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

28 new papers for you this month, starting with the most entertaining: “successful management of acute-onset torticollis in a giraffe” which included a laser to reduce “cervical muscle hypertonicity”, an RCT on cellulite (see commentary), an analysis of 589 tooth extractions in patients under bisphosphonate therapy following LLLT, chronic rhinosinusitis, oral lichen planus, combined bone marrow aspirate and LLLT on bone healing, mesenchymal stem cells and LLLT on peripheral nerve regeneration and more …

reticulated giraffeSuccessful management of acute-onset torticollis in a giraffe (Giraffa camelopardalis reticulata).

Dadone LI, Haussler KK, Brown G, Marsden M, Gaynor J, Johnston MS, Garelle D

Cheyenne Mountain Zoo, Colorado Springs, Colorado 80906, USA. ldadone@cmzoo.org

A 2-yr-old male reticulated giraffe (Giraffa camelopardalis reticulata) presented with severe midcervical segmental torticollis upon arrival as an incoming shipment. Despite initial medical management, the giraffe developed marked neck sensitivity, focal muscle spasms, and decreased cervical range of motion. Using operant conditioning to assist patient positioning and tolerance to cervical manipulation, a series of manually applied chiropractic treatments were applied to the affected cervical vertebrae in an effort to restore normal cervical mobility. Laser therapy and cervical range of motion exercises were also used to reduce cervical muscle hypertonicity. The combined application of these nontraditional therapies produced marked clinical improvement. This case highlights the potential benefits of combining traditional medical management with chiropractic treatment and physical therapy techniques for management of severe acute-onset torticollis in a giraffe.

J Zoo Wildl Med 2013 Mar 44(1) 181-5

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23505724

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A double-blind, placebo-controlled randomized trial evaluating the ability of low-level laser therapy to improve the appearance of cellulite.

Jackson RF, Roche GC, Shanks SC

Surgeon’s, Inc., Marion, Indiana 46952.

BACKGROUND AND OBJECTIVE: Cellulite is present in 90% of post-adolescent women. Several technologies have been developed for treating cellulite; however, they all involve some degree of massage or mechanical manipulation. The purpose of this study was to assess the effectiveness of a low-level laser light device employing green 532 nm diodes as a stand-alone procedure without massage or mechanical manipulation for improving the appearance of cellulite in the thighs and buttocks. STUDY DESIGN/MATERIALS AND METHODS: This double-blind study randomized subjects to undergo treatment with the LLLT device (N = 34) or sham treatment (N = 34). During a 2-week treatment phase, each subject received three weekly treatment sessions 2-3 days apart. During each session, the front and back of the hips, thighs, and waist were exposed for 15 minutes (30 minutes total). RESULTS: Nineteen subjects in the LLLT group achieved a decrease of one or more stages on the Nurnberger-Muller grading scale (55.88%) versus three subjects (8.82%) in the sham-treated group (P < 0.0001). Two LLLT-treated subjects achieved 2-stage improvements on the Nurnberger-Muller Scale at the 2-week study endpoint and four did at the 6-week follow-up evaluation versus none of the sham-treated subjects at either time point. Subjects treated with LLLT achieved a significant decrease in combined baseline thigh circumference at the 2-week study endpoint and 6-week follow-up evaluation (for each, p < 0.0001 vs. baseline) versus no change for sham-treated subjects. LLLT-treated subjects also showed significant decreases in mean baseline body weight (P < 0.0005), BMI (P < 0.001), and percent BSA affected by cellulite (P < 0.0005) versus no change for any parameter among sham-treated subjects. Most LLLT-treated subjects (62.1%) were Very Satisfied or Somewhat Satisfied with the improvement in cellulite they received versus 25.8% of sham-treated subjects. There were no reports of adverse events. CONCLUSIONS: Low-level laser therapy using green 532 nm diodes is safe and effective for improving the appearance of cellulite in the thighs and buttocks. In contrast with other technologies, LLLT is effective as a stand-alone procedure without requiring massage or mechanical manipulation. Future studies will assess the long-term benefits of LLLT for the treatment of cellulite. Lasers Surg. Med. 45: 141-147, 2013. (c) 2013 Wiley Periodicals, Inc.

Lasers Surg Med 2013 Mar 45(3) 141-7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23508376

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Evaluation of the effectiveness of vibroacoustic therapy treatment of patients with so-called “heel spur”. A preliminary report.

Lukasiak A, Krystosiak M, Widlak P, Woldanska-Okonska M

Klinika Rehabilitacji i Medycyny Fizykalnej , Uniwersytecki Szpital Kliniczny im. WAM w Lodzi, Polska.

Background: The so-called “heel spur” is a radiological term referring to adaptive bone growth as a result of chronic overload enthesopathy of the proximal attachment of the plantar fascia. The main cause of the pain is continued localised pressure on the surrounding soft tissues. Vibroacoustic wave therapy is a relatively new method gaining popularity among doctors, physiotherapists and patients. The aim of this study was to confirm the clinical efficacy of vibroacoustic therapy compared to laser and ultrasound therapy. Material and Methods: The study enrolled 60 patients treated for plantar heel spurs who were divided into a study group of 40 patients who underwent vibroacoustic therapy and a control group of 20 patients treated with ultrasound and laser therapy. The outcome measure for evaluating the effectiveness of physiotherapy was a subjective assessment of pain intensity by VAS and the modified short-form McGill Pain Questionnaire. Results: The mean pain intensity score in patients undergoing vibroacoustic therapy decreased by about 2.6 points according to the VAS scale and 17 points according to the McGill questionnaire, compared to reductions of 0.6 and 6 points, respectively, in the ultrasound and laser therapy group. The correlation between subjective assessment of pain according to the VAS scale and palpation-based assessment of pain was significantly positive between the two groups, demonstrating similarity of the two scales, with a slight dominance of the group undergoing laser and ultrasound therapy. Conclusions: These results represent a tentative confirmation of analgesic effectiveness of the vibro-acoustic method in musculoskeletal overload conditions. 2. In order to confirm its effectiveness, it is necessary to conduct further prospective randomized studies with blinding and evaluate the long-term results.

Ortop Traumatol Rehabil 2013 Feb 28 15(1) 77-88

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23510823

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Case series of 589 tooth extractions in patients under bisphosphonates therapy. Proposal of a clinical protocol supported by Nd:YAG low-level laser therapy.

Vescovi P, Meleti M, Merigo E, Manfredi M, Fornaini C, Guidotti R, Nammour S

Sezione di Odontostomatologia, c/o Clinica Odontostomatologica, Azienda Ospedaliero-Universitaria, via Gramsci 14, 43100 Parma, Italy, elisabetta.merigo@unipr.it.

Objective: Trauma during dental surgery is a predisposing factor for bisphosphonates (BP)-related osteonecrosis of the jaws (BRONJ). However, about 40% of cases of BRONJ are not related to dental invasive procedures, being probably associated to endodontic or periodontal infections. Extraction of non-treatable teeth is considered a reliable choice, to improve symptoms and to reduce the risk of BRONJ. Here we report our experience of tooth extractions in patients under oral or intravenous BP therapy. Study Design: Two-hundred and seventeen patients (38 males, 179 females; mean age 68.72 +/- 11.26 years, range 30 to 83 years) under BP therapy received 589 tooth extractions at the Unit of Oral Medicine, Pathology and Laser-assisted Surgery of the University of Parma, Italy, between June 2006 and December 2010. Ninety five patients were under BP therapy for oncological disease (multiple myeloma (MM): 23; bone metastases (BM): 72) and 122 patients for non oncological diseases: 119 osteoporosis (OP), 2 rheumatoid arthritis (RA) and 1 Paget’s disease (PD). The mean duration of BP was of 35 months. Antibiotic treatment was administered three days before and 2 weeks after tooth extractions. Patients were additionally treated with low level laser therapy (LLLT) through Nd:YAG laser (1064 nm – power 1.25 W; frequency 15 Hz; fibre diameter: 320 mum), 5 application of 1 minute each. Patients were evaluated 3 days and once a week for 2 months after the extractions and every time they received LLLT. Mean follow-up was 15 months (ranging from 4 to 31 months). Results: In a total of 589 extractions (285 mandibular, 304 maxillary) performed, a minimal bone exposure was observed in 5 cases, treated with Er:YAG laser vaporization and than healed. Conclusions: Our experience supports the hypothesis that the association of antibiotic treatment and LLLT can be effective in preventing ONJ after tooth extractions in patients under BPT.

Med Oral Patol Oral Cir Bucal 2013 Mar 25

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23524436

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A pilot study into the effect of low-level laser therapy in patients with chronic rhinosinusitis.

Naghdi S, Ansari NN, Fathali M, Bartley J, Varedi M, Honarpishe R

Assistant Professor, Department of Physiotherapy, School of Rehabilitation , Tehran University of Medical Sciences , Tehran , Iran.

Chronic rhinosinusitis (CRS) is a common inflammatory disease of the nose and paranasal sinuses that has a significant impact on patients’ quality of life. No study has examined the effectiveness of applying low-level laser therapy (LLLT) locally over the sinuses in patients with CRS. The aim of this study was to evaluate the effect of LLLT in patients with CRS. Fifteen adult patients with CRS participated in this pilot pretest-posttest clinical study. Patients were treated with a 830-nm Ga-Al-As laser in continuous-wave mode at a power output of 30 mW and energy dose of 1 J. Laser irradiation was delivered on six points over each maxillary or frontal sinus with 33 sec irradiation for each point and a total treatment duration of 198 sec for each sinus. Patients were given LLLT three times per week for ten treatment sessions. Patients were asked to score their symptoms in accordance with a four-point scale (0-3), and a total symptom score (TSS) for each patient was calculated. Percentage improvement of TSS was considered as the primary outcome measure. TSS was calculated at baseline (T0), at 2 weeks (T1) and at 4 weeks (T2). The TSS was improved significantly at T1 (39%) and at T2 (46.34%). A large effect size for LLLT was found (etap2 etap2 = 0.63). The therapeutic effect was sustained for a mean of 5 months. This pilot study indicates that LLLT applied for 4 weeks improves symptoms in patients with CRS.

Physiother Theory Pract 2013 Mar 22

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23521568

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Is acupuncture “stimulation” a misnomer? A case for using the term “blockade”

Silberstein M

BACKGROUND: The term used most frequently in the literature to describe acupuncture’s effects is “stimulation” which may be used to describe either (or both) the direct stimulus applied to a needle as well as putative stimulation of the nervous system, despite little published evidence describing what is actually being stimulated. In contrast, recent published work has suggested that acupuncture may, in fact be inhibitory at a peripheral level, acting by blocking neural transmission. DISCUSSION: The suggestion that acupuncture exerts its effects through peripheral neural blockade is supported by recent evidence explaining related techniques including low level laser and capsaicin at acupoints. It also explains acupuncture’s effect on painful and non-painful conditions and both Eastern and Western concepts of acupuncture. There is a need for additional work to elucidate acupuncture’s mechanism of action, and the suggestion that it acts through neural blockade should prompt further research in this direction. SUMMARY: If the term “blockade” were applied to acupuncture, this would, likely, be expected to promote this minimally invasive technique, and, potentially, bring it into mainstream clinical practice for pain management as well as other therapeutic applications.

BMC Complement Altern Med 2013 Mar 25 13(1) 68

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23530528

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Efficacy of diode laser in the management of oral lichen planus.

Misra N, Chittoria N, Umapathy D, Misra P

Department of Oral Medicine and Radiology, BBD College of Dental sciences, Lucknow, Uttar Pradesh, India.

Oral lichen planus (OLP) is a common chronic disease of uncertain aetiology. Treatment of patients with symptomatic OLP represents a therapeutic challenge. Despite numerous existing remedies, there are many treatment failures. The diode laser therapy is used as a possible alternative method in the treatment of lichen planus. The patient with OLP lesions was treated using diode laser (940 nm) for the symptomatic relief of pain and burning sensation. The patient was assessed before, during and after the completion of the treatment weekly. The treatment was performed for 2 months and the patient showed complete remission of burning sensation and pain (visual analog scale 0%). The follow-up was performed for 7 months and no recurrence of burning sensation was found. Diode laser therapy seems to be an effective alternative treatment for relieving the symptoms of OLP.

BMJ Case Rep 2013 2013

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23505269

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Comparison of the influence of ozone and laser therapies on pain, swelling, and trismus following impacted third-molar surgery.

Kazancioglu HO, Ezirganli S, Demirtas N

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, 34093, Fatih, Istanbul, Turkey, dt_oguz@yahoo.com.

This study aims to evaluate the efficacy of the ozone and laser application in the management of pain, swelling, and trismus after third-molar surgery. Sixty consecutive patients with asymptomatic impacted mandibular third molars were recruited into the study. Patients were randomized into three treatment groups of 20 patients each: two study groups (group 1 = low-level laser therapy (LLLT), group 2 = ozone therapy) and a control group (no-LLLT or ozone therapy). Twenty teeth extractions were performed in each group. Evaluations of postoperative pain, the number of analgesics tablets taken, trismus, swelling, and quality of life (Oral Health Impact Profile-14 questionnaire) were made. The sample consisted of 28 female and 32 male patients, whose total mean age was 23.5 +/- 3.4 (range, 18-25) years. The pain level and the number of analgesics tablets taken were lower in the ozonated and LLLT applied groups than in the control group. This study showed that ozone and low power laser therapies had a positive effect on the patients’ quality of life. Trismus in the LLLT group was significantly less than in the ozonated and control groups (p = 0.033). Ozone application showed no superiority in regards of postoperative swelling; however, LLLT group had significantly lower postoperative swelling. This study demonstrates that ozone and laser therapies are useful for the reduction of postoperative pain and they increase quality of life after third-molar surgery. Although the ozone therapy had no effect on postoperative swelling and trismus after surgical removal of impacted lower third molars, LLLT had a positive effect.

Lasers Med Sci 2013 Mar 14

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23494104

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Osteoarthritis: physical medicine and rehabilitation-nonpharmacological management.

Stemberger R, Kerschan-Schindl K

Abteilung fur Physikalische Medizin und Rehabilitation, Herz Jesu Krankenhaus, Baumgasse 20A, 1030, Vienna, Austria, regina.stemberger@chello.at.

Osteoarthritis (OA) is the most common joint disease, mainly affecting middle-aged and elderly persons. People with OA of the knee or hip experience pain and deconditioning that may lead to disability. Treatment goals include pain control, maximizing functional independence, and improving quality of life within the constraints imposed by both OA and comorbidities. Exercise is a core recommendation in all nonpharmacological guidelines for the management of patients with knee or hip OA; it is supposed to ameliorate pain and maybe function as well. Therapeutic ultrasound, neuromuscular as well as transcutaneous electrostimulation, pulsed magnetic field therapy, low-level laser therapy, thermal agents, acupuncture, and assistive devices such as insoles, canes, and braces can be used additionally in a multimodal therapeutic program. They may positively influence pain and function, mobility, and quality of life in patients suffering from OA of the lower limbs.

Wien Med Wochenschr 2013 Mar 22

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23519486

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[The application of helium-neon laser radiation for the combined treatment of the patients with atrophic rhinitis].

Sharipov RA, Sharipova ER

The objective of the present study was to improve the efficacy of the treatment of the patients presenting with atrophic rhinitis (ozena) of the upper respiratory tract by the application of helium-neon laser radiation. A total of 120 patients aged from 15 to 53 years were treated based at the Department of Otorhinolaryngology, G.G. Kuvatov Republican Clinical Hospital, Ufa. All these patients underwent routine clinical, roentgenological, microbiological, and rheographic examination. The method for the treatment of atrophic rhinitis is described; it includes the application of helium-neon laser radiation in combination with the administration of the purified preparation of liquid polyvalent Klebsiella bacteriophage. The positive results of the treatment by the proposed method were documented in 90% of the patients.

Vestn Otorinolaringol 2012 (6) 48-50

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23268248

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[Possibilities of magnetic-laser therapy in comprehensive treatment of patients with brain concussion in acute period].

The efficacy of magnetic-laser therapy used according to the method developed by us was studied in patients having the brain concussion (BC) in an acute period. The study was based on the dynamics of values of the evoked vestibular potentials and the disease clinical course. It was shown that following the magnetic-laser therapy in combination with traditional pharmacotherapy in BC acute period, the statistically significant positive changes were registered in the quantitative characteristics of the evoked vestibular brain potentials that correlated with the dynamics of the disease clinical course. The data obtained substantiate the possibility of using the magnetic-laser therapy in patients with a mild craniocereblal injury in an acute period.

Lik Sprava 2012 Jul-Sep (5) 106-11

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23534278

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Yes, there is deqi sensation in laser acupuncture.

Litscher G

Stronach Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, and TCM Research Center Graz, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria.

Deqi, a composite of unique sensations, is essential for clinical efficacy according to Traditional Chinese Medicine. It is described as a sensory perception of varying character and is mostly ascribed to metal needle acupuncture. However, it can also be elicited by different kinds of laser acupuncture stimulation. This short paper summarizes the current scientific status of deqi in laser stimulation. Different kinds of laser acupuncture are described in a comprehensive form, and the most interesting studies concerning deqi and laser acupuncture are presented.

Evid Based Complement Alternat Med 2013 2013 198254

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23533464

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Five-year retrospective study of laser-assisted periodontal therapy.

Kusek ER, Kusek AJ, Kusek EA

University of South Dakota Hygiene School, Vermillion, SD, USA.

This article outlines a five-year retrospective study involving a diode dental laser used on periodontally infected teeth. The present study utilized a specific protocol: scaling and root planing, light ultrasonic scaling, and the use of a diode laser. In 80% of cases, pocket depth of 3 mm or less was maintained.

Gen Dent 2012 Nov-Dec 60(6) 540-3

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23220310

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Intravenous laser blood irradiation, interstitial laser acupuncture, and electroacupuncture in an animal experimental setting: preliminary results from heart rate variability and electrocorticographic recordings.

He W, Litscher G, Wang X, Jing X, Shi H, Shang H, Zhu B

Department of Meridians, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China ; Stronach Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine, TCM Research Center Graz, Medical University of Graz, 8036 Graz, Austria.

This is the first study to investigate intravenous (i.v.) laser blood irradiation, interstitial (i.st.) laser acupuncture, and electroacupuncture (EA) in combination with heart rate variability (HRV) and electrocorticogram. We investigated 10 male anesthetized Sprague-Dawley rats under the three conditions mentioned previously in Beijing, China, and data analysis was performed in Graz, Europe. For i.v. laser stimulation in the femoral vein and i.st. laser acupuncture at Neiguan (PC6), we used a European system (Modulas needle, Schwa-Medico, Germany; 658 nm, 50 mW, continuous wave mode), and for EA at Neiguan, a Chinese system (Hanshi-100A; Nanjing Jisheng Medical Technology Company, China; 15 Hz, 1 mA). HR, HRV, and electrocorticogram were recorded using a biophysical amplifier AVB-10 (Nihon-Kohden, Japan). HR changed significantly during i.st. laser acupuncture stimulation of Neiguan in anesthetized rats. Total HRV increased insignificantly during i.v. and i.st. laser stimulation. The LF/HF ratio showed significant changes only during i.v. laser blood irradiation. Integrated cortical EEG (electrocorticogram) decreased insignificantly during EA and i.v. laser blood irradiation. Further studies concerning dosage-dependent alterations are in progress.

Evid Based Complement Alternat Med 2013 2013 169249

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23476681

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Bone marrow aspirate combined with low-level laser therapy: A new therapeutic approach to enhance bone healing.

Nagata MJ, Santinoni CS, Pola NM, de Campos N, Messora MR, Bomfim SR, Ervolino E, Fucini SE, Faleiros PL, Garcia VG, Bosco AF

Division of Periodontics, Department of Surgery and Integrated Clinic, Dental School of Aracatuba, Univ. Estadual Paulista – UNESP, Brazil. Electronic address: mjnagata@foa.unesp.br.

This study evaluated the influence of bone marrow aspirate (BMA), low-level laser therapy (LLLT) and their combination on bone healing in surgically created critical-size defects (CSDs) in rat calvaria. 40 rats were divided into four groups: C (control), BMA, LLLT and BMA/LLLT. A 5mmdiameter CSD was created in the calvarium of each animal. In Group C, the defect was filled by blood clot only. In Group BMA, the defect was filled with BMA. In groups LLLT and BMA/LLLT, the defect received laser irradiation (InGaAlP laser), was filled with blood clot or BMA respectively, and irradiated again. Animals were euthanized 30days postoperatively. Histomorphometric and immunohistochemical analyses were performed. Newly formed bone area (NFBA) was calculated as percentage of the total area of the original defect. Proliferating cell nuclear antigen (PCNA), runt-related transcription factor 2 (Runx2) and osteocalcin (OCN) immunohistochemical staining were performed. PCNA-positive, Runx2-positive and OCN-positive cells were quantified. Data were statistically analyzed. Group BMA/LLLT had significantly greater NFBA than groups C, BMA or LLLT. Group BMA presented significantly greater NFBA than control, while group LLLT did not. Group BMA/LLLT presented a significantly higher number of PCNA-positive and OCN-positive cells than any of the other groups. Groups BMA/LLLT and BMA showed a significantly lower number of Runx2-positive cells than groups C or LLLT. The combination of BMA/LLLT yielded significantly greater bone formation in surgically created CSD in rat calvaria when compared to control, or either treatment alone.

J Photochem Photobiol B 2013 Apr 5 121 6-14

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23474527

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Synergistic effects of low-level laser and mesenchymal stem cells on functional recovery in rats with crushed sciatic nerves.

Yang CC, Wang J, Chen SC, Hsieh YL

Department of Physical Medicine and Rehabilitation, Taichung Tzu Chi General Hospital, Taiwan.

Transplantation of mesenchymal stem cells (MSCs) has been proposed to exert beneficial effects on peripheral nerve regeneration after a peripheral nerve injury, but the functional recovery in the denervated limb is still limited. In this study, we used low-level laser therapy (LLLT) as an adjunct therapy for MSC transplantation on the functional recovery of crushed sciatic nerve in rats. Peripheral nerve injury was induced in 48 Sprague-Dawley rats by crushing the unilateral sciatic nerve, using a vessel clamp. The animals with crushed injury were randomly divided into four groups: control group, with no treatment; MSC group, treated with MSC alone; LLLT group, treated with LLLT alone; and MSCLLLT group, treated with a combination of MSC and LLLT. The sciatic function index (SFI), vertical activity of locomotion (VA) and ankle angle (AA) of rats were examined for functional assessments after treatment. Electrophysiological, morphological and S100 immunohistochemical studies were also conducted. The MSCLLLT group showed a greater recovery in SFI, VA and AA, with significant difference from MSC, LLLT and control groups (p < 0.05). Moreover, markedly enhanced electrophysiological function and expression of S100 immunoreactivity, as well as fewer inflammatory cells and less vacuole formation were also demonstrated after nerve crush injury in the MSCLLLT group when compared with the groups receiving a single treatment (p < 0.05). MSC transplantation combined with LLLT could achieve better results in functional recovery than a conventional treatment of MSC or LLLT alone. LLLT has a synergistic effect in providing greater functional recovery with MSC transplantation after nerve crush injury. Copyright (c) 2013 John Wiley & Sons, Ltd.

J Tissue Eng Regen Med 2013 Mar 7

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23468370

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Therapeutic low-intensity red laser for herpes labialis on plasmid survival and bacterial transformation.

da Silva Sergio LP, da Silva Marciano R, Teixeira GR, da Silva Canuto K, Polignano GA, Guimaraes OR, Geller M, de Paoli F, de Souza da Fonseca A

Centro de Ciencias da Saude, Centro Universitario Serra dos Orgaos, Avenida Alberto Torres, 111, Teresopolis, Rio de Janeiro, 25964004, Brazil.

A low-intensity laser is used in treating herpes labialis based on the biostimulative effect, albeit the photobiological basis is not well understood. In this work experimental models based on Escherichia coli cultures and plasmids were used to evaluate effects of low-intensity red laser on DNA at fluences for treatment of herpes labialis. To this end, survival and transformation efficiency of plasmids in E. coli AB1157 (wild type), BH20 (fpg/mutM-) and BW9091 (xthA-), content of the supercoiled form of plasmid DNA, as well as nucleic acids and protein content from bacterial cultures exposed to the laser, were evaluated. The data indicate low-intensity red laser: (i) alters the survival of plasmids in wild type, fpg/mutM- and xthA-E. coli cultures depending of growth phase, (ii) alters the content of the supercoiled form of plasmids in the wild type and fpg/mutM-E. coli cells, (iii) alters the content of nucleic acids and proteins in wild type E. coli cells, (iv) alters the transformation efficiency of plasmids in wild type and fpg/mutM-E. coli competent cells. These data could be used to understand positive effects of low-intensity lasers on herpes labialis treatment.

Photochem Photobiol Sci 2013 Mar 13

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=23483124

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Photobiomodulation preserves behaviour and midbrain dopaminergic cells from MPTP toxicity: evidence from two mouse strains.

Moro C, Torres N, El Massri N, Ratel D, Johnstone DM, Stone J, Mitrofanis J, Benabid AL

BACKGROUND: We have shown previously that near-infrared light (NIr) treatment or photobiomodulation neuroprotects dopaminergic cells in substantia nigra pars compacta (SNc) from degeneration induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) in Balb/c albino mice, a well-known model for Parkinson’s disease. The present study explores whether NIr treatment offers neuroprotection to these cells in C57BL/6 pigmented mice. In addition, we examine whether NIr influences behavioural activity in both strains after MPTP treatment. We tested for various locomotive parameters in an open-field test, namely velocity, high mobility and immobility. RESULTS: Balb/c (albino) and C57BL/6 (pigmented) mice received injections of MPTP (total of 50 mg/kg) or saline and NIr treatments (or not) over 48 hours. After each injection and/or NIr treatment, the locomotor activity of the mice was tested. After six days survival, brains were processed for TH (tyrosine hydroxylase) immunochemistry and the number of TH+ cells in the substantia nigra pars compacta (SNc) was estimated using stereology. Results showed higher numbers of TH+ cells in the MPTP-NIr groups of both strains, compared to the MPTP groups, with the protection greater in the Balb/c mice (30% vs 20%). The behavioural tests revealed strain differences also. For Balb/c mice, the MPTP-NIr group showed greater preservation of locomotor activity than the MPTP group. Behavioural preservation was less evident in the C57BL/6 strain however, with little effect of NIr being recorded in the MPTP-treated cases of this strain. Finally, there were differences between the two strains in terms of NIr penetration across the skin and fur. Our measurements indicated that NIr penetration was considerably less in the pigmented C57BL/6, compared to the albino Balb/c mice. CONCLUSIONS: In summary, our results revealed the neuroprotective benefits of NIr treatment after parkinsonian insult at both cellular and behavioural levels and suggest that Balb/c strain, due to greater penetration of NIr through skin and fur, provides a clearer model of protection than the C57BL/6 strain.

BMC Neurosci 2013 Mar 27 14(1) 40

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Potentiated anti-inflammatory effect of combined 780nm and 660nm low level laser therapy on the experimental laryngitis.

Marinho RR, Matos RM, Santos JS, Ribeiro MA, Smaniotto S, Barreto EO, Ribeiro RA, Lima RC Jr, Albuquerque RL Jr, Thomazzi SM

Departamento de Fisiologia, Universidade Federal de Sergipe, Av. Marechal Rondon, Sao Cristovao, Sergipe, Brazil.

Reflux laryngitis is a common clinic complication of nasogastric intubation (NSGI). Since there is no report concerning the effects of low level laser therapy (LLLT) on reflux laryngitis, this study aimed to analyze the protective effect of single and combined therapies with low level laser at the doses of 2.1J and 2.1+1.2J with a total irradiation time of 30s and 30+30s, respectively, on a model of neurogenic reflux laryngitis. NSGI was performed in Wistar rats, assigned into groups: NGI (no treatment), NLT17.5 (single therapy), and NLT17.5/10.0 (combined therapy, applied sequentially). Additional non-intubated and non-irradiated rats were use as controls (CTR). Myeloperoxidase (MPO) activity was assessed by colorimetric method after the intubation period (on days 1, 3, 5, and 7), whereas paraffin-embedded laryngeal specimens were used to carry out histopathological analysis of the inflammatory response, granulation tissue, and collagen deposition 7days after NSGI. Significant reduction in MPO activity (p<0.05) and in the severity of the inflammatory response (p<0.05), and improvement in the granulation tissue (p<0.05) was observed in NLT17.5/10.0group. Mast cells count was significantly decreased in NGI and NLT17.5 groups (p<0.001), whereas no difference was observed between NLT17.5/10.0 and CTR groups (p>0.05). NLT17.5/10.0 group also showed better collagenization pattern, in comparison to NGI and NLT17.5 groups. This study suggests that the combined therapy successfully modulated the inflammatory response and collagenization in experimental model of NSGI-induced neurogenic laryngitis.

J Photochem Photobiol B 2013 Apr 5 121 86-93

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A review of the influence of growth factors and cytokines in in vitro human keratinocyte migration.

Peplow PV, Chatterjee MP

Department of Anatomy, University of Otago, New Zealand. Electronic address: phil.peplow@stonebow.otago.ac.nz.

OBJECTIVE: Keratinocyte migration from the wound edge is a crucial step in the reepithelization of cutaneous wounds. Growth factors and cytokines, released from cells that invade the wound matrix, play an important role, and several in vitro assays have been performed to elucidate this. The purposes of this study were to review in vitro human studies on keratinocyte migration to identify those growth factors or cytokines that stimulate keratinocyte migration and whether these assays might serve as a screening procedure prior to testing combinations of growth factors or cytokines to promote wound closure in vivo. METHODS: Research papers investigating effect of growth factors and cytokines on human keratinocyte migration in vitro were retrieved from library sources, PubMed databases, reference lists of papers, and searches of relevant journals. RESULTS: Fourteen different growth factors and cytokines enhanced migration in scratch wound assay and HGF together with TGF-beta, and IGF-1 with EGF, were more stimulatory than either growth factor alone. HGF with TGF-beta1 had a greater chemokinetic effect than either growth factor alone in transmigration assay. TGF-beta1, FGF-7, FGF-2 and AGF were chemotactic to keratinocytes. EGF, TGF-alpha, IL-1alpha, IGF and MGSA enhanced cell migration on ECM proteins. CONCLUSION: Many growth factors and cytokines enhanced migration of keratinocytes in vitro, and certain combinations of growth factors were more stimulatory than either alone. These and other combinations that stimulate keratinocyte migration in vitro should be tested for effect on wound closure and repair in vivo. The scratch wound assay provides a useful, inexpensive and easy-to-perform screening method for testing individual or combinations of growth factors or cytokines, or growth factors combined with other modalities such as laser irradiation, prior to performing wound healing studies with laboratory animals.

Cytokine 2013 Apr 62(1) 1-21

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Low-level laser therapy promotes the osteogenic potential of adipose-derived mesenchymal stem cells seeded on an acellular dermal matrix.

Choi K, Kang BJ, Kim H, Lee S, Bae S, Kweon OK, Kim WH

Department of Veterinary Surgery, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea.

This study investigates the feasibility of using an adipose-derived mesenchymal stem cell (ASC)-seeded acellular dermal matrix (ADM) along with low-level laser therapy (LLLT) to repair bone defect in athymic nude mice. Critical-sized calvarial defects were treated either with ADM, ADM/LLLT, ADM/ASCs, or ADM/ASCs/LLLT. In micro-computed tomography scans, the ADM/ASCs and the ADM/ASCs/LLLT groups showed remarkable bone formation after 14 days. Additionally, bone regeneration in the ADM/ASCs/LLLT group was obvious at 28 days, but in the ADM/ASCs group at 56 days. Bone mineral density and bone tissue volume in the ADM/ASCs/LLLT group significantly increased after 7 days, but in the ADM/ASCs group after 14 days. Histological analysis revealed that the defects were repaired in the ADM/ASCs and the ADM/ASCs/LLLT group, while the defects in the ADM and the ADM/LLLT groups exhibited few bone islands at 28 and 56 days. The successful seeding of ASCs onto ADM was confirmed, and LLLT enhanced the proliferation and the survival of ASCs at 14 days. Our results indicate that ASC-seeded grafts promote bone regeneration, and the application of LLLT on ASC-seeded ADM results in rapid bone formation. The implantation of an ASC-seeded ADM combined with LLLT may be used effectively for bone regeneration. (c) 2013 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2013.

J Biomed Mater Res B Appl Biomater 2013 Mar 26

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Effects of pulsed infra-red low level-laser irradiation on mast cells number and degranulation in open skin wound healing of healthy and streptozotocin-induced diabetic rats.

Fathabadie FF, Bayat M, Amini A, Bayat M, Rezaie F

Anatomy and Cell Biology Department, Shahid Beheshti University of Medical Sciences , Tehran , Iran.

Introduction: Low-level laser therapy (LLLT) has been reported to be capable of changing mast cell numbers and degranulation in experimental wounds. Objective: We conducted a study on the influence of pulsed LLLT on mast cells in wounds of non-diabetic and diabetic rats. Methods: Thirty-six rats were randomly divided into non-diabetic and diabetic groups. Type 1 diabetes milletes (DM) was induced in rats of the diabetic group by administration of streptozotocin (STZ). We inflicted two wounds in each rat. The first wound in both non-diabetic and diabetic groups was treated with an 890-nm laser, having pulse frequency of 80 Hz and energy density of 0.2 J/cm2. Mast cell numbers and degranulation of all subgroups were assessed at 4, 7, and 15 days after the infliction of the wounds. Results and conclusion: According to the paired t-test, the total number of laser-treated mast cells was significantly higher than that of the placebos in the non-diabetic groups on days 4 and 15. The total number of laser-treated mast cells was significantly higher than that of the placebos in the diabetic groups on days 4 and 15. The number of granulated mast cells was significantly higher than that of degranulated mast cells for all laser-treated mast cells and placebo mast cells of the non-diabetic and diabetic groups.

J Cosmet Laser Ther 2013 Mar 6

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Wound-healing effects of low-level laser therapy in diabetic rats involve the modulation of MMP-2 and MMP-9 and the redistribution of collagen types I and III.

Aparecida Da Silva A, Leal-Junior EC, Alves AC, Rambo CS, Dos Santos SA, Vieira RP, De Carvalho PD

MSc and PhD Graduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE) , Sao Paulo, SP , Brazil.

The present study aimed to determine if LLLT restores the balance between mRNA expression of matrix metalloproteinases (MMP-2 and MMP-9) and also the balance between collagen types I and III during the healing process of diabetic wounds. One hundred and twenty male Wistar rats were distributed in Control (untreated non-diabetic rats: UND); Laser (laser treated in non-diabetic rats: LTND); Diabetic (diabetic rats non-laser treated rats: UD); and Diabetic+ Laser (diabetic rats laser treated: DLT) groups. The diabetes model using streptozotocin efficiently induced diabetes, as demonstrated through increased levels of blood glucose. Diode laser (50 mW, 660 nm, 4 J/cm2, 80 s) was applied a single time after scare induction. Twenty-four hours after LLLT application, rats were euthanized, the scarred areas were collected for MMP-2 and MMP-9 mRNA analysis and also for histological analysis (inflammation and types I and III collagen). The results demonstrated that scare in untreated diabetic rats significantly increased the MMP-2 and MMP-9 expression compared with that in non-diabetic rats (p < 0.05), while LLLT significantly reduced MMP-2 and MMP-9 expression compared with that in untreated diabetic rats (p < 0.05). To conclude, the results also showed that LLLT was able to alter the expression of MMP-9 as well as accelerate the production of collagen and increase the total percentage of collagen type III in diabetic animals.

J Cosmet Laser Ther 2013 Mar 6

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The effects of low-level laser irradiation on cellular viability and proliferation of human skin fibroblasts cultured in high glucose mediums.

Esmaeelinejad M, Bayat M, Darbandi H, Bayat M, Mosaffa N

Dental Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Delayed wound healing is one of the most challenging complications of diabetes mellitus (DM) in clinical medicine. This study has aimed to evaluate the effects of low-level laser therapy (LLLT) on human skin fibroblasts (HSFs) cultured in a high glucose concentration. HSFs were cultured either in a concentration of physiologic glucose (5.5 mM/l) or high glucose media (11.1 and15 mM/l) for either 1 or 2 weeks after which they were subsequently cultured in either the physiologic glucose or high concentration glucose media during laser irradiation. LLLT was carried out with a helium-neon (He-Ne) laser unit at energy densities of 0.5, 1, and 2 J/cm2, and power density of 0.66 mW/cm2 on 3 consecutive days. HSFs’ viability and proliferation rate were evaluated with the dimethylthiazol-diphenyltetrazolium bromide (MTT) assay. The LLLT at densities of 0.5 and 1 J/cm2 had stimulatory effects on the viability and proliferation rate of HSFs cultured in physiologic glucose (5.5 mM/l) medium compared to their control cultures (p = 0.002 and p = 0.046, respectively). All three doses of 0.5, 1, and 2 J/cm2 had stimulatory effects on the proliferation rate of HSFs cultured in high glucose concentrations when compared to their control cultures (p = 0.042, p = 0.000, and p = 0.000, respectively). This study showed that HSFs originally cultured for 2 weeks in high glucose concentration followed by culture in physiologic glucose during laser irradiation showed enhanced cell viability and proliferation. Thus, LLLT had a stimulatory effect on these HSFs.

Lasers Med Sci 2013 Mar 2

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Effect of low-level laser therapy on odontoblast-like cells exposed to bleaching agent.

Lima AF, Ribeiro AP, Basso FG, Bagnato VS, Hebling J, Marchi GM, de Souza Costa CA

Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas-UNICAMP, Avenida Limeira, 901, 13404-903, Piracicaba, Sao Paulo, Brazil.

The aim of the present study was to evaluate the effect of low-level laser therapy (LLLT) on odontoblast-like MDPC-23 cells exposed to carbamide peroxide (CP 0.01 %-2.21 mug/mL of H2O2). The cells were seeded in sterile 24-well plates for 72 h. Eight groups were established according to the exposure or not to the bleaching agents and the laser energy doses tested (0, 4, 10, and 15 J/cm2). After exposing the cells to 0.01 % CP for 1 h, this bleaching solution was replaced by fresh culture medium. The cells were then irradiated (three sections) with a near-infrared diode laser (InGaAsP-780 +/- 3 nm, 40 mW), with intervals of 24 h. The 0.01 % CP solution caused statistically significant reductions in cell metabolism and alkaline phosphate (ALP) activity when compared with those of the groups not exposed to the bleaching agent. The LLLT did not modulate cell metabolism; however, the dose of 4 J/cm2 increased the ALP activity. It was concluded that 0.01 % CP reduces the MDPC-23 cell metabolism and ALP activity. The LLLT in the parameters tested did not influence the cell metabolism of the cultured cells; nevertheless, the laser dose of 4 J/cm2 increases the ALP activity in groups both with and without exposure to the bleaching agent.

Lasers Med Sci 2013 Mar 23

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Effects of low-level laser therapy on the expression of osteogenic genes related in the initial stages of bone defects in rats.

Fernandes KR, Ribeiro DA, Rodrigues NC, Tim C, Santos AA, Parizotto NA, de Araujo HS, Driusso P, Renno AC

Department of Bioscience, Federal University of Sao Paulo, Av. Ana Costa, 95, Vila Mathias, Santos, Sao Paulo 11050-240, Brazil.

We evaluate the effects of low-level laser therapy (LLLT) on the histological modifications and temporal osteogenic genes expression during the initial phase of bone healing in a model of bone defect in rats. Sixty-four Wistar rats were divided into control and treated groups. Noncritical size bone defects were surgically created at the upper third of the tibia. Laser irradiation (Ga-Al-As laser 830 nm, 30 mW, 0.028 cm(2), 1.071 W/cm(2), 1 min and 34 s, 2.8 Joules, 100 J/cm(2)) was performed for 1, 2, 3, and 5 sessions. Histopathology revealed that treated animals presented higher inflammatory cells recruitment, especially 12 and 36 h postsurgery. Also, a better tissue organization at the site of the injury, with the presence of granulation tissue and new bone formation was observed on days three and five postsurgery in the treated animals. The quantitative real time polymerase chain reaction showed that LLLT produced a significantly increase in mRNA expression of Runx-2, 12 h and three days post-surgery, a significant upregulation of alkaline phosphatase mRNA expression after 36 h and three days post-surgery and a significant increase of osteocalcin mRNA expression after three and five days. We concluded that LLLT modulated the inflammatory process and accelerated bone repair, and this advanced repair pattern in the laser-treated groups may be related to the higher mRNA expression of genes presented by these animals.

J Biomed Opt 2013 Mar 18(3) 038002

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Low-level laser therapy enhances the expression of osteogenic factors during bone repair in rats.

Tim CR, Pinto KN, Rossi BR, Fernandes K, Matsumoto MA, Parizotto NA, Renno AC

Department of Physiotherapy, Federal University of Sao Carlos, Rod Washington Luis, Km 235, Sao Carlos, Sao Paulo, Brazil.

The aim of this study was to evaluate the effects of low-level laser therapy (LLLT) on bone formation, immunoexpression of osteogenic factors, and biomechanical properties in a tibial bone defect model in rats. Sixty male Wistar rats were distributed into bone defect control group (CG) and laser irradiated group (LG). Animals were euthanized on days 15, 30, and 45 post-injury. The histological and morphometric analysis showed that the treated animals presented no inflammatory infiltrate and a better tissue organization at 15 and 30 days postsurgery. Also, a higher amount of newly formed bone was observed at 15 days postsurgery. No statistically significant difference was observed in cyclooxygenase-2 immunoexpression among the groups at 15, 30, and 45 days in the immunohistochemical analysis. Considering RUNX-2, the immunoexpression was statistically higher in the LG compared to the CG at 45 days. BMP-9 immunoexpression was significantly higher in the LG in comparison to CG at day 30. However, there was no expressivity for this immunomarker, both in the CG and LG, at the day 45 postsurgery. No statistically significant difference was observed in the receptor activator of nuclear factor kappa-B ligand immunoexpression among the groups in all periods evaluated. No statistically significant difference among the groups was observed in the maximal load in any period of time. Our findings indicate that laser therapy improved bone healing by accelerating the development of newly formed bone and activating the osteogenic factors on tibial defects, but the biomechanical properties in LG were not improved.

Lasers Med Sci 2013 Mar 21

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High-frequency low-level diode laser irradiation promotes proliferation and migration of primary cultured human gingival epithelial cells.

Ejiri K, Aoki A, Yamaguchi Y, Ohshima M, Izumi Y

Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.

In periodontal therapy, the use of low-level diode lasers has recently been considered to improve wound healing of the gingival tissue. However, its effects on human gingival epithelial cells (HGECs) remain unknown. The aim of the present study was to examine whether high-frequency low-level diode laser irradiation stimulates key cell responses in wound healing, proliferation and migration, in primary cultured HGECs in vitro. HGECs were derived from seven independent gingival tissue specimens. Cultured HGECs were exposed to a single session of high-frequency (30 kHz) low-level diode laser irradiation with various irradiation time periods (fluence 5.7-56.7 J/cm2). After 20-24 h, cell proliferation was evaluated by WST-8 assay and [3H]thymidine incorporation assay, and cell migration was monitored by in vitro wound healing assay. Further, phosphorylation of the mitogen-activated protein kinase (MAPK) pathways after irradiation was investigated by Western blotting. The high-frequency low-level irradiation significantly increased cell proliferation and [3H]thymidine incorporation at various irradiation time periods. Migration of the irradiated cells was significantly accelerated compared with the nonirradiated control. Further, the low-level diode laser irradiation induced phosphorylation of MAPK/extracellular signal-regulated protein kinase (ERK) at 5, 15, 60, and 120 min after irradiation. Stress-activated protein kinases/c-Jun N-terminal kinase and p38 MAPK remained un-phosphorylated. The results show that high-frequency low-level diode laser irradiation promotes HGEC proliferation and migration in association with the activation of MAPK/ERK, suggesting that laser irradiation may accelerate gingival wound healing.

Lasers Med Sci 2013 Mar 21

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About James Carroll

Founder and CEO at THOR Photomedicine Ltd. About THOR
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