Assessment of the effectiveness of low level laser in the treatment of alveolar osteitis.
Univerzitet u Nisu, Medicinski fakultet, Klinika za stomatologiju, Nis, Srbija.
Alveolar osteitis (AO) is the extraction wound healing disorder with a presence of severe pain. Low level laser therapy stimulates cell metabolism and microcirculation, have has pronounced analgesic, antiedematous and anti-inflammatory effect and speeds up wound healing process. The aim of this study was to present results of clinical research that examined the effectiveness of low level laser in pain relief and healing of extraction wounds with alveolar osteitis in the lower jaw which was formed on the second day after tooth extraction.
The study was conducted on 60 subjects divided into the study and the control group. In both groups extraction wounds were processed in similar way, except that in the study group was applied daily treatment of low level laser with a total of eight sessions of radiation, while in the control group extraction wounds were dressed with zinc oxide eugenol paste, which was changed every 48 hours up to the pain cessation. Measurement of pain intensity was done with a visual analogue scale (VAS) 10 min prior to processing of extraction wounds and daily for the next eight days. Assessment of the effectiveness of low level laser on healing of extraction wounds was performed on the day eight of the treatment.
On the day five after beginning of the treatment of extraction wounds with alveolar osteitis in the patients of the study group a lower average value of pain as compared to the control group was registered. This difference was increased within the following days. Extraction wounds healing in the study group was more successful and faster than in the control group.
This study suggested that the reduction of pain was more pronounced in the patients with alveolar osteitis whose extraction wounds were subjected to low level laser radiation in comparison to those in which extraction wounds were treated with zinc oxide eugenol paste.
Influence of carbon dioxide laser irradiation on the healing process of extraction sockets.
Department of Oral Rehabilitation, Fukuoka Dental College, Japan. firstname.lastname@example.org
To clarify the healing-promoting effects of carbon dioxide laser irradiation in high and low reactive-level laser therapies (HLLT and LLLT, respectively) on extraction sockets after tooth extraction.
MATERIAL AND METHODS:
Forty-two 5-week-old male Wistar rats were divided into laser irradiation and non-irradiation (control) groups and compared. The laser-irradiation group underwent HLLT immediately after tooth extraction and then LLLT 1 day post-extraction. Tissue was excised 6 h and 3, 7, or 21 days after extraction and histopathologically investigated. The alveolar crest height was measured osteomorphometrically 21 days post-extraction, and granulation tissue in the extraction socket surface layer was immunohistologically investigated using anti-?-smooth muscle actin (anti-?-SMA) antibody 3 and 7 days post-extraction.
Many osteoclasts appeared and active bone resorption was noted in the irradiation group 3 days after extraction compared to the controls. On Day 7, new bone formation started around the extraction socket in the control group, but from the superficial to over the middle layer of the socket in the irradiation group. On Day 21, a concavity existed in the alveolar crest region in the controls, whereas this region was flat, with no concavity, in the irradiation group. On osteomorphometry, the alveolar crest height was significantly higher in the irradiation (0.7791 ± 0.0122) than the control (0.6516 ± 0.0181) group (P < 0.05). On immunostaining, many ?-SMA-positive cells were noted in the control group, but very few in the irradiation group.
Laser-irradiated extraction wound healing showed characteristics different from those of the normal healing process, suggesting a favorable healing-promoting effect.
J Mass Dent Soc. 1999 Spring;48(1):8-13, 40.
Rapid healing of gingival incisions by the helium-neon diode laser.
Fifty-eight extraction patients had one of two gingival flap incisions lased with a 1.4 mw helium-neon (670 nm) diode laser for 30 seconds (fluence = 0.34 J/cm2). Healing rates were evaluated clinically and photographically. Sixty-nine percent of the irradiated incisions healed faster than the control incisions. No significant difference in healing was noted when patients were compared by age, gender, race, and anatomic location of the incision. This study concludes that helium-neon diode lasers, at the previously mentioned energy level, increase the rate of gingival wound healing in 69 percent of patients, without any side effects. For the last 30 years, low-power lasers in dentistry have appeared to stimulate healing rates and increase the rate of repair of injured tissue. Helium-neon and similar lasers emit light in the red (600-700 nm) spectrums and produce energy densities (fluences) below 20 Joules/cm2. They have been studied in a variety of animal tissue culture and human evaluations to determine their ability to increase the rates of wound healing by biostimulation. Over the last three decades, researchers have found that ruby and gas helium-neon (low-power laser radiation) have a biostimulatory effect on living tissue. Studies show that under specific conditions, red spectrum laser light speeds the healing of wounds. Photons from the red light lasers, which include ruby lasers (694 nm), helium-neon gas lasers (632 nm), and helium-neon diode lasers (650-670 nm), appear to stimulate rapid epithelialization and fibroblast (collagen) proliferation in animal and human tissue cultures. Low-power lasers have been reported to reduce post-extraction pain and swelling and to increase rates of wound healing (including scar formation, phagocytosis) in cell culture, animal, and human clinical studies. The new, compact, and inexpensive (under $50) helium-neon diode lasers have produced similar effects. These FDA Class IIIa lasers have no hazards associated with them, although one should avoid direct exposure to the eye for a prolonged period of time. In the past, many biostimulation studies using red spectrum lasers produced confusing data and conflicting results. Some studies reported that the biostimulation effect did not occur in all cases of laser irradiation, while other research reported that it did. Results seem to depend on the delivery of appropriate energy fluence levels (between 1 and 20 J/cm2) and the type of laser (wavelength) used. Several of these studies never described the levels of laser energy used to promote the described biostimulatory results. This caused controversy when determining whether or not helium-neon lasers influence wound healing. Studies suggest that low-power laser exposure can significantly increase the healing rate during the first few days of the healing process; however, studies do not show appreciable net benefit as compared to controls toward the end of a two-week wound repair cycle. The increased healing effect appears to be centered around the early, most sensitive stages of the healing process. Several studies showed optimum tissue healing rates at helium-neon laser exposure levels between 1 J/cm2 and 20 J/cm2. Laser-enhanced biostimulation has been reported to produce metabolic changes within the cells. This results in faster cell division, rapid matrix production (increased collagen, myofibroblasts, etc.), and cell movement. There have been few controlled studies using adequate numbers of human subjects in identifying the beneficial effects of helium-neon laser biostimulation. Ethical concerns, bulky equipment, and problems with biased study designs have frustrated a practical evaluation of laser biostimulation for general dental practice. A recently published “preliminary” study involving 52 patients was designed to reduce these issues. The purpose of this study is to complement the above research and to evaluate whether helium-neon diode laser radiation at average fluences of 0.34 J/c