Surgical treatment of squamous cell carcinoma of tongue with carbon dioxide laser radiation (CO2)

In this clinical study, we proposed to observe the efficacy of the treatment of squamous cell carcinoma of the tongue (SCCT) by carbon dioxide (CO2) laser surgery. Twelve patients with SCCT were treated with excisional surgery using the CO2 laser with a spot size of 0.8 mm, 10 W, power density of 2.5 W/cm(2) in continuous mode, and under constant vacuum removal of the plume. The post surgical clinical evaluations were done every day until the sutures were removed and then every 7 days up to 1 month postoperatively. Subjects were re-examined quarterly until the fifth year post surgery. After 5 yr of follow-up for all subjects, there was no recurrence of the SCCT at the involved sites. The functional and aesthetic results observed were excellent. It is concluded that CO2 laser ablation of SCCT is an extremely useful surgical technique that can provide a clean field and is capable of providing surgical results consistent with accepted principles of oncological surgery. (C) 2012 Laser Institute of America.

Effect of Low-Level Laser Therapy and Calcitonin on Bone Repair in Castrated Rats: A Densitometric Study

Objective: To investigate the healing of bone defects in male rats treated with salmon calcitonin, low-level laser therapy (LLLT), or both. Background: Healing of bone defects still represents a challenge to health professionals in several areas. In this article, the effect of calcitonin in combination with LLLT on bone repair was studied. Densitometry was used as a valuable tool for the measurement of bone regeneration. Methods: Sixty male Wistar rats underwent bilateral castration surgery before the creation of a surgical bone defect. The animals were randomly divided into four groups: control, treated with calcitonin (Ca), treated with LLLT (La), and treated with calcitonin and LLLT (CaLa). Groups Ca and CaLa received 2 IU/kg of synthetic salmon calcitonin intra-muscularly three times a week. Groups La and CaLa received laser therapy using a gallium-aluminum-arsenide laser (10mW, 20 J/cm(2), wavelength 830 nm). Control animals were submitted to sham irradiation. The animals were sacrificed 7, 14, and 21 days after surgery, and bone defects were analyzed using densitometry. Results: The CaLa group had a higher degree of bone regeneration 14 and 21 days after surgery. Conclusions: The La and CaLa had significantly higher bone mineral density than the control and Ca groups.

Marginal leakage in Class V cavities pretreated with different laser energy densities

The purpose of the present study was to evaluate in vitro the degree of marginal leakage in Class V cavities involving the cementoenamel junction. Cavities were 4 rum wide and 2 mm deep. The specimens received dentin pretreatment (37% phosphoric acid) followed by the Single Bond (3M) adhesive system application. The 40 specimens were then divided into four groups: Group I (control); Group 2 (Nd:YAG laser at 120 mJ/pulse, frequency of 10 Hz, power of 1.2 W); Group 3 (Nd:YAG laser at 140 mJ/pulse, frequency of 10 Hz, power of 1.4 W); Group 4 (Nd:YAG laser at 160 mJ/pulse, frequency of 10 Hz, power of 1.6 W). The cavities were restored with Z100 composite resin (3M) and light cured at 300-600 mW/cm(2) light intensity. Specimens were thermocycled to 500 cycles from 2-50 degrees C. After that, they were dried and sealed with nail varnish, respecting 1 mm around the restorations, and immersed in 0.5% methylene blue solution for 4 h. After this period, the teeth were rinsed, dried, sectioned, and analyzed in a stereoscopic loupe. The highest leakage scores were considered for each specimen. The results were statistically analyzed by the analysis of variance (ANOVA) Kruskal-Wallis test to the 5% level. For both the enamel and cementum, there was a decrease in marginal leakage with the application of laser energy; no significant differences were observed for Groups 2, 3, and 4. The results also showed a smaller tendency to marginal leakage on the cementum than on the enamel.

A histologic assessment of the influence of low-intensity laser therapy on wound healing in steroid-treated animals

Objective: the aim of the present study was to evaluate the effect of low-intensity laser therapy on the wound healing process treated with steroid. Background Data: Various biological effects have been associated with low-level laser therapy (LLLT). Materials and Methods: Forty-eight rats were used, and after execution of a wound on the dorsal region of each animal, they were divided into 4 groups (n = 12), receiving the following treatments: G1 (control), wounds and animals received no treatment; G2, wounds were treated with LLLT; G3, animals received an intraperitoneal injection of steroid dosage (2 mg/kg of body weight); G4, animals received steroid and wounds were treated with LLLT. The laser emission device used was a GaAIAs (904 nm), in a contact mode, with 2.75 mW gated with 2.900 Hz during 120 sec (33 J/cm(2)). After the period of 3, 7, and 14 days, the animals were sacrificed and the parts sent to histological processing and dyed using hematoxylin and eosin (HE) and Masson trichromium (MT) techniques. Results: the results have shown that the wounds treated with steroid had a delay in healing, while LLLT accelerated the wound healing process. Also, wounds treated with laser in the animals treated with steroid presented a differentiated healing process with a larger collagen deposition and also a decrease in both the inflamatory infiltrated and the delay on the wound healing process. Conclusion: LLLT accelerated healing, caused by the steroid, acting as a biostimulative coadjutant agent, balancing the undesirable effects of cortisone (in the tissue healing process.

Infrared laser photobiomodulation (lambda 830 nm) on bone tissue around dental implants: A Raman spectroscopy and scanning electronic microscopy study in rabbits

Objective: the aim of this study was to assess, through Raman spectroscopy, the incorporation of calcium hydroxyapatite (CHA; similar to 960 cm(-1)), and scanning electron microscopy (SEM), the bone quality on the healing bone around dental implants after laser photobiomodulation ( lambda 830 nm). Background Data: Laser photobiomodulation has been successfully used to improve bone quality around dental implants, allowing early wearing of prostheses. Methods: Fourteen rabbits received a titanium implant on the tibia; eight of them were irradiated with lambda 830 nm laser ( seven sessions at 48-h intervals, 21.5 J/cm(2) per point, 10 mW, phi similar to 0.0028 cm(2), 86 J per session), and six acted as control. The animals were sacrificed 15, 30, and 45 days after surgery. Specimens were routinely prepared for Raman spectroscopy and SEM. Eight readings were taken on the bone around the implant. Results: the results showed significant differences on the concentration of CHA on irradiated and control specimens at both 30 and 45 days after surgery ( p < 0.001). Conclusion: It is concluded that infrared laser photobiomodulation does improve bone healing, and this may be safely assessed by Raman spectroscopy or SEM.

Comparison between wound healing in induced diabetic and nondiabetic rats after low-level laser therapy

Objective: the aim of this work was to compare the effect of low-level laser therapy (LLLT) on the wound healing process in nondiabetic and diabetic rats. Background Data: Among the clinical symptoms caused by diabetes mellitus, a delay in wound healing is a potential risk for patients. It is suggested that LLLT can improve wound healing. Methods: the tissue used for this study was extracted from animals suffering from diabetes, which was induced by Streptozotocin (R), and from nondiabetic rats. Animals were assembled into two groups of 25 rats each (treated and control) and further subdivided into two groups: diabetic (n = 15) and nondiabetic (n = 10). A full-thickness skin wound was made on the dorsum. area, with a round 8-mm hole-punch. The treated group was irradiated by a HeNe laser at 632.8 nm, with the following parameters: 15 mW, exposition time of 17 sec, 0.025 cm(2) irradiated area, and energy density of 10 J/cm(2). Square full-thickness skin samples (18 mm each side, including both injured and noninjured tissues) were obtained at 4, 7, and 15 days after surgery and analyzed by qualitative and quantitative histological methods. Results: Quantitative histopathological analysis confirmed the results of the qualitative analysis through histological microscope slides. When comparing tissue components (inflammatory cells, vessels and fibroblast/area), we found that treated animals had a less intense inflammatory process than controls. Conclusion: Results obtained by both qualitative and quantitative analyses suggested that irradiation of rats with HeNe (632.8 nm), at the tested dose, promoted efficient wound healing in both nondiabetic and diabetic rats as, compared to the control group.

Effects of Nd : YAG laser irradiation on root canal dentin wall: A scanning electron microscopic study

Objective: the purpose of this study was to evaluate, by scanning electron microscopy (SEM), the effects of Nd:YAG laser irradiation applied perpendicular or parallel to the root canal dentin wall. Methods: Thirty human teeth were divided into two groups: Group A (20 roots), laser application with circular movements, parallel to the dentin root surface; and Group B (10 roots), roots cut longitudinally and laser applied perpendicular to the root surface. Group A was subdivided into A1 (10 roots), laser application with 100 mJ, 15 Hz and 1.5 W; and A2 (10 roots) with 160 mJ, 15 Hz, and 2.4 W. Group B was subdivided into B1 (10 hemisections) and B2 (10 hemi-sections) with parameters similar to A I and A2. Four applications of 7-sec duration were performed, with a total exposure of 28 sec. SEM evaluations were made in the cervical, middle, and apical thirds, with 500X and 2000X magnifications. Morphological changes scores were attributed, and the results were submitted to Kruskal Wallis statistical test (5%). Results: Significant statistical differences were found between groups A and B (p = 0.001). In groups A1 and A2, few areas of dentin melting were observed. In groups B1 and B2, areas of melting dentin covering dentin surface were observed. Conclusions: It was concluded that intracanal laser application with circular movements (parallel to the surface) produces limited morphological changes in root canal dentin wall.

Root instrumentation with an erbium:yttrium-aluminum-garnet laser: Effect on the morphology of fibroblasts

Objective: The purpose of this study was to evaluate the effect of erbium:yttrium-aluminum-garnet laser instrumentation of root surfaces on the morphology of fibroblasts from continuous lineage. Method and materials: Dentinal slices with 4 mm2 of surface area were obtained from teeth extracted for severe periodontal involvement. Specimens were assigned to one of three treatment groups: group 1, application of the laser with an energy level of 250 mJ at 103 pulses per second; group 2, application of the laser with an energy level of 80 mJ at 166 pulses per second; and group 3, similar to group 2, but with concomitant water irrigation of the device. The specimens were incubated in multiwell plates containing cell culture media. After 24 hours, the specimens were submitted to routine preparation for scanning electron microscopy. Three independent and blind examiners used photomicrographs to evaluate the morphology of the fibroblasts: 0 = without cells; 1 = flat cells; 2 = round cells; and 3 = combination of round and flat cells. Results: Statistical analysis indicated that there were significant differences among treatment groups and that group 3 was significantly different from groups 1 and 2. Conclusion: There was no difference between groups 1 and 2 in the morphology of fibroblasts. Laser instrumentation with concomitant irrigation impaired the adhesion of fibroblasts to dentinal surfaces.

Variation of Laser Intensity on the Healing of Cutaneous Wounds

Tissue repair is an integration of dynamic interactive processes that involves soluble mediators, blood components, production of extra-cellular matrix and mesenchymal cells. Many studies involving the use of LLLT shows that the healing process is favored by such therapy. The aim of this work was to evaluate, through histological analysis, the tissue effects of cutaneous wounds submitted to different intensities and a same irradiation dose with lasers in λ670 or λ685nm. Eighteen animals were divided in two experimental groups according to wavelength used (λ670 or λ685nm). Each one of these groups was divided still in three subgroups of three animals each, related to the intensity of applied irradiation (2, 15 or 25mW). Twelve animals acted as untreated controls and were not irradiated. The irradiation was carried out during seven days. The animals were sacrificed eight days after surgery. The specimens were removed, kept in 4% formaldehyde for 24 hours, routinely prepared to wax, stained with H&E and analyzed under light microscopy. The histological characteristics observed, so much in the irradiated animals, as in the control, they are indicative of a substitution repair process, however, the LLLT modulatory positive effect was observed, in the healing process, mainly associate to the use of the shorter wavelength and low power. The results of the present study indicate that LLLT improves cutaneous wound repair and best results are achieved when higher potencies associated to short wavelengths or lower potencies associated to higher wavelengths are used.

A preliminary report on the effect of laser therapy on the healing of cutaneous surgical wounds as a consequence of an inversely proportional relationship between wavelength and intensity: Histological study in rats

Objective: The objective of the present investigation was to assess the histological effects of different wavelengths and intensities on the healing process of cutaneous wounds. Background Data: Tissue repair is a dynamic interactive process which involves mediators, cells and extra-cellular matrix. Several reports on the use of laser therapy have shown that the healing process is positively affected when the correct parameters are used. Methods: Eighteen standardized wounds were surgically created on the dorsum of male and female Wistar rats, which were subsequently divided into two experimental groups according to wavelength used λ.670 or λ685 nm) for lasertherapy (LLLT). Each group was divided into three subgroups of three animals according to the intensity of the applied irradiation (2,15, or 25 mW). Twelve animals were used as entreated controls and were not irradiated. The irradiation was carried out during seven consecutive days. The animals were sacrificed eight days after surgery. The specimens were removed, kept in 4% formaldehyde for 24 h, routinely prepared to wax, stained with H&E, and analyzed under light microscopy. Results: For both groups, light microscopy showed a substitution repair process; however, when LLLT was used, a positive biomodulatory effect was detectable, chiefly associated with shorter wavelength and low intensity. Conclusions: The results of the present study indicate that LLLT improved cutaneous wound repair and that the effect is a result of an inversely proportional relationship between wavelength and intensity, with treatment more effective when combining higher intensity with short wavelength or lower intensity with higher wavelength.

Effects of copper vapor laser radiation on the root canal wall of human teeth: A scanning electron microscope study

Objective: The aim of this study is to analyze the effects of copper vapor laser radiation on the radicular wall of human teeth. Materials and Methods: Immediately after the crowns of 10 human uniradicular teeth were cut along the cement-enamel junction, a chemical-surgical preparation of the radicular canals was completed. Then the roots were longitudinally sectioned to allow for irradiation of the surfaces of the dentin walls of the root canals. The hemi-roots were separated into two groups: one (control) with five hemi-roots that were not irradiated, and another (experimental) with 15 hemi-roots divided into three subgroups that were submitted to the following exposure times: 0.02,0.05, and 0.1 s. A copper vapor laser (510.6 nm) with a total average power of 6.5 W in green emission, frequency of 16.000 Hz, and pulse duration of 30 ns was used. Results: The results obtained by scanning electron microscope analysis showed the appearance of a cavity in the region of laser beam impact, with melting, recrystallization, and cracking on the edges of the dentin of the cavity due to heat diffusion. Conclusions: We determined that the copper vapor laser produces significant morphologic changes in the radicular wall of human teeth when using the parameters in this study. However, further research should be done to establish parameters that are compatible with dental structure in order to eliminate thermal damages. © Mary Ann Liebert, Inc.

In vitro transdentinal effect of low-level laser therapy

Low-level laser therapy (LLLT) has been used for the treatment of dentinal hypersensitivity. However, the specific LLL dose and the response mechanisms of these cells to transdentinal irradiation have not yet been demonstrated. Therefore, this study evaluated the transdentinal effects of different LLL doses on stressed odontoblast-like pulp cells MDPC-23 seeded onto the pulpal side of dentin discs obtained from human third molars. The discs were placed in devices simulating in vitro pulp chambers and the whole set was placed in 24-well plates containing plain culture medium (DMEM). After 24 h incubation, the culture medium was replaced by fresh DMEM supplemented with either 5% (simulating a nutritional stress condition) or 10% fetal bovine serum (FBS). The cells were irradiated with doses of 15 and 25 J cm-2 every 24 h, totaling three applications over three consecutive days. The cells in the control groups were removed from the incubator for the same times as used in their respective experimental groups for irradiation, though without activating the laser source (sham irradiation). After 72 h of the last active or sham irradiation, the cells were evaluated with respect to succinic dehydrogenase (SDH) enzyme production (MTT assay), total protein (TP) expression, alkaline phosphatase (ALP) synthesis, reverse transcriptase polymerase chain reaction (RT-PCR) for collagen type 1 (Col-I) and ALP, and morphology (SEM). For both tests, significantly higher values were obtained for the 25 J cm-2 dose. Regarding SDH production, supplementation of the culture medium with 5% FBS provided better results. For TP and ALP expression, the 25 J cm-2 presented higher values, especially for the 5% FBS concentration (Mann-Whitney p < 0.05). Under the tested conditions, near infrared laser irradiation at 25 J cm -2 caused transdentinal biostimulation of odontoblast-like MDPC-23 cells. © 2013 Astro Ltd.

Histeroscopia ambulatorial com laser diodo: uma nova modalidade para tratamento de pólipos endometriais

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Effects of Low-Level Laser Therapy on Biceps Braquialis Muscle Fatigue in Young Women

Objective: This study aims to investigate the effects of low-level laser therapy (LLLT) on biceps brachi muscular fatigue in 20 young females. Background data: Exhausting physical activity leads to muscular fatigue, which could decrease muscular strength, and may cause impairment in motor control and muscle pain. Several biochemical and biophysical resources have been studied in an attempt to accelerate the recovery of muscle fatigue. Among these, LLLT is emphasized. Methods: Twenty subjects were randomized in one laser group and one placebo group in two sessions of a crossover design experimental procedure; the second session taking place within 7 days of the first. In the first session, subjects underwent a collection of surface electromyographic (SEMG) data of the biceps brachii muscle, followed by active or placebo LLLT at the same muscle, followed then by another EMG sample of biceps brachii. Blood samples were collected five times during the experimental procedure. Second session procedures were identical to the first, with exception of LLLT, which was the opposite of the first session. The fatigue protocol consisted of 60sec of elbow flexion-extension movement performed with 75% of one maximum repetition. Blood lactate, EMG fatigue, and the number of elbow flexion-extension repetitions during the fatigue protocol were used to evaluate the effects of laser therapy (808nm wavelength, 100mW output power, power density of 35.7 W/cm(2), 70sec each point and 7J/point on eight points). Results: No statistical differences were found for eletromyographic fatigue and blood lactate values between groups. Mean numbers of elbow flexion-extension repetitions were 22.6 +/- 7.58 after placebo, and 25.1 +/- 9.89 after active LLLT group, but these differences were not statistically significant (p=0.342). Conclusions: LLLT had limited effects on delaying muscle fatigue in a young female sample, although a tendency was observed in the active laser group toward showing lower electromyography fatigue of biceps brachii muscle. No intergroup differences were found in the number of muscle contractions and lactate concentration.

A Novel 785-nm Laser Diode-Based System for Standardization of Cell Culture Irradiation

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)