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), , 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.


DOI:10.34172/jlms.2022.01

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), , 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


DOI:10.34172/jlms.2022.04.

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), , 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.


Doi:10.34172/jlms.2022.05

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), , 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.


DOI:10.34172/jlms.2022.8

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), , 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.


DOI:10.34172/jlms.2022.09.

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), , 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.

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), , 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.


DOI:10.34172/jlms.2022.12

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.


Doi:10.34172/jlms.2022.14.

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), , 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.


Doi:10.34172/jlms.2022.15.

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), , 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.


Doi:10.34172/jlms.2022.16.

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), , 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.


Doi:10.34172/jlms.2022.

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), , 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.


Doi:10.34172/jlms.2022.21

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), , 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.


Doi:10.34172/jlms.2022.23.

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), , 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.


Doi:10.34172/jlms.2022.24.

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), , 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.


Doi:10.34172/jlms.2022.03.

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), , 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.


Doi:10.34172/jlms.2022.07.

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), , 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.


Doi:10.34172/jlms.2022.13.

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), , 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.


DOI:10.34172/jlms.2022.02

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), , 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.


Doi:10.34172/jlms.2022.06.

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), , 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.


Doi:10.34172/jlms.2022.17.

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), , 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.


Doi:10.34172/jlms.2022.19

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), , 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.


Doi:10.34172/jlms.2022.22