THOR Literature watch for June 2013 Low Level Laser Therapy / Cold Laser / Photobiomodulation PBM

Does LLLT make you thinner? a Harvard research group investigates, LEDs for muscle function in patients with chronic obstructive pulmonary disease and laser vs needles for myofascial trigger points. There is  my own introductory paper on LLLT for dentists, another review of laser and LED treatments for neurological and psychological applications, a TMJ study, and a trial of class IV laser for epicondylitis (see my rant  “LLLT companies may be no better than Big Pharma“).

Low-Level Laser Therapy for Fat Layer Reduction: A Comprehensive Review.

Avci P, Nyame TT, Gupta GK, Sadasivam M, Hamblin MR

Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, 02114; Department of Dermatology, Harvard Medical School, Boston, Massachusetts, 02114; Department of Dermatology, Dermatooncology and Venerology, Semmelweis University School of Medicine, Budapest, 1085, Hungary.

BACKGROUND AND OBJECTIVE: Low-level laser (light) therapy (LLLT) is a noninvasive, nonthermal approach to disorders requiring reduction of pain and inflammation and stimulation of healing and tissue regeneration. Within the last decade, LLLT started being investigated as an adjuvant to liposuction, for noninvasive body contouring, reduction of cellulite, and improvement of blood lipid profile. LLLT may also aid autologous fat transfer procedures by enhancing the viability of adipocytes. However the underlying mechanism of actions for such effects still seems to be unclear. It is important, therefore, to understand the potential efficacy and proposed mechanism of actions of this new procedure for fat reduction. MATERIALS AND METHODS: A review of the literature associated with applications of LLLT related to fat layer reduction was performed to evaluate the findings from pre-clinical and clinical studies with respect to the mechanism of action, efficacy, and safety. RESULTS: The studies as of today suggest that LLLT has a potential to be used in fat and cellulite reduction as well as in improvement of blood lipid profile without any significant side effects. One of the main proposed mechanism of actions is based upon production of transient pores in adipocytes, allowing lipids to leak out. Another is through activation of the complement cascade which could cause induction of adipocyte apoptosis and subsequent release of lipids. CONCLUSION: Although the present studies have demonstrated safety and efficacy of LLLT in fat layer reduction, studies demonstrating the efficacy of LLLT as a stand-alone procedure are still inadequate. Moreover, further studies are necessary to identify the mechanism of action. Lasers Surg. Med. 9999:XX-XX, 2013. (c) 2013 Wiley Periodicals, Inc.

Lasers Surg Med 2013 Jun 7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23749426

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Acute effects of light emitting diodes therapy (LEDT) in muscle function during isometric exercise in patients with chronic obstructive pulmonary disease: preliminary results of a randomized controlled trial.

Miranda EF, Leal-Junior EC, Marchetti PH, Dal Corso S

Post-Graduate Program in Rehabilitation Sciences, Universidade Nove de Julho, Av. Francisco Matarazzo, 612-1 masculine Andar, 05001-100, Bairro Agua Branca, SP, Brazil.

Patients with chronic obstructive pulmonary disease (COPD) are susceptible to early muscle fatigue. Light-emitting diodes therapy (LEDT) has been used to minimize muscle fatigue in athletes and healthy subjects. The aim of this study is to investigate the acute effects of LEDT on muscle fatigue and perception of effort in patients with COPD during isometric endurance test of the quadriceps femoris (QF). Ten patients (VEF1 50 +/- 13 % of predicted) underwent a single LEDT and sham application, 48 h apart, in a randomized crossover design. The LEDT and sham were applied in three localized areas of the QF (rectus femoris, vastus lateralis, and vastus medialis). Before and after exposure to LEDT and sham, the patients performed an isometric endurance test (60 % of the maximum voluntary isometric contraction), until the limit of tolerance concomitant to surface electromyography recording (median frequency as mean outcome). The slope obtained from linear regression analysis of the median frequency (MF) over endurance time was also used as an endurance index. Endurance time increased significantly after exposure to LEDT (from 26 +/- 2 to 53 +/- 5 s) as compared to sham (from 23 +/- 3 to 30 +/- 4 s) (F = 64, P = 0.0001). A greater decline in MF was observed during isometric endurance test after sham, compared to LEDT (F = 14.6, P = 0.004). The slope of the MF over time was lower post-LEDT compared to post-sham (-0.7 +/- 0.3 vs. -1.5 +/- 0.8; P = 0.004). The dyspnea score corrected for endurance time was lower post-LEDT (P = 0.008) but similar for fatigue both post-LEDT and post-sham. A single application of LEDT minimizes muscle fatigue and increases isometric endurance time.

Lasers Med Sci 2013 Jun 7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23743817

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Laser therapy and needling in myofascial trigger point deactivation.

Uemoto L, Antonio C Garcia M, Vinicius D Gouvea C, V Vilella O, A Alfaya T

Dentistry Graduation Program, Federal Fluminense University.

The aim of this study was to evaluate different approaches to deactivating myofascial trigger points (MTPs). Twenty-one women with bilateral MTPs in the masseter muscle were randomly divided into three groups: laser therapy, needle treatment and control. Treatment effectiveness was evaluated after four sessions with intervals ranging between 48 and 72 h. Quantitative and qualitative methods were used to measure pain perception/sensation. The Wilcoxon test based on results expressed on a visual analog scale (VAS) demonstrated a significant (P < 0.05) decrease in pain only in the laser and needle treatments groups, although a significant increase in the pressure pain threshold was evident only for needling with anesthetic injection (P = 0.0469), and laser therapy at a dose of 4 J/cm(2) (P = 0.0156). Based on these results, it was concluded that four sessions of needling with 2% lidocaine injection with intervals between 48 and 72 h without a vasoconstrictor, or laser therapy at a dose of 4 J/cm(2), are effective for deactivation of MTPs. (J Oral Sci 55, 175-181, 2013).

J Oral Sci 2013 55(2) 175-81

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23748458

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Introduction to Low-Level Laser / Light Therapy (LLLT) for Dentists

Carroll JD

THOR Photomedicine Ltd

Low Level Light / Laser Therapy (LLLT) is the application of light (usually a low-power laser or light-emitting diode [LED]) to promote tissue repair, reduce inflammation, or induce analgesia. LLLT has been the subject of several systematic reviews for a range of musculoskeletal pathologies with favorable conclusions reported by The Lancet,1 Clinical Evidence,2 International Association for the Study of Pain,3 and the World Health Organization.4 Unlike other many laser treatments, LLLT is not an ablating- or heating-based therapy, it is more akin to photosynthesis. Dental applications for LLLT are not so well documented as are musculoskeletal applications, but are rapidly catching up. There is a great deal of encouraging data reported for a wide range of endodontic, maxillofacial, oral pathology, oral surgery, orthodontic, pediatric, periodontic, prosthodontic, postoperative, chronic pain, and nonhealing bone or soft tissue applications in the oral cavity and maxillofacial region. The laser or LED devices are typically in the 600 to 1,000 nm spectrum (red and near-infrared), in the power density range of 5 mW/cm2 to 5 W/cm2 produced by devices with as little power as 1 mW and as much as 10 Watts. Pulsed or continuous beams are used. Treatment time is typically in the range of 30 to 60 seconds per point. As little as one point may be treated but a dozen or more points may be treated at a time. For acute and postoperative pathologies as little as one treatment is all that is necessary, but for chronic pain and degenerative conditions as many as 10 sessions may be necessary. While other wavelengths have similar effects, they do not penetrate into tissue nearly as well as the red and near-infrared range.5 The following is a brief overview of how LLLT works, the clinical benefits, and treatment parameters.

J Laser Dent 2013;21(1):10-20

http://www.jdentlasers.org

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Neurological and psychological applications of transcranial lasers and LEDs.

Rojas JC, Gonzalez-Lima F

Departments of Psychology, Pharmacology and Toxicology, University of Texas at Austin, Austin, Texas 78712, USA; Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas 75235, USA.

Transcranial brain stimulation with low-level light/laser therapy (LLLT) is the use of directional low-power and high-fluency monochromatic or quasimonochromatic light from lasers or LEDs in the red-to-near-infrared wavelengths to modulate a neurobiological function or induce a neurotherapeutic effect in a nondestructive and non-thermal manner. The mechanism of action of LLLT is based on photon energy absorption by cytochrome oxidase, the terminal enzyme in the mitochondrial respiratory chain. Cytochrome oxidase has a key role in neuronal physiology, as it serves as an interface between oxidative energy metabolism and cell survival signaling pathways. Cytochrome oxidase is an ideal target for cognitive enhancement, as its expression reflects the changes in metabolic capacity underlying higher-order brain functions. This review provides an update on new findings on the neurotherapeutic applications of LLLT. The photochemical mechanisms supporting its cognitive-enhancing and brain-stimulatory effects in animal models and humans are discussed. LLLT is a potential non-invasive treatment for cognitive impairment and other deficits associated with chronic neurological conditions, such as large vessel and lacunar hypoperfusion or neurodegeneration. Brain photobiomodulation with LLLT is paralleled by pharmacological effects of low-dose USP methylene blue, a non-photic electron donor with the ability to stimulate cytochrome oxidase activity, redox and free radical processes. Both interventions provide neuroprotection and cognitive enhancement by facilitating mitochondrial respiration, with hormetic dose-response effects and brain region activational specificity. This evidence supports enhancement of mitochondrial respiratory function as a generalizable therapeutic principle relevant to highly adaptable systems that are exquisitely sensitive to energy availability such as the nervous system.

Biochem Pharmacol 2013 Jun 24

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23806754

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Does low intensity laser therapy reduce pain and change orofacial myofunctional conditions?

Melchior Mde O, Venezian GC, Machado BC, Borges RF, Mazzetto MO

Dental School of Ribeirao Preto, University of Sao Paulo, Brazil. me_melchior@yahoo.com.br

Due to its multifactorial pain aspects, combined therapies are required for the the comprehensive management of temporomandibular joint disorders (TMD). Interdisciplinary forms of therapies, such as laser therapy, and health care or medical professionals, such as speech therapists, have been proposed for this comprehensive management. The aims of this study were the following: 1. verify whether low-intensity laser therapy would promote significant pain remission; 2. evaluate whether this changes orofacial myofunctional conditions in the sample, as tested, using the Orofacial Myofunctional Evaluation with Scores (OMES); and 3. evaluate whether or not the pain improvement would remain stable after a 30-day follow-up for pain conditions. The study included 12 female volunteers diagnosed with myofascial pain and ages ranging from 18 to 60 years old, with or without intra-articular TMD, according to axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Participants were assessed for pain on palpation, using a visual analogue scale (VAS), before treatment (A1), immediately after 30 days of intervention, i.e, after eight sessions of Low Intensity Laser Therapy (LILT) (A2), and 30 days after the end of the treatment with LILT (A3) (follow-up). Comparing the three evaluation times, it was observed that there was a significant decrease in the values of subjective pain to palpation (p < 0.05). The initial pain (A1) differed significantly from the A2, but did not differ significantly from A3.

Cranio 2013 Apr 31(2) 133-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23795403

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Photobiomodulation of surgical wound dehiscence in a diabetic individual by low-level laser therapy following median sternotomy.

Dixit S, Maiya A, Umakanth S, Borkar S

Department of Physiotherapy, Manipal College of Allied Health Sciences, Manipal University, Manipal, Karnataka, India.

In this single case study, we attempt to outline the possible effect of low-level laser therapy (LLLT) on delayed wound healing and pain in chronic dehiscent sternotomy of a diabetic individual. The methods that were employed to evaluate changes pre and post irradiation were wound photography, wound area measurement, pressure ulcer scale of healing (PUSH), and visual analogue scale (VAS) for pain. After irradiation, proliferation of healthy granulation tissue was observed with decrease in scores of PUSH for sternal dehiscence and VAS for bilateral shoulders and sternal dehiscence. We found that LLLT irradiation could be a novel method of treatment for chronic sternal dehiscence following coronary artery bypass grafting, as it augments wound healing with an early closure of the wound deficit. Hence, this might be translated into an early functional rehabilitation and decreased pain perception of an individual following surgical complication.

Indian J Palliat Care 2013 Jan 19(1) 71-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23766600

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The Effectiveness of Therapeutic Class IV (10 W) Laser Treatment for Epicondylitis.

Roberts DB, Kruse RJ, Stoll SF

Selkirk College, Castlegar, British Columbia, Canada, V1N 4L3.

BACKGROUND AND OBJECTIVE: Photobiomodulation has been shown to modulate cellular protein production and stimulate tendon healing in a dose-dependent manner. Previous studies have used class IIIb lasers with power outputs of less than 0.5 W. Here we evaluate a dual wavelength (980/810 nm) class IV laser with a power output of 10 W for the purpose of determining the efficacy of class IV laser therapy in alleviating the pain and dysfunction associated with chronic epicondylitis. METHODS: Sixteen subjects volunteered for laser therapy, or an identically appearing sham instrument in a randomized, placebo-controlled, double-blinded clinical trial. Subjects underwent clinical examination (pain, function, strength, and ultrasonic imaging) to confirm chronic tendinopathy of the extensor carpi radialis brevis tendon, followed by eight treatments of 6.6 +/- 1.3 J/cm(2) (laser), or sham over 18 days. Safety precautions to protect against retinal exposure to the laser were followed. The exam protocol was repeated at 0, 3, 6 and 12 months post-treatment. RESULTS: No initial differences were seen between the two groups. In the laser treated group handgrip strength improved by 17 +/- 3%, 52 +/- 7%, and 66 +/- 6% at 3, 6, and 12 months respectively; function improved by 44 +/- 1%, 71 +/- 3%, and 82 +/- 2%, and pain with resistance to extension of the middle finger was reduced by 50 +/- 6%, 93 +/- 4%, and 100 +/- 1% at 3, 6 and 12 months, respectively. In contrast, no changes were seen until 12 months following sham treatment (12 months: strength improved by 13 +/- 2%, function improved by 52 +/- 3%, pain with resistance to extension of the middle finger reduced by 76 +/- 2%). No adverse effects were reported at any time. CONCLUSIONS: These findings suggest that laser therapy using the 10 W class IV instrument is efficacious for the long-term relief of the symptoms associated with chronic epicondylitis. The potential for a rapidly administered, safe and effective treatment warrants further investigation. Lasers Surg. Med. 45:311-317, 2013. (c) 2012 Wiley Periodicals, Inc.

Lasers Surg Med 2013 Jul 45(5) 311-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23733499

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Evaluation of the efficacy of low-level light therapy using 1072 nm infrared light for the treatment of herpes simplex labialis.

Dougal G, Lee SY

Virulite Distribution Ltd, Evans Incubation Centre, Newton Aycliffe, Durham, UK.

BACKGROUND: Recent research has shown that low-level light therapy (LLLT) using 1072 nm infrared light is effective in reducing the duration of herpes simplex labialis (HSL) episodes and enhancing the healing process. METHODS: This was a prospective, randomized, placebo-controlled, clinical trial to evaluate the efficacy of a 1072 nm light-emitting diode device for the treatment of HSL. In total, 87 patients with recurrent HSL were recruited and randomly divided into two groups. Subjects received a 3-min treatment with either 1072 nm infrared light therapy or placebo (sham) light therapy three times/day for 2 days. The devices used for both groups were identical in appearance and could not be differentiated by volunteers or researchers, and 1072 nm light is invisible to the human eye. The primary endpoint was healing time, which was taken as the time for the HSL lesions to resolve fully and for the underlying skin to become completely re-epithelialized, and the secondary endpoint was lesion crusting. RESULTS: The median time to healing for the active group was 129 h, compared with 177 h for the control group, which was significant (P = 0.01). There was no difference between the two groups for median time to lesion crusting (P = 0.66). CONCLUSIONS: Compared with placebo treatment, the treatment of HSL lesions with 1072 nm infrared light significantly reduced healing time.

Clin Exp Dermatol 2013 Jun 3

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23731454

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The use of low level laser therapy in the treatment of temporomandibular joint disorders. Review of the literature.

Herranz-Aparicio J, Vazquez-Delgado E, Arnabat-Dominguez J, Espana-Tost A, Gay-Escoda C

Centro Medico Teknon, C/ Vilana 12 , 08022 Barcelona, Spain, cgay@ub.edu.

Introduction: The temporomandibular disorders (TMDs) have been identified as the most important cause of pain in the facial region. The low level laser therapy (LLLT) has demonstrated to have an analgesic, anti-inflammatory and biostimulating effects. The LLLT is a noninvasive, quick and safe, non-pharmaceutical intervention that may be beneficial for patients with TMDs. However the clinical efficiency of LLLT in the treatment of this kind of disorders is controversial. Objectives: Literature review in reference to the use of LLLT in the treatment of TMDs, considering the scientific evidence level of the published studies. Material and Methods: A MEDLINE and COCHRANE database search was made for articles. The keywords used were “temporomandibular disorders” and “low level laser therapy” or “phototherapy” and by means of the Boolean operator “AND”. The search provided a bank of 35 articles, and 16 relevant articles were selected to this review. These articles were critically analyzed and classified according to their level of scientific evidence. This analysis produced 3 literature review articles and 13 are clinical trials. The SORT criteria (Strength of Recommendation Taxonomy) was used to classify the articles. Results: Only one article presented an evidence level 1, twelve presented an evidence level 2, and three presented an evidence level 3. According to the principle of evidence-based dentistry, currently there is a scientific evidence level B in favor of using LLLT for treatment of TMDs. Discussion and conclusions: Publications on the use of LLLT for treatment of TMDs are limited making difficult to compare the different studies due to the great variability of the studied variables and the selected laser parameters. The great majority of the studies concluded that the results should be taken with caution due to the methodological limitations.

Med Oral Patol Oral Cir Bucal 2013 18(4) e603-12

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23722130

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A pilot randomized trial evaluating low-level laser therapy as an alternative treatment to manual lymphatic drainage for breast cancer-related lymphedema.

Ridner SH, Poage-Hooper E, Kanar C, Doersam JK, Bond SM, Dietrich MS

School of Nursing, Vanderbilt University Nashville, TN.

Purpose/Objectives: To examine the impact of advanced practice nurse (APN)-administered low-level laser therapy (LLLT) as both a stand-alone and complementary treatment for arm volume, symptoms, and quality of life (QOL) in women with breast cancer-related lymphedema.Design: A three-group, pilot, randomized clinical trial.Setting: A private rehabilitation practice in the southeastern United States.Sample: 46 breast cancer survivors with treatment-related lymphedema.Methods: Patients were screened for eligibility and then randomized to either manual lymphatic drainage (MLD) for 40 minutes, LLLT for 20 minutes, or 20 minutes of MLD followed by 20 minutes of LLLT. Compression bandaging was applied after each treatment. Data were collected pretreatment, daily, weekly, and at the end of treatment.Main Research Variables: Independent variables consisted of three types of APN-administered lymphedema treatment. Outcome variables included limb volume, extracellular fluid, psychological and physical symptoms, and QOL.Findings: No statistically significant between-group differences were found in volume reduction; however, all groups had clinically and statistically significant reduction in volume. No group differences were noted in psychological and physical symptoms or QOL; however, treatment-related improvements were noted in symptom burden within all groups. Skin improvement was noted in each group that received LLLT.Conclusions: LLLT with bandaging may offer a time-saving therapeutic option to conventional MLD. Alternatively, compression bandaging alone could account for the demonstrated volume reduction.Implications for Nursing: APNs can effectively treat lymphedema. APNs in private healthcare practices can serve as valuable research collaborators.Knowledge Translation: Lasers may provide effective, less burdensome treatment for lymphedema. APNs with lymphedema certification can effectively treat this patient population with the use of LLLT. In addition, bioelectrical impedance and tape measurements can be used to assess lymphedema.

Oncol Nurs Forum 2013 Jul 1 40(4) 383-93

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23803270

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Near-infrared spectroscopy for objectifying cerebral effects of laser acupuncture in term and preterm neonates.

Raith W, Pichler G, Sapetschnig I, Avian A, Sommer C, Baik N, Koestenberger M, Schmolzer GM, Urlesberger B

Division of Neonatology, Department of Paediatrics, Medical University of Graz, Auenbruggerplatz 30, 8036 Graz, Austria ; Research Group for Paediatric Traditional Chinese Medicine, TCM Research Centre Graz (Acupuncture Research), Medical University of Graz, Auenbruggerplatz 30, 8036 Graz, Austria.

Laser acupuncture (LA) becomes more and more relevant in neonates and infants. With near-infrared spectroscopy (NIRS), a continuous and noninvasive measurement of tissue oxygenation is possible. Aim was to investigate, whether the application of LA was associated with any changes in regional cerebral oxygen saturation (rcSO2) in term and preterm neonates. The study included 20 neonates (12 males, 8 females). The Large Intestine 4 acupuncture point (LI 4, Hegu) was stimulated by a microlaser needle (10 mW, 685 nm laser needle EG GmbH, Germany) for 5 minutes, bilaterally. All neonates underwent polygraphic recording during undisturbed daytime sleep, including heart rate (HR), peripheral oxygen saturation (SpO2), and measurement of nasal flow. Using NIRS, rcSO2 was measured continuously. Cerebral fractional tissue oxygen extraction (cFTOE) was calculated. We did not observe any significant changes in SpO2 and HR values during the whole observation period. However, there was a significant decrease in rcSO2 (P = 0.003) within postintervention period, accompanied by a significant increase in cFTOE (P = 0.010) in postintervention period.

Evid Based Complement Alternat Med 2013 2013 346852

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23762122

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The effects of low-level laser therapy on palatal mucoperiosteal wound healing and oxidative stress status in experimental diabetic rats.

Firat ET, Dag A, Gunay A, Kaya B, Karadede MI, Kanay BE, Ketani A, Evliyaoglu O, Uysal E

1 Department of Periodontology, Faculty of Dentistry, Dicle University , Diyarbakir, Turkey .

Abstract Objective: The biostimulation effects of low-level laser therapy (LLLT) have recently been demonstrated. In this study, we aimed to investigate the effects of LLLT on palatal mucoperiostal wound healing and oxidative stress status in experimental diabetic rats. Materials and methods: Forty-two male Wistar rats that weighed 250-300 g were used in this study. Experimental diabetes was induced in all of the rats using streptozotocin. A standardized full thickness wound was made in the mucoperiosteum of the hard palates of the rats using a 3 mm biopsy punch. The rats were divided into groups: 1 (control group, non- irradiated), and 2 (experimental group, irradiated). Treatment using a GaAlAs laser at a wavelength of 940 nm and at dose of 10 J/cm(2) began after surgery, and was repeated on the 2nd, 4th, and 6th days post-surgery. Seven animals from each group were killed on the 7th, 14th, and 21st day after surgery. Biopsies were performed for the histological analysis and blood samples were collected by cardiac puncture for biochemical analysis. Results: The histopathological findings revealed reduced numbers of inflammatory cells, and increased mitotic activity of fibroblasts, collagen synthesis, and vascularization in rats in group 2. The total oxidative status was significantly decreased in the laser-treated group on the 21st day. Conclusions: LLLT elicits a positive healing effect on palatal mucoperiostal wounds, and modulates the oxidative status in experimental diabetic rats.

Photomed Laser Surg 2013 Jul 31(7) 315-21

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23789588

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LED therapy or cryotherapy between exercise intervals in Wistar rats: anti-inflammatory and ergogenic effects.

da Costa Santos VB, de Paula Ramos S, Milanez VF, Correa JC, de Andrade Alves RI, Dias IF, Nakamura FY

Department of Physical Education, Universidade Estadual de Londrina, Londrina, Parana, Brazil.

The aim of this study was to test, between two bouts of exercise, the effects of light-emitting diode (LED) therapy and cryotherapy regarding muscle damage, inflammation, and performance. Male Wistar rats were allocated in four groups: control, passive recovery (PR), cryotherapy (Cryo), and LED therapy. The animals were submitted to 45 min of swimming exercise followed by 25 min of recovery and then a second bout of either 45 min of exercise (muscle damage analysis) or time to exhaustion (performance). During the rest intervals, the rats were kept in passive rest (PR), submitted to cold water immersion (10 min, 10 degrees C) or LED therapy (940 nm, 4 J/cm2) of the gastrocnemius muscle. Blood samples were collected to analyze creatine kinase activity (CK), C-reactive protein (CRP), and leukocyte counts. The soleus muscles were evaluated histologically. Time to exhaustion was recorded during the second bout of exercise. After a second bout of 45 min, the results demonstrated leukocytosis in the PR and Cryo groups. Neutrophil counts were increased in all test groups. CK levels were increased in the Cryo group. CRP was increased in PR animals. The PR group presented a high frequency of necrosis, but the LED group had fewer necrotic areas. Edema formation was prevented, and fewer areas of inflammatory cells were observed in the LED group. The time to exhaustion was greater in both the LED and Cryo groups, without differences in CK levels. CRP was decreased in LED animals. We conclude that LED therapy and cryotherapy can improve performance, although LED therapy is more efficient in preventing muscle damage and local and systemic inflammation.

Lasers Med Sci 2013 Jun 19

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23780711

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Effect of laser phototherapy in the prevention and treatment of chemo-induced mucositis in hamsters.

Lopez TC, Martins MD, Pavesi VC, Ferreira LS, Bussadori SK, Moreira MS, Marques MM

Univ de Sao Paulo, School of Dentistry, Department of Restorative Dentistry, ,Sao Paulo,SP, Brazil.

The aim of this study was to investigate the effect of laser phototherapy (LPT) in the prevention and/or treatment of oral mucositis induced by 5-fluorouracil (5-FU; Eurofarma, Sao Paulo, Brazil) in hamsters. Ninety-six hamsters were divided into four groups (n = 24): Control (no treatment); Preventive [LPT from day (D) D-5 to D+5]; Therapeutic (LPT from D+5 to D+15); and Combined (preventive plus therapeutic LPT from D-5 to D+15). The animals received an intraperitoneal injection of 5-FU on Days 0 and 2. The pouch mucosa was scratched on Days 3 and 4. The irradiation parameters were: indium-gallium-aluminum-phosphide (InGaAlP) diode laser (MM Optics, Sao Carlos, Brazil) (660 nm), beam area of 0.036 cm2, 40 mW, 1.11 W/cm2, 6.6 J/cm2, power density applied daily of 39.6 J/cm2, in punctual mode (six points and six seconds per point) and contact mode, one application per day. The animals were sacrificed on Days 0, 5, 10 and 15 (n = 6) and weighed, and the pouch mucosa was removed for histopathological analysis. Clinical and corresponding histological scores were compared using ANOVA and Tukey’s test (p
Braz Oral Res 2013 Jun 11

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23752482

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Low intensity laser therapy accelerates muscle regeneration in aged rats.

Vatansever F, Rodrigues NC, Assis LL, Peviani SS, Durigan JL, Moreira FM, Hamblin MR, Parizotto NA

Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, USA; and Department of Dermatology, Harvard Medical School, Boston, MA, USA.

Elderly people suffer from skeletal muscle disorders that undermine their daily activity and quality of life; some of these problems can be listed as but not limited to: sarcopenia, changes in central and peripheral nervous system, blood hypoperfusion, regenerative changes contributing to atrophy, and muscle weakness. Determination, proliferation and differentiation of satellite cells in the regenerative process are regulated by specific transcription factors, known as myogenic regulatory factors (MRFs). In the elderly, the activation of MRFs is inefficient which hampers the regenerative process. Recent studies found that low intensity laser therapy (LILT) has a stimulatory effect in the muscle regeneration process. However, the effects of this therapy when associated with aging are still unknown. This study aimed to evaluate the effects of LILT (lambda=830 nm) on the tibialis anterior (TA) muscle of aged rats. The total of 56 male Wistar rats formed two population sets: old and young, with 28 animals in each set. Each of these sets were randomly divided into four groups of young rats (3 months of age) with n=7 per group and four groups of aged rats (10 months of age) with n=7 per group. These groups were submitted to cryoinjury + laser irradiation, cryoinjury only, laser irradiation only and the control group (no cryoinjury/no laser irradiation). The laser treatment was performed for 5 consecutive days. The first laser application was done 24 h after the injury (on day 2) and on the seventh day, the TA muscle was dissected and removed under anesthesia. After this the animals were euthanized. Histological analyses with toluidine blue as well as hematoxylin-eosin staining (for counting the blood capillaries) were performed for the lesion areas. In addition, MyoD and VEGF mRNA was assessed by quantitative polymerase chain reaction. The results showed significant elevation (p<0.05) in MyoD and VEGF genes expression levels. Moreover, capillary blood count was more prominent in elderly rats in laser irradiated groups when compared to young animals. In conclusion, LILT increased the maturation of satellite cells into myoblasts and myotubes, enhancing the regenerative process of aged rats irradiated with laser.

Photonics Lasers Med 2012 Oct 1 1(4) 287-297

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23750328

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Low-Level Laser-Accelerated Peripheral Nerve Regeneration within a Reinforced Nerve Conduit across a Large Gap of the Transected Sciatic Nerve in Rats.

Shen CC, Yang YC, Huang TB, Chan SC, Liu BS

Department of Neurosurgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan ; Department of Medicine, National Defense Medical Center, Taipei 114, Taiwan ; Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan ; Department of Physical Therapy, Hungkuang University, Taichung 43302, Taiwan.

This study proposed a novel combination of neural regeneration techniques for the repair of damaged peripheral nerves. A biodegradable nerve conduit containing genipin-cross-linked gelatin was annexed using beta-tricalcium phosphate (TCP) ceramic particles (genipin-gelatin-TCP, GGT) to bridge the transection of a 15 mm sciatic nerve in rats. Two trigger points were irradiated transcutaneously using 660 nm of gallium-aluminum arsenide phosphide (GaAlAsP) via laser diodes for 2 min daily over 10 consecutive days. Walking track analysis showed a significant improvement in sciatic functional index (SFI) (P < 0.01) and pronounced improvement in the toe spreading ability of rats undergoing laser stimulation. Electrophysiological measurements (peak amplitude and area) illustrated by compound muscle action potential (CMAP) curves demonstrated that laser stimulation significantly improved nerve function and reduced muscular atrophy. Histomorphometric assessments revealed that laser stimulation accelerated nerve regeneration over a larger area of neural tissue, resulting in axons of greater diameter and myelin sheaths of greater thickness than that observed in rats treated with nerve conduits alone. Motor function, electrophysiological reactions, muscular reinnervation, and histomorphometric assessments all demonstrate that the proposed therapy accelerated the repair of transected peripheral nerves bridged using a GGT nerve conduit.

Evid Based Complement Alternat Med 2013 2013 175629

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23737818

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Effects of temperature-dependent optical properties on the fluence rate and temperature of biological tissue during low-level laser therapy.

Kim S, Jeong S

School of Mechatronics, Gwangju Institute of Science and Technology, 1 Oryong-dong Buk-gu, Gwangju, 500-712, Republic of Korea.

The effects of temperature-dependent optical properties on the change of fluence rate and temperature distribution within biological tissues during low-level laser therapy (LLLT) were investigated by experimental and numerical methods. The fluence rate and temperature within a porcine skin were measured in vitro using an optical fiber sensor and a thermocouple, respectively, while irradiating the sample with a continuous wave laser (IPG Laser GmbH, Burbach, Germany, 1,064 nm, 3.14 W/cm2). The absorption and reduced scattering coefficients of porcine skin were estimated using an inverse adding-doubling algorithm from the total reflectance and transmittance measured with a double-integrating sphere. It was shown that the reduced scattering coefficient of porcine skin decreased significantly as the skin temperature increased within the range of 26-40 degrees C. To incorporate the temperature dependency of tissue optical properties in the simulation, a mathematical model that adopted coupled equations for fluence rate and bioheat transfer was developed. It was shown that the predicted fluence rate and temperature by the proposed mathematical model agreed closely with the measured values of porcine skin. The calculation of human skin temperature using the developed model revealed that the skin temperature could be significantly underestimated if the temperature dependency of optical properties of human skin were ignored during LLLT simulation.

Lasers Med Sci 2013 Jun 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23807181

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Effects of biosilicate((R)) scaffolds and low-level laser therapy on the process of bone healing.

Pinto KN, Tim CR, Crovace MC, Matsumoto MA, Parizotto NA, Zanotto ED, Peitl O, Renno AC

1 Department of Morphology, Federal University of Sao Carlos , Sao Carlos, Sao Paulo, Brazil .

Abstract Objective: This study aimed to investigate the in vivo tissue performance of the association of Biosilicate((R)) scaffolds and low-level laser therapy (LLLT) in a tibial bone defects model in rats. Background data: Many studies have been demonstrating the osteogenic potential of Biosilicate and LLLT. However, there is a need to investigate the effects of both treatments for bone consolidation. Methods: The animals were divided into control group (CG), Biosilicate scaffold group (BG), and Biosilicate scaffolds plus LLLT group (BLG). Animals were euthanized after 15, 30, and 45 days post-injury. Results: The histological analysis revealed that all the experimental groups showed inflammatory infiltrate and granulation tissue, at the area of the defect at day 15. After 30 days, CG still showed granulation tissue and bone ingrowth. Both Biosilicate groups presented newly formed bone and interconected trabeculae. At 45 days, CG showed immature newly formed bone. A more mature newly formed bone was observed in BG and BLG. On day 15, BG demonstrated a statistically higher expression of cyclooxygenase (COX)-2 compared with CG and BLG. No statistically significant difference was observed in COX-2 immunoexpression among the groups at 30 and 45 days. Similar expression of bone morphogenetic protein (BMP)-9 was demonstrated for all experimental groups at 15 and 30 days. At 45 days, the BMP-9 immunoexpression was statistically upregulated in the BLG compared with the CG and BG. No statistically significant difference was observed in the receptor activator of nuclear factor kappa-B ligand (RANKL) immunoexpression among the groups in all periods evaluated. Biosilicate groups presented a decrease in biomechanical properties compared with CG at 30 and 45 days post-surgery. Conclusions: Our findings suggest that Biosilicate presented osteogenic activity, accelerating bone repair. However, laser therapy was not able to enhance the bioactive properties of the Biosilicate.

Photomed Laser Surg 2013 Jun 31(6) 252-60

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23741994

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Antimicrobial Action of Minocycline Microspheres Versus 810 nm Diode Laser on Human Dental Plaque Microcosm Biofilms.

Song X, Yaskell T, Klepac-Ceraj V, Lynch MC, Soukos NS

Applied Molecular Photomedicine Laboratory, Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, Massachusetts.

Background: The purpose of this study was to investigate the antimicrobial effects of minocycline hydrochloride microspheres vs. infrared light at 810 nm from a diode laser on multi-species oral biofilms in vitro. These biofilms were evolved from dental plaque inoculum (oral microcosms) obtained from six systemically healthy human individuals with generalized chronic periodontitis. Methods: Multi-species biofilms were derived using supra- and subgingival plaque samples from mesiobuccal aspects of premolars and molars exhibiting probing depths in the 4-5mm range and 1-2 mm loss of attachment. Biofilms were developed anaerobically on blood agar surfaces in 96-well plates using a growth medium of PRAS brain heart infusion with 2% horse serum. Minocycline HCl 1 mg microspheres were applied on biofilms on day 2 and day 5 of their development. Biofilms were also exposed on day 2 and 5 of their growth to 810 nm light for 30 seconds using power of 0.8 Watts in a continuous wave mode. The susceptibility of microorganisms to minocycline or infrared light was evaluated by a colony forming assay and DNA probe analysis at different time points. Results: At all time points of survival assessment, minocycline was more effective (>2 log10 CFU reduction) compared with light treatment (P<0.002). Microbial analysis did not reveal susceptibility of certain dental plaque pathogens to light and was not possible following treatment with minocycline due to lack of bacterial growth. Conclusion: The cumulative action of minocycline microspheres on multi-species oral biofilms in vitro led to enhanced killing of microorganisms, whereas a single exposure of light at 810 nm exhibited minimal and non-selective antimicrobial effects.

J Periodontol 2013 Jun 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23805814

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Low-power laser irradiation promotes the proliferation and osteogenic differentiation of human periodontal ligament cells via cyclic adenosine monophosphate.

Wu JY, Chen CH, Yeh LY, Yeh ML, Ting CC, Wang YH

Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.

Retaining or improving periodontal ligament (PDL) function is crucial for restoring periodontal defects. The aim of this study was to evaluate the physiological effects of low-power laser irradiation (LPLI) on the proliferation and osteogenic differentiation of human PDL (hPDL) cells. Cultured hPDL cells were irradiated (660 nm) daily with doses of 0, 1, 2 or 4 Jcm-2. Cell proliferation was evaluated by the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay, and the effect of LPLI on osteogenic differentiation was assessed by Alizarin Red S staining and alkaline phosphatase (ALP) activity. Additionally, osteogenic marker gene expression was confirmed by real-time reverse transcription-polymerase chain reaction (RT-PCR). Our data showed that LPLI at a dose of 2 Jcm-2 significantly promoted hPDL cell proliferation at days 3 and 5. In addition, LPLI at energy doses of 2 and 4 Jcm-2 showed potential osteogenic capacity, as it stimulated ALP activity, calcium deposition, and osteogenic gene expression. We also showed that cyclic adenosine monophosphate (cAMP) is a critical regulator of the LPLI-mediated effects on hPDL cells. This study shows that LPLI can promote the proliferation and osteogenic differentiation of hPDL cells. These results suggest the potential use of LPLI in clinical applications for periodontal tissue regeneration.

Int J Oral Sci 2013 Jun 5(2) 85-91

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23788285

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Temporal Modulation of Sodium Current Kinetics in Neuron Cells by Near-Infrared Laser.

Li X, Liu J, Liang S, Guan K, An L, Wu X, Li S, Sun C

College of Physics and Optoelectronic Engineering, Dalian University of Technology, Dalian, 116023, China.

Near-infrared laser provides a novel nerve stimulation modality to regulate the cell functions. Understanding its physiological effect is a prerequisite for clinic laser therapy applications. Here, the whole-cell sodium (Na) channel kinetics of neuron cell was employed to determine the temporal roles of infrared laser. The Na currents were elicited by electrical pulses that were synchronized at the rising and falling edges of the 980 nm laser pulses, respectively, to investigate the different infrared effect on cell functions. The time constants of activation (tau m) and inactivation (tau h) kinetics were extracted from fitting of the Na current (m3h) according to the Hodgkin-Huxley (HH) model. By comparing the time constants without and with the laser irradiation, we obtained that laser pulses changed the Na current kinetics by accelerating tau h-phase and slowing down tau m-phase at the beginning of the laser pulse, whereas both phases were accelerated at the end of the pulse. After relating the ratios of the time constants to the temperature characteristics of Na channel by Q 10, we found that the accelerating in Na current kinetics could be related to the average temperature of extracellular solution in the corresponding time span by choosing Q 10 = 2.6. The results of this study demonstrated that there was a positive correlation between the acceleration of the Na current kinetics and increases in temperature of the extracellular solution.

Cell Biochem Biophys 2013 May 31

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23723007

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Regulation of miRNA Expression by Low-Level Laser Therapy (LLLT) and Photodynamic Therapy (PDT).

Kushibiki T, Hirasawa T, Okawa S, Ishihara M

Department of Medical Engineering, National Defense Medical College 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan. toshi@ndmc.ac.jp.

Applications of laser therapy, including low-level laser therapy (LLLT), phototherapy and photodynamic therapy (PDT), have been proven to be beneficial and relatively less invasive therapeutic modalities for numerous diseases and disease conditions. Using specific types of laser irradiation, specific cellular activities can be induced. Because multiple cellular signaling cascades are simultaneously activated in cells exposed to lasers, understanding the molecular responses within cells will aid in the development of laser therapies. In order to understand in detail the molecular mechanisms of LLLT and PDT-related responses, it will be useful to characterize the specific expression of miRNAs and proteins. Such analyses will provide an important source for new applications of laser therapy, as well as for the development of individualized treatments. Although several miRNAs should be up- or down-regulated upon stimulation by LLLT, phototherapy and PDT, very few published studies address the effect of laser therapy on miRNA expression. In this review, we focus on LLLT, phototherapy and PDT as representative laser therapies and discuss the effects of these therapies on miRNA expression.

Int J Mol Sci 2013 14(7) 13542-58

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23807510

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Subthreshold Laser Therapy for Diabetic Macular Edema: Metabolic and Safety Issues.

Vujosevic S, Martini F, Convento E, Longhin E, Kotsafti O, Parrozzani R, Midena E

Department of Ophthalmology, University of Padova, Via Giustiniani 2, 35128 Padova, Italy. edoardo.midena @unipd.it.

Purpose: To review the most important metabolic effects and clinical safety data of subthreshold micropulse diode laser (D-MPL) in diabetic macular edema (DME). Methods: Review of the literature about the mechanisms of action and role of D-MPL in DME. Results: The MPL treatment does not damage the retina and is selectively absorbed by the retinal pigment epithelium (RPE). MPL stimulates secretion of different protective cytokines by the RPE. No visible laser spots on the retina were noted on any fundus image modality in different studies, and there were no changes of the outer retina integrity. Mean central retinal sensitivity (RS) increased in subthreshold micropulse diode laser group compared to standard ETDRS photocoagulation group. Conclusions: MPL is a new, promising treatment option in DME, with both infrared and yellow wavelengths using the less aggressive duty cycle (5%) and fixed power parameters. It appears to be safe from morphologic and functional point of view in mild center involving DME.

Curr Med Chem 2013 May 27

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23745552

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Laser biostimulation.

Mester A

National Laser Therapy Centre, Peterfy Sandor Teaching Hospital , Budapest, Hungary .

Photomed Laser Surg 2013 Jun 31(6) 237-9

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23741992

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Wearable textile-based phototherapy systems.

van Os K, Cherenack K

Philips Group Innovation, Research, Eindhoven, The Netherlands.

In this paper, we discuss the phototherapy concepts developed by Philips in the EU FP7 PLACE-it project. These concepts demonstrate the use of e-textiles for medical applications in a meaningful way. By introducing a comfortable, wearable technology, Philips has enabled a new world of devices which provide comfortable home treatment of different diseases and complaints. Here, we show concepts and clinical validation, and give insight in the development steps to be taken to build this kind of devices.

Stud Health Technol Inform 2013 189 91-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23739364

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About James Carroll

Founder and CEO at THOR Photomedicine Ltd. About THOR
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