Effects of Kangfuxin Solution (康复新液) Combined with Low-level Laser on Cytokines and Immune Function in Patients with Radiation-induced Oral Mucositis

Objective:To investigate the effect of Kangfuxin Solution(康复新液)combined with low-level laser therapy(LLLT)on cytokines and immune function in patients with radiation-induced oral mucositis.Methods:There were 84 nasopharyngeal carcinoma patients with oral mucositis after intensity-modulated radiation therapy(IMRT)were randomly divided into the control group(CG)and the observation group(OG),with 42 cases in each group.The CG was given LLLT,and the OG was treated with Kangfuxin Solution in addition to LLLT for 10 consecutive days.The healing time of oral mucosa,mucositis grading,oral pain scores,cytokines(interleukin-6,interleukin-1βand tumor necrosis factor-α)and T lymphocyte subsets were compared between the 2 groups before and after treatment.Results:The healing time of oral mucosa in the OG was(6.8±1.4)d,which was significantly shorter than(8.6±1.9)d in the CG(t=4.943,P<0.01).After treatment,the grading of oral mucositis in the OG was better than that in the CG,with a statistically significant difference(Z=2.942,P<0.05).The oral pain scores of the OG was lower than that in the CG at different time points after treatment,and the difference was statistically significant(t=8.207,11.017,P<0.01).After treatment,the levels of IL-6,IL-1βand TNF-αin peripheral blood of the OG were significantly lower than those in the CG(t=5.217,2.775,4.053,P<0.01).There were statistically significant differences in CD4+,CD8+and CD4+/CD8+between the OG and the CG after treatment(t=5.692,6.093,3.658,P<0.01).Conclusion:Kangfuxin Solution combined with LLLT can significantly shorten the healing time of oral mucosal,reduce the grading of oral mucositis,relieve oral pain,reduce inflammatory response and improve the immune function of patients.

Effect of low-level laser therapy on tooth-related pain and somatosensory function evoked by orthodontic treatment

Low-level laser therapy(LLLT) may have an effect on the pain associated with orthodontic treatment. The aim of this study was to evaluate the effect of LLLT on pain and somatosensory sensitization induced by orthodontic treatment. Forty individuals(12–33 years old; mean ± standard deviations: 20.8 ± 5.9 years) scheduled to receive orthodontic treatment were randomly divided into a laser group(LG) or a placebo group(PG)(1:1). The LG received LLLT(810-nm gallium-aluminium-arsenic diode laser in continuous mode with the power set at 400 mW, 2 J·cm–2) at 0 h, 2 h, 24 h, 4 d, and 7 d after treatment, and the PG received inactive treatment at the same time points. In both groups, the non-treated side served as a control. A numerical rating scale(NRS) of pain, pressure pain thresholds(PPTs), cold detection thresholds(CDTs), warmth detection thresholds(WDTs), cold pain thresholds(CPTs), and heat pain thresholds(HPTs) were tested on both sides at the gingiva and canine tooth and on the hand. The data were analysed by a repeated measures analysis of variance(ANOVA). The NRS pain scores were significantly lower in the LG group(P = 0.01). The CDTs,CPTs, WDTs, HPTs, and PPTs at the gingiva and the PPTs at the canine tooth were significantly less sensitive on the treatment side of the LG compared with that of the PG(P < 0.033). The parameters tested also showed significantly less sensitivity on the nontreatment side of the LG compared to that of the PG(P < 0.043). There were no differences between the groups for any quantitative sensory testing(QST) measures of the hand. The application of LLLT appears to reduce the pain and sensitivity of the tooth and gingiva associated with orthodontic treatment and may have contralateral effects within the trigeminal system but no generalized QST effects. Thus, the present study indicated a significant analgesia effect of LLLT application during orthodontic treatment.Further clinical applications are suggested.

Low-level laser therapy enhances the number of osteocytes in calvaria bone defects of ovariectomized rats

Background : Osteoporosis can make bone repair difficult. Low-level laser therapy( LLLT) has been shown to be a promising tool for bone neoformation. This study aimed to analyze the effect of LLLT on calvaria bone defects of ovariectomized rats using stereology. Methods : Fifty-four Wistar rats were subjected to bilateral ovariectomy, and bone defects were created in calvaria after 150 days. The animals were divided into nine groups(n = ?6 per group), and 24 hours after the bone defects were created they received three, six or 12 sessions of LLLT at 0, 20 or 30 J/cm 2, using a 780-nm low-intensity GaAlAs laser. One-way ANOVA followed by Tukey ' s post hoc test was used for data processing. A difference of P < 0.05 was considered statistically significant. The parameters evaluated were osteocyte density( Nv_(ost)), total osteocyte number( Nto ost), trabecular surface density( Sv_t), and trabecular surface area( Sa_t). Results : Data obtained showed that Nto ost, Sv t, and Sa t in group G2 rats were significantly different from G1(0 J/cm^2)( P < 0.05). Compared to group G4, G5 presented higher values for the parameters Sv t and Sa t, and G6 presented significantly higher values for almost all the analyzed parameters( Nv _(ost), Nto_(ost), Sv_t, and Sa t)( P < 0.05). Compared to group G7, G8 showed a higher value only for the parameter Sa t, and G9 showed significantly higher values for parameters Nv ost, Nto ost, Sv_t, and Sa_t. Conclusion : We conclude that LLLT stimulated bone neoformation and contributed to an increase in the total number of osteocytes, especially with a laser energy density of 30 J/cm^2 given for six and 12 sessions.

Induction of Autologous Bone-Marrow Stem Cells by Low-Level Laser Therapy Has Beneficial Effects on the Kidneys Post-Ischemia-Reperfusion Injury in the Rat

Acute renal failure has a 50% - 80% mortality rate. Currently, treatment options for this life-threatening disease are limited. Low-level laser therapy (LLLT) has been found to modulate biological activity. The aim of the present study was to investigate the possible beneficial effects of laser application to stem cells in the bone marrow, on the kidneys of rats that had undergone ischemia-reperfusion injury (IRI). IRI was induced by occlusion of the renal artery to 3- and 7-month-old rats for 15 or 30 minutes. In an additional experiment IRI was applied to both kidneys for 20 min each in 2-3-month-old rats. Rats were then divided randomly into two groups of control and laser-treated. Laser therapy (Ga-Al-As 810 nm, 200 mW output for 2 min) was applied to the bone marrow 1 and 7 days post-IRI to the kidneys, and rats were sacrificed 2 weeks later. Histomorphometry and immunohistochemistry were performed on kidney sections and blood markers for kidney function. Quantitative histomorphometric analysis revealed a reduction in dilatation of the renal tubules, restored structural integrity of the renal tubules, and reduced necrosis in the laser-treated rats as compared to the control, non-laser-irradiated group. C-kit positive cell density in kidneys post-IRI and laser-treatment was significantly (p = 0.015) 3.2-fold higher compared to the control group. Creatinine and blood urea nitrogen content were significantly lower in the laser-treated rats as compared to control. It is concluded that LLLT application to the bone marrow (BM) causes a significant increase in the density of mesenchymal stem cells in the kidneys post-IRI, probably by induction of stem cells in the BM, which subsequently migrate to the IRI kidney, significantly reducing the pathological features of the kidney and increasing kidney function post IRI.

Low-Level Laser Therapy versus Four Layers Compression Technique in the Treatment of Venous Ulcers

Objective: The aim of the study is to evaluate the effect of low-level laser therapy in comparison to compression bandage therapy in the treatment of venous ulcers. Subjects & Methods: This study was carried out in the period from March 2013 to March 2014. The study included 40 adult patients with a diagnosis of venous ulcer classified as C6 according to the clinical classification of CEAP classification. The patients were divided into 2 groups: the first one included 20 patients treated by low-level laser therapy at the Rheumatology and Rehabilitation department, and the second group included 20 patients in whom we use four layers compression bandaging at the vascular surgery department. Results: 32 ulcers were treated in group I and 35 ulcers were treated in group II. The patients of group I were 7 (35%) females and 13 (65%) males, their age range were (24 - 56) years. The patients of group II were 11 (55%) males and 9 (45%) females;their age ranges were (32 - 50) years. Measurements of the ulcers size by (cm2) were taken at the beginning of therapy, at 1 month, at 2 months and at 3 months later on. The calculation of the area of the ulcer was done by using the graph papers to document the ulcer’s perpendicular linear dimensions. According to the size of the ulcer, some ulcers heal within 1 month (15.6%) ulcers in group I, and (28.5%) in group II. Some ulcers heal within 2 months (28%) in group I, and (37%) in group II. The remaining ulcers heal within 3 months or more which are (56%) ulcers in group I, and (34.2%) ulcers in group II. The recurrence rate of chronic venous leg ulcer in compression bandage technique used in group II was the least one as the total number of recurrent cases were 5 (25%), followed by laser therapy used in group I. Conclusion: There was no significant efficacy of the low-level laser therapy over the four layers compression technique in the management of chronic venous ulcers.

Roles of reinforced nerve conduits and low-level laser phototherapy for long gap peripheral nerve repair

Peripheral nerve injuries are common in clinical practice because of traumas such as crushing and sectioning. Lesions of the nerve structure result in lost or diminished sensitivity and/or motor activity in the innervated territory. The degree of lesion depends on the specific nerve involved, the magnitude and type of pres- sure exerted, and the duration of the compression. The results of such injuries commonly include axonal degeneration and retro- grade degeneration of the corresponding neurons in the spinal medulla, followed by very slow regeneration （Rochkind et al., 2001）. The adverse effects on the daily activities of patients with a peripheral nerve injury are a determining factor in establishing the goals of early recovery （Rodriguez et al., 2004）.

Effect of low-level laser irradiation(LLLI)combined with ferulic acid on the osteoblast differentiation and maturation as well as osteogenesis signaling pathway expression

Objective: To study the effect of low-level laser irradiation (LLLI) combined with ferulic acid on the osteoblast differentiation and maturation as well as osteogenesis signaling pathway expression. Methods: The cranium was collected from the SD rats born within 24 h, osteoblasts were separated, cultured and then divided into control group, ferulic acid group, LLLI group, ferulic acid + LLLI group, and the expression osteoblast differentiation markers, proliferation molecules and signaling pathway molecules were detected after continuous treatment with different conditions for three days. Results: 3 d after treatment, the Bax and Bid mRNA expression in ferulic acid group, LLLI group and ferulic acid + LLLI group of cells were significantly lower than those in control group while Bcl-2, CyclinD1, E2F, Col-I, OC and ALP mRNA expression as well as Wnt, β-catenin, Runx2, cAMP and PKA protein expression were significantly higher than those in control group;Bax and Bid mRNA expression in ferulic acid + LLLI group of cells were significantly lower than those in ferulic acid group and LLLI group while Bcl-2, CyclinD1, E2F, Col-I, OC and ALP mRNA expression as well as Wnt, β-catenin, Runx2, cAMP and PKA protein expression were significantly higher than those in ferulic acid group and LLLI group;Col-I, OC, ALP, Bax, Bid, Bcl-2, CyclinD1 and E2F mRNA expression as well as Wnt, β-catenin, Runx2, cAMP and PKA protein expression were not significantly different between ferulic acid group and LLLI group. Conclusion: Low-level laser irradiation (LLLI) combined with ferulic acid can promote osteoblast differentiation and maturation and activate osteogenesis signaling pathway.

Photobiomodulation with Super-Pulsed Laser Shows Efficacy for Stroke and Aphasia: Case Studies

Background: Brain disorders have become more and more common today, due to both the aging population and the ever-expanding sports community. However, a new therapeutic technology called photobiomodulation (PBM) is giving hope to thousands of individuals in need. Traumatic brain injury (TBI), dementia, post traumatic stress (PTSD) and attention deficit (ADD) disorders are in many cases quickly and safely improved by PBM. PBM employs red or near-infrared (NIR) light (600 - 1100 nm) to stimulate healing, protect tissue from dying, increase mitochondrial function, improve blood flow, and tissue oxygenation. PBM can also act to reduce edema, increase antioxidants, decrease inflammation, protect against apoptosis, and modulate the microglial activation state. All these effects can occur when light is delivered to the head, and can be beneficial in both acute and chronic brain conditions. Methods: In this case series, we used a high power, FDA-approved superpulsed laser system applied to the head to treat four chronic stroke patients. Patients received as few as three 6 - 9 minute treatments over a one-week period. The follow up time varied, but in one case was two years. Results: Patients showed significant improvement in their speech and verbal skills. Improvements were also noticed in walking ability, limb movement, less numbness, and better vision. Conclusion: The use of PBM in stroke rehabilitation deserves to be tested in controlled clinical trials, because this common condition has no approved pharmaceutical treatment at present.

Application of Well-Known Antiviral Drugs in the Field Formed by the Unexplained Properties of Low-Level Laser Radiation in Therapy of Covid-19 and Chronic Viral Hepatitis

Low-level laser therapy (LLLT) or cold laser has been used in medicine for several decades. However, the method utilizes a direct contact of the light beam with a patient. Further research resulted in development of another method that enables remote transmission of the pharmacological properties of a medicament into a human body with the application of low-level laser radiation as the light source. 18 patients with different viral diseases were treated with the antiviral drugs placed into the field formed by the unexplained properties of low-level laser radiation of the “device for transfer of the pharmacological properties of a drug into the patient’s body”. This resulted in improvement of the patient’s condition, the absence of side effects and adverse reactions when using drugs in the proposed device and shortened therapy period for patients with chronic hepatitis C infection and Covid-19 patients. The long-term follow-up of the patients with chronic hepatitis B infection showed that hepatitis B virus remained at low replication levels under the influence of the therapy, which made it possible to avoid such formidable complications of the disease as cirrhosis of the liver and liver cancer.

Laser and Its Application in Periodontology: A Review of Literature

Introduction: The use of lasers is an emerging therapy in periodontology, however, controversies regarding its use. Despite the vast amount of literature that is currently available, debates regarding the use of lasers in periodontal therapy continue. This review aims to summarize and clarify the myths surrounding the use of lasers in periodontal therapy, which may offer new hope for the treatment’s future. Methods: A comprehensive computer-based search was done using various databases like PubMed, Medline, and Cochrane Library. Results: Laser therapy has influenced periodontal treatment in many aspects. The advantages of laser over conventional instruments were reported, which include pain relief, inflammation reduction, tissue repair acceleration, wound healing, reduction of scar formation, removal of granulation tissue and epithelial lining, and treatment of periodontal pockets. Today, the laser starts to get more people’s attention. However, an evidence-based approach to using lasers in periodontal treatment must be developed. The potential risks associated with lasers should also be considered. There must be careful and strict safety precautions implemented. Conclusion: Although laser therapy has shown promising results in the treatment of periodontal disease, further research is needed before the clinical use of lasers in evidence-based practice. Further long-term studies and clinical studies in human models are needed to generalize laser therapy in periodontology.

Effect of autologous mesenchymal stem cells induced by low level laser therapy on cardiogenesis in the infarcted area following myocardial infarction in rats

In this study, we investigated the hypothesis that photobiostimulation by low-energy laser therapy (LLLT) applied to the bone marrow (BM) of myocardial infarcted rats may attenuate the scarring processes that follow myocardial infarction (MI). Wistar rats underwent experimental MI. LLLT (Ga-Al-As diode laser) was applied to the BM of the exposed tibia at different time intervals post-MI (4 hrs, 48 hrs and 5 days). Sham-operated infarcted rats served as control. Infarct size was significantly reduced (55%) in the laser-treated rats as compared to the control non-treated rats, at 2 weeks post-MI. A significant 3-fold increase was observed in the density of desmin immunopositive stained cells 14 days post-MI in the infarcted area of the laser-treated rats as compared to the non-laser-treated controls. The electron microscopy from the control infarcted rat hearts revealed a typical interphase area between the intact myocardium and the infarcted area, with conspicuous fibroblasts with collagen deposition dispersed among them. In rats that were laser treated (to BM), the interphase zone demonstrated cells with different intracellular structures. There was also a significant increase in the percentage of c-kit positive cells and macrophages in the circulating blood of the laser treated rats as compared to control non treated ones. In the majority of the cells clusters of myofibrils anchored to well-developed Z-lines and structures resembling the morphological characteristics of mature intact cardiomyocytes were evident. In conclusion, LLLT to the BM of rats post-MI induces cardiogenesis mainly at the borders of the infarcted area in the heart.

Photobiomodulation provides neuroprotection through regulating mitochondrial fission imbalance in the subacute phase of spinal cord injury

Increasing evidence indicates that mitochonarial lission imbalance plays an important role in derayed neuronal cell death. Our previous study round that photo biomodulation improved the motor function of rats with spinal cord injury.However,the precise mechanism remains unclear.To investigate the effect of photo biomodulation on mitochondrial fission imbalance after spinal cord injury,in this study,we treated rat models of spinal co rd injury with 60-minute photo biomodulation(810 nm,150 mW) every day for 14 consecutive days.Transmission electron microscopy results confirmed the swollen and fragmented alte rations of mitochondrial morphology in neurons in acute(1 day) and subacute(7 and 14 days) phases.Photo biomodulation alleviated mitochondrial fission imbalance in spinal cord tissue in the subacute phase,reduced neuronal cell death,and improved rat posterior limb motor function in a time-dependent manner.These findings suggest that photobiomodulation targets neuronal mitochondria,alleviates mitochondrial fission imbalance-induced neuronal apoptosis,and thereby promotes the motor function recovery of rats with spinal cord injury.

Potential targets and mechanisms of photobiomodulation for spinal cord injury

As a classic noninvasive physiotherapy,photobiomodulation,also known as low-level laser therapy,is widely used for the treatment of many diseases and has anti-inflammatory and tissue repair effects.Photobiomodulation has been shown to promote spinal cord injury repair.In our previous study,we found that 810 nm low-level laser therapy reduced the M1 polarization of macrophages and promoted motor function recovery.However,the mechanism underlying this inhibitory effect is not clear.In recent years,transcriptome sequencing analysis has played a critical role in elucidating the progression of diseases.Therefore,in this study,we performed M1 polarization on induced mouse bone marrow macrophages and applied low-level laser therapy.Our sequencing results showed the differential gene expression profile of photobiomodulation regulating macrophage polarization.We analyzed these genes using gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses.Networks of protein-protein interactions and competing RNA endogenous networks were constructed.We found that photobiomodulation inhibited STAT3 expression through increasing the expression of miR-330-5p,and that miR-330-5p binding to STAT3 inhibited STAT3 expression.Inducible nitric oxide synthase showed trends in changes similar to the changes in STAT3 expression.Finally,we treated a mouse model of spinal cord injury using photobiomodulation and confirmed that photobiomodulation reduced inducible nitric oxide synthase and STAT3 expression and promoted motor function recovery in spinal cord injury mice.These findings suggest that STAT3 may be a potential target of photobiomodulation,and the miR-330-5p/STAT3 pathway is a possible mechanism by which photobiomodulation has its biological effects.

Low-level laser acupuncture reduces postoperative pain and morphine consumption in older patients with total knee arthroplasty: A randomized placebo-controlled trial

Background: Patients commonly develop postoperative pain after total knee arthroplasty(TKA).Acupuncture-related techniques and low-level laser therapy could be beneficial for pain management for older individuals.Objective: To examine the effect of low-level laser acupuncture(LA) in reducing postoperative pain, painrelated interference in daily life, morphine consumption, and morphine-related side effects in older patients with knee osteoarthritis who underwent TKA.Design, setting, participants and intervention: A single-blind randomized placebo-controlled trial was conducted. Patients(N = 82) were recruited and randomly assigned via a computer-generated list to the LA group or a placebo group. The LA group received low-level laser therapy at Sanyinjiao(SP6), Taixi(KI3),Kunlun(BL60), Fengshi(GB31), Futu(ST32) and Neiguan(PC6) after TKA, while the placebo acupuncture group received the same treatment procedure without laser energy output.Main outcome measures: The primary outcome was postoperative pain intensity, and it was measured at baseline and hours 2, 6, 10, 24, 48 and 72 after TKA. The secondary outcomes, including relative pain,postoperative pain-related interference in daily life and morphine consumption, were measured at hours24, 48 and 72 after TKA.Results: Generalized estimating equations revealed significant between-group differences in pain intensity(P = 0.01), and trend differences in pain intensity for the LA group starting at hours 10 to 72(P < 0.05)and morphine consumption at hours 48 and 72(P < 0.05). The changes in pain-related interference in daily life were significant(P < 0.05) at 72 h, with the exception of the parameters for worst pain, mood,and sleep. Nausea and vomiting side effects from morphine had significant between-group differences at hours 10 and 24(P < 0.05).Conclusion: Low-level LA gradually reduced older patients’ postoperative pain intensity and morphine consumption within the first 72 h after their TKA for osteoarthritis. Low-level LA may have benefits as an adjuvant pain management technique for clinical care.Trial registration: ClinicalTrials.gov registration number NCT03995446.

Laser acupuncture combined with auricular acupressure improves low-back pain and quality of life in nurses:A randomized controlled trial

Background Low-back pain(LBP)in nurses is a major health concern that affects their quality of life and ability to work,with consequences for their economic status.Objective This study evaluates the effect of low-level laser acupuncture combined with auricular acupressure(LAA)on pain intensity,pain interference and quality of life in nurses with LBP.Design,setting,participants and interventions This randomized controlled trial recruited a convenience sample of hospital-based nurses from one teaching hospital in Taiwan,China.Participants were randomly assigned to the LAA group(n=38)receiving low-level laser acupuncture and auricular acupressure for 4 weeks,and the control group(n=38)receiving only sham laser acupuncture treatment without laser energy output.Main outcome measures Data were collected for the primary pain outcome using the Short Form of the Brief Pain Inventory,while the secondary outcome,quality of life,was evaluated using the Roland-Morris Disability Questionnaire.Both primary and secondary outcomes were scored before the intervention,and after 2-week and 4-week intervention.The rate of LBP recurrence was evaluated at the 4th week and 8th week after the end of intervention.Results After controlling for prior pain,the result of linear mixed model analysis showed trends in significant between-group differences in the level of current pain occurring in week 4(P<0.001),worst pain in week 2(P<0.001)and week 4(P<0.001),least pain in week 2(P=0.032)and week 4(P<0.001),pain interference in week 2(P=0.009)and week 4(P<0.001),and in the life dysfunction in week 2(P<0.001)and week 4(P<0.001).Recurrence rates of LBP at the 4th and 8th weeks after the end of intervention were 0%and 36.89%in the LAA group,and 69.44%and 36.11%in the control group.Conclusion This study shows that 4-week LAA intervention reduced pain intensity and pain interference,and improved quality of life for hospital-based nurses with LBP.These effects were maintained continuously for at least 4 weeks after the intervention.The nonpharmacological intervention,LAA,may be another efficacious,feasible,noninvasive,analgesic intervention for LBP.

Photobiomodulation therapy for osteoarthritis: Mechanisms of action

Photobiomodulation(PBM)is a non-invasive therapeutic modality with demonstrated effects in many fields related to regenerative medicine.In the field of orthopedics,in particular,PBM at various wavelengths has demonstrated the capacity to trigger multiple biological effects associated with protective mechanisms in musculoskeletal tissues.The articles cited in this review show that devices operating close to or within the near infrared range at low intensities can provoke responses which favor the shift in the predominant catabolic microenvironment typically seen in degenerative joint diseases,especially osteoarthritis(OA).These responses include proliferation,differentiation and expression of proteins associated with stable cell cycles.Additionally,PBM can also modulate oxidative stress,inflammation and pain by exerting regulatory effects on immune cells and blocking the transmission of pain through sensory neuron fibers,without adverse events.Collectively,these effects are essential in order to control the progression of OA,which is in part attributed to exacerbated inflammation and degradative enzymatic reactions which gradually contribute to the destruction of joint tissues.PBM may offer medical experts ease of application,financial viability,efficacy and lack of serious adverse events.Therefore,it may prove to be a suitable ally in the management of mild to moderate degrees of OA.This review explores and discusses the principal biological mechanisms of PBM and how the produced effects may contribute to the amelioration of osteoarthritic progression.Literature was reviewed using PubMed and Google Scholar in order to find studies describing the mechanisms of PBM.The investigation included a combination of nomenclature such as:“photobiomodulation”,“phototherapy”,“laser therapy”,“PBM”,“osteoarthritis”,low level light therapy”,“inflammation”and“cartilage”.We considered only articles written in English,with access to the full text.

Photobiomodulation therapy assisted orthodontic tooth movement:potential implications,challenges,and new perspectives

Over the past decade,dramatic progress has been made in dental research areas involving laser therapy.The photobiomodulatory effect of laser light regulates the behavior of periodontal tissues and promotes damaged tissues to heal faster.Additionally,photobiomodulation therapy(PBMT),a non-invasive treatment,when applied in orthodontics,contributes to alleviating pain and reducing inflammation induced by orthodontic forces,along with improving tissue healing processes.Moreover,PBMT is attracting more attention as a possible approach to prevent the incidence of orthodontically induced inflammatory root resorption(OIIRR)during orthodontic treatment(OT)due to its capacity to modulate inflammatory,apoptotic,and anti-antioxidant responses.However,a systematic review revealed that PBMT has only a moderate grade of evidence-based effectiveness during orthodontic tooth movement(OTM)in relation to OIIRR,casting doubt on its beneficial effects.In PBMT-assisted orthodontics,delivering sufficient energy to the tooth root to achieve optimal stimulation is challenging due to the exponential attenuation of light penetration in periodontal tissues.The penetration of light to the root surface is another crucial unknown factor.Both the penetration depth and distribution of light in periodontal tissues are unknown.Thus,advanced approaches specific to orthodontic application of PBMT need to be established to overcome these limitations.This review explores possibilities for improving the application and effectiveness of PBMT during OTM.The aim was to investigate the current evidence related to the underlying mechanisms of action of PBMT on various periodontal tissues and cells,with a special focus on immunomodulatory effects during OTM.

Comparison between four treatment modalities for active myofascial triggers points

Aim:The study aimed at the painful trigger points(TrPs)for the purpose of ablating muscle spasms and restoring normal muscle length to find the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain dysfunction.Methods:We enrolled 72 patients with pain and reduced mouth opening due to temporomandibular joint dysfunction.Patients assigned to four groups and four treatment modalities used to treat myofascial TrPs pain.We used mean and standard deviation values.The Mann–Whitney U-test was used to compare the two groups.The Wilcoxon signed-rank test was used to study the changes by the time in mean pain scores.The Student’s t-test was used to compare maximum mouth opening(MMO)groups.Then paired t-test was also used to study the changes of time in an MMO.Results:The results showed that pulsed electromagnetic field(PEMF)therapy is the most effective treatment modality regarding for pain relief.Both the anesthesia and PEMF groups showed a reduction in mean pain scores throughout all follow-up periods,and a statistically significant increase in mean MMO.Conclusion:The findings suggest that PEMF is the most effective treatment for alleviating pain and improving mouth range of motion in patients with myofascial pain.