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Antimicrobial efficacy of photodynamic therapy on dental implant surfaces: A systematic review of in vitro studies
摘要： Background: To systematically review the literature regarding the antimicrobial effects of photodynamic therapy (PDT) on the multi-bacterial species and the possible surface alterations of the dental implants as a result of PDT. Methods: The addressed focused question was: “Does PDT show antimicrobial efficacy against multi-bacterial species colonization and result in surface alteration on dental implants?” Electronic databases including MEDLINE and EMBASE up to and including December 2018 were searched. Results: Seven studies were included. Two studies used a total of 110 titanium dental implants, while 1 study included a total of 72 zirconia dental implants. Three studies investigated the antimicrobial PDT effects on titanium discs, while 1 study used titanium plates with germanium prisms. All in-vitro studies used diode laser. Energy fluence was reported only in 2 studies. Power output and density were 100 milliwatts (mW) and 150 mW cm-2, respectively. All in-vitro studies reported the multibacterial species outcomes after the application of antimicrobial PDT. All studies showed a significant reduction in the bacterial load. Only two studies reported the outcomes of microstructural changes on the titanium surface, in which both studies did not report any significant alterations on the titanium implants or discs with the application of PDT. Conclusion: This systematic review demonstrated significant reduction in the bacterial load but inconclusive findings regarding structural alterations on the titanium surface with the use of PDT. The results of this review should be considered preliminary and further in-vitro studies with standardized laser parameters are needed to obtain strong conclusions.
关键词： systematic review,titanium surface,dental implants,photodynamic therapy,bacterial load
更新于2025-09-23 15:22:29
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A Systematic Review and Meta-Analysis of the Effects of Low-Level Laser Therapy in the Treatment of Diabetic Foot Ulcers
摘要： Diabetic foot ulcers (DFUs) are considered one of the most aggressive and expensive complications of diabetes. Low-level laser therapy (LLLT) has been highlighted as a potential modality of treatment to accelerate the healing of ulcers. This systematic review and meta-analysis aimed to investigate the efficacy of LLLT in the treatment of DFU and identify the LLLT application parameters recommended for the treatment of DFU over the past 10 years. A systematic search was conducted in PubMed, BVS, PEDro, Scopus, Web of Science, and CINAHL up to March 31, 2019. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines, randomized controlled trials (RCTs) that assessed the effect of LLLT on the treatment of DFU were included. Thirteen RCTs with a total of 361 participants were included in this review. Three RCTs reported a reduction in the percentage size of the ulcers and were included in the meta-analysis. The meta-analysis of the percentage size difference demonstrated a significant reduction in ulcer size in the LLLT group compared with controls (22.96 [95% confidence interval = 18.22-27.69; z = 9.51, P < .0001]). Treatment with 632.8 to 685 nm, 50 mW/cm2, 3 to 6 J/cm2, and irradiation for 30 to 80 seconds, 3 times weekly for a month is of benefit to patients with DFU. LLLT is effective and safe for the treatment of DFU. Additionally, well-designed, high-quality studies are needed to allow its ideal parameterization for clinical practice.
关键词： diabetic foot ulcer,meta-analysis,low-level laser therapy,systematic review
更新于2025-09-23 15:21:01
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Use of lasers seems to result in a small decrease in postoperative complications after labial frenectomy compared with scalpels
摘要： The authors conducted a systematic review (SR) to compare the postoperative complications after labial frenectomy (LF) with lasers and scalpels. The authors searched 5 electronic databases and the gray literature for randomized clinical trials addressing this question. The authors included 7 studies in which researchers enrolled a total of 397 participants who were followed up through 90 days. Meta-analysis showed that participants who received LF with a laser had pain scores, on average, 3.18 and 1.04 points lower than those who received LF with a scalpel at 1 and 7 days, respectively. Participants who received LF with a laser had discomfort during speech, on average, 2.15 and 1.60 points lower than those who received LF with a scalpel at 1 and 7 days, respectively. Participants who received LF with a laser had discomfort during chewing, on average, 2.90 and 1.56 points lower than those who received LF with a scalpel at 1 and 7 days, respectively. There were no statistical differences between the groups on the odds of consuming analgesics.
关键词： frenectomy,labial,Surgery,laser,postoperative complications,scalpel,frenulum,systematic review
更新于2025-09-23 15:19:57
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Laser therapy for recurrent aphthous stomatitis: an overview
摘要： Objectives To evaluate therapeutic effects of laser therapy on patients with recurrent aphthous stomatitis assessing evidences from previously published systematic reviews. Materials and methods An overview of systematic reviews was conducted based on PRISMA checklist. Search strategies were developed and adapted for six different electronic databases and a gray literature search was also performed. The methodology quality of the included systematic reviews was assessed by the Measurement Tool to Assess the Methodological Quality of Systematic Reviews 2 (AMSTAR 2). Results After a two-step selection, five systematic reviews were included. Methodology quality was considered as a high risk of bias in two systematic reviews, while in the other three were graded as moderate. The systematic reviews’ conclusions demonstrated that all included systematics reviews showed positive effects of laser therapy for pain relief, and most of them demonstrated healing improvement. A meta-analysis was not feasible due to heterogeneity in treatments parameters. Conclusions Evidence suggested that laser therapy is an effective tool to treat recurrent aphthous stomatitis; nevertheless, more randomized clinical trials should be conducted to compare different lasers parameters. Clinical relevance The present overview evaluated recent evidence about laser therapy for recurrent aphthous stomatitis management in order to contribute for evidence-based dentistry and decision-making. This overview suggests that laser therapy is a safe and promising alternative to treat recurrent aphthous stomatitis, since it promotes wound healing and pain relief.
关键词： Evidence-based medicine,Lasers,Oral medicine,Overview,Systematic review,Oral ulcer
更新于2025-09-16 10:30:52
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The laser of the future: reality and expectations about the new thulium fiber laser—a systematic review
摘要： The Holmium:yttrium-aluminum-garnet (Ho:YAG) laser has been the gold-standard for laser lithotripsy over the last 20 years. However, recent reports about a new prototype thulium fiber laser (TFL) lithotripter have revealed impressive levels of performance. We therefore decided to systematically review the reality and expectations for this new TFL technology. This review was registered in the PROSPERO registry (CRD42019128695). A PubMed search was performed for papers including specific terms relevant to this systematic review published between the years 2015 and 2019, including already accepted but not yet published papers. Additionally, the medical sections of ScienceDirect, Wiley, SpringerLink, Mary Ann Liebert publishers, and Google Scholar were also searched for peer-reviewed abstract presentations. All relevant studies and data identified in the bibliographic search were selected, categorized, and summarized. The authors adhered to PRISMA guidelines for this review. The TFL emits laser radiation at a wavelength of 1,940 nm, and has an optical penetration depth in water about four-times shorter than the Ho:YAG laser. This results in four-times lower stone ablation thresholds, as well as lower tissue ablation thresholds. As the TFL uses electronically-modulated laser diodes, it offers the most comprehensive and flexible range of laser parameters among laser lithotripters, with pulse frequencies up to 2,200 Hz, very low to very high pulse energies (0.005–6 J), short to very long-pulse durations (200 μs up to 12 ms), and a total power level up to 55 W. The stone ablation efficiency is up to four-times that of the Ho:YAG laser for similar laser parameters, with associated implications for speed and operating time. When using dusting settings, the TFL outperforms the Ho:YAG laser in dust quantity and quality, producing much finer particles. Retropulsion is also significantly reduced and sometimes even absent with the TFL. The TFL can use small laser fibers (as small as 50 μm core), with resulting advantages in irrigation, scope deflection, retropulsion reduction, and (in)direct effects on accessibility, visibility, efficiency, and surgical time, as well as offering future miniaturization possibilities. Similar to the Ho:YAG laser, the TFL can also be used for soft tissue applications such as prostate enucleation (ThuFLEP). The TFL machine itself is seven times smaller and eight times lighter than a high-power Ho:YAG laser system, and consumes nine times less energy. Maintenance is expected to be very low due to the durability of its components. The safety profile is also better in many aspects, i.e., for patients, instruments, and surgeons. The advantages of the TFL over the Ho:YAG laser are simply too extensive to be ignored. The TFL appears to be a real alternative to the Ho:YAG laser and become a true game-changer in laser lithotripsy. Due to its novelty, further studies are needed to broaden our understanding of the TFL, and comprehend the full implications and benefits of this new technology, as well its limitations.
关键词： laser,systematic review,Inventions,lithotripsy,urinary calculi,thulium
更新于2025-09-16 10:30:52
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High rate of clinical improvement of actinic cheilitis with laser, surgery, and chemotherapeutic agents in patients who have a favorable prognosis
摘要： This review does not in any way substitute for professional advice and should not be regarded as clinical guidance. As always, any evidence should be carefully considered by clinician and patient to ensure that in their views, all potentially desirable consequences outweigh all potentially undesirable consequences.
关键词： premalignant lesions,effectiveness,Pathology,actinic cheilitis,oral medicine,treatments,systematic review
更新于2025-09-12 10:27:22
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A systematic review of outcome reporting in laser treatments for dermatological diseases
摘要： The standardization of outcome reporting is crucial for interpretation and comparison of studies related to laser treatment of skin disorders. In collaboration with the Cochrane Skin-Core Outcome Set Initiative (CS-COUSIN), a procedure has been proposed to find consensus on the most important generic outcome domains (what to measure) for implementation in the international Laser TrEAtment in Dermatology (LEAD) registry. As the first step in the development of a generic outcome set for the LEAD registry, we undertook a systematic review to identify outcomes, outcome measurement instruments, methods and definitions reported in recently published literature of laser treatments for skin disorders. A systematic search was conducted and generated a total of 707 papers. We assessed 150 studies including all types of studies involving laser treatments for the skin. Two researchers independently extracted the type, definition and frequency of all outcomes and used outcome measurement instruments. We identified 105 verbatim outcomes that were categorized into eight domains recommended by the COMET framework: appearance, long-term effects, physician and patient-reported physical signs, satisfaction, health-related quality of life, psychological functioning and adverse events. Heterogeneity in outcome reporting (e.g. categories and outcome measurement instruments) was high, and definitions were insufficiently reported. There was a clear under representation of life impact domains, including satisfaction (23%) quality of life (3%) and psychological functioning (1%). Outcome reporting concerning laser treatments for the skin is heterogeneous. Standardized outcomes are needed for improving evidence synthesis. Results of this review will be used in the next step to reach consensus between stakeholders on the outcome domains to be implemented in the LEAD registry.
关键词： laser treatments,dermatological diseases,systematic review,LEAD registry,outcome reporting
更新于2025-09-11 14:15:04
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Laser treatment for onychomycosis
摘要： Background: Laser systems are a common treatment choice for onychomycosis. They exert their effects on inhibiting the growth of the fungus by selective photothermolysis but efficacy is dependent on the specific type of apparatus used. To systematically review the available published literature on the curative effects and safety of laser treatment for onychomycosis. Methods: Databases including PubMed, web of science, China National Knowledge Internet (CNKI), WanFang Database and VIP were searched systematically to identify relevant articles published up to July 2018. Potentially relevant articles were sourced, assessed against eligibility criteria by 2 researchers independently and data were extracted from included studies. A meta-analysis was performed using R software. Results: Thirty-five articles involving 1723 patients and 4278 infected nails were included. Meta-analysis of data extracted from these studies revealed that: the overall mycological cure rate was 63.0% (95%CI 0.53-0.73); the mycological cure rate associated with the 1064-nm Nd: YAG laser was 63.0% (95%CI 0.51-0.74); and that of CO2 lasers was 74.0% (95%CI 0.37-0.98). The published data indicate that laser treatment is relatively safe, but can cause tolerable pain and occasionally lead to bleeding after treatment. Conclusion: Laser treatment of onychomycosis is effective and safe. The cumulative cure rate of laser treatment was significantly higher for CO2 lasers than other types of laser. Laser practitioners should be made aware of potential adverse effects such as pain and bleeding.
关键词： onychomycosis,CO2 laser,single rate,systematic review,laser,Nd-YAG laser
更新于2025-09-11 14:15:04