Low-level Laser Therapy Group Research Articles

Effects of Low-Level Laser Therapy and Transcutaneous Electrical Nerve Stimulation on Pain and Hand Function Following Carpal Tunnel Syndrome

Introduction: This study aimed to compare the short-term effects of Low-Level Laser Therapy (LLLT) and Transcutaneous Electrical Nerve Stimulation (TENS) on hand pain and function in patients with low or moderate levels of Carpal Tunnel Syndrome (CTS). Materials and Methods : Twenty-four patients with confirmed mild to moderate CTS were recruited for this study. The eligible patients were randomly divided into two groups: LLLT and TENS. Patients in the LLLT group were exposed to GaAlAs diode laser, 808 nm with 6.5 J/cm 2 for two points perpendicularly over the carpal area. Patients in the TENS group were treated daily by conventional TENS with 80 µs duration for a period of 30 minutes per day. All patients were treated daily, five days per week for a period of two weeks. The researchers performed clinical assessment using visual analogue scale and McGill Pain questionnaire for pain rating and Disabilities of the Arm, Shoulder and Hand questionnaire for functional scales. For statistical analysis, paired t-test was used in each group, and analysis of variance was used for comparison between groups. Results: All outcome measures in the LLLT group were substantially improved while the TENS group provided better pain sensation. Conclusion: This study documented that LLLT might be effective in reducing pain and improving function in patients with mild to moderate CTS. Electrical stimulation might have been effective (short term) in controlling pain in these patients. Keywords: Carpal Tunnel Syndrome; Function; Low-level Lasers; Pain; TENS

The effect of light-emitting diode (590/830 nm)−based low-level laser therapy on posttraumatic edema of facial bone fracture patients

PurposePosttraumatic edema in facial bone fracture patients may interfere with the operation field and delay the schedule. Thus, swiftly reducing the edema alleviates patient discomfort and advances the operation date. Ice packing and compression bandages are often used for such a purpose, but such methods are often inconvenient for the face. In this study, we aim to analyze the effect of light-emitting diode (LED) (590/830 nm)−based low-level laser therapy (LLLT) in posttraumatic edema in facial bone fracture patients. Materials and methodsWe conducted a prospective cohort study of 40 patients who were admitted to a single institution for facial bone fracture. The patients were divided into two groups of 20 each, treated either with LLLT or with sham treatment light. We used an LLLT device that consists of planar LED-based arrays with double wavelengths 590 nm and 830 nm. The patients were treated with either true or sham light from posttraumatic day 1–5, twice a day. After each treatment, the volume of a patient's face was measured with a 3-dimensional camera. We analyzed and compared the changes in facial edema. The Wilcoxon rank sum test was conducted for statistical comparison of the two groups, and significance was set to the level of p < 0.05. ResultsThe sex ratio and mean age of the two groups were of little difference. The fracture sites included the nasal bone, orbital wall, zygomaticomaxillary bone, mandible, and frontal sinus. Mechanisms of injury included fall, assault, traffic accident, sports, and gunshot. The total operation rate of both groups was equal to 85%. Our analysis showed a 16.5% reduction of edema in the LLLT group and 7.3% in the sham light group. The edema reduction was statistically significantly greater in the LLLT group than in the sham light group (p < 0.047). ConclusionLED-based LLLT is recently receiving attention worldwide for its cost-effectiveness and large coverage area compared to traditional laser therapy. Recent studies support its effectiveness in various areas such as wound healing, skin rejuvenation, and pain alleviation. In this study, we treated facial bone fracture patients with LED-based LLLT, and showed its effectiveness in reducing posttraumatic edema.

Preconditioning by light-load eccentric exercise is equally effective as low-level laser therapy in attenuating exercise-induced muscle damage in collegiate men.

Background/objectivePrevious studies have already reported an independent effect of light-load eccentric exercise (10% eccentric exercise contraction [EEC]) and low-level laser therapy (LLLT) as a protective measure against more strenuous eccentric exercise. However, the difference between these two interventions is largely unknown. Therefore, the present study aimed to compare the preconditioning effect of 10% EEC vs. LLLT on subjective, physiological, and biochemical markers of muscle damage in elbow flexors in collegiate men.MethodsAll 36 enrolled subjects were randomly assigned to either 10% EEC or LLLT group. Subjects in 10% EEC group performed 30 repetitions of an eccentric exercise with 10% maximal voluntary contraction strength 2 days prior to maximal eccentric exercise bout, whereas subjects in LLLT group were given LLLT. All the indirect markers of muscle damage were measured pre-exercise and at 24, 48, and 72 hours after the exercise-induced muscle damage protocol.ResultsThe muscle soreness was reduced in both groups (p = 0.024); however, soreness was attenuated more in LLLT group at 48 hours (33.5 vs. 42.7, p = 0.004). There was no significant difference between the effect of 10% EEC and LLLT groups on other markers of muscle damage like a maximum voluntary isometric contraction (p = 0.47), range of motion (p = 0.16), upper arm circumference (p = 0.70), creatine kinase (p = 0.42), and lactate dehydrogenase (p = 0.08). Within-group analysis showed both interventions provided similar protection over time.ConclusionThis study indicated that light-load eccentric exercise confers similar protective effect against subsequent maximal eccentric exercise as LLLT. Both the treatments could be used reciprocally based on the patient preference, costs, and feasibility of the equipment.

Long-term results of a randomized, controlled, double-blind study of low-level laser therapy before exercises in knee osteoarthritis: laser and exercises in knee osteoarthritis

Objectives: To assess the long-term effects of low-level laser therapy (LLLT), in combination with strengthening exercises in patients with osteoarthritis of the knee. Design: Follow-up results at three and six months in a previously published randomized, double-blind, placebo-controlled trial. Setting: Specialist Rehabilitation Services. Subjects: Forty participants of both genders, aged 50–75 years with knee osteoarthritis grade 2–4 on Kellgren–Lawrence scale. Intervention: The LLLT group received 10 LLLT treatments with invisible infrared laser (904 nm, 3 Joules/point) over three weeks followed by an eight-week supervised strengthening exercise program. The placebo LLLT group received identical treatment, but the infrared laser output was disabled. Main measures: Pain on a visual analogue scale, paracetamol consumption, and osteoarthritis severity measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Lequesne Index. Results: The new data obtained during the follow-up period showed that all outcomes remained stable and there were no significant differences between the groups at three and six months. However, daily consumption of rescue analgesics (paracetamol) was significantly lower in the LLLT group throughout the follow-up period, ending at a group difference of 0.45 vs. 3.40 units (P < 0.001) at six months follow-up. We conclude that within the limitations of this small study, the previously reported improvement after LLLT plus exercise was maintained for a period of six months. Conclusion: We find that the immediate post-intervention improvements from LLLT plus strengthening exercises were maintained for six months.

Efficacy of Multiwave Locked System Laser on Pain and Function in Patients with Chronic Neck Pain: A Randomized Placebo-Controlled Trial.

Multiwave locked system (MLS) laser therapy utilizes the synchronized emission of an 808 nm continuous laser and a 905 nm pulsed laser. It is postulated that MLS enables greater penetration and therapeutic benefit than single-wavelength low-level laser therapy (LLLT). The aim of this research was to evaluate the efficacies of MLS laser therapy and the 830 nm laser in the treatment of patients with chronic neck pain (CNP). Seventy-five patients with CNP (mean age 46.28 ± 5.89, weight 83.78 ± 5.65 kg, height 1.72 ± 4.96 m, and duration of illness of 5.98 ± 1.44 months). They were randomized into three groups. Group I received MLS laser therapy and exercises, Group II received LLLT and exercises, and Group III received placebo laser therapy plus exercises (PL + EX). Neck pain levels and neck function were measured using the visual analogue scale (VAS) and neck disability index (NDI), respectively. Both VAS and NDI were significantly reduced post-treatment for all treatment groups. After 6 weeks of treatment, MLS plus exercise showed a significantly greater decrease in pain and disability scores {Δ VAS (6.68) and Δ NDI (39.84)} compared to both LLLT plus exercise group {Δ VAS (5.72) and Δ NDI (37.88)} and PL + EX {Δ VAS (4.84) and Δ NDI (36.68)}. MLS laser therapy in conjunction with exercises decreased pain and increased functional activity following 6 months of therapy. MLS laser therapy in combination with exercises is a more effective therapy for CNP compared to exercise plus LLLT or exercise alone.

Magnetic Resonance Imaging and Clinical Outcomes of Laser Therapy, Ultrasound Therapy, and Extracorporeal Shock Wave Therapy for Treatment of Plantar Fasciitis: A Randomized Controlled Trial

We determined and compared the effectiveness of low-level laser therapy (LLLT), therapeutic ultrasound (US) therapy, and extracorporeal shock wave therapy (ESWT) using magnetic resonance imaging (MRI). We performed a randomized, prospective, comparative clinical study. A total of 60 patients with a diagnosis of chronic plantar fasciitis were divided randomly into 3 treatment groups: group 1 underwent 15 sessions of LLLT (8 J/cm2; 830 nm); group 2 underwent 15 sessions of continuous US (1 mHz; 2 W/cm2); and group 3 underwent 3 sessions of ESWT (2000 shocks). All patients were assessed using the visual analog scale (VAS), heel tenderness index (HTI), American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, Roles–Maudsley score, and MRI before and 1 month after treatment. The primary efficacy success criterion was the percentage of decrease in heel pain of >60% from baseline at 1 month after treatment for ≥2 of the 3 heel pain (VAS) measurements. Significant improvement was measured using the mean VAS, AOFAS scale, and HTI scores for all 3 groups. The thickness of the plantar fascia had decreased significantly on MRI in all 3 groups. The treatment success rate was 70.6% in the LLLT group, 65% in the ESWT group, and 23.5% in the US group. LLLT and ESWT proved significantly superior to US therapy using the primary efficacy criterion (p = .006 and p = .012, respectively), with no significant difference between the LLLT and ESWT groups (p > .05). The treatment of chronic plantar fasciitis with LLLT and ESWT resulted in similar outcomes and both were more successful than US therapy in pain improvement and functional outcomes.

The effect of low-level laser therapy as an adjunct to non-surgical periodontal treatment on gingival crevicular fluid levels of transforming growth factor-beta 1, tissue plasminogen activator and plasminogen activator inhibitor 1 in smoking and non-smoking chronic periodontitis patients: Asplit-mouth, randomized control study.

This study aimed to investigate the effects of low-level laser therapy (LLLT) as an adjunct to scaling and root planing (SRP) on smoking and non-smoking patients with chronic periodontitis. The study was conducted using a split-mouth design with 30 patients with chronic periodontitis (15 smokers, 15 non-smokers) and 30 healthy individuals matched for age, sex and smoking status as controls. Groups were constituted as follows: Cp+SRP+Sham: non-smokers with chronic periodontitis treated with SRP; Cp+SRP+LLLT: non-smokers with chronic periodontitis treated with SRP+LLLT; SCp+SRP+Sham: smokers with chronic periodontitis treated with SRP; SCp+SRP+LLLT: smokers with chronic periodontitis treated with SRP+LLLT; C: control group comprised of periodontally healthy non-smokers; SC: control group comprised of periodontally healthy smokers. LLLT was first applied on the same day as SRP and again on days 2 and 7 after SRP treatment. Clinical parameters were recorded before non-surgical periodontal treatment (baseline) and on day 30. Gingival crevicular fluid samples were collected before periodontal treatment (baseline) and during follow-up visits on days 7, 14 and 30. Gingival crevicular fluid transforming growth factor (TGF)-β1, tissue plasminogen activator (tPA) and plasminogen activator inhibitor 1 (PAI-1) levels were measured using enzyme-linked immunosorbent assay. All clinical parameters showed significant reductions between baseline and day 30 following SRP treatment in both the LLLT and sham groups (P<.001). No significant differences were observed between the LLLT and sham groups of either the smokers or non-smokers (P>.05). Gingival crevicular fluid PAI-1 levels decreased significantly in the SCp+SRP+sham and SCp+SRP+LLLT groups (P<.05), and gingival crevicular fluid tPA levels decreased significantly in the Cp+SRP+sham, Cp+SRP+LLLT and SCp+SRP+LLLT groups (P<.05). Gingival crevicular fluid TGF-β1 levels decreased significantly in all treatment groups (P<.05). Although no significant differences were found between the gingival crevicular fluid PAI-1, tPA and TGF-β1 levels of the LLLT versus sham groups (P>.05) at any of the time points measured, both LLLT groups showed significant reductions in tPA/PAI-1 ratios over time. Within the limits of this study, LLLT may be understood to play a role in the modulation of periodontal tissue tPA and PAI-1 gingival crevicular fluid levels, particularly in smoking patients with chronic periodontitis, and may thus be recommended as an adjunct to non-surgical periodontal treatment.

Low-level laser facilitates alternatively activated macrophage/microglia polarization and promotes functional recovery after crush spinal cord injury in rats

Macrophages and resident microglia play an import role in the secondary neuroinflammation response following spinal cord injury. Reprogramming of macrophage/microglia polarization is an import strategy for spinal cord injury restoration. Low-level laser therapy (LLLT) is a noninvasive treatment that has been widely used in neurotrauma and neurodegenerative diseases. However, the influence of low-level laser on polarization of macrophage/microglia following spinal cord injury remains unknown. The present study applied low-level laser therapy on a crush spinal cord injury rat model. Using immunofluorescence, flow cytometry, RT-qPCR, and western blot assays, we found that low-level laser therapy altered the polarization state to a M2 tendency. A greater number of neurons survived in the pare injury site, which was accompanied by higher BBB scores in the LLLT group. Furthermore, low-level laser therapy elevated expression of interleukin 4 (IL-4) and interleukin 13 (IL-13). Results from this study show that low-level laser therapy has the potential for reducing inflammation, regulating macrophage/microglia polarization, and promoting neuronal survival. These beneficial effects demonstrate that low-level laser therapy may be an effective candidate for clinical treatment of spinal cord injury.

Low-Level Laser Therapy in Enhancing Wound Healing and Preserving Tissue Thickness at Free Gingival Graft Donor Sites: A Randomized, Controlled Clinical Study.

The aim of this study was to determine the effects of low-level laser therapy (LLLT) on wound healing at free gingival graft (FGG) donor sites. Forty patients requiring FGG were selected for this randomized, controlled, and double-blinded prospective clinical trial. The FGG donor sites were treated with LLLT and compared with an untreated control group. The Wound-Healing Index (WHI), tissue consistency, color match, and H2O2 bubbling test for the evaluation of complete wound epithelialization were recorded on the 3rd, 7th, 14th and 21st days. The pain-burning level, number of analgesics, and bleeding were recorded for 7 days. Donor area soft tissue thickness (TT) was measured at baseline and at the first month. The prevalence of Complete Wound Epithelization was higher in the LLLT group than in the control group on the 14th day (p < 0.001). The bleeding was lower in the test group than in the control group during the first 2 days (p ≤ 0.001). Higher WHI Scores were observed in the test group relative to the control group at all visits (p ≤ 0.001). Color match scores were higher in the test group than in the control group at the first 3 visits (p < 0.05). The TT changed from 4.62 ± 0.79 to 4.71 ± 0.82 mm in the LLLT group and from 4.23 ± 0.62 to 4.01 ± 0.68 mm in the control group. It can be concluded that LLLT enhances FGG donor site wound healing and preserves TT at palatinal donor sites.

Preoperative low level laser therapy in dogs undergoing tibial plateau levelling osteotomy: A blinded, prospective, randomized clinical trial.

To evaluate the influence of preoperative low-level laser therapy (LLLT) on therapeutic outcomes of dogs undergoing tibial plateau levelling osteotomy (TPLO). Healthy dogs undergoing TPLO were randomly assigned to receive either a single preoperative LLLT treatment (800-900 nm dual wavelength, 6 W, 3.5 J/cm2, 100 cm2 area) or a sham treatment. Lameness assessment and response to manipulation, as well as force plate analysis, were performed preoperatively, then again at 24 hours, two weeks, and eight weeks postoperatively. Radiographic signs of healing of the osteo-tomy were assessed at eight weeks postoperatively. Twenty-seven dogs (27 stifles) were included and no major complications occurred. At eight weeks postoperatively, a significant difference in peak vertical force analysis was noted between the LLLT (39.6% ± 4.7%) and sham groups (28.9% ± 2.6%), (p<0.01 Time, p <0.01 L). There were no significant differences noted between groups for all other parameters. The age of dogs in the LLLT group (6.6 ± 1.6 years) was greater than that for the sham group (4.5 ± 2.0, p <0.01). Although not significant, a greater proportion of LLLT dogs (5/8) had healed at the eight-week time point than in the sham group (3/12) despite the age difference (p = 0.11) Clinical significance: The results of this study demonstrate that improved peak vertical force could be related to the preoperative use of LLLT for dogs undergoing TPLO at eight weeks postoperatively. The use of LLLT may improve postoperative return to function following canine osteotomies and its use is recommended.

The effects of grapeseed extract and low level laser therapy administration on the liver in experimentally fractured mandible

Aim: The present study investigated the changes in the liver tissues of rats with experimentally fractured mandible following the use of Grape Extract (GSE) and Low Level Laser Therapy (LLLT) in healing the fracture in dentistry. Materials and Methods: 60 adult male Wistar Albino rats were randomly assigned to 5 main groups (Control, Fractured Mandible (FM), FM + GSE, FM + LLLT, FM + LLLT + GSE), and then these groups were divided into two groups of 7 and 21 days (n = 6). A vertical fracture line passing through the molar teeth was formed in the right mandibles of all subjects except for these in the control group, and the fracture was internally fixed with a four-hole microplate and four micro-screws. Malondialdehyde (MDA), reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT) activities were analyzed to determine the changes caused by GSE and LLLT administration in rat liver tissues in fractured mandibles. Results: It was determined that MDA and SOD levels in FM group and GSH and CAT activity levels in FM + GSE group and MDA levels in FM + LLLT group and GSH and CAT levels in FM + GSE + LLLT group increased statistically significantly to the control group on days 7 and 21. Conclusion: Biochemical parameters were investigated on the 7th and the 21st days, and it was determined that the oxidative damage caused by mandibular defects could be eliminated substantially in the rat liver especially with the administration of grapeseed that has antioxidant capacity.

Low-level laser therapy: A novel therapeutic approach to temporomandibular disorder - A randomized, double-blinded, placebo-controlled trial.

The objective of this study was to assess the effectiveness of low-level laser therapy (LLLT)/low intensity laser therapy (LILT) in the management of temporomandibular joint (TMJ) pain in a random and double-blind research design. TMJ pain patients, randomly assigned into two groups: Group 1 (n = 20) and Group 2 (n = 20), received 2-3 treatments per week for 8 sessions of active LILT with diode laser (gallium aluminum arsenide, 810 nm, 0.1 W). Measures of TMJ pain during function were evaluated at baseline, after completion of 8 sessions of laser treatment, and 30 days after the final laser therapy. At the final treatment point, within-group, pain reduction was observed in both active LLLT and placebo groups at day 0 (P = 0.000), 8th session (P = 0.000), and 1 month (P = 0.001). Between the groups, there is no significant difference at day 0 (P = 0.214), 8th session (P = 0.806), and 1 month (P = 0.230). Significant increased mouth opening was observed in both Group 1 and Group 2 (P = 0.006 and P = 0.021, respectively) after treatment. However, no significant difference was found between the two groups (P = 0.330). Furthermore, significant improvement in clicking was recorded before and after treatment both in Group 1 (P = 0.000) and Group 2 (P = 0.001). The study suggests that LLLT is not better than placebo at reducing TMJ pain during function. It may be assumed that a more tailored application of LLLT should be developed to take into account the multifactorial aspect of the disorder.

Effects of radiofrequency, electroacupuncture, and low-level laser therapy on the wrinkles and moisture content of the forehead, eyes, and cheek

[Purpose] The purpose of this study was to investigate the effects of radiofrequency (RF), electroacupuncture (EA), and low-level laser therapy (LLLT), which are used in physical therapies, on facial wrinkles and moisture. [Subjects and Methods] A total of 30 female participants aged 30–55 years participated in this study and the results will be used as a reference for further development of skin physical therapy. Thirty adult females were assigned to an LLLT (n=10), EA (n=10), or RF group (n=10). The intervention was performed in two 15-minute sessions per week for six weeks. Subjects’ skin tone and pigmentation were observed before and after the intervention. [Results] Treatment of the under eye area showed that wrinkles were significantly decreased on both sides after RF, EA, and LLLT. Treatment of the eye rims indicated that wrinkles significantly decreased on the right side after RF, EA, and LLLT. [Conclusion] The application of LLLT, EA, and RF had positive effects on wrinkle and moisture content of adult women’s faces.

Electromyographic evaluation of a low-level laser protocol for the treatment of temporomandibular disorder: a randomized, controlled, blind trial.

[Purpose] Problems involving the temporomandibular joint and associated structures can lead to temporomandibular disorder (TMD). The aim of the present study was to evaluate muscle activity in individuals with a diagnosis of TMD before and after treatment with low-level laser therapy (LLLT) through the use of electromyography (EMG). [Subjects and Methods] Male and female individuals aged 14 to 23 years were evaluated. TMD was determined by a clinical examination and the administration of the Research Diagnostic Criteria for Temporomandibular Disorders, followed by the evaluation of sensitivity to palpation of the masseter and anterior temporal muscles as well as the EMG determination of muscle activity. The participants were randomly allocated to an active LLLT group (n=9) and sham group (n=7). Twelve sessions of LLLT were conducted using a wavelength of 780 nm, energy density of 25 J/cm2, power of 50 mW, power density of 1.25 W/cm2 and a 20-second exposure time or sham LLLT. Muscle activity was determined prior to treatment and after the last session. [Results] During the isometric evaluation of the masseter and anterior temporal muscles, an increase in the mean EMG signal was found in the group submitted to active LLLT. When evaluated individually, some participants in the active LLLT group demonstrated a reduction in muscle activity, but no significant differences were found in the mean EMG signal between the initial and final evaluations. [Conclusion] Further studies with a larger sample size are needed to confirm the present findings.

Strength training prior to muscle injury potentiates low-level laser therapy (LLLT)-induced muscle regeneration.

We evaluated whether strength training (ST) performed prior to skeletal muscle cryolesion would act as a preconditioning, improving skeletal muscle regeneration and responsiveness to low-level laser therapy (LLLT). Wistar rats were randomly assigned into non-exercised (NE), NE plus muscle lesion (NE + LE), NE + LE plus LLLT (NE + LE + LLLT), strength training (ST), ST + LE, and ST + LE + LLLT. The animals performed 10weeks of ST (climbing ladder; 3× week; 80% overload). Forty-eight hours after the last ST session, tibialis anterior (TA) cryolesion was induced and LLLT (InGaAlP, 660nm, 0.035W, 4.9J/cm2/point, 3 points, spot light 0.028cm2, 14J/cm2) initiated and conducted daily for 14 consecutive days. The difference between intergroups was assessed using Student's t test and intragroups by two-way analysis of variance. Cryolesion induced massive muscle degeneration associated with inflammatory infiltrate. Prior ST improved skeletal regeneration 14-days after cryolesion and potentiated the regenerative response to LLLT. Cryolesion induced increased TNF-α levels in both NE + LE and ST + LE groups. Both isolated ST and LLLT reduced TNF-α to control group levels; however, prior ST potentiated LLLT response. Both isolated ST and LLLT increased IL-10 levels with no additional effect. In contrast, increased TA IL-6 levels were restricted to ST and ST + LE + LLLT groups. TA myogenin mRNA levels were not changed by neither prior ST or ST + LLLT. Both prior ST and LLLT therapies increased MyoD mRNA levels and, interestingly, combined therapies potentiated this response. Myf5 mRNA levels were increased only in ST groups. Taken together, our data provides evidences for prior ST potentiating LLLT efficacy in promoting skeletal muscle regeneration.

Low-level laser therapy as an adjunct to conventional therapy in the treatment of diabetic foot ulcers

Foot ulcers are serious complications of diabetes mellitus (DM) and are known to be resistant to conventional treatment. This study was conducted to evaluate the efficacy of low-level laser therapy (LLLT) for the treatment of diabetic foot ulcers in a tertiary care centre (Department of Surgery, Mahatma Gandhi Memorial Medical College and Maharaja Yashwantrao Hospital, A.B. Road, Indore). A total of 30 patients with type 2 DM having Meggitt-Wagner grade I foot ulcers of more than 6weeks duration with negative culture were studied. Patients were randomized into two groups of 15 each. Patients in study group received LLLT (660 ± 20nm, 3J/cm2) along with conventional therapy and those in control group were treated with conventional therapy alone. The primary outcome measure was the absolute and relative wound size reduction at 2weeks compared to the baseline parameter. Percentage ulcer area reduction was 37 ± 9% in the LLLT group and 15 ± 5.4% in the control group (p < 0.001). For ∼75% of wounds of the treatment group, wound area reduction of 30-50% was observed. In contrast, for the control group, ∼80% of wounds showed a wound area reduction of <20% on day 15. Further, the wounds with initial wound area 1000-2000mm2 seems to have better final outcome than the groups with larger areas. The treated groups showed higher amount of granulation than the control group. The results suggest that LLLT is beneficial as an adjunct to conventional therapy in the treatment of diabetic foot ulcers.

Gingival crevicular fluid periostin levels in chronic periodontitis patients following nonsurgical periodontal treatment with low-level laser therapy.

Objective:Periostin is a matricellular protein highly expressed in periosteum, periodontal ligament and is essential for tissue integrity and maturation. It plays a role in collagen fibrillogenesis and is downregulated in periodontal disease. Biostimulation utilizing low-level laser therapy (LLLT) influences periodontal ligament fibroblast proliferation. This study was conducted with the objective of estimating periostin levels in chronic periodontitis (CP) patients following LLLT as an adjunct to root surface debridement (RSD).Materials and Methods:Thirty periodontally healthy participants (Group I) and sixty CP participants were recruited. Based on the therapeutic intervention, CP patients were allocated to either RSD (Group II) or to RSD with LLLT (Group III) group. Clinical parameters and gingival crevicular fluid (GCF) periostin levels were assessed at the baseline and at the 3rd month.Results:Periostin levels were significantly lower in CP patients when compared to healthy individuals at the baseline (P < 0.01). Following nonsurgical periodontal treatment (NSPT), periostin levels significantly increased in both Group II and III, when compared to baseline values (P < 0.001). Comparison of mean periostin levels between both the treatment groups showed a significant increase in LLLT group than RSD at the 3rd month (P < 0.05).Conclusion:Within the limitations of the present study, LLLT application was found to have additional benefits over RSD with respect to clinical periodontal parameters and GCF periostin levels. Moreover, periostin may be used as a possible biomarker to evaluate the outcome following NSPT.

Low-level laser therapy stimulates bone metabolism and inhibits root resorption during tooth movement in a rodent model.

This study evaluated the biological effects of low-level laser therapy (LLLT) on bone remodeling, tooth displacement and root resorption, occurred during the orthodontic tooth movement. Upper first molars of a total of sixty-eight male rats were subjected to orthodontic tooth movement and euthanized on days 3, 6, 9, 14 and 21 days and divided as negative control, control and LLLT group. Tooth displacement and histomorphometric analysis were performed in all animals; scanning electron microscopy analysis was done on days 3, 6 and 9, as well as the immunohistochemistry analysis of RANKL/OPG and TRAP markers. Volumetric changes in alveolar bone were analyzed using MicroCT images on days 14 and 21. LLLT influenced bone resorption by increasing the number of TRAP-positive osteoclasts and the RANKL expression at the compression side. This resulted in less alveolar bone and hyalinization areas on days 6, 9 and 14. LLLT also induced less bone volume and density, facilitating significant acceleration of tooth movement and potential reduction in root resorption besides stimulating bone formation at the tension side by enhancing OPG expression, increasing trabecular thickness and bone volume on day 21. Taken together, our results indicate that LLLT can stimulate bone remodeling reducing root resorption in a rat model. LLLT improves tooth movement via bone formation and bone resorption in a rat model.

Low-intensity laser (660nm) on sternotomy healing in patients who underwent coronary artery bypass graft: a randomized, double-blind study.

The aim of this study was to analyze the healing effects of low-level laser therapy (LLLT) on the longitudinal sternotomy incisions of patients who underwent coronary artery bypass graft (CABG). The volunteers were randomized into three groups of equal size (n = 30): control, placebo, and laser (λ = 660nm and spatial average energy fluency [SAEF] = 1.06J/cm2). The patients in the laser group underwent irradiation on postoperative days 2, 4, 6, and 8, and their sternotomy incisions were photographed immediately after the surgery and 8days later for analysis. Three researchers who were blinded to the patient treatment groups analyzed the incision photographs to assess hyperemia and wound closure on the day of hospital discharge (eighth postoperative day). The sternotomy incisions in the LLLT group demonstrated less hyperemia, incisional bleeding, and dehiscence (p ≤ 0.005).

Low-Level Laser Therapy and Cryotherapy as Mono- and Adjunctive Therapies for Achilles Tendinopathy in Rats.

Low-level laser therapy (LLLT) and cryotherapy are widely used treatments in the acute phase of tendon injury. The aim of this study was to investigate the interaction of these two treatments on tendon inflammation and mechanical properties. Six groups of six Wistar rats were used in this study. The Achilles tendons of the healthy control group were not subjected to injury or treatment. The tendons of the injured nontreated group (ING) were injured, but not treated. The remaining four groups were injured and subjected to LLLT, cryotherapy, LLLT first/cryotherapy, or cryotherapy first/LLLT. All treatments were performed at 1 h post-trauma. Inflammatory mediators, tendon histology, and biomechanical properties were assessed at 24 h post-trauma by comparing the treatment groups with the ING. In all treatment groups, the inflammatory process shifted in an anti-inflammatory direction compared with the ING. Significant alterations in cytokine expression were found in only the LLLT group (↓IL-1β) and the combined intervention groups (↓IL-1β, ↓TNF-α, ↑IL-6). It was also found that cryotherapy followed by LLLT was the only treatment that significantly (p < 0.05) improved the biomechanical parameters of force (N) and displacement (mm) at the tendon rupture and corresponded with the best histological scores of all of the treatment groups. Our results demonstrate that cryotherapy in combination with LLLT can produce an anti-inflammatory "add-on" effect. The order of therapy administration seems essential, as superior histology and biomechanical results were found in the cryotherapy first/LLLT group.