Effects of low-level laser therapy and eccentric exercises in the treatment of recreational athletes with chronic achilles tendinopathy

Background: Eccentric exercises (EEs) are recommended for the treatment of Achilles tendinopathy, but the clinical effect from EE has a slow onset. Hypothesis: The addition of low-level laser therapy (LLLT) to EE may cause more rapid clinical improvement. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 52 recreational athletes with chronic Achilles tendinopathy symptoms were randomized to groups receiving either EE + LLLT or EE + placebo LLLT over 8 weeks in a blinded manner. Low-level laser therapy (lambda = 820 nm) was administered in 12 sessions by irradiating 6 points along the Achilles tendon with a power density of 60 mW/cm(2) and a total dose of 5.4 J per session. Results: The results of the intention-to-treat analysis for the primary outcome, pain intensity during physical activity on the 100-mm visual analog scale, were significantly lower in the LLLT group than in the placebo LLLT group, with 53.6 mm versus 71.5 mm (P = .0003) at 4 weeks, 37.3 mm versus 62.8 mm (P = .0002) at 8 weeks, and 33.0 mm versus 53.0 mm (P =.007) at 12 weeks after randomization. Secondary outcomes of morning stiffness, active dorsiflexion, palpation tenderness, and crepitation showed the same pattern in favor of the LLLT group. Conclusion: Low-level laser therapy, with the parameters used in this study, accelerates clinical recovery from chronic Achilles tendinopathy when added to an EE regimen. For the LLLT group, the results at 4 weeks were similar to the placebo LLLT group results after 12 weeks.

Effects of Low-Level Laser Therapy on Collagen Expression and Neutrophil Infiltrate in 5-Fluorouracil-Induced Oral Mucositis in Hamsters

Background and Objectives: Several studies have suggested that low-level laser therapy (LLLT) can ameliorate oral mucositis, however, the mechanisms involved are not well understood. The aim of this study was to investigate the mechanisms of action of LLLT on chemotherapy-induced oral mucositis, as related to effects on collagen expression and inflammation Materials and Methods: A hamster cheek pouch model of oral mucositis was used with all animals receiving intraperitoneal 5-fluorouracil, followed by surface irritation. Animals were randomly allocated into three groups, and treated with an InGaAIP diode laser at a wavelength of 660 nm and output power of 35 or 100 mW laser, or no laser Clinical severity of mucositis was assessed at four time-points by a blinded examiner Buccal pouch tissue was harvested from a subgroup of animals in each group at four time-points. Collagen was qualitatively and quantitatively evaluated after picrosinus staining. The density of the neutrophil infiltrate was also scored Results: Peak clinical severity of mucositis was reduced in the 35 mW laser group as compared to the 100 mW and control groups The reduced peak clinical severity of mucositis in the 35 mW laser group was accompanied by a decrease in the number of neutrophils and an increase in the proportion of mature collagen as compared to the other two groups. The total quantity of collagen was significantly higher in the control (no laser) group at the day 11 time-point, as compared to the 35 mW laser group, consistent with a more prolonged inflammatory response in the control group. Conclusion: This study supports two mechanisms of action for LLLT in reducing mucositis severity. The increase in collagen organization in response to the 35 mW laser indicates that LLLT promotes wound healing In addition, LLLT also appears to have an anti-inflammatory effect, as evidenced by the reduction in neutrophil infiltrate Lasers Surg Med 42 546-552, 2010. (C) 2010 Wiley-Liss, Inc.

Cyclooxygenase-2 and vascular endothelial growth factor expression in 5-fluorouracil-induced oral mucositis in hamsters: evaluation of two low-intensity laser protocols

The aim of this study was to investigate the mechanisms whereby low-intensity laser therapy may affect the severity of oral mucositis. A hamster cheek pouch model of oral mucositis was used with all animals receiving intraperitoneal 5-fluorouracil followed by surface irritation. Animals were randomly allocated into three groups and treated with a 35 mW laser, 100 mW laser, or no laser. Clinical severity of mucositis was assessed at four time-points by a blinded examiner. Buccal pouch tissue was harvested from a subgroup of animals in each group at four time-points. This tissue was used for immunohistochemistry for cyclooxygenase-2 (COX-2), vascular endothelial growth factor (VEGF), and factor VIII (marker of microvessel density) and the resulting staining was quantified. Peak severity of mucositis was reduced in the 35 mW laser group as compared to the 100 mW laser and control groups. This reduced peak clinical severity of mucositis in the 35 mW laser group was accompanied by a significantly lower level of COX-2 staining. The 100 mW laser did not have an effect on the severity of clinical mucositis, but was associated with a decrease in VEGF levels at the later time-points, as compared to the other groups. There was no clear relationship of VEGF levels or microvessel density to clinical mucositis severity. The tissue response to laser therapy appears to vary by dose. Low-intensity laser therapy appears to reduce the severity of mucositis, at least in part, by reducing COX-2 levels and associated inhibition of the inflammatory response.

Evaluation of dental pulp repair using low level laser therapy (688 nm and 785 nm) morphologic study in capuchin monkeys

The aim of this study was to evaluate the hypothesis that low-level laser therapy (LLLT) 688 nm and 785 nm accelerate dentin barrier formation and repair process after traumatic pulp exposure. The sample consisted of 45 premolars of capuchin monkeys (Cebus apella) with pulp exposure Class V cavities. All premolars were treated with calcium hydroxide (Ca(OH)(2)), divided in groups of 15 teeth each, and analyzed on 7(th), 25(th), and 60(th) day. Group GI - only Ca(OH)(2), GIF- laser 688 nm, and GIII - laser 785 nm. Laser beam was used in single and punctual dose with the parameters: continuous, 688 nm and 785 nm wavelength, tip`s area of 0.00785 cm(2), power 50 mW, application time 20 s, dose 255 J/cm(2), energy 2 J. Teeth were capped with Ca(OH)(2), Ca(OH)(2) cement and restored with amalgam. All groups presented pulp repair. On 25(th) day the thickness of the formed dentin barrier was different between the groups GI and GII (p < 0.05) and between groups GI and GIII (p < 0.01). On 60(th) day there was difference between GI and GIII (p < 0.01). It may be concluded that, LLLT 688 nm and 785 nm accelerated dentin barrier formation and consequently pulp repair process, with best results using infrared laser 785 nm. (c) 2009 by Astro Ltd. Published exclusively by WLLEY-VCH Verlag GmbH & Co. KGaA

In vitro analysis of human tooth pulp chamber temperature after low-intensity laser therapy at different power outputs

In vitro studies have provided conflicting evidence of temperature changes in the tooth pulp chamber after low-level laser irradiation of the tooth surface. The present study was an in vitro evaluation of temperature increases in the human tooth pulp chamber after diode laser irradiation (GaAlAs, lambda = 808 nm) using different power densities. Twelve human teeth (three incisors, three canines, three premolars and three molars) were sectioned in the cervical third of the root and enlarged for the introduction of a thermocouple into the pulp chamber. The teeth were irradiated with 417 mW, 207 mW and 78 mW power outputs for 30 s on the vestibular surface approximately 2 mm from the cervical line of the crown. The highest average increase in temperature (5.6A degrees C) was observed in incisors irradiated with 417 mW. None of the teeth (incisors, canines, premolars or molars) irradiated with 207 mW showed temperature increases higher than 5.5A degrees C that could potentially be harmful to pulp tissue. Teeth irradiated with 78 mW showed lower temperature increases. The study showed that diode laser irradiation with a wavelength of 808 nm at 417 mW power output increased the pulp chamber temperature of certain groups of teeth, especially incisors and premolars, to critical threshold values for the dental pulp (5.5A degrees C). Thus, this study serves as a warning to clinicians that ""more"" is not necessarily ""better"".

High-power diode laser in the disinfection in depth of the root canal dentin

Objective. The objective of this study was to evaluate the disinfection degree of dentine caused by the use of diode laser after biomechanical procedures. Study design. Thirty teeth were sectioned and roots were autoclaved and incubated for 4 weeks with a suspension of Enterococcus faecalis. The specimens were randomly divided into 3 groups (n = 10): G1, instrumented with rotary files, irrigated with 0.5% sodium hypochlorite and 17% EDTA-T, and then irradiated by 830-nm diode laser at 3 W; G2, the same procedures as G1 but without laser irradiation; and G3, irrigation with saline solution (control). Dentin samples of each third were collected with carbide burs and aliquots were sowed to count viable cells. Results. The disinfection degree achieved was 100% in G1 and 98.39% in G2, when compared to the control group (G3). Conclusion. Diode laser irradiation provided increased disinfection of the deep radicular dentin in the parameters and samples tested.

Effects of Low-Level Laser Therapy (LLLT) in the Development of Exercise-Induced Skeletal Muscle Fatigue and Changes in Biochemical Markers Related to Postexercise Recovery

STUDY DESIGN: Randomized crossover double-blinded placebo-controlled trial. OBJECTIVE: To investigate if low-level laser therapy (LLLT) can affect biceps muscle performance, fatigue development, and biochemical markers of postexercise recovery. BACKGROUND: Cell and animal studies have suggested that LLLT can reduce oxidative stress and inflammatory responses in muscle tissue. But it remains uncertain whether these findings can translate into humans in sport and exercise situations. METHODS: Nine healthy male volleyball players participated in the study. They received either active LLLT (cluster probe with 5 laser diodes; A = 810 nm; 200 mW power output; 30 seconds of irradiation, applied in 2 locations over the biceps of the nondominant arm; 60 J of total energy) or placebo LLLT using an identical cluster probe. The intervention or placebo were applied 3 minutes before the performance of exercise. All subjects performed voluntary elbow flexion repetitions with a workload of 75% of their maximal voluntary contraction force until exhaustion. RESULTS: Active LLLT increased the number of repetitions by 14.5% (mean +/- SD, 39.6 +/- 4.3 versus 34.6 +/- 5.6; P = .037) and the elapsed time before exhaustion by 8.0% (P = .034), when compared to the placebo treatment. The biochemical markers also indicated that recovery may be positively affected by LLLT, as indicated by postexercise blood lactate levels (P<.01), creatine kinase activity (P = .017), and C-reactive protein levels (P = .047), showing a faster recovery with LLLT application prior to the exercise. CONCLUSION: We conclude that pre-exercise irradiation of the biceps with an LLLT dose of 6 J per application location, applied in 2 locations, increased endurance for repeated elbow flexion against resistance and decreased postexercise levels of blood lactate, creatine kinase, and C-reactive protein. LEVEL OF EVIDENCE: Performance enhancement, level 1b. J Orthop Sports Phys Ther 2010;40(8):524-532. doi:10.2519/jospt.2010.3294

Low-level Laser Therapy Improves Skeletal Muscle Performance, Decreases Skeletal Muscle Damage and Modulates mRNA Expression of COX-1 and COX-2 in a Dose-dependent Manner

We tested if modulation in mRNA expression of cyclooxygenase isoforms (COX-1 and COX-2) can be related to protective effects of phototherapy in skeletal muscle. Thirty male Wistar rats were divided into five groups receiving either one of four laser doses (0.1, 0.3, 1.0 and 3.0 J) or a no-treatment control group. Laser irradiation (904 nm, 15 mW average power) was performed immediately before the first contraction for treated groups. Electrical stimulation was used to induce six tetanic tibial anterior muscle contractions. Immediately after sixth contraction, blood samples were collected to evaluate creatine kinase activity and muscles were dissected and frozen in liquid nitrogen to evaluate mRNA expression of COX-1 and COX-2. The 1.0 and 3.0 J groups showed significant enhancement (P < 0.01) in total work performed in six tetanic contractions compared with control group. All laser groups, except the 3.0 J group, presented significantly lower post-exercise CK activity than control group. Additionally, 1.0 J group showed increased COX-1 and decreased COX-2 mRNA expression compared with control group and 0.1, 0.3 and 3.0 J laser groups (P < 0.01). We conclude that pre-exercise infrared laser irradiation with dose of 1.0 J enhances skeletal muscle performance and decreases post-exercise skeletal muscle damage and inflammation.

Efficacy of high intensity diode laser as an adjunct to non-surgical periodontal treatment: a randomized controlled trial

The high intensity diode laser has been studied in periodontics for the reduction of subgingival bacteria in non-surgical treatment. Our study evaluated the bacterial effect as well as changes in periodontal clinical parameters promoted by root scaling and planing associated with this wavelength. Twenty-seven patients randomly assigned in two groups underwent root scaling and planing on the tested sites, and only the experimental group received the diode laser irradiation. Among the clinical parameters studied, the clinical probing depth (CPD) and the clinical attachment level (CAL) resulted in significant enhancement in the control group when compared with the experimental group (P = 0.014 and P = 0.039, respectively). The results were similar for both groups regarding the plaque index (PI) and bleeding on probing (BP). No significant difference in the microbiological parameters was observed between the control and experimental groups. It was possible to conclude that the high power diode laser adjunct to the non-surgical periodontal treatment did not promote additional effects to the conventional periodontal treatment.

Measurement of shrinkage of composite resin by laser speckle contrast analysis

The aim of this study was to evaluate the shrinkage of a microhybrid dental composite resin photo-activated by one LED with different power densities by means of speckle technique. The dental composite resin Filtek (TM) Z-250 (3M/ESPE) at color A(2) was used for the samples preparation. Uncured composite was packed in a metallic mold and irradiated during 20 s from 100 to 1000 mW cm(-2). For the photo-activation of the samples, it was used a LED prototype (Light Emission Diode) with wavelength centered at 470 nm and adjustable power density until 1 W cm(-2). The speckle patterns obtained from the bottom composite surfaces were monitored using a CCD camera without lens. The speckle field is recorded in a digital picture and stored by CCD camera as the carrier of information on the displacement of the tested surface. The calculated values were obtained for each pair of adjacent patterns and the changes in speckle contrast as a function of time were obtained from six repeated measurements. The speckle contrasts obtained from the bottom surface with 100 mW cm(-1) were smaller than those than the other power densities. The higher power densities provided the higher shrinkage.

Degree of Conversion and Temperature Increase of a Composite Resin Light Cured with an Argon Laser and Blue LED

Different light sources and power densities used on the photoactivation process may provide changes in the degree of conversion (DC%) and temperature ( T) of the composite resins. Thus, the purpose of this study was to evaluate the DC (%) and T (degrees C) of the microhybrid composite resin (Filtek (TM) Z-250, 3M/ESPE) photoactivated with one argon laser and one LED (light-emitting diode) with different power densities. For the KBr pellet technique, the composite resin was placed into a metallic mould (2-mm thickness, 4-mm diameter) and photoactivated as follows: a continuous argon laser (CW) and LED LCUs with power density values of 100, 400, 700, and 1000 mW/cm(2) for 20 s. The measurements for DC (%) were made in a FTIR spectrometer Bomen ( model MB 102, Quebec, Canada). Spectroscopy ( FTIR) spectra for both uncured and cured samples were analyzed using an accessory of the reflectance diffusion. The measurements were recorded in absorbance operating under the following conditions: 32 scans, 4 cm(-1) resolution, 300 to 4000-cm(-1) wavelength. The percentage of unreacted carbon double bonds (% C=C) was determined from the ratio of absorbance intensities of aliphatic C=C (peak at 1638 cm(-1)) against an internal standard before and after the curing of the specimen: aromatic C-C (peak at 1608 cm(-1)). For T (degrees C), the samples were created in a metallic mould (2-mm thickness, 4-mm diameter) and photoactivated for 20 s. The thermocouple was attached to the multimeter allowing temperature readings. The DC (%) and T (degrees C) were submitted to ANOVA and Tukey`s test (p < 0.05). The degree of conversion values varied from 35.0 to 50.0% ( 100 to 1000 mW/cm(2)) for an argon laser and from 41.0 to 49% (100 to 1000 mW/cm(2)) for an LED. The temperature change values varied from 1.1 to 13.1 degrees C (100 to 1000 mW/cm(2)) for an argon laser and from 1.9 to 15.0 degrees C (100 to 1000 mW/cm(2)) for an LED. The power densities showed a significant effect on the degree of conversion and changes the temperature for both light-curing units.

Effect of power densities and irradiation times on the degree of conversion and temperature increase of a microhybrid dental composite resin

The different parameters used for the photoactivation process provide changes in the degree of conversion (DC%) and temperature rise (TR) of the composite resins. Thus, the purpose of this study was to evaluate the DC (%) and TR of the microhybrid composite resin photoactivated by a new generation LED. For the KBr pellet technique, the composite resin was placed into a metallic mould (1-mm thickness and 4-mm diameter) and photoactivated as follows: continuous LED LCU with different power density values (50-1000 mW/cm(2)). The measurements for the DC (%) were made in a FTIR Spectrometer Bomen (model MB-102, Quebec-Canada). The spectroscopy (FTIR) spectra for both uncured and cured samples were analyzed using an accessory for the diffuse reflectance. The measurements were recorded in the absorbance operating under the following conditions: 32 scans, 4-cm(-1) resolution, and a 300 to 4000-cm(-1) wavelength. The percentage of unreacted carbon-carbon double bonds (% C=C) was determined from the ratio of the absorbance intensities of aliphatic C=C (peak at 1638 cm(-1)) against an internal standard before and after the curing of the specimen: aromatic C-C (peak at 1608 cm-1). For the TR, the samples were made in a metallic mould (2-mm thickness and 4-mm diameter) and photoactivated during 5, 10, and 20 s. The thermocouple was attached to the multimeter to allow the temperature readings. The DC (%) and TR were calculated by the standard technique and submitted to ANOVA and Tukey`s test (p < 0.05). The degree of conversion values varied from 35.0 (+/- 1.3) to 45.0 (+/- 2.4) for 5 s, 45.0 (+/- 1.3) to 55.0 (+/- 2.4) for 10 s, and 47.0 (+/- 1.3) to 52.0 (+/- 2.4) for 20 s. For the TR, the values ranged from 0.3 (+/- 0.01) to 5.4 (+/- 0.11)degrees C for 5 s, from 0.5 (+/- 0.02) to 9.3 (+/- 0.28)degrees C for 10 s, and from 1.0 (+/- 0.06) to 15.0 (+/- 0.95)degrees C for 20 s. The power densities and irradiation times showed a significant effect on the degree of conversion and temperature rise.

Surface modification and crystallization of the BaO-B2O3-SiO2 glassy system using CO2 laser irradiation

The surface modification and crystallization process of BaO-B2O3-SiO2 glass compositions when exposed to CO2 laser irradiation was evaluated as a function of the laser power, irradiation time and surface condition. The glass surface was modified by the application of laser power exceeding 0.40 W and an irradiation time of more than 300 s. Micro-Raman and X-ray diffraction measurements revealed at high laser power the formation of beta-BaB2O4 (beta-BBO) crystalline phase. The crystallization of the irradiated region was enhanced when beta-BBO micrometer sized particles were dispersed on the surface of the glass sample. The intensity of the second harmonic generation observed in the crystallized region was found to depend mainly on the condition of the glassy surface prior to glass irradiation. (C) 2007 Elsevier B.V. All rights reserved.