Review Article

The Combination of Laser Therapy and Metal Nanoparticles in Cancer Treatment Originated From Epithelial Tissues: A Literature Review

Reza Fekrazad, Nafiseh Naghdi, Hanieh Nokhbatolfoghahaei, Hossein Bagheri

Journal of Lasers in Medical Sciences, Vol. 7 No. 2 (2016), 15 March 2016, Page 62-75

Several methods have been employed for cancer treatment including surgery, chemotherapy and radiation therapy. Today, recent advances in medical science and development of new technologies, have led to the introduction of new methods such as hormone therapy, Photodynamic therapy (PDT), treatments using nanoparticles and eventually combinations of lasers and nanoparticles. The unique features of LASERs such as photo-thermal properties and the particular characteristics of nanoparticles, given their extremely small size, may provide an interesting combined therapeutic effect. The purpose of this study was to review the simultaneous application of lasers and metal nanoparticles for the treatment of cancers with epithelial origin. A comprehensive search in electronic sources including PubMed, Google Scholar and Science Direct was carried out between 2000 and 2013. Among the initial 400 articles, 250 articles applied nanoparticles and lasers in combination, in which more than 50 articles covered the treatment of cancer with epithelial origin. In the future, the combination of laser and nanoparticles may be used as a new or an alternative method for cancer therapy or diagnosis. Obviously, to exclude the effect of laser’s wavelength and nanoparticle’s properties more animal studies and clinical trials are required as a lack of perfect studies.

Can Antimicrobial Photodynamic Therapy (aPDT) Enhance the Endodontic Treatment?

Nasim Chiniforush, Maryam Pourhajibagher, Sima Shahabi, Emad Kosarieh, Abbas Bahador

Journal of Lasers in Medical Sciences, Vol. 7 No. 2 (2016), 15 March 2016, Page 76-85


 In order to achieve a long-lasting effect, one of the main goals in root canal treatment is to eliminate the endodontic bacteria. Conventional chemomechanical debridement is considered as the basic treatment in root canal therapy, but adjunctive techniques such as antimicrobial photodynamic therapy (aPDT) can also be helpful. The aim of this study was to evaluate reports in the scientific literature that used different photosensitizers (PSs) for bacterial reduction. The literature search was conducted using databases including PubMed, Scopus, and Google Scholar with the keywords “photodynamic therapy,” “antimicrobial photodynamic therapy,” or “photoactivated disinfection” and “endodontic,” “Enterococcus faecalis,” or “root canal treatment,” from 2000 to 2015. By evaluating different studies, it was concluded that aPDT should be applied in combination with conventional mechanical debridement and irrigants. However, it is also important to note that the success rate is critically dependent on the type of the PS, output power of the laser used, irradiation time, pre-irradiation time, and type of tips used.




Original Article

Structural and Morphological Changes in Human Dentin after Ablative and Subablative Er:YAG Laser Irradiation

Horieh Moosavi, Sajedeh Ghorbanzadeh, Farzaneh Ahrari

Journal of Lasers in Medical Sciences, Vol. 7 No. 2 (2016), 15 March 2016, Page 86-91

Introduction: This study investigated the influence of Erbium-Doped Yttrium Aluminum Garnet (Er:YAG) laser on microhardness, chemical composition and subsurface morphology of dentin cavity walls.

Methods: Forty sound human premolars were selected and randomly assigned into four groups. Class V cavities were prepared either with an Er:YAG laser (groups 1 and 2; 15 Hz, 250 mJ for enamel, 10 Hz, 200 mJ for dentin) or with a high speed handpiece (groups 3 and 4). The specimens in groups 1 and 3 served as the control, whereas those in groups 2 and 4 were exposed to subablative laser irradiation following cavity preparation (10 Hz, 50 mJ). After bisecting the specimens, one half was subjected to microhardness assessment and the other half was evaluated by SEM-EDS analysis.

Results: Microhardness was significantly greater in the specimens prepared by both ablative and subablative laser irradiation (group 2) than that of the bur-prepared cavities (groups 3 and 4) (P<0.05). The quantity of calcium ion was significantly greater in cavities prepared by the Er:YAG laser (groups 1 and 2) compared to that of the bur cavities (groups 3 and 4) (p<0.05). Subablative irradiation improved microhardness and weight percentage of calcium ion in both laser and bur cavities, but the difference was not significant compared to that of the relevant control group (P>0.05).

Conclusion: Cavity preparation with an Er:YAG laser could be considered as an alternative to the conventional method of drilling, as it enhances the mechanical and compositional properties of lased dentin, especially when combined by subablative irradiation.

High Power Laser for Treatment of Achilles Tendinosis – a Single Blind Randomized Placebo Controlled Clinical Study

Anders Mårdh, Iréne Lund

Journal of Lasers in Medical Sciences, Vol. 7 No. 2 (2016), 15 March 2016, Page 92-98

Introduction: Pain in the Achilles tendon during loading is a very common condition. Conservative treatments, such as low level laser therapy (LLLT) have been reported to give varying results. Recently, a new laser treatment technique, high power laser treatment (HPLT) (Swiss DynaLaser®), was introduced in Scandinavia, but has not, to our knowledge, been systematically tested before. The objective of this study was to evaluate the effects of HPLT compared to placebo HPLT in rated pain and assessed pain threshold in patients with chronic Achilles tendinosis.

Methods: The study was a randomized, single blind, placebo controlled trial. Patients were randomized to receive 6 treatments of either HPLT or placebo HPLT during a period of 3-4 weeks with a follow up period of 8-12 weeks. Outcome measures were rated pain according to questions of the Foot and Ankle Outcome Score (FAOS, Swedish version LK1.0) and assessment of electro-cutaneous stimulated pain threshold and matched pain (PainMatcher).

Results: The results of the study demonstrated significant changes of assessments within groups, that were more pronounced towards lower levels of rated pain in the HPLT group than in the placebo HPLT group. The between group difference were significant in four of nine questions regarding loading activities of the FAOS subscale. Assessed pain thresholds were found increased in the HPLT group, as compared to the placebo HPLT group. At individual level, the results varied.

Conclusion: The results indicate that HPLT may provide a future option for treatment of Achilles tendinosis related pain, but further studies are warranted.


Comparison of the Antibacterial Effect of 810 nm Diode Laser and Photodynamic Therapy in Reducing the Microbial Flora of Root Canal in Endodontic Retreatment in Patients With Periradicular Lesions

Mohammad Asnaashari, Mostafa Godiny, Saranaz Azari-Marhabi, Fahimeh Sadat Tabatabaei, Maryam Barati

Journal of Lasers in Medical Sciences, Vol. 7 No. 2 (2016), 15 March 2016, Page 99-104

Introduction: The aim of this study was to compare the antibacterial efficacy of diode laser 810nm and photodynamic therapy (PDT) in reducing bacterial microflora in endodontic retreatment of teeth with periradicular lesion.

Methods: In this in vivo clinical trial, 20 patients who needed endodontic retreatment were selected. After conventional chemo mechanical preparation of root canals, microbiological samples were taken with sterile paper point (PP), held in thioglycollate broth, and then were transferred to the microbiological lab. In the first group, PDT with methylene blue (MB) and diode laser (810 nm, 0.2 W, 40 seconds) was performed and in the second group diode laser (810 nm, 1.2 W, 30 seconds) was irradiated. Then second samples were taken from all canals.

Results: CFU/ml amounts showed statistically significant reduction in both groups (P < 0.001). CFU/ml amounts were compared between the two groups and there was no statistical difference.

Conclusion: PDT and diode laser 810 nm irradiation are effective methods for root canal disinfection. PDT is a suitable alternative for diode laser 810 nm irradiation, because of lower thermal risk on root dentin.

Penetration Depth of Sodium Hypochlorite in Dentinal Tubules after Conventional Irrigation, Passive Ultrasonic Agitation and Nd:YAG Laser Activated Irrigation

Abdollah Ghorbanzadeh, Mohsen Aminsobhani, Khosro Sohrabi, Nasim Chiniforush, Sarvenaz Ghafari, Ahmad Reza Shamshiri, Niusha Noroozi

Journal of Lasers in Medical Sciences, Vol. 7 No. 2 (2016), 15 March 2016, Page 105-111

Introduction: The penetration depth of irrigating solutions in dentinal tubules is limited; consequently, bacteria can remain inside dentinal tubules after the cleaning and shaping of the root canal system. Therefore, new irrigation systems are required to increase the penetration depth of irrigating solutions in dentinal tubules.

Methods: A comparative study regarding the penetration depth of sodium hypochlorite (NaOCl) solution in dentinal tubules using four methods, (1) conventional irrigation (CI), (2) smear layer removal plus conventional irrigation (gold standard), (3) passive ultrasonic agitation (PUA) and (4) Nd:YAG laser activated irrigation (LAI), took place on 144 extracted mandibular teeth with a single root canal. After decoronation with a diamond disc and working length determination, the apical foramen was sealed with wax. The canals were prepared up to #35 Mtwo rotary file and 5.25% NaOCl was used for irrigation during preparation. To study the penetration depth of NaOCl, smear layer was eliminated in all samples. Dentinal tubules were stained with crystal violet and after longitudinal sectioning of teeth, the two halves were reassembled and root canal preparation was performed up to #40 Mtwo rotary file. Then the samples were distributed into four experimental groups. Depth of the bleached zone was evaluated by stereomicroscope (20X). Data were analyzed by Kruskal-Wallis test.

Results: The highest and lowest average for NaOCl penetration depth in all three coronal, middle and apical sections belonged to CI + smear layer removal and CI. A statistically significant difference was seen when comparing the penetration depth of CI + smear layer removal group to CI and PUA groups in coronal and middle third, in which the average NaOCl penetration depth of the gold standard group was higher (P < 0.05). A statistically significant difference was seen between CI + smear layer removal group and the other three groups including CI, PUA and LAI in apical third, in which the average NaOCl penetration depth in the gold standard group was higher (P < 0.001).

Conclusion: The standard protocol for smear layer removal led to more effective smear layer elimination and deeper penetration depth of irrigation solutions. PUA and LAI groups exhibited less smear layer elimination and penetration depth of irrigation solutions. Therefore, CI+smear layer removal should still be considered as the gold standard.

Effect of Laser Therapy on Chronic Osteoarthritis of the Knee in Older Subjects

Enas Fawzey Youssef, Qassim Ibrahim Muaidi, Alsayed Abdelhameed Shanb

Journal of Lasers in Medical Sciences, Vol. 7 No. 2 (2016), 15 March 2016, Page 112-119

Introduction: Osteoarthritis (OA) is a common degenerative joint disease particularly in older subjects. It is usually associated with pain, restricted range of motion, muscle weakness, difficulties in daily living activities and impaired quality of life. To determine the effects of adding two different intensities of low-level laser therapy (LLLT) to exercise training program on pain severity, joint stiffness, physical function, isometric muscle strength, range of motion of the knee, and quality of life in older subjects with knee OA.

Methods: Patients were randomly assigned into three groups. They received 16 sessions, 2 sessions/week for 8 weeks. Group-I: 18 patients were treated with a laser dose of 6 J/cm2 with a total dose of 48 J. Group-II: 18 patients were treated with a laser dose of 3 J/cm2 with a total dose of 27 J. Group-III: 15 patients were treated with laser without emission as a placebo. All patients received same exercise training program including stretching and strengthening exercises. Patients were evaluated before and after intervention by visual analogue scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index for quality of life, handheld dynamometer and universal goniometer.

Results: T test revealed that there was a significant reduction in VAS and pain intensity, an increase in isometric muscle strength and range of motion of the knee as well as increase in physical functional ability in three treatment groups. Also analysis of variance (ANOVA) proved significant differences among them and the post hoc tests (LSD) test showed the best improvements for patients of the first group.

Conclusion: It can be concluded that addition of LLLT to exercise training program is more effective than exercise training alone in the treatment of older patients with chronic knee OA and the rate of improvement may be dose dependent, as with 6 J/cm2 or 3 J/cm2.

Effects of 3 Hz and 60 Hz Extremely Low Frequency Electromagnetic Fields on Anxiety-Like Behaviors, Memory Retention of Passive Avoidance and Electrophysiological Properties of Male Rats

Amin Rostami, Minoo Shahani, Mohammad Reza Zarrindast, Saeed Semnanian, Mohammad Rahmati Roudsari, Mostafa Rezaei Tavirani, Hadi Hasanzadeh

Journal of Lasers in Medical Sciences, Vol. 7 No. 2 (2016), 15 March 2016, Page 120-125

Introduction: The effects of electromagnetic fields on biological organisms have been a controversial and also interesting debate over the past few decades, despite the wide range of investigations, many aspects of extremely low frequency electromagnetic fields (ELF/EMFs) effects including mechanism of their interaction with live organisms and also their possible biological applications still remain ambiguous. In the present study, we investigated whether the exposures of ELF/EMF with frequencies of 3 Hz and 60 Hz can affect the memory, anxiety like behaviors, electrophysiological properties and brain’s proteome in rats.

Methods: Male rats were exposed to 3 Hz and 60 Hz ELF/EMFs in a protocol consisting of 2 cycles of 2 h/day exposure for 4 days separated with a 2-day interval. Short term memory and anxiety like behaviors were assessed immediately, 1 and 2 weeks after the exposures. Effects of short term exposure were also assessed using electrophysiological approach immediately after 2 hours exposure.

Results: Behavioral test revealed that immediately after the end of exposures, locomotor activity of both 3 Hz and 60 Hz exposed groups significantly decreased compared to sham group. This exposure protocol had no effect on anxiety like behavior during the 2 weeks after the treatment and also on short term memory. A significant reduction in firing rate of locus coeruleus (LC) was found after 2 hours of both 3 Hz and 60 Hz exposures. Proteome analysis also revealed global changes in whole brain proteome after treatment.

Conclusion: Here, some evidence regarding the fact that such exposures can alter locomotor activity and neurons firing rate in male rats were presented.

Microbiological Efficacy of Photodynamic Therapy as an Adjunct to Non-surgical Periodontal Treatment: A Clinical Trial

Mohammadreza Talebi, Rojin Taliee, Masoud Mojahedi, Mansour Meymandi, Maryam Torshabi

Journal of Lasers in Medical Sciences, Vol. 7 No. 2 (2016), 15 March 2016, Page 126-130

Introduction: The efficiency of routine scaling and root planning is negatively influenced by the tooth anatomy and residual bacteria all possibly affecting the treatment outcomes in future. The present study compared the microbiologic effectiveness of the photodynamic therapy (PDT) as an adjunctive treatment modality for nonsurgical treatment in chronic periodontitis.

Methods: In this randomized controlled clinical trial, 18 chronic periodontitis patients were selected. Four quadrants were randomly treated by scaling and root planning (SRP), diode laser (810n m wavelength, 1.5 W and 320 μm fiber, contact and sweeping technique), SRP + PDT (with diode laser 808 nm, 0.5 W) and laser + SRP (with diode laser 808 nm, 1 W) in each patient. Presence of periodontal pathogen species in the treated areas were measured before the treatment, at 1 and 3 months afterwards. The identification and reproduction of the specific genes of pathogen bacteria were done by means of polymerase chain reaction (PCR) technique. Presence of oral pathogen bacteria in the treatment groups were analyzed by chi-square test. A semi quantitative analysis was used to measure the intensity of white light in each band. This was calculated by number of pixels in each band.

Results: In the qualitative analysis, Fusobacterium nucleatum (Fn) and Treponema denticola (Td) species were killed after 1 month in all treatment modalities. PDT had more effects to decrease Prevotella intermedia (Pi) species than SRP while Tannerella forsythensis count (Tf) species increased in all treatments. Furthermore, Actinobacillus actinomycetemcomitans (Aa) species decreased in all treatments and Porphyromonas gingivalis (P.g) species increased in all treatments after 1 and 3 months.

Conclusion: It can be concluded that PDT was more effective as an adjunctive treatment to SRP than SRP alone; however, no distinct differences were found between both treatment modalities regarding reduction of certain pathogen bacteria.

Case Report

Case Report of Photodynamic Therapy in the Treatment of Dental Caries on Primary Teeth

Ana Carolina Costa da Mota, Cinthia Raquel Lima Leal, Silvia Olivan, Marcela Leticia Leal Gonçalves, Vanessa Adriana de Oliveira, Marcelo Mendes Pinto, Sandra Kalil Bussadori

Journal of Lasers in Medical Sciences, Vol. 7 No. 2 (2016), 15 March 2016, Page 131-133

Introduction: The partial removal of dental caries aiming to maintain the integrity of the pulp has been considered the therapy of choice in the treatment of deep carious lesions, as long as certain principles of diagnosis are respected. Dentists are always looking for techniques to remove the decayed tissue with biosafety, what provides more comfort to the patient especially when it comes to children. Photodynamic therapy (PDT) is an antimicrobial treatment. PapacárieMblue is a modification of the regular Papacárie, with a photosensitizer added to it.

Case Report: PapacárieMblue was used in a patient who had deep carious lesions in a primary molar. After 5 minutes of application, the soft and infected tissues were removed from the side walls of the cavity and, after, PDT was held in the pulp wall with red laser (660 nm), energy of 30 J, output power of 100 mW and 5 minutes of exposure time. This caused a reduction in the amount of dental tissue removed, what favored the prognosis of the dental element. After a period of 3 months, a control of the case was done and we discovered that the tooth that received the PDT was not painful and the x-ray showed an absence of lesions in the furcation.

Conclusion: PDT with PapacárieMblue has been effective in the removal of a deep carious lesion that had a risk of pulp exposure