Dentistry Journal

Research

19 pages, 4961 KB

Open AccessArticle

In Vivo Evaluation of Diode Laser Use in Lingual Frenectomy: A Histological and Histomorphometric Study

by Claudia Marcia de Moraes Souza, Adriana Terezinha Neves Novellino Alves, Rodrigo Figueiredo de Brito Resende, Juliana Pires Abdelnur, Jose de Albuquerque Calasans-Maia, Carlos Fernando Mourão, Jamil Awad Shibli, Jose Mauro Granjeiro and Monica Diuana Calasans-Maia

Dent. J. 2026, 14(4), 209; https://doi.org/10.3390/dj14040209 - 3 Apr 2026

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Abstract

Background/Objectives: Morphological alterations of the lingual frenulum may impair sucking, speech articulation, and tongue mobility. In such cases, frenectomy is considered the most effective therapeutic approach. High-power lasers have been increasingly adopted due to their precision and reduced surgical trauma. This study [...] Read more.

Background/Objectives: Morphological alterations of the lingual frenulum may impair sucking, speech articulation, and tongue mobility. In such cases, frenectomy is considered the most effective therapeutic approach. High-power lasers have been increasingly adopted due to their precision and reduced surgical trauma. This study aimed to compare the effects of frenectomy performed with a cold scalpel, electric scalpel, and diode laser in Wistar rats. Methods: Forty-five female rats, approximately six months old and weighing 250–300 g, were randomly allocated into three experimental groups (n = 15) according to the surgical technique used. Each group was further divided into three subgroups (n = 5) based on postoperative evaluation periods of 1, 3, and 7 days. After surgery, animals were euthanized at the predetermined time points, and tissue samples from the operated area were collected for histological analysis. Specimens were processed histologically, and sections were analyzed descriptively and semi-quantitatively for inflammatory response. Results: All surgical techniques produced similar inflammatory responses across the evaluated periods, with no statistically significant differences among groups. The inflammatory infiltrate was predominantly acute, characterized by the presence of neutrophils, lymphocytes, and macrophages, with scarce plasma cells and no multinucleated giant cells. Although the cold scalpel group showed greater variability in macrophage response over time, the electric scalpel and diode groups exhibited more consistent inflammatory patterns. Conclusions: All evaluated techniques were biologically equivalent with respect to the initial inflammatory response, with the electric scalpel and high-power laser showing slightly greater temporal stability. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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15 pages, 2217 KB

Open AccessArticle

Early Phase Gingival Wound Healing Following Low-Level Er:YAG Laser Irradiation: In Vitro and In Vivo Studies

by Lu Chen, Koji Mizutani, Natsumi Saito, Bruna Akinaga Moreira, Daisuke Kido, Takanori Iwata and Akira Aoki

Dent. J. 2026, 14(3), 138; https://doi.org/10.3390/dj14030138 - 2 Mar 2026

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Abstract

Background: Low-level laser irradiation (LLLI) can promote wound healing. However, the biological effects of the erbium-doped yttrium aluminum garnet (Er:YAG) laser on gingival wound healing remain unclear. Objectives: To assess the effects of low-level Er:YAG laser irradiation on endothelial cell activity in vitro [...] Read more.

Background: Low-level laser irradiation (LLLI) can promote wound healing. However, the biological effects of the erbium-doped yttrium aluminum garnet (Er:YAG) laser on gingival wound healing remain unclear. Objectives: To assess the effects of low-level Er:YAG laser irradiation on endothelial cell activity in vitro and on early phase gingival wound healing in vivo. Methods: In vitro, human umbilical vein endothelial cells were irradiated with a low-level Er:YAG laser (30 mJ/pulse, 10 Hz, 20 and 30 s, defocused, no water spray) and assessed for viability, cytotoxicity, and migration. Standardized bilateral wounds (4 × 1 mm) were created in the palatal gingiva of 14 male mice using a scalpel and curette. The wounds were irradiated for 20 s under the same irradiation settings, using a contact tip (diameter 800 μm) to induce superficial blood surface coagulation, while contralateral sites were assigned to controls in a split-mouth design. Postoperative wound area and mRNA expression of IL-6, TNF-α, VEGF, FGF-2, and TGF-β1 were analyzed after 48 h. Results: In vitro, LLLI significantly enhanced cell proliferation with/without increasing cytotoxicity. In the wound healing assay, the LLLI significantly promoted cell migration compared with the control. In vivo, the reduction in residual wound area in the laser group was comparable to that in the control group. IL-6 and TNF-α expressions were significantly downregulated, whereas VEGF was significantly upregulated in the laser group. Conclusions: Low-level Er:YAG laser irradiation enhances anti-inflammatory and pro-angiogenic effects, suggesting its potential in promoting gingival wound healing. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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20 pages, 5270 KB

Open AccessArticle

Er:YAG Laser Versus Sandblasting for Build-Up Conditioning in Adhesive Cementation: A Retrospective Study of 187 Posterior Indirect Restorations

by Ilaria Giovannacci, Giuseppe Pedrazzi, Beatrice Spaggiari and Paolo Vescovi

Dent. J. 2026, 14(1), 34; https://doi.org/10.3390/dj14010034 - 5 Jan 2026

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Abstract

Background: Adhesive indirect restorations have become increasingly common in daily clinical routine in most dental practices. Before etching and adhesive application, a sandblasting procedure is essential to clean and increase the microporosity of the surface. Air abrasion with aluminum oxide particles significantly [...] Read more.

Background: Adhesive indirect restorations have become increasingly common in daily clinical routine in most dental practices. Before etching and adhesive application, a sandblasting procedure is essential to clean and increase the microporosity of the surface. Air abrasion with aluminum oxide particles significantly improves the bond strength. However, this procedure may have some limitations, such as the presence of powder particles. Recently, the Er:YAG laser in QSP mode has been proposed for conditioning build-ups prior to adhesive cementation. The aim of this study was a retrospective analysis of adhesive indirect restoration in which build-up was conditioned or using a traditional sandblaster with alumina powder or using the Er:YAG laser in QSP mode. Methods: 187 posterior indirect adhesive restorations were cemented using two different conditioning techniques: in 96 cases (51.34%) build-up conditioning was performed using an intraoral sandblaster with alumina oxide (Microetcher CD, Kavo, Biberach, Germany); in 91 cases (48.66%) build-up conditioning was performed using the Er:YAG laser (Fotona LighWalker^®, Ljubljana, Slovenia) in QSP modality (1 W, 10 Hz, 100 mJ). The clinical efficacy of the two techniques was evaluated and compared, assessing the occurrence of complications such as debonding, fracture, secondary leakage, and hypersensitivity over time. Results: The frequency of secondary complications was very low in both groups. Only one case of debonding and one case of restoration cracking was observed in the sandblasting group, with none in the laser group (p = 0.329). Secondary caries occurred in both groups. A difference was observed in postoperative hypersensitivity: 6% in the sandblasting group and 1% in the laser group (p = 0.064). The Kaplan–Meier curves of the two conditioning techniques showed comparable survival over time (Log-rank test χ² = 2.4864/p = 0.1148). The mean follow-up was 30 months. Conclusions: The success rates of these restorations are very high if adhesive cementation steps are properly followed. Conditioning the build-up before etching is essential. Among these, the Er:YAG laser in QSP mode seems to provide excellent results in the absence of dust and smear layer. Recurrence rates of complications such as decementation, leakage, and cracking resulted in less than 1%. Furthermore, it is interesting to note that using the laser to condition the build-up appears to reduce the recurrence of post-cementation hypersensitivity. These data require confirmation through prospective clinical trials. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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10 pages, 940 KB

Open AccessArticle

Low-Level Laser Therapy in Maxillofacial Trauma: A Prospective Single-Arm Observational Study

by Raissa Dias Fares, Jonathan Ribeiro da Silva, Sylvio Luiz Costa De-Moraes, Jose Mauro Granjeiro and Monica Diuana Calasans-Maia

Dent. J. 2025, 13(11), 532; https://doi.org/10.3390/dj13110532 - 13 Nov 2025

Cited by 1 | Viewed by 1251

Abstract

Background: Surgical management of trauma in the maxillofacial complex can result in iatrogenic nerve injuries, particularly involving the infraorbital, inferior alveolar, and mental nerves. Paresthesia is a common postoperative complication, often attributed to the anatomical positioning of these nerve structures, making them vulnerable [...] Read more.

Background: Surgical management of trauma in the maxillofacial complex can result in iatrogenic nerve injuries, particularly involving the infraorbital, inferior alveolar, and mental nerves. Paresthesia is a common postoperative complication, often attributed to the anatomical positioning of these nerve structures, making them vulnerable to injury. Among current therapeutic options for nerve injuries, low-level laser therapy (LLLT) has shown promising results in published studies. Objectives: This prospective observational study evaluated the effects of LLLT on nerve recovery following maxillofacial trauma surgery. Methods: A total of 21 participants, with a median age of 35 years and no gender-based selection criteria, were enrolled. Cases included zygomaticomaxillary complex and mandibular osteosynthesis; analyses were within-subject across time. Postoperative laser therapy was administered to both groups using the DUO MMO device (MMOptics, São Carlos, Brazil), delivering infrared light along the pathways of the inferior alveolar, infraorbital, and mental nerves. Nerve function was assessed regularly using a Visual Analog Scale (VAS) and the Brush Stroke Direction (BSD) test to evaluate sensory recovery. Results: Compared with baseline (15 days post-op, pre-LLLT), VAS scores showed significant reductions at sessions 7 and 10, and BSD responses increased over time. Conclusion: After multiplicity control, only the session 10 comparison remained significant. These observational findings support the feasibility of multi-session LLLT after maxillofacial trauma; controlled trials are warranted to determine efficacy. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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17 pages, 2406 KB

Open AccessArticle

Microscopic and Crystallographic Analysis of Increased Acid Resistance of Melted Dental Enamel Using 445 nm Diode Laser: An Ex-Vivo Study

by Samir Nammour, Marwan El Mobadder, Aldo Brugnera, Praveen Arany, Mireille El Feghali, Paul Nahas and Alain Vanheusden

Dent. J. 2025, 13(8), 376; https://doi.org/10.3390/dj13080376 - 19 Aug 2025

Cited by 2 | Viewed by 1296

Abstract

Background/Objectives: This study aimed to evaluate the efficacy of a 445 nm diode laser in enhancing enamel resistance to acid-induced demineralization and to investigate the associated compositional and structural modifications using scanning electron microscopy (SEM), electron spectroscopy for chemical analysis (ESCA), and [...] Read more.

Background/Objectives: This study aimed to evaluate the efficacy of a 445 nm diode laser in enhancing enamel resistance to acid-induced demineralization and to investigate the associated compositional and structural modifications using scanning electron microscopy (SEM), electron spectroscopy for chemical analysis (ESCA), and X-ray diffraction (XRD) crystallographic analysis. Methods: A total of 126 extracted human teeth were used. A total of 135 (n = 135) enamel discs (4 × 4 mm) from 90 teeth were assigned to either a laser-irradiated group or an untreated control group for SEM, ESCA, and XRD analyses. Additionally, 24 mono-rooted teeth were used to measure pulp temperature changes during laser application. Laser irradiation was performed using a 445 nm diode laser with a pulse width of 200 ms, a repetition rate of 1 Hz, power of 1.25 W, an energy density of 800 J/cm², a power density of 3980 W/cm², and a 200 µm activated fiber. Following acid etching, SEM was conducted to assess microstructural and ionic alterations. The ESCA was used to evaluate the Ca/P ratio, and XRD analyses were performed on enamel powders to determine changes in phase composition and crystal lattice parameters. Results: The laser protocol demonstrated thermal safety, with minimal pulp chamber temperature elevation (0.05667 ± 0.04131 °C). SEM showed that laser-treated enamel had a smoother surface morphology and reduced acid-induced erosion compared with controls. Results of the ESCA revealed no significant difference in the Ca/P ratio between groups. XRD confirmed the presence of hydroxyapatite structure in laser-treated enamel and detected an additional diffraction peak corresponding to a pyrophosphate phase, potentially enhancing acid resistance. Results of the spectral analysis showed the absence of α-TCP and β-TCP phases and a reduction in the carbonate content in the laser group. Furthermore, a significant decrease in the a-axis lattice parameter suggested lattice compaction in laser-treated enamel. Conclusions: Irradiation with a 445 nm diode laser effectively enhances enamel resistance to acid demineralization. This improvement may be attributed to chemical modifications, particularly pyrophosphate phase formation, and structural changes including prism-less enamel formation, surface fusion, and decreased permeability. These findings provide novel insights into the mechanisms of laser-induced enhancement of acid resistance in enamel. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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14 pages, 1172 KB

Open AccessArticle

Laser-Mediated Hemostasis for Older Patients Receiving Routine Dental Treatment

by Suwat Tanya, Saengsome Prajaneh, Piyachat Patcharanuchat and Sajee Sattayut

Dent. J. 2025, 13(7), 315; https://doi.org/10.3390/dj13070315 - 11 Jul 2025

Cited by 1 | Viewed by 1906

Abstract

Background/Objective: Laser therapy has gained attention in dental practice to minimize bleeding and enhance blood clot formation. This study aimed to explore the utilization and to compare the clinical efficacy of laser-mediated hemostasis for older patients receiving routine dental treatment. Methods: A prospective [...] Read more.

Background/Objective: Laser therapy has gained attention in dental practice to minimize bleeding and enhance blood clot formation. This study aimed to explore the utilization and to compare the clinical efficacy of laser-mediated hemostasis for older patients receiving routine dental treatment. Methods: A prospective observational study was conducted across research networks between October 2023 and August 2024, involving 60 patients aged 50 years and older (average = 63.35 years) at risk of postoperative bleeding following dental treatments. Additionally, laser therapy for hemostasis was selected and provided among calibrated operators. A single researcher performed data collection. Before statistical analysis, data verification and clinical assessment were conducted by the operators and researcher. A clinical cut-off for hemostasis was set at 5 min. Two diode laser machines were used namely, an 810 nm and dual wavelengths of 635 nm and 980 nm. Results: There were 94 extraction sockets, 28 procedures of scaling and root planing and 18 procedures of minor oral surgery. Combining laser ablating sulcular fiber and photobiomodulation initiating blood clot formation was a preferable hemostatic technique for extraction socket, while photobiomodulation alone was a preferred technique for soft tissue hemostasis (p < 0.001). All operators confirmed that 97.86 percent of bleeding events achieved more rapid hemostasis. 61.43 percent of bleeding events clinically achieved hemostasis within 5 min by using laser-mediated hemostasis alone (p = 0.092). Full recovery of the extraction socket was significantly observed during the 2- to 4-week follow-up period (p = 0.005). No clinical complications were reported. Conclusions: Laser-mediated hemostasis effectively reduced hemostatic duration, prevented postoperative bleeding and promoted wound healing in older patients undergoing routine dental treatment. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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14 pages, 6740 KB

Open AccessArticle

Er:YAG Laser in QSP Modality for Treatment of Indirect Adhesive Restoration Build-Up: Surface Roughness Analysis and Morphology Assessment by Environmental Scanning Electron Microscopy (ESEM)

by Ilaria Giovannacci, Monica Mattarozzi, Fabrizio Moroni, Giuseppe Pedrazzi, Paolo Vescovi and Maria Careri

Dent. J. 2025, 13(5), 223; https://doi.org/10.3390/dj13050223 - 21 May 2025

Cited by 2 | Viewed by 985

Abstract

Background/Objectives: Sandblasting build-ups before applying the acid and adhesive significantly improves the bond strength. The aim of this study is to evaluate, for the first time, the effectiveness of an Er:YAG laser used in QSP mode to treat the surface of build-ups before [...] Read more.

Background/Objectives: Sandblasting build-ups before applying the acid and adhesive significantly improves the bond strength. The aim of this study is to evaluate, for the first time, the effectiveness of an Er:YAG laser used in QSP mode to treat the surface of build-ups before the adhesive cementation sequence. Methods: This ex vivo study was conducted on 12 intact, undecayed extracted teeth kept hydrated in NaCl 0.9% solution. A cavity was created in the center and reconstructed with composite resin (build-up). Then, samples were prepared with burs and divided into three groups: control group G1, prepared only with burs; group G2, in which surfaces were treated with a sandblaster (2.5 bar, 10 mm from composite surface, aluminum oxide, 10 s); and group G3, treated using an Er:YAG laser (QSP modality, 1 W, 10 Hz, 100 mJ). The surface roughness of the build-ups was measured using a CCI MP-L digital optical profiler (Taylor Hobson, Leicester, UK), and surface morphology was studied using the Quanta™ 250 FEG (FEI, Hillsboro, OR, USA) ESEM instrument. Results: Regarding enamel, mean surface roughness in G1 vs. G2 was not statistically significant (p = 0.968); meanwhile, differences between the Er:YAG laser group (G3) and G1 or G2 were significant (G3 vs. G1 p < 0.001; G3 vs. G2 p < 0.001). Regarding dentin, G1 vs. G2 was significant (p = 0.021); differences between G3 and G1 or G2 were extremely significant (G3 vs. G1 p < 0.001; G3 vs. G2 p < 0.001). The same trend was detected for resin. Conclusions: An Er:YAG laser in QSP mode used on the build-up surface for indirect adhesive restorations is innovative and should be investigated with further studies. However, it seems extremely effective with increased roughness, the absence of a smear layer and characteristics potentially favorable for good adhesion for all substrates (enamel, dentin, resin). Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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14 pages, 3030 KB

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Effect of Vascular Photobiomodulation in the Postoperative Period of Alveolar Bone Grafting

by Nicole Rosa de Freitas, Luisa Belluco Guerrini, Denise Sabbagh Haddad, Roberta Martinelli de Carvalho, Renato Yassutaka Faria Yaedú and Ana Lúcia Pompéia Fraga de Almeida

Dent. J. 2025, 13(5), 190; https://doi.org/10.3390/dj13050190 - 26 Apr 2025

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Abstract

Background/Objectives: This study evaluated the effects of vascular photobiomodulation (VPBM) on pain intensity, edema, and facial temperature variation in patients undergoing alveolar bone grafting (ABG) surgery. Methods: A total of 42 patients with cleft lip and palate (aged 9–25 years) scheduled for ABG [...] Read more.

Background/Objectives: This study evaluated the effects of vascular photobiomodulation (VPBM) on pain intensity, edema, and facial temperature variation in patients undergoing alveolar bone grafting (ABG) surgery. Methods: A total of 42 patients with cleft lip and palate (aged 9–25 years) scheduled for ABG using iliac crest bone were randomly assigned in equal numbers (14 per group) to one of three groups: control (ABG only), test (ABG + VPBM), and placebo (ABG + simulated VPBM). Iliac and facial pain and edema were clinically evaluated 24 h post-surgery, along with thermographic facial analysis. Follow-up was conducted via phone calls for one week. Results: No statistically significant differences were observed among the groups regarding facial pain and edema at 24 h post-surgery. However, iliac pain significantly differed between the placebo and control groups (p = 0.045). A significant time-related effect on both facial and iliac pain outcomes was noted during follow-up, irrespective of the group. The need for rescue medication and self-perception of reduced edema did not differ significantly. Thermographic analysis reveals a significantly lower temperature variation in the test group (2.36 °C) compared to the other groups (p = 0.007). Conclusions: Overall, VPBM therapy influenced postoperative pain in the early recovery phase and temperature in the immediate postoperative period but did not significantly affect edema. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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16 pages, 9741 KB

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Evaluation of the Disinfection Efficacy of Er: YAG Laser Light on Single-Species Candida Biofilms—An In Vitro Study

by Diana Dembicka-Mączka, Małgorzata Kępa, Jakub Fiegler-Rudol, Zuzanna Grzech-Leśniak, Jacek Matys, Kinga Grzech-Leśniak and Rafał Wiench

Dent. J. 2025, 13(2), 88; https://doi.org/10.3390/dj13020088 - 19 Feb 2025

Cited by 13 | Viewed by 3102

Abstract

Background/Objectives: Oral candidiasis is an opportunistic infection caused by Candida species. Recently, antifungal drugs have become less effective due to yeast resistance, emphasizing the need for new treatment strategies. This study aimed to assess the effect of the Er:YAG laser on the inhibition [...] Read more.

Background/Objectives: Oral candidiasis is an opportunistic infection caused by Candida species. Recently, antifungal drugs have become less effective due to yeast resistance, emphasizing the need for new treatment strategies. This study aimed to assess the effect of the Er:YAG laser on the inhibition of growth and elimination of mature single-species Candida biofilms. Methods: The study utilized reference strains of C. albicans, C. glabrata, C. parapsilosis, and C. krusei organized in single-species biofilms on Sabouraud dextrose agar (SDA). First part: Candida suspensions (0.5 McFarland standard) were spread on SDA plates—two for each strain. Er:YAG laser irradiation was applied in a single pulse mode, 30 to 400 mJ, to 32 predetermined points. The growth inhibition zones (GIZs) were measured at 24–96 h of incubation. Second part: biofilms were prepared similarly and, after 96 h of incubation, exposed to Er:YAG laser irradiation at different energies (50, 100, 150, 200 mJ) for 180 s, per 1.44 cm area. Post-irradiation, impressions were taken using Rodac Agar to determine yeast counts. The count of colony-forming units (CFU) after irradiation was measured and results were analysed statistically. Results: First part: GIZ was found in all irradiated sites, with various Candida strains. The results showed a significant increase in the width of GIZ in the energy range of 30–280 mJ and a non-significant increase in the energy range of 300–400 mJ. Second part: the number of CFU remaining after the irradiation of biofilms with 150 mJ energy differed statistically significantly from other results obtained after using 50, 100, or 200 mJ energy, regardless of the Candida strain tested. Conclusions: The Er:YAG is shown to have good disinfecting properties (inhibiting biofilm growth, even at low-energy doses (50 mJ), and eliminating maturity, Candida spp. biofilms most effective on the 150 mJ energy dose). Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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22 pages, 6709 KB

Open AccessArticle

Photobiomodulation LED Devices for Home Use: Design, Function and Potential: A Pilot Study

by Mark Cronshaw, Steven Parker, Omar Hamadah, Josep Arnabat-Dominguez and Martin Grootveld

Dent. J. 2025, 13(2), 76; https://doi.org/10.3390/dj13020076 - 10 Feb 2025

Cited by 5 | Viewed by 9381

Abstract

Background/Objectives: Many commercial light-emitting diode (LED) devices are available for consumer home usage. The performance characteristics in respect to the dosimetry of many of the devices, currently on direct sale to the public, have not been subject to formal appraisal. In order [...] Read more.

Background/Objectives: Many commercial light-emitting diode (LED) devices are available for consumer home usage. The performance characteristics in respect to the dosimetry of many of the devices, currently on direct sale to the public, have not been subject to formal appraisal. In order to ‘bridge the gap’ between the evidence-based photobiomodulation therapy (PBMT) community and other interested parties, an evaluation is made of a selection of torch type hand-held LED PBMT products currently available for home use. Methods: Five randomly chosen intra-oral and hand-held LED PBMT devices were selected. The optical delivery parameters of the devices were measured, including the beam divergence angle, surface area exposure as well as the output power at the level of the LEDs. The surface and sub-surface temperature changes in porcine tissue samples were assessed under standardised conditions. The manufacturer’s patient instructions were correlated to the measured optical parameters. Calculations were made of irradiance and surface radiant exposure. Consumer satisfaction ratings and feedback data were collated, and a relevant statistical analysis conducted. Results: The results were heterogeneous with a wide range of applied wavelengths, output power and irradiance. Power output stability was variable, and, together with a wide beam divergence angle of 74°, the manufacturer’s directions for dosimetry were found to be inconsistent with an accurate dose delivery. Conclusions: The manufacturer’s proposed dosimetry fails to consider the relevance of the beam divergence angle and optical attenuation in view of the scatter and absorption. Appropriate instructions on how best to gain and optimise an acceptable clinical outcome were inconsistent with an evidence-based approach. Subject to validation by well-planned clinical trials, the concept of home PBMT may open interesting new therapeutic approaches. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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13 pages, 1059 KB

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Multiple Sessions of Antimicrobial Photodynamic Therapy Improve Periodontal Outcomes in Patients with Down Syndrome: A 12-Month Randomized Clinical Trial

by Rafael Ferreira, Sebastião Luiz Aguiar Greghi, Adriana Campos Passanezi Sant’Ana, Mariana Schutzer Ragghianti Zangrando and Carla Andreotti Damante

Dent. J. 2025, 13(1), 33; https://doi.org/10.3390/dj13010033 - 15 Jan 2025

Cited by 3 | Viewed by 5511

Abstract

Background/Objectives: Individuals with Down syndrome (DS) often present with severe periodontal disease at a young age. Adjuvant treatments to scaling and root planing (SRP), such as antimicrobial photodynamic therapy (aPDT), may benefit this population. This study evaluated the effectiveness of aPDT as an [...] Read more.

Background/Objectives: Individuals with Down syndrome (DS) often present with severe periodontal disease at a young age. Adjuvant treatments to scaling and root planing (SRP), such as antimicrobial photodynamic therapy (aPDT), may benefit this population. This study evaluated the effectiveness of aPDT as an adjunct to SRP in individuals with DS. A randomized, double-blind, parallel trial was conducted with 37 individuals with DS. Methods: The test group (aPDT; n = 18) received SRP + aPDT, while the control group (C group; n = 19) received SRP only. For aPDT, a red laser (658 nm; 0.1 W; 2229 J/cm²; 40 s sweeping with optical fiber) combined with methylene blue (MB) (100 µg/mL) was applied across repeated sessions (on days 3, 7, and 14). Clinical parameters, such as plaque index (PI), clinical attachment level (CAL), probing depth (PD), and bleeding on probing (BOP), were recorded at baseline and after 3, 6, and 12 months of treatment. Statistical analyses were performed using parametric and non-parametric tests (p < 0.05). Results: Both treatments promoted improvements in all clinical periodontal parameters (p < 0.05). The aPDT group showed a statistically significant reduction in CAL at 3 months (aPDT = 4.58 mm vs. C = 4.72 mm; p < 0.05) and 12 months (aPDT = 4.59 mm vs. C = 4.84 mm; p < 0.05). Conclusions: aPDT improved periodontal health in the long term through a stable gain in attachment. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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17 pages, 19149 KB

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The Efficacy of Er:YAG Laser in the Extraction of Impacted Third Molars: A Randomized Clinical Trial

by Diana Sologova, Ekaterina Diachkova, Susanna Sologova, Elena Smolyarchuk, Arus Margaryan, Ekaterina Grigorevskikh, Pavel Petruk, Elizaveta Tumanova, Oxana Svitich and Svetlana Tarasenko

Dent. J. 2024, 12(12), 388; https://doi.org/10.3390/dj12120388 - 27 Nov 2024

Cited by 2 | Viewed by 3546

Abstract

(1) Background: Impacted third molar extraction with a scalpel and rotary instruments is one of the most traumatic surgeries in dentistry. Therefore, it is necessary to discover less traumatic methods and instruments to reduce the risk of postoperative complications. (2) Methods: [...] Read more.

(1) Background: Impacted third molar extraction with a scalpel and rotary instruments is one of the most traumatic surgeries in dentistry. Therefore, it is necessary to discover less traumatic methods and instruments to reduce the risk of postoperative complications. (2) Methods: This study is reported in accordance with the CONSORT guidelines. The study aim is to assess the effectiveness of an Er:YAG laser with a wavelength of 2.94 μm, cutting and rotating instruments in the extraction of lower third molars in comparison with the traditional instruments using clinical and radiology parameters. In the control group, the impacted third molars were extracted with the traditional instruments, like scalpel and rotary instruments; in the test group, the impacted third molars were extracted with an Er:YAG laser. As per the inclusion and exclusion criteria, we enrolled 60 patients who were randomly assigned into two groups (Er:YAG laser group and control group). The efficacy of the Er:YAG laser was assessed by postoperative pain, collateral swelling, mouth opening, and radiology parameters such as radiographic infrabony defects and radiographic bone height after tooth extraction. (3) Results: The results showed that the clinical postoperative parameters like pain, collateral swelling, and mouth opening were less pronounced in the Er:YAG laser group than those in the control group (p < 0.001). According to the data of the radiology parameters (RBH and RID), the regeneration of the socket after extraction was better in the laser group than in the control group (p < 0.001). (4) Conclusions: Based on the obtained results of clinical and radiology parameters assessment, it was shown that third molar extraction using an Er:YAG laser is a less traumatic method than extraction using a scalpel and rotary instruments. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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Review

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19 pages, 1070 KB

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Blue Photosensitizer, Red Light, Clear Results: An Integrative Review of the Adjunctive Periodontal Treatment with Methylene Blue in Antimicrobial Photodynamic Therapy

by Higor Henrique Carvalho Oliveira, Gabriela Moura Chicrala-Toyoshima, Carla Andreotti Damante and Rafael Ferreira

Dent. J. 2025, 13(7), 289; https://doi.org/10.3390/dj13070289 - 26 Jun 2025

Cited by 2 | Viewed by 5436

Abstract

The adjunctive use of antimicrobial photodynamic therapy (aPDT) has been investigated as a promising approach to enhance periodontal therapy. Methylene blue (MB) is the most commonly used photosensitizer due to its favorable characteristics, including a neutral pH and an absorption peak at 660 [...] Read more.

The adjunctive use of antimicrobial photodynamic therapy (aPDT) has been investigated as a promising approach to enhance periodontal therapy. Methylene blue (MB) is the most commonly used photosensitizer due to its favorable characteristics, including a neutral pH and an absorption peak at 660 nm. Due to the considerable heterogeneity among studies and the lack of well-established clinical protocols, this study aims to conduct an integrative review to highlight the effects of MB-mediated aPDT as an adjunct to periodontal treatment. The inclusion criteria were randomized clinical trials that used MB as the PS, published between 2009 and 2024, with a minimum follow-up of three months. Studies included patients with periodontitis treated with SRP alone or in combination with aPDT. Of the 237 studies initially identified, 23 met the eligibility criteria and were included in this integrative review. The risk of bias was evaluated using the Cochrane criteria for randomized controlled trials. Although the included studies reported heterogeneous clinical outcomes, a general trend toward improvement in key periodontal parameters—probing depth, bleeding on probing, clinical attachment level, and plaque index—was observed when MB-mediated aPDT was used as an adjunct to conventional periodontal treatment. However, substantial variability in clinical protocols—including differences in photosensitizer concentration, type of light source, irradiation time, and frequency of application—limited the comparability of results across studies. Despite these methodological inconsistencies, current evidence suggests that MB-mediated aPDT holds promise as an adjunctive approach in periodontal therapy. Nevertheless, due to the clinical heterogeneity and the limited number of studies with long-term follow-up, its overall efficacy remains inconclusive. Further well-designed randomized controlled trials with standardized protocols and subgroup analyses are essential to validate its clinical relevance. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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12 pages, 259 KB

Open AccessReview

Laser Technology in Dentistry: From Clinical Applications to Future Innovations

by Liliana Sachelarie, Roxana Cristea, Ecaterina Burlui and Loredana Liliana Hurjui

Dent. J. 2024, 12(12), 420; https://doi.org/10.3390/dj12120420 - 23 Dec 2024

Cited by 35 | Viewed by 8844

Abstract

This narrative review comprehensively synthesizes laser technology’s clinical applications, advantages, and limitations in modern dentistry. The review of 67 articles published between 2018 and 2023 highlights the latest advancements, including photobiomodulation (PBM) for enhanced tissue healing and inflammation control, alongside innovative uses in [...] Read more.

This narrative review comprehensively synthesizes laser technology’s clinical applications, advantages, and limitations in modern dentistry. The review of 67 articles published between 2018 and 2023 highlights the latest advancements, including photobiomodulation (PBM) for enhanced tissue healing and inflammation control, alongside innovative uses in implantology, endodontics, and teeth whitening. The findings underscore the transformative potential of lasers in improving dental treatment precision and patient outcomes while addressing the barriers to their widespread adoption, such as costs and training needs. This review emphasizes the integration of laser technology into routine clinical practice and identifies pathways for future innovations in dentistry. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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23 pages, 2133 KB

Open AccessSystematic Review

Clinical Efficacy and Safety of Photobiomodulation Therapy for Orofacial Conditions in Older Adults: A Systematic Review of Randomized Controlled Trials

by Suwat Tanya and Patcharawan Srisilapanan

Dent. J. 2026, 14(4), 231; https://doi.org/10.3390/dj14040231 - 13 Apr 2026

Viewed by 562

Abstract

Background/Objectives: Photobiomodulation therapy (PBMT) is a non-invasive therapeutic modality that enhances tissue healing, modulates inflammation, and reduces pain. Despite increasing clinical use, evidence regarding PBMT in geriatric oral conditions has not been comprehensively synthesized. This systematic review aimed to evaluate the clinical [...] Read more.

Background/Objectives: Photobiomodulation therapy (PBMT) is a non-invasive therapeutic modality that enhances tissue healing, modulates inflammation, and reduces pain. Despite increasing clinical use, evidence regarding PBMT in geriatric oral conditions has not been comprehensively synthesized. This systematic review aimed to evaluate the clinical efficacy and safety of PBMT in managing orofacial conditions in older adults. Methods: A systematic search of PubMed, Embase, Scopus, and Google Scholar was conducted to identify randomized controlled trials (RCTs) published between January 2000 and March 2025. Eligible studies included patients aged ≥60 years receiving PBMT for orofacial conditions. Study selection followed predefined criteria. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and findings were narratively synthesized. Results: Twenty-three RCTs were included. Evidence for PBMT was most frequently reported in cancer therapy-induced oral mucositis (n = 8), with consistent reductions in lesion severity and pain. Studies on burning mouth syndrome (n = 7) and hyposalivation (n = 2) generally reported improvements in symptoms, although placebo effects were noted. Fewer studies evaluated postoperative pain (n = 2), oral lichen planus (n = 1), peri-implant conditions (n = 1), and implant osseointegration (n = 2). No clinically significant adverse events were reported. However, heterogeneity in PBMT parameters and outcome measures limited comparability. Conclusions: PBMT is a safe and clinically effective adjunctive therapy for managing orofacial conditions in older adults, particularly oral mucositis. These findings support its integration into geriatric oral care. Standardized protocols and well-designed RCTs are needed to determine optimal treatment parameters and long-term effectiveness. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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19 pages, 752 KB

Open AccessSystematic Review

Enhancing Root Canal Disinfection with Er:YAG Laser: A Systematic Review

by Jakub Fiegler-Rudol, Zuzanna Grzech-Leśniak, Marcin Tkaczyk, Kinga Grzech-Leśniak, Anna Zawilska and Rafał Wiench

Dent. J. 2025, 13(3), 101; https://doi.org/10.3390/dj13030101 - 26 Feb 2025

Cited by 18 | Viewed by 6380

Abstract

Background: The quest for minimally invasive disinfection in endodontics has led to using Erbium:Yttrium-Aluminum-Garnet (Er:YAG) lasers. Conventional approaches may leave bacterial reservoirs in complex canal anatomies. Er:YAG’s strong water absorption generates photoacoustic streaming, improving smear layer removal with lower thermal risk than other [...] Read more.

Background: The quest for minimally invasive disinfection in endodontics has led to using Erbium:Yttrium-Aluminum-Garnet (Er:YAG) lasers. Conventional approaches may leave bacterial reservoirs in complex canal anatomies. Er:YAG’s strong water absorption generates photoacoustic streaming, improving smear layer removal with lower thermal risk than other laser systems. Methods: This systematic review followed PRISMA 2020 guidelines. Database searches (PubMed/MEDLINE, Embase, Scopus, Cochrane Library) identified studies (2015–2025) on Er:YAG laser-assisted root canal disinfection. Fifteen articles met the inclusion criteria: antibacterial efficacy, biofilm disruption, or smear layer removal. Data on laser settings, irrigants, and outcomes were extracted. The risk of bias was assessed using a ten-item checklist, based on guidelines from the Cochrane Handbook for Systematic Reviews of Interventions. Results: All studies found Er:YAG laser activation significantly improved root canal disinfection over conventional or ultrasonic methods. Photon-induced photoacoustic streaming (PIPS) and shock wave–enhanced emission photoacoustic streaming (SWEEPS) yielded superior bacterial reduction, especially apically, and enabled lower sodium hypochlorite concentrations without sacrificing efficacy. Some research indicated reduced post-operative discomfort. However, protocols, laser parameters, and outcome measures varied, limiting direct comparisons and emphasizing the need for more standardized, long-term clinical trials. Conclusions: Er:YAG laser-assisted irrigation appears highly effective in biofilm disruption and smear layer removal, supporting deeper irrigant penetration. While findings are promising, further standardized research is needed to solidify guidelines and confirm Er:YAG lasers’ long-term clinical benefits. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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15 pages, 2069 KB

Open AccessSystematic Review

Efficacy of Antimicrobial Photodynamic Therapy for Treating Moderate to Deep Periodontal Pockets in Individuals with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

by João Victor Soares Rodrigues, Mariella Boaretti Deroide, Wilton Mitsunari Takeshita, Valdir Gouveia Garcia, Rafael Scaf de Molon and Leticia Helena Theodoro

Dent. J. 2025, 13(1), 21; https://doi.org/10.3390/dj13010021 - 2 Jan 2025

Cited by 4 | Viewed by 4780

Abstract

Background/Objectives: Diabetes mellitus and periodontitis share a significant, bidirectional relationship. Diabetes raises the risk of periodontitis and influences its severity, impacting tissue repair and bone metabolism. Conversely, periodontal inflammation can disrupt glycemic control, further complicating this interlinked relationship. This systematic review aimed to [...] Read more.

Background/Objectives: Diabetes mellitus and periodontitis share a significant, bidirectional relationship. Diabetes raises the risk of periodontitis and influences its severity, impacting tissue repair and bone metabolism. Conversely, periodontal inflammation can disrupt glycemic control, further complicating this interlinked relationship. This systematic review aimed to evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) as an adjunct to subgingival instrumentation (SI) in the treatment of periodontal pockets with a probing pocket depth (PPD) ≥ 5 mm in individuals with type 2 diabetes mellitus (DM2) and periodontitis. Methods: Using the PICOS framework, this review addressed the following question: “How does aPDT as an adjunct to SI compare to SI alone in treating periodontal pockets with PPD ≥ 5 mm in individuals with DM2 and periodontitis?” Databases searched included PubMed, Scopus, and Web of Science up to December 2024. Randomized clinical trials evaluating periodontal status and HbA1c levels in patients with DM2 undergoing periodontal therapy and experiencing SI were included. Patients who received adjunctive aPDT were compared to a control group that received SI alone. A meta-analysis was conducted illustrating treatment effects across groups. Results: After screening 117 studies based on titles and abstracts, three and four studies met the eligibility criteria for quantitative and qualitative analyses, respectively. The principal periodontal parameters assessed included PPD, clinical attachment level (CAL), plaque index (PI), and bleeding on probing (BOP). Forest plots for PD, BOP, PI, and CAL at baseline, three months, and six months revealed no statistically significant differences between the SI+aPDT group and the SI-only group. Glycated hemoglobin across treatment groups was not different. Conclusions: The combination of aPDT with SI provides limited clinical benefits in treating periodontal pockets with a PPD ≥ 5 mm in diabetic patients with periodontitis. Full article

(This article belongs to the Special Issue Laser Dentistry: The Current Status and Developments)

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