Metin Güngörmüş

The Effect of Low-Level Laser Therapy on Trismus and Facial Swelling Following Surgical Extraction of a Lower Third Molar

OBJECTIVE The purpose of this study was to evaluate the effect of low-level laser therapy (LLLT) on postoperative trismus and edema after the removal of mandibular third molars. MATERIALS AND METHODS Thirty-two patients who were to undergo surgical removal of lower third molars were studied. Patients were randomly allocated to two groups, LLLT and placebo. Patients in the LLLT group received 12 J (4 J/cm(2)) low-level laser irradiation to the operative side intraorally 1 cm from the target tissue, and to the masseter muscle extraorally immediately after surgery. In the placebo group the handpiece was inserted into the operative side intraorally and was applied to the masseter muscle extraorally each for 1 min, but laser power was not activated. Inter-incisal opening and facial swelling were evaluated on postoperative days 2 and 7. Students t-test used to analyze the data. RESULTS It was determined that the trismus and the swelling in LLLT group were significantly less than in the placebo group on postoperative days 2 and 7. CONCLUSION Within the limitations of this study it can be concluded that LLLT can be beneficial for the reduction of postoperative trismus and swelling after third molar surgery.

Effect of biostimulation on wound healing in diabetic rats.

BACKGROUND AND OBJECTIVE Impaired wound healing is a complication of diabetes and is a serious problem in clinical practice. The purpose of this study was to evaluate the effect of biostimulation on wound healing in diabetic rats. MATERIAL AND METHODS Thirty-six female Wistar rats weighting 250 to 300 g were used for this study. Diabetes was chemically induced with streptozotocin. Eighteen nondiabetic and 18 diabetic rats were included in the analysis. One incision was performed on the dorsum of each nondiabetic rat and the wound served as a control. Two parallel incisions were performed on the dorsum of each diabetic rat. The laser treatments were started immediately after surgery and were repeated on the second, fourth, sixth, and eighth days. A GaAlAs laser was used with an 808 nm wavelength. One wound of each diabetic rat received 10 J/cm(2) laser stimulation. RESULTS Inflammation and re-epithelialization were evaluated in all groups, and there was a significant difference between the nondiabetic scalpel, diabetic scalpel, and diabetic scalpel + biostimulation groups. CONCLUSIONS Treatment with laser biostimulation showed a beneficial effect on wound healing in diabetic rats. It can be concluded that low-level laser therapy (808 nm laser at 10 J/cm(2)) can have a beneficial effect on diabetic wound healing, when used at 2 d intervals over 5 d.

Comparison of Alvogyl, SaliCept Patch, and Low-Level Laser Therapy in the Management of Alveolar Osteitis

PURPOSE The aim of the present randomized prospective clinical trial was to compare the effects of alvogyl, the SaliCept patch, and low-level laser therapy in the management of alveolar osteitis. PATIENTS AND METHODS The study population included 104 patients who had been referred to our clinic with a complaint of alveolar osteitis. The patients were randomly assigned to 1 of 4 groups: group 1, curettage and irrigation alone; group 2, curettage and irrigation followed by alvogyl applied directly to the socket; group 3, curettage and irrigation followed by a SaliCept patch applied directly to the socket; and group 4, curettage and irrigation followed by continuous-mode diode laser irradiation (808 nm, 100 mW, 60 seconds, 7.64 J/cm(2)). The treatment procedures were repeated after 3 days. The clinical signs and symptoms for each patient were recorded at diagnosis, at 3 days after the diagnosis, and at 7 days after the diagnosis. In addition, the pain intensity levels for each patient were recorded at diagnosis and daily for 7 days after the initial treatment. RESULTS No statistically significant differences in the management of alveolar osteitis were observed between groups 2 and 3. However, the management of alveolar osteitis was significantly better in group 4 than in the other 3 groups. CONCLUSION Within the limitations of the present study, it can be concluded that acemannan in the form of the SaliCept patch is an acceptable alternative to alvogyl as a dressing for the management of alveolar osteitis. However, low-level laser therapy treatment at 7.64 J/cm(2) (0.1 W × 60 seconds = 6 J) performed superiorly to both SaliCept and alvogyl in managing alveolar osteitis in our study population.

Effect of Biostimulation on Healing of Bone Defects in Diabetic Rats

BACKGROUND AND OBJECTIVE The aim of this study was to investigate the effects of biostimulation on healing of bone defects in diabetic rats. STUDY DESIGN/MATERIAL AND METHODS Twenty-eight Wistar rats weighting 250 to 300 g were used for this study. Diabetes was chemically induced with streptozotocin, and 14 nondiabetic and 14 diabetic rats were included in the study. The distal epiphysis of the right and left femurs of the diabetic rats were perforated with a surgical bone drill. This surgical procedure was performed on the left femurs of normal rats too. The wound on the right side of each diabetic rat received laser stimulation. The left femur of each nondiabetic (normal) rat served as a control. The rats were assigned to three experimental groups: (1) normal bur (control group); (2) diabetic bur; (3) diabetic bur + biostimulation. RESULTS There was a significant difference among all groups in substantia spongiosa formation on day 10. According to the Mann-Whitney U test, there was a difference between Groups 1 and 2. A significant difference was noted between Groups 2 and 3 as well as between Groups 1 and 3 and between Groups 2 and 3 in union at 20 d of healing. CONCLUSIONS Substantia spongiosa formation was slightly more evident in Groups 1 and 3 than in Group 2. Also, there was more union in Group 3 than in the other groups on day 20. As a result, it can be concluded that low-level laser therapy (808 nm laser at 10 J/cm(2)) can have a beneficial effect on spongiosa in diabetic bone repair when five treatments are administered with 2 d intervals between treatments.

The use of 808-nm light therapy to treat experimental chronic osteomyelitis induced in rats by methicillin-resistant Staphylococcus aureus.

BACKGROUND DATA In vivo and in vitro studies have reported that laser energy in differing wavelengths and irradiation regimes has a potential bactericidal effect on Staphylococcus aureus. OBJECTIVE The purpose of this study was to investigate whether a light wavelength of 808  nm in varying doses has an effect on chronic osteomyelitis induced experimentally in the rat tibia. METHODS Intramedullary cavities were surgically created in the left tibias of 39 adult Wistar albino rats. Five randomly selected subjects were injected with a sterile saline solution, and methicillin-resistant S. aureus (MRSA) was used to induce osteomyelitis in the remaining rats. After 3 weeks, rats with evidence of osteomyelitis were treated with debridement alone (n = 7), with debridement plus laser irradiation to induce photoeradication (n = 21), or were not treated at all [negative control, (n = 6)]. Active irradiation was performed using an 808  nm, 100  mW continuous-wave diode laser with a beam spot size of 0.7854  cm(2) (irradiance = 127.3  mW/cm(2)). Laser treatment commenced immediately after debridement surgery and was applied daily for 5 consecutive days. Irradiation lasted 60  secs (6  J at 7.64  J/cm(2): n = 7), 120  secs (12  J at 15.29  J/cm(2): n = 7), or 180  secs (18  J at 22.93  J/cm(2): n = 7). Rats in the sham and negative control groups were killed 21 days post-induction surgery, and those in the treatment groups were killed after 42 days. Following killing, tibias were removed and analyzed histopathologically, radiographically, and microbiologically. RESULTS Histopathological analysis showed that infection levels had decreased by 37%, 67%, 81%, and 93% in the groups treated by debridement or by debridement plus 7.64, 15.29, and 22.93  J/cm(2) light therapy, respectively, compared to the negative control group. Osteomyelitis-induced rats had the highest bacteria count (5 × 10(5)). Bacterial counts fell to 1.6 × 10(4), 4.3 × 10(2), 5.5 × 10(1), and 3.3 × 10(0) in groups treated by debridement or by debridement plus 7.64, 15.29, and 22.93  J/cm(2) light therapy, respectively, compared to the negative control group. CONCLUSIONS Within the limitations of this study, laser phototherapy with the appropriate irradiation parameters appears to be a promising adjunct and/or alternative technique to pharmacological agents in the treatment of osteomyelitis. The 808  nm 100  mW (127.3  mW/cm(2)) laser device used in this study achieved a maximum effect with an irradiation time of 180  secs, delivering 18  J at an energy density of 22.93  J/cm(2).

Comparison of diode laser and Er:YAG lasers in the treatment of ankyloglossia.

OBJECTIVES The purpose of this study was to compare the tolerance of lingual frenectomy with regard to a local anesthesia requirement and comparison of postsurgical discomfort experienced by patients operated on with both diode and erbium:yttrium-aluminium-garnet (Er:YAG) lasers. BACKGROUND Ankyloglossia, commonly known as tongue-tie, is a congenital oral anomaly characterized by a short lingual frenulum. A short lingual frenulum may contribute to feeding, speech, and mechanical tongue problems. METHODS Sixteen referred patients with tongue mobility complaints were included in this study. A GaAlAs laser device with a continuous wavelength of 808 nm was used in the diode group. Frenulums were incised by applying 2 W of laser power. The Er:YAG laser device with a continuous wavelength of 2940 nm was used in the Er:YAG group. Frenulums were incised by applying 1 W of laser power. The acceptability of the lingual frenectomy without local anesthesia and the degree of the postsurgical discomfort were evaluated. RESULTS Although the majority of patients (six) could be operated on without local anesthesia in the Er:YAG group, all patients could not be operated on without local anesthetic agent in the diode group. There were no differences between the two groups with regard to pain, chewing, and speaking on the first or seventh day after surgery, whereas patients had more pain in the Er:YAG group than in the diode group the first 3 h after surgery. CONCLUSIONS The results indicate that only the Er:YAG laser can be used for lingual frenectomy without local anesthesia, and there was no difference between the two groups regarding the degree of the postsurgical discomfort except in the first 3 h. In conclusion, these results indicate that the Er:YAG laser is more advantageous than the diode laser in minor soft-tissue surgery because it can be performed without local anesthesia and with only topical anesthesia.

The effect of low-level laser therapy on healing of skin incisions made using a diode laser in diabetic rats.

BACKGROUND AND OBJECTIVE To investigate the effect of low-level laser therapy (LLLT) on healing of skin incisions made using a diode laser in diabetic rats. MATERIAL AND METHODS Eighteen diabetic Wistar rats were used for this study. One incision was performed on the left side of the dorsum using a diode laser, and the other two incisions were made with a scalpel and diode laser on the right side of each rat. The wound on the left side of each rat received laser stimulation (10 J/cm(2)). The rats were assigned to three experimental groups. Group 1, scalpel (n = 18); Group 2, diode (n = 18); Group 3, diode + biostimulation (n = 18). RESULTS Reepithelialization was fastest in Group 2 than Group 1 at day 10. The difference between Groups 1 and 3 was also statistically significant in reepithelialization at day 10. There was a significant difference between Groups 1 and 2 and between Groups 2 and 3 in inflammation at day 10. There was no difference between any of the groups in inflammation and reepithelialization at day 20. CONCLUSIONS Scalpel incisions heal more slowly than diode and diode + biostimulation incisions in diabetic rats. We can suggest that diode + biostimulation may produce the least amount of tissue injury, with the fastest resolution of inflammatory response in diabetic rats. Diode laser incision (4 W) with 10-J/cm(2) LLLT seems to have a beneficial effect on skin incisions in diabetic rats.

Does Low-Level Laser Therapy Have an Antianesthetic Effect? A Review

Because local anesthetics are vasodilators, they tend to be absorbed into the bloodstream from the operative field as a result of the vasodilation of peripheral arterioles. To counteract this vasodilation, vasoconstrictive agents are often included in local anesthetic solutions to provide a longer duration of anesthesia. Low-level laser therapy (LLLT) has the same benefits, such as microcirculation activation and more-efficient tissue metabolism, analgesic effects, and vasodilatation. If LLLT is used to prevent pain postoperatively, improvements in local circulation and increased vasodilatation may increase the absorption of a local anesthetic agent. This may reduce the duration of the anesthesia, thereby allowing postoperative pain management to begin sooner. The maximal intensity of pain occurs during the first hours after surgery, when the local anesthetic has worn off. Theoretically, postoperative pain control can be increased with the use of a local anesthetic with a more-prolonged action. If a treatment method has both analgesic and antianesthetic effects, then the method may block its own effects. We review whether LLLT applied postoperatively to operated-on areas has an antianesthetic effect, that is, whether pain in the first hours after surgery was greater for patients who received LLLT than for control patients. Not too much evidence supports the antianesthetic effects of LLLT. However, additional experimental and clinical studies must be performed to investigate the effects of LLLT on the duration of anesthesia.

Er:YAG laser ablation of bone in experimental diabetics.

BACKGROUND AND OBJECTIVE The aim of this study was to compare bone healing in experimental diabetics after ostectomies obtained by Er:YAG laser and bur drilling. STUDY DESIGN/MATERIAL AND METHODS Twenty-eight Wistar rats weighing 250-300 g were used for this study. Diabetes was chemically induced with streptozotocin administered as a single intraperitoneal injection. Fourteen nondiabetic (normal) and 14 diabetic rats were included in the analysis. Left femur distal epiphysis of nondiabetic and diabetic rats was perforated with a surgical bone drill. Another defect with similar dimensions was created by an Er:YAG laser on the left femur of diabetic rats. An Er:YAG laser of 2940-nm wavelength with an energy density of 1.5 W was used. The rats were assigned to three experimental groups: normal bur group (control), diabetic bur group, and diabetic Er:YAG group. The rats were killed at 10 and 20 days to compare the bone healing of each group. RESULTS At 10 days of healing, the sum of histologic scores was higher in the normal bur group than in the diabetic bur and diabetic Er:YAG groups. In the present study, union, spongiosa, and bone marrow were evaluated, respectively, and there were no significant differences among the groups regarding the union and bone marrow (p > 0.05). Spongiosa bone formation was higher in the normal bur group than in the diabetic bur and diabetic Er:YAG groups (p = 0.011). There were no significant differences among the groups as to union, spongiosa, bone marrow, and sum of histologic scores (p > 0.05) at 20 days of healing. CONCLUSIONS Histologically, no difference was found between the Er:YAG and bur cavities in diabetic rats regarding bone healing. With these histological and experimental results, we believe that the 2940-nm Er:YAG laser (1.5 W) can be used confidently in the ablation of bones in diabetic cases.

The effect of a single dose of prednisolone on pain, trismus and swelling after removal of third mandibular molars

Abstract The purpose of this investigation was to study the effect of a single intramuscular dose of prednisolone on the postoperative pain, trismus and edema after the removal of third molars.Thirty patients who had to undergo surgical removal of lower third molars were studied. Patients were divided into two groups. In the first group, each patient was treated with 25 mg of prednisolone intramuscularly immediately after surgery, and in the second group a sterile saline solution was injected to patients (control group). Postoperative pain was evaluated by visual analogue scale (VAS) on the day of surgery. Facial swelling and trismus were evaluated 2 and 7 days after surgery. Students t-test was used to analyze the data.Statistical analysis of the data indicated a significant decrease in edema in the prednisolone group 2 days after surgery (p < 0.05). No significant difference was found 7 days after. Trismus did not differ significantly between the two groups. Swelling significantly improved 2 days after...