Search Results (41)

Objectives: The aim of this study was to determine the differential temperature produced on ceramic implants using laser irradiation on a pulsed setting of intrabony defects in vitro. Methods: A ceramic (Zr) dental implant (Zeramex, 4.8 × 12 mm) was placed into a bovine bone block. A three-wall intrabony defect (6 × 4 × 3 mm) was created to mimic an osseous peri-implant defect. Thermocouples were placed on the apical and coronal areas to measure temperature changes (∆T) during 60 s of laser irradiation. The bovine block was heated to 37 °C, and the defect walls were irradiated with the CO₂ and Er,Cr:YSGG laser. The settings used were pulsed mode for both lasers, with 30 Hz and 1.5 W for the Er,Cr:YSGG laser and 70 Hz and 2 W for the CO₂ laser. The same laser settings were repeated at room temperature (RT, 23 °C). Twenty trials were performed for each experimental group at room and body temperature for assessment of ∆T. Paired t-test were used to compare the measurements between 37 °C and 23 °C for the Er,Cr:YSGG, and CO₂ laser, respectively. Results: The CO₂ laser resulted in the highest ∆T (°C) at the coronal (15.22 ± 0.28/8.82 ± 0.21) and apical (5.84 ± 0.14/2.30 ± 0.28) level when this laser was used in both room temperature and body temperature, respectively. The highest ∆T (°C) for the Er,Cr:YSGG laser at body temperature at the coronal thermocouple was 7.64 ± 0.55, while for the CO₂ laser, at body temperature was 8.82 ± 0.21. Conclusion: Within the limitations of our study, the use of CO₂ laser and Er,Cr:YSGG laser on peri-implant defects generally appears to be safe in treating peri-implant defects around zirconia implants in vitro. Full article

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

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

Background: Diode lasers are valuable in oral surgery due to their excellent hemostasis, minimum post-operative pain, and minimally invasive procedures. A dual-wavelength diode laser in dentistry combines two distinct wavelengths, typically 450 nm and 808 nm, to provide a versatile approach to soft tissue procedures. This ex vivo study investigated the quantity of thermal effects of a dual-wavelength diode laser on porcine lingual mucosa to determine the optimal laser parameters for oral soft tissue biopsies and to improve the reliability of histological evaluation. The presence of thermal damage in the prelesional margins may compromise the diagnostic accuracy, particularly in cases of suspected malignancy. Methods: Thirty-six porcine lingual mucosa samples were excised using a diode laser (Wiser 3, Doctor Smile) in continuous wave (CW) and pulsed wave (PW) modes at average powers of 2, 3, and 4 W. The samples, preserved in 5% buffered formalin, underwent histological evaluation to measure epithelial and connective tissue damage. Results: The study demonstrated variable thermal effects depending on the laser mode and power settings. Minimal epithelial damage (0.62 mm) was observed at 2 W CW, while maximum damage (3.12 mm) occurred at 4 W pulsed wave (PW). Connective tissue exhibited slightly greater damage than epithelial tissue, with minimal damage (0.53 mm) at 4 W CW and maximum damage (3.19 mm) at 4 W pulsed wave (PW). Statistical analyses were performed using t-tests and ANOVA and revealed significant differences in tissue damage between certain groups, highlighting the impact of laser parameters on thermal effects. Conclusions: The dual-wavelength diode laser seems to have good surgical properties and is suitable for managing complex clinical cases. Although the low power average showed minimal thermal damage, for the importance of the diagnosis of suspected lesions of malignancy, a 2 mm prelesional margin should be maintained. Full article

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

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

Background: Denosumab is a human monoclonal antibody playing a central role in bone resorption. The impaired bone healing observed in patients on denosumab is linked to the drug’s inhibition of osteoclast activity. Photobiomodulation (PBM) has garnered attention as a potential adjunctive therapy for managing oral complications in patients on denosumab therapy. The aim of this study is to provide a review of the literature regarding the benefits of photobiomodulation therapy in patients taking denosumab while providing a case report of a patient treated with this therapy. Materials and Methods: Key terms were used to search PubMed (MEDLINE), Scopus, and Web of Science, and at last, 25 articles were compared. Following the proposed review, a case of a patient is illustrated. Results: Based on our literature findings, there are no papers regarding the benefits of photobiomodulation therapy in patients taking denosumab specifically, but there are articles regarding photobiomodulation therapy and MRONJ osteonecrosis patients, which can be caused by denosumab. Discussion: Despite all the limitations of the data in the literature, it can be deduced that there are evident benefits of photobiomodulation therapy in patients taking denosumab. The integration of laser-assisted techniques and photobiomodulation into MRONJ management protocols represents a significant evolution in treatment strategies. Conclusions: Further studies are needed to better understand a potential association between odontoclasts (which can cause external root resorption) and neoplastic disease or medication, as well as to explore the role of photobiomodulation in the therapeutic rehabilitation process. Full article

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

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

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

The development of laser technology has revolutionized dentistry, offering complementary and alternative approaches to traditional techniques. Lasers have been successfully integrated into various dental procedures, enhancing treatment outcomes and patient care. Several types of lasers can increase the acid resistance of enamel, thus preventing caries. Laser fluorescence has been utilized for the pre-operative diagnosis of dental caries, enabling early detection and effective treatment planning. The therapeutic application of lasers in caries treatment aligns with the contemporary philosophy of minimally invasive procedures. Clinicians can use laser Doppler flowmetry as a supplementary tool for pulp vitality testing by detecting pulpal blood flow. Lasers are also employed in various pulp-related interventions, such as managing dentine hypersensitivity and performing root canal therapy. These procedures benefit from the precision and reduced invasiveness provided by laser technology. Furthermore, laser fluorescence serves as an additional tool for subgingival calculus detection. High-power and low-power lasers are used in both nonsurgical and surgical therapies to treat periodontal and peri-implant diseases, oral mucosa conditions, and even cancer based on their specific properties. Lasers are also utilized to accelerate bone regeneration, promote adhesive strength, and remove ceramic brackets. In summary, laser technology has significantly impacted contemporary dentistry by facilitating early diagnosis, minimally invasive treatments, and precise operative procedures, ultimately improving patient outcomes and expanding the scope of dental practice. Full article

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

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 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

Background/Objectives: This study aims to compare the effects of conventional surgical techniques and laser-assisted methods on salivary oxidative stress biomarkers following third molar extraction, in order to evaluate the potential benefits of laser surgery in reducing oxidative stress and promoting faster recovery. Methods: A total of 154 patients, aged 16–30, undergoing third molar extractions were included in the study. Patients were divided into two groups: conventional surgery (n = 75) and laser-assisted surgery (n = 79). Saliva samples were collected at baseline, and 24, 48, 72, and 168 h postoperatively. The levels of total antioxidant capacity (TAC), malondialdehyde (MDA), and 8-hydroxy-2′-deoxyguanosine (8-OHdG) were measured as indicators of oxidative stress. Results: Initial biomarker levels were similar across all participants. Postoperative oxidative stress increased in both groups, with significantly higher levels in the conventional surgery group at 48 and 72 h. Salivary biomarkers of oxidative stress were significantly lower in the laser group at 48 and 72 h post-surgery (p < 0.05), indicating a faster recovery. By 168 h, biomarker levels in the laser group had nearly returned to baseline, whereas levels in the conventional group remained slightly elevated. Conclusions: Laser-assisted surgery significantly reduces oxidative stress and promotes faster recovery when compared with conventional methods, as evidenced by the more rapid normalization of salivary biomarkers. These findings suggest that laser techniques may offer superior clinical outcomes in third molar extractions. Full article