Effect of diode laser biostimulation on implant stability, post-surgical inflammation, and bone healing in immediate implant in the maxillary premolars. A randomized double-blind trial.

Low-intensity lasers have been utilized in medicine in two ways: for local stimulation and for stimulation of acupuncture points. Literature data reveal that this method has been indiscriminately applied in psychiatry, rheumatology, gynecology, dermatology, otorhinolaryngology, in diverse acute and chronic pains, inflammations, vascular disorders, angina pectoris, bronchial asthma. Most commonly reported clinical effects are analgesia, spasmolytic and anti-inflammatory effects, as well as faster wound and bone healing. This prospective study analyses effects of laser biostimulation on patients with pleurisy. The analysis included 25 patients treated at the Institute of Lung Diseases in Sremska Kamenica during 2000, 2001 and 2002. Apart from conservative treatment, these patients were treated with laser biostimulation of acupuncture points and local region for ten days. During treatment, changes of present clinical signs, general symptoms, radiological findings, as well as changes of some relevant biochemical parameters were recorded. Results were compared with the control group which included the same number of patients, who differed from the examined group only by not being exposed to laser biostimulation. The examined group of patients with pleuritis presented with quicker resorption of pleural effusion, less pleural adhesions, more significant decrease of clinical symptoms, especially pain, as well as more significant increase of cortisol and immunoglobulin A and decrease of circulating immune complexes (CIC), leukocytes and sedimentation rate than the control group. Mechanisms of laser biostimulation in treatment of pleurisy were described in detail and the obtained results were correlated to those reported by other authors. 1. Patients with pleurisy undergoing laser stimulation presented with faster resorption of effusion and remission of the subjective symptoms, as well as significant decrease of biochemical acute inflammation parameters in the peripheral blood and therefore with faster recovery. 2. In patients with pleurisy laser treatment increases regenerative mechanisms of the pleural surface, thus decreasing the quantity of formed adhesions and resulting in better mobility of the diaphragm.

Summary: BACKGROUND: The stimulating effect of low level laser phototherapy on bone healing has been shown in a number of in vitro and animal studies. However, the effect of LLLT on the bone healing in human has not been previously wide demonstrated. The article reports an accidentally injury pattern and reported as fractures of the mid third of the left tibia. OBJECTIVE: The purpose of this case study was to demonstrate the biological effects of low-level laser therapy (LLLT) on tibial fractures treated surgically using radiographic, examinations. CASE REPORT: The case hospitalized for conventional surgery and followed by applying Low Level Laser Therapy LLLT to enhance and accelerate the bone fracture healing of the left tibia using the effect of laser bio-stimulation. Radiological x-ray imaging evaluation follow up for our case showed a significant bone healing rate as result of exposure of Diode Laser 650 nm with energy density of 5 J/cm 2 three times/week for one month. Radiographic findings revealed no significant fracture callus thickness difference before using LLLT however, the fractures showed significant callus formation after using LLLT. CONCLUSION: The study suggests that LLLT accelerates the process of fracture repair or cause increases in callus volume

The aim of this study was to evaluate the bone healing of tight-fit implants placed in the maxilla and mandible of subjects compromised with metabolic syndrome (MS) and type-2 Diabetes Mellitus (T2DM). Eighteen Göttingen minipigs were randomly distributed into three groups: (i) control (normal diet), (ii) MS (cafeteria diet for obesity induction), (iii) T2DM (cafeteria diet for obesity induction + Streptozotocin for T2DM induction). Maxillary and mandibular premolars and molar were extracted. After 8 weeks of healing, implants with progressive small buttress threads were placed, and allowed to integrate for 6 weeks after which the implant/bone blockswere retrieved for histological processing. Qualitative and quantitative histomorphometric analyses (percentage of bone-to-implant contact, %BIC, and bone area fraction occupancy within implant threads, %BAFO) were performed. The bone healing process around the implant occurred predominantly through interfacial remodeling with subsequent bone apposition. Data as a function of systemic condition yielded significantly higher %BIC and %BAFO values for healthy and MS relative to T2DM. Data as a function of maxilla and mandible did not yield significant differences for either %BIC and %BAFO. When considering both factors, healthy and MS subjects had %BIC and %BAFO trend towards higher values in the mandible relative to maxilla, whereas T2DM yielded higher %BIC and %BAFO in the maxilla relative to mandible. All systemic conditions presented comparable levels of %BIC and %BAFO in the maxilla; healthy and MS presented significantly higher %BIC and %BAFO relative to T2DM in the mandible. T2DM presented lower amounts of bone formation around implants relative to MS and healthy. Implants placed in the maxilla and in the mandible showed comparable amounts of bone in proximity to implants.

Purpose: The aim of this study was to evaluate the factors affecting healing patterns of surgically created circumferential gap defects around implants in dogs. Materials and Methods: In four mongrel dogs, all mandibular premolars were extracted. After 8 weeks of healing periods, implants were submerged. According to the surface treatment, turned surface was designated as a group A and rough surface as a group B. In each dog, surgical defects on the left side were made with a customized tapered step drill and on the right with a customized paralleled drill. Groups were also divided according to the width of the coronal gaps: 1.0mm, 1.5mm, or 2.0mm. The dogs were sacrificed following 8 weeks and the specimens were analyzed histologically and histomorphometrically. Results: During the postoperative period, healing was uneventful and implants were well-maintained. As the size of the coronal gap was increased, the amount of bone-to-implant contact was decreased. The bone healing was greater in rough surface implants compared to the turned ones. About the defect morphology, tapered shape showed much bone healing and direct bone to implant contact even in the smooth surface implants. Conclusion: Healing of the circumferential defect around dental implant is influenced by the implant surface, defect width and the morphology of the defect. When using rough surface implants, circumferential gap defects within 2 mm do not need any kinds of regenerative procedures and the healing appeared to be faster in the tapered defect morphology than the paralleled one. (J Korean Acad Periodontol 2008;38:385-394)

Effects of micro-osteoperforations on tooth movement and bone in the beagle maxilla.

Purpose: Laser photobiostimulation has recently gained recognition as a non-invasive and effective technique for accelerating orthodontic tooth movement and enhancing bone healing. This article evaluates the effects of laser biostimulation at an energy density of 15.9 Joules/cm² on the amount of orthodontic movement and its impact at the histological level. Materials and Methods: Thirty adult male albino rabbits were randomly chosen to form two groups (n=15 per group): a Control (C) and a Laser Treatment (LT) group. The LT group received laser treatment for three weeks at 976 ± 10 nm and an energy density of 15.9 Joules/cm². Laser irradiation was applied to four specific spots on the lower incisors for 80 seconds, administered on days 0, 3, 6, 9, 11, 13, 16, 18, and 20. Five rabbits from each group were euthanized at 7, 14, and 21 days for subsequent analysis. Results: The amount of orthodontic movement, the extent of osteogenesis, osteoblasts, and osteoclast counts were significantly larger in the laser-exposed group than in the unexposed group. Notably, bone alkaline phosphatase and tartrate-resistant acid phosphatase 5b activity significantly increased, particularly at two weeks relative to the control group. Conclusion: Laser biostimulation offered evidence of improved parameters of teeth movement, providing insight to enhance the orthodontic therapy outcome.

HighlightsThe effect of laser biostimulation on wheat germination was explored using a single- and dual-wavelength (DW) laser.An 80 mW green-infrared DW laser treatment significantly enhanced several germination traits of wheat.The effect of a 100 mW single-wavelength red laser on wheat germination was non-significant.Abstract. Laser biostimulation of seeds has established itself as a safe and sustainable alternative to genetic modification or chemical use to enhance plant germination and growth. A knowledge gap, however, exists to define optimal laser parameters for different seeds as inappropriate irradiation may seriously damage or destroy germinability. To this end, the effect of laser biostimulation on germination of Canada Western Red Winter (CWRW) wheat seeds was evaluated using two low power portable lasers: 1) a single-wavelength red laser (659 nm) and 2) a dual-wavelength (DW) green/infrared laser [531 and 810 nm (ratio ~10:1)]. The seeds were pretreated with laser light before germination tests for 5, 10, and 15 minutes using total power densities of ~14.2 and 11.3 mW/cm2, respectively. Laser treatment with a DW laser for a duration of 10 min was found to be the most efficient as it significantly enhanced mean germination time, germination rate index, germination speed, number of roots, and hypocotyl length by 14.3%, 15.2%, 15.2%, 31.8%, and 60.9%, respectively, with respect to control samples. The effect of single-wavelength red laser on CWRW wheat seed germination traits was not statistically significant. To the best of our knowledge, this study is the first on evaluating the effect of DW laser treatments in plant biostimulation and introduces a new pathway for manipulating the germination, growth, and development of seeds/plants. Keywords: Agriculture, Biostimulation, Dual-wavelength laser, Laser, Wheat.

To study the effect of osteogenic inducer (dexamethasone, beta-sodium glycerophosphate and Vitamin C) carried by gelatin sponge on healing and remodeling of tooth extraction sockets. Fifty rabbits were selected. After extracting the first premolars of bilateral maxillary, the right side tooth extraction sockets were filled with gelatin sponge containing osteogenic inducer as experimental side, tooth extraction sockets on left side were filled with gelatin sponge as control. Every ten rabbits were executed at the end of 1, 2, 4, 8, 12 weeks after tooth extraction. Bone density was measured through digital X-ray images. The specimens were examined by histology. The absorption height of alveolar bone at 12 weeks was measured. X-ray measurement showed that the bone density of experimental side was higher than that of control side at 2, 4, 8, 12 weeks, the difference had statistical significance (P<0.01). The histology examination showed that new bone formation in tooth extraction sockets of experimental side was earlier than that in control side. The absorptional height of alveolar bone had significant difference between experimental side and control side (P<0.01), of which experimental side was less. Filling the osteogenic inducer in tooth extraction sockets can promote the healing and new bone formation and prevent from alveolar bone absorption.

INTRODUCTION: Biphasic calcium phosphate (BCP) is very widely used as a grafting material around dental implants. The properties of such material can be enhanced by adding interpositional graft materials to enhance osteoinduction. Hyaluronic acid (HyA) is an example of osteopromoting materials that can be added to the BCP to enhance its osteoinductive properties. OBJECTIVES: Histological evaluation of using HyA with BCP on bone healing around dental implants. MATERIALS AND METHODS: This study was a split mouth design. It was conducted on 9 mongrel dogs. The dogs were allocated into two groups: Group A (Study Group): The right side of the mandible received dental implants with biphasic calcium phosphate bone graft mixed with hyaluronic acid following extraction of the mandibular third premolar. Group B (Control Group): The left side of the mandible received dental implants with biphasic calcium phosphate bone graft only following extraction of the mandibular third premolar. Dogs were sacrificed at 2, 4 and 6 weeks postoperatively. Segments containing the implant and bone graft were retrieved with adjacent bone to be prepared for histological examination using Haematoxylin and eosin stain and Trichrome stain. RESULTS: All animals survived well, and remained active and alert all over the course of the experiment. Both groups were characterized by new bone formation. The newly formed bone was more evident in association with group (A). CONCLUSIONS: HyA accelerates the onset of new bone formation when combined with BCP for bone augmentation in the treatment of osseous defects.

The aim of the present experiment was to study early stages of osseointegration to implants with a fluoride-modified surface. Six mongrel dogs, about 1-year old, were used. All mandibular premolars and the first mandibular molars were extracted. Three months later, mucoperiosteal flaps were elevated in one side of the mandible and six sites were identified for implant placement. The control implants (MicroThread) had a TiOblast surface, while the test implants (OsseoSpeed) had a fluoride-modified TiOblast surface. Both types of implants had a similar geometry, a diameter of 3.5 mm and were 8 mm long. Following installation, cover screws were placed and the flaps were adjusted and sutured to cover all implants. Four weeks after the first implant surgery, the installation procedure was repeated in the opposite side of the mandible. Two weeks later, biopsies were obtained and prepared for histological analysis. The void that occurred between the cut bone wall of the recipient site and the macro-threads of the implant immediately following implant installation was used to study early bone formation. It was demonstrated that the amount of new bone that formed in the voids within the first 2 weeks of healing was larger at fluoride-modified implants (test) than at TiOblast (control) implants. It was further observed that the amount of bone-to-implant contact that had been established after 2 weeks in the macro-threaded portion of the implant was significantly larger at the test implants than at the controls. It is suggested that the fluoride-modified implant surface promotes osseointegration in the early phase of healing following implant installation.

Leukocyte- and platelet-rich fibrin (L-PRF) has been suggested to enhance bone healing and the effects of L-PRF need to be evaluated in lateral residual alveolar bone augmentation. This in vivo study aimed to analyze the effects of L-PRF as a membrane on bone regeneration in lateral residual alveolar augmentation. Eight mongrel dogs were used; the mandibular premolars were extracted and then three lateral ridge defects were surgically created on each side of the arch. After 4 weeks, guided bone ridge augmentation was performed in each defect with the following treatment groups: N+D (nonresorbable membrane with deproteinized bovine bone mineral [DBBM]), N+B (nonresorbable membrane with β-tricalcium phosphate [β-TCP]), R+D (resorbable membrane with DBBM), R+B (resorbable membrane with β-TCP), and P+D (L-PRF with DBBM), and P+B (L-PRF and β-TCP). Following 4 weeks of bone healing, the new bone amount for each group was measured by light microscopy (primary outcome) and microcomputed tomography (micro-CT) (secondary outcome). The mean values were compared at the 0.05 significance level. The P+D group showed the most newly formed bone in histology and in micro-CT analyses. L-PRF was more effective in bone regeneration when compared to nonresorbable and resorbable barrier membranes. Additionally, this study indicated DBBM was the more favorable osseous graft material for bone regeneration than β-TCP when barrier membranes are used. From the results of this in vivo study using surgically created defects, L-PRF plays an effective role as a barrier membrane for lateral ridge augmentation. L-PRF may be an excellent barrier membrane in place of other nonresorbable and resorbable membranes.

To evaluate the suitability of a minipig model for the study of bone healing and osseointegration of dental implants following bone splitting and expansion of narrow ridges. In four minipigs, the mandibular premolars and first molars were extracted together with removal of the buccal bone plate. Three months later, ridge splitting and expansion was performed with simultaneous placement of three titanium implants per quadrant. On one side of the mandible, the expanded bone gap between the implants was filled with an alloplastic biphasic calcium phosphate (BCP) material, while the gap on the other side was left unfilled. A barrier membrane was placed in half of the quadrants. After a healing period of 6weeks, the animals were sacrificed for histological evaluation. In all groups, no bone fractures occurred, no implants were lost, all 24 implants were osseointegrated, and the gap created by bone splitting was filled with new bone, irrespective of whether BCP or a barrier membrane was used. Slight exposure of five implants was observed, but did not lead to implant loss. The level of the most coronal bone-to-implant contact varied without being dependent on the use of BCP or a barrier membrane. In all groups, the BCP particles were not present deep in the bone-filled gap. However, BCP particles were seen at the crestal bone margin, where they were partly integrated in the new bone. This new minipig model holds great promise for studying experimental ridge splitting/expansion. However, efforts must be undertaken to reduce implant exposure and buccal bone resorption.

PurposeLow-magnitude, high-frequency (LMHF) loading plays an important role in bone healing. The present study aimed to evaluate the effect of LMHF loading applied directly to titanium dental implants on peri-implant bone healing and implant osseointegration. MethodsThe mandibular premolars and molars were extracted from six male Beagle dogs. Three months post-extraction, each of the six dogs had three titanium implants (Aadva Standard Implant Narrow, Φ3.3×8mm) inserted into the mandibular premolar and molar area (three implants per side). In each animal, one side was randomly selected to undergo daily LMHF loading (treatment group), while the other side had no further intervention (control). The loading was applied directly to the implant abutment using an individual jig and a custom-made loading device (8μm, 100Hz). The implant stability quotient (ISQ) was tested every week. Three dogs were euthanized after 2 weeks, and three were euthanized after 8 weeks. Tissue samples were fixed and stained for micro-computed tomography (micro-CT) and histomorphometric analyses. Data were analyzed statistically, with significance set at p<0.05. ResultsThe treatment group had significantly increased peri-implant bone volume relative to tissue volume in region of interest 2 (100–500μm) compared with the control group after 2 weeks of loading (p<0.05); however, there was no significant difference between groups after 8 weeks. The ISQ value and the micro-CT results did not differ between groups during the study period. ConclusionsLMHF loading positively influenced peri-implant bone healing in the early healing period.

Complicated mandibular fractures were recognised in one foal, one pony and four horses. The foal was two months old while the adult animals ranged in age from 12 to 24 years. Three horses had a unilateral horizontal ramus fracture. Two fractures were open and one was closed. Comminution was present in one of these patients while the other two horses had marked displacement of the fragments. Two suffered from comminuted fractures of the horizontal and vertical ramus of the mandible. One of these patients had open and infected fractures. One foal had a bilateral horizontal ramus fracture with marked periosteal 'new bone' formation and malalignement which required corrective osteotomy. Each horse underwent locking compression plate (LCP) osteosynthesis consisting of open fracture reduction and application of one to three 4.5/5.0 mm LCP at the ventral, lateral or caudal aspect of the mandible under fluoroscopic control. Two 3.5 mm LCP were used in the foal. Plate fixation was supported by application of a cerclage wire construct between the incisor and premolar teeth in most patients. Complete fracture healing, with an excellent functional and cosmetic outcome, was achieved in all of the patients. Complications encountered included seroma formation, screw and wire breakage, as well as implant and apical tooth root infections. The LCP was removed after fracture healing had occurred in four patients.

The purpose of this investigation was to evaluate the effect on healing of fast and slow absorbable Tisseel in combination with periodontal flap surgery. Mucoperiosteal flaps were raised on the buccal aspect of maxillary premolars and mandibular premolars and first molars in 4 beagle dogs. The underlying buccal, interproximal and inter-radicular bone was then removed to a level of approximately 5 mm apically to the original bone crest and half way into the interdental spaces and bifurcations. The exposed root surfaces were curetted in order to remove the periodontal ligament tissue, and a notch was made in the root surface at the base of the defects. On the control teeth, the flaps were sutured immediately after creation of the defects, while on the test teeth, a layer of fast (group I) or slow (group II) absorbable Tisseel was applied between the curetted roots and the subsurface of the flaps prior to suturing. Postoperatively, the teeth were brushed 2 x weekly. The dogs were sacrificed after 4 months. Histological analysis revealed that the amounts of new attachment and bone regrowth were similar in the test and control groups, although the results tended to be most favorable for the group of teeth treated with fast absorbable Tisseel (Group I).