December 2015 LITERATURE REVIEW

Compiled by Dr Igor Cernavin, Prosthodontist, Honorary Senior Fellow University of Melbourne School of Medicine, Dentistry and Health Sciences, Director and Cofounder of the Asia Pacific Institute of Dental Education and Research (AIDER), Australian representative of World Federation of Laser Dentistry (WFLD)

de Oliveira et al1 have published a review of the use of lasers for acupuncture in dentistry. The abstract is reproduced in full.

Studies have shown the use of laser therapy at points of acupuncture as an alternative to metal needles. The scientific literature in the area of laser acupuncture is rather large; however, the actual mechanisms and effects have not yet been proven in detail. Therefore, the current manuscript reviews the existing literature regarding the effects of laser acupuncture in Dentistry, seeking treatment modalities in which this technique is used and which are able to generate positive clinical results. Thus, the literature survey was conducted in electronic databases – Medline/Pubmed, VHL and Science Direct – using the uniterms “alternative medicine”, “low-power laser and acupuncture”, “laser acupuncture and dentistry” and “laser therapy and acupuncture”. Retrospective and prospective clinical studies were considered. According to the findings of the literature, laser therapy at points of acupuncture was effective for the treatment of various orofacial problems encountered in dentistry, but there are still many differences among the parameters used for irradiation and there is a lack of important information reported by the studies, such as the wavelength, dose, power density, irradiation time and frequency, points of acupuncture selected for irradiation and therapy outcomes. Although these results indicate the potential benefit of the use of laser therapy at points of acupuncture on Dentistry, further double-blinded, controlled clinical trials should be carried out in order to standardize protocols for clinical application.

Mayer and coworkers2 evaluated the effects of low-level laser therapy on peri-implant bone regeneration by means of resonance frequency analysis and histologic analysis of bone-to-implant contact. They concluded that Laser therapy at a dose of 20 J per treatment session, based on the irradiation protocol used in this study, was able to significantly increase implant stability quotient values and of bone-to-implant contact after implant placement, indicating that laser irradiation affected an improvement in peri-implant bone healing. They used an aluminum-gallium-arsenide laser diode every 48 hours over a 13-day period for a total of seven sessions.

Papadopoulos et al3 compared the effectiveness of open flap debridement used alone and with an approach employing the additional use of a diode laser for the treatment of peri-implantitis and concluded that the additional use of a diode laser in the surgical treatment of peri-implantitis offers a limited clinical benefit.

Nguyen and coworkers4 compared the effectiveness of scaling and root planning plus the adjunctive use of diode laser therapy to SRP alone on changes in the clinical parameters of disease and on the gingival crevicular fluid (GCF) inflammatory mediator interleukin-1beta (IL-1beta) in patients receiving regular periodontal maintenance therapy. They concluded that SRP + Laser did not enhance clinical outcomes compared to SRP alone in the treatment of inflamed sites with pockets ≥5 mm.

Soboutiet al5 examined the effect of single-dose low-level helium-neon laser irradiation on orthodontic pain in a split-mouth single-blind placebo-controlled randomized clinical trial.
They used a single dose of He-Ne laser irradiation (632.8nm, 10mw, 6j/cm(2) density) and showed significant pain reduction.

Ginani and coworkers6 carried out a systematic review of the effect of low-level laser therapy on mesenchymal stem cell proliferation and found that it positively influences the in vitro proliferation of stem cells.

Moreira et al7 present case reports of antimicrobial photodynamic therapy via sinus tract in conservative treatment of a late failure of endodontic retreatment in two clinical cases of post-treatment apical periodontitis. The readers may find this of interest/ value.

Amaral and coworkers8 compared the effects of diode laser surgery to those of the conventional technique in patients with fibrous hyperplasia in the form of a randomized clinical trial. They concluded that diode laser surgery proved to be more effective and less invasive when compared with scalpel surgery in the management of fibrous hyperplasia. However, wound healing proved to be faster when using scalpel surgery.

Cakir-Ozkan et al9 evaluated the effect of low level laser therapy (LLLT) on bone mineral density by using high-resolution computerized tomography (HR-CT) and stereology in patients subjected to mandibular midline distraction. A GaAlAs laser with a wavelength of 830 nm, power of 40 mW, energy of 8.4 J/cm dose per spot, was directly applied from 2 points on the mandibular midline. The laser was applied in 8 treatment sessions at 48-hour intervals. They found that the retention period can be shortened and mineralization may be increased by using LLLT in mandibular distraction osteogenesis.

Mathur and coworkers10 examined the use of diode Laser in the excision of oral benign lesions and conclude that they are rapidly becoming the standard of care in contemporary dental practice.

Reddy Kundoor et al11 examined the efficacy and safety of diode laser for the management of white lesions such as oral leukoplakia and oral lichen planus. Their conclusion was that diode lasers provide acceptable clinical improvement of potentially malignant lesions with minimal side effects and can be considered one of the best alternative treatment modalities for oral mucosal lesions.

Aena and coworkers12 compared the clinical efficacy of use of a diode laser (810 nm) as an adjunct to modified Widman flap surgery to that of modified Widman flap surgery alone. They concluded that a 810 nm diode laser provided additional benefits to the surgery in terms of clinical parameters.

Curylofo-Zotti et al13 evaluated the effects of Er:YAG laser irradiation applied at a varying pulse repetition rate on the surface roughness of eroded enamel. They concluded that the Er:YAG laser at 1 Hz presented a less rough surfaces than those irradiated at 2, 3, and 4 Hz.

Kazancioglu and coworkers14 compared the effect of Low-Level Laser Therapy versus Ozone Therapy in the Treatment of Oral Lichen Planus. They found that ozone and corticosteroid therapies were more effective than 808-nm LLLT in the treatment of OLP.

Migliari et al15 assessed the effectiveness of photocoagulation with Nd:YAG laser in the treatment of lip and oral venous varices. Their conclusion was that most patients with oral and lip varices only need some clinical advice regarding the nature of their lesions. However, for those who seek treatment for these conditions, the use of the Nd:YAG laser is an option as it yields satisfactory outcomes.

Sancakli and coworkers16 evaluated the effect of Low Level Laser application at the points of greatest pain in patients with chronic masticatory muscle pain in a double-blind randomized clinical study. The patients were randomly divided into three groups; laser group I patients received the LLLT at the point of greatest pain, laser group II patients received LLLT at pre-established points in the affected muscles and a placebo group .Treatment was applied three times per week for a total of 12 sessions. Mandibular mobility was examined, masticator muscles tenderness were assessed. Subjective pain levels were evaluated using VAS. They concluded that LLLT can be accepted as an alternative treatment modality in the management of masticatory muscle pain and direct irradiation seems to produce a better result.

Monea et al17 examined whether low level laser therapy could decrease the time between extraction/socket graft and implant placement by evaluating histological changes in sockets grafted with a particulate allograft material and treated with LLLT. Their histological evidence suggested that new bone formation in the sockets appeared within 60days after LLLT treatment compared with a minimum of 120days in the control group.

Minovska18compared gingival curettage and scaling and root planning using an Er:Yag laser versus mechanical hand instrumentation on patients with chronic periodontal disease and concluded that the laser produced superior results.

Leconte C19 published an informative article on periimplantitis and Er:Yag laser use.

Merigo et al20 published a clinical study showing the advantages of the Er:YAG laser in the conservative treatment of Special Care patients.

Romao and coworkers21 evaluated human alveolar bone repair 40 days after molar extraction in patients submitted to laser phototherapy (LPT). The results suggest that LPT is able to accelerate alveolar bone repair after molar extraction, leading to a more homogeneous trabecular configuration represented by thin and close trabeculae.

References

1. de Oliveira, Renata Ferreira; da Silva, Camila Vieira; Cersosimo, Maria Cecilia Pereira; Borsatto, Maria Cristina; de Freitas, Patricia Moreira. Laser therapy on points of acupuncture: Are there benefits in dentistry? Journal of photochemistry and photobiology. B, Biology, 151 76-82; 10.1016/j.jphotobiol.2015.07.008 2015-Oct.
2. Mayer, Luciano; Gomes, Fernando Vacilotto; Carlsson, Lennart; Gerhardt-Oliveira, Marilia. Histologic and Resonance Frequency Analysis of Peri-Implant Bone Healing After Low-Level Laser Therapy: An In Vivo Study. The International journal of oral & maxillofacial implants, 30 (5):1028-35; 10.11607/jomi.3382 2015 Sep-Oct.
3. Papadopoulos, Christos A; Vouros, Ioannis; Menexes, Georgios; Konstantinidis, Antonis.
The utilization of a diode laser in the surgical treatment of peri-implantitis. A randomized clinical trial. Clinical oral investigations, 19 (8):1851-60; 10.1007/s00784-014-1397-9 2015-Nov.
4. Nguyen, Naomi-Trang; Byarlay, Matthew R; Reinhardt, Richard A; Marx, David B; Meinberg, Trudy A; Kaldahl, Wayne B. Adjunctive Non-Surgical Therapy of Inflamed Periodontal Pockets During Maintenance Therapy Using Diode Laser: A Randomized Clinical Trial. Journal of periodontology, 86 (10):1133-40; 10.1902/jop.2015.150152 2015-Oct.
5. Sobouti, Farhad; Khatami, Maziar; Chiniforush, Nasim; Rakhshan, Vahid; Shariati, Mahsa.
Effect of single-dose low-level helium-neon laser irradiation on orthodontic pain: a split-mouth single-blind placebo-controlled randomized clinical trial. Progress in orthodontics, 16 (1):32; 10.1186/s40510-015-0102-0 2015-Dec.
6. Ginani, Fernanda; Soares, Diego Moura; Barreto, Mardem Portela E Vasconcelos; Barboza, Carlos Augusto Galvao. Effect of low-level laser therapy on mesenchymal stem cell proliferation: a systematic review. Lasers in medical science, 30 (8):2189-94; 10.1007/s10103-015-1730-9 2015-Nov.
7. Moreira, Maria Stella Nunes Araujo; de FreitasArchilla, Jose Ricardo; Lascala, Cesar Angelo; Ramalho, Karen Muller; Gutknecht, Norbert; Marques, Marcia Martins. Post-Treatment Apical Periodontitis Successfully Treated with Antimicrobial Photodynamic Therapy Via Sinus Tract and Laser Phototherapy: Report of Two Cases. Photomedicine and laser surgery, 33 (10):524-8; 10.1089/pho.2015.3936 2015-Oct.
8. Amaral, M B F; de Avila, J M S; Abreu, M H G; Mesquita, R A. Diode laser surgery versus scalpel surgery in the treatment of fibrous hyperplasia: a randomized clinical trial. International journal of oral and maxillofacial surgery, 44 (11):1383-9; 10.1016/j.ijom.2015.05.015 2015-Nov.
9. Cakir-Ozkan, Nilufer; Bereket, Cihan; Arici, Nursel; Elmali, Muzaffer; Sener, Ismail; Bekar, Esengul. The Radiological and Stereological Analysis of the Effect of Low-Level Laser Therapy on the Mandibular Midline Distraction Osteogenesis. The Journal of craniofacial surgery, 26 (7):e595-9; 10.1097/SCS.0000000000002046 2015-Oct.
10. Mathur, Ena; Sareen, Mohit; Dhaka, Payal; Baghla, Pallavi. Diode Laser Excision of Oral Benign Lesions. Journal of lasers in medical sciences, 6 (3):129-32; 10.15171/jlms.2015.07 2015.
11. Reddy Kundoor, Vinay Kumar; Patimeedi, Ashwini; Roohi, Shameena; Maloth, Kotya Naik; Kesidi, Sunitha; Masabattula, Geetha Kumari. Efficacy of Diode Laser for the Management of Potentially Malignant Disorders. Journal of lasers in medical sciences, 6 (3):120-3; 10.15171/jlms.2015.05 2015.
12. Aena, Pundir J; Parul, Agrawal; Siddharth, Pundir; Pravesh, Goyal; Vikas, Diwan; Vandita, Agrawal. The clinical efficacy of laser assisted modified Widman flap: A randomized split mouth clinical trial. Indian journal of dental research : official publication of Indian Society for Dental Research, 26 (4):384-9; 10.4103/0970-9290.167626 2015 Jul-Aug.
13. Curylofo-Zotti, Fabiana Almeida; Lepri, Taisa Penazzo; Colucci, Vivian; Turssi, Cecilia Pedroso; Corona, Silmara Aparecida Milori. Sub ablative Er: YAG laser irradiation on surface roughness of eroded dental enamel. Microscopy research and technique, 78 (11):989-93; 10.1002/jemt.22563 2015-Nov.
14. Kazancioglu, Hakki Oguz; Erisen, Merve. Comparison of Low-Level Laser Therapy versus Ozone Therapy in the Treatment of Oral Lichen Planus. Annals of dermatology, 27 (5):485-91; 10.5021/ad.2015.27.5.485 2015-Oct.
15. Migliari, Dante; Vieira, Rodrigo R; Nakajima, Edgar K; Azevedo, Luciane H. Successful Management of Lip and Oral Venous Varices by Photocoagulation with Nd:YAG Laser. The journal of contemporary dental practice, 16 (9):723-6; 2015 Sep 01.
16. Sancakli, Erkan; Gokcen-Rohlig, Bilge; Balik, Ali; Ongul, Deger; Kipirdi, Selin; Keskin, Haluk. Early results of low-level laser application for masticatory muscle pain: a double-blind randomized clinical study. BMC oral health, 15 (1):131; 10.1186/s12903-015-0116-5 2015 Oct 23.
17. Monea, Adriana; Beresescu, Gabriela; Tibor, Mezei; Popsor, Sorin; Antonescu, Dragos Mihai. Bone healing after low-level laser application in extraction sockets grafted with allograft material and covered with a resorbable collagen dressing: a pilot histological evaluation. BMC oral health, 15 (1):134; 10.1186/s12903-015-0122-7 2015 Oct 29.
18. Minovska A, Stojceva C, Tomov G. Use of the Er:YAG laser for initial treatment of chronic periodontitis. Laser international magazine of laser dentistry. 6-10 Vol.7 Issue 3/2015.
19. Leconte C. Perimplantitis and Er:YAG laser. Laser international magazine of laser dentistry. 14-17 Vol.7 Issue 3/2015.
20. Merigo, Elisabetta; Fornaini, Carlo; Clini, Fabio; Fontana, Matteo; Cella, Luigi; Oppici, Aldo. Er:YAG laser dentistry in special needs patients. Laser therapy, 24 (3):189-93; 10.5978/islsm.15-CR-02 2015-Oct-2.
21. Romao, M M A; Marques, M M; Cortes, A R G; Horliana, A C R T; Moreira, M S; Lascala, C A. Micro-computed tomography and histomorphometric analysis of human alveolar bone repair induced by laser phototherapy: a pilot study. International journalof oral and maxillofacial surgery, 44 (12):1521-8; 10.1016/j.ijom.2015.08.989 2015-Dec.

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