Biostimulation with low-level laser therapy and its effects on soft and hard tissue regeneration. Literature review

Objective. Low-Level Laser Therapy encourages the healing process, reduces inflammation and pain. The aim of this study is to identify the impact of Low-Level Laser Therapy on tissue regeneration with special attention to hard tissues and to compare the effect of several wave lengths in the proliferation and differentiation of cells. Methods. The keywords used were “bone regeneration”, “laser therapy”, “photobiomodulation” OR “bio-stimulation”, “Low-Level Laser therapy” OR “LLLT”, “osteoblast proliferation” AND “differentiation”. Results. The bio-stimulation with Low-Level Laser Therapy also seems to interfere with the osseous integration of implants, by increasing its adherence on the bone-implant surfaces. Evidence has shown that Low-Level Laser Therapy influences the cellular proliferation and differentiation. Conclusions. Low-Level Laser Therapy is a promising therapy in the field of regeneration, but further studies are needed in order to define the standard protocol

The Effects of Pre and Post Exercise Low-Level Laser Therapy on Biochemical Markers of Skeletal Muscle Fatigue in Equines

Our objective was to determine whether administering low-level laser therapy before or after exercise had the greatest effect on biochemical markers of skeletal muscle fatigue in equines such as cortisol and blood lactate. Twelve quarter horses were divided into three groups: Group A received no laser therapy, Group B received laser therapy before exercise, and Group C received laser therapy after exercise. A Class II ERCHONIA ® PL500 handheld low-level laser was utilized for treatment with a wavelength of 635nm. Exercise was utilized using a horse walker system for 30 minutes five days a week for three weeks. Blood was collected via jugular venipuncture at time zero and then once a week for the remainder of the study. According to the results of this study, there is no evidence to suggest that laser therapy had a significant effect on equine cortisol or lactate, regardless if it was performed before or after exercise. However, there was an interaction between group and time for both lactate and cortisol. The results also showed that lactate increased as time increased as a result of lactic acid build up due to exercise, and cortisol decreased over time, which could be due to several possible variables such as weather. Several factors could have altered the results of this study, such as age, gender, weather, and diet of the equine subjects

Applications of Low Level Laser Therapy

Principles of biostimulation via therapeutic lasers was introduced more than 20 years ago when they were used in dermatology for wound healing. According to Genovese, biological effects caused by low level lasers are due to low energy deposited into tissues where deposited energy results in primary, secondary and general therapeutic effects. This results in the analgesic and anti-inflammatory effects as well as in improvement in healing. LLLT acts according to the Arndt-Schulz principle which states that if the stimulus is too weak, no effect is seen. Increased stimulation and optimal dose leads to the optimal effect ; while, further dose increase leads to a decreased effect. Additional stimulation leads to the inhibition of stimulation. It seems that LLLT act analgesically since they improve endorphin release and therefore inhibit nociceptive signals and control pain mediators. They can also act analgesically by inhibiting pain signals which partially leads to the transient varicosities along the neurons which decrease impulse transmission

Comparative study between the effects of isolated manual therapy techniques and those associated with low level laser therapy on pain in patients with temporomandibular dysfunction

Objective: This study sought to evaluate the pain condition in patients with temporomandibular dysfunction after applying manual therapy techniques and those associated with this low level laser therapy. Methods: The study involved 20 patients with temporomandibular dysfunction, divided randomly into two groups: G1 (n = 10), formed by 7 women and 3 men, average age 28.2 years (± 7), treated with manual therapy techniques and G2 (n = 10), formed by 8 women and 2 men, with average age 24.01 (± 6.04), treated with the combination of manual therapy techniques and low level laser therapy. The patients were treated three times a week for four consecutive weeks. The memorandum of manual therapy techniques based on Chaintow,Makofsky and Bienfaint was used. For low level laser therapy GaAs laser (904 nm), 6 J/cm2, 0.38 mW/cm2 was used, applied at 4pre-auricular points. To analyze the pain level, the visual analog pain scale was used. For data analysis the Student’s-t and Wilcoxon tests were used, both with significance level of 5% (p <0.05).Results: There was significant reduction (p <0.05) in the level of pain in both groups treated, but in G2 the significance was higher.Conclusion: Manual therapy techniques, either alone or associated with low level laser therapy showed satisfactory results for pain control in patients with temporomandibular dysfunction

Low Level Laser Therapy in Management of Complications after Intra Oral Surgeries

One of the basic purposes in dental treatment is providing a painless treatment for patients. This purpose may be achieved by the application of laser in dentistry. Low-level laser therapy (LLLT) is an internationally accepted title for biomodulation with low-level lasers which we use to achieve ideal therapeutic effects. Low-level laser therapy is a painless, reproducible, non-invasive, and without need of anesthesia treatment which is used to treat a variety of pain syndromes, injuries, wounds, fractures, neurological conditions and pathologies. Laser therapy works on the principle of inducing a biological response through energy transfer. The parameters that used in laser therapy determine the effective depth of penetration. We can mention anti-inflammatory effects, stimulation of wound healing, stimulation of immune system, increase of blood flow and activation of vasodilatation, increase of cellular metabolism and analgesic effects as advantages of the application of this type of laser. The aim of this review study was to evaluate the effect of low-level laser therapy after oral surgeries

Calibration of low-level laser therapy equipment

CONTEXTUALIZAÇÃO: A laserterapia de baixa intensidade (LBI) vem sendo cada vez mais utilizada, porém ainda não há consenso na literatura quanto ao tempo em que os equipamentos devem ser submetidos à aferição ou calibragem. OBJETIVO: Analisar a potência média real (PmR) dos equipamentos de LBI na região da Grande São Paulo. MÉTODOS: Para análise dos equipamentos, utilizou-se um potenciômetro (Lasercheck), próprio para aferição de equipamentos contínuos, o qual foi programado com dados referentes ao comprimento de onda do laser a ser avaliado, obtendo-se assim a PmR emitida. Os equipamentos foram analisados de duas formas: uma, com o LBI desaquecido, e outra, após 10 minutos de uso (aquecido), sendo que três análises foram feitas para cada condição. A caneta emissora foi acoplada ao potenciômetro, o qual fornecia a PmR emitida pelo LBI. Todos os dados e informações referentes à aplicação do laser foram coletados por um questionário respondido pelos responsáveis. RESULTADOS: Os 60 equipamentos avaliados mostraram déficit na PmR com os equipamentos desaquecidos e aquecidos. A análise estatística (ANOVA) mostrou diminuição significativa (P<0,05) da PmR aferida em relação à potência média do fabricante (PmF). Em média, a dose mais empregada nas clínicas foi de 4 J/cm², tendo os efeitos de cicatrização e anti-inflamatório como os mais desejados. Segundo a World Association for Laser Therapy (WALT), para atingir esse efeito, necessita-se de 1 a 4 J de energia final, sendo que apenas um dos 60 aparelhos conseguiria atingir a janela terapêutica preconizada. CONCLUSÃO: Os equipamentos de LBI apresentam um déficit acentuado na PmR, o que mostra uma desordem na utilização desse recurso. Neste estudo, observou-se a necessidade de aferição periódica dos aparelhos de LBI bem como melhor conhecimento técnico dos profissionais envolvidos.BACKGROUND: Despite the increase in the use of low-level laser therapy (LLLT), there is still a lack of consensus in the literature regarding how often the equipment must be calibrated. OBJECTIVE: To evaluate the real average power of LLLT devices in the Greater São Paulo area. METHODS: For the evaluation, a LaserCheck power meter designed to calibrate continuous equipment was used. The power meter was programmed with data related to the laser's wavelength to gauge the real average power being emitted. The LLLT devices were evaluated in two ways: first with the device cooled down and then with the device warmed up for 10 minutes. For each condition, three tests were performed. The laser probe was aligned with the power meter, which provided the real average power being emitted by the LLLT device. All of the data and information related to the laser application were collected with the use of a questionnaire filled in by the supervising therapists. RESULTS: The 60 devices evaluated showed deficit in real average power in the cooled-down and warmed-up condition. The statistical analysis (ANOVA) showed a significant decrease (p<0.05) in the real average power measured in relation to the manufacturer's average power. On average, the most common dose in the clinics was 4 J/cm², and the most desired effects were healing and anti-inflammatory effects. According to the World Association for Laser Therapy (WALT), 1 to 4 J of final energy are necessary to achieve these effects, however only one device was able to reach the recommended therapeutic window. CONCLUSION: The LLLT devices showed a deficit in real average power that emphasized a lack of order in the application of this tool. The present study also showed the need for periodical calibration of LLLT equipment and a better technical knowledge of the therapists involved

Low-level laser therapy in the management of muscle fatigue caused after long Endodontic procedure

The masticatory muscles may undergo fatigue due to prolonged mouth opening during the endodontic procedures. Low-level laser can be used to treat muscle fatigue due its capacity to produce reactive oxygen species and improve function of mitochondria. Aim: To determine the effectiveness of low-level laser therapy in the management of masticatory muscle fatigue caused after long endodontic procedure under Local anesthesia. MATERIAL AND METHODS: 44 patients complaining of reduced mouth opening and pain while mouth opening, after long endodontic therapy were considered for the study and were randomly allocated into study and control group. In the study group, low-level laser was applied while patients of control group didn't receive any therapy. In the study group, Visual analogue scale (VAS) score of pain was taken after endodontic therapy, immediately after laser therapy and 4 hours after endodontic therapy. Mouth opening of the patients was measured, before and after endodontic procedure and immediately after laser therapy. In the control group, VAS score of pain was recorded immediately after endodontic therapy and 4 hours after endodontic therapy. Statistical analysis used: ANOVA test and un-paired t-test was used for the data analysis. RESULTS: When both groups were compared, a statistically significant (P=0.0000) reduction with fatigue was found. CONCLUSIONS: The low-level laser can be a useful procedure immediately post long endodontic procedure causing masticatory muscle fatigue. Hence, this therapy can be considered as an add-on therapeutic procedure along with prolonged endodontic appointments to relieve the patient from the discomfort. Key words:Muscle fatigue, Masticatory muscles, Low-level laser therapy

Biological Effects of Low Level Laser Therapy

The use of low level laser to reduce pain, inflammation and edema, to promote wound, deeper tissues and nerves healing, and to prevent tissue damage has been known for almost forty years since the invention of lasers. This review will cover some of the proposed cellular mechanisms responsible for the effect of visible light on mammalian cells, including cytochrome c oxidase (with absorption peaks in the Near Infrared (NIR)). Mitochondria are thought to be a likely site for the initial effects of light, leading to increased ATP production, modulation of reactive oxygen species, and induction of transcription factors. These effects in turn lead to increased cell proliferation and migration (particularly by fibroblasts)

Low Level Laser Therapy for Painful Joints

Low Level Laser Therapy (LLLT) uses a light source that generates extremely pure light, of a single wavelength1. The effect is not thermal, but rather related to photochemical reactions in the cells. LLLT was introduced as an alternative non-invasive treatment for OA about 10 years ago, but its effectiveness is still controversial2. A Cochrane review of LLLT in osteoarthritis included five trials, and concluded that despite some positive findings, the meta-analysis lacked data on how LLLT effectiveness was affected by the important factors of wavelength, treatment duration of LLLT, dosage, and site of application over nerves instead of joints1,3,4,5,6,7. A different review2 addresses some of these issues in a wider range of trials, and is broadly positive, if limited by numbers