Low-level Laser Research Articles

Efficacy of laser adjuvant therapy in the management of post-operative endodontic pain: A systematic review and meta-analysis.

Postoperative endodontic pain (PEP) is crucial in clinical practice. Recently, the effects of various laser adjuvant therapies in endodontic treatments have been widely evaluated. However, as a virtually side-effect-free treatment, its effect on postoperative pain management during endodontic treatment remains controversial. This review aimed to compare the efficacy of laser adjuvant therapy for pain management after endodontic treatment. The Cochrane Library, PubMed, Embase, Scopus and Web of Science databases were systematically searched for articles published until 12 February 2023. The risk of bias in the included studies was evaluated based on the Cochrane risk-of-bias assessment tool. Data on continuous outcomes of visual analogue scale pain scores are expressed as standard mean difference (SMD) and dichotomous outcomes of pain prevalence as relative risk (RR). We included 22 studies, of which 15 enrolled 892 patients with visual analogue scale pain scores and 7 enrolled 422 patients with pain prevalence. Of the 22 studies, seven studies had a low risk of bias, 10 had a moderate risk of bias and 5 had a high risk of bias. For pain level, the pooled outcomes indicated reduced pain scores in all laser adjuvant therapy, including low-level laser therapy (SMD = -0.86 [95% CI: -1.16, -0.55] in 24 h and SMD = -0.64 [95% CI: -0.84, -0.43] in 48 h), diode laser therapy (SMD = -0.27 [95% CI: -0.50, -0.04] in 48 h) and photodynamic therapy (SMD = -1.12 [95% CI: -2.18, -0.05] in 24 h). For postoperative pain incidence, a significant correlation was observed with reduced pain incidence rates in the photodynamic therapy group (pooled RR = 0.47 [95% CI: 0.31, 0.72]) but not in the low-level laser therapy group (RR = 0.89 [95% CI: 0.30, 2.70] at 12 h and RR = 0.57 [95% CI: 0.09, 3.72] at 24 h). High-quality evidence suggests that laser adjuvant therapies such as low-level laser therapy, diode laser therapy and photodynamic therapy have a positive impact on reducing postoperative endodontic pain intensity. However, the differences in PEP management effects between laser therapies are unknown, and no significant differences were observed among the subgroups. CRD 42023402872 (PROSPERO).

The cytotoxic effect of 4 different wavelengths of Low-level laser therapy on squamous cell carcinoma – An invitro study

Background: Low-level laser therapy is a noninvasive method with the potential ability to change the balance of cell mediators and gene expressions. It affects cellular function resulting in beneficial clinical effects. This study aims to assess the effect of low-level light therapy (LLLT) using four different laser wavelengths on oral carcinoma cell viability in vitro. Methods and Material: HN5 human head and neck squamous cell carcinoma cell lines (HNSCC) were cultured and irradiated using four wavelengths of blue (485 nm), green (532nm), red (660 nm), and near Infra-red (810 nm) in a continuous mode with a dose of 1 J/cm2 (0.1W, 10sec) every 24hours for five consecutive days. Cell viability was assessed by evaluating mitochondrial activity by MTT assay. Results: All the wavelengths resulted in reduced viability of these cells compared to the controls. (P<0.05) There were statistically significant differences in cell viability between different wavelengths (P<0.001). The 810 nm laser irradiation showed the highest percentage of cell survival (55.92%) while 660 nm induced the lowest (36.02%). Conclusion: Different laser wavelengths may result in different effects on irradiated cells and red irradiation showed the lowest cell viability and the infrared laser had the highest cell viability results.

Photobiomodulation Modulates Proliferation and Gene Expression Related to Calcium Signaling in Human Osteoblast Cells.

Introduction: Photobiomodulation with low-level laser treatment can enhance bone formation by stimulating the cell division of osteoblasts and increasing the amount of protein deposition, thus encouraging the formation of new bone. The aim of this study was to evaluate the effects of photobiomodulation with a low-level laser on proliferation and gene expression related to calcium signaling in human osteoblasts. Methods: Osteoblastic cell lines of the hFOB1.19 lineage, human osteoblasts, were grown and assigned into two groups, control (C; n=78 cultured wells) and photobiomodulation (L; n=78 cultured wells) with n=6 per day of the experimental period. Cells were cultured (immature at 34 ºC), and after maturation at 37 ºC, group L cells were exposed to laser irradiation with a low-level laser device (gallium and aluminum arsenide), at a wavelength of 808 nm, a power output of 200 mW, and a power density of 200 mW/cm2. The energy delivered to the cells was 37 J/cm2, with a beam area of 0.02 mm2 and an exposure time of 5 seconds. This treatment was applied daily for a period of 13 days. Following this, the number of cells was counted, and RNA was isolated, measured, and then converted into cDNA for further quantification using a comparative Ct method with real-time polymerase chain reaction. The results were then subjected to statistical analysis through a Mann-Whitney test, with a significance level of P<0.05. Results: The cell count in the L group (37.25x10±4±22.02) was statistically higher compared to the control group (22.75x10±4±7.660) with a P value of 0.0259. The values of 2-ΔΔCt for S100A6, plasma membrane calcium ATPase (PMCA), and calmodulin genes indicated hyper-expression on the thirteenth day, while the osteocalcin gene showed hypo-expression. Conclusion: The study suggests that the photobiomodulation mechanism with a low-level laser may regulate gene expression in human osteoblasts in a dose-dependent and cumulative manner.

Physical therapy in burn care: Development of clinical prediction rules to determine the efficacy of low-level laser therapy

This study aimed to demonstrate the benefits of low-level laser therapy (LLLT) on burn healing and to investigate whether patients' age, burn wound size, wound stage, and total burned surface area influence the burn wound healing response to LLLT. This was a quasi-experimental study with a single-group design that included eighty male and female patients with partial-thickness burn wounds recruited from burn units. The participants were placed in a single intervention group receiving LLLT. The duration of the intervention was six weeks, divided into 18 sessions (three sessions per week). The statistical analysis was conducted using version 25 of the SPSS statistical package for Windows. The results showed a statistically significant negative relationship between wound improvement from LLLT and age (p &lt; 0.05) and between total body surface area (TBSA) and wound improvement (p &lt; 0.05). Additionally, a statistically significant positive relationship was found between initial wound size and wound improvement (p &lt; 0.05). There was no statistically significant relationship between wound improvement and wound stage (p &gt; 0.05). The current study revealed that age, TBSA, and initial wound size can predict the efficacy of low-level laser treatment for burn wounds.

Low-Level Laser Therapy for Tooth Sensitivity after Tooth Bleaching: A Systematic Review

Tooth bleaching is a popular cosmetic procedure known for its effective whitening results. However, it may cause tooth sensitivity. Various desensitizing therapies, including laser treatments, are used to alleviate pain and improve patient comfort. This study aims to conduct a systematic review to evaluate the effectiveness of low-level laser therapy for treating tooth sensitivity following bleaching therapy. A comprehensive search was conducted across 13 electronic databases (PubMed, Scopus, ScienceDirect, Google Scholar, Web of Science, Ovid, BMJ evidence-based medicine, proQuest, Greylit.org, Ethos, Livivo, Clinical trials gov, and Meta register of controlled trials) to identify relevant studies according to specific eligibility criteria, following the PRISMA guidelines. Two independent reviewers screened and selected the studies, performed data extraction, and assessed the risk of bias using the revised Cochrane risk-of-bias tool for randomized clinical trials (RCTs). The initial search yielded 2875 articles, which were subsequently screened to remove duplicates. After evaluating 1532 articles based on title and 136 by abstract, 21 studies remained for full-text assessment. Ultimately, only six RCTs met all of the eligibility criteria. The application of low-level laser therapy appears to reduce tooth sensitivity following tooth bleaching. Despite the positive reported effects, further research is necessary to determine the optimal use of low-level laser therapy for effective pain relief.

Evaluation of biopsychosocial model for pain management in postoral cancer therapy patients

Background. Approximately 50 % of cancer patients have pain in their daily lives, which is multifaceted sensation goes beyond basic biochemical signal of pain. Oral mucositis is one of the negative consequences with intense pain, discomfort, challenges in speaking and eating. These components collectively influence patient's total quality of life across mental, biological, social aspects. Biopsychosocial model (BPS) is an effective technique for understanding and addressing conceptualization and treatment of pain in cancer patients. The aim of this study is to assess efficacy of the BPS in managing post-cancer distress and potential to improve quality of life for individuals with cancer. Material and Methods. This study evaluated 30 cancer patients who completed radiotherapy and were referred from cancer hospital. The examination encompasses three distinct categories: biological, psychological, and social components. The biological aspect was documented based on mucosal lesions and VAS scores for individuals; followed by photo-biomodulation was given. Palliative care was provided in psychological aspect through implementation of exercise, meditation, music therapy. The social component encompasses community engagement, social activities, counseling services for family members. Patients were categorized into 3 groups – A, B, C. All three components were carefully evaluated and one-month follow-up was done. Results. The outcome derived from statistical analysis of the data collected from groups A, B, and C. When group A was compared to group B, there was 46 % increase in quality of life. When group C was compared to group A, 65 % of patients exhibited favorable quality of life. The average VAS score of patients decreased from 9.2 to 4.5 after Low-Level Laser Therapy (LLLT), demonstrating gradual decrease in discomfort. P value showed statistically significant (&lt;0.05). Conclusion. Healthcare providers can enhance their treatment efficiency, addressing root cause of illness, and enhance overall well-being by incorporating BPS into their practice. Addressing the various elements of biological, psychological, and social factors would have beneficial effect on overall quality of life.

Low-level laser therapy parameters in the treatment of Orofacial pain in temporomandibular disorder

Temporomandibular disorder (TMD) comprises a group of dysfunctions of the masticatory system involving joint, myofascial, and even sensory alterations. The main symptom of TMD is orofacial pain, which has a negative impact on the quality of life of TMD sufferers, affecting their productivity at work and school, the quality of their sleep, their appetite, and their satisfaction with life. An alternative for the treatment of TMD is the low-level laser therapy (LLLT), which stimulates cellular functions and promotes therapeutic effects. However, there is no consensus in the literature. Objective: This review aimed to elucidate the parameters of low-level laser therapy in the treatment of orofacial pain in patients with temporomandibular disorder. Methods: A search was carried out for scientific articles published between 2013 and 2023 in the MEDLINE, PEDro, LILACS and SciELO databases. Results: A total of 21 studies were previously selected and after the eligibility criteria, 10 studies were included. Can be suggest a protocol for treating patients with temporomandibular disorder by low-level laser therapy with the following parameters: infrared wavelength, energy density less than 10 J/cm2, output power from 100 to 250 mW and at least 8 sessions of treatment. Conclusion: The low-level laser therapy improves orofacial pain in patients with temporomandibular disorder.

Effects of Low-Level LASER Therapy on Temporomandibular Joint Dysfunction-Related Pain: A Systematic Literature Review

Purpose Low-Level LASER therapy (LLLT) is a non-pharmacologic medical device that purports to take advantage of photo biomodulation to induce cellular level biomechanical adaptations. Such mechanisms are sought by clinicians and patients to take advantage of reduced symptoms via faster healing times in cases like temporomandibular joint dysfunction (TMJD), where the joint affected is not easily accessible to traditional care. Systematic literature searches for randomized controlled trials between 2014 and 2024 were performed in PubMed, EBSCO, and Science Direct. A total of six randomized controlled trials (full text available, PEDro score 6, and conducted in the past ten years) met search criteria with a total of 363 subjects. Half the trials, with 36% of the total subjects, showed no difference between LLLT and the control or placebo. This review of current randomized controlled trials presented limited evidence for utilizing LLLT on patients with TMJD-related pain.

Effect of postoperative 660-nm low-level laser therapy on the radiographic crestal bone loss of fresh-socket dental implants.

Although the benefits of low-level laser therapy (LLLT) in soft tissue healing have been demonstrated, the effects of laser on bone have remained controversial. This study investigated the impact of postoperative 660-nm LLLT on the radiographic crestal bone loss of fresh-socket dental implants. Thirty patients referred to the Department of Oral and Maxillofacial Surgery for tooth extraction and placement of fresh-socket implants were selected and assigned to two groups: laser (intervention) and no-laser (control) groups. Immediately after tooth extraction, the implant was inserted into the tooth socket. 660-nm LLLT was immediately started after surgery and was repeated three times per week for two weeks. Bone quantification at the implant site was assessed using periapical intraoral radiographs and computerized software immediately after surgery and after six months. This study showed a statistically significant difference in mean bone resorption between the mesial and distal aspects of the two groups, with lower bone resorption in the laser group compared to the no-laser group. The results of this study suggest that LLLT can effectively reduce bone resorption in fresh-socket implant placement. This might indicate the positive effect of LLLT on bone resorption reduction.

Effect of resin cement viscosities and surface roughness on shear bond strength of conditioned polymer infiltrated ceramic network

BackgroundHybrid ceramics bonding with the dentinal substrate is crucial for clinical success and longevity. To enhance adhesion, the surface of ceramic restorations is modified through various conditioning techniques AimEffect of Different Surface Conditioners Erbium-doped yttrium aluminum garnet (ER: YAG) laser and Low-level laser therapy (LLLT) activated Methylene blue (MB) on the surface roughness (Ra) and shear bond strength (SBS) of Polymer infiltrating ceramic network (PICN) discs bonded using different viscosity resin cement before and after thermal aging. Material and MethodsOne hundred and fifty human central incisors and one hundred and fifty-three PICN discs were prepared. PICN discs were randomly allocated into three groups based on the surface conditioning(n = 51) Group 1:10 % HF acid-S, Group 2: LLLT (MB), and Group 3: Er: YAG laser. Following conditioning Ra scores of ten samples were performed. Surface topography of samples was performed using a scanning electron microscope (SEM). Bonding of forty PICN discs from each conditioning group was performed with high (A) or low viscosity (B) dual-curing resin cement (n = 20 each). Each subgroup was divided into two cohorts and subjected to varying storage conditions. The SBS test and failure mode analysis were performed using a universal testing machine and stereomicroscope. Descriptive statistics of SBS and Ra for each group were analyzed using ANOVA and Tukey post hoc tests. HF acid-S attained the highest Ra scores. ResultsGroup 1A (HF-S+HIGH) samples achieved the highest SBS values at baseline. Group 3A, on the other hand, displayed the lowest bond score (Er: YAG laser+HIGH) after thermal aging. Intergroup comparison analysis at baseline unveiled that Group 1A and Group 1B (HF(S) + LOW) displayed no significant difference in their bond strength scores (p>0.05). Following artificial aging, it was observed that Group 2A (LLLT (MB) + HIGH) and Group 3A (Er:YAG laser + HIGH) ) presented comparable SBS(p > 0.05). Thermal aging decreased SBS significantly in all groups. PICN conditioned with HF-S results in high surface roughness. ConclusionPICN conditioned with HF acid with silane and bonded with low-viscosity resin cement to the dentinal substrate is preferable. Aging influences SBS.

Preventive and reparative effects of low-level laser therapy on orthodontically induced inflammatory root resorption-An animal study.

Orthodontically induced inflammatory root resorption (OIIRR) is one of the most important side effects of orthodontic treatment. Low-level laser therapy (LLLT) is a useful way to reduce the orthodontic treatment duration and may have some effect on preventing and repairing OIIRR. However, the specific effects of LLLT on OIIRR remain unknown. Our research aimed to evaluate the Dentin Sialophosphoprotein (DSPP) expression level and root resorption volume during treatment and retention to explore the role of LLLT in preventing and repairing OIIRR. Thirty-seven 6-week-old male Sprague-Dawley rats were selected to establish an OIIRR model; the rats were divided into Group B (blank), Group F (force), Group F(LLLT) (force and LLLT), Group F+R (force and retention) and Group F+R(LLLT) (force, retention and LLLT). The root resorption volume of the distal buccal root and mesial root in the maxillary left first molar was calculated by micro-CT, and the DSPP expression level on the compression side of the periodontal ligament was analysed by immunohistochemical staining. The resorption volume in Group F was greater than that in Group F(LLLT). For the mesial root, the volume in Group F was greater than that in Groups F+R and F+R(LLLT). For the distal buccal root, the volume in Groups F and F+R was greater than that in Group F+R(LLLT). The DSPP level in Group F(LLLT) was greater than that in Group F and there was no difference between Groups F+R and F+R(LLLT). LLLT has a certain preventive effect and a limited reparative effect on OIIRR in rats.

Effectiveness of the Association of Fibrin Scaffolds, Nanohydroxyapatite, and Photobiomodulation with Simultaneous Low-Level Red and Infrared Lasers in Bone Repair.

Biomaterials and biopharmaceuticals for correcting large bone defects are a potential area of translational science. A new bioproduct, purified from snake venom and fibrinogen from buffalo blood, aroused interest in the repair of venous ulcers. Expanding potential uses, it has also been used to form biocomplexes in combination with bone grafts, associated with physical therapies or used alone. The aim of this preclinical study was to evaluate low-level laser photobiomodulation (PBM) in critical defects in the calvaria of rats filled with nanohydroxyapatite (NH) associated with the heterologous fibrin biopolymer (HFB). Sixty animals were used, divided into six groups (n = 10 each): G1 (NH); G2 (HFB); G3 (NH + HFB); G4 (NH + PBM); G5 (HFB + PBM); G6 (NH + HFB + PBM). PBM simultaneously used red (R) and infrared (IR) light emission, applied intraoperatively and twice a week, until the end of the experiment at 42 days. Microtomography, bone formation can be seen initially at the margins of the defect, more evident in G5. Microscopically, bone formation demonstrated immature and disorganized trabeculation at 14 days, with remnants of grafting materials. At 42 days, the percentage of new bone formed was higher in all groups, especially in G5 (HFB, 45.4 ± 3.82), with collagen fibers at a higher degree of maturation and yellowish-green color in the birefringence analysis with Picrosirius-red. Therefore, it is concluded that the HFB + PBM combination showed greater effectiveness in the repair process and presents potential for future clinical studies.

The Effect of Cold Plasma and Low-Level Laser Therapy on Oral Fibroblast Proliferation

Background: Wound healing is a complex physiological process involving multiple phases and cellular mechanisms that restore damaged tissue. The oral cavity presents unique challenges for wound healing due to the presence of microorganisms and the impact of various diseases and treatments. Recent advancements, including low-level laser therapy (LLLT) and cold plasma, offer promising approaches to enhance wound healing by promoting cell proliferation and reducing inflammation. This study aimed to investigate the effects of cold plasma and low-level 980nm laser on the growth of oral fibroblasts and compare their respective impacts on wound healing. Methods: Human gingival fibroblasts were divided into nine study groups, including a control group. Two groups were exposed to low-level 980nm diode laser irradiation for 15 and 30 seconds, while six groups received cold plasma irradiation with helium gas at flow rates of 1.85, 2.78 and 5.56 cm3/s for the same durations. Fibroblast proliferation was evaluated on days 1, 3, and 5 after treatment using the MTT assay. Results: The results showed that on the 5th day after irradiation, 30 seconds of 980 nm laser irradiation significantly increased fibroblast proliferation compared to the other groups. In contrast, 15 seconds of plasma irradiation at a flow rate of 1.85 cm3/s had the least effect on promoting fibroblast proliferation. On the 1st day after radiation, plasma irradiation at flow rates of 2.78 and 5.56 cm3/s exhibited a greater impact on fibroblast proliferation compared to the other five test groups. Conclusion: The 980nm diode laser demonstrated a greater capacity to enhance the proliferation of oral fibroblasts compared to cold plasma using helium gas.

Effect of Low-Level Laser Therapy on Osseointegration of Immediate Dental Implants in Anterior and Premolar Region of the Mandible: A Pilot Clinical Study

Effect of Low-Level Laser Therapy on Osseointegration of Immediate Dental Implants in Anterior and Premolar Region of the Mandible: A Pilot Clinical Study

Evaluation of The Efficacy of Therapeutic Ultrasound, Transcutaneous Electrical Nerve Stimulation and Low-Level Laser Therapy in the Management of Temporomandibular Disorders: A Comparative Study

Evaluation of The Efficacy of Therapeutic Ultrasound, Transcutaneous Electrical Nerve Stimulation and Low-Level Laser Therapy in the Management of Temporomandibular Disorders: A Comparative Study

Patients Experience Improvements in Pain and Quality of Life When Treated at a Physician Led Integrative Medicine Clinic at a Large Air Force Military Treatment Facility

ObjectiveA large percentage of military treatment facilities (MTFs) offer at least one type of complementary medicine and 80% of patients surveyed felt that integrative therapies should be routinely offered at all MTFs. We are the first to offer the breadth of modalities outlined below in a dedicated MTF Integrative Medicine Clinic (IMC). The purpose of this study was to determine whether the basket of services offered at our IMC improved patient pain and quality of life. Design and SettingPatient outcomes over a three-year period were retrospectively evaluated from a single cohort. Patients referred to the IMC for chronic pain at the MTF recorded pain scores using the Defense and Veterans Pain Rating Scale (DVPRS) and completed the Dallas Pain Questionnaire (DPQ), a 16-item visual analog quality of life questionnaire, at each visit. They also completed a non-validated quality of life question on discharge from the clinic. Modalities used include microcurrent therapies, extracorporeal shockwave therapy, medical Acupuncture, myofascial release techniques, low-level laser therapy, and the AllCore360. Results761 patients were seen from August 2019 to October 2022 in over 3,280 clinic visits. On average per visit, DVPRS scores were reduced from 4.4 to 1.5 (MD 2.9; 95%CI, 2.7-3.1). Total DPQ scores were reduced by 16.5% (MD 27.7; 95%CI 22.7-32.7). On discharge from the clinic 81% of patients reported their quality of life was either “a lot better” or “somewhat better.” ConclusionsIf implemented, we believe comparable clinics across the Department of Defense can replicate these improvements in patient-oriented outcomes.

Efficacy Comparison of Low Level Laser Treatment with Muscle Energy Procedure Among Diabetic Patients Suffering from Frozen Shoulder

Frozen shoulder incidence in diabetic patient is twice as high as normal controls. There are various conventional as well as electrotherapies for its treatment within which low-level laser therapy versus muscle energy technique are well debated for efficacy in diabetic patients frozen shoulder. Objective: Comparative analysis of effectiveness of low-level laser therapy and muscle energy technique among diabetic patients with frozen shoulder. The study design was comparative study. The Place and Duration of Study was Department of Orthopaedic, Indus Medical College, Tando Muhammad Khan from 1st January 2023 to 30th June 2023. Methods: One hundred and twenty patients who were having diabetes mellitus (type 1 and type 2) and suffering from frozen shoulders were enrolled. The conventional therapeutic exercise included exercises like pendulum, arm overhead, finger wall ladder, twisting arm outwards, overhead pulley, cross-body reach exercises, hand behind-back exercise and outward rotation exercise. Muscle energy technique was administered in cases where restriction in shoulder flexion, as well as abduction, external rotation was observed. Results: There were 59% females and 41% males with majority being within the age group of 45-65 years. It was observed that there was a significant variance between pain scores at pretreatment and post treatment stages with highest value decrease observed in muscle energy technique group II. The ROM was least improved in control group only treated through conventional protocol. Conclusions: The Muscle energy technique is slightly more effective than low-level laser therapy technique in terms of pain, inflammation reduction and angular movements.

In-vitro study on type I collagen synthesis in low-level laser therapy on the early ligament fibroblasts’ healing process

BackgroundLow-level Laser Therapy (LLLT) has demonstrated its potential in promoting fiber matrix maturation, collagen synthesis, and fibroblast proliferation, contributing to tissue regeneration. Our study aimed to investigate the impact of LLLT on collagen type I synthesis, cell proliferation, and viability in human ligament fibroblasts derived from the Anterior Cruciate Ligament (ACL).MethodsTissue samples were obtained from individuals undergoing arthroscopic ACL reconstruction surgery. Primary human fibroblasts were isolated, and immunohistochemical assays confirmed their characteristics. LLLT at 850 nm was administered in three groups: Low dose (1.0 J/cm²), High dose (5.0 J/cm²), and Control (0.0 J/cm²). Cell viability was calculated using a membrane integrity assay, proliferation was determined by automated counting, and collagen type I concentration in cell culture was measured using an immunoassay.ResultsFibroblasts showed decreased viability after low and high doses of LLLT, increased proliferation at the low dose, and increased collagen synthesis at the high dose on day 10 for both sexes after treatment.ConclusionOur study demonstrated that LLLT may improve the early ligament healing process by increasing cell proliferation at the low dose and enhancing collagen type I synthesis at the high dose in human ligament fibroblasts.

Major aspects of the use of bisphosphonates and the formation of osteonecrosis in the involvement of dental implants: a systematic review

Introduction: Bisphosphonates are widely used to treat osteoporosis and malignant tumors due to their effectiveness in increasing bone density and inhibiting bone resorption. Dental patients receiving bisphosphonate treatment are at higher risk of bisphosphonate-related osteonecrosis of the jaws (BRONJ), necessitating dentists' awareness of these risks. Objective: It was to highlight the main aspects of the use of bisphosphonates and the formation of osteonecrosis in the involvement of dental implants, as well as possible treatments. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from April to July 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 120 articles were found, 40 articles were evaluated in full and 15 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 14 studies with a high risk of bias and 21 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=89.5%&gt;50%. Therefore, the present study suggests that patients undergoing treatment with BFs should be informed about the potential risk of BRONJ. Furthermore, it would be advisable for providers responsible for BF therapy to refer patients for dental check-ups before starting treatment, allowing for patient monitoring by a multidisciplinary team. Although the morbidity rate of this pathology is not high, prevention should be mandatory, thus avoiding mutilating and painful processes. However, if surgery is necessary, the use of these new adjuvant therapies, such as lowlevel laser therapy and magnetotherapy, can be proposed in the treatment of BRONJ. It is essential to increase our caseload and also involve other institutions in the use of these new effective and safe therapies in BRONJ.

Combined application of Er:YAG laser and low-level laser in non-surgical treatment of periodontitis.

To compare the efficacy of combined treatment of Er:YAG laser (ERL) and low-level laser therapy (LLLT) with single laser applications, and scaling and root planing (SRP) for non-surgical periodontal treatment. In a randomized controlled trial, 25 non-smoking Stage II or Stage III periodontitis patients were recruited. The four intraoral quadrants were randomly assigned to four different treatments: (1) combined application with ERL plus SRP plus LLLT; (2) ERL plus SRP; (3) SRP plus LLLT; and (4) SRP. We assessed periodontal indexes, including probing depth (PD), clinical attachment level (CAL), bleeding index (BI), and plaque index (PLI), along with three cytokines (IL-1β, TNF-α, IL-10) from gingival crevicular fluid and red complex pathogens from subgingival dental plaque at baseline, 3 months, and 6 months. For initial moderate pockets (4mm≤PD≤6mm), quadrants treated with ERL+SRP+LLLT, ERL+SRP, and SRP+LLLT exhibited greater PD improvement compared to the control (SRP) quadrants at the 3-month follow-up (1.25±1.06, 1.23±1.12, 1.00±1.21vs. 0.98±1.21mm) and the 6-month follow-up (1.35±1.06, 1.23±1.17, 1.35±0.98vs. 0.98±1.23mm) (p=0.002). Quadrants treated with ERL+SRP+LLLT and SRP+LLLT showed more CAL gain means than the control quadrants at the 3-month follow-up (0.96±1.42, 0.61±1.39vs. 0.55±1.57mm) and the 6-month follow-up (0.84±1.54, 0.89±1.49vs. 0.48±1.68mm) (p=0.008). For initial deep pockets (PD≥7mm), the ERL+SRP+LLLT quadrants had more PD improvement and CAL gain compared to the control quadrants at follow-up. There were no significant differences in BI, PLI, inflammatory cytokines, and periodontal pathogens among the four groups. The combined application of ERL and LLLT demonstrated potential efficacy in reducing PD, particularly for deep pockets. To compare the therapy effect of combined use of Er:YAG laser (ERL) and low level laser therapy (LLLT) with single laser applications, and traditional periodontal treatment (SRP). A total of 25 nonsmoking patients with periodontitis were involved, and their mouths were divided into four sections, each receiving a different treatment: ERL+SRP+LLLT, ERL+SRP, SRP+LLLT, and SRP. Clinical indexes and laboratory indicators were assessed at baseline, 3 months, and 6 months. After six months, for initial moderate pockets, combined laser group and single laser group showed better improvements than traditional group in reducing the depth of periodontal pockets and increasing attachment levels. But for initial deep pockets, only combined laser group showed better improvement than traditional group. There were no significant differences in bleeding, plaque, inflammation, or harmful bacterial levels among the groups. These findings suggest that the integration of Er:YAG laser and lowlevel laser therapy into standard periodontal treatment may enhance the treatment's benefits in reducing pocket depth, especially for severe conditions.