This study assessed the effect of photobiomodulation therapy (PBMT) by simultaneous irradiation of 635 and 980 nm lasers on proliferation of periodontal ligament (PDL) mesenchymal cells and their osteoblastic differentiation. In this in vitro study, PDL mesenchymal cells were cultured in osteogenic medium. The cells were subjected to PBM by 980 nm diode laser in the first group, PBM by 635 nm diode laser in the second group, and PBM by both lasers in the third group. Each group had two subgroups for one-time irradiation on day 1, and two irradiations on days 1 and 3. The control group did not receive any intervention. Cell proliferation was analyzed by the methyl thiazolyl tetrazolium (MTT) assay (days 1 and 3), apoptosis was assessed by DAPI staining (days 2 and 4), and osteoblastic differentiation was assessed by Alizarin red staining (day 14) and evaluation of expression of osteocalcin (OCN), osteopontin (OPN), and runt-related transcription factor 2 (RUNX2) osteogenic genes by real-time polymerase chain reaction (PCR). Data were analyzed by one-way ANOVA (α = 0.05). Cell viability was the highest in 980 nm laser group with one-time irradiation and 635 nm laser group with two irradiations on day 3. The lowest rate of apoptosis was noted in 635 nm laser group with two irradiations on day 4; this group also showed the best results in Alizarin red staining and the highest expression of all three genes (P < 0.05). PBM by 635 nm laser yielded more promising results regarding proliferation of PDL mesenchymal cells and their differentiation to osteoblasts.

Laser tattoo removal often requires multiple treatment sessions despite advances in picosecond laser technology. Multimodal approaches aimed at improving treatment efficiency are increasingly being explored. This study retrospectively evaluated the clinical outcomes of a vacuum-assisted multimodal picosecond laser tattoo removal protocol.A retrospective observational case series was conducted including 16 tattoos that completed treatment with standardized photographic follow-up. The protocol combined fractional ablative laser pretreatment (1064nm, 3-5 stacks), followed by two full-beam picosecond 1064nm passes with application of a vacuum-assisted device between passes. Standardized images were acquired using the Quantificare imaging system. Treatment outcomes were independently evaluated by three blinded experts. Kirby-Desai estimated treatment sessions were additionally calculated as a historical comparative reference.Sixteen tattoos completed treatment and were included in the final analysis. Mean pigment clearance exceeded 90% following a mean of 3.19 treatment sessions, with high interobserver agreement among blinded evaluators. The observed number of treatment sessions was lower than Kirby-Desai estimated values used as historical reference. No severe long-term adverse events were observed.This retrospective case series suggests that a vacuum-assisted multimodal picosecond laser tattoo removal protocol may be associated with high tattoo clearance rates using relatively few treatment sessions. However, given the retrospective design, absence of a control group, and multimodal nature of the protocol, the independent contribution of vacuum assistance cannot be determined. Prospective controlled studies are needed to further evaluate the role of adjunctive mechanical approaches in tattoo removal optimization.

Selective photothermolysis, which enables precise targeting of melanin, hemoglobin, and water, is the foundation for modern dermatologic laser therapy. This review bridges laser physics with clinical practice by organizing systems on the basis of spectral domain and indication: Q-switched and picosecond lasers for tattoos and lentigines; pulsed-dye and long-pulsed neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers for vascular lesions; alexandrite and diode lasers for hair removal; and fractional ablative (CO₂, erbium-doped yttrium aluminum garnet [Er:YAG]) and non-ablative platforms for scar revision and rejuvenation. Unlike conventional textbook reviews that merely list device specifications, we specifically define how to dynamically adjust comprehensive parameters not just wavelength, but also pulse duration, fluence, and spot size-in direct response to immediate clinical endpoints observed during treatment. We delineated the selection of parameters-wavelength, pulse duration, fluence, and spot size-in relation to the Fitzpatrick skin type, focusing on cooling, treatment endpoints, and recovery. Current evidence regarding efficacy, recurrence, and complications has been synthesized, and the device parameters have been linked to thermal relaxation and Arrhenius injury kinetics to inform safer evidence-based algorithms and multimodal treatment strategies.

To evaluate the effectiveness and safety of subthreshold micropulse laser (MPL) in patients with residual subretinal fluid (SRF) after vitrectomy for myopic traction maculopathy (MTM).This was a prospective, pilot randomized controlled trial. We recruited eyes with residual SRF≥200μm on OCT at 1-month follow-up after vitrectomy for macular hole retinal detachment (MHRD) and macular schisis with foveal detachment (MSRD). Forty eligible patients were randomized to control and MPL group in a 1:1 allocation ratio. Patients in the MPL group received MPL treatment 1-month after surgery by a same doctor and the procedure was repeated at 1-month intervals when necessary. Follow-up endpoint was defined as either complete absorption of subretinal fluid (SRF) or a minimum postoperative observation period of 6 months.The median follow-up time was 6 months (range: 3-28 months). Postoperatively, BCVA was significantly improved, and macular thickness was significantly reduced (P < 0.001) compared with preoperative baseline. The patients in the MPL group received 2.05 ± 0.89 (range 1-3) times of MPL. The Kaplan Meier curve showed a trend that the MPL group had better SRF absorption, but the difference is not significant between the two groups (P = 0.33). No severe complications in both groups during the follow-up.MPL is a safe non-invasive procedure in pathologic myopia patients. The limited therapeutic effect of MPL on SRF absorption may reflect the compromised RPE function resulting from progressive thinning and atrophy in highly myopic eyes.

This preliminary prospective study aimed to evaluate the effectiveness of antimicrobial photodynamic therapy (aPDT) as an adjunct treatment for angular cheilitis (AC) in critically ill patients and to investigate its feasibility in a high-complexity hospital setting. The study included 13 patients admitted to the intensive care unit (ICU) of a referral infectious disease hospital in Northeastern Brazil. The aPDT protocol consisted of 0.1% methylene blue (10-minute pre-irradiation) followed by low-level laser therapy (660nm, 4J/point, 40s) applied to three points per affected commissure. Clinical evolution was monitored at T1 (72h), T2 (7 days), and T3 (follow-up), with lesions classified according to severity. Most patients presented severe systemic compromise, predominantly related to HIV infection and diabetes mellitus. In addition, 76.9% of patients exhibited concomitant oral candidiasis, and 92.3% were receiving systemic antifungal therapy. Complete lesion regression was observed in 40% of patients within 72h (T1). By the final follow-up (T3), the overall clinical cure rate reached 61.5% (8/13), including cases of delayed resolution confirmed up to day 15. Although a 30.8% loss to follow-up occurred due to the inherent challenges of the intensive care setting, no adverse effects or complications were reported. Within the limitations of this preliminary study, aPDT demonstrated promising clinical applicability as an adjunctive approach for managing angular cheilitis in critically ill patients.

This study aimed to evaluate the effectiveness of low-level laser therapy (LLLT) in reducing pain intensity and improving wound healing quality in women during the immediate postoperative period following cesarean section. This randomized clinical trial included 104 postpartum women recruited between April and October 2024, who were allocated into two groups: a control group (n = 52) and an experimental group (n = 52). The experimental group received infrared LLLT at a dose of 5J/cm². Pain intensity was assessed using the Visual Analog Scale (VAS), and wound healing was evaluated using the Vancouver Scar Scale (VSS). Two LLLT sessions were performed at 12-24h and 48h postpartum. A significant reduction in pain intensity was observed after the second application (mean difference [MD]: -1.4; 95% CI: -2.3 to - 0.5), as well as an improvement in overall wound healing quality (MD: 3.31; 95% CI: 3.19 to 3.43). Domain-specific analysis of the VSS revealed improvements in vascularity (MD: 1.0; 95% CI: 1.00 to 1.03) and scar pliability (MD: 1.11; 95% CI: 1.07 to 1.15). No significant differences were observed in global health perception or in the need for pharmacological analgesia. These findings suggest that LLLT is effective in reducing postoperative pain intensity and improving wound healing quality-particularly in terms of scar vascularity and pliability-in women undergoing cesarean section.Clinical trial registrationThis study was prospectively registered in the Brazilian Registry of Clinical Trials (ReBEC) under the registration number RBR-4pkhf4b.

Hidradenitis suppurativa (HS) is a chronic, debilitating skin disease often requiring multimodal therapy. Laser hair removal (LHR) is an emerging treatment option, yet patient-centered data is limited. This study aimed to assess patient perspectives on the effectiveness, safety, motivations, and barriers associated with LHR for HS. An anonymous cross-sectional online survey was administered via REDCap (July-December 2024) to adults with HS living in the United States. Respondents reported prior treatments, LHR parameters, outcomes, adverse effects, and barriers. Descriptive statistics were used. Of 110 participants who completed the survey (110/132, 83%), 24 (22%) had used LHR and comprised the analytic cohort, with a median of 8 LHR sessions (IQR 6-12). Leading motivations included reducing inflammation (92%), relieving pain (75%), and seeking durable treatment (71%). Highest median improvements (score 4, IQR 4-5) were in lumps/abscesses, swelling, and flare frequency. Other symptoms, including pain, odor, and quality of life, also showed moderate improvement. Half reported benefits lasting over 12 months. While biologics were perceived as most effective (median 4.5, IQR 3.5-5), LHR received one of the highest median scores among non-biologic options (3.5, IQR 3-5). Barriers included cost, insurance limitations, and low awareness; 63% paid over $1,000, and 38% discontinued early. Common adverse effects included discomfort (71%) and transient erythema (46%). Most patients perceived LHR as beneficial for HS, but affordability and awareness remain barriers. Findings highlight the need for payer advocacy and additional trials defining LHR's role in HS management.

Laser treatment is rapidly becoming a staple of hypertrophic scar management, but literature reviews have identified significant heterogeneity in laser protocols. Mapping laser operative practices can help to share clinical expertise and identify new research directions. A questionnaire to characterize laser treatment techniques for hypertrophic scars was conducted. The questionnaire was developed with a multidisciplinary team of burns clinicians and researchers and translated into Spanish, Chinese and German. It was distributed internationally to burns clinicians between December 2021 and June 2023. Forty-three clinicians participated in the questionnaire. Respondents used laser to treat both immature (n = 36, 84%) and mature (n = 42, 98%) scars, with varying approaches to how soon therapy should commence post-injury, and how frequently it should be repeated. Almost all respondents used CO2 fractional ablative laser (n = 41, 95%) for scar treatment, one-third used pulsed dye laser (n = 14, 33%), and approximately one-half reported using more than one laser during a single procedure (n = 21, 49%). Respondents used scar thickness to assist with setting laser parameters (n = 29, 67%), chiefly determining this by estimation (n = 25, 58%). 60% of respondents performed scar reconstruction (n = 26), and 91% (n = 39) used adjunct therapies, such as corticosteroids, concurrently with laser treatment. Choices of anesthetic, analgesia and dressings varied widely. While there are similarities in the broad aspects of how burns clinicians use laser to treat hypertrophic scars, there are several differences in practice. These variations highlight potential research directions to optimize patient outcomes from this treatment modality.

The aim of this study was to compare the effectiveness of diode laser and combined treatment protocols, applied in addition to mechanical debridement, in the treatment of peri-implantitis on clinical periodontal parameters and S100A8 levels in peri-implant sulcus fluid (PISF). A total of 39 patients diagnosed with peri-implantitis were divided into three groups based on the treatment protocols used: Mechanical Debridement, Diode Laser, and Combined Treatment. Probing depth, clinical attachment level, modified plaque index, gingival index, and PISF volume measurements were recorded at baseline and at weeks 4 and 12. S100A8 levels in PISF samples were measured by ELISA. During the 12-week follow-up period, statistically significant improvements in clinical parameters were observed in all groups compared with baseline (p < 0.05). In the intergroup comparison, the most significant decrease and statistical superiority in mPI and GI values were observed in the combined treatment group (p < 0.001). Although there was no statistically significant difference among the groups in probing depth and clinical attachment gain, the greatest numerical improvement was observed in the combined group. Despite clinical improvement, no significant change in total S100A8 levels was detected between groups or over time (p > 0.05). The combined use of mechanical debridement and a diode laser in the treatment of peri-implantitis is more effective at reducing clinical signs of inflammation than either method used alone. However, the lack of correlation between S100A8 levels and clinical improvement suggests that this biomarker may not be sensitive in short-term follow-up of treatment.

Chronic skin defects, particularly venous leg ulcers, impose a substantial clinical and socio-economic burden. This single-arm observational study was undertaken to describe the healing dynamics, pain outcomes, feasibility and tolerability of adjuvant visible incoherent polarised (VIP) phototherapy in patients with chronic skin defects who were managed with full standard care, and to examine whether outcomes varied with the principal clinical problem and treatment duration.A prospective, single-arm cohort of 50 patients (38 females, 12 males; mean age 69.4 years) was observed. Adjuvant VIP phototherapy (626nm; 2 mW/cm2) was applied alongside the standard conservative and surgical wound care received by all patients, for 10-20min per field, two to three times daily; the continuous emission mode was changed to a pulsed mode (5Hz) after 7-10 days. Wound area was assessed planimetrically in a representative case, and pain on a 0-10 numeric scale. No sham-irradiated control group was included.Positive healing dynamics were recorded in 92% of the cohort and complete defect closure in 52% (n = 26). In the chronic-pain subgroup (n = 17), pain was reduced in 12 patients and resolved in 5. Improvement was associated with the principal clinical problem (χ2 = 10.406; df = 3; p = 0.015) and with therapy duration (χ2 = 8.630; df = 3; p = 0.035). Two patients reported mild, transient local reactions; no severe adverse events occurred.In this uncontrolled cohort, adjuvant VIP phototherapy was feasible, well tolerated and accompanied by favourable healing and pain outcomes. Because no control group was studied, these findings cannot be attributed to the light itself and are hypothesis-generating; randomised, sham-controlled trials are required.