Search Results (239)

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

Background: Fluoroquinolone (FQ) resistance in Escherichia coli (E. coli) undermines empiric therapy and often coincides with multidrug resistance (MDR). Because sequencing is not routinely available in many laboratories, we evaluated a phenotype-first, sequencing-independent diagnostic framework deployable on standard platforms. Methods: We profiled 45 archived E. coli isolates for susceptibility (Clinical and Laboratory Standards Institute [CLSI]-guided), extended-spectrum β-lactamase (ESBL) and AmpC β-lactamase (AmpC) phenotypes, MDR, and multiple-antibiotic resistance (MAR) indices. Ten founders (five FQ-susceptible [FQ-S], five low-level resistant [LLR]) seeded 20 parallel lineages exposed to stepwise ciprofloxacin. We tracked minimum inhibitory concentrations (MICs), collateral resistance, growth kinetics, and biofilm biomass using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) for identification, automated and reference antimicrobial susceptibility testing (AST), growth-curve analysis, and crystal violet microtiter assays. The intended use is a sequencing-independent workflow for routine laboratories—especially where whole-genome sequencing is not readily available—working with archived or prospective clinical E. coli. This workflow is best applied when local FQ nonsusceptibility threatens empiric reliability; inputs include standard ID/AST with simple growth and biofilm assays. Primary outputs include: (i) MIC trajectories with time to high-level resistance (HLR), (ii) ΔMAR-summarized collateral resistance with class-level susceptible-to-resistant conversions, and (iii) concise fitness/biofilm summaries to guide empiric-policy refresh and early de-escalation. Results: At baseline, ciprofloxacin nonsusceptibility was 40.0%; ESBL and AmpC phenotypes were confirmed in 28.9% and 15.6%, respectively; 46.7% met the MDR definition; and the median MAR index was 0.29. During evolution, 70% of lineages reached HLR (MIC ≥ 4 μg/mL), with earlier conversion from LLR versus FQ-S founders (median 7 vs. 11 passages). Collateral resistance emerged most often to third-generation cephalosporins (3GCs), trimethoprim–sulfamethoxazole, and tetracyclines, while carbapenem activity was preserved. MAR increased in parallel with rising MICs. Resistance acquisition imposed modest fitness costs (slightly reduced growth rates and longer lag phases) that were partly offset under subinhibitory ciprofloxacin, whereas biofilm biomass changed little. Conclusions: this phenotype-first, routine-laboratory workflow rapidly maps FQ resistance and clinically relevant co-selection in E. coli. In high-resistance settings, empiric FQ use is difficult to justify, and MAR trends provide practical co-selection signals for stewardship. This reproducible framework complements genomic surveillance and is directly applicable where sequencing is unavailable. Full article

Background/Objectives: The aim of this literature review is to evaluate the clinical and radiographic success of various types of lasers used in pulpotomy procedures for primary teeth. Methods: A comprehensive literature search was conducted using PubMed and Web of Science databases, with no time limits applied. Keywords included various types of lasers (e.g., diode, Nd:YAG, Er:YAG, LLLT, CO₂) and terms related to pulpotomy in primary teeth. The search was performed in August 2025. Studies were screened for eligibility based on inclusion and exclusion criteria, focusing on clinical trials and studies assessing long-term outcomes of laser pulpotomies. Results: The review included 36 studies, categorized by laser type. Diode lasers were the most commonly used laser and showed high clinical success rates (>85%) with various dressing materials. Nd:YAG lasers demonstrated positive long-term outcomes, while Er:YAG lasers had inconsistent results. Low-Level Laser Therapy (LLLT) and CO₂ lasers also showed high clinical and radiographic success. The studies highlighted the variability in laser specifications and clinical protocols, making direct comparisons challenging. Conclusions: Laser pulpotomy offers a viable alternative to traditional methods, with diode and Nd:YAG lasers showing particularly high success rates. However, the lack of standardized protocols and the variability in study methodologies call for further research to establish clear guidelines for clinical practice. Full article

This study evaluated the effect of irradiation of different energy densities in low-level laser therapy (LLLT) and exogenous nerve growth factor (NGF) on Schwann cells (SCs). SCs (SCL 4.1/F7) exposed to LLLT (4 or 80 J/cm²) and NGF (25 ng/mL) were evaluated on days 1, 3, and 7. Cell viability (MTT), proliferation (crystal violet) and morphology (SEM—Scanning Electron Microscopy) on the polyhydroxybutyrate (PHB) scaffold were compared among five study groups: Control; L4. 4 J/cm² LLLT; L80. 80 J/cm² LLLT; L4N. 4 J/cm² LLLT + NGF; and L80N. 80 J/cm² LLLT + NGF. Viability and proliferation increased over time in groups treated exclusively with LLLT, with 4 J/cm² reduced cell viability on the third day. The NGF exposition showed a reduction in cell viability and proliferation. The SCs remained attached to the PHB scaffold during the 7 days analyzed. The LLLT energy densities did not modify SC behavior, except for a reduction in cell viability after irradiation of 4 J/cm² on the third day. Consistently, SC exposure to exogenous NGF significantly reduced proliferation and viability in all periods analyzed. Morphological changes were observed, and NGF exposure appears to have helped cells intertwine with PHB scaffold fibers. Full article

To evaluate the impact of different surface treatment regimens, Neodymium-doped yttrium orthovanadate (Nd: YVO4) laser, Toluidine blue (TB) activated Low-level laser therapy (LLLT), and Bioactive glass particles (BAGPs) on the surface roughness (Ra), surface morphology, and bond strength (BS) of Glass fiber posts (GFP) bonded to canal dentin. Forty single human rooted incisors with a closed apex were included. The endodontic treatment was performed, followed by post space preparation. Fifty-six GFP were sorted into four categories based on the conditioning method used (n = 14). Group 1: H₂O₂, Group 2: Nd: YVO4 laser, Group 3: TB-LLLT, and Group 4: BAGPs. Surface Ra and topographic changes were identified using a profilometer and Scanning Electron Microscopy (SEM). Post cementation was executed by utilizing self-adhesive resin cement. Analysis of BS and fracture pattern was performed using a universal testing machine and a stereomicroscope, respectively. Variance analysis with Tukey’s test was used to compare Ra and BS between the study groups at different root sections (p < 0.05). Group 2 (Nd: YVO4 laser) displayed the highest Ra scores (1051.54 ± 0.087 µm) and BS at all thirds. Whereas Group 3 TB-activated LLLT exhibited the lowest outcomes of Ra (539.39 ± 0.091) and BS at all three sections. Comparison among the investigated groups displayed that Group 1 (H₂O₂) and Group 2 Nd: YVO₄ exhibited comparable outcomes of Ra and BS (p ˃ 0.05). Nd: YVO₄ laser has the potential to roughen the surface of GFP, thereby enhancing its BS to resin cement Full article

Background and Objectives: Diabetes mellitus (DM) is associated with impaired wound healing and increased oxidative stress, posing a significant challenge in dental wound healing. Low-level laser therapy (LLLT) has emerged as a potential regenerative treatment to enhance tissue repair. This study aims to investigate the effects of LLLT on oral mucosal wound healing and oxidative stress markers in rats with DM. Materials and Methods: Male Wistar rats (n = 108) were divided into six equal groups (healthy and diabetic, with or without mucosal ulcers, with or without LLLT). DM was induced with alloxan, and standardized mucosal ulcers were created. Every other day for 10 days, LLLT (6 J/cm²) was applied, and tissue samples were collected after 3, 7, and 10 days. Wound healing was assessed by planimetry, while systemic biochemical analyses included total oxidative status (TOS), total antioxidant capacity (TAC), superoxide dismutase (SOD) activity, and oxidative stress index (OSI). Results: LLLT significantly accelerated oral ulcer closure and showed between-group differences in redox markers. In healthy rats, LLLT increased wound closure on day 7 (p = 0.018). In diabetic rats, LLLT improved closure on day 3 (p = 0.035) and on day 7 (p = 0.001). Across groups, oxidative markers differed significantly (e.g., TOS on day 10 overall, p = 0.011; OSI on day 10 overall, p = 0.047; SOD p < 0.001 at all time points). In diabetic rats, on day 10, median TOS was lower with LLLT (p = 0.004). Conclusions: LLLT enhances oral wound healing and restores redox balance in diabetic rats, which supports the potential usage of LLLT as an adjunctive therapy for managing oral lesions in diabetic patients. Full article

Background: Knee osteoarthritis (KOA) is a degenerative joint disorder marked by cartilage degradation, synovial inflammation, and altered synovial fluid (SF) rheology, resulting in pain and impaired joint function. Intra-articular hyaluronic acid (IA-HA) injections aim to restore SF viscoelasticity and improve lubrication; however, their efficacy may be potentiated when combined with physiotherapy (PT). This monocentric observational study evaluated whether the addition of a multimodal PT program to IA-HA therapy enhances SF rheologic properties compared to IA-HA alone. Methods: A total of 52 patients (aged 47–61) with radiographically confirmed moderate KOA (Kellgren–Lawrence grade 2) were enrolled. Patients were assigned to a pilot group (PG; n = 37) receiving IA-HA (Kombihylan^®, 3 MDa) combined with a multimodal PT protocol, or a control group (CG; n = 15) receiving IA-HA alone. The PT program included ten sessions of transcutaneous electrical nerve stimulation, low-level laser therapy, therapeutic ultrasound, progressive exercise, and cryotherapy. SF samples were collected immediately after the first injection and again at six weeks, then analyzed rheologically using the Kinexus Pro+ rheometer. Viscosity parameters were assessed via steady and oscillatory shear tests. Results: At baseline, both groups demonstrated comparable SF viscosity profiles. After six weeks, the PG exhibited significantly higher shear viscosity values across all measured percentiles and reduced variability in rheological parameters, suggesting a more stable intra-articular milieu. Rheometric analysis indicated enhanced SF viscoelasticity, potentially mediated by reduced inflammation and stimulation of endogenous HA synthesis. In contrast, the CG showed inconsistent viscosity changes, reflecting variable responses to IA-HA monotherapy. Conclusions: Combining IA-HA with multimodal PT significantly improves SF rheological properties in moderate KOA patients compared to IA-HA alone. These findings support the role of mechanical stimulation in enhancing joint lubrication and homeostasis, offering a more consistent and effective approach to viscosupplementation. Full article

Photobiomodulation (PBM) has been widely studied for its regenerative and anti-inflammatory properties. Its application, combined with biomaterials, is emerging as a promising strategy for promoting tissue regeneration. Considering the diversity of available evidence, this study conducted an integrative literature review, aiming to critically analyze and synthesize the effects of PBM on bone tissue, particularly its potential role as an adjunct in guided bone regeneration (GBR) procedures. To ensure an integrative approach, studies with different methodological designs were included, encompassing both preclinical and clinical research. The article search was performed in the digital databases PubMed/MEDLINE, Scopus, and Web of Science, using the following search terms: “Photobiomodulation therapy” AND “guided bone regeneration”. The search was conducted from November 2024 to January 2025. A total of 85 articles were found using the presented terms; after checking the results, 11 articles were selected for this study. The remaining articles were excluded because they did not fit the proposed inclusion and exclusion criteria. Studies to date have shown preclinical models that demonstrated increased bone-volume fraction and accelerating healing. Although it has exciting potential in bone regeneration, offering a non-invasive and promising approach to promote healing and repair of damaged bone tissue, the clinical application of PBM faces challenges, such as the lack of consensus on the ideal treatment parameters. Calcium phosphate ceramics were one of the most used biomaterials in the studied associations. Further well-designed studies are necessary to clarify the effectiveness, optimal parameters, and clinical relevance of PBM in bone regeneration, in order to strengthen the current evidence base and guide its potential future use in clinical practice. Full article

Background: Third lower molar (TLM) extraction is one of the most common oral surgical procedures, often accompanied by postoperative pain and inflammation. In order to treat postoperative pain, different methods are used, mainly based on painkillers. PBMT may represent an adjunct to pain management. Objective: This narrative review aims to evaluate the efficacy of PBMT in reducing postoperative pain following TLM extraction. Methods: A comprehensive search was conducted to identify studies examining the use of PBMT for postoperative pain relief after TLM extraction. Four randomized controlled trials (RCTs) met the inclusion criteria and were analyzed qualitatively. Results: Two studies showed statistically significant reductions in pain with PBMT. Kahraman et al. reported lower pain scores in the intraoral PBMT (p = 0.001), with up to a 3.2-point reduction on the Visual Analog Scale (VAS). De Paula et al. found improved pain control using a dual-wavelength (808 + 660 nm) versus a single wavelength protocol (p = 0.031). The remaining studies showed non-significant results toward pain reduction. Conclusions: PBMT shows encouraging results in managing postoperative pain after TLM extraction, specifically with intraoral and multi-wavelength protocols. However, further studies are necessary to confirm its clinical utility. Full article

The present investigation was conducted to observe the effects of different energy densities of a low-level red laser (LLRL) on human embryonic stem cell-derived mesenchymal stem cells (hESC-MSCs). hESC-MSCs were cultured and irradiated with a LLRL from 0.5 to 5.0 J/cm² at a wavelength of 635 nm. Biological parameters such as proliferation, viability, and migration were observed after 72 h of LLRL irradiation. Compared with the control, LLRL irradiation significantly increased the proliferation and viability of hESC-MSCs from 0.5 to 2.5 J/cm² (p < 0.001, p < 0.05). LLRL irradiation from 0.5 to 3.0 J/cm² significantly increased the migration of hESC-MSCs (p < 0.01). These results revealed that LLRL irradiation at lower energy densities significantly increased the proliferation, viability, and migration of hESC-MSCs. However, higher energy densities were ineffective; this was also true when we examined osteogenic differentiation, as low energy densities of LLRL had a positive effect on differentiation, whereas higher energy densities had a negative effect on alkaline phosphatase activity, Alizarin Red staining and gene expression analysis. In addition, not all stem cell markers were affected by the laser, and a slight decrease in the expression of CD146, which is a stemness marker, was detected, indicating improved differentiation. These findings indicate that low energy densities of LLRL irradiation have positive effects on the proliferation, migration, and differentiation of hESC-MSCs. However, higher energy densities showed inhibitory effects. Full article

Low-level laser therapy (LLLT) is gaining attention as an effective adjunct to non-surgical periodontal treatment. This study evaluates the potential of LLLT to reduce bacterial load in a clinically relevant in vitro subgingival biofilm model and its impact on the inflammatory response. A subgingival biofilm model consisting of seven bacterial species was established. Primary human gingival fibroblasts (GFs) and periodontal ligament cells (PDLs) were cultured. Both biofilms and host cells were treated with the DenLase Diode Laser (980 nm) under various clinically relevant settings. The composition and structure of the seven-species biofilms were evaluated using quantitative PCR and fluorescence microscopy, respectively. The inflammatory response in host cells was analyzed by measuring the gene and protein expression levels of various inflammatory mediators. Laser treatment at power outputs ranging from 0.3 to 2 W had no significant effect on biofilm composition or architecture. LLLT, particularly at higher power settings, reduced the viability in both GFs and PDLs up to 70%. Gene expression levels of inflammatory mediators were only minimally influenced by laser treatment. However, LLLT significantly decreased the secretion of all examined cytokines. These findings suggest that LLLT with a 980 nm diode laser, under clinically relevant conditions, exerts anti-inflammatory rather than antimicrobial effects. Full article

The aim of this study was to evaluate the efficacy of manual therapy based on neurodynamic techniques and electrophysical modalities in the conservative treatment of cubital tunnel syndrome (CuTS). A total of 128 upper limbs affected by CuTS were initially enrolled in this study, with 82 completing the full treatment protocol. The participants were divided into the following two intervention arms: the first arm (MT) (42 arms) received therapy based on sliding and tensioning neurodynamic techniques, while the second arm (EM) (40 arms) underwent physiotherapy based on electrophysical modalities, specifically low-level laser therapy (LLLT) and ultrasound therapy (US). Chi² and Student’s t-test were used to compare the intervention arms, and no statistically significant differences were found. The evaluated outcomes included nerve conduction testing, ultrasound assessments (measuring cross-sectional area and shear modulus), pain levels, two-point discrimination, thresholds for cutaneous sensory perception, symptom severity, functional ability in specific tasks, and overall post-treatment improvement. Baseline comparisons indicated no statistically significant differences in any measured variables between the intervention groups (p > 0.05). Following treatment, each group exhibited significant improvements in their respective parameters (p < 0.01). Comparisons between groups post-intervention revealed statistically significant differences in nerve conduction results, ultrasound measurements (cross-sectional area and shear modulus), two-point discrimination, and sensory perception thresholds. These parameters improved more in the MT intervention arm. The use of neurodynamic techniques, ultrasound, and low-level laser therapy in the conservative treatment of mild to moderate forms of CuTS has a beneficial therapeutic effect. Full article

Background: Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ) is a severe complication associated with bisphosphonate therapy, commonly used in the treatment of osteoporosis and metastatic bone diseases. Low-Level Laser Therapy (LLLT) has been proposed as a potential treatment modality for BRONJ, with its anti-inflammatory, analgesic, and regenerative effects being of particular interest. This systematic review aims to critically assess the current evidence regarding the efficacy of LLLT in the management of BRONJ. Methods: This review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive search of electronic databases, including PubMed, Scopus, and Web of Science, was performed to identify relevant studies published up to September 2024. The systematic review protocol has been registered on the International Prospective Register of Systematic Reviews (PROSPERO) with the number 423003. All studies considered are observational. Studies were included if they investigated the application of LLLT in BRONJ treatment, reporting clinical outcomes such as pain reduction, lesion healing, and quality of life. The quality of the studies was assessed using the Cochrane Risk of Bias tool, and the data were synthesized descriptively. Results: A total of four studies met the inclusion criteria. The findings indicate that LLLT, particularly when used in conjunction with surgical debridement and pharmacological therapy, significantly may reduce pain and promote soft tissue healing in patients with BRONJ. However, the heterogeneity of study designs, laser parameters, and outcome measures limits the generalizability of these results. Furthermore, most studies were small-scale, with moderate to high risk of bias. Conclusions: The current evidence suggests that LLLT may be a beneficial adjunctive therapy in the treatment of BRONJ. However, conclusions are limited by the lack of randomized controlled trials and methodological heterogeneity, particularly for pain management and soft tissue regeneration. However, further high-quality randomized controlled trials with standardized laser protocols are necessary to establish its efficacy and optimize clinical application. Therefore, one of the limitations of this literature review with meta-analysis is that only four studies were considered and, moreover, they were observational. The results of the meta-analysis showed that there is not enough evidence to declare a statistical correlation; this result will surely be due to the small number of studies and heterogeneity. Full article

Temporomandibular disorders (TMDs) impact quality of life and present diagnostic and treatment challenges. Biomarkers may serve as an additional tool to support diagnosis and monitor disease progression, offering supplementary information for treatment strategies in specific and selected patients. This systematic review aimed to assess the role of biomarkers in diagnosing TMD and guiding personalized treatment. It also examined key biomarkers linked to chronic temporomandibular joint (TMJ) pain and how therapies affect biomarker levels and clinical outcomes. A comprehensive search was conducted in PubMed, Scopus, and Web of Science to identify observational and interventional studies assessing the role of biomarkers in synovial fluid/tissue, saliva, and blood. The research was registered in PROSPERO, adhered to PRISMA guidelines, and employed Cochrane Risk of Bias tools. To assess the effect, only studies examining biomarker levels were considered. A total of forty-six studies met the inclusion criteria: three randomized controlled trials were rated as having some concerns, as were most of the observational studies. Elevated levels of interleukins (1ß and 6), tumour necrosis factor alpha, and prostaglandin E2 in synovial fluid were correlated with temporomandibular joint (TMJ) inflammation. Increased matrix metalloproteinases (2, 7, and 9) indicated cartilage deterioration, while oxidative stress markers such as malondialdehyde were higher in TMD patients. Treatments including hyaluronic acid, platelet-rich plasma, and low-level laser therapy effectively reduced inflammatory biomarkers and improved symptoms. Biomarkers show potential to contribute to the understanding of pathophysiological mechanisms in TMD and may support future diagnostic and therapeutic strategies for selected patients. After high-quality studies confirm these findings, this approach will enable personalized medicine by tailoring treatments to individual patient profiles, ultimately leading to improved outcomes and quality of life. Full article

Objectives: The aims of the presented study were to investigate and compare the effectiveness of Low-Level Laser Therapy (LLLT) and therapeutic ultrasound (US) on pain, function, emotional status, and sleep disturbances in patients with rotator cuff tendinopathy (RCT). Method: A total of 84 patients with RCT were included in the study and randomly divided into the US group (n = 42) and the LLLT group (n = 42). Hot-pack, transcutaneous electrical nerve stimulation, and a home-based exercise program were also administered to patients in each group. The patients were evaluated at baseline, and at 1st, 4th, and 12th weeks after treatment by Visual Analog Scale (VAS), Shoulder Pain and Disability Index (SPADI), Constant Murley Score (CMS), Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH), Hand Grip Strength (HGS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index (PSQI), and Short Form-36 (SF-36). Results: Significant improvements in VAS, SPADI, CMS, DASH, BDI, BAI, PSQI, and SF-36 scores were observed over time in both groups (p < 0.05 for all). The improvements in HGS scores were significantly greater in the US group compared to the LLLT group (p < 0.05 for all). There were no statistically significant differences between the groups in VAS, SPADI, CMS, DASH, BDI, BAI, PSQI, and SF-36 scores at each time point (p > 0.05 for all). Conclusions: Both therapeutic US and LLLT are effective and safe in the treatment of patients with RCT. However, our findings indicate no superiority of one treatment over the other in terms of pain relief or improvements in function, emotional status, sleep disturbances, or quality of life. Full article