Combination Of Low-level Laser Therapy Research Articles

Combination of Low-Level Laser Therapy and Autologous Exosome Therapy in Hair Growth; Case Series

Combination of Low-Level Laser Therapy and Autologous Exosome Therapy in Hair Growth; Case Series

Effects of Low-Level Laser Therapy on Shoulder Pain, Functional Disability and Range of Motion in Patients with Type II Slap Tear

BACKGROUND: Low-level lasers may occasionally replace surgery or medications without adverse effects, so studying them stands to reason. It heals, regenerates tissue, reduces inflammation, discomfort, and boosts immunity. Research is continuing. It may help physical therapy, healthcare, and the community by being cost-efficient, simple, and successful. OBJECTIVE: To compare the effects of low-level laser therapy and routine physical therapy on shoulder pain, functional disability, and range of motion in patients with Type II SLAP tear. METHODS: It was a Randomized Controlled Trial conducted at Physical therapy department, Sialkot Medical and Physiotherapy Center Branches Pasroor and Sambrail. The estimated sample size is 52, and adjusting for an expected 20% dropouts, the sample size was 62, allocated 31 in each group. Both male and female patients with Age between 50-70 years having Type II SLAP tear, Visual analogue scale (VAS) score above 3 and the patients diagnosed by physician, orthopedic physician or surgeon or rheumatologist were included. The included patients were allocated in group A, routine physical therapy, and Group B low level laser. All the patients were assessed at baseline, at 4th week of Treatment and at 8th week of Treatment for pain, shoulder pain and disability index and shoulder ranges. RESULTS: The results regarding age showed mean and standard deviation to be 1.8387±.77875 in routine physical therapy group while 1.8065±.79244 in low level laser therapy group. The comparison of mean SPADI total score at 8th week of assessment it was found to be respectively 58.3226±4.57083 and 50.3871±4.85577 with a significant mean difference of 7.935 in favor of low-level laser therapy as shown by p value 0.000. Other outcome measures including pain and shoulder ranges were also significantly improved in low level laser therapy group, p value < 0.05. CONCUSSION: The findings of the study concluded that low level plays the therapy is significantly more effective improving pain disability and shoulder range of motions in patients with slap tear, except for abduction range of motion which was improved equally in both groups. Moreover, within routine physical therapy and low-level laser therapy group showed significant improvement at pre and post level of assessment except that of total shoulder and pain disability index score which was not improved significantly in routine physical therapy group without combination of low-level laser therapy.

Effect of antimicrobial photodynamic therapy on the treatment of peri-implantitis: narrative review

Background and Objective: The greatest challenge of implantology is the maintenance of dental implants, with peri-implantitis being the main cause of implant loss. Studies highlight the importance of dental biofilm control, reduction of the inflammatory process in the peri-implant mucosa and decontamination of the implant surface, as well as the need for surgical intervention. Recently, low-level laser therapy (LLLT) has been introduced in different dental specialties, especially those related to oral mucosa lesions and the treatment of periodontal disease. The combination of LLLT and a photosensitizer dye promotes antimicrobial activity (aPDT) and may be used as a noninvasive treatment of peri-implantitis. The objective of this study was to conduct a literature review on the use of antimicrobial photodynamic therapy (aPDT) in the treatment of peri-implantitis.

The Effectiveness of Repetition or Multiplicity of Different Surgical and Non-Surgical Procedures Compared to a Single Procedure Application in Accelerating Orthodontic Tooth Movement: A Systematic Review and Meta-Analysis.

In this study, we aimed to assess the current scientific evidence concerning the effectiveness of combining two acceleration techniques or repeating an acceleration procedure in comparison with the single application in terms of the speed of the orthodontic tooth movement (OTM).We performed a comprehensive electronic search to retrieve relevant studies on 10 databases. Randomized controlled trials (RCTs) on fixed orthodontic treatment patients who received multiple types of acceleration techniques or underwent a repeated acceleration procedure compared to a single application were included. Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2) was used for assessing the risk of bias of retrieved studies.A total of six RCTs were included in this review. Regarding multiple acceleration methods, it seems that the combination of low-level laser therapy (LLLT) with a surgical technique outperforms the single application of each technique separately. Additionally, the combination of two surgical interventions may have a synergistic effect leading to reduced treatment time compared to the application of a single intervention. Regarding acceleration method repetition, it seems that the re-application of surgical procedures twice is more efficient than the single application. The meta-analysis showed a non-significant difference in the canine retraction rate between the four-weekly micro-osteoperforations (MOPs) (three times of applications) and both the eight-weekly MOPs (two times of applications) [mean difference (MD) = 0.24; 95% CI: -0.2-0.77; p = 0.36], as well as 12-weekly MOPs (two times of applications) (MD = 0.06; 95% CI: -0.14-0.27; p = 0.55).Based on very low evidence, combining two acceleration techniques is superior over a single application in accelerating tooth movement. Again, very low evidence suggests that the efficacy of repetition of surgical procedures twice and three times is similar. Further high-quality RCTs are required to assess the benefit of repeating an acceleration procedure or combining two different methods. In addition, more insight is needed into the possible side effects associated with the repetition or multiplicity of procedures.

Evaluation of Efficacy of Three Treatment Modalities in the Management of Symptomatic Oral Lichen Planus—A Prospective Comparative Study

Context: Oral lichen planus (OLP) is a relatively common chronic inflammatory condition of the oral mucosa. OLP is currently managed by various treatment protocols, the most common being topical and systemic corticosteroid therapy. Low-level laser therapy (LLLT), or photo-biomodulation, is gaining popularity as a palliative treatment for OLP. Aim: The present study was aimed to compare the efficacy of LLLT, topical corticosteroid therapy, or a combination of both in the management of OLP. Settings and Design: Thirty patients who were clinically and histopathologically diagnosed as OLP were randomly selected and divided into three groups: Group 1 (n = 10) received topical corticosteroid therapy (TCT); Group 2 (n = 10) received LLLT; and Group 3 (n = 10) received combination of both the therapies. Materials and Method: Each group of patients received treatment in five sessions of their respective therapy over the course of 15 days, with a three-day interval between each follow-up. The VAS (visual analogue scale) was used to collect data on pain. The percentage of healing was calculated using the WHO oral mucositis assessment scale, the global healing index, and the WU et al. (2010) disease grading system. Results: A reduction in scores in VAS, WHO oral mucositis assessment scale, global healing index, and WU et al. (2010) disease scoring system with the combination of LLLT and topical corticosteroid therapy was observed. Conclusion: Both LLLT and TCT were effective against the symptom control and improvement in clinical manifestation of oral lichen planus, nevertheless; a combination of the two was found to be more beneficial in treatment of symptomatic OLP.

The Effect of Laser Therapy Along With Mediterranean Diet Versus Mediterranean Diet Only on Older Adults With Non-alcoholic Fatty Liver Disease: A Randomized Clinical Trial.

Introduction: Obesity is the major pathogenesis of the non-alcoholic fatty liver disease (NAFLD). The combination of low-level laser therapy (LLLT) and Mediterranean diet (MD) is a new approach for improving liver function. Methods: 60 obese older adults (65-75 years old) with NAFLD were randomly assigned equally to two groups: a study group and a control group. The study group received LLLT and MD, while the control group followed MD only. These findings evaluated the changes in the level of liver enzymes, serum lipid profile, and anthropometric measurements (body mass index [BMI] and waist circumference [WC]) after 12 weeks of intervention. Results: Both study and control groups showed a significant reduction in the levels of liver enzymes, serum lipid profile, BMI, and WC (P < 0.001 and P < 0.01 respectively); however, the study group showed more significant results compared to the control group (P < 0.01). Conclusion: LLLT and MD may be considered as a treatment approach for NAFLD in older adults to improve their liver function, control dyslipidemia, and help in losing weight.

A comparative study on photobiological effects of low-level laser therapy and tinnitus retraining therapy in patients with acoustic trauma-induced tinnitus

Background and Aim: Tinnitus is a subjective auditory symptom referred to the perception of sound in the absence of external stimuli, and there is no definite treatment for it. Rehabilitation methods and laser therapy have been recommen­ded used for its management. This study aimed to investigate the photobiological effects of low-level laser therapy (LLLT) and tinnitus retraining therapy (TRT) in patients with acoustic trauma-induced tinnitus. Methods: This clinical trial was conducted on 60 patients suffering from acoustic trauma-induced tinnitus for more than six months, divided into three groups of LLLT, TRT and LLLT + TRT. The Persian version of tinnitus handicap inven­tory (P-THI), visual analog scale (VAS), and loudness match (LM) scale were used to collect data. The collected data were analyzed in SPSS version.22 software. The effect of time, group and time × group on the scores of VAS, LM, P-THI and its subscales were examined. Results: There was a statistically significant diff­erence between LLLT + TRT and LLLT groups after intervention in terms of LM (p = 0.002) and VAS (p = 0.001) variables, but no statistical sig­nificance for P-THI and its subscales (p = 0.442) was found. Conclusion: Combination of LLLT and TRT, as a therapeutic protocol, is recommended due to their remarkable effects in reducing acoustic trauma-induced tinnitus symptoms. The use of LLLT method alone, however, is not recommen­ded due to its lower effects. Keywords: Tinnitus; low-level laser therapy; tinnitus retraining therapy; tinnitus handicap inventory; loudness matching; visual analog scale

Dentoskeletal effects following Twin-Block functional treatment of skeletal Class II malocclusion accompanied with low-level laser therapy: A prospective clinical evaluation

Abstract Objective: The current prospective study evaluated the dentoskeletal effects subsequent to Twin-Block (TB) functional treatment of skeletal Class II malocclusion accompanied with low-level laser therapy (LLLT). Materials and methods:Twenty eight pre-pubertal patients, 14 boys and 14 girls were randomly allocated to control (mean initial age 10.64±1.36 years) and laser groups (mean initial age 10.55 ±1.45 years). All patients treated with TB appliance where Gallium Aluminum Arsenide diode laser applied in one group weekly around condylar region for 12 sessions inthree months with parameters; continuous mode, 635 nm, 50 mW, 4.5J/cm2, 45 seconds/point, and 11.25J total dose per side. Dentoskeletal variables were analyzed and compared within and between both groups via Cone Beam Computed Tomography (CBCT) images before (T1) and after functional therapy (T2). Results: Within each group, TB therapy resulted in significant mandibular skeletal changes (p 0.05). Conclusions: Combination of LLLT, with the current parameters and protocol, accomplished no considerable dentoskeletal effects subsequent to functional orthopaedic treatment of skeletal Class II malocclusion with TB appliance.

The combination of low level laser therapy and efavirenz drastically reduces HIV infection in TZM-bl cells

BackgroundHuman immunodeficiency virus (HIV) infection remains a global health challenge despite the use of antiretroviral therapy, which has led to a significant decline in the mortality rates. Owing to the unavailability of an effective treatment to completely eradicate the virus, researchers continue to explore new methods. Low level laser therapy (LLLT) has been widely used to treat different medical conditions and involves the exposure of cells or tissues to low levels of red and near infrared light. The study aimed to determine the effect of combining two unrelated therapies on HIV infection in TZM-bl cells. MethodsIn the current study, LLLT was combined with efavirenz, an HIV reverse transcriptase inhibitor to establish their impact on HIV infection in TZM-bl cells. Both the HIV infected and uninfected cells were laser irradiated using a wavelength of 640 nm with fluencies of 2–10 J/cm2. ResultsThe impact of HIV, efavirenz and irradiation were determined 24 h post irradiation using biological assays. Luciferase assay results showed that the combination of LLLT and efavirenz significantly reduced HIV infection in cells, despite the undesirable effects observed in the cells as demonstrated by cell morphology, proliferation and cell integrity assay. Flow cytometry results demonstrated that cell death was mainly through necrosis while fluorescence microscopy showed the production of reactive oxygen species in HIV infected cells. ConclusionEfavirenz and LLLT significantly reduced HIV infection in TZM-bl cells. Furthermore, the death of HIV infected cells was due to necrosis.

Low-Level Laser Therapy as a Coadjuvant in Sodium Hypochlorite Extrusion Management

Aim: The extrusion of sodium hypochlorite through the apical foramen is an accident that can occur during the endodontic treatment although is relatively uncommon, Due to the severe tissue damage that is caused by the solution, the management becomes important to prevent serious sequalae. Low-level laser therapy might be useful to treat damaged soft tissues because of its bio modulatory effects, which may reduce edema and prevent infection. Methods: In this clinical case, the accidental leakage of 5% sodium hypochlorite during the preparation of the root canal of an upper left canine is reported. The accident caused immediate and intense pain and severe edema and ecchymosis. The conventional treatment protocol was applied along with low-level laser therapy. Results: Clinical examination revealed the healing of soft tissue in thirteen days, besides a significant pain reduction in three days after laser therapy was applied. Conclusion: The combination of low-level laser therapy with a conventional treatment protocol could be a useful tool to manage such an accident.

A Comparative Study of Low-Level Laser Therapy and Transcutaneous Electrical Nerve Stimulation as an Adjunct to Pharmaceutical Therapy for Myofascial Pain Dysfunction Syndrome: A Randomized Clinical Trial

Objectives: Myofascial pain dysfunction syndrome (MPDS) is the most common form of temporomandibular disorders. Because of the multifactorial nature of the problem, its management usually involves several treatment modalities to maximize their synergistic effects. This randomized clinical trial aimed to assess the efficacy of low-level laser therapy (LLLT) and transcutaneous electrical nerve stimulation (TENS) as an adjunct to pharmaceutical therapy for treatment of MPDS.&#x0D; Materials and Methods: This clinical trial evaluated 108 MPDS patients. First, the initial pain intensity of patients was determined using a visual analogue scale (VAS). The first phase of the study included education, awareness, self-care, behavior and relaxation therapy. After 1 month, the pain score was measured again using VAS. Patients who acquired a pain score &gt;1 were divided into three groups of LLLT with diode (GAAlAr) laser with 0.2 W power, TENS, and control, using block randomization. All groups received 10 mg fluoxetine once daily, 0.25 mg clonazepam once daily and 10 mg baclofen three times a day. ANOVA was used to compare the recovery rate of the three groups.&#x0D; Results: Pain in the trapezius muscle and pain on mouth opening resolved faster in the laser + medication group. The recovery rate was faster in the mean muscle pain, general pain reported by patients, pain in the masseter and pterygoid muscles and pain and limitation in lateral movements in both laser + medication and TENS groups.&#x0D; Conclusion: Combination of LLLT and TENS with medication accelerated pain relief and resolved movement restrictions in MPDS patients.&#x0D; (IRCT registration number: IRCT201411113144N4)

Effects of the combination of low-level laser therapy and anionic polymer membranes on bone repair.

In view of the limitations of bone reconstruction surgeries using autologous grafts as a gold standard, tissue engineering is emerging as an alternative, which permits the fabrication and improvement of scaffolds to stimulate osteogenesis and angiogenesis, processes that are essential for bone repair. Polymers are used to mimic the extracellular bone matrix and support cell growth. In addition, bone neoformation can be induced by external factors such as laser irradiation, which stimulates bone metabolism. The objective of this study was to evaluate the regeneration of bone defects using collagen and elastin membranes derived from intestinal serosa and bovine auricular cartilage combined with low-level laser application. Thirty-six Wistar rats were operated to create a 3-mm defect in the distal metaphysis of the left femur and divided into six groups: G1 (control, no treatment); G2 (laser); G3 (elastin graft), G4 (elastin+laser); G5 (collagen graft); G6 (collagen+laser). The animals were sacrificed 6weeks after surgery and the femurs were removed for analysis of bone repair. Macroscopic and radiological results showed the absence of an infectious process in the surgical area. This was confirmed by histological analysis, which revealed no inflammatory infiltrate. Histomorphometry showed that the formation of new bone started from the margins of the bone defect and its volume was greater in elastin+laser and collagen+laser. We conclude that newly formed bone in the graft area was higher in the groups that received the biomaterials and laser. The collagen and elastin matrices showed biocompatibility.

A Comparative Study of Low-Level Laser Therapy and Transcutaneous Electrical Nerve Stimulation as an Adjunct to Pharmaceutical Therapy for Myofascial Pain Dysfunction Syndrome: A Randomized Clinical Trial

Objectives:Myofascial pain dysfunction syndrome (MPDS) is the most common form of temporomandibular disorders. Because of the multifactorial nature of the problem, its management usually involves several treatment modalities to maximize their synergistic effects. This randomized clinical trial aimed to assess the efficacy of low-level laser therapy (LLLT) and transcutaneous electrical nerve stimulation (TENS) as an adjunct to pharmaceutical therapy for treatment of MPDS.Materials and Methods:This clinical trial evaluated 108 MPDS patients. First, the initial pain intensity of patients was determined using a visual analogue scale (VAS). The first phase of the study included education, awareness, self-care, behavior and relaxation therapy. After 1 month, the pain score was measured again using VAS. Patients who acquired a pain score >1 were divided into three groups of LLLT with diode (GAAlAr) laser with 0.2 W power, TENS, and control, using block randomization. All groups received 10 mg fluoxetine once daily, 0.25 mg clonazepam once daily and 10 mg baclofen three times a day. ANOVA was used to compare the recovery rate of the three groups.Results:Pain in the trapezius muscle and pain on mouth opening resolved faster in the laser + medication group. The recovery rate was faster in the mean muscle pain, general pain reported by patients, pain in the masseter and pterygoid muscles and pain and limitation in lateral movements in both laser + medication and TENS groups.Conclusion:Combination of LLLT and TENS with medication accelerated pain relief and resolved movement restrictions in MPDS patients.(IRCT registration number: IRCT201411113144N4)

Low-level Laser Therapy in Combination with Desensitising Agent Reduces Dentin Hypersensitivity in Fluorotic and Non-fluorotic Teeth - A Randomised, Controlled, Double-blind Clinical Trial.

Dentin hypersensitivity (DH) is a prevalent painful condition of the teeth, the management of which lies in the obliteration of patent dentinal tubules. The purpose of this study was to compare the efficacy of 5% potassium nitrate (PN), low-level laser therapy (LLLT), and combination of low-level laser therapy and 5% potassium nitrate (LLLT+PN) in patients with fluorotic and non-fluorotic hypersensitive teeth. Ninety self reporting patients with DH completed the randomised, double-blind study. Patients were equally divided into fluorosis group (FG), with moderate to moderately severe fluorosis and the non-fluorosis group (NFG) and subdivided into 3 groups to receive PN, LLLT (810 nm, 1 W) alone and LLLT+PN. Each participant had at least one tooth eliciting a response of ≥ 3 on a visual analog scale (VAS) to evaporative, thermal and electric tactile stimulus (digital scratch-o-meter). The teeth were evaluated at baseline, 30 min post treatment, 1 week, 4 weeks and 12 weeks. The magnitude of pressure applied by the scratch-o-meter was also assessed for all three interventions. Statistically, LLLT+PN was more effective in alleviating DH at all time intervals compared to baseline. However, statistically significant results (p ˂ 0.05) were seen with LLLT+PN at 12 weeks in FG. Magnitude of pressure applied showed statistically significant differences with LLLT+PN at 30 min post treatment. LLLT+PN alleviated DH at all time intervals, with a greater effect in the fluorotic group. However, LLLT+PN was more efficacious in reducing DH at 12 weeks post treatment in the fluorotic group.

Photobiomodulation therapy protects skeletal muscle and improves muscular function of mdx mice in a dose-dependent manner through modulation of dystrophin.

This study aimed to analyze the protective effects of photobiomodulation therapy (PBMT) with combination of low-level laser therapy (LLLT) and light emitting diode therapy (LEDT) on skeletal muscle tissue to delay dystrophy progression in mdx mice (DMD mdx ). To this aim, mice were randomly divided into five different experimental groups: wild type (WT), placebo-control (DMD mdx ), PBMT with doses of 1J (DMD mdx ), 3J (DMD mdx ), and 10J (DMD mdx ). PBMT was performed employing a cluster probe with 9 diodes (1 x 905nm super-pulsed laser diode; 4 x 875nm infrared LEDs; and 4 x 640nm red LEDs, manufactured by Multi Radiance Medical®, Solon - OH, USA), 3 times a week for 14weeks. PBMT was applied on a single point (tibialis anterior muscle-bilaterally). We analyzed functional performance, muscle morphology, and gene and protein expression of dystrophin. PBMT with a 10J dose significantly improved (p < 0.001) functional performance compared to all other experimental groups. Muscle morphology was improved by all PBMT doses, with better outcomes with the 3 and 10J doses. Gene expression of dystrophin was significantly increased with 3J (p < 0.01) and 10J (p < 0.01) doses when compared to placebo-control group. Regarding protein expression of dystrophin, 3J (p < 0.001) and 10J (p < 0.05) doses also significantly showed increase compared to placebo-control group. We conclude that PBMT can mainly preserve muscle morphology and improve muscular function of mdx mice through modulation of gene and protein expression of dystrophin. Furthermore, since PBMT is a non-pharmacological treatment which does not present side effects and is easy to handle, it can be seen as a promising tool for treating Duchenne's muscular dystrophy.

A randomized, open-label pilot of the combination of low-level laser therapy and lorcaserin for weight loss.

BackgroundObesity is a significant public health problem and innovative treatments are needed. The purpose of this pilot study was to assess the preliminary efficacy and safety of a combined treatment of low-level laser therapy (LLLT) and lorcaserin on weight loss, health quality of life (QOL) measures, and cardiovascular risk factors.MethodsForty-five overweight and obese adult participants with a body mass index (BMI) >26.9 and <40 were randomized to receive LLLT, lorcaserin, or a combination of the two therapies. All study participants received treatment for 3 months and were followed for 3 months post-treatment. Participants were recruited from June 2014 through September 2014.ResultsThe majority of the 44 participants accrued to this study were female (84 %) with an average age of 43.9 years (range 22 to 64 years). Most participants (93 % LLLT alone, 87 % LLLT + lorcaserin) completed at least 80 % of the LLLT treatments. From baseline to end of treatment, significant reductions in waist circumference were noted for each treatment group (-2.3 ± 4.1 cm, -6.0 ± 7.3 cm, and -4.0 ± 5.5 cm for LLLT, lorcaserin and combination respectively); however, the reduction in body weight was only significant in those receiving lorcaserin and combination treatment (-0.4 ± 1.5 kg, -1.3 ± 1.2 kg and -1.3 ± 1.3 kg). No significant differences were noted between the groups. Self-reported satisfaction was higher in the lorcaserin versus the LLLT group.ConclusionThis small pilot demonstrates that when combined with behavioral intervention, Lorcaserin and LLLT may be effective components of a comprehensive approach to the treatment of overweight and obesity in the clinical setting. Further studies with larger sample size and longer duration of treatment and follow-up are needed to further address efficacy.Trial Registry InformationTrial registration: NCT02129608. Registered June 15, 2014.

LLLT for the management of patients with ankylosing spondylitis.

This study aimed to compare the effectiveness of the combined low-level laser therapy (LLLT) and passive stretching with combined placebo LLLT laser and the same passive stretching exercises in patients suffering from Αnkylosing spondylitis. Forty-eight patients suffering from Αnkylosing spondylitis participated in the study and were randomized into two groups. Group A (n = 24) was treated with a λ = 820 Ga-Al-As laser CW, with power intensity = 60 mW/cm(2), energy per point in each session = 4.5 J, total energy per session = 27.0 J, in contact with specific points technique, plus passive stretching exercises. Group B (n = 24), received placebo laser plus the same passive stretching exercises. Both groups received 12 sessions of laser or placebo within 8 weeks; two sessions per week (weeks 1-4) and one session per week (weeks 5-8). Pain and function scales were completed before the treatment, at the end of the fourth and eighth week of treatment, and 8 weeks after the end of treatment (follow-up). Group A revealed a significant improvement after 8 weeks of treatment in all pain and function scales. At 8-week follow-up, the improvement remained only for the pain, while for all other function outcomes the differences were not statistically significant. The results suggested that after an 8-week treatment and after a follow-up, the combination of LLLT and passive stretching exercises decreased pain more effectively than placebo LLLT along with the same passive stretching exercises in patients with Αnkylosing spondylitis. Future studies are needed to establish the relative and absolute effectiveness of the above protocol.

Use of a 660-nm Laser to Aid in the Healing of Necrotic Alveolar Mucosa Caused by Extruded Sodium Hypochlorite: A Case Report

The extrusion of sodium hypochlorite through the apical foramen is an accident that can occur during the flushing procedure in endodontic treatment. The symptomatology is immediate and intense, and there is a long period before the tissues return to normal. Low-level laser therapy might be useful as an adjunctive treatment for damaged soft tissues because of its anti-inflammatory and analgesic effects, which may reduce edema and prevent infection. In this clinical case, the accidental leakage of 1% sodium hypochlorite during the preparation of the root canal of a maxillary right central incisor is reported. This leakage caused immediate and intense pain and edema formation and resulted in an extensive necrotic area in the alveolar mucosa adjacent to the root of the treated tooth. The conventional treatment protocol was combined with low-level laser therapy. Clinical and radiographic examinations after 7 months revealed complete repair of the necrotic area with no paresthesia and further indicated the integrity of the apical region of the tooth where the extrusion of sodium hypochlorite occurred. The combination of low-level laser therapy with a conventional treatment protocol in this case of the extrusion of 1% sodium hypochlorite resulted in the healing of the wounds.

Piroxicam and laser phototherapy in the treatment of TMJ arthralgia: a double‐blind randomised controlled trial

This study aimed to evaluate the efficacy of piroxicam associated with low-level laser therapy compared with single therapies in 32 patients presenting temporomandibular joint arthralgia in a random and double-blind research design. The sample, divided into laser + piroxicam, laser + placebo piroxicam and placebo laser + piroxicam groups, was submitted to the treatment with infrared laser (830nm, 100 mW, 28s, 100Jcm(-2) ) at 10 temporomandibular joint and muscle points on each side during four sessions concomitant to take one capsule a day of piroxicam 20mg during 10days. The treatment was evaluated throughout four sessions and 30days follow-up through visual analogue scale (VAS), maximum mouth opening and joint and muscle (temporal and masseter) pain on palpation. The results showed that all the study groups had a significant improvement in the VAS scores (P<0·05), and there were no significant group differences. Piroxicam was effective in the reduction of joint and muscle pain on palpation (P<0·05) and showed the lowest temporal pain (P=0·02) at the 30-day follow-up. The combination of low-level laser therapy and piroxicam was not more effective than single therapies in the treatment of temporomandibular joint arthralgia. The use of piroxicam was more effective in the following 30days.

Phenothiazine Chloride and Soft Laser Light Have a Biostimulatory Effect on Human Osteoblastic Cells

Low-level laser therapy (LLLT) is a well accepted tool to accelerate wound healing and to reduce inflammation after oral implant insertion. Since there are no in vitro data on a combination of LLLT with prior photosensitization, it was the aim of this study to investigate if photosensitization with phenothiazine chloride results in an alteration of the biostimulatory effect of low-level laser irradiation. LLLT and antimicrobial photodynamic therapy are well established for the treatment of peri-implantitis. In vitro studies have shown a biostimulatory effect of LLLT on various cell types, including osteogenic cells. SaOS-2 cells were treated with the photosensitizer phenothiazine chloride before irradiation with matched laser light. At 24-h intervals the viability and differentiation were analyzed in treated and untreated cells. While the biostimulatory effect of the LLLT could be observed for the lower irradiation dose, the pretreatment with phenothiazine chloride did not significantly affect the growth and differentiation of the SaOS-2 cells. It can thus be concluded that combined treatment with phenothiazine chloride and LLLT does not result in a synergistic enhancement of the biostimulatory effect of LLLT, but there was also no evidence for antagonizing effects on growth and differentiation of human osteoblasts.