Marina Stella Bello-Silva

Laser phototherapy in the treatment of periodontal disease. A review

Many studies in the literature address the effect of low-power lasers in the management of pathologies related to periodontal tissues. Due to the lack of standardized information and the absence of a consensus, this review presents the current status of laser phototherapy (LPT) in periodontics and discusses its benefits and limits in the treatment of periodontal disease. The literature was searched for reviews and original research articles relating to LPT and periodontal disease. The articles were selected using either electronic search engines or manual tracing of the references cited in key papers. The literature search retrieved references on wound and bone healing, analgesia, hypersensitivity, inflammatory process and antimicrobial photodynamic therapy. Each topic is individually addressed in this review. The current literature suggests that LPT is effective in modulating different periodontal disease aspects in vitro, in animals, and in simple clinical models. Further development of this therapy is now dependent on new clinical trials with more complex study designs.

Sealer penetration and marginal permeability after apicoectomy varying retrocavity preparation and retrofilling material

Apicoectomy failure is generally related to inappropriate marginal sealing of the retrocavity, which allows percolation of microorganisms and their products from root canal system to periapex. This study evaluated tubular penetration of canal sealers and marginal permeability after retrocavity irradiation with Er;Cr:YSGG laser and retrofilling with MTA or cyanoacrylate. Twenty-two single-rooted teeth were decoronated and endodontically treated, their apical 3 mm were resected and the root ends were retroprepared with a low-speed bur. Twenty roots were randomly assigned to 4 groups (n=5): GI and GII--retrofilling with MTA and cyanoacrylate, respectively; GIII and GIV--retrocavity irradiation with Er;Cr:YSGG laser (2.78 microm, 4 W, 20 Hz, 70.8 J/cm(2)) and retrofilling with MTA and cyanoacrylate, respectively. The remaining 2 roots served as positive and negative controls. The analysis of rhodamine B dye infiltration (p=0.05) demonstrated that laser irradiation and MTA retrofilling presented significantly higher permeability rates (p<0.05). Retrofilling with cyanoacrylate showed significantly lower permeability, either when laser was used or not on retrocavity. SEM analysis depicted more cyanoacrylate penetration through dentinal tubules when compared to MTA, suggesting a more efficient marginal sealing. Based on these results, it may be concluded that cyanoacrylate provided a less permeable retrofilling regardless of the retropreparation method, suggesting a more favorable condition to the establishment of the periapical healing.

Low- and High-Intensity Lasers in the Treatment of Herpes Simplex Virus 1 Infection

Herpes simplex virus (HSV) is one of the most common viral infections of the human being. Although most of the seropositive persons do not manifest symptoms, infected individuals may present recurrent infections, characterized by cold sores. HSV-1 infection can result in potentially harmful complications in some patients, especially in those with compromised immunity. We report a clinical case of a patient with severe oral HSV-1 infection in the lower lip. The treatment of the lesions with the association of high-intensity (erbium-doped yttrium aluminum garnet, 2.94 mum, 80 mJ/pulse, 2-4 Hz) and low-intensity (indium gallium aluminum phosphide, 660 nm, 3.8 J/cm(2), 10 mW) lasers has not been reported in the literature. During treatment, no systemic or topical medication was used. Pain sensitivity was completely gone after the first irradiation with the low-intensity laser. During the healing process, lesions were traumatized twice, on the days 4 and 7. Even though the lesions were completely healed within 10 days.

Laser treatment of recurrent herpes labialis: a literature review

Recurrent herpes labialis is a worldwide life-long oral health problem that remains unsolved. It affects approximately one third of the world population and causes frequent pain and discomfort episodes, as well as social restriction due to its compromise of esthetic features. In addition, the available antiviral drugs have not been successful in completely eliminating the virus and its recurrence. Currently, different kinds of laser treatment and different protocols have been proposed for the management of recurrent herpes labialis. Therefore, the aim of the present article was to review the literature regarding the effects of laser irradiation on recurrent herpes labialis and to identify the indications and most successful clinical protocols. The literature was searched with the aim of identifying the effects on healing time, pain relief, duration of viral shedding, viral inactivation, and interval of recurrence. According to the literature, none of the laser treatment modalities is able to completely eliminate the virus and its recurrence. However, laser phototherapy appears to strongly decrease pain and the interval of recurrences without causing any side effects. Photodynamic therapy can be helpful in reducing viral titer in the vesicle phase, and high-power lasers may be useful to drain vesicles. The main advantages of the laser treatment appear to be the absence of side effects and drug interactions, which are especially helpful for older and immunocompromised patients. Although these results indicate a potential beneficial use for lasers in the management of recurrent herpes labialis, they are based on limited published clinical trials and case reports. The literature still lacks double-blind controlled clinical trials verifying these effects and such trials should be the focus of future research.

Prevention of recurrent herpes labialis outbreaks through low-intensity laser therapy: a clinical protocol with 3-year follow-up

IntroductionThe recurrent herpes labialis (RHL) is a chronic lifelonginfection that affects a great part of the world’s population.It is caused by the herpes simplex virus type 1 (HSV 1) [1].The first virus contact causes the primary infection, whichis characterized by symptoms like multiple oral vesicles,fever, chills, fatigue, and muscle aches, lasting for 10 to14 days [2]. In general, primary infection is more severethan recurrences and is more commonly observed inchildren, teenagers, and young adults [3].After the primary infection and resolution of the lesions,the virus moves through the nerve endings and establishes alatent state at sensory ganglia, most commonly thetrigeminal ganglion. The exposition of the host to severalkinds of stress causes virus reactivation and migrationthrough sensory nerves to skin and mucosa, achieving thebasal epithelium of the lips and perioral area. Replication ofthe virus at these sites takes place and initiates a clinicalepisode of recurrent herpes labialis [4]. During theseepisodes, most of the clinical symptoms such as pain,redness, and swelling are consequences of the anti-inflammatory response generated by the immune systemof the host [5]. Thus, it is well known that patients withrecurrent herpes simplex infections have two concomitantmedical problems: virus multiplication and the overreactingimmune system [5].The virus reactivation may be triggered by fever, sunexposure, menstruation, psychological stress, or physicaltrauma. Afterwards, recurrent herpes labialis infection willmanifest clinically in different stages [6, 7]. The “coldsores” are the visible sign of RHL orofacial outbreaks andappear most frequently on the lips, at the juncture of themucous membrane, and perioral skin or inside the nose [8,9]. Up to 60% of the patients will experience a prodromicstage, after which the cold sores outbreaks develop through

Lasers in Esthetic Dentistry: Soft Tissue Photobiomodulation, Hard Tissue Decontamination, and Ceramics Conditioning

The increasing concern and the search for conservative dental treatments have resulted in the development of several new technologies. Low and high power lasers can be cited as one of these new technologies. Low power lasers act at cellular level leading to pain reduction, modulation of inflammation, and improvement of tissue healing. High power lasers act by increasing temperature and have the potential to promote microbial reduction and ablation of hard and soft tissues. The clinical application of both low and high power lasers requires specific knowledge concerning laser interaction with biological tissues, so that the correct irradiation protocol can be established. The present case report describes the clinical steps of two metal-ceramic crowns development in a 60-year-old patient. Three different laser wavelengths were applied throughout the treatment with different purposes: Nd:YAG laser (1,064 nm) for dentin decontamination, diode (660 nm) for soft tissue biomodulation, and Er:YAG laser (2,940 nm) for inner ceramic surface conditioning. Lasers were successfully applied in the present case report as coadjutant in the treatment. This coadjutant technology can be a potential tool to assist treatment to reach the final success.