Photobiomodulation, photomedicine, and laser surgery最新文献

Background: Rheumatoid arthritis (RA) is a persistent inflammatory condition that results in joint deterioration and impairment. A noninvasive treatment option that has shown promise is photobiomodulation therapy (PBMT), but the optimal energy density for RA management is not well established.

Objective: This study aims to assess the therapeutic efficacy of PBMT utilizing varying energy densities on RA in male rats, in comparison with methotrexate treatment.

Methods: A case-control study was conducted on 48 male rats randomly assigned to six groups: Group I is the negative control, Group II is the RA positive control, Group III is the RA + PBMT 36 J/cm², Group IV is the RA + PBMT 54 J/cm², Group V is the RA + PBMT 72 J/cm², and Group VI is the RA plus methotrexate. RA was induced in all groups except Group I. Treatments were applied over a defined period. Outcomes included paw thickness and biochemical markers: superoxide dismutase (SOD), interleukin-6 (IL-6), interleukin-1β (IL-1β), malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-α), and rheumatoid factor.

Results: All PBMT-treated groups showed significant reductions in paw thickness, and pro-inflammatory indicators were compared with the RA positive control (p < 0.05). PBMT at 54 J/cm² (Group IV) demonstrated the most pronounced anti-inflammatory effect, comparable with methotrexate. Oxidative stress marker MDA decreased significantly, while SOD levels increased in all PBMT groups, particularly in Group IV.

Conclusion: PBMT at an energy density of 54 J/cm² appears optimal in mitigating inflammation and oxidative stress in RA, providing a potential non-pharmacologic adjunct to conventional therapy.

Aim: To investigate the impact of different post space sterilants, namely methylene blue (MB) photosensitizer (PS)-loaded chitosan nanoparticles (CHNPs), sepiolite nanoparticles (SepNPs), and Er, Cr: YSGG laser (ECL), on the smear layer (SL) removal and push-out bond strength (PBS) of glass fiber posts (GFPs) to canal dentin.

Methods: A total of 52 single-rooted premolars were carefully selected, crowns were decoronated, and endodontic therapy was performed; subsequently, the samples were prepared for post space utilizing Gates-Glidden instruments. The specimens were categorized into four cohorts based on the disinfection regime (n = 13): Group 1: 2.5% NaOCl + ethylenediamine tetraacetic acid (EDTA), Group 2: MB-CHNPs-PDT + EDTA, Group 3: MB-SepNPs-PDT + EDTA, and Group 4: ECL + EDTA. SL removal analysis and PS-loaded nanoparticle characterization were executed using scanning electron microscopy. Self-cure resin cement was used for bonding GFP, followed by thermocycling. The evaluation of bond strength and the analysis of the fracture mode were conducted utilizing a universal testing machine and stereomicroscope, respectively. Data analysis was conducted using Analysis of Variance (ANOVA) and a post hoc test (p < 0.05).

Result: The cervical section of Group 2 (MB-CHNPs-PDT + EDTA) test specimens displayed the maximum cleaning of SL (1.22 ± 0.23) and the highest PBS (11.23 ± 0.12 MPa). However, the apical third of Group 1 (MB-SepNPs-PDT + EDTA) reported minimum SL removal (4.53 ± 0.17) and the lowest bond strength (6.65 ± 0.13 MP). Group 1 (2.5% NaOCl + EDTA) and Group 4 (ECL + EDTA) presented no significant variation in SL elimination and PBS of GFP.

Conclusion: Using EDTA co-application, the MB-loaded CHNP protocol was associated with lower smear layer scores and higher PBS compared with the other tested groups.

Background: Laser-assisted irrigation may enhance chemomechanical debridement and improve the sealing of root canals during endodontic treatment.

Objective: This study aimed to address the scientific deficit in understanding the laser-assisted sequential versus continuous chelation in root canal irrigation.

Methods: One hundred and twenty single-rooted teeth were prepared using Reciproc R40 instruments and randomly divided into six groups (n = 20) based on the irrigation protocol. In the sequential chelation groups, canals were irrigated with NaOCl during instrumentation, followed by 17% ethylenediaminetetraacetic acid using a needle, ultrasound, or erbium-doped yttrium aluminum garnet laser activation. In the continuous chelation groups, canals were irrigated with a mixture of 2% sodium hypochlorite and 9% hydroxyethylidene diphosphonic acid during and after instrumentation, followed by final activation using the same three techniques. Ten samples per group were used to evaluate sealer penetration with Fluo-3 dye, while the remaining samples underwent push-out bond strength testing. Statistical analyses were conducted using the Kruskal-Wallis and Friedman tests (p < 0.05).

Results: No significant differences in sealer penetration were found between sequential and continuous protocols in the apical third when needle or ultrasonic activation was used. However, laser activation combined with continuous chelation resulted in significantly higher sealer penetration and bond strength (p < 0.001). Sealer penetration followed the trend: coronal > middle > apical (p < 0.05) with all irrigation techniques.

Conclusions: Continuous chelation protocols, especially when combined with laser activation, were as effective or superior to conventional methods in improving sealer penetration and bond strength. Continuous chelation with laser-assisted irrigation may improve clinical efficiency and shorten treatment time in root canal procedures.

Background and aim: Hypertrophic scars (HTs) pose challenges in aesthetic management and patient satisfaction. Conventional treatments such as corticosteroid injections and silicone gels often show limited efficacy on the vascular component. Rhodamine-based intense pulsed light (IPL) targets vascular tissues selectively, offering a potential noninvasive solution. The study aims to evaluate the efficacy and safety of rhodamine-based IPL in treating HTs with a prominent vascular component, using clinical photography, dynamic optical coherence tomography (D-OCT), and patient-reported outcomes.

Methods: A retrospective analysis was conducted on 12 patients with persistent HTs characterized by a prominent vascular component. Each patient received two IPL treatments at 20-day intervals using a rhodamine-based IPL device. Outcomes were assessed through digital photography and D-OCT imaging to quantify changes in vascular and structural characteristics. The Vancouver Scar Scale was used for clinical assessment. Patient satisfaction was evaluated using the Aesthetic Numeric Analogue (ANA) scale, and adverse effects were documented at each visit.

Results: Most patients demonstrated clinical and instrumental improvements. Digital photography and D-OCT data indicated significant reductions in erythema, vessel diameter, and vessel density. Clinical observers reported good to excellent improvements in 10 out of 12 patients. ANA scores showed increased patient satisfaction. Mild, transient erythema was observed in some patients, with no severe adverse effects reported.

Conclusion: Rhodamine-based IPL therapy is a safe, effective treatment for HTs with prominent vascular components, reducing vascularization and improving scar texture and appearance. Despite the small sample size, these findings support further exploration of rhodamine-based IPL as a targeted noninvasive therapy in HT management.

Aim: Tumor-associated macrophages (TAMs) constitute a major component of the tumor microenvironment (TME) and are frequently skewed toward an M2-like phenotype that promotes immune suppression, angiogenesis, and tumor progression.

Objectives: Reprogramming these macrophages into an M1-like, pro-inflammatory state has emerged as a promising strategy to reinvigorate antitumor immunity and enhance the efficacy of immunotherapeutic interventions. Photobiomodulation (PBM), a non-invasive therapeutic modality utilizing low-intensity red to near-infrared light (600-1100 nm), has shown growing potential in immunomodulation through its effects on mitochondrial bioenergetics, redox signaling, and transcriptional regulation.

Materials and methods: This review presents a comprehensive analysis of the molecular mechanisms by which PBM influences macrophage polarization, including activation of cytochrome c oxidase, transient increases in reactive oxygen species (ROS) and adenosine triphosphate (ATP), and downstream activation of nuclear factor κB, signal transducer and activator of transcription 1, and hypoxia-inducible factor-1alpha pathways.

Results: Pre-clinical evidence demonstrates that PBM can effectively reprogram M2-polarized TAMs toward an M1 phenotype, characterized by increased expression of inducible nitric oxide synthase and interleukin (IL)-12 and reduced levels of CD206 and IL-10. When combined with immune checkpoint inhibitors, PBM further enhances CD8⁺ T cell infiltration and tumor clearance. Nanotechnology-based delivery platforms-such as TAM-targeted upconversion nanoparticles and ROS-sensitive polymeric carriers-have enabled precise, localized PBM activation within tumors, overcoming the limitations of light penetration and systemic exposure.

Conclusion: Collectively, PBM offers a spatiotemporally controlled, drug-free approach to modulate tumor immunity by reeducating TAMs and reshaping the TME. Its integration with existing immunotherapies and nanomedicine holds significant promise for next-generation precision oncology strategies.

Background: Phototherapy is a well-established treatment for various chronic inflammatory dermatoses, yet data on its safety and efficacy in geriatric populations remain limited. Older adults face unique clinical challenges due to age-related physiological changes, comorbidities, and polypharmacy, which may impact treatment responses and tolerance. Objective: This study aimed to evaluate the safety, efficacy, and clinical outcomes of phototherapy in elderly patients treated over a 10-year period at a tertiary dermatology center. Materials and Methods: A retrospective analysis was conducted on patients aged ≥65 years who received ≥8 sessions of phototherapy between 2013 and 2023. Narrowband UVB (NB-UVB), systemic psoralen plus ultraviolet A (PUVA), and localized PUVA therapies were administered using standardized protocols. Diagnosis-specific clinical criteria were used to assess treatment response. Data on adverse events, recurrence, and the need for additional sessions were recorded. Results: The study included 149 patients (mean age 70.2 ± 5.0 years; 44.3% female, 55.7% male) with 19 distinct dermatologic diagnoses. The most common indications were psoriasis (24.8%), generalized pruritus (18.1%), mycosis fungoides (11.4%), and lichen planus (6.7%). NB-UVB was used in 85.2% patients, while 10.1% received local PUVA and 4.7% underwent systemic PUVA. Overall, 83.2% of patients demonstrated clinical improvement. The highest treatment durations and cumulative doses were observed in mycosis fungoides (mean 9.3 months, 88.7 J/cm²) and lichen planus (9.5 months, 59.6 J/cm²). Adverse events occurred in 12.8%, predominantly mild erythema and pruritus. Recurrence was noted at 18.1%, and 16.1% required additional sessions. Despite 40.9% of patients using photosensitizing medications, no severe phototoxic reactions were observed. Conclusions: Phototherapy is a safe, effective, and well-tolerated treatment option for elderly patients with a variety of dermatologic conditions. The high clinical response rates, even in complex and refractory cases, support its continued use in this population. With its favorable safety profile and non-systemic nature, phototherapy remains a particularly suitable modality in the context of multimorbidity and polypharmacy. Further large-scale, multicenter prospective studies are warranted to establish standardized protocols tailored for geriatric populations.

Background and Objectives: This study reports an adaptive experience of pigmented scar treatment management with different characteristics. It is complicated to define a single solution for all the patients. For this reason, we report a multi-modal approach combining CO₂ laser, Q-switched lasers (QSL), and dye laser to adapt to every different patient clinical situation. Materials and Methods: Thirty patients were enrolled to treat pigmented scars. Twenty patients presented scars with exogenous pigment (such as traumatic tattoos) and 10 with endogenous pigment (hyperpigmentation cases). A combination of CO₂ laser, QSL, and dye laser was used. The number of treatment sessions performed for each laser, or their combination was as follow: For keloid scars from tattoo: 1-4 combined treatment sessions with QS and dye lasers; 3-4 combined treatment sessions with dye and CO₂ laser;1-4 treatment sessions with QS followed by dye laser; for asphalt traumatic tattoo: 2-3 treatment sessions with QS; for surgical hypertrophic scars: 2-3 combined treatment sessions of QS and CO₂ laser; for burn scars (due to asphalt contact) and hyperpigmentation: one treatment session with QS followed by CO₂ laser. Six months after the final treatment, the patient's scar improvement was evaluated compared with baseline (T0) using a five-point Global Aesthetic Improvement Scale (GAIS). Results: Regardless of the type of lesion and treatment, the whole population of the study showed satisfactory clinical results. The GAIS mean value was 3.3 ± 0.6. Specifically, 47% of the patients reported good results while 43% had excellent ones. No serious side effects were observed. Conclusions: Our results suggest that a combination of CO₂, dye, and Nd:YAG lasers is a feasible strategy for treating scars, reducing the pigmentary, fibrotic, and vascular components.

Background: The major challenge in cosmetics is the ability of functional ingredients to penetrate the skin barrier. For this reason, "skin boosters" have been developed, indicating a change from the traditional application of hyaluronic acid (HA) fillers, which had been confined to increasing the volume of the skin, to a more diversified use designed to relieve dermal complications. Methods: Thirty subjects (aged between 31 and 83 years and Fitzpatrick skin types II-IV) with skin irregularities as mild wrinkles or pigmented lesions were enrolled. Patients were treated on the one side with laser and a medical repairing ointment, and on the other side with laser and postlaser exosomes booster solution. Different laser procedures were used (Q-switched laser, CO₂ laser, 675 nm nonablative laser). To analyze the effect on postprocedure laser management, patients were monitored before treatment, immediately after, 1 h after, 3 days after, and 30 days after with the imaging system. Results: All the patients treated did not show any significant side effects apart from the redness. The side of the face treated with laser and medical repairing ointment showed a more intense redness than the side treated with laser and postlaser booster solution, both immediately after and 1 h after the treatment. Conclusions: These data confirm that the use of the postprocedure laser booster solution helps in posttreatment management by reducing redness statistically significantly, thus allowing patients to return to everyday life in a shorter time.

Background: There is strong evidence supporting the effectiveness of photobiomodulation therapy (PBMT) in improving neuronal damage and enhancing neuropsychological activities. However, there is limited research on the effects of this method on cognitive function and mood disorders. This project aimed to evaluate the potential benefits of PBMT in improving cognitive status and mood disorders in patients with dementia. Methods: In this randomized, double-blinded, controlled trial, 30 patients with mild-to-moderate dementia participated. The patients were divided into two groups: the first group (n = 15) received standard treatment along with PBMT, whereas the second group (n = 15) received standard treatment along with the use of an off-device on the head. Cognitive function, anxiety, and depression levels were assessed before, immediately after treatment, and 1 month later. Results: The comparison of cognitive functional score at baseline, after completing the therapeutic regimen, as well as one later showed no difference between the two groups (Table 1). Similarly, the two groups had similar mean scores for depression and anxiety at baseline and after treatment interventions. [Table: see text] Conclusion: The treatment likely has no significant impact on improving cognitive status or mood disorders in patients with mild-to-moderate dementia.

Background: Green light photobiomodulation (GPBM, 500-565 nm) promotes tissue healing, reduces inflammation, and alleviates pain, with emerging potential in bone repair. This review evaluates GPBM's therapeutic effects on bone-related cells (proliferation, differentiation, migration), inflammation, vascularization, and neuronal responses. Methods: We assessed the influence of different GPBM parameters, possible underlying molecular mechanisms, and prospects for in vivo applications based on available studies. Results: GPBM acts through mitochondria, opsins, and transient receptor potential vanilloid (TRPV) channels. The most effective irradiation method uses low irradiance (5.3-100 mW/cm²) with a single exposure of ∼5 J/cm². Excessively low irradiance is ineffective, while excessively high irradiance may cause inhibitory effects. GPBM enhances bone-related cell functions, suppresses inflammation, and promotes vascular and neuronal responses. Conclusions: GPBM shows promise for bone repair, but further research is needed to optimize parameters, clarify molecular mechanisms, and standardize clinical trial protocols to ensure reliable in vivo outcomes.