THOR Photobiomodulation Therapy Products & Training

Cell signalling governs basic cellular activities and coordinates cell actions. Cells respond to their local microenvironment and these signals may prompt tissue repair or immune response as well as normal tissue homeostasis. Guenter Albrecht-Buehler has conducted a series of experiments on cells with near-infrared light (NIR) and reports on how cells might be communicating with pulsed NIR. He also demonstrates with video how cell motility responds to a pulsed light stimulus.

Guenter Albrecht-Buehler, Ph.D.

Fellow, European Academy of Sciences, Brussels

Fellow, Institute for Advanced Studies, Berlin

Robert Laughlin Rea Professor of Cell Biology

Northwestern University Medical School, Chicago

Here is my selection for the April 2008 Photomedicine and Laser Surgery

The Impact of low power laser in the treatment of conditioning-induced oral mucositis: a report of 11 clinical cases and their review.

Antunes HS, Ferreira EM, de Matos VD, Pinheiro CT, Ferreira CG

Serviso de Pesquisa Clinica, Instituto Nacional de Cancer, Rua Andre Cavalcante, Rio de Janeiro, Brasil. hspindola@inca.gov.br

We have investigated the clinical effects of low power laser therapy (LPLT) on the treatment of conditioning-induced oral mucositis (OM) in patients submitted to hematopoietic stem cell transplantation (HSCT). The evaluation of OM was done using the Oral Mucositis Assessment Scale (OMAS) and World Health Organization (WHO) scale. In the context of a randomized placebo-controlled trial with 38 patients for the evaluation of preventive LPLT, eleven individuals were submitted to allogeneic (AL) HSCT and developed oral mucositis grade 4 (WHO) or a total area of OM of 12 cm (OMAS) and due to that were treated with LPLT with the purpose of symptom relief. The irradiation used was a diode InGaAlP, emitting light at 660 nm, 50 mW and 8 J/cm(2) measured at the end of fiber optic with 0.196 cm(2) of section area during the treatment. The tip of the laser device touched the oral mucosa and patients recovered on average 6 days (3-12 days) from the beginning of the laser application. Our results have indicated that the use of LPLT in HSCT patients is a powerful instrument in the treatment of overt OM and is now a standard procedure in this group of patients in our hospital.

Med Oral Patol Oral Cir Bucal 2008 Mar 13(3) E189-92

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18305441

Efficacy of He-Ne Laser in the prevention and treatment of radiotherapy-induced oral mucositis in oral cancer patients.

Arora H, Pai KM, Maiya A, Vidyasagar MS, Rajeev A

Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Karnatka, India. drarora@gmail.com

OBJECTIVE: The objective of this study was to evaluate the efficacy of low-level lasers for the prevention and treatment of radiotherapy-induced oral mucositis in oral cancer patients. MATERIAL AND METHODS: Twenty-four hospitalized patients with oral cancer, scheduled to undergo radiotherapy at KMC, Manipal, were enrolled in the present study and assigned to laser (Group I)/control group (Group II). They were treated using He-Ne laser (lambda = 632.8nm, output = 10 mW and energy density = 1.8 J/cm(2)). Patients were subjected to treatment using laser scanner for 8 days and subsequently were treated using laser probe at 6 anatomic sites in the oral cavity for 5 minutes each. The patients were evaluated on each day of treatment for pain severity (NRS), functional impairment (FIS), and oral mucositis (RTOG) and were followed until the end of cancer treatment. Statistical analysis was done using SPSS version 10. RESULTS: Laser therapy applied prophylactically during radiotherapy can reduce the severity of oral mucositis, severity of pain, and functional impairment.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008 Feb 105(2) 180-6, 186.e1

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18230388

Fiber-coupled light-emitting diode for localized photostimulation of neurons expressing channelrhodopsin-2.

Campagnola L, Wang H, Zylka MJ

Department of Cell and Molecular Physiology, 5109A NRB, CB #7545, 115 Mason Farm Road, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7545, United States.

Channelrhodopsin-2 (ChR2) is a blue-light-gated ion channel that can be used to stimulate genetically defined neurons reproducibly, rapidly and non-invasively. Existing approaches for delivering light to cells expressing ChR2 rely upon microscopes, lasers, arc lamps and shutters, all of which are relatively expensive and are not readily scalable for use on more than one brain region or animal at a time. In this paper, we describe an inexpensive method for delivering blue light locally and with millisecond precision to cells expressing ChR2. We accomplished this by coupling the light from a high-intensity blue light-emitting diode (LED; XLamp XR-E from CREE) into an optical fiber. When positioned in proximity to ChR2-expressing HEK293 cells, this fiber-coupled LED provided localized illumination of up to 32mW/mm(2) and generated ChR2 photocurrents as efficiently as wide-field mercury arc lamp illumination. This fiber-coupled LED was also used to photostimulate action potentials in ChR2-expressing dorsal root ganglia (DRG) sensory neurons. LED light power and pulse frequency were controlled with an inexpensive, custom-built amplifier circuit. This scalable fiber-coupled LED system can be used to deliver light independent of the microscope objective and could, in principle, deliver light in parallel to multiple brain regions or to multiple genetically engineered animals.

J Neurosci Methods 2008 Mar 30 169(1) 27-33

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18187202

Select modalities.

Canapp DA

Veterinary Orthopedic and Sports Medicine Group, Ellicott City, MD 21042, USA. dcanapp@vetsportsmedicine.com

Physical rehabilitation modalities such as therapeutic ultrasound (TU), transcutaneous electrical neuromuscular stimulation (TENS), neuromuscular electrical stimulation (NMES), cold or low-level laser therapy (LLLT), and pulsed magnetic field therapy (PMF) can all, when used properly, assist in treating orthopedic injuries, neurological conditions, and chronic conditions brought about by normal aging in our small animal companions. TU uses sound waves to produce both thermal and nonthermal effects that aid in tissue healing, repair, and function. TENS uses different frequencies of electrical current to decrease pain and inflammation. NMES also uses an electrical current to stimulate muscle contraction to assist in normal neuromuscular function in postorthopedic and neurological injuries. LLLT uses light energy to reduce pain, decrease inflammation, and stimulate healing at a cellular level. PMF uses magnetic field to stimulate normal cellular ion exchange and oxygen utilization and promote generalized healing of tissues. These modalities are discussed in detail covering mechanism of action, parameters, settings, and indications/contraindications of use in our small animals. Although these modalities are important in the physical rehabilitation of small animals, they need to be incorporated with a proper diagnosis, manual therapy, and home exercise program into a specific and individualized patient treatment protocol.

Clin Tech Small Anim Pract 2007 Nov 22(4) 160-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18198784

Light therapy and advanced wound care on a neuropathic plantar ulcer on a charcot foot.

Cordrey R

Renee Cordrey, PT, MSPT, MPH, CWS, St. Francis Medical Center, Impatient Wound Care, Lynwood, California.

J Wound Ostomy Continence Nurs 2008 Jan-Feb 35(1) 116-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18199949

Clinical Effect of CO(2) Laser in Reducing Pain in Orthodontics.

Fujiyama K, Deguchi T, Murakami T, Fujii A, Kushima K, Takano-Yamamoto T

Objective: To test the hypothesis that there is no difference in the pain associated with orthodontic force application after the application of local CO(2) laser irradiation to the teeth involved. Materials and Methods: Separation modules were placed at the distal contacts of the maxillary first molars in 90 patients in this single-blinded study. In 60 of these patients (42 females and 18 males; mean age = 19.22 years) this was immediately followed by laser therapy. The other 30 patients (18 females and 12 males; mean age = 18.8 years) did not receive active laser irradiation. Patients were then instructed to rate their levels of pain on a visual analog scale over time, and the amount of tooth movement was analyzed. Results: Significant pain reductions were observed with laser treatment from immediately after insertion of separators through day 4, but no differences from the nonirradiated control side were noted thereafter. No significant difference was noted in the amount of tooth movement between the irradiated and nonirradiated group. Conclusions: The hypothesis was rejected. The results suggest that local CO(2) laser irradiation will reduce pain associated with orthodontic force application without interfering with the tooth movement.

Angle Orthod 2008 Mar 78(2) 299-303

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18251609

Treatment of neck pain: noninvasive interventions: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.

Hurwitz EL, Carragee EJ, van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Cote P, Hogg-Johnson S, Cassidy JD, Haldeman S

Department of Public Health Sciences, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96822, USA. ehurwitz@aii.edu

STUDY DESIGN: Best evidence synthesis. OBJECTIVE: To identify, critically appraise, and synthesize literature from 1980 through 2006 on noninvasive interventions for neck pain and its associated disorders. SUMMARY OF BACKGROUND DATA: No comprehensive systematic literature reviews have been published on interventions for neck pain and its associated disorders in the past decade. METHODS: We systematically searched Medline and screened for relevance literature published from 1980 through 2006 on the use, effectiveness, and safety of noninvasive interventions for neck pain and associated disorders. Consensus decisions were made about the scientific merit of each article; those judged to have adequate internal validity were included in our best evidence synthesis. RESULTS: Of the 359 invasive and noninvasive intervention articles deemed relevant, 170 (47%) were accepted as scientifically admissible, and 139 of these related to noninvasive interventions (including health care utilization, costs, and safety). For whiplash-associated disorders, there is evidence that educational videos, mobilization, and exercises appear more beneficial than usual care or physical modalities. For other neck pain, the evidence suggests that manual and supervised exercise interventions, low-level laser therapy, and perhaps acupuncture are more effective than no treatment, sham, or alternative interventions; however, none of the active treatments was clearly superior to any other in either the short- or long-term. For both whiplash-associated disorders and other neck pain without radicular symptoms, interventions that focused on regaining function as soon as possible are relatively more effective than interventions that do not have such a focus. CONCLUSION: Our best evidence synthesis suggests that therapies involving manual therapy and exercise are more effective than alternative strategies for patients with neck pain; this was also true of therapies which include educational interventions addressing self-efficacy. Future efforts should focus on the study of noninvasive interventions for patients with radicular symptoms and on the design and evaluation of neck pain prevention strategies.

Spine 2008 Feb 15 33(4 Suppl) S123-52

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18204386

A randomized double-blind comparative study of Biolight light therapy following surgical extraction of impacted lower third molars.

Kashani H, Kanagaraja S, Kahnberg KE

Department of Oral & Maxillofacial Surgery, NAL Medical Center Hospital, Trollhattan, Sweden. hossein.kashani@vgregion.se

Monochromatic light has been used in many studies and indicated that phototherapy might be effective in the treatment of pain relief. The aim of this investigation was to evaluate the efficacy of monochromatic light phototherapy on patients who had undergone impacted third molar surgery. Sixty adult patients were included in the study. The patients were divided into 2 groups; the Biolight therapy group and the placebo therapy group. All the subjects received phototherapy 6 minutes preoperative and 10 minutes postoperative.They were examined 3 and 7 days after surgery to evaluate postoperative pain and wound healing. One patient was excluded from the study due to extraction of the third molar in maxilla. All the patients received a questionnaire to answer regarding pain and the number of pain killers consumed.The results from this study showed that Phototherapy using monochromatic light Biolight therapy had no significant differences compared to the placebo group.

Swed Dent J 2007 31(4) 165-70

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18220219

[Complex therapy of chronic bacterial prostatitis using matrix-urologist laser therapy]

Kozdoba AS, Popov SV, Ivanchenko LP

A total of 49 patients with chronic bacterial prostatitis (CBP) were divided into two groups matched by age, the disease duration and severity of clinical symptoms. The study group consisted of 27 CBP patients who received antimicrobial therapy with sparfloxacine (fluoroquinolone of the third generation) and impact of vibromagnetolaser head of the VMLG-10 unit. The control group consisted of 22 CBP patients given antimicrobial therapy with sparfloxacine and 10 sessions of manual massage. Eradication of the bacteria was achieved in 25 (92%) patients of the study group and 19 (86.4%) patients of the control group. The treatment significantly attenuated the symptoms, normalized leukocyte count in the prostatic secretion, reduced size of the gland. Thus, application of the vibromagnetolaser head VMLG-10 of the laser therapy unit Matrix-urologist raises treatment efficacy in CBP patients.

Urologiia 2007 Sep-Oct (5) 51, 53-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18257156

Low-level laser therapy modulates cyclo-oxygenase-2 expression during bone repair in rats.

Matsumoto MA, Ferino RV, Monteleone GF, Ribeiro DA

Department of Oral Maxillofacial Surgery, School of Dentistry, University of the Sacred Heart (USC), Bauru, SP, Brazil.

The goal of this study was to analyze the role of cyclo-oxygenase-2 following bone repair in rats submitted to low-level laser therapy. A total of 48 rats underwent surgery to inflict bone defects in their tibias having been randomly distributed into two groups: negative control and laser exposed group, i.e., the animals were treated with low-level laser therapy by means of gallium arsenide laser at 16 J/cm(2). The animals were killed after 48 h, 7 days, 14 days, or 21 days. The tibias were removed for morphological, morphometric, and immunohistochemistry analysis for cyclo-oxygenase-2. Statistical significant differences (P < 0.05) were observed in the quality of bone repair and quantity of formed bone between groups 14 days after surgery in the laser exposed group. In the same way, cyclo-oxygenase-2 immunoreactivity was more intense in bone cells for intermediate periods evaluated in this group. Taken together, such results suggest that low-level laser therapy is able to improve bone repair in the tibia of rats after 14 days of surgery as a result of an up-regulation for cyclo-oxygenase-2 expression in bone cells.

Lasers Med Sci 2008 Feb 29

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18309458

[Patients with tuberculosis associated with chronic non-specific lung diseases]

Nikolaieva OD

159 patients have been observed to assess the efficiency of laseropuncture use in a complex treatment of patients with lung tuberculosis and chronic bronchitis. Disbalance in renal meridian (R), urinary bladder (V) and insufficiency of the energy in colon meridian (60.3%) were observed in patients with tuberculosis associated with chronic bronchitis. Medium deviations of electro-skin conductivity from the physiological gape in meridians of GI, IG, F, V, R in patients with tuberculosis associated with chronic bronchitis considerably differ from those data obtained from patients with only tuberculosis. Obtained data testify more severe disorders of energy balance in meridians of patients having except tuberculosis other associated diseases. Medium parameters of deviations from the physiological gape considerably decrease after the course of laseropuncture compared with those patients treated traditionally. Improve of the course of the chronic bronchitis was noted in patients who underwent laseropuncture.

Lik Sprava 2007 Apr-May (3) 42-6

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18271179

The short-term efficacy of laser, brace, and ultrasound treatment in lateral epicondylitis: a prospective, randomized, controlled trial.

Oken O, Kahraman Y, Ayhan F, Canpolat S, Yorgancioglu ZR, Oken OF

Ankara Education and Research Hospital, Department of Physical Medicine and Rehabilitation, Division of Hand Rehabilitation, Ankara, Turkey. okenoznur@yahoo.com

The aims of this study were to evaluate the effects of low-level laser therapy (LLLT) and to compare these with the effects of brace or ultrasound (US) treatment in tennis elbow. The study design used was a prospective and randomized, controlled, single-blind trial. Fifty-eight outpatients with lateral epicondylitis (9 men, 49 women) were included in the trial. The patients were divided into three groups: 1) brace group-brace plus exercise, 2) ultrasound group-US plus exercise, and 3) laser group-LLLT plus exercise. Patients in the brace group used a lateral counterforce brace for three weeks, US plus hot pack in the ultrasound group, and laser plus hot pack in the LLLT group. In addition, all patients were given progressive stretching and strengthening exercise programs. Grip strength and pain severity were evaluated with visual analog scale (VAS) at baseline, at the second week of treatment, and at the sixth week of treatment. VAS improved significantly in all groups after the treatment and in the ultrasound and laser groups at the sixth week (p<0.05). Grip strength of the affected hand increased only in the laser group after treatment, but was not changed at the sixth week. There were no significant differences between the groups on VAS and grip strength at baseline and at follow-up assessments. The results show that, in patients with lateral epicondylitis, a brace has a shorter beneficial effect than US and laser therapy in reducing pain, and that laser therapy is more effective than the brace and US treatment in improving grip strength.

J Hand Ther 2008 Jan-Mar 21(1) 63-7; quiz 68

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18215753

Improved wound healing by low-level laser irradiation after gingivectomy operations: a controlled clinical pilot study.

Ozcelik O, Cenk Haytac M, Kunin A, Seydaoglu G

Department of Periodontology, Faculty of Dentistry, Cukurova University, Adana, Turkey

AIM: Low-level laser therapy (LLLT) may induce morphological, molecular and cellular processes, which are involved in wound healing. The aim of this split-mouth controlled clinical trial was to assess the effects of LLLT on healing of gingiva after gingivectomy and gingivoplasty. MATERIAL AND METHODS: Twenty patients with inflammatory gingival hyperplasias on their symmetrical teeth were included in this study. After gingivectomy and gingivoplasty, a diode laser (588 nm) was randomly applied to one side of the operation area for 7 days. The surgical areas were disclosed by a solution (Mira-2-tones) to visualize the areas in which the epithelium is absent. Comparison of the surface areas on the LLLT-applied sites and controls were made with an image-analysing software. RESULTS: Despite the prolonged time needed for application, patients have tolerated LLLT well. While there were no statistically significant differences between the stained surface areas of the LLLT applied and the control sites immediately after the surgery, LLLT-applied sites had significantly lower stained areas compared with the controls on the post-operative third, seventh and 15th day (p<0.001 for each). CONCLUSIONS: Within the limitations of this study, the results indicated that LLLT may enhance epithelization and improve wound healing after gingivectomy and gingivoplasty operations.

J Clin Periodontol 2008 Mar 35(3) 250-4

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18269665

Rehabilitation in the first 48 hours after surgery.

Shumway R

Animal Medical Center, New York, New York 10021, USA. renee.shumway@amcny.org

Physical therapy is commonly used postoperatively in humans to decrease pain, inflammation and recovery time. The same goals can be achieved in our veterinary patients using similar modalities such as; cryotherapy, passive range of motion, massage, transcutaneous electrical stimulation and low-level light laser therapy. When used in the first 48 hours following surgery, the reduction in pain, increased mobility, and decreased inflammation will aid in early return to normal function. Applied appropriately these treatments have both immediate and long term benefits.

Clin Tech Small Anim Pract 2007 Nov 22(4) 166-70

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18198785

Laser phototherapy effect on protein metabolism parameters of rat salivary glands.

Simoes A, Siqueira WL, Lamers ML, Santos MF, Eduardo CD, Nicolau J

Oral Biology Research Center, Faculty of Dentistry, University of Sao Paulo, Av. Prof. Lineu Prestes, 2227, Cidade Universitaria, Sao Paulo, SP, 05508-000, Brazil, lysimoes@usp.br.

The aim of this study was to evaluate the effects of infrared diode laser phototherapy (LP) on tissues of the submandibular gland (SMG) and parotid gland (PG). Wistar rats were randomly divided into experimental (A and B) and control (C) groups. A diode laser, 808 nm wavelength, in continuous wave mode, was applied to the PG, SMG and sublingual gland in the experimental groups on two consecutive days. The doses were 4 J/cm(2) and 8 J/cm(2), and total energy was 7 J and 14 J, respectively. The power output (500 mW) and power density (277 mW/cm(2)) were the same for both experimental groups. In order to visualize the area irradiated by the infrared laser, we used a red pilot beam (650 nm) with 3 mW maximum power for the experimental groups. For the control group, the red pilot beam was the only device used. The SMG and PG were removed after 1 week of the first irradiation. Total protein concentration, amylase, peroxidase, catalase and lactate dehydrogenase assays were performed, as well as histological analysis. Statistical tests revealed significant increase in the total protein concentration for groups A and B in the parotid glands (P < 0.05). Based on the results of this study, LP altered the total protein concentration in rats’ parotid glands.

Lasers Med Sci 2008 Feb 29

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18309457

Initial effects of low-level laser therapy on growth and differentiation of human osteoblast-like cells.

Stein E, Koehn J, Sutter W, Wendtlandt G, Wanschitz F, Thurnher D, Baghestanian M, Turhani D

Department of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Austria.

Low-level laser therapy is a clinically well established tool for enhancement of wound healing. In vitro studies have also shown that low level laser therapy has a biostimulatory effect on cells of different origin. The aim of this in vitro study was to investigate the initial effect of low-level laser therapy on growth and differentiation of human osteoblast-like cells. SaOS-2 cells were irradiated with laser doses of 1 J/cm(2) and 2 J/cm(2) using a diode laser with 670 nm wave length and an output power of 400 mW. Untreated cells were used as controls. At 24 h, 48 h and 72 h post irradiation, cells were collected and assayed for viability of attached cells and alkaline phosphatase specific activity. In addition, mRNA expression levels of osteopontin and collagen type I were assessed using semi-quantitative RT-PCR. Over the observation period, cell viability, alkaline phosphatase activity and the expression of osteopontin and collagen type I mRNA were slightly enhanced in cells irradiated with 1 J/cm(2) compared with untreated control cells. Increasing the laser dose to 2 J/cm(2) reduced cell viability during the first 48 h and resulted in persistently lower alkaline phosphatase activity compared with the other two groups. The expression of osteopontin and collagen type I mRNA slightly decreased with time in untreated controls and cells irradiated with 1 J/cm(2), but their expression was increased by treatment with 2 J/cm(2) after 72 h. These results indicate that low-level laser therapy has a biostimulatory effect on human osteoblast-like cells during the first 72 h after irradiation. Further studies are needed to determine the potential of low-level laser therapy as new treatment concept in bone regeneration.

Wien Klin Wochenschr 2008 Feb 120(3-4) 112-117

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=DetailsSearch&Term=18322773

Effect of the CO2 laser combined with fluoridated products on the inhibition of enamel demineralization.

Steiner-Oliveira C, Rodrigues LK, Lima EB, Nobre-dos-Santos M

Piracicaba School of Dentistry at the State University of Campinas in Piracicaba, SP, Brazil.

AIM: This in vitro study evaluated the combined effects of a 10.6 microm CO2 laser, fluoridated dentifrice, and mouthrinse on the reduction of lesion progression in carious human enamel. METHODS AND MATERIALS: Slabs of previously demineralized dental enamel were assigned to nine groups, either treated with/without a CO2 laser, with/without fluoridated dentifrice, and with/without fluoridated mouthrinse. After a pH-cycling regime, fluoride concentrations were determined in the demin- and remineralizing solutions. A qualitative polarized light analysis was performed on enamel, and enamel mineral loss was determined by cross-sectional microhardness testing. RESULTS: All treatments were able to decrease mineral loss, and the inhibition of demineralization progression ranged from 48% to 60%. CONCLUSION: The 10.6 microm CO2 laser irradiation alone or combined with fluoridated products reduced demineralization progression in enamel. However, there was no significant additional demineralization inhibitory effect with the use of the combined laser-fluoride treatments. CLINICAL SIGNIFICANCE: CO2 lasers have proven to be efficient in reducing subsurface enamel demineralization. Its association with a high frequent fluoride therapy may enhance this protective effect.

J Contemp Dent Pract 2008 9(2) 113-21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18264533

Effects of Low-Level Laser Therapy and Eccentric Exercises in the Treatment of Recreational Athletes With Chronic Achilles Tendinopathy.

Stergioulas A, Stergioula M, Aarskog R, Lopes-Martins RA, Bjordal JM

Peloponnese University, Sparta, Laconia, Greece.

BACKGROUND: Eccentric exercises (EEs) are recommended for the treatment of Achilles tendinopathy, but the clinical effect from EE has a slow onset. HYPOTHESIS: The addition of low-level laser therapy (LLLT) to EE may cause more rapid clinical improvement. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: A total of 52 recreational athletes with chronic Achilles tendinopathy symptoms were randomized to groups receiving either EE + LLLT or EE + placebo LLLT over 8 weeks in a blinded manner. Low-level laser therapy (lambda = 820 nm) was administered in 12 sessions by irradiating 6 points along the Achilles tendon with a power density of 60 mW/cm(2) and a total dose of 5.4 J per session. RESULTS: The results of the intention-to-treat analysis for the primary outcome, pain intensity during physical activity on the 100-mm visual analog scale, were significantly lower in the LLLT group than in the placebo LLLT group, with 53.6 mm versus 71.5 mm (P = .0003) at 4 weeks, 37.3 mm versus 62.8 mm (P = .0002) at 8 weeks, and 33.0 mm versus 53.0 mm (P = .007) at 12 weeks after randomization. Secondary outcomes of morning stiffness, active dorsiflexion, palpation tenderness, and crepitation showed the same pattern in favor of the LLLT group. CONCLUSION: Low-level laser therapy, with the parameters used in this study, accelerates clinical recovery from chronic Achilles tendinopathy when added to an EE regimen. For the LLLT group, the results at 4 weeks were similar to the placebo LLLT group results after 12 weeks.

Am J Sports Med 2008 Feb 13

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18272794

Light therapy and advanced wound care for a neuropathic plantar ulcer on a charcot foot.

Sutterfield R

Christian Hospital NE, St. Louis, Missouri 63136, USA. retta@fidnet.com

Light therapy is a relatively novel modality in wound care. I used a light-emitting diode (LED) and superluminous diode (SLD) to deliver low-intensity laser light as an adjunctive treatment to a patient with a chronic diabetic foot ulcer. Standard treatment of conservative sharp debridement, off-loading, bioburden management, and advanced dressings was delivered in a WOC clinic setting. This combination of therapies resulted in closure of the neuropathic plantar ulcer within 8 weeks.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18199948
Photobiomodulation of the development of early mouse embryos by luminescent irradiation with lambda(max) = 626 nm.

Sviridova-Chailakhyan TA, Paskevich SI, Fahranurova LI, Khramov RN, Manokhin AA, Simonova NB, Chailakhyan LM

Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, pr Nauki, Pushchino, Moscow oblast 142292, Russia.

Dokl Biol Sci 2007 Nov-Dec 417 472-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18274495

Pulsed dye laser for the treatment of hypergranulation tissue with chronic ulcer in postsurgical defects.

Wang SQ, Goldberg LH

Department of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY 07920, USA. wangs@mskcc.org

BACKGROUND AND OBJECTIVE: Hypergranulation tissue may complicate postoperative wounds, causing them to become chronic nonhealing ulcers. There is no reliably effective treatment. We report the use of the 595-nm pulsed-dye laser (PDL) for the treatment of wounds healing by second intention and complicated by hypergranulation tissue after Mohs micrographic surgery. METHODS: In a retrospective case review, 9 patients with slow-healing or nonhealing postoperative wounds with hypergranulation tissue were treated with the 595-nm PDL. The majority of the wounds were located on the scalp, forehead, and temple. RESULTS: All of the patients demonstrated dramatic improvement after one treatment. Most patients achieved complete or near complete re-epithelialization of the ulcers after 1 to 2 treatments. The PDL treatment required no local anesthesia, and there were no postlaser treatment complications reported. CONCLUSIONS: The 595-nm PDL is an effective, safe, and reliable treatment to promote second intention healing in postsurgical wounds complicated by the formation of hypergranulation tissue.

J Drugs Dermatol 2007 Dec 6(12) 1191-4

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18189058

Phototherapy promotes cell migration in the presence of hydroxyurea.

Zungu IL, Mbene AB, Hawkins Evans DH, Houreld NN, Abrahamse H

Laser Research Group, Faculty of Health Sciences, University of Johannesburg, P.O. Box 17011, Doornfontein, Johannesburg, 2028, South Africa, habrahamse@uj.ac.za.

Phototherapy has been shown to cause an increase in cell proliferation and migration. This study focused on viability (trypan blue), proliferation [sodium 3′-(1-(phenylaminocarbonyl)-3,4-tetrazolium)-bis(4-methoxy-6-nitro)-benzen e sulphonic acid hydrate (XTT) and adenosine triphosphate (ATP)] and migration of WS1 cells following irradiation in the presence of hydroxyurea (HU), which is an inhibitor of proliferation. Wounded cells were irradiated on days 1 and 4 with a fluence of 5 J/cm(2) with a helium-neon (He-Ne) laser at 632.8 nm. After a repair time of 24 h, cellular responses were assessed. Wounded irradiated cells without HU showed an increase in cell viability and proliferation, which was confirmed by complete wound closure by day 4. Although wounded irradiated cells treated with 5 mM HU showed incomplete wound closure, these cells showed increased migration compared with that of control cells. This study showed that laser irradiation using an He-Ne laser with a fluence of 5 J/cm(2) stimulates cell viability. The HU results confirmed that laser irradiation promotes cell migration and proliferation.

Lasers Med Sci 2008 Jan 23

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18214574

Here is yet another study demonstrating the effect of LLLT for patents suffering from Oral Mucositis – how much longer can oncologists ignore this procedure ?

IF YOU ARE AN ONCOLOGIST READ THIS

1: Med Oral Patol Oral Cir Bucal. 2008 Mar 1;13(3):E189-92.

The Impact of low power laser in the treatment of conditioning-induced oral mucositis: A report of 11 clinical cases and their review.Antunes HS, Ferreira EM, Matos VA, Pinheiro CT, Ferreira CG.Dr. Héliton Spíndola Antunes, Servişo de Pesquisa Clínica, Instituto Nacional de Cancer (INCA), Rua André Cavalcante, n 37, 2 andar, Rio de Janeiro, Brasil, CEP-20231-050, E-mail: hspindola@inca.gov.br.

We have investigated the clinical effects of low power laser therapy (LPLT) on the treatment of conditioning-induced oral mucositis (OM) in patients submitted to hematopoietic stem cell transplantation (HSCT). The evaluation of OM was done using the Oral Mucositis Assessment Scale (OMAS) and World Health Organization (WHO) scale. In the context of a randomized placebo-controlled trial with 38 patients for the evaluation of preventive LPLT, eleven individuals were submitted to allogeneic (AL) HSCT and developed oral mucositis grade 4 (WHO) or a total area of OM of 12 cm (OMAS) and due to that were treated with LPLT with the purpose of symptom relief. The irradiation used was a diode InGaAlP, emitting light at 660 nm, 50 mW and 8 J/cm(2) measured at the end of fiber optic with 0.196cm(2) of section area during the treatment. The tip of the laser device touched the oral mucosa and patients recovered on average 6 days (3-12 days) from the beginning of the laser application. Our results have indicated that the use of LPLT in HSCT patients is a powerful instrument in the treatment of overt OM and is now a standard procedure in this group of patients in our hospital.

PMID: 18305441 [PubMed – in process]

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2: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Feb;105(2):180-6, 186.e1.

Efficacy of He-Ne Laser in the prevention and treatment of radiotherapy-induced oral mucositis in oral cancer patients.Arora H, Pai KM, Maiya A, Vidyasagar MS, Rajeev A.Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Karnatka, India. drarora@gmail.com

OBJECTIVE: The objective of this study was to evaluate the efficacy of low-level lasers for the prevention and treatment of radiotherapy-induced oral mucositis in oral cancer patients. MATERIAL AND METHODS: Twenty-four hospitalized patients with oral cancer, scheduled to undergo radiotherapy at KMC, Manipal, were enrolled in the present study and assigned to laser (Group I)/control group (Group II). They were treated using He-Ne laser (lambda = 632.8nm, output = 10 mW and energy density = 1.8 J/cm(2)). Patients were subjected to treatment using laser scanner for 8 days and subsequently were treated using laser probe at 6 anatomic sites in the oral cavity for 5 minutes each. The patients were evaluated on each day of treatment for pain severity (NRS), functional impairment (FIS), and oral mucositis (RTOG) and were followed until the end of cancer treatment. Statistical analysis was done using SPSS version 10. RESULTS: Laser therapy applied prophylactically during radiotherapy can reduce the severity of oral mucositis, severity of pain, and functional impairment.

PMID: 18230388 [PubMed – indexed for MEDLINE]

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3: Oral Dis. 2007 Nov;13(6):538-43.

Low-energy laser therapy for prevention of oral mucositis in hematopoietic stem cell transplantation.

Jaguar GC, Prado JD, Nishimoto IN, Pinheiro MC, de Castro DO Jr, da Cruz Perez DE, Alves FA.

Department of Stomatology, Cancer Hospital A.C. Camargo, São Paulo, Brazil.

AIM: To evaluate the clinical effects of laser therapy on the prevention and reduction of oral mucositis in patients who underwent hematopoietic stem cell transplantation (HSCT). PATIENTS AND METHODS: From January 2003 to September 2004, 24 patients received prophylactic laser therapy (L+ group). The applications started from the beginning of the conditioning regimen up to day +2. The oral assessment was performed daily until day +30. This group was compared with historical controls, namely 25 patients, who did not receive laser therapy (L- group). RESULTS: All patients developed some grade of mucositis. However, the L- group presented initial mucositis by 4.36 days, whereas the L+ group presented it in 6.12 days (P = 0.01). The maximum mucositis occurred between day +2 and day +6 with healing by day +25 in the L- group and between day +2 and day +7 with healing by day +14 for the L+ group (P = 0.84). Laser therapy also reduced the time of oral pain from 5.64 to 2.45 days (P = 0.04), and decreased the consumption of morphine (P = 0.07). CONCLUSION: This study suggests that laser therapy can be useful in oral mucositis to HSCT patients and improve the patient’s quality of life. However, controlled randomized trials should be performed to confirm the real efficacy of laser therapy.

PMID: 17944669 [PubMed – indexed for MEDLINE]

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4: Support Care Cancer. 2007 Oct;15(10):1145-54. Epub 2007 Mar 29.

A phase III randomized double-blind placebo-controlled clinical trial to determine the efficacy of low level laser therapy for the prevention of oral mucositis in patients undergoing hematopoietic cell transplantation.Schubert MM, Eduardo FP, Guthrie KA, Franquin JC, Bensadoun RJ, Migliorati CA, Lloid CM, Eduardo CP, Walter NF, Marques MM, Hamdi M.Department of Oral Medicine, Seattle Cancer Care Alliance, University of Washington, 825 Eastlake Ave E, Seattle, WA 98109, USA. mschuber@seattlecca.org

INTRODUCTION: Oral mucositis (OM) is a significant early complication of hematopoietic cell transplantation (HCT). This phase III randomized double-blind placebo-controlled study was designed to compare the ability of 2 different low level GaAlAs diode lasers (650 nm and 780 nm) to prevent oral mucositis in HCT patients conditioned with chemotherapy or chemoradiotherapy. MATERIALS AND METHODS: Seventy patients were enrolled and randomized into 1 of 3 treatment groups: 650 nm laser, 780 nm laser or placebo. All active laser treatment patients received daily direct laser treatment to the lower labial mucosa, right and left buccal mucosa, lateral and ventral surfaces of the tongue, and floor of mouth with energy densities of 2 J/cm2. Study treatment began on the first day of conditioning and continued through day +2 post HCT. Mucositis and oral pain was measured on days 0, 4, 7, 11, 14, 18, and 21 post HCT. RESULTS: The 650 nm wavelength reduced the severity of oral mucositis and pain scores. Low level laser therapy was well-tolerated and no adverse events were noted. DISCUSSION: While these results are encouraging, further study is needed to truly establish the efficacy of this mucositis prevention strategy. Future research needs to determine the effects of modification of laser parameters (e.g., wavelength, fluence, repetition rate of energy delivery, etc.) on the effectiveness of LLE laser to prevent OM.

PMID: 17393191 [PubMed – indexed for MEDLINE]

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5: Oral Health Prev Dent. 2007;5(1):63-71.

Macroscopic and microscopic effects of GaAIAs diode laser and dexamethasone therapies on oral mucositis induced by fluorouracil in rats.Lara RN, da Guerra EN, de Melo NS.Oral Medicine, Department of Dentistry, School of Health Science, University of Brasília, Brasília, Brazil. nemetala@unb.br

PURPOSE: To present an animal model for mucositis induced by fluorouracil in rats, and test two therapeutic options, the GaAIAs laser and topical dexamethasone, analysing them with regard to the quality and quantity of tissue alterations and comparing them with the phases of mucositis. MATERIALS AND METHODS: Forty-five Wistar rats (250 g) were treated with fluorouracil (60 mg/kg) and, in order to mimic the clinical effect of chronic irritation, the palatal mucosa was irritated by superficial scratching with an 18-gauge needle. When all of the rats presented oral ulcers of mucositis, they were randomly allocated to one of three groups: group I was treated with laser (GaAIAs), group II was treated with topical dexamethasone, and group III was not treated. Excisional biopsies of the palatal mucosa were then performed, and the rats were killed. Tissue sections were stained with haematoxylin and eosin for morphological analyses, and with toluidine blue for mast-cell counts. RESULTS: Group I specimens showed higher prevalence of ulcers, bacterial biofilm, necrosis and vascularisation, while group II specimens showed higher prevalance of granulation tissue formation. There were no significant statistical differences in the numbers of mast cells and epithelial thickness between groups. CONCLUSION: For the present model of mucositis, rats with palatal mucositis treated with laser (GaAIAs) showed characteristics compatible with the ulcerative phase of oral mucositis, and rats treated with topical dexamethasone showed characteristics compatible with the healing phase of mucositis. Topical dexamethasone was more efficient in the treatment of rats’ oral mucositis than the laser.

PMID: 17366763 [PubMed – indexed for MEDLINE]

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6: Indian J Med Res. 2006 Oct;124(4):399-402.

Effect of low level helium-neon (He-Ne) laser therapy in the prevention & treatment of radiation induced mucositis in head & neck cancer patients.Arun Maiya G, Sagar MS, Fernandes D.Departments of Physiotherapy , Manipal College of Allied Health Sciences, Kasturba Medical College, MAHE University, Manipal, India. ajmaiya@yahoo.com

BACKGROUND & OBJECTIVES: Oral mucositis is a common debilitating complication of radiotherapy occurring in about 60 per cent of cancer patients. Considerable buccal toxicity of radiotherapy or chemotherapy in cancer patients to become discouraged and can affect their quality of life. In addition, such toxicity can alter the treatment plan. At present, there is no clinically appropriate prophylaxis efficacious antidote for mucositis. The low level laser (LEL) appears to be a simple, non-traumatic technique for the prevention and treatment of radiation induced mucositis. Therefore the present study was carried out to find out the effect of low-level helium-neon (He-Ne) laser in the prevention and treatment of radiation induced mucositis in head and neck cancer patients. METHODS: The patients with carcinoma of oral cavity with stages II-IV a being uniformly treated with curative total tumour dose of 66 Gy in 33 fractions over 6 wk were selected for the study. The patients were divided based on computer generated randamosization into laser (study group) and control groups with 25 patients in each group. Both study and control groups were comparable in terms of site of the lesion, stage of the cancer and histology. The study group patients were treated with He-Ne laser (wavelength 632.8 nm and output of 10mW) and control group patients were given oral analgesics, local application of anaesthetics, 0.9 per cent saline and povidine wash during the course of radiotherapy. RESULTS: All patients tolerated the laser treatment without any adverse effect or reactions. The result showed a significant difference in pain and mucositis (P<0.001) between the two groups. At the end of radiotherapy (after 6 wk) mean pain sure and mucositis grade were significantly lower (P<0.001) in the study group compared to control. INTERPRETATION & CONCLUSION: The low-level He-Ne laser therapy during the radiotherapy treatment was found to be effective in preventing and treating the mucositis in head and neck cancer patients. Further studies need to be done on a larger sample to find the mechanism.

PMID: 17159259 [PubMed – indexed for MEDLINE]

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8: Blood. 2007 Mar 1;109(5):2250-5. Epub 2006 Oct 19.

Low-power laser in the prevention of induced oral mucositis in bone marrow transplantation patients: a randomized trial.Antunes HS, de Azevedo AM, da Silva Bouzas LF, Adão CA, Pinheiro CT, Mayhe R, Pinheiro LH, Azevedo R, D’Aiuto de Matos V, Rodrigues PC, Small IA, Zangaro RA, Ferreira CG.Section of Dentistry, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil. hspindola@inca.gov.br

We investigated the clinical effects of low-power laser therapy (LPLT) on prevention and reduction of severity of conditioning-induced oral mucositis (OM) for hematopoietic stem cell transplantation (HSCT). We randomized 38 patients who underwent autologous (AT) or allogeneic (AL) HSCT. A diode InGaAlP was used, emitting light at 660 nm, 50 mW, and 4 J/cm2, measured at the fiberoptic end with 0.196 cm2 of section area. The evaluation of OM was done using the Oral Mucositis Assessment Scale (OMAS) and the World Health Organization (WHO) scale. In the LPLT group, 94.7% of patients had an OM grade (WHO) lower than or equal to grade 2, including 63.2% with grade 0 and 1, whereas in the controls group, 31.5% of patients had an OM grade lower than or equal to grade 2 (P < .001). Remarkably, the hazard ratio (HR) for grades 2, 3, and 4 OM was 0.41 (range, 0.22-0.75; P = .002) and for grades 3 and 4 it was 0.07 (range, 0.11-0.53; P < .001). Using OMAS by the calculation of ulcerous area, 5.3% of the laser group presented with ulcers of 9.1 cm2 to 18 cm2, whereas 73.6% of the control group presented with ulcers from 9.1 cm2 to 18 cm2 (P = .003). Our results indicate that the use of upfront LPLT in patients who have undergone HSCT is a powerful instrument in reducing the incidence of OM and is now standard in our center.

Publication Types:

• Randomized Controlled Trial

PMID: 17053058 [PubMed – indexed for MEDLINE]

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9: Pediatr Blood Cancer. 2007 Apr;48(4):435-40.

Influence of low-energy laser in the prevention of oral mucositis in children with cancer receiving chemotherapy.Cruz LB, Ribeiro AS, Rech A, Rosa LG, Castro CG Jr, Brunetto AL.Pediatric Oncology Unit, Federal University of Rio Grande do Sul, Porto Alegre, Brazil. lcruz@hcpa.ufrgs.br

BACKGROUND: This study assessed the use of low-energy laser in the prevention or reduction of the severity of oral mucositis. PROCEDURE: A randomized clinical trial was carried out. Patients from 3 to 18 years of age treated with chemotherapy or hematopoietic stem-cell transplantation between May, 2003 and February, 2005 were eligible. The intervention group received laser application for 5 days following the start of chemotherapy. The grade of oral mucositis was assessed by the WHO per NCI-CTC common toxicity criteria and the assessments were made on days 1, 8 and 15 by a trained examiner blind to the intervention. RESULTS: Sixty patients were evaluable for analysis; thirty-nine (65%) were males, 35 (58%) patients had a diagnosis of leukemia or lymphoma, and 25 (42%) had solid tumors. The mean age was 8.7 +/- 4.3 years. Twenty-nine patients were randomized in the laser group and 31 in the control group. On day 1, no patients presented with mucositis. On day 8, of 20 patients (36%) who developed mucositis, 13 of them were from the laser group and 7 from the control group. On day 15, of 24 patients (41%) who developed mucositis, 13 of them were from the laser group and 11 from the control group. There was no significant difference between groups concerning the grades of mucositis on day 8 (P = 0.234) or on day 15 (P = 0.208). CONCLUSIONS: This study showed no evidence of benefit from the prophylactic use of low-energy laser in children and adolescents with cancer treated with chemotherapy when optimal dental and oral care was provided.

PMID: 16862549 [PubMed – indexed for MEDLINE]

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10: Pharmacotherapy. 2005 Apr;25(4):540-54.

Chemotherapy- and radiotherapy-induced oral mucositis: review of preventive strategies and treatment.Saadeh CE.Department of Pharmacy Practice, College of Pharmacy, Ferris State University, Big Rapids, Michigan, USA. saadehc@ferris.edu

Oral mucositis is a frequently encountered and potentially severe complication associated with administration of chemotherapy and radiotherapy. Although many pharmacologic interventions have been used for the prevention and treatment of oral mucositis, there is not one universally accepted strategy for its management. Most preventive and treatment strategies are based on limited, often anecdotal, clinical data. Basic oral hygiene and comprehensive patient education are important components of care for any patient with cancer at risk for development of oral mucositis. Nonpharmacologic approaches for the prevention of oral mucositis include oral cryotherapy for patients receiving chemotherapy with bolus 5-fluorouracil, and low-level laser therapy for patients undergoing hematopoietic stem cell transplantation. Chlorhexidine, amifostine, hematologic growth factors, pentoxifylline, glutamine, and several other agents have all been investigated for prevention of oral mucositis. Results have been conflicting, inconclusive, or of limited benefit. Treatment of established mucositis remains a challenge and focuses on a palliative management approach. Topical anesthetics, mixtures (also called cocktails), and mucosal coating agents have been used despite the lack of experimental evidence supporting their efficacy. Investigational agents are targeting the specific mechanisms of mucosal injury; among the most promising of these is recombinant human keratinocyte growth factor.

PMID: 15977916 [PubMed – indexed for MEDLINE]

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11: Photomed Laser Surg. 2005 Jun;23(3):328-32.

Effect of low-level laser therapy on Candida albicans growth in patients with denture stomatitis.

Maver-Biscanin M, Mravak-Stipetic M, Jerolimov V.

Department of Prosthodontics, Clinical Hospital Centre, Zagreb, Croatia. mirela.maver@zg.htnet.hr

OBJECTIVE: The purpose of our report is to present the effect of low-level laser therapy on Candida albicans growth and palatal inflammation in two patients with denture stomatitis. BACKGROUND DATA: The most common oral mucosal disorder in denture wearers is denture stomatitis, a condition that is usually associated with the presence of the yeast Candida albicans. Different treatment methods have been suggested to treat this symptom, none of which is proven to be absolutely effective. METHODS: Two denture-wearing patients, both with palatal inflammation diagnosed as Newton type II denture stomatitis were treated with low-power semiconductor diode laser (BTL-2000, Prague, Czech Republic) at different wavelengths (685 and 830 nm) for 5 d consecutively. In both patients, palatal mucosa and acrylic denture base were irradiated in noncontact mode (probe distance of 0.5 cm from irradiated area) with different exposure times-5 min (830 nm, 3.0 J/cm2, 60 mW) and 10 min (685 nm, 3.0 J/cm2, 30 mW). The effect of laser light on fungal growth in vivo was evaluated after the final treatment using the swab method and semiquantitative estimation of Candida albicans colonies growth on agar plates. The severity of inflammation was evaluated using clinical criteria. RESULTS: After lowlevel laser treatment, the reduction of yeast colonies on the agar plates was observed and palatal inflammation was diminished. CONCLUSION: LLLT is effective in the treatment of denture stomatitis. Further placebo controlled studies are in progress.

PMID: 15954824 [PubMed – indexed for MEDLINE]

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12: Curr Opin Oncol. 2005 May;17(3):236-40.

Low-level laser for prevention and therapy of oral mucositis induced by chemotherapy or radiotherapy.Genot MT, Klastersky J.Laboratoire d’Investigation Clinique H.J. Tagnon, Institut Jules Bordet, Centre des Tumeurs, Université Libre de Bruxelles, Bruxelles, Belgium.

PURPOSE OF REVIEW: Oral mucositis is a common morbid condition associated with chemotherapy or radiotherapy for which there is no standard prophylaxis or treatment. There is increasing evidence that the use of low-level laser can reduced the severity of mucositis associated with chemotherapy or radiation therapy. The purpose of this review is to examine the available evidence for it. RECENT FINDINGS: For most approaches commonly used to prevent or treat chemotherapy-associated or radiotherapy-associated oral mucositis, a recent panel of experts could not find sufficient levels of evidence to recommend or suggest their use. As for low-level laser therapy, the results are difficult to assess and compare because of interoperator variability and because clinical trials are difficult to conduct in that field. Nevertheless, there is accumulating evidence in support of low-level laser therapy. SUMMARY: On the basis of literature data, it is reasonable to conclude that the evidence that low-level laser therapy may be useful in decreasing the severity of chemotherapy-associated or radiotherapy-associated mucositis is substantial, even though there have been few controlled studies in the field of prevention.

Publication Types:

• Review

PMID: 15818167 [PubMed – indexed for MEDLINE]

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14: Int Nurs Rev. 2005 Mar;52(1):68-72.

Patients with moderate chemotherapy-induced mucositis: pain therapy using low intensity lasers.Nes AG, Posso MB.Buskerud University, Drammen, Norway. s-oddmun@online.no

BACKGROUND: Intensive cancer therapy normally affects malignant and normal cells with high replication rates. Cells in the gastrointestinal tract are therefore commonly affected by cytotoxins. This often results in the development of chemotherapy-induced oral mucositis (COM). COM is the inflammatory response of the oral mucous membrane to the chemotherapy drugs. Low level laser therapy (LLLT) has proved to be effective in treating and repairing biologically damaged tissue and to reduce pain. LLLT has also proven to be an efficient method for the prevention of oral mucositis. OBJECTIVE: To investigate the effect of LLLT on pain relief among patients who have developed COM. METHOD: The study was performed as a clinical test with a sample consisting of 13 adult patients receiving oncology treatment. The patients were treated during a 5-day period, and the pain was measured before and after each laser application. The laser used was an AsGaAl, with a wavelength of 830 nm and a potency of 250 mW. The energy given was 35 J cm(-2). ANALYSIS: The results were analysed using the Wilcoxon test. RESULTS: There was a significant (P = 0.007) 67% decrease in the daily average experience of pain felt before and after each treatment, confirming that LLLT can relieve pain among patients who have developed COM. STUDY LIMITATIONS: The low number of COM patients at the hospital did not allow a control group to be included in the study, and therefore the results contain a potential placebo effect. IMPLICATIONS FOR NURSING CARE: The most important benefit the authors consider to be the value for the patients of better and quicker treatment with a drastic reduction in painful mucositis.

Publication Types:

• Clinical Trial

PMID: 15725279 [PubMed – indexed for MEDLINE]

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15: Lasers Surg Med. 2004;35(4):259-62.

Fungicidal effect of diode laser irradiation in patients with denture stomatitis.Maver-Biscanin M, Mravak-Stipetic M, Jerolimov V, Biscanin A.Department of Prosthodontics, Clinical Hospital Centre Zagreb, Dobojska 38-D, 10000 Zagreb, Croatia. mirela.maver@zg.htnet.hr

BACKGROUND AND OBJECTIVE: Denture stomatitis (DS) is a common inflammatory condition that affects denture wearers. The aim of this study was to examine, in vivo, the effect of diode laser irradiation on fungal growth in both the palatal mucosa and in denture base materials, in denture wearing patients. STUDY DESIGN/MATERIALS AND METHODS: In total, 70 patients with clinical study design evidence of DS participated in this parallel, single blind, and placebo controlled study. The subjects were randomly assigned to one of four different treatment regimens: (1) irradiation with a 685 nm wavelength laser for 10 minutes (30 mW); (2) irradiation with a 830 nm wavelength laser for 5 minutes (60 mW). A semiconductor diode laser, BTL-2000 (BTL-2 Dravotnicka Technika, Prague, Czech Republic), was used in both treatment cases using an energy density of 3.0 J/cm(2) and a continuous working mode for five consecutive days; (3) placebo-sham irradiation of patients; (4) antimicotic-self treatment of patient’s palatal mucosa with an antifungal oral gel and the use of an antiseptic solution for their dentures. The effect of laser light on fungal growth in vivo was evaluated after final treatment using the swab method and a semi-quantitative estimation of Candida albicans colonies cultivated on agar plates. RESULTS: A fungicidal effect was achieved in the laser treated and antimicotic treated groups, whereas most subjects in the placebo group were found to have unchanged conditions on both their palate (P = 0,004) and dentures (P < 0,001). CONCLUSIONS: Light from a low-power laser (LLLT) may be valuable in the treatment of DS. This is of great importance since the rate of recurrence of disease is high, whereas an optimal treatment modality has not yet been found. (c) 2004 Wiley-Liss, Inc.

PMID: 15493034 [PubMed – indexed for MEDLINE]

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16: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004 Mar;97(3):332-4.

CO2-laser treatment of ulcerative lesions.Sharon-Buller A, Sela M.Department of Maxillofacial Prosthetics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

This article reports the successful use in our clinic of CO(2)-laser to reduce severe pain in the treatment of oral aphthosis. The patients, presenting stress-related, chemoradiotherapy-induced, and immuno-related oral aphthosis, reported immediate pain relief and rapid recovery. Treatment technique and laser parameters are described.

PMID: 15024356 [PubMed – indexed for MEDLINE]

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17: Eur J Haematol. 2004 Mar;72(3):222-4.

Successful treatment of oral lesions of chronic lichenoid graft-vs.-host disease by the addition of low-level laser therapy to systemic immunosuppression.Chor A, de Azevedo AM, Maiolino A, Nucci M.University Hospital, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.

We report a case of severe oral stomatitis caused by lichenoid chronic graft-vs.-host disease in which low-level laser therapy applied to the oral mucosa, in addition to standard systemic immunosuppressive treatment, resulted in quick healing and symptomatic relief.

PMID: 14962242 [PubMed – indexed for MEDLINE]

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18: J Clin Laser Med Surg. 2003 Dec;21(6):363-7.

Usefulness of low-level laser for control of painful stomatitis in patients with hand-foot-and-mouth disease.Toida M, Watanabe F, Goto K, Shibata T.Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu, Japan. toida@cc.gifu-u.ac.jp

OBJECTIVE: The aim of this study was to evaluate the usefulness of low-level laser therapy (LLLT) for the control of painful stomatitis in patients with hand-foot-and-mouth disease (HFMD). BACKGROUND DATA: LLLT has been successfully applied to various painful oral mucosal diseases, although there have been few reports on LLLT for HFMD patients. MATERIALS AND METHODS: Through a randomized double-blind placebo controlled trial, the painful period of HFMD stomatitis was compared between the LLLT group (n=11) and the placebo LLLT one (n=9), which had similar clinical backgrounds. The LLLT parameters supplied were as follows: wavelength of 830 nm, power of 30 mW, frequency of 30 Hz, and energy output of 1.1 J/cm2. Acceptability and safety of the treatment were also evaluated. RESULTS: The painful period was shorter in the LLLT group (4.0 +/- 1.3 days) than in the placebo LLLT one (6.7 +/- 1.6 days) with a statistically significant difference (p<0.005). The treatment was judged acceptable for 90.0% (18 of 20) of patients. No adverse events were observed in any cases. CONCLUSION: LLLT is a useful method to control HFMD stomatitis by shortening the painful period, with its high acceptability and lack of adverse events.

Publication Types:

• Clinical Trial
• Randomized Controlled Trial

PMID: 14709221 [PubMed – indexed for MEDLINE]

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19: Cancer J. 2002 May-Jun;8(3):247-54.

Comment in:

• Cancer J. 2002 May-Jun;8(3):236-8.

Pilot study of laser effects on oral mucositis in patients receiving chemotherapy.

Wong SF, Wilder-Smith P.

Western University of Health Sciences, College of Pharmacy, Division of Hematology/Oncology, Pomona, California 91766, USA.

PURPOSE: The purpose of this study was to examine the effectiveness of laser therapy in the prevention and/or healing of chemotherapy-induced oral mucositis lesions. This study also evaluated the ease and feasibility of the laser therapy and the impact of the treatment on improving the patient’s quality of life. PATIENTS AND METHODS: Fifteen patients with an episode of prior chemotherapy-induced grade 3 or 4 mucositis with 5-fluorouracil continuous infusion consented to participate in this study. All patients were provided with standardized mouth care instructions at the initiation of chemotherapy treatments. Enrolled patients received laser therapy treatments 24 hours before the chemotherapy and then recommenced weekly with evenly distributed exposure to the standardized designated areas by one operator during the entire cycle of chemotherapy at the same doses until the mucositis resolved or the chemotherapy cycle was completed. lntraoral perfusion was measured by laser Doppler technology. Patients were assessed for response to laser therapy according to standardized mucositis grading criteria by evaluating development of lesions, extent and duration of lesions, and time to healing. The effect of laser therapy on ability to continue planned chemotherapy, the reduction in dose, delays, and ability to maintain planned dose intensity were assessed. The impact of laser therapy on pain control was evaluated using the visual analogue score. A quality-of-life survey was completed by each patient at the initiation of chemotherapy and then weekly throughout the chemotherapy. RESULTS: Eleven of 15 patients experienced grade 0 mucositis, three patients experienced grade 1 to 2 mucositis, and one patient experienced grade 3 to 4 mucositis. Fourteen patients completed the lasertherapy as planned, and none of the patients withdrew from the laser therapy treatments because of noncompliance. One patient continued to experience grade 4 mucositis that necessitated an interruption in the planned chemotherapy regimen and, consequently, the laser treatment. Patients tolerated the laser therapy very well and did not report any increased discomfort. No significant changes in perfusion were observed as a result of laser therapy. DISCUSSION: In this pilot study, laser therapy significantly reduced the incidence and the severity of mucositis in chemotherapy patients. The laser therapy does not appear to promote wound healing by affecting the intraoral perfusion, as assessed by Doppler measurements. The mechanisms involved in the mediating of the observed effects remain unknown at this time. Continued research is warranted to determine the optimal laser wavelength and parameters.

PMID: 12074324 [PubMed – indexed for MEDLINE]

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20: Cancer J. 2002 May-Jun;8(3):236-8.

Comment on:

• Cancer J. 2002 May-Jun;8(3):247-54.

Low level laser therapy: a real hope in the management of chemo-induced and radiation-induced mucositis?

Bensadoun RJ.

Department of Radiation Oncology, Centre Antoine-Lacassagne, Nice, France.

Publication Types:

• Comment

PMID: 12074321 [PubMed – indexed for MEDLINE]

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