were investigated.
Methods: HCT-116 cells were treated with various concentrations of irinotecan and 17-AAG and also irradiated with a 2-Gy of X-ray radiation. Then, the cell viability was examined by a watersoluble tetrazolium-1 assay after 24 hours. For single therapies and double and triple combination cases, IC50, 0.5×IC50 and 0.25×IC50 concentrations of each drug were selected respectively for a terminal deoxynucleotidyl transferase (TdT) dUTP nick-end labeling (TUNEL) assay and other tests. In treated and untreated cells, the caspase 3 and Bcl-2 gene expression ratios were evaluated by the real-time PCR method. Likewise, caspase 3 activity was detected with a colorimetric assay.
Results: In all combined treatments, including 17-AAG- radiation, irinotecan - radiation, irinotecan -17-AAG, and irinotecan-17-AAG-radiation, decreased cell viability, and increased TUNEL positive cells were presented versus the control group (P<0.05). There were increased TUNEL positive cells in the triple combination, in concentrations of 0.25×IC50 of each drug, in comparison with single and double agent treatments. Moreover, in the triple combination, the caspase 3 mRNA level and caspase 3 activity increased versus related single treatments. Likewise, in the irinotecan17-AAG-radiation combined treatment and the 17-AAG-radiation double treatment, the Bcl-2 gene expression level decreased in comparison with single therapies.
Conclusion: It can be indicated that the combination of chemo-radiotherapy versus single treatments has significant anti-cancer effects.


Different Protocols of Combined Application of Photobiomodulation In Vitro and In Vivo Plus AdiposeDerived Stem Cells Improve the Healing of Bones in Critical Size Defects in Rat Models

Armin Khosravipour, Atarodalsadat Mostafavinia, Abdollah Amini, Rouhallah Gazor, Fatemeh Zare, Somaye Fallahnezhad, Fatemehalsadat Rezaei, Mehrdad Asgari, Fatemeh Mohammadian, Zhaleh Mohsenifar, Sufan Chien, Mohammad Bayat

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e10

Introduction: Long bone segmental deficiencies are challenging complications to treat. Hereby, the effects of the scaffold derived from the human demineralized bone matrix (hDBMS) plus human adipose stem cells (hADSs) plus photobiomodulation (PBM) (in vitro and or in vivo) on the catabolic step of femoral bone repair in rats with critical size femoral defects (CDFDs) were evaluated with stereology and high stress load (HSL) assessment methods.
Methods: hADSs were exposed to PBM in vitro; then, the mixed influences of hDBMS+hADS+PBM on CSFDs were evaluated. CSFDs were made on both femurs; then hDBMSs were engrafted into both CSFDs of all rats. There were 6 groups (G)s: G1 was the control; in G2 (hADS), hADSs only were engrafted into hDBMS of CSFD; in G3 (PBM) only PBM therapy for CSFD was provided; in G4 (hADS+PBM in vivo), seeded hADSs on hDBMS of CSFDs were radiated with a laser in vivo; in G5 (hADSs+PBM under in vitro condition), hADSs in a culture system were radiated with a laser, then transferred on hDBMS of CSFDs; and in G6 (hADS+PBM in conditions of in vivo and in vitro), laser-exposed hADSs were transplanted on hDBMS of CSFDs, and then CSFDs were exposed to a
laser in vivo.
Results: Groups 4, 5, and 6 meaningfully improved HSLs of CSFD in comparison with groups 3, 1, and 2 (all, P=0.001). HSL of G5 was significantly more than G4 and G6 (both, P=0.000). Gs 6 and 4 significantly increased new bone volumes of CSFD compared to Gs 2 (all, P=0.000) and 1 (P=0.001 & P=0.003 respectively). HSL of G 1 was significantly lower than G5 (P=0.026).
Conclusion: HSLs of CSFD in rats that received treatments of hDBMS plus hADS plus PBM were significantly higher than treatments with hADS and PBM alone and in control groups.

DOI: 10.34172/jlms.2022.10.

Numerical Modeling of The Dysplastic Vessel Heating in PWS by Yellow 578 nm Copper Vapor Laser Radiation for Different Skin Phototypes

IGOR Vladimirovich PONOMAREV, Sergey B. Topchiy, Alexandra E. Pushkareva

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e11

Background: This study aimed to develop the algorithm for choosing both effective and safe mode of dual-wavelengths copper vapor laser (CVL) photodestruction of dilated dermal vessels in PWS for different skin phototypes. This study is expected to assess the safe parameters for CVL treatment.

Methods: We used the multilayered skin model with different melanin content for simulation. The calculation of the vascular component’s selective heating with CVL radiation at the green and yellow wavelengths for different skin phototypes was performed with Matlab mathematical programming system and its application Femlab for solving partial differential equations using the Finite element method.

Results:   We determined the location depth and size of blood vessels that could be selectively heated to the coagulation temperature for different skin phototypes.

Conclusion:   CVL can selectively heat 15-300 mcm vessel diameters that correspond to the PWS vessel diameter range. CVL fluence values need to be reduced almost twice for the IV skin phototype than the II skin phototype. The maximum depth of the vessels’ location also decreased for dark skin phototypes.


Efficacy of Photoinduced Photoacoustic Streaming and Diode Laser Irrigation Techniques on Smear Layer Removal, Sealer Penetration and Push-out Bond Strength

latifa M abdelgawad, Nancy Attia Ahmed ElShafei, Somaia Abdlatif Eissa, Dalia Yahia Ibrahim

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e12

Introduction: The present study aimed to test the efficiency of photoinduced photoacoustic streaming using 2940 nm Er: YAG laser and 980 nm diode laser agitation on smear layer removal, sealer penetration, and push-out bond strength.
Methods: 60 single canaled human permanent teeth were collected. Specimens were grouped into three experimental groups (20 teeth in each group), depending on the activation protocol used for final irrigation: Group I (needle agitation), group II (980nm diode laser agitation), and group III (photon induced photoacoustic streaming (PIPS) using 2940 nm Er: YAG laser. The quantity of irrigant was standardized in all groups to 4 ml. The irrigant was activated for 40 seconds in different groups under continuous flow. Two teeth from each group were used to check the smear layer removal, then the remaining teeth in each group were randomly divided into three equal experimental subgroups according to the methods of evaluation used: subgroup A: Sealing ability evaluated by dye penetration method; subgroup B: SEM for sealer penetration; and subgroup C: Push-out bond strength assessed by the universal test machine.
Results: results showed that the PIPS group had opened dentinal tubules, while the least cleaning effect was found in the Sidevented needle group. As for Sealing ability and dye penetration, a statistically significant difference was found between all of the three groups, with the Er:YAG laser (PIPS) having the best sealing ability and sealer penetration. Push-out bond strength results showed no statistically significant difference between diode and Er:YAG groups, with a significant difference between each of them and the Side-vented needle group.
Conclusion: Using the diode or Er: YAG laser for irrigant activation led to better irrigant penetration and smear layer removal which subsequently led to obvious sealer penetration, better sealing, and strength properties of endodontic treated teeth.


Introduction: The presence of gaps at the bonding interface of resin composite restorations is known to have an impact on restoration longevity. This study aimed to evaluate the effect of erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er, Cr:YSGG) laser irradiation on gap formation at the tooth–resin interface and to compare the reliability of micro-computed tomography (µCT) and scanning electron microscopy (SEM) scans for gap formation assessment.
Methods: Thirty standardized non-retentive class V cavities were prepared on sound human premolars using either an Er,Cr:YSGG laser or a round carbide bur (n=15 for each). A universal adhesive and A nano-filled resin composite were applied in accordance with the manufacturer’s recommendations. After water storage for 24 hours at 37°C, the teeth were subjected to thermocycling. Gap formation assessments were performed by µCT (Skyscan 1173 µCT, Brucker, Belgium) and SEM (JEOL JSM6610LV, Japan), and SPSS version 24.0 (IBM Inc., Chicago, USA) was used to analyze the data at P value<0.05. Descriptive statistics were used to describe the gap formation percentages. To compare the impact of both preparation and assessment methods, a non-parametric Mann–Whitney U test was used.
Results: In enamel, similar gap formation values were detected for the two preparation methods (bur and laser). However, the laser-prepared group showed higher gap formation values in dentin. Additionally, higher gap formation values were reported for both preparation methods when µCT was used for assessment.
Conclusion: Cavity preparation using a Waterlase laser led to higher gap formation percentages at the dentin–resin interface. In addition, SEM assessment is more reliable for assessing the tooth–resin interface.


The Effect of bisphenol A and Photobiomodulation Therapy on Autophagy-Related Genes Induction in Adipose Tissue-Derived Stem Cells

Yasaman Ebrahimi-kia, Ali Noori-Zadeh, Farzad Rajaee, Shahram Darabi, Leila Darabi, Hatef Ghasemi Hamidabadi

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e15

Introduction: As adipose tissue-derived stem cells (ADSCs) can divide rapidly and be prepared noninvasively, they have extensively been used in regenerative medicine. On the other hand, a new method of therapy, known as photobiomodulation (PHT), has been used to treat many diseases, such as inflammatory conditions, wound healing and pain. Besides, exposure to chemical substances such as bisphenol A (BPA), at low levels, can lead to autophagy. This study investigated the effects of BPA and PHT on the expression of autophagy-related genes, including LC3, NRF2, and P62, in rat ADSCs as a model.
Methods: ADSCs isolation and purification were confirmed by immunocytochemistry (ICC). The cells were then treated with different concentrations of BPA and also subjected to PHT. Reverse transcription polymerase chain reaction (RT-PCR) was used for the evaluation of LC3, NRF2 and P62 gene expressions. Oil red O staining was used for adipogenic vacuole formation.
Result: ICC showed that the isolated cells were CD 49-positive but CD 31 and CD 34-negative. The viability test indicated that the number of live cells after 24 hours in the BPA groups at concentrations of 0, 1, 50, 100 and 200 μM was 100%, 93%, 81%, 72%, and 43% respectively. The difference in cell viability between groups 50, 100 and 200 μM was significant as compared with the control groups (P<0.05). Moreover, in the group with 1 μM concentration of BPA, the expressions of LC3, NRF2 and P62 genes were upregulated. However, in the treatment group at the concentration of 200 μM of BPA, the LC3 gene was expressed, but NRF2 and P62 genes were downregulated.
Conclusion: BPA and PHT induce autophagy and adiposeness in ADSCs in a dose-dependent manner.


Evaluation of Efficacy and Safety of Low-Fluence Q-Switched 1064-nm Laser in Infra-orbital Hyperpigmentation Based on Biometric Parameters

Shiva Alavi, Azadeh Goodarzi , Mohammad Ali Nilforoushzadeh, Parvin Mansouri, Mohammad Amin Jafari, Somayeh Hejazi, Zahra Azizian

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e16

Introduction: Dark circles and wrinkles under the eyes are common cosmetic problems, caused by various conditions, especially aging and overproduction of melanin in the epidermis or dermis of the skin. In addition to the application of topical lightening agents, different types of lasers, especially the Q-Switched ND:YAG laser, has been used for the treatment of cutaneous hyperpigmentation. Because of a high prevalence of idiopathic eye dark circles (EDCs) or periorbital melanosis and a poor response to available therapies, we decided to evaluate the efficacy and safety of the Fractional QS 1064 nm ND:YAG Laser through a before-after trial.
Methods: 18-65-year-old patients with skin Fitzpatrick phototype of I-V and without any usage of a topical or systemic therapeutic regimen (2-4 weeks before the trial) were enrolled in the study. Each patient was treated with 6 sessions of the Fractional QS 1064 nm ND:YAG Laser at 2-week intervals and assessed for response and possible side effects or recurrences through 4 outcome measures, including Visoface-based color and erythema, melanin index and lightness (Before the fourth and sixth sessions of the therapy; also 1 week and 3 months after finishing the trial).
Results: The changes in Visoface-based color and erythema, the melanin pigment amount by the Mexameter (melanin index) and the degree of lightness by the Colorimeter of patients after 6 months of intervention were statistically significant (P<0.001).
Conclusion: The fractional QS 1,064 nm ND: YAG Laser is an effective and safe therapy in EDCs since objective outcomes like the reduction of the melanin index and improving lightness and subjective ones like the reduction of darkness and erythema were confirmed.


Microtensile Repair Bond Strength of a Composite After Accelerated Artificial Aging: Effect of the Air Abrasion, Bur, Er:YAG Laser, Two-Step Self-etch Bonding, and Universal Bonding Repair System

Marie Rashidi, Simin Berangi, Nasim Chiniforush, Elham Ahmadi, Ladan Ranjbar Omrani

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e18

Introduction: Repair of old composite restorations is a conservative approach. This study sought to compare the effects of two adhesive systems on the bond strength of repaired composites prepared by three different surface treatments: erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiation, air-abrasion, and bur preparation.
Methods: Eight microhybrid (Polofil Supra, VOCO, Germany) composite resin blocks were fabricated. The blocks were aged and assigned to four groups as stated by the surface treatment: (I) air-abrasion (50 μ aluminum oxide particles), (II) diamond bur (fine grit), (III) Er:YAG laser (3 W output power, 300 mJ energy) and (IV) control. After surface treatment, the blocks were acid-etched and salinized. Each group was divided two subgroups, and the Clearfil SE Bond or All-Bond Universal was applied on their surface. Composite resin was bonded to the aged composites. The blocks were cut into eight samples, and the microtensile bond strength (MTBS) was measured.
Results: The maximum MTBS was noted in the air-abrasion (25.1 + 6 MPa) group, followed by the Er:YAG laser (21.2 + 4.7 MPa). The mean MTBS in laser and air-abrasion groups was significantly higher than that in other groups (P < 0.05). The mean MTBS was not significantly different between the laser and air-abrasion groups (P > 0.05). Composite resin conditioning by All-Bond Universal in laser and air-abrasion groups yielded significantly higher MTBS than the Clearfil SE Bond (P < 0.05).
Conclusion: All surface treatments created acceptable bond strength. The surface treatment of the aged composite by the Er:YAG laser or air-abrasion along with the application of silane and All-Bond Universal provide high bond strength.

Comparing the Surface Behavior of Conventional and CAD-CAM Feldspathic Porcelains in the Face of LaserAssisted Bleaching and Post-bleach Polishing

Solaleh Amirpour-Harehdasht, Somayeh Zeyghami, Foujan Chitsaz, Safoura Ghodsi

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e20

Introduction: The prevalence of using different esthetic methods increases the possibility of close contact between them with potential adverse interactions. This study aimed to compare the surface changes (microhardness and roughness) in two types of feldspathic porcelain after laser bleaching and post-bleach polishing.
Methods: 12 standardized rectangular specimens were prepared for each porcelain group (conventionally layered and CAD-CAM milled). Vickers microhardness and roughness were evaluated before and after the bleaching procedure and after polishing. Data were statistically analyzed using repeated measures ANOVA and t test (P<0.05).
Results: The surface roughness of both groups increased significantly after laser bleaching (P<0.001 for conventional and P=0.004 for CAD-CAM porcelains). The polishing process reduced the roughness of both groups; the reduction was significant in conventional specimens (P=0.020). The surface hardness values did not change significantly in the groups after the bleaching and post-bleach polishing stages (P=0.142). Generally, the average surface roughness of CAD-CAM specimens was significantly lower (P<0.001), and the surface microhardness of the CAD-CAM group was significantly higher than conventional porcelains (P=0.011).
Conclusion: Laser bleaching significantly increased the surface roughness of feldspathic porcelains; however, it did not affect the surface microhardness significantly. Unlike CAD-CAM specimens, polishing significantly improved the surface smoothness of conventional porcelains.


Effect of Simvastatin and Low-Level Laser Therapy on Sutural Bone Formation After Expansion in Rats: Biomechanical, Computed Tomography and Immunohistochemical Assessment

Arash Farzan, Ali Moshiri, Sina Andalib, Mostafa Shamsi, Nima Motamed

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e21

Introduction: The application of low-level laser therapy (LLLT) and some medications have been shown to accelerate bone formation in the rapid palatal expansion (RPE). A combination of these two therapeutic modalities may reduce the time required for the retention period. This study sought to assess the effects of simvastatin and LLLT, alone and combined, on sutural bone formation in rats.
Methods: Sixty male Wistar rats averagely weighing 150 g were divided into five groups (n=12) of control (group 1), 5 mg simvastatin (group 2), 10 mg simvastatin (group 3), LLLT (group 4), and LLLT plus 10 mg simvastatin (group 5). The expansion appliance was placed in the parietal bone in all groups. One week after placing the appliance, the spring was fixed with Duralay acrylic resin to serve as a retainer during the rest of the experiment. The rats were sacrificed after 30 (for biomechanical and computed tomography [CT] assessments) or 60 days (for biomechanical, CT, and immunohistochemical [IHC] assessments).
Results: Groups 3 and 4 showed a significant improvement in osteogenesis (confirmed by CT findings, histological analysis, and biomechanical test) compared to the control group. Group 5 was significantly superior to all other groups in terms of all parameters (P<0.001). Group 2 and the control group were not significantly different (P>0.05).
Conclusion: Although LLLT, simvastatin treatment, and the combination of both significantly improved sutural bone formation in rats compared to the control group, the combined treatment showed significantly superior clinical results compared to other interventions.


Evaluating the Efficacy of the Er,Cr:YSGG Fractional Laser Before Treatment With Triamcinolone NN Ointment in Oral Lichen Planus Lesions

Hamid Reza khalighi, Fahimeh Anbari, Seyed Masoud Mojahedi, Gelareh Forouzani

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e23

Introduction: It has been demonstrated that laser technology can enhance topical drug absorption. This study aimed to determine the effects of Er, Cr: YSGG laser radiation before the application of topical corticosteroids in the healing of oral lichen planus.
Methods: In this double-blind split-mouth clinical trial, 32 lesions were chosen from eight patients affected by oral lichen planus (OLP). The oral lesions were randomly categorized into two groups. The first group had topical treatment with triamcinolone NN ointment and the second group had laser radiation (Er,Cr:YSGG) for eight weeks before starting the ointment. For each lesion, the irritating level based on the VAS score, the lesion level based on the Thongprasom scale score, and the healing time were measured, and the collected data were analyzed by the Friedman test and the Wilcoxon’s statistical test.
Results: The mean healing time based on the verbal analog scale (VAS) score was not significantly different between the two treatment groups (P>0.05). The mean healing time based on Thongprasom scale scores did not show any significant difference between the two treatment groups (P>0.05).
Conclusion: The application of the Er,Cr:YSGG laser before treatment with triamcinolone NN ointment did not show any advantage for the average healing time compared to a medicine regimen with only triamcinolone NN ointment.


Myocardial Ischemia Detection by a Sensitive PumpProbe Atomic Magnetometer

Amin Zamani, Maliheh Ranjbaran , Mohammad Mehdi Tehranchi, Seyedeh Mehri Hamidi, Seyed Mohammad Hosein Khalkhali

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e24

Introduction: Magnetocardiography (MCG) based on optical atomic magnetometers has shown promise for detecting heart diseases accurately. Different methods were introduced to improve the sensitivity of detecting magnetic fields during cardiac activity.
Methods: In this paper, an optical pump-probe magnetometer operated on the ground-state Hanle effect based on the zero-field level crossing technique was developed and the laser output signal was optimized in an unshielded environment. Then, the optical magnetometer was utilized to record the simulated MCG trace of different stages of myocardial ischemia.
Results: The probe output light intensity followed the variation of cardiac magnetic field (MCG trace) generated by the Helmholtz coil accurately.
Conclusion: Based on the results, the feasibility of our highly sensitive optical magnetometer in tracing showed no change in the P-QRS-T waveform associated with ischemic heart disease (IHD), where P indicates atrial depolarization, QRS is responsible for ventricular depolarization, and T represents ventricular repolarization.


Assessment of Immunological Effects of Low-Level Er: YAG Laser Radiation

Mojtaba Ansari, Mostafa Rezaei-Tavirani, Maryam Hamzeloo-Moghadam, Reza Vafaee, Mohhamadreza Razzaghi, Mahfam Nikzamir, Mohammad Rostami Nejad, Mona Zamanizn Azodi

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e25

Introduction: Low-level laser radiation have a significant effect on cell proliferation. Various investigations about effect of Er: YAG laser on the treated cell lines are published. Determining of core targeted proteins is an attractive subject. Aim of this research is identifying the critical targeted protein by low-level Er: YAG laser in Primary Osteoblast-like Cells.

Methods: Data was extracted from literature about proteomic assessment of 3.3 J/cm2 of low-level Er: YAG laser radiation on osteoblast-like cells of rat calvaria. The significant differentially expressed proteins (DEPs) plus 100 first neighbors were analyzed via network analysis and gene ontology enrichment.


Results: Numbers of 9 DEPs among the 12 queried proteins were included in the main connected component. Analysis revealed that Cxcl1 is a key targeted protein in response to laser radiation. Presence of Cxcl1 in the significant cellular pathways indicates that cell growth and proliferation are affected.   

Conclusion: It can be concluded that Immune system is affected by laser to activate cellular defend against stress.

A Correlation Analysis among Pain Intensity, Functional Disability and Range of Motion using Low Level Laser Therapy in patients with Discogenic Lumbar Radiculopathy

Ishaq Ahmed, Mohammad Ali Mohseni Bandpei, Syed Amir Gilani, Ashfaq Ahmad, Faryal Zaidi

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e26

Background: Laser is a pain-free and non-invasive treatment modality. It is used in many acute and chronic painful conditions. In recent times, the use of low intensity laser for physical therapy has been shown to significantly reduce pain with a variety of causes.                                                                                          

Objectives: To determine the correlation among pain intensity, functional disability and range of motion using Low Level Laser therapy in patients with Discogenic Lumbar Radiculopathy.

Methodology: This cross sectional study was conducted as a part of a randomized controlled trial of Low Level Laser therapy in treating patients with Discogenic Lumbar Radiculopathy at Physical therapy departments of three different hospitals from August 2021 to September 2021. The study was conducted according to STROBE guidelines. Fifty Five (55) patients from experimental group of trial were invited to participate in this study. The outcomes of treatment were recorded on a semi-structured questionnaire on the first day and last day of treatment from each patient’s pain intensity, functional disability and Lumbar range of motion by using Visual Analogue Scale, Oswestry Disability Index, Dual Inclinometer respectively. The data was analyzed through SPSS version 21.0.

Results: The results of Correlation Coefficient/ Pearson’s Correlation of VAS, ODI and Dual Inclinometer were varied. The strength of correlation between variables was weak to moderate (r = 0.033 to 0.425) with statistically Insignificant correlation coefficient (P > 0.05, CI 95%) except for Lumbar Flexion (P < 0.05, CI 95%).

Conclusions: Weak to moderate correlations were found among pain intensity, functional disability and Lumbar range of motion using Low Level Laser Therapy at a wavelength of 830-nm and a dose of 3 J/point for acute LBP with Discogenic Lumbar Radiculopathy. In addition, no major side effects were observed during and after the use of LLL.

A trend of Medical Negligence in Laser Therapy in the Capital City: A Nine-Year Survey

Somayeh Jahani sherafat, Zahra Razzaghi, Seyed Amirhossein Mahdavi, Mehdi Forouzesh, Mohammad Ali Emam Hadi, Mohammad Rostami-Nejad, Mostafa Rezaei Tavirani, Mohammadreza Razzaghi

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e29

Background: the purpose of the present study is to investigate the common causes of injuries, claims, and decisions related to laser therapy medical malpractice during a nine-year survey.

Study design: This study is a retrospective descriptive study.

Methods: The legal documents in the coroner’s Office of Forensic Medicine were investigated in a national database from 2012 to 2020 in Tehran, Iran. The frequency and nature of the cases, including the year of litigation, the location and certificate of the provider, the injury sustained, the cause of legal action and judgment were collected.

Results: Three hundred and eighty-three cases related to injury from laser therapy were registered in the coroner’s Office of Forensic Medicine during the study period. The incidence of litigation related to laser surgery showed an increasing trend, with a peak occurrence in 2020.

Laser hair removal was the most common (51.2%) litigated procedure. General practice operators (48%) recorded the highest rate of laser-related medical complaints. lack of skill was the most common reason for failure. Among 383 cases with public decisions, 62.4% of them were fault liability in paid judgment.

Conclusions: Medical claims related to laser application are increasing. However, as it is clear, the growth of laser technology and the increasing demand for lasers in medical science require more surveillance to avoid probable injuries and improve patient safety, especially surveillance of the physicians who work outside the scope of their specialty. 

Therapeutic Effect of a Low-Level Laser on Acute Pain and Post-operative Mouth Opening After Closed Reduction of Mandibular-Condylar Fracture

Arash Bahari Bandari, Saeed Hajmohammadi, Sahar Mafi

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e30

Introduction: The purpose of this study was to determine the therapeutic effect of low-level laser therapy (LLLT) on acute pain and the range of mouth opening after condylar closed reduction surgery. The use of low-level lasers, especially to reduce inflammation and pain, has received more attention in recent years. The results of many studies performed in this field are contradictory, and the effectiveness of low-level lasers in the treatment of patients is still uncertain. Methods: This study was performed as a randomized, double-blinded clinical trial on 40 patients with condylar closed reduction surgery. Patients were randomly assigned to two groups of 20 patients, including the placebo and intervention groups. In the intervention group, the patients received LLLT ( 100 mw, 2 J/cm 2 , 20 S/point, 14 extraoral points, 7 days) . The range of jaw movements after opening the intermaxillary-fixation was measured. Patients’ pain was assessed using the visual analog scale (VAS). Data were analyzed using SPSS software version 21, the chi-square test, and repeated measures ANOVA. Results: There was no significant difference between the study groups in terms of the range of jaw motions. The mean VAS score was 56.85 (SD = 3.817) in the intervention group and 60.95 (SD = 4.861) in the placebo group, showing a statistically significant difference between the two groups at the end of the study ( P= 0.007) Conclusion: The results of this study indicated the effectiveness of low-level lasers in reducing acute pain in patients undergoing closed condylar surgery. Iranian Registry of Clinical Trials (IRCT20200520047519N1)

Shear Bond Strength of Two Repair Systems to Zirconia Ceramic by Different Surface Treatments

Mohammed A Abdulla, Radhwan H Hasan

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e31

Introduction: Intraoral repair has been recommended as an option of treatment to repair the chipping or fracture of the veneered zirconia; the success of the procedure mainly determined by the adhesion between the composite resin and zirconia; The present study aimed to investigate the shear bond strength (SBS) of zirconia ceramic treated by a laser and air abrasion and repaired using different intraoral repair systems.

Methods: Ninety tube- shaped samples (diameter of 10 mm, and 4 mm height) were divided into three main groups: (1) Group I Zirconia 100%, (2) Group II veneer ceramic 100%, and (3) Group III zirconia 50% veneered with veneering ceramic 50%. Each main group was subdivided into three subgroups (n=10) according to the type of repair system and different surface treatments (no surface treatment, Er,Cr:YSGG laser surface treatment, and air abrasion surface treatment). The SBS was employed using a universal testing machine. The mode of failure was observed using a stereomicroscope.

Results: Significant differences in the mean SBS values between the different surface treatments (P˂ 0.05) were observed. Tukey’s post hoc test showed that air abrasion surface treatment of veneer ceramic repaired with Ceramic repair N system showed the highest mean value (13.74 MPa) among the different groups, while no surface treatment of zirconia repaired with Cimara repair system showed the lowest mean value (2.84 MPa). The control group (no surface treatment) had the lowest mean value among all the treated groups.

Conclusion: The SBS is surface treatment dependent, and a higher SBS is obtained by air abrasion than laser surface treatments. The Ceramic repair N system had a significantly higher SBS in all surface- treated substrates than in the Cimara repair system.

Effect of Photobiomodulation Therapy Associated With Biphasic Phosphate Calcium on Bone Repair: A Histomorphometric Study in Rats

Andrea Carvalho De Marco, Letícia Cavassini Torquato, Tatiana Camacho Ribeiro, Camilla Moretto Nunes, Daniella Vicensotto Bernardo, Clarissa Carvalho Martins Maciel, Kauê Alberto Pereira, Maria Aparecida Neves Jardini, Mauro Pedrine Santamaria

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e33

Background: This study aimed to investigate the effects of photobiomodulation therapy associate with biphasic calcium phosphate on calvaria critical defects in rats.

Methods: Forty-eight (90days old) adult male rats (Rattus norvegicus, Albinus variation, Wistar) received critical defects with 5 mm in diameter were made on their skull and were randomly assigned into the groups: C-blood clot, B-biphasic calcium phosphate, L-photobiomodulation therapy and B+L-biphasic calcium phosphate+photobiomodulation therapy. A low-level GaAlAs was applied in a single dose tran-surgically, in a wavelength 660 nm, total dense energy density of 45 J/cm2. At 30 and 60 days, animals from each group were euthanized. Histological and histomorphometric analyzes were performed. 

Results: In 30 days, almost all specimens (C, L, B and B+L) showed bone neoformation areas in regions near the borders of the surgical defect. In 60 days, in many specimens (C, L, B, B+L), it was possible to see a narrow neoformed bone structure along almost the whole extension of the surgical defect, though being thinner than the original calvary bone.  Data were recorded as mean ± standard deviation, after normality was tested, suitable statistical test was applied (α= 5%). At 60 days, there was a statistically significant difference when comparing the proportion of neoformation area between group L (0.52%±0.13) and B+L (0.20%±0.08). Group L showed a difference compared with all the groups when comparing the remaining distance between de edges of neoformed bone (C×L, p=0.0431; B×L, p=0.0386; L×B+L, p=0.0352), demonstrating a great defect closure. 

Conclusions: Our findings suggest that photobiomodulation therapy applied at 45 J/cm² resulted in the highest percentage of bone neoformation area after 60 days, although biphasic calcium phosphate exerts some osteogenic activity during bone repair, photobiomodulation therapy is not able to modulate this process.

Investigation into Chronic Low-Dose Ionizing Radiation Effect on Gene Expression Profile of Human HUVECs Cells

Mojtaba Ansari, Mostafa Rezaei-Tavirani, Maryam Hamzeloo-Moghadam, Mohhamadreza Razzaghi, Babak Arjmand, Mona Zamanian Azodi, Mahmood Khodadoost, Farshad Okhovatian

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e35

Introduction: Understanding the molecular mechanism of chronic low-dose ionizing radiation (LDIR) effects on the human body is the subject of many research studies. Several aspects of cell function such as cell proliferation, apoptosis, inflammation, and tumorigenesis are affected by LDIR. Detection of the main biological process that is targeted by LIDR via network analysis is the main aim of this study. Methods: GSE66720 consisting of gene expression profiles of human umbilical vein endothelial cells (HUVECs) (a suitable cell line to be investigated), including irradiated and control cells, was downloaded from Gene Expression Omnibus (GEO). The significant differentially expressed genes (DEGs) were determined and analyzed via protein-protein interaction (PPI) network analysis to find the central individuals. The main cell function which was related to the central nodes was introduced. Results: Among 64 queried DEGs, 48 genes were recognized by the STRING database. C-X-C motif chemokine ligand 8 (CXCL8), intercellular adhesion molecule 1 (ICAM1), Melanoma growth-stimulatory activity/growth-regulated protein α (CXCL1), vascular cell adhesion molecule 1 (VCAM-1), and nerve growth factor (NGF) were introduced as hub nodes. Conclusion: Findings indicate that inflammation is the main initial target of LDIR at the cellular level which is associated with alteration in the other essential functions of the irradiated cells.

Photoacoustic Imaging for Periodontal Disease Examination

Atika Windra Sari, Rini Widyaningrum, Mi Mitrayana

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e37

Introduction: After caries, periodontal tissue inflammation (periodontitis) is the most common oral health problem. Photoacoustic imaging (PAI) is a new technique that uses simple components such as a diode laser and a condenser microphone. This study aimed to evaluate the performance of a simple PAI system in periodontal disease imaging by using an animal model. Methods: Normal periodontal and periodontitis tissues were obtained from Sprague–Dawley rats categorized as the control group, treatment group 1 (7 days of periodontitis induction), treatment group 2 (11 days of periodontitis induction), and treatment group 3 (14 days of periodontitis induction). The PAI system was controlled by LabVIEW and Arduino IDE software from a personal computer. Results: Results revealed that the optimal frequency of laser modulation for periodontal tissue imaging was 19 kHz with a duty cycle of 50%. The photoacoustic (PA) intensity of periodontal tissues was −68.71 dB for treatment group 3, −70.34 dB for treatment group 2, −71.69 dB for treatment group 1, and −73.07 dB for the control group. PA image analysis showed that the PA intensity from periodontal disease groups was higher than the control group. Conclusion: This study indicates the feasibility of using a simple PAI system to differentiate normal periodontal tissues from periodontitis tissues.

Hypofractionated Radiation Versus Conventional Fractionated Radiation: A Network Analysis

Babak Arjmand, Mostafa Rezaei-Tavirani, Maryam Hamzeloo-Moghadam, Zahra Razzaghi, Mahmood Khodadoost, Farshad Okhovatian, Mona Zamanian-Azodi, Mojtaba Ansari

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e39

Introduction: Conventional fractionation (CF) and hypofractionation (HF) are two radiotherapy methods against cancer, which are applied in medicine. Understanding the efficacy and molecular mechanism of the two methods implies more investigations. In the present study, proteomic findings about the mentioned methods relative to the controls were analyzed via network analysis. Methods: The significant differentially expressed proteins (DEPs) of prostate cancer (PCa) cell line DU145 in response to CF and HF radiation therapy versus controls were extracted from the literature. The protein-protein interaction (PPI) networks were constructed via the STRING database via Cytoscape software. The networks were analyzed by “NetworkAnalyzer” to determine hub DEPs. Results: 126 and 63 significant DEPs were identified for treated DU145 with CF and HF radiation respectively. The PPI networks were constructed by the queried DEPs plus 100 first neighbors. ALB, CD44, THBS1, EPCAM, F2, KRT19, and MCAM were highlighted as common hubs. VTM, OCLN, HSPB1, FLNA, AHSG, and SERPINC1 appeared as the discriminator hub between the studied cells. Conclusion: 70% of the hubs were common between CF and HF conditions, and they induced radio-resistance activity in the survived cells. Six central proteins which discriminate the function of the two groups of irradiated cells were introduced. On the basis of these findings, it seems that DU145-CF cells, relative to the DU145-UF cells, are more radio-resistant.

Conventional and Pattern Scanning Pan-Retinal Photocoagulation Laser in Diabetic Patients’ Visual Field

Narges Hassanpoor, Mohamadhosein Ahoor, Atena Latifi, Mohamadreza Niyousha

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e40

Introduction: In this study, we aimed to compare visual field defects in two different laser methods, namely conventional pan-retinal photocoagulation (PRP) and pattern scanning PRP, in patients with either proliferative diabetic or very severe non-proliferative diabetic retinopathy. Methods: This study was a randomized, single-blind, prospective clinical trial. Twenty patients with either proliferative or very severe non-proliferative diabetic retinopathy were enrolled in this study. Notably, only those patients with the same severity scores in both eyes were included. One eye underwent the conventional PRP laser and another eye underwent the pattern scanning PRP laser simultaneously. Swedish interactive threshold algorithms (SITA) standard perimetry was performed at baseline and one month after the treatment, and visual field defects were evaluated. Results: The pattern standard deviation (PSD) significantly increased in both the pattern and conventional PRP laser groups after one month. The change in PSD at baseline and after the treatment was not significant between the groups. The mean deviation (MD) level significantly decreased in the conventional group after one month. The change in the MD level at baseline and after the treatment was not significant between the pattern and conventional groups. The change in the mean best corrected visual acuity (BCVA) between the groups was not significant. Conclusion: Changes in visual acuity and visual fields of the patients between the pattern and conventional PRP laser methods showed no significant difference; however, the pattern PRP method caused a smaller reduction in overall sensitivity in the patient’s visual field.

Introduction: There is an interest in developing materials with bioactive potential that could block exposed dentinal tubules. This study compared the effects of eggshell and seashell nanoparticles individually or combined with ND:YAG laser on dentinal tubules occlusion and remineralization. Methods: Fifty radicular dentin discs were prepared from freshly extracted human premolars. The smear layer created by cutting was removed using 37% phosphoric acid gel for 15 sec. The discs were divided into five groups according to the applied treatment(A) (n= 10 each): (A1) control, (A2); Nano eggshells, (A3); Nano seashells, (A4); Nano eggshells + Nd: YAG Laser, and (A5); Nano sea shell + Nd: YAG Laser. Each specimen was evaluated for tubular patency and mineral contents before and after each therapy using ESEM-EDXA energy dispersive spectroscopy for the assessment of tubule occlusion and remineralization. Results: ESEM results revealed a statistically significant decrease in the mean percent changes of the dentinal tubules number after the treatment of the experimental groups compared to the control. The greatest percent decrease was recorded in the seashell NPs + Nd: YAG laser, followed by the eggshell NPs + Nd: YAG laser, then Eggshell NPs only and then Seashell NPs only, while the lowest percentage decrease was recorded in the control group. EDXA revealed that the greatest percentage increase in Ca wt% was recorded in the Eggshell + Nd:YAG laser group, followed by Eggshell only, then Seashell only and then Seashell NPs + Nd: YAG laser, while the lowest percent increase was recorded in the control group. The post hoc test revealed no significant difference between the experimental groups. Conclusions: Both eggshell and seashell nanoparticles are effective in the occlusion and remineralization of dentinal tubules. The combined treatments with Nd: YAG laser had no benefits when compared to the effect of treatments alone.

Facial Rejuvenation in Indonesian Skin With a Picosecond 755-nm Laser

Putri Hendria Wardhani, Cita Rosita Sigit Prakoeswa, Muhammad Yulianto Listiawan

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e45

Background: Skin aging is a natural process that occurs as people age, affected by various factors, ultraviolet irradiation is a major factor, leading to appear wrinkles, pigmentations, and textural irregularities. Laser had gained popularity for facial rejuvenation in the Asian population, but melanin rick skin type like Asian are more susceptible to pigmentary alterations. Majority of Indonesians have brown skin color and the rest have lighter skin color. The aim of this study is to know the efficacy and safety of the picosecond 755 nm laser on facial rejuvenation in Indonesian skin.

Methods: This is a retrospective analysis of 20 healthy subjects with Fitzpatrick skin type III-V presenting with facial photoaging from 36 to 55 years old. Assessments were conducted at the baseline and 4 weeks after the second session of the treatment. Standardized photographs were taken from the front and side of both cheeks using VISIA. Clinical improvement was categorized as mild - excellent. Patients were also asked and examined about the presence of adverse events.

Results: Patients were predominantly female with a mean age of 44 years old. Sixty percent of patients had a good improvement and 40% of patients had a moderate improvement. The VISIA analysis showed significant improvement in wrinkles, pigments, and textures (p < 0.001). Only mild anticipated adverse events were observed, and there was no post-inflammatory hyperpigmentation or hypopigmentation.

Conclusion: Picosecond 755 nm laser is effective and safe for facial rejuvenation in Indonesian skin without significant adverse events.

Effect of Laser-Assisted Hair Removal (LAHR) on the Quality of Life and Depression in Hirsute Females: A Single-Arm Clinical Trial

Mahboubeh Sadat Hosseini, Amir Houshang Ehsani, Yousef Fakour, Zeinab Aryanian, Mojtaba Elhamfar, Pedram Noormohammadpour

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e46


Hirsutism, mainly due to poly cystic ovary syndrome (PCOS), causes stress, anxiety and depression in females. LAHR is currently accepted as a good treatment option for hirsutism. The goal of the current study was to ascertain how LAHR affected the degree of hirsutism, quality of life, and depression in hirsute females.


A single arm before/after clinical trial was designed and performed in the Razi Hospital Laser Clinic over a 15-months period. All hirsute females visiting Razi hospital laser clinic, were enrolled and received three sessions of LAHR every 4-6 weeks if they were interested and signed an informed consent. Before the commencement of LAHR and six to eight weeks after the last session, the Ferriman-Gallwey score (hirsutism severity), Beck score (depression index) and DLQI score (quality of life index) were calculated and stored.


There were 80 subjects in all. The mean± (SD) of the Ferriman-Gallwey score was reduced from 7.05 ± 2.27 to 4.91 ± 2.41, p<0.001. Beck depression score’s mean± (SD) was reduced from 13.3 ± 8.7 to 10.2 ± 8.4, p<0.001 and mean± (SD) of DLQI score was decreased from 5.6 ± 5.2 to 3.5 ± 2.3, p<0.001. No significant complication were reported.


LAHR can improve hirsutism related depression and degradation of quality of life as well as hirsutism physical signs.

Introducing Protein Homeostasis and Glycogen Synthesis as Two Targets of Blue Light Radiation in Lentinula edodes

Reza Vafaee, Maryam Hamzeloo-Moghadam, Zahra Razzaghi, Mahfam Nikzamir, Mohammad Rostami Nejad, Vahid Mansouri

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e47

Introduction: There are documents about biological effects of blue light radiation on different organisms. Molecular mechanism understanding of radiation effects on biological samples is an important event which attracted attention of researchers. Determining of the critical dysregulated proteins of Lentinula edodes following blue light radiation is the aim of this study.

Methods: Number of 22 differentially expressed proteins of Lentinula edodes in response to 300 lux of blue light were extracted from literature. Experimental, text mining, and co-expression connections between the queried proteins were assessed via STRING database. The maps were compared and the critical proteins were identified.

Results: Among the 21 queried proteins, six individuals including; heat shock HSP70 protein, 20S proteasome subunit, 26S proteasome subunit P45, Aspartate aminotransferase, Phosphopyruvate hydratase, and Phosphoglucomutase were highlighted as the critical proteins in response to blue light radiation.  

Conclusion: Finding indicates that protein homeostasis and glycogen synthesis are affected by blue light radiation.



Bone neoformation induced by low level laser and methylene blue suggest early ossification in rats

Fabiano Luiz Dulce de Oliveira, Akinori Cardozo Nagato, Fernando Monteiro Aarestrup, Beatriz Julião Vieira Aarestrup

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e48

Introduction: Bone healing depends on inflammation control and tissue repair time. Low-level laser therapy (LLLT) has been investigated to accelerate this process. Methylene blue (MB), together with LLLT, has been investigated for its antioxidant and anti-inflammatory potential; however, the effects of photosensitizers (photodynamic therapy, PDT) are controversial. This study aimed to verify whether the combination of MB and LLLT changes the course of the consolidation of experimental bone defects. Methods: Sixteen Wistar rats underwent femoral bone defects. In the control group (n= 4), LLLT simulations were performed without MB. The MB group (n= 4) received MB and simulation of LLLT. The LLLT group (n= 4) was exposed to LLLT. The PDT + LLLT group (n= 4) received MB and LLLT. At the end of 7 or 14 days, the animals were euthanized, and samples were collected. Results: PDT and LLLT induced osteogenic formation with cellularity (after seven days) and union of bony edges (14 days). On the seventh day, LLLT combined with PDT induced an increase (P< 0.05) of 484% in the area of bone neoformation compared to the control. On the fourteenth day, LLLT combined with PDT or alone increased (P < 0.05) the area of bone neoformation by 214% and 240% respectively, compared to the control group. The PDT/LLLT combination was associated with increased radiopacity (P< 0.038). Conclusion: The combined use of MB with LLLT initiated during the transoperative phase may stimulate the bone repair process in rats

Evaluation of Antibacterial Effects of Cold Atmospheric Plasma, Calcium Hydroxide, and Triple Antibiotic Paste on Enterococcus faecalis Biofilm in the Root Canal System: An In Vitro Study

Mohammad Asnaashari, Pegah Mehrabinia, Zahra Yadegari, Hanieh Hoseini, Mehdi Sadafi, Shiva Shojaeian

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e50

Introduction: One of the essential factors in successful endodontic therapy is effective cleaning and disinfection of the root canal. This study aims to determine the effect of the cold plasma on the infected root canals with Enterococcus faecalis and compare its antibacterial effect with the conventional medicaments in vitro.

Methods: 63 single-root teeth were extracted. Canals were cleaned and shaped. Ten teeth were selected as a negative control randomly. The rest of the teeth were incubated at 37°C for 21 days to form Enterococcus faecalis biofilm. The specimens were divided into five groups; 2 positive control groups of medicaments and plasma, 1 group treated with calcium hydroxide; 1 group treated with 10 mg/ml of TAP; 1 group treated helium/oxygen plasma. After treatment, F4 Pro-Taper rotary file was used to collect root canal microbial biofilms. Bacterial suspensions are serially diluted, and the percentage of growth reduction for each group was obtained by dividing the logarithm of CFU /mL of each group by CFU /mL of the control of the same group.

Results: The CFU/mL of TAP and plasma-treated samples was significantly lower than the control groups; however, there were no significant differences between the control group and samples treated by calcium hydroxide. The most percentage of CFU reduction was in the TAP-treated group compared with plasma and calcium hydroxide-treated groups.

Conclusion: The application of cold plasma effectively inhibits the growth of Enterococcus faecalis and reduces bacterial biofilm. Also, in the present study, 10 mg/ml of TAP caused the complete elimination of Enterococcus faecalis. Calcium hydroxide had the most negligible effect on Enterococcus faecalis biofilm elimination.

The The Effect of 2.45 GHz Electromagnetic Fields on Fear Memory Extinction in Male Rats

Zobeideh Dehghani, Seyed Mohammad Mahdavi, Amir Modarresi Chahardehi, Vahid Mansouri, Somayeh Jahani Sherafat

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e52

Emotional and environmental factors influence the extinction of fear memories. To evaluate the possible risks, we investigated the effect of 2.45 GHz microwave radiation on rats' fear learning and memory capacity. The present study aimed to assess the impacts of corticosterone levels on the consolidation and reconsolidation of fear-conditioning memories. The rats were evaluated in contextual fear conditioning using foot shocks in both the short-term (7 days) and the long-term (30 days). Exposure was carried out on young male Wistar rats for 5–6 weeks continuously (1 h/day) with radio frequency electromagnetic field radiation possessing a frequency, power density, and pulse width of 2.45 GHz, 6.0 mW/cm2, and 2 ms, respectively. Several animals housed without exposure to radiation under identical conditions are controlled. Based on the results obtained in this research, a decrease in body weight and percentage of freezing time was observed after the long-term exposure groups significantly. As corticosterone levels were analyzed, they did not alter their responses after the conditioning fear memory test.

Pulsed Laser Acupuncture in the Treatment of Pain and Heart Rate Variability in Fibromyalgia Patients: A Pilot Randomized Clinical Trial

Érika Almeida Boggiss, Rhaynara Coelho Rosário, Rosana Aparecida De lima, Paula Aparecida Silva, Rosa Maria Moreira, Karol Priscila Da Silva, Caroline Lima De farias, Vanessa de Queiroz Dos Santos, Rodrigo Polaquini Simões, Adriana Teresa Silva Santos, Andreia Maria Silva Vilela Terra

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e53

Background: Laser acupuncture is a medically approved treatment for chronic pain, especially fibromyalgia. It is widely known that all pain is related to autonomic modulation, which may influence heart rate variability (HRV). There are robust studies in the literature on the effect of laser acupuncture with continuous frequency on musculoskeletal pain and autonomic modulation. However, little is known about the effect of pulsed frequency or individualized protocols. Therefore, the aim of this study was to evaluate the effect of pulsed laser acupuncture, applied in an individualized protocol, on pain intensity and HRV in patients with fibromyalgia. Methods: The study is characterized as a pilot randomized clinical controlled trial. The sample consisted of women with fibromyalgia between the ages of 40 and 80 years, who were randomized into two groups: a control group (CG; n = 10) and an experimental group (EG; n = 10). EG received the intervention twice a week for three weeks. Statistical analysis was calculated by delta (difference between post-intervention and pre-intervention) and the Shapiro–Wilk test (normality). For comparison between the groups, the Mann–Whitney test was used. Results: The results show a significant reduction in pain intensity as reported via the Pain Numerical Scale (PNS; p = 0.00), Generalized Pain Index (GPI; p = 0.00), and Symptom Severity Scale (SSS; p = 0.00). Conclusion: Pulsed laser acupuncture, when applied in an individualized protocol, can reduce pain intensity as reported on the PNS, GPI, and SSS. However, no therapeutic effect was observed for HRV.

In Vitro Efficacy of Antimicrobial Photodynamic Therapy With Phycocyanin and Diode Laser for the Reduction of Porphyromonas gingivalis

Ardavan Etemadi, Arian Azizi, Maryam Pourhajibagher, Nasim Chiniforush

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e55

Objectives: This study sought to assess the efficacy of antimicrobial photodynamic therapy (aPDT) with phycocyanin and diode laser for reduction of Porphyromonas gingivalis (P. gingivalis).

Materials and Methods: In this in vitro, experimental study, first the minimum inhibitory concentration (MIC) of phycocyanin, the sub-lethal exposure time of diode laser, and the sub-lethal dose of aPDT were determined. The wells containing P. gingivalis suspension were randomly divided into three experimental groups for exposure to ½ MIC phycocyanin for 5 min, minimum lethal dose of diode laser (635 nm, 4 min), and aPDT with phycocyanin and diode laser. The positive control group was exposed to 0.2% chlorhexidine (CHX) for 5 min, and the negative control group received no treatment. The colony count was calculated in the five groups and compared using one-way ANOVA and t-test.

Results: aPDT with diode laser (635 nm, 4 min) and 125 µg/mL phycocyanin caused significantly greater reduction of P. gingivalis count (mean reduction of 44.24%) compared with other groups (P<0.0001). Minimum and maximum colony counts were noted in 0.2% CHX and negative control groups, respectively. The reduction in colony count was significant in all experimental groups, compared with the control group (P<0.0001).

Conclusion: aPDT with 635 nm diode laser and phycocyanin can significantly decrease P. gingivalis count in vitro. Considering the conservative nature of this modality, it may be used for decontamination of peri-implant

Effects of 2.45 GHz Non-Ionizing Radiation on Anxiety-Like Behavior, Gene Expression, and Corticosterone Level in Male Rats

Mahvash Tarsaei, Zeinab Sadat Peyrovan, Seyed Mohammad Mahdavi, Amir Modarresi Chahardehi, Reza Vafaie , Mohammad Hosain Haidari

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e56

The effects of short-term and long-term exposures to 2.45 GHz radiofrequency electromagnetic radiation (RF-EMR) on anxiety-like behavior, corticosterone level, and gene expression were investigated. The animals have been classified into eight groups, sham groups and, exposed groups for short-term and long-term exposure to the same dose of RF-EMR for one hour daily. The Wi-Fi equipment in the sham control group was not turned on during the experiment. The goal of this study was to explore the effect of electromagnetic fields of 2.45 GHz on clinical signs such as bodyweight and anxiety-like behavior, including the elevated plus maze test and open-field test, and also on messenger RNA (mRNA) expression of Bax (Bcl2-associated x) and Bcl-2 (B-cell lymphoma 2) genes on the cognitive memory functions in an animal model of rats. Both genes were further confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR). The semi-quantitative PCR method of electromagnetic fields in the 2.45 GHz range impacted the expression of Bax and Bcl-2 genes in the rat's memory. The present study exhibited that short-term radiation could decrease the percentage of entry into the open arm and the percentage of time spent, while there were no substantial impacts on the long-term radiation effect. Our data support the hypothesis that short-term exposure worked as a systemic stressor, raising plasma corticosterone and changing glucocorticoid receptor expression in the hippocampus. Additional research on this specific frequency and amount of radiation is required to discover strategies for protecting the nervous system from the detrimental effects of RF-EMR radiation.

Er:YAG Laser Debonding of Lithium Disilicate Laminate Veneers: Effect of Laser Power Settings and Veneer Thickness on The Debonding Time and Pulpal Temperature

Hatem M. El-Damanhoury, Basheer Salman, Waad Kheder, Dalenda Benzina

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e57

Aim: This study aimed to investigate the influence of different laser power output on the pulpal temperature and the time required to achieve debonding of lithium disilicate laminate veneers with two different thicknesses.

Methods: labial enamel of forty-eight maxillary central incisors was flattened and polished. The teeth restored with flat lithium disilicate ceramic veneers (4.0 mm X 6.0 mm), with one of two different thicknesses (0.5 and 1.0 mm). Veneer debonding was done using Er:YAG laser (Fidelis AT, Fotona) with 2940 nm wavelength and a 100 μm pulse duration (VSP mode) and 10 Hz and one of three laser power output settings: 1.5W (150 mj), 3W (300 mj), and 5.4W (360 mj) (n=8).

The veneer debonding time and intra-pulpal temperature changes (∆T) were measured. Statistical analysis was done using Two-way ANOVA and Bonferroni post-hoc test (a = 0.05). Correlation between the debonding time and temperature changes was computed using a Pearson’s correlation.

Results: Debonding 1.0 mm veneers with 1W power recorded the longest time (p<0.05), while debonding 0.5 veneers with 3W and 5.4 W recorded the shortest times (p<0.05). There was a significant decrease in ∆T with the increase of laser power. A low correlation was found between the debonding time and ∆T (R² = 0.113)

Conclusions: The laser power and veneer thickness are crucial factors in debonding, with the thinner veneers being faster to remove. When debonding thick veneers, a laser power output 5.4W is more efficient and less harmful to the pulp tissues.

Combination of Dental Capping Agents With LowLevel Laser Therapy Increases the Cell Viability Percent of Stem Cells From Apical Papilla (SCAPs)

Jaber Zafari, Hamed Karkehabadi, Forough Nikzad, Sogand Esmailnasab, Zahra Abbasi Javan, Fatemeh Javani Jouni

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e58

Introduction: Stem cells from apical papillae (SCAPs) are adult stem cells capable of differentiating into multiple cell lineages. Dental pulp capping materials promote the differentiation of stem cells of the apical papilla (SCAPs). Higher proliferation and cell viability of stem cells have been reported upon exposure to low-level laser therapy (LLLT). However, there is limited evidence on the combinational effects of dental pulp capping materials and low-level laser radiation. In this study, the effects of dental dressing materials combined with laser on the SCAPs viability will assess.

Methods: SCAPs isolation was performed from two immature third molar teeth through collagenase type I enzymatic activity. Isolated stem cells were then cultured with DMEM and α-MEM media enriched with 15% and 10% FBS, respectively. After reaching 70-80% confluency, cells were seeded in a 96-well plate. Cell viability percent was assessed using MTT assay after treatment by MTA, EMD, CEM, and LLLT alone and in combination for 24, 48, and 168 h.

Results: A combination of MTA, CEM, EMD, and LLLT could result in significantly increased SCAPs viability as compared with other treatment groups. Increased levels of SCAPs proliferation and viability were observed in groups treated with the combination of MTA and CEM with EMD. SCAPs viability percent in all defined times was reduced with MTA and CEM treatment.

Conclusion: LLLT is a stimulator of SCAPs cell viability percent and differentiation rate when applied with dental capping agents such as MTA, EMD, and CEM, which is a therapeutic option for stem cell-based therapy.

In Vitro Effect of a High-Intensity Laser on Candida albicans Colony Count

Ehsan Momeni, Mojtaba Didehdar, Elham Sarlak, Malihe Safari

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e59


Introduction: This study assessed the effect of high-intensity laser on Candida albicans (C.albicans) colony count.

Methods: In vitro, an experimental study was conducted on standard-strain C. Albicans (ATCC18804). Seventy-two samples with two different concentrations of C. Albicans (104 cells/mL and 106 cells/mL) were randomly assigned to three groups of control, laser, and nystatin. Each group included 12 samples from each concentration. In the nystatin group, 10 cc of nystatin suspension was added to the samples and mixed for 30 60 seconds. In the laser group, the Ga-Al-Ar diode laser with 940 nm wavelength and 2 W power was irradiated to the samples with 0.4 mm tip diameter in non-contact mode (1 mm distance) at a speed of 1 mm/second. The suspensions in the three groups were cultured on Sabouraud dextrose agar culture medium and incubated at 37°C for 24 hours. The number of C. Albicans colonies was then counted and reported. The three groups were compared by ANOVA and Tukey’s test (alpha=0.05).

Results: In both concentrations, the mean colony count in the nystatin group was significantly lower than that in the control (P<0.05) and laser (P<0.05) groups. The mean colony count in the laser group was significantly lower than that in the control group (P<0.05).

Conclusion: High-intensity laser with 940 nm wavelength and 2 W power in non-contact mode can significantly decrease the C. Albicans colony count in vitro, but its effect is lower than that of nystatin.

The Effect of Low-Level Laser Therapy on the Viability of Human Dental Pulp Stem Cells

Mohamad Asnaashari, Shiva Shojaeian, Ali Mesgharani, Pegah Mehrabinia

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e60

Objectives: This study assessed the effect of low-level laser (LLL) irradiation on the viability of dental pulp stem cells (DPSCs).

Materials and Methods: In this in vitro experimental study, human DPSCs were purchased from the cell bank of Iranian Genetic Resources and cultured in flasks containing Dulbecco's modified Eagle's medium supplemented with 20% fetal bovine serum (FBS) at 37°C, 5% CO2, and 95% humidity. The cells were stored in semi-confluent form, and the culture medium was refreshed every two days. The cells in the control group were not laser-irradiated. The cells in the experimental groups were irradiated with 660 and 808 nm diode lasers with 4.1 J/cm2 energy density. Cell viability was assessed at baseline and after 24, 48, and 72 hours using the methyl thiazolyl tetrazolium (MTT) assay. The effects of laser irradiation, laser wavelength, and time on the percentage of cell viability were analyzed by two-way ANOVA and Tukey's test.

Results: The effects of laser irradiation and its wavelength (P=0.04), time of assessment (P<0.001), and the interaction effect of group and time (P=0.02) on cell viability were significant. Cell viability in 660 and 808 nm laser groups at 48 and 72 hours was higher than that of the control group; however, statistically, only the difference in cell viability between the 660 nm laser and control group at 72 hours was significant (P=0.03).

Conclusion: Considering the optimal effect of diode laser irradiation (particularly 660 nm) on the viability of DPSCs, it may be suitable for relevant clinical applications.

The Effect of Beam Direction on Absorption and Transmission of Ultraviolet to Infrared Wavelength Regions in Three Different Dentin Thicknesses

Elmira Eslami, Ezatolah Kazeminejad, Azizeh Karimian, Hasan Khandan Fadafan

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e61

Background: Lasers and optics have been used extensively in dental procedures in recent years, making the realization of the optical properties of the tooth a milestone in its successful applications. The aim of this study was to compare the absorption and transmission of applied wavelengths in the range of 190–1100 nm at different dentin thicknesses and the effect of changing the direction of radiation emission in the dentin tubules.

Methods: Fifteen dentin specimens of thicknesses of 300, 600, and 1000 μm and five specimens of each thickness were prepared through a transverse section of the coronal dentin over the pulpal roof area of ​​human molars. Considering the coronal-apical and apical-coronal directions, we measured the absorption and transmission of parallel light rays perpendicular to the dentin samples in different thicknesses and two directions with a UV/Vis spectrometer.

Results: The absorption rate of the ultraviolet wavelength was significantly higher than that of visible and infrared light irradiation from both directions at three thicknesses (p<0.001). Radiation shift direction had no significant differences in the absorption and transmission wavelengths of ultraviolet, visible, and infrared light in any of the three thicknesses (p >0.05).

Conclusion: Accordingly, a change in beam direction does not cause a significant difference in light absorption.

Laser-Induced Smoke in Dermatologic Practice: A Survey to Explore Hazard Perceptions, Safety Measures and Unmet Needs

Frederike Fransen , Marjolein Hiel, Firas Al-Niaimi, Ashraf Badawi, Merete Haedersdal, Hans-Joachim Laubach, Johan Snauwaert, Albert Wolkerstorfer

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e63

Introduction: Inhalation of laser-induced smoke is a potential health hazard to exposed physicians and laser operators. To date, little is known about the perception of health hazards related to laser-induced smoke exposure among physicians and the actual use of safety measures to mitigate these risks.
Methods: In May 2020, 514 members of the European Society for Lasers and Energy-Based Devices (ESLD) were invited by email to participate in an online survey. The survey comprised 16 questions including multiple-choice and open-ended questions.
Results: Responses were received from 109 participants. The majority (90%) were aware of potential hazards and highlighted a desire for better protective measures (60%). A smoke evacuation system was frequently used with ablative lasers (66%) and fractional ablative lasers (61%), but less the case with non-ablative lasers (30%) and hair removal lasers (28%). The COVID-19 outbreak had no clear effect on the use of smoke evacuation systems. Prior to the COVID-19 outbreak, mainly surgical masks were used (40-57%), while high filtration masks (FFP1, FFP2 or FFP3) were used by only a small percentage (15-30%). The post-COVID-19 outbreak, the use of high filtration masks increased significantly (54-66%), predominately due to an increase in the use of FFP2 masks. Reasons mentioned for inadequate protective measures were sparse knowledge, limited availability, discomfort, excessive noise, high room temperatures, and financial costs.
Conclusion: While there is considerable awareness of the hazards of laser-induced smoke among physicians and laser operators, a substantial number of them do not use appropriate protective measures. The implementation of regulations on safety measures is hampered by sparse knowledge, limited availability, discomfort, excessive noise, financial issues, and high room temperatures

The Effect of Time-Dependence of 10 Hz Electromagnetic Field on Spatial Learning and Memory in Rats

Farzaneh Zarrin, Seyed Mohammad Mahdavi, Amir Modarresi Chahardehi, Zahra Razzaghi, Nayebali Ahmadi

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e64

Introduction: In everyday life, electrical devices are the primary sources of extremely low-frequency electromagnetic fields (ELF-EMF), and the human body may be a great conductor of these fields. We chose alpha band power, especially at 10 Hz frequency, due to its prior beneficial role in memory. The purpose was to clarify whether there is a relationship between ELF-EMF exposure and cognitive deficits in rats, clinical signs, behavioral analysis, and the impact of ELF-EMF during different times of exposure on neuroplasticity via the expression of BDNF.
Methods: Forty adult male rats were selected randomly. The rats were exposed to ELF-EMF (10 Hz, 4 mT) for 7 days and 30 days, one hour daily. The expression of BDNF proteins in the hippocampus was evaluated after sacrificing animals to assess learning and memory function. The body weight of rats in the long-term exposed group differed significantly (P<0.05). The level of BDNF mRNA in the hippocampus was found by the RT-PCR method.
Results: Our findings indicate that exposure to ELF-EMF affects spatial learning and memory and can improve memory, especially with long-term exposure. In addition, we discovered a significant difference in the long-term exposed group (P<0.05), where radiation for 30 days resulted in a substantial rise in BDNF levels.
Conclusion: After prolonged exposure, male rats spent more time and traveled a greater percentage of their distance in the target quadrant, demonstrating that long-term exposure improves spatial memory and that 10 Hz might be safe.

Electromyographic Evaluation of Superior Orbicularis Oris Muscle Activity in Patients With Complete Cleft Lip and Cleft Palate Before and After Vestibuloplasty Using Carbon Dioxide Laser Therapy

Soghra Yassaei, Hosseinagha Aghili, Elahe Salarpour, Ali Dehghan dehnavi

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e67

Introduction: Cleft lip and cleft palate are the most typical congenital craniofacial anomalies. Postsurgical scars in cleft lip patients can cause shallow upper labial sulcus and reduced upper lip length. The aim of the present study was to evaluate the impact of CO2 laser vestibuloplasty on the electromyographical (EMG) activity of patients’ superior orbicularis oris muscle, depth of labial sulcus, and upper lip length, and their satisfaction with the procedure and its results. The CO2 laser is an effective vestibuloplasty procedure, is safe and highly acceptable for patients, and has little effect on muscle contraction.
Methods: A total of 15 cleft lip and cleft palate patients participated in this study. Vestibuloplasty was performed using carbon dioxide laser therapy in one session in such a way that EMG activity in the upper lip muscle, depth of labial sulcus, and upper lip length were measured two times: before (T0) and twenty days after surgery (T1). Patients’ satisfaction surveys were also recorded using a patient questionnaire at T1.
Results: The mean values for vestibular depth at T0 and T1 were 2.00±1.71 and 4.52±1.43, respectively. The mean values for upper lip length at T0 and T1 were 6.90±2.32 and 8.00±2.40, respectively, suggesting a significant change in vestibular depth and upper lip length. The vestibular depth and upper lip length significantly increased at T1. The EMG recording of the upper lip muscle experienced a moderate decrease after laser treatment, both at rest and at maximum lip protrusion. Moreover, patient’s satisfaction with the surgical procedure was 82% positive.
Conclusion: Using the CO2 laser increased the vestibular depth and upper lip length successfully and made small changes in the EMG activity of the superior orbicularis oris.

Network Analysis of Effect of Light-Dark Time Ratio on the Gene Expression Profile of Mouse Skin

Mostafa Rezaei-Tavirani, Babak Arjmand, Maryam Hamzeloo Moghadam, Zahra Razzaghi, Mohammad Rostami-Nejad, Mona Zamanian Azodi, Mahmood Khodadoost, Majid Rezaei-Tavirani, Alireza Ahmadzadeh

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e68

Introduction: Circadian rhythms refer to daily cyclic events such as activity and rest in biology. A protein-based core related to the mechanism of circadian is identified. In the present study, the gene expression profiles of mouse skin in different conditions of light-dark times were investigated via protein-protein interaction (PPI) analysis to explore the main affected genes.
Methods: GSE174155 was derived from Gene Expression Omnibus (GEO) and was analyzed via GEO2R to find the significant differentially expressed genes (DEGs). The gene expression profiles of Cry-null (genotype: cryptochrome-1(-/-): crytochrome-2 (-/-)) mouse skin versus the wild-type samples in the various circadian times (CTs) were assessed. The queried DEGs plus 50 first neighbors were included in a PPI network via the STRING database by Cytoscape software. The networks were analyzed and the central nodes were evaluated.
Results: Three groups of mice based on CTs were identified. 15, 15, and 14 central nodes were determined as central nodes for the analysis networks. There was not a common central node for the analyzed networks.
Conclusion: It was pointed out that the light/dark time ratio had a gross effect on the gene expression profile of the skin in the mice. Results imply more investigations to suggest a standard protocol related to CT, considering human lifestyle and exploring suitable protective methods for the jobs which are fixed in the abnormal CT sets.

Identification of Targeted Central Genes (IGF1 and HMOX1) by Indirect Cold Physical Plasma in Human Melanocytes

Reza Vafaee, Babak Arjmand, Maryam Hamzeloo Moghadam, Zahra Razzaghi, Mostafa Rezaei-Tavirani, Sina Rezaei-Tavirani

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e70

Introduction: Cold physical plasma is a growing tool in medicine that is applied for the treatment of different cancers. In the present study, the gene profiles of human melanocytes exposed to indirect cold physical plasma versus control individuals are analyzed via protein-protein interaction (PPI) network analysis.
Methods: The gene expression profiles were derived from Gene Expression Omnibus (GEO), and the significant differentially expressed genes (DEGs) were decoded via “Expression Atlas”. PPI network analysis was applied to find the targeted central genes by indirect cold physical plasma.
Results: The main connected component of the constructed network including 74 queried DEGs and 50 added first neighbors was analyzed. Considering degree value, betweenness centrality, closeness centrality, and stress, IGF1 and HMOX1 were introduced as the central nodes.
Conclusion: The finding of this study indicates that the down-regulation of IGF1 and the upregulation of HMOX are the prominent events in response to indirect cold physical plasma treatment
at the cellular level. Detection of related biological terms via gene ontology is suggested.

The Effects of a 2-W Laser on the Nasolabial Fold of Ageing Individuals Investigated by High-Frequency Ultrasonography: A Nonrandomized Controlled Trial

Parinaz Omidi, Roya Ravanbod, Ghazi Sarhan, Manijhe Mokhtari Dizaji

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e71

Introduction: Biomechanical qualities of the skin tissue change following numerous pathological and natural (ageing) conditions. The best skin treatments are those resulting in a positive outcome with the fewest adverse effects. In this study, high-frequency ultrasonography (US), which provides a quantifiable scale, was utilized to evaluate the impact of a 2-W laser on characteristics of nasolabial fold (NLF) including depth and area, epidermis and dermis thicknesses, and Young’s modulus (YM).
Methods: Nine female subjects (54.09±0.09 years old) with Fitzpatrick skin types III-IV and five young control participants (26±1.28 years old) for providing the control data were included in this study. Laser therapy was applied twice weekly for seven consecutive sessions. A class IV laser with 810-nm and 980-nm wavelengths, 2-W power, and 25-Hz frequency was applied twice a week for seven consecutive sessions. The energy administered had a density of 8 /cm2. An evaluation using high-frequency ultrasound (40 MHz) was accomplished before and 48 hours after the final treatment session. The Face-Q questionnaire was used to assess the patient’s perspective on this procedure.
Results: For each US parameter, the intraclass correlation coefficient was high (ICC>0.9). After the laser treatment, NLF depth, area, epidermis, dermis, YM, and Face-Q significantly improved compared to baseline (P<0.05).
Conclusion: For the assessment of skin tissue, high-frequency US is a reliable technique. The 2-W laser is a safe, effective, and non-invasive procedure for enhancing skin features.

Effective Combination Therapy with Human Amniotic Membrane Mesenchymal Stem Cells and Low-Level Laser Therapy in Wound Healing in Animal Models

Fatemeh Abbasnezhad, Sona Zare, Mohammadreza Razzaghi, Reza Karjou, Zahra Karjou, Shahrzad Zadehmodarres

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e72

Introduction: Many studies have recognized the importance of new methods in wound healing. This study aims to investigate the healing effects of allograft extra embryonic mesenchymal stem cells (MSCs) with and without low-level diode laser irradiation when grafted into full-thickness skin defects in diabetic animal models.
Methods: In this experimental study, in order to make the rats diabetic, we used an intra-peritoneal injection of streptozotocin. Human amniotic membrane derived mesenchymal stem cells (hAMSCs) were irradiated with a low-level diode laser. Two full-thickness excisions were made on the backs of the rats. Next, the rats were divided into the following groups: group 1: low-level laser (LLL) irradiated hAMSCs, and group 2: hAMSCs alone transplanted into skin wounds. Histopathologic, ultrasound, and elasticity evaluations were performed 7, 14 and 21 days after grafting.
Results: In the evaluated rats, the epithelial formation was on day 7 and increased until day 14. On days 7, 14 and 21, the percentage of epithelial formation in the irradiated cell group was significantly higher than that in the cell group, so that, on day 21, the epithelium in this group completely covered the wound surface while in the control group, the wound surface was still not completely covered. In terms of angiogenesis, on day 7, the irradiated cells were significantly lower than the cells. Also, the formation of collagen in the cellular hydrogel group could confirm the effectiveness of amniotic MSCs in collagen production and thus accelerate the wound healing process. In comparison with hAMSCs alone, irradiated hAMSCs increased the thickness and elasticity of the skin.
Conclusion: Low-power lasers along with MSCs can be effective in improving chronic wound conditions in the animal model.

Efficacy of Low-Level Laser Therapy for the Treatment of Nonspecific Chronic Neck Pain: LowLevel Laser Therapy vs. Sham Laser

Sirous Momenzadeh, Alireza Zali, Zahra Razzaghi, Fatemeh Momenzadeh, Alireza Mirkheshti, Shahram Sayadi, Houman Teymourian, Raziyeh Momenzadeh

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e74

Introduction: The most common type of neck pain is chronic nonspecific pain. There are conflicting opinions about the beneficial effects of a low-level laser in reducing chronic nonspecific neck pain. The aim of this study was to evaluate the efficacy of low-level laser therapy (LLLT) for the treatment of non-specific chronic neck pain.
Methods: This study was conducted as a prospective randomized clinical trial. Forty-four patients were randomly divided into two groups: (1) Intervention group (n=22): LLLT in the red spectra range with a wavelength of 980 (nm) and a power of 16 (J/cm2) was irradiated in the affected areas of the neck, the muscles along the spine, and the upper trapezius; (2) sham group (n=22): A low-level laser was irradiated with a passive probe (non-laser red light) in the affected areas of the neck, the muscles along the spine, and the upper trapezius. The treatment protocol consisted of 12 sessions (15 minutes, three times a week, for four weeks). These patients were evaluated for pain using the visual analog scale (VAS) (0-10). The patients were followed up for four weeks.
Results: This study showed a statistically significant reduction in chronic nonspecific neck pain in the LLLT group (P<0.05).
Conclusion: It is concluded that LLLT was effective in reducing chronic nonspecific neck pain. LLLT is a non-invasive, safe, and effective method that can improve chronic nonspecific neck pain in patients in the short term

Introducing BDNF and SNAI1 as the Crucial Targeted Genes by UV Radiation

Mostafa Rezaei-Tavirani, Vahid Mansouri, Babak Arjmand, Maryam Hamzeloo Moghadam, Zahra Razzaghi, Mahmood Khodadoost, Majid Rezaei-Tavirani, Alireza Ahmadzadeh

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e76

Introduction: Due to the widespread penetration of UV radiation in human life, the biological effect of UV radiation is studied through many investigations in the field of medicine. There are many assessments about UV radiation that are concerned with protein-protein interaction (PPI) network analysis. In the present study, a network analysis associated with the complementary evaluation of UV radiation on human primary melanocytes is presented.
Methods: The gene expression profiles of the irradiated human primary melanocytes and the control cells were extracted from Gene Expression Omnibus (GEO) and were evaluated via PPI network analysis and action map assessment.
Results: 69 significant differentially expressed genes (DEGs) were included in the main component of the PPI network. Brain-derived neurotrophic factor (BDNF), SNAI1, and SOCS1 were highlighted as the top dysregulated and hub genes. Results indicate that BDNF and SNAI1 participate in the regulatory unit including the total hubs and top dysregulated genes.
Conclusion: Considerable down-regulation of BDNF and up-regulation of SNAI1 as the two critical targeted genes by UV radiation are accompanied by gross alteration in cell functions.

Influence of Fiber Laser (1064 nm) on Shear Bond Strength of Titanium Abutment and Resin Cement

Ruba Husam Abdulrazzaq, basima Mohammed Ali hussein

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e77

Introduction: The present study was performed to evaluate the influence of a 1064 nm fiber laser on shear bond strength (SBS) at the interface of titanium and resin cement.
Methods: Forty titanium discs of 6 mm × 3 mm (diameter and thickness respectively) were categorized into four groups (n=10): control group without any surface treatment and three groups treated with a fiber laser with 81 ns pulse duration, 30 kHz frequency, 10000 mm/s scanning speed, 0.05 mm spot size, and different average power values (3, 5 and 7 W) depending on the tested group. Titanium disc characterization was performed by the scanning electron microscope (SEM) and surface roughness tester. Phase analysis was achieved using an X-ray diffractometer (XRD). Following these tests, resin cement application to titanium discs was performed. SBS values were determined by the universal testing machine. After debonding, the surface of titanium discs
was examined by the stereomicroscope for the determination of failure modes. Data analysis was performed using analysis of variance (ANOVA) and Tukey HSD tests (α=0.05).
Results: A higher surface roughness value was observed in the 7 W group followed by the 5 W and 3 W groups, and the lowest surface roughness was in the control group. Additionally, the lowest SBS value was obtained from the control group and the highest SBS value was obtained from the 7 W group followed by the 5 W and 3 W groups.
Conclusion: SBS between titanium abutment and resin cement can be significantly enhanced by using a fiber laser as a surface treatment considering tested laser parameters; additionally, a positive association between surface roughness and SBS was noted in the experimental groups.

Review Article

Parameters Used With Diode Lasers (808-980 nm) in Dentin Hypersensitivity Management: A Systematic Review

Haitham Abdelkarim-Elafifi, Isabel Parada Avendaño, Josep Arnabat Domínguez

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e3

Introduction: The present study aimed to describe parameters used with 808- to 980-nm wavelength diode lasers for managing dentin hypersensitivity and analyze their results.
Methods: The inclusion criteria were based on randomized controlled clinical trials using diode lasers at an 808-980 nm wavelength range in patients with dentine hypersensitivity with a minimum of 1-month follow-up. An electronic search for articles on Medline, PubMed, and Cochrane databases was performed. The risk of bias was assessed with the Cochrane collaboration tool.
Results: Our electronic search resulted in 130 papers, of which 11 articles met the inclusion criteria. A majority of the studies assessed dentine hypersensitivity using the Visual Analogue Scale, which ranged between 2.3 and 8.8 before treatment and significantly reduced to a mean value of 0.45-3.7 after diode laser application. The power settings ranged between 1.5 mW and 3 W with an emission mode of continuous wave, except for 2 authors who used chopped mode. The energy density varied from 2.5 to 128 J/cm2, and the exposure time was between 10 and 120 seconds. The authors applied a minimum of 1 to 4 treatment sessions with a 2-day to 1-week interval between them. Most of the studies mentioned the tooth surface as the treatment site but without describing the specific irradiation points.
Conclusion: Despite the heterogeneity of the analyzed variables, a statistically significant improvement in all laser groups as described. However, they cannot be compared homogenously.


Does photobiomodulation therapy improve the postoperative outcomes of tonsillectomy? A systematic review and meta-analysis

José Alcides Almeida de Arruda, Gerhilde Callou Sampaio, Ana Carolina Velasco Pondé de Sena, Lauren Frenzel Schuch, Jaziel Pereira Ribeiro, Manoela Domingues Martins, Tarcília Aparecida Silva, Ricardo Alves Mesquita, Lucas Guimarães Abreu

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e7

Introduction: Postoperative management of patients undergoing tonsillectomy is challenging. Photobiomodulation therapy (PBMT) has emerged as a new tool providing therapeutic benefits. However, the contribution of PBMT to the postoperative outcomes of tonsillectomy is still undefined. This systematic review and meta-analysis evaluated the published literature addressing the effects of PBMT on post-tonsillectomy.
Methods: Searches in Scopus, PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and grey literature were carried out for the identification of randomized controlled trials reported up to August/2021. The risk of bias with the Cochrane Collaboration tool and meta-analysis was performed. Outcomes were assessed with the Kaplan-Meier method and the log-rank test.
Results: A total of 1183 articles were retrieved, of which only two were included for qualitative and quantitative analysis. The wavelengths were 685 nm and 980 nm with energy density set at 4 J/cm². The mandibular angle and the surgical wound were the sites of laser irradiation. Individuals who had not undergone PBMT after tonsillectomy were more likely to report pain and odynophagia in the first 24 hours after surgery than individuals who had undergone PBMT after tonsillectomy (P<0.001). Children who received PBMT after tonsillectomy were equally affected by pain and odynophagia in the first seven days after surgery compared to children who had not undergone PBMT after tonsillectomy (P>0.05). However, both studies found a significant association of PBMT with reduced analgesic consumption.
Conclusion: Although PBMT seems promising for the management of individuals undergoing tonsillectomy, a limited number of studies are available in the literature.


Effect of Low-Level Laser Therapy on Bone Formation in Rapid Palatal Expansion: A Systematic Review

Arash Farzan, Katayoon Khaleghi, Zeynab Pirayesh

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e13

Introduction: Crossbite is a common malocclusion with a 7-23% prevalence rate. Treatment is based on the expansion of the mid-palatal suture (MPS) with Rapid Palatal Expansion(RPE) followed by a retention period to reach new bone maturation, enough to maintain the results stable. This systematic review was conducted to evaluate the effectiveness of low-level laser therapy (LLLT) in increasing bone formation in MPS.
Methods: This article was written by the PRISMA checklist. Electronically, 3 databases, namely PubMed, Scopus, and Embase, were searched with the keywords selected based on PICO. Time (2010-2021) and language restrictions were performed.
Results: 528 articles, out of which 374 studies were screened, were found, and 9 full-text articles were subsequently included considering these inclusion criteria: randomized clinical trial (RCT) that examines the efficacy of LLLT in rapid palatal expansion (RPE), age under 15 years, non-surgical RPE with a tooth-supported appliance, and low-intensity laser application. Finally, 4 articles were appraised by Cochrane version 5.2.0 with 7 domains. 3 of 4 articles showed LLLT has a significant impact on bone formation. One of them showed no significant difference in pain perception and bone density between the laser and non-laser groups.
Conclusion: While many studies have assessed the effect of LLLT on bone formation in animal models, high-quality clinical trials are missing in this regard. The available clinical trials suggest a positive effect of LLLT on sutural bone formation after RPE.


The effect of photobiomodulation therapy on the stability of orthodontic mini-implants in human and animal studies: A systematic review and meta-analysis

Parnian Razaghi, Janet Moradi Haghgoo, Salman Khazaei, Nasrin Farhadian, Reza Fekrazad, Leila Gholami

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e27

Purpose: The present study aimed is to systematically explore available literature on the possible impact of PBM therapy on stability and success of orthodontic mini-implants.

Methods:.A comprehensive electronic search was conducted in PubMed, ISI Web of Science, Scopus, Cochrane and Embase databases for human and animal studies published till July 2021.Two independent researchers reviewed the studies based on specific eligibility criteria.

Results: After a comprehensive search removing unrelated items, 15 studies were included in the systematic review. In the meta-analysis, 10 studies were included. 4 human RCT studies that evaluate the stability with Preriotest, 3 human RCT studies and 2 animal studies that evaluate the stability with implant stability quotient (ISQ) and 2 human RCT studies that examined the displacement of mini-implants. The analysis results of Periotest stability results showed a positive effect of PBM on mini-implant stability 30 and 60 days after implantation (P<0.05). In human studies using the ISQ method, an improvement was seen in PBMT group, however, this was not statistically significant. (CI=-1.92-2.70, SMD=0.39). In the studies that examined the displacement of mini-implants, no statistically significant difference was observed (CI= -1.92-2.70, SMD= 0.03). In the animal studies, which had used the ISQ method, the use of laser was effective in increasing the stability of micro-implants (SMD= 1.43, CI=1.00 - 1.85). Although positive effects were observed with PBM, however, further studies are still needed for establishing evidence-based dosing and irradiation protocols.

Conclusion: Photobiomodulation therapy can be suggested as an adjunctive clinical method to improve stability of mini-implant treatment.

Keywords: mini-implant, stability, photobiomodulation

Photobiomodulation Therapy and Cell Therapy Improved Parkinson’s Diseases by Neuro-regeneration and Tremor Inhibition

Behnaz Ahrabi, Fatemeh Sadat Tababtabee Mirkabad , Somayeh Niknazar , Ali Asghar Payvandi , Mahnaz Ahrabi , Shaysteh Dordshaikh Torkamani, Hojjat Allah Abbaszadeh

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e28

Introduction: Parkinson's disease is a progressive and severe neurodegenerative disorder of the central nervous system. The most prominent features of this disease are cell reduction in Substantia nigra and accumulation of α-Synuclein, especially in the brainstem, spinal cord, and cortical areas. In addition to drug-based treatment, other therapies such as surgery, cell therapy, laser therapy can be mentioned. In this study, articles on cell therapy and laser therapy for Parkinson's disease have been collected to evaluate the improvement of motor function, cell differentiation, and dopaminergic cell proliferation. Method: Articles were collected from four electronic databases PubMed, Scopus, Google Scholar Web of Science from 2010 to 2022 and electronically to study the effects of stem cell therapy and laser therapy on Parkinson's disease through the keywords "photobiomodulation", "low-level light therapy", "Low-level laser therapy", "near-infrared light", "Parkinson's disease", "Parkinsonism" and "stem cell therapy" were searched. About 80 related articles were included in the study. Result: The results of studies show that cell therapy and laser therapy are each useful in the treatment of Parkinson's disease and despite their limitations can be useful in improving Parkinson's disease. Conclusion: Concomitant use of cell therapy and Photobiomodulation therapy can improve the symptoms of Parkinson's.

Therapeutic Effects of Photobiomodulation Therapy on Multiple Sclerosis by Regulating the Inflammatory Process and Controlling Immune Cell Activity: A Novel Promising Treatment Target

Saeed Vafaei-Nezhad, Somayeh Niknazar, Ali Asghar Payvandi, Atefeh Shirazi Tehrani, Navid Ahmady Roozbahany, Behnaz Ahrabi, Hojjat-allah Abbaszadeh, Shahram Darabi

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e32

Introduction: Multiple sclerosis (MS) is one of the autoimmune and chronic diseases of the central ‎nervous system, this disease occurs more frequently in young people and women ‎and leads to neurological symptoms. Oxidative stress, inflammatory process, and ‎oligodendrocyte dysfunction has a pivotal role in the pathophysiology of this ‎disease. Nowadays, it has been reported that Photobiomodulation (PBM) as a non-invasive threat has neuroprotective potential but the exact mechanisms are not understood.   Methods: In this manuscript, we have reviewed the Photobiomodulation effects on MS. in this regard, we used "Photobiomodulation", " Laser therapy", and "Low-level laser therapy" keywords on MS to find related studies on this subject in PubMed, Google scholar, Elsevier, Medline, and Scopus databases.  Results: Photobiomodulation has positive effects on MS by regulating the inflammatory ‎process, controlling immune cell activity, and mitochondrial functions, as well as inhibiting free ‎radicals’ production. ‎

Conclusion: Overall, researchers have suggested that laser therapy could be considered a promising new treatment for neurodegenerative diseases, such as multiple sclerosis.

Low-Level Laser Therapy in the Treatment of Autoimmune Thyroiditis

Nikoo Hossein-Khannazer, Mandana Kazem Arki, Aliasghar Keramatinia, Mostafa Rezaei-Tavirani

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e34

Autoimmune thyroiditis is an autoimmune disorder which characterized by thyroid gland dysfunction. Low Level Laser Therapy(LLLT) is a safe and non-invasive intervention that gained much attention in many clinical applications including pain relief, regenerative medicine, and autoimmune. In the present review, we discuss the effects of LLLT on the treatment of autoimmune thyroiditis.

Therapeutic Effects of Combination Therapy and Photobiomodulation Therapy on Retinal Regeneration

Behnaz Ahrabi, Samareh Omidvari, Shamim Mollazadeh Ghomi, Navid Ahmady Roozbahany, Saeed Vafaei-Nezhad, Atefeh Shirazi Tehrani, Hojjat-allah Abbaszadeh, Shahram Darabi

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e36

Introduction: Macular edema (ME) is produced by central extravascular inflammation of the macula subsequent to a major loss of visual action. Macular edema can happen at any phase of diabetic retinopathy, whether non-proliferative or proliferative retinopathy.

Method and material: Articles were collected from four electronic databases PubMed, Google Scholar Web of Science from 2000 to 2022 and electronically to study the effects of macular laser grid photocoagulation on Diabetic macular edema or Cystoid macular edema through the keywords " macular laser photocoagulation ", " macular edema ", " Cystoid macular edema ", " Intravitreal pharmacotherapies ", " Antivascular endothelial growth factor “, were searched about 219 articles found in google scholar and 165 articles in PubMed, that   58 articles were included in the study.

Result: In this study, the effects of various laser photocoagulation such as Focal and/or grid macular laser, subthreshold micropulse laser (SMPL), and Intravitreal pharmacotherapies (Corticosteroids such as triamcinolone acetonide, fluocinolone, Bevacizumab, and dexamethasone) on macular edema were investigated. A few studies had shown that the effects of corticosteroids are more effective than lasers, and a number of studies have found the effects of lasers and the combined effects of lasers with corticosteroids to be more effective. Also, some studies have also shown that the frequency and duration of follow-up and concentrations of intravitreal pharmacotherapies are effective in increasing visual outcomes.

Conclusion: The results of studies showed that although corticosteroids have side effects, the combined effects of corticosteroids with subthreshold micropulse laser are effective in increasing visual acuity (VA) and central macular thickness (CMT).

Photobiomodulation Therapy in the Prevention and Treatment of Radiodermatitis in Breast Cancer Patients: Systematic Review

Suzy Ramos Rocha, Suzana Aparecida da Costa Ferreira, Aline Ramalho, Vera Lúcia Conceição Gouveia Santos, Paula Cristina Nogueira

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e42

Background: Radiodermatitis (RD) is the most common associated effects of radiotherapy, which prevention and treatment has been shown promising results with Photobiomodulation Therapy (PBMT). This study aims to synthesize the evidence about the use of PBMT in management of RD among breast cancer patients undergoing radiotherapy.

Methods: Systematic review with no time restrictions, based on the methodology proposed by the Joanna Briggs Institute (JBI), including the databases PubMed, Cochrane, Web of Science, Scopus and CINAHL. The studies were selected based on inclusion criteria: female participants over 18 years old, with breast cancer and undergoing radiotherapy, using a tridimensional technique or intensity-modulated radiotherapy technique (IMRT). Two reviewers assessed the methodological quality using JBI Critical Appraisal Checklist, and the report was described based on PRISMA.

Results:  Red and infrared wavelengths were used. Device power ranged from 1.1 W to 0.08 W for continuous modes and 25 W for pulsed mode, resulting in a 3 and 4 J/cm2 fluence, applied throughout radiotherapy, leading to a reduced severity in cutaneous reactions.

Conclusions: PBMT can reduce radiodermatitis severity. New clinical trials are required for defining protocols, given the scarcity of studies for the adopted site and methodological diversity.

In Vitro Anti-tumor Effects of Photodynamic Therapy on Oral Squamous Cell Carcinoma: A Review

Sogol Saberi, Neda Hakimiha, Mojgan Alaeddini, Shahroo Etemad-Moghadam, Payam Roudbari, Sima shahabi

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e49

Background: Due to the increasing prevalence and high mortality rate of oral cancer and problems of routine treatments, more recent modalities like photodynamic therapy (PDT) have been developed. PDT can effectively destroy tumor cells with minimum side effects. Research on the in vitro effects of PDT may be helpful in determining the molecular mechanisms responsible for its effectiveness, and can lead to development of more efficient techniques. The aim of this study was to review the use of PDT on oral cancer among in-vitro studies.

Materials and methods: A literature search for English articles on photodynamic therapy in oral squamous cell carcinoma (SCC) was performed using PubMed, Scopus, Google Scholar, and Web of Science databases. The search string included both MeSH terms and relevant text words. Data extraction was performed based on the inclusion/exclusion criteria.

Results: Forty-one studies were selected after reviewing 567 articles. According to the extracted data, the tongue, 5-aminolevulinic acid, viability/cytotoxicity and apoptosis, laser, 600-700nm, were the most common cell-line-source, photosensitizer, assessed outcome, light source, and wavelength respectively used in the studies. Reduced viability and increase apoptosis were the most reported outcomes.

Conclusion: PDT showed generally promising effects on reducing the viability of different oral cancer cells. Different cell lines, from various sources or even those originating from the same location, sometimes responded differently to the same protocol. Due to the favorable results obtained from using natural photosensitizers and considering their additional health-promoting properties, their use in future investigations with different cell lines and light specifications is recommended.

Low-Level Laser Therapy for Rheumatoid Arthritis: A Review of Experimental Approaches

Nikoo Hossein-khannazer, Mandana Kazem Arki, Aliasghar Keramatinia, Mostafa Rezaei Tavirani

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e62

Introduction: Rheumatoid arthritis (RA) is an inflammatory and autoimmune disorder that is characterized by joint inflammation, pain, physical disability, and morning stiffness. In the present study, the effect of low-level laser therapy (LLLT) on RA was reviewed.
Methods: “Low-level laser therapy”, “rheumatoid arthritis disease”, and “photobiomodulation” keywords were searched in Google Scholar, PubMed, and Medline.
Results: A literature survey led to a discussion about the immunology of the RA, laser therapy, mechanism of LLLT action, and anti-inflammatory and immunomodulatory properties of LLLT.
Conclusion: It was concluded that LLLT could improve RA patients’ quality of life, reduce pain, and enhance physical movement.

The Effect of High-Power Lasers on Root Canal Disinfection: A Systematic Review

Mohammad Asnaashari, Ali Sadeghian, Parham Hazrati

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e66

Introduction: In root canal therapy, the cleaning and shaping of canals are routinely applied by clinicians in order to remove microorganisms. Eradicating bacteria from the root canal system plays a crucial role in long-term success; however, it is not always easy to disinfect root canals properly because of their complicated anatomy and bacterial load. Achieving an optimally disinfected root canal environment requires adjunctive antibacterial therapeutic methods. High-power laser utilization as an adjunctive strategy to conventional treatment is a relatively new approach that helps clinicians.
Methods: This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Online databases, namely Web of Science, PubMed/MEDLINE, Scopus, and Cochrane Library, were searched electronically regarding lasers and endodontic treatments. Appropriate studies were included according to the inclusion/exclusion criteria.
Results: Among 504 obtained studies by search, 48 were considered for a detailed analysis. Ten articles performed in vivo evaluation, nine assessed the effect of lasers on artificial models, and 29 conducted ex vivo experiments on extracted teeth. When the diode laser, the most frequently used laser, was utilized as an adjunct therapy after NaOCl irrigation, it killed more bacteria than conventional irrigation with NaOCl. Laser-activated irrigation (LAI) with the Er, Cr: YSGG laser, and NaOCl disinfects the root canal effectively. Also, photon-induced photoacoustic streaming (PIPS) with Er: YAG and NaOCl exhibited a high bactericidal effect and deep tubular penetration.
Conclusion: High-power laser utilization, considering proper case selection and method, can assist in root canal treatment of infected teeth.

Impact of Blue Light Therapy on Wound Healing in Preclinical and Clinical Subjects: A Systematic Review

Mohammad Bayat, Richard Albright, Michael R Hamblin, Sufan Chien

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e69

Introduction: While a wound caused by a minor cutaneous incision routinely heals in a short time, wounds from major surgical operations might need numerous days to heal and may leave an obvious cicatrix. The use of blue light therapy (BLT) to destroy infectious microorganisms and disrupt biofilm formation could be an efficient method for healing ulcers. This systematic review focused on the effects of BLT in different preclinical in vivo studies and clinical models of skin wound healing. Furthermore, this study attempted to determine what main light parameters should be tested in preclinical and clinical studies.
Methods: The online databases PubMed.gov, Google Scholar, Scopus, Web of Science, and Cochrane were searched using the keywords “blue light” and “wound healing” according to PRISMA guidelines. No publication time limit was enforced.
Results: A total of 858 articles were identified, and 17 articles in three distinct categories were included for review. They comprised two articles on humans, fourteen articles on healthy animals, and one article on diabetic animals.
Conclusion: Some studies have shown that the application of BLT on preclinical and clinical models of wound healing in vivo is able to significantly accelerate the healing process. Few studies, however, have explored the bactericidal effect of BLT on skin injury repair in burn patients. Further preclinical investigations designed to provide a better understanding of the bactericidal effect of BLT using standardized protocols, different BLT wavelengths, and different stages of the wound-healing process of infected wounds and ulcers in healthy and diabetic animals should be carried out before clinical trials can be considered. BLT could eventually be a good option for treating infected chronic wounds, including those in diabetic patients.

Preclinical and Clinical Applications of Photobiomodulation Therapy in Sperm Motility: A Narrative Review

Mahnaz poorhassan, Morteza Gholaminejhad, Houssein Ahmadi, Leila Mehboudi, Mahdis Chahar Kameh, Maryam pirani, Gholamreza Hasanzadeh

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e75

About 50% of infertility problems are related to male factors and reduced sperm motility. The important factor that affects the structure and function of sperm is reactive oxygen species (ROS), and over-concentration of ROS reduces the quality and motility of sperm. Photobiomodulation therapy (PBMT) using red to near-infrared (NIR) light is useful in oxidative stress restoration. It plays a therapeutic role in disorders such as asthenospermia, oligospermia cases, and cryopreserved sperm. It also enhances the metabolic capacity of sperm and increases the low-level and nonharmful intracellular content of Ca2+, nitric oxide (NO), and ROS in the stressed cells. Likewise, it modulates survival intracellular pathways and maintains the motility, viability, DNA, and acrosome
integrity of sperm. This article reviews the state-of-the-art preclinical and clinical evidence regarding the efficacy of semen PBMT.

Case Report

Comparison of Bichectomy Techniques Through a Clinical Case and 6-Month Follow-up

Yasmin Rabelo Batalha de Sena, Paulo Maria Santos Rabêlo-Júnior, Leticia Machado Gonçalves, Andrea Dias Neves Lago

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e2

Introduction: Bichectomy consists of the partial removal of the Bichat ball (BB) of its buccal extension and smoothing the facial contour. The objective of this study is to present, by means of a clinical case, bichectomy surgery with the use of a high-power diode laser and cold scalpel on different sides of the same patient, analyzing the trans-surgical phase and the pain and edema like consequence operative of each technique and 6-month follow-up.
Case Presentation: A 20-year-old female patient reported the occurrence of involuntary trauma to the cheek mucosa and rounded facial appearance. After anamnesis and clinical examination, bichectomy was proposed. For comparison, on the right side, an incision was made using a laser, while on the left side, with a cold scalpel. To assess and measure the progression of treatment, photographs and facial measurements were repeated before the procedure, 7, 14, and 28 days after the procedure, and 2, 3, and 6 months after the procedure.
Conclusion: The high-power diode laser showed excellent applicability for bichectomy due to its hemostatic properties in the trans-surgical phase. In addition, it promoted greater patient comfort, with less edema and pain on the side of the face where it was used.


Diode Laser Excision of Focal Epithelial Hyperplasia (Heck’s Disease): A Case Report

Javad Sarabadani, Nasim Chiniforush, Yasaman Yazdandoust

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e6

Introduction: Focal epithelial hyperplasia (FEH), also known as Heck’s disease, is a human papilloma virus-induced proliferation of epithelial cells, which causes asymptomatic lesions in the oral mucosa. Heck’s disease is more prevalent among children or in a family. Despite the self-limitation of lesions, they may progress or cause esthetical and functional discomforts. Hence, early diagnosis is necessary.
Case Presentation: A middle-aged man with peripheral multiple soft, elevated, sessile, smooth, lobulated surface and nodular lesions in his right buccal mucosa was referred. The dimensions of the lesions varied from 5 to 25 mm. Through clinical and histopathological examinations, Heck’s disease was diagnosed. The diode laser (wavelengths of 980 nm), 1-W power using continuous waves) was applied serially (in 2 sessions with a 1-week interval) for surgically removing the lesions. The patient was followed up for 6 months with no lesion recurrence, and gradual healing was observed.
Conclusion: The laser is an effective treatment with no scar remaining after the procedure and brings satisfaction to patients.


Photobiomodulation and Antimicrobial Photodynamic Therapy for Oral Ulcers in a Patient With Thrombocytopenia Following Bone Marrow Transplantation

Luana Campos, Daniel Campanhã, Ricardo Yudi Tateno, Luiz Felipe Palma

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e17

Introduction: Thrombocytopenia is usually seen after allogeneic hematopoietic stem cell transplantation (HSCT) and may favor the development of oral bleeding, infections, and ulcerations.
Case Report: A patient with chronic myelomonocytic leukemia had been submitted to allogeneic HSCT. Within a few days, she developed severe thrombocytopenia and an extensive ulcerative area comprising both lips, which bled spontaneously, as well as smaller ulcers on the tongue mucosa. The lesions were managed using a combination of phototherapies (photobiomodulation and antimicrobial photodynamic therapies), totalizing 4 laser sessions. After 4 days, there was an important reduction in the severity of the lesions, with spontaneous disappearance of the crusts and reepithelization.
Conclusion: The proposed combination of phototherapies would be a suitable therapeutic modality for the management of oral lesions related to platelet disorders induced by oncologic treatments.


The Combined Effects of a Methacrylate Powder Dressing (Altrazeal Powder) and Photobiomodulation Therapy on the Healing of a Severe Diabetic Foot Ulcer in a Diabetic Patient: A Case Report

Roya Derakhshan, Houssein Ahmadi, Mohammad Bayat, Leila Mehboudi, Erfan Pourhashemi, Abdollah Amini, Dorsa Vatandoust, Shahin Aghamiri, Robabeh Asadi, Babak Sabet

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e38

Weakened wound healing is a popular, severe complication of patients with diabetes which poses a risk for foot infection and amputation. Researchers have searched for new treatments for treating diabetic foot ulcers (DFUs) in recent years. In this case report, for the first time, we applied photobiomodulation therapy (PBMT) and Altrazeal powder together to treat a severe case of DFU in a 47-year-old woman who was suffering from type 1 diabetes. Along with the progress of combination therapy, we observed that the ulcer area was significantly reduced, and the wound healed within 16 weeks. Furthermore, dermatitis and purulent secretion were treated, and the pain was reduced. This reported case study indicated the beneficial effect of the combination of PBMT and Altrazeal powder for the healing of a severe DFU in a patient with type one diabetes. The combined application of PBMT plus Altrazeal powder demonstrated an additive effect. Further clinical trials in the clinical setting are suggested to validate the results further. Besides, more studies in preclinical models are suggested to find the mechanism of the action of combination therapy.

Systemic Photodynamic Therapy With Chlorine e6 as a Photosensitizer for the Treatment of Nodular BCC: A Case Report

Seyed Mehdi Tabaie, Parvin Mansuri, Mina Sadat Naderi, Katayoun Kebriti, Gholamreza Esmaeeli Djavid, Afshan Shirkavand

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e44

Introduction:  Photodynamic therapy (PDT) is an established therapeutic method for basal cell carcinoma (BCC). BCC is the most common human cancer and also convenient cancer to treat using PDT. This is our experienced case report about Systemic Photodynamic Therapy with Chlorine e6 as a Photosensitizer for BCC Treatment.

Case Report: A 78-year-old man was diagnosed with a 4-year history of nodular BCC on the nose area. The patient had under control and treatment for hypertension and type 2 diabetes. Chlorine e6 was injected intravenously at a dose of 0.08 mg/kg in 500cc normal saline within 20 minutes. After 3 hours of injection, Laser irradiation was performed with the wavelength of 665 nm, a dose of 150 j/cm2, the irradiance of 150 mW/cm2. His nodular BCC has been completely cured after 1 session of PDT with chlorin e6 without any side effects.

Conclusion: Systemic PDT with Chlorine e6 as a Photosensitizer has been safe and effective in the removal of BCC lesions due to the data achieved in a two-month follow-up.

Notable Enhancement of Facial Scarring Following Autologous Melanocyte-Keratinocyte Transplantation and NUVB Therapy: A Case Report

Mohammad Ali Nilforoushzadeh, Maryam Nouri, Shiva Alavi, Mohammad Amir Amirkhani, Solmaz Zare, Ehsan Alavi Rad, Masoumeh Rohaninasab, Elham Behrangi, Amir Shamloo, Bahareh Maleki, Sona Zare

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e78

Introduction: There are various types of treatment targeting the healing of traumatic or accidental skin scars. Transplantation of skin grafts and surgical alternatives, including autologous transplantation of melanocyte-keratinocyte suspension, has also been suggested previously. This study is representing a case of previous skin graft transplantation, complaining of scar formation and discoloration on the transplanted segment.
Case Presentation: The patient was a 37-year-old lady. This patient underwent melanocytekeratinocyte suspension transplantation and narrow-band ultraviolet B (NUVB) therapy and could reach 40% re-pigmentation enhancement. This method could be introduced as an efficient and safe method of approaching facial scarring.
Conclusion: This method could be introduced as an efficient and safe method of approaching facial scarring.

Case Series

Photodynamic Therapy in Root Canal Disinfection: A Case Series and Mini-Review

Soheil Shahbazi, Saharnaz Esmaeili, Mojgan Feli, Mohammad Asnaashari

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e19

Introduction: Photodynamic therapy (PDT) is now a widely used treatment modality in many fields of dentistry, including endodontics. The most common application of PDT in endodontics is to disinfect root canals. The purpose of this study was to present the experience of using PDT in root canal disinfection of three patients.
Case Presentation: Three patients were referred to the Endodontics Department of Shahid Beheshti University of Medical Sciences and were treated using 0.1 mg/mL Toluidine Blue (FotoSan® agent; CMS Dental, Denmark) irradiated with a light-emitting diode (LED) lamp (FotoSan®; CMS Dental, Denmark) with a mean wavelength of 630 nm and a mean power density of 3 W/cm2 over two 30-second periods.
Conclusion: PDT using LED lighting can be used in conjunction with conventional root canal treatment (RCT) to achieve great results.


Laser-Assisted Lip Repositioning Surgery: A Modification to The Conventional Technique

Pilar Rocío Blanco Florez, Jessica Alvis Guzmán, Jennifer Orozco Páez

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e22

Introduction: The lip repositioning surgical technique arose with the objective of correcting and harmonizing the act of smiling. Since the conventional technique was published, some modifications of the technique have been proposed in order to counteract postoperative recurrence and to achieve the best esthetic appearance of the smile. The objective of this paper was to describe the laser-assisted lip repositioning technique (laser-assisted LRS) with a 940nm diode laser and 2780nm Er, Cr: YSGG, as a modification to the conventional lip repositioning technique, for the treatment of a gummy smile.
Case Report: The proposed technique consists in achieving the descent of the upper lip by removing the intraoral mucosal band through the laser peeling of the oral mucosa, preserving the connective tissue intact for healing by secondary intention. The technique was implemented in two patients with a diagnosis of a gummy smile caused by a short and hyperactive upper lip; the healing process was satisfactory, and there was no bleeding or postoperative edema. Postoperative controls were performed at 3 and 10 months, and no recurrence was found.
Conclusion: the 940nm Diode laser or 2780nm Er, Cr: YSGG laser-assisted lip repositioning the technique described here is less invasive than that performed with a conventional scalpel, offers aesthetic results, lower risk of infection, and recurrence of the gummy smile in the long term.


Gingival Melanin Depigmentation Using a Diode 808-nm Laser: A Case Series

Saharnaz Esmaeili, Soheil Shahbazi, Mohammad Asnaashari

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e41

Abstract Introduction: Gingival hyperpigmentation is caused by an increase in the amount of melanin production or the number of melanocytes in the epithelium, which can impair smile esthetics. The current study aimed to report the experience of using a diode laser for gingival depigmentation of three different patients. Case Presentation: Three adult patients are presented with hyperpigmentation in labial gingivae of both jaws. The depigmentation was done using a diode laser at a wavelength of 808 nm, fiber diameter of 300 μm, and power of 1 W and in continuous mode. All three patients showed proper resolution of hyperpigmented areas in short- and long-term follow-up sessions. However, degrees of recurrence were noticeable in two cases. Conclusion: The 808-nm diode laser can be utilized safely and efficiently in gingival depigmentation, resulting in an acceptable cosmetic outcome. Doi:https:doi.org/10.34172/jlms.2022.41 Keywords: Hyperpigmentation; Laser therapy; Diode laser; Melanocytes; Cosmetic dentistry.

Tonsillotomy by a Fractional Carbon Dioxide Laser: A New Technique in the Treatment of Chronic Tonsillitis

Heloisa Juliana Zabeu Rossi Costa, Renata Cantisani Di Francesco, Suzana Maria Giancoli, Fernando Mathias Pereira De Miranda, Ricardo Ferreira Bento

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e51

Introduction: chronic tonsillitis has a global prevalence ranging from 5-12%. Its clinical manifestations, like recurrent acute tonsillitis, tonsils hypertrophy, caseum and halitosis, can lead adult patients to be submitted to palatine tonsillectomy, surgery that has morbidity and the potential risk of complications, including severe bleeding.

This article proposes a new therapy for chronic tonsillitis in adult patients using a   fractional carbon dioxide (CO2) laser, a fast, minimally invasive procedure capable of removing the need for the traditional tonsillectomy in many patients.

            Objective: to verify the efficacy of tonsillotomy by fractional ablation using the CO2 laser by comparing number of bacterial infections, tonsils hypertrophy, halitosis and caseum; to analyze the benefits, risks and complications of the technique. 

Methods: 20 patients were subjected to one session of tonsillotomy by fractional ablation and were followed up on for a year. The control group was formed by the same patients in the pre-procedure period (one year) without treatment.

Results: no complications occurred, the procedure was fast (30 seconds), safe and tolerated well without general anesthesia. After one year, there was a total remission of recurrent acute tonsillitis in 95% of the patients, and after six months there was a statistically significant improvement of halitosis and caseum, and tonsils size reduction (p<0,05).  The level of satisfaction average was 10 after three months and 8 after one year.

Conclusion: tonsillotomy by fractional ablation using the CO2 laser is a safe, efficient procedure for chronic tonsillitis in adults, which can be incorporated into the daily clinical practice.

Transcranial Infrared Laser Stimulation for the Treatment of Traumatic Brain Injury: A Case Series

Elisabeth Rindner, Jonathan Haroon, Kaya Jordan, Kennedy Mahdavi, Jean Rama Surya, Margaret Zielinski, Barshen Habelhah, Victoria Venkatraman, Sergio Becerra, Lider Chan, Taylor Kuhn, Sheldon Jordan

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e65

Introduction: This study intended to evaluate the safety and possible therapeutic effect of transcranial infrared laser stimulation (TILS) based on photobiomodulation (PBM) among patients with traumatic brain injury (TBI).
Methods: Eleven participants were diagnosed with TBI after a full neurological examination and MRI evaluation by a board-certified neurologist completed five to eight 20-minute TILS sessions using the Cytonsys CytonPro-5000 apparatus (pilot laser control, focused wavelength of 1064 nm, maximum output power of 10W, maximum optical power density of 500 mW/cm2, effective area 4.5 cm2 in diameter). Per TILS session, participants underwent a laser dose of 250 mW/cm2 continuous laser wave to each hemisphere using predetermined patient-specific coordinates. Structural imaging was used to neuronavigate individual treatment targets in the frontal cortex (Brodmann area 10). The primary safety measure for this study was the occurrence of adverse events (AEs) or serious adverse events (SAEs). The primary efficacy outcome measure was the participant-rated global rating of change (GRC) post-intervention. Secondary outcome measures included a battery of neuropsychological testing and mood questionnaires done both pre-and post-intervention.
Results: All patients enrolled in this study protocol were able to tolerate the study procedures without any AEs or SAEs. Nine out of eleven participants had clinically significant improvements in GRC score (≥ +2). Neuropsychological testing and mood questionnaire outcomes also suggested a positive therapeutic effect.
Conclusion: This study provides preliminary evidence supporting the safety and potential efficacy of TILS as a non-invasive clinical intervention for individuals with TBI.

Nd:YAG Laser Tattoo Removal in Individuals With Skin Phototypes IV-VI: A Case Series

Christiane Pavani, Giancarlo Pincelli, Michelle Mota Sena

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e79

Introduction: Although tattoos are ancient and very popular among young people, it is also a reason for regret, and many people today have the desire to remove them. Among the possibilities for this, laser removal is the most successful procedure with the highest degree of pigment removal and the lowest risk of complications.
Methods: This study was recorded on three patients with tattoos, and only the black pigments were removed. None of the patients involved had a history of skin allergies, skin cancer, and/or keloid formation. Case 1 had a professional tattoo removed in the right calf region in two sessions. Case 2 had an amateur tattoo that was removed on the scalp in three sessions. Finally, Case 3 had two professional tattoos, which were removed from the face in a total of eleven sessions. The following equipment was used: Spectra XT Q-Switched Nd: YAG 1064 nm with a pulse width of 5 ns; Pico Ultra 300 Nd: YAG 1064 nm with a pulse width of 300 ps; and SoftLight Q-Switched Nd:YAG 1064 nm with a pulse width of 17 ns.
Results: In general, satisfactory results were obtained, but hypopigmentation was present in Cases 1 and 3. This was probably due to sun exposure at the laser removal site, the short interval between the sessions, and/or higher radiant exposure combined with a smaller spot size, respectively.
Conclusion: To achieve successful tattoo removal in the higher phototypes and reduce unwanted effects, the professionals must know the best parameters to be used, as well as the adequate foundation on the individual characteristics of each patient and the tattoos. Furthermore, patient compliance with the pre/post session care and a suitable interval between the laser sessions are essential to avoid undesirable complications.

Brief Report

Muscle Function Recovery Following Botulinum Toxin Type A Facial Injections: A Case Managed With Photobiomodulation Therapy

Luiz Felipe Palma, Susana Morimoto, Rafael Verardi Serrano, Cristina Maria Arvate Alvares, Victor Ricardo Manuel Muñoz Lora, Luana Campos

Journal of Lasers in Medical Sciences, Vol. 13 (2022), 10 January 2022, Page e54

Background: Aesthetic applications of Botulinum toxin type A (BoNT-A) may lead to some complications or unwanted muscle paralysis.

Case Report: Given that the BoNT-A effects may last several months and there is no medical intervention to accelerate muscle function recovery so far, the present study aims at reporting a clinical case in which movement disorder of the mimic muscles resulting from BoNT-A injections was managed with daily sessions of photobiomodulation therapy (PBMT). It was noted a fast improvement in both facial asymmetry and muscle function within a few weeks. After nine weeks, almost complete recovery was achieved.

Conclusion: According to the current case, PMBT seems to be an effective intervention to accelerate muscle function recovery following BoNT-A use.