Laser Lit Review Feb 2018

Laser Literature Review

Compiled by Dr Igor Cernavin, Prosthodontist, Honorary Senior Fellow University of Melbourne School of Medicine, Dentistry and Health Sciences, Director and Cofounder of the Asia Pacific Institute of Dental Education and Research (AIDER), Australian representative of World Federation of Laser Dentistry (WFLD)

Kara et al1 published an important paper on the effect of LLLT on isolated cancer cells. The abstract is reproduced in full.

Cell proliferation, 10.1111/cpr.12417 2017-Nov-20


OBJECTIVES: Low level laser therapy (LLLT), which stimulates natural biological processes in the application region, is frequently used in dental treatments. The aim of our study was to evaluate the effects of LLLT which could activate precancerous cells or increase existing cancerous tissue in case of clinically undetectable situations. MATERIALS AND METHODS: Saos-2 osteoblast-like osteosarcoma cells and A549 human lung carcinoma cells were used. Twenty-four hours after preparation of cell culture plates, laser irradiation was performed 1, 2 and 3 times according to the test groups using Nd:YAG laser with the power output 0.5, 1, 2 and 3W. Cell proliferation analysis was performed by MTT assay at the 24th hour following the last laser applications. RESULTS: Generally, it was observed that the proliferation rates increased as the number of applications increased, when compared to the controls, especially in those cases in which the irradiation was performed 2 or 3 times more. CONCLUSION: The findings of this study have led to the conclusion that LLLT increases cancer cell proliferation, depending on the power output level of the laser and the number of applications. In addition to the proliferation and mitotic activity of the cancer tissue cells, we concluded that LLLT, which is frequently used in dental practice, could activate precancerous cells or increase existing cancerous tissue.

Fabrice Baudot2 published an interesting article in the International Magazine of Laser Dentistry discussing the use of the Er:Yag laser and its advantages in the use of peri-implantitis treatment.

Papadimitriou and Almagout3 published an interesting article on the successful use of laser for the treatment of gingival hyperpigmentation.

Kurtzman G4 published an article showing that laser enhanced activation of endodontic irrigants allows for a more complete obturation of the root canal system.

Kouadio et al5 published a literature review of articles defining the conditions for improving the use of laser Doppler flowmetry (LDF) and to determine the limits for the use of this technique. Several points emerged from this review. The use of LDF involves specific constraints; however, the influence of different factors (temperature, tobacco, pressure etc.) must be adequately controlled when using LDF. LDF measurements of soft tissue within the oral cavity vary depending on the anatomical site. In dentistry, LDF can be used to track healing progress in periodontal surgery and to diagnose vascular flow changes in the connective tissue of mucosae covered by a removable prosthesis at an early stage prior to the onset of clinical inflammation signs.

Stein and coworkers6 investigated temperature increases in dental pulp resulting from laser-assisted debonding of ceramic brackets using a 445-nm diode laser. Their conclusion was that there is no risk to the vitality of dental pulp during laser-assisted debonding of ceramic brackets.

Hamid7 evaluated the effect of intraoral LLLT on postoperative pain after extraction of mandibular third molars and found that Intraoral 810 nm GaAlAs is effective in reducing postoperative pain when a dose of 32.86 J/cm2 is used.

Petrovic et al8 designed a clinical prospective study to evaluate microbiological, cytomorphometric and clinical efficacy of low-level laser therapy (LLLT) as an adjunct to periodontal therapy in the treatment of chronic periodontitis. Their conclusion was that Low-level laser therapy as an adjunct to periodontal therapy demonstrates short-term additional bacteriological, cytological and clinical benefits.

ALBalkhi and coworkers9 carried out an in vitro study to determine the efficiency of debonding porcelain laminate veneers by using several laser parameters and two different application modes of Er:YAG laser [contact (CM) and non-contact (NCM)]. They concluded that the Er:YAG laser is an effective tool in debonding PLVs.

Giannelli ey al10 examined treatment of severe periodontitis with a laser and light-emitting diode (LED) procedure adjunctive to scaling and root planning using a double-blind, randomized, single-center, split-mouth clinical trial. Their study confirmed the efficacy of combined phototherapy in adjunct to SRP which had emerged from previous clinical trials, extending its field of application to severe periodontitis.

Zeitouni and coworkers11 designed a study was to compare the erbium-doped yttrium aluminium garnet (Er:YAG) laser and conventional drilling techniques, by observing the effects on trabecular bone microarchitecture and the extent of thermal and mechanical damage.

They showed that with laser-mediated cutting, the marrow remains exposed to the margins of the cut, facilitating cellular infiltration and likely accelerating healing. However, with drilling, trabecular collapse and thermal damage is likely to delay healing by restricting the passage of cells to the site of injury and causing localized cell death.

Favia et al12 published a retrospective study was to describe the therapeutic approaches and outcomes of 131 lesions from 106 MRONJ patients using surgical and non surgical techniques. The abstract is reproduced in full.

Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect of antiresorptive (bisphosphonates and denosumab) and anti-angiogenic therapy used in the management of oncologic and, less frequently, osteoporotic patients. While there is good international agreement on the diagnostic and staging criteria of MRONJ and the cessation of antiresorptive/anti-angiogenic treatments, the gold standard of treatment is still controversial, in particular between non-surgical and surgical approaches. The former usually includes antiseptic mouth rinse, cyclic antibiotic therapy, low-level laser therapy and periodic dental checks; the latter consists of surgical necrotic bone removal. The purpose of this retrospective study was to describe the therapeutic approaches and outcomes of 131 lesions from 106 MRONJ patients treated at the Policlinic of Bari. Non-surgical treatments were chosen for 24 lesions that occurred in 21 patients who, due to comorbidities and/or the impossibili ty of stopping oncologic therapies, could not undergo surgical treatment. As to the outcome, all the surgically treated lesions (107) showed complete healing, with the exception of 13.5% of the lesions, all of which were stage III, which did not completely heal but showed reduction to stage I. The 24 non-surgically treated lesions never completely healed and, rather, generally remained stable. Only two cases exhibited a reduction in staging. Based on our observations, MRONJ occurring both in neoplastic and non-neoplastic patients benefits more from a surgical treatment approach, whenever deemed possible, as non-surgical treatments do not seem to allow complete healing of the lesions.


The WFLD meeting which was advertised as being held in BERLIN 14-18th of June 2018 has been altered to Aachen Oct 1-3 2018


1. Kara, C; Selamet, H; Gokmenoglu, C; Kara, N. Low level laser therapy induces increased viability and proliferation in isolated cancer cells. Cell proliferation, 10.1111/cpr.12417 2017-Nov-20.

2. Baudot F. Er:Yag laser for peri-implantitis treatment. Laser International Magazine of Laser Dentistry, Vol. 9 Issue 4/2017, pages 6-11.

3. Papadimitriou I; Almagout P. Treatment of gingival hyperpigmentation. . Laser International Magazine of Laser Dentistry, Vol. 9 Issue 4/2017, pages 20-24.

  1. Kurtzman G. Laser-enhanced endodontic treatment. . Laser International Magazine of Laser Dentistry, Vol. 9 Issue 4/2017, pages 26-28.

5. Kouadio, Ayepa Alain; Jordana, Fabienne; Koffi, N'goran Justin; Le Bars,

Pierre; Soueidan, Assem. The use of laser Doppler flowmetry to evaluate oral soft tissue blood flow in humans: A review. Archives of oral biology, 86 58-71; 10.1016/j.archoralbio.2017.11.009 2018-Feb.

6. Stein, Steffen; Wenzler, Johannes; Hellak, Andreas; Schauseil, Michael;

Korbmacher-Steiner, Heike; Braun, Andreas. Intrapulpal Temperature Increases Caused by 445-nm Diode Laser-Assisted Debonding of Self-Ligating Ceramic Brackets During Simulated Pulpal Fluid Circulation. Photomedicine and laser surgery, 10.1089/pho.2017.4356 2018-Jan-03.

7. Hamid. Low-level Laser Therapy on Postoperative Pain after Mandibular Third Molar Surgery. Annals of maxillofacial surgery, 7 (2):207-216; 10.4103/ams.ams_5_17 2017 Jul-Dec.

8. Petrovic, M S; Kannosh, I Y; Milasin, J M; Mihailovic, D S; Obradovic, R R; Bubanj, S R; Kesic, L G. Clinical, microbiological and cytomorphometric evaluation of low-level laser therapy as an adjunct to periodontal therapy in patients with chronic periodontitis. International journal of dental hygiene, 10.1111/idh.12328 2018-Jan-12.

9. ALBalkhi, Mohand; Swed, Eyad; Hamadah, Omar. Efficiency of Er:YAG laser in debonding of porcelain laminate veneers by contact and non-contact laser application modes (in vitro study). Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.], 10.1111/jerd.12361 2018-Jan-11.

10. Giannelli, Marco; Materassi, Fabrizio; Fossi, Tiziana; Lorenzini, Luca; Bani, Daniele

Treatment of severe periodontitis with a laser and light-emitting diode (LED) procedure adjunctive to scaling and root planing: a double-blind, randomized, single-center, split-mouth clinical trial investigating its efficacy and patient-reported outcomes at 1year. Lasers in medical science, 10.1007/s10103-018-2441-9 2018-Jan-18.

11. Zeitouni, Jihad; Clough, Bret; Zeitouni, Suzanne; Saleem, Mohammed; Al Aisami, Kenan; Gregory, Carl. The effects of the Er:YAG laser on trabecular bone micro-architecture: Comparison with conventional dental drilling by micro-computed tomographic and histological techniques. F1000Research, 6 1133; 10.12688/f1000research.12018.1 2017.

12. Favia, G; Tempesta, A; Limongelli, L; Crincoli, V; Maiorano, E. Medication-related osteonecrosis of the jaw: Surgical or non-surgical treatment? Oral diseases, 24 (1-2):238-242; 10.1111/odi.12764 2018-Mar.


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