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

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

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

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

Oral Mucositis Prevention and Management by Therapeutic Laser in Head and Neck Cancers

Introduction: Oral mucositis is considered a severe complication in cancer patients receiving radiotherapy or chemotherapy for head and neck cancer. The aim of this review study was to assess the effect of low level laser therapy for prevention and management of oral mucositis in cancer patients.Methods: The electronic databases searched included Pubmed, ISI Web of Knowledge and Google scholar with keywords as “oral mucositis”, “low level laser therapy” from 2000 to 2013.Results: The results of most studies showed that photobiomodulation (PBM) reduced the severity of mucositis. Also, it can delay the appearance of severe mucositis.Conclusion: Low level laser therapy is a safe approach for management and prevention of oral mucositis

Evaluation of Efficacy of Low-Level Laser Therapy

Introduction: Given the inconsistencies in the literature regarding laser performance in non-surgical treatments, this study investigated the available literature to determine the advantages and disadvantages of low-power lasers in treating non-surgical complications and diseases.Methods: Authentic information from articles was extracted and evaluated to assess low-power laser performance for non-surgical treatments. A systematic search of studies on low-level laser therapy (LLLT) for non-surgical treatments was conducted mainly in PubMed and google scholar articles.Results: Four categories of diseases, including brain-related diseases, skin-related diseases, cancers, and bone-related disorders, which were treated by LLLT were identified and introduced. The various types of LLLT regarding the studied diseases were discussed.Conclusion: Positive aspects of LLLT versus a few disadvantages of its application imply more investigation to find better and efficient new methods

Low Level Laser Therapy (LLLT) for Orofacial Pain

Low-power lasers are a group of lasers with a power less than 500 mW and unlike high-power lasers they have no effect on tissue temperature; they produce light-dependent chemical reactions in tissues. The purpose of this study was to review the clinical applications of these lasers and their success rate in different studies in orofacial pains. The articles with the key word “low level laser therapy” were extracted from pubmed. Clinical trials, meta-analysis, randomized clinical trials, and review articles were selected. Related articles to orofacial region were gathered and selected from the search results and carefully reviewed. Laser therapy may affect many cellular and sub-cellular processes, although exact mechanism has not been well-defined yet. Articles had different points of views as mentioned in the context of this article. Low level laser therapy was effective in orofacial pain relief in most studies, but the use of laser remains controversial. These lasers have analgesic features, and it is according to these features they have been used in the treatment of orofacial pain, Including myofacial pain, mucositis, facial myalgia, temporomandibular joint disorders and neuralgia. It seems that laser therapy can be considered as an alternative physical modality in treatment of orofacial pain

Low-level laser therapy for carpal tunnel syndrome

Peer reviewedPublisher PD

Efficacy of low-level laser therapy on scar tissue

Physiotherapy has a very important role in the maintenance of the integumentary system integrity. There is very few evidence in humans. Nevertheless, there are some studies about tissue regeneration using low-level laser therapy (LLLT). Aim: To analyze the effectiveness of LLLT on scar tissue. Methods: Seventeen volunteers were stratified by age of their scars, and then randomly assigned to an experimental group (EG) — n = 9 – and a placebo group (PG) – n = 8. Fifteen sessions were conducted to both the groups thrice a week. However, in the PG, the laser device was switched off. Scars’ thickness, length, width, macroscopic aspect, pain threshold, pain perception, and itching were measured. Results: After 5 weeks, there were no statistically significant differences in any variable between both the groups. However, analyzing independently each group, EG showed a significant improvement in macroscopic aspect (p = 0.003) using LLLT. Taking into account the scars’ age, LLLT showed a tendency to decrease older scars’ thickness in EG. The intervention with LLLT appears to have a positive effect on the macroscopic scars’ appearance, and on old scars’ thickness, in the studied sample. However, it cannot be said for sure that LLLT has influence on scar tissue