Effect of Low-Level Laser Therapy on the Osseointegration of Immediately Loaded Implants with a Connective Tissue Graft: A Randomized Clinical Trial.

Introduction: This study assessed the effect of low-level laser therapy (LLLT) on the osseointegration of immediately loaded implants with a connective tissue graft (CTG). Methods: This clinical trial was conducted on patients with buccal bone dehiscence requiring dental implants. A CTG was harvested from the palate and placed in the labial side by considering the 2 mm distance between the implant thread and bone. Autogenous bone was harvested from the tuberosity, mixed with the allograft, and implanted at the site. After sufficient torquing of the implant, a customized abutment was fabricated and placed. The patients were randomly assigned to two groups (n=5) of intervention and control. The patients in the intervention group received LLLT with a 940 nm gallium-aluminum-arsenide laser while those in the control group received placebo irradiation. The primary implant stability was measured before the delivery of customized abutment while the secondary implant stability was measured after 12 weeks by Osstell® and reported as the implant stability quotient (ISQ). Results: No significant difference was found in secondary ISQ between the laser and control groups (P>0.05). In the intervention group, a significant difference was found between the primary and secondary ISQ in the buccolingual dimension (P<0.05) but not in the mesiodistal dimension (P>0.05). The two groups had no significant difference in gingival thickness or vertical bone gain (P>0.05). All implants were successful with no complications. Conclusion: LLLT had a significant positive efficacy for the enhancement of secondary stability of implants in the buccolingual dimension. CTG showed optimal efficacy for the treatment of buccal bone dehiscence.

The prophylactic effect of photobiomodulation therapy on pain perception due to infiltration injection: a randomized clinical trial.

OBJECTIVES: Fear of pain in dentistry especially the injection involved in most of the processes has always been an important issue preventing the patients from consulting a dentist at the right time. This study aims to evaluate the effect of photobiomodulation therapy on reduction of pain in infiltration injection. MATERIALS AND METHODS: This trial is a crossover study including 30 patients. The patients are divided into two groups (laser therapy in the first period and placebo effect in the next period or vice versa with split-mouth design) using the covariate adaptive randomization method. All the patients received bilateral maxillary canine anesthesia in two periods performed with an ICT injection device (amount of anesthesia solution loaded: 1.8 mL) at a speed of 1 mL/min and a temperature of the solution of 37 °C. In each period, patients received either a prophylactic dose of 940-nm laser (500 mW, 10 J/cm2) or its placebo effect before the injection. The degree of pain perception after each sort of treatment is evaluated by both SEM (Sound, Eye, Motor, and Pain) and VAS (Visual Analogue Scale) scales. RESULTS: According to analysis, all the patients scored a VAS scale under 3 in the period they received intervention. Also considering the SEM scale, most of the patients scored 0 in the intervention period. No adverse effect was reported during or after the process. CONCLUSIONS: The study showed a significant effect of photobiomodulation on reducing pain perception during infiltration injection. CLINICAL RELEVANCE: This method can be useful in order to lower the pain for the patients consulting a dentist and therefore facilitate consulting at early stages of the dental issues. TRIAL REGISTRATION: The registration number (date) of the clinical trial in a Primary Registry in the WHO Registry Network is IR.ARAKMU.REC.1398.248(13/03/2020). The related URL is https://en.irct.ir/trial/45362 .

Extraoral low-level laser therapy can decrease pain but not edema and trismus after surgical extraction of impacted mandibular third molars: a randomized, placebo-controlled clinical trial.

BACKGROUND: This study aimed to assess the effect of extraoral 940 nm low-level diode laser on pain, edema, and trismus following surgical extraction of impacted mandibular third molars. MATERIALS AND METHODS: This split-mouth, randomized, placebo-controlled clinical trial evaluated 25 patients with bilaterally impacted mandibular third molars. One side of the jaw was randomly assigned to the laser and the other side to the control group. The laser quadrant received 940 nm diode laser irradiation (0.5 W, 10 J/cm2, continuous-wave mode, 20 s) at three points in the master muscle in contact mode immediately after surgical extraction of third molar. The third molar in the placebo quadrant was extracted after 2 weeks by the same surgeon using the same standard approach. The pain score was measured at 2 and 7 days postoperatively using a visual analog scale (VAS). To assess trismus, the distance between the incisal edges of the upper and lower central incisors was measured in maximum opening. To assess edema, the distance between the tragus and chin point was measured before and immediately after surgery and after 2 and 7 days. Data were analyzed using t-test, ANOVA, and Bonferroni test. RESULTS: The mean pain score in the first 7 days was significantly lower in the laser group (P < 0.05). Edema and trismus were the same in both groups (P > 0.05). Number of analgesics taken was significantly lower in the laser group (P < 0.05). CONCLUSION: Single-session irradiation of 940 nm diode laser can effectively decrease pain following third molar extraction surgery. TRIAL REGISTRATION NUMBER: IRCT20141209020258N91 on 29/12/2018.

In Vitro Effect of a High-Intensity Laser on Candida albicans Colony Count.

Introduction: This study assessed the effect of a high-intensity laser on Candida albicans colony count. Methods: This in vitro, experimental study was conducted on standard-strain C. albicans (ATCC18804). Seventy-two samples with two different concentrations of C. albicans (104 cells/mL and 106 cells/mL) were randomly assigned to three groups of control, laser and nystatin. Each group included 12 samples from each concentration. In the nystatin group, 10 cc of nystatin suspension was added to the samples and mixed for 30-60 seconds. In the laser group, the Ga-Al-Ar diode laser with a 940-nm wavelength and 2-W power was irradiated to the samples with 0.4 mm tip diameter in non-contact mode (1-mm distance) at a speed of 1 mm/s. The suspensions in the three groups were cultured on the Sabouraud dextrose agar culture medium and incubated at 37°C for 24 hours. The number of C. albicans colonies was then counted and reported. The three groups were compared by ANOVA and Tukey's test (alpha=0.05). Results: In both concentrations, the mean colony count in the nystatin group was significantly lower than that in the control (P<0.05) and laser (P<0.05) groups. The mean colony count in the laser group was significantly lower than that in the control group (P<0.05). Conclusion: The high-intensity laser with a 940-nm wavelength and 2-W power in non-contact mode can significantly decrease the C. albicans colony count in vitro, but its effect is lower than that of nystatin.

Management of internal root resorption in the maxillary central incisor with fractured root using Biodentine.

Biodentine is desirable to successfully manage internal root resorption, and the MTA apical plug backfilled with thermoplasticized gutta-percha is suggested for the tooth with external apical root resorption.

Low-level laser therapy using laser diode 940 nm in the mandibular impacted third molar surgery: double-blind randomized clinical trial.

BACKGROUND: The effect of low-level laser therapy (LLLT) on pain mitigation following the third molar surgery is still controversial. The absence of a standard method for using laser among the studies is related to the types of sample selection, sample size, control, and LLLT parameters, which make pain mitigation following surgery more controversial. Therefore, this study aimed to determine the effect of LLLT on reducing pain, swelling, and trismus following the mandibular impacted third molar surgery. METHODS: This study was performed on 25 healthy subjects. After the surgery, amoxicillin 500 mg was prescribed every 8 h for a 7-day period besides oral Ibuprofen (Gelofen) 400 mg every 12 h for a 3-day period. The intraoral Laser diode 940 nm was applied immediately after suture on the tested side, while on the placebo side, a fiber tip was used with no laser radiation following surgery. Eventually, the pain score was evaluated by VAS index from the 1st to the 7th-day post-surgery and then analyzed by SPSS 24. RESULTS: The results indicate that the mean swelling and trismus before, during, 2 days after, and 7 days after the intervention did not differ significantly between the two studied groups. However, the results show that on the sixth and seventh days, the pain was significantly lower in the intervention group compared to the control group. CONCLUSIONS: The results suggest that although the pain, swelling, and trismus following surgery were lower on the radiated side, only pain was found to be significant on the radiated side (p < 0.05). The registration number of the clinical trial in a Primary Registry in the WHO Registry Network is IRCT20141209020258N110 and the date of retrospective registration is 04/05/2019. The related URL is https://www.irct.ir/trial/36321 .

Comparison the efficacy of herbal mouthwash with chlorhexidine on gingival index of intubated patients in Intensive Care Unit.

BACKGROUND: Intubated patients in Intensive Care Unit (ICU) are not able to take care of their mouth health, so they are at risk of bacterial colonization and dental plaques formation that can lead to systemic diseases such as pneumonia and gingivitis. AIMS: In randomized, double-blind clinical study, the efficacy of natural herbal mouthwash containing Salvadora persica ethanol extract and Aloe vera gel was compared with chlorhexidine on gingival index (GI) of intubated patients in ICU. MATERIALS AND METHODS: Seventy-six intubated patients (18-64 years old with mean age 40.35 ± 13.2) in ICU were admitted to this study. The patients were randomly divided into two groups: (1) Herbal mouthwash and (2) chlorhexidine solution. Before the intervention, the GIs was measured by modified GI device into two groups. The mouth was rinsed by mouthwashes every 2-3 h for 4 days. 2 h after the last intervention, GIs were determined. RESULTS: Along with mechanical methods, herbal mouthwash in reducing GI was statistically significant than that of chlorhexidine (P < 0.05). CONCLUSION: The results of this study introduce a new botanical extract mouthwash with dominant healing effects on GI (1.5 ± 0.6) higher than that of synthetic mouthwash, chlorhexidine (2.31 ± 0.73).

The effect of ovalbumin on orthodontic induced root resorption.

BACKGROUND: This randomized trial was undertaken to investigate the effect of experimentally induced allergy on orthodontic induced root resorption. MATERIALS AND METHODS: A total of 30 Wistar rats were divided randomly into test and control groups. Starting from the first 3 days, the rats in the test group were injected intra-peritoneally by 2 mg ovalbumin as allergen and 0.5 mg Alume as adjuvant. Afterward only allergen was injected once a week. The control group was injected by normal saline. After 21 days, Wistar immunoglobulin E was measured and peripheral matured eosinophil was counted. A total of 50 g nickel-titanium closed coil spring was ligated between right incisor and first molar. All animals were sacrificed after 14 days. The mesial root of the right and left first molar was dissected in a horizontal plane. The specimens were divided into four groups considering whether force and/or ovalbumin was applied or not. Root resorption was measured and compared among these groups. Repeated measures analysis of variance (ANOVA), and Bonferoni tests were used to analyze the data. The level of significance was determined at 0.05. RESULTS: In general, the differences were insignificant (P < 0.05). As the only exception, the group in which both ovalbumin and force were applied had significantly more root resorption than the group in which neither force nor ovalbumin was applied (P > 0.001). CONCLUSION: Allergy may increase the susceptibility to root resorption. Application of light force, periodical monitoring of root resorption and control of allergy are advisable.