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The Effect of 670-nm Low Laser Therapy on Herpes Simplex Type 1
Abstract
The purpose of this work was to study the effect of low-level laser therapy (LLLT) on the healing and relapse intervals in patients with recurrent labial herpes simplex infections.
Several pharmaceuticals are available to reduce symptoms and improbé healing of labial herpes, but only LLLT has been reported to significantly influence the length of the recurrence period. Material and methods: In an initial study, 232 patients with herpes simplex type 1 virus symptoms were consecutively selected for either LLLT or conventional therapy, including acyclovir cream or tablets. One of the dentists was responsible for the diagnosis, a second dentist for the treatment, and and a third for the evaluation, to allow for a semi-blinded procedure. Patients in the laser group received 670-nm laser irradiation, 40 mW, 1.6 J, 2.04 J/cm(2), 51 mW/cm(2) per blister in the prodromal stage and 4.8 J in the crust and secondarily infected stages, plus 1.2 J at the C2-C3 vertebrae. Patients were monitored daily during the first week to control healing, and monthly for 1 year to check on recurrence. In a consecutive study, 322 patients receiving LLLT were followed during 5 years to observe the period of ocurrences.
An obvious effect of LLLT was found for both initial healing and for the length of the recurrence periods.
LLLTof herpes simples virus 1 (HSV-1) appears to be an effective treatment modality without any observed side effects.
... We found 665 references, of which nine were included in the qualitative analyses (45,(50)(51)(52)(53)(54)(55)(56)(57). We excluded duplicates and articles that did not comply with the inclusion criteria (Figure 1). ...
... In five studies (50)(51)(52)55,57), the outcome evaluated was the healing time in days. In three studies (45,54,56), the outcome assessed was the recurrence of HSV-1. In the study of Schindl and Neumann 1999 (53), the outcome was the median healing time in weeks. ...
... Regarding the type of intervention, González, Hernández, and Estevez 2008 (45) (56), used laser therapy of 780 nm and the others three studies employed laser therapy of 1072 nm (50)(51)(52). Six studies compared the intervention with Acyclovir (45,51,(54)(55)(56)(57). Four studies used a placebo as a control group (50,52,53,55). ...
Objective: This systematic review aimed to determine the effectiveness of laser therapy as a treatment for herpes labialis. This review seeks to answer our research question: What is the effectiveness of laser therapy compared to Acyclovir for treating patients with HSV-1? We consider it important to find new alternatives to treating HSV-1 with the most minor adverse effects, so this question has been posed. Methods: The Cochrane, Lilacs, Ovid, Embase, Google Scholar, ClinicalTrials.gov, and Open Gray databases were searched for literature and gray literature. Clinical trials were retrieved and manually checked for inclusion. We carried out data extraction and the evaluation of the methodological quality of the included articles. An assessment of the certainty of the evidence was also performed. Results: The mean healing time in the placebo and acyclovir groups was longer, with healing in the laser therapy groups being faster. Otherwise, one study reported that individuals under acyclovir presented a higher recurrence risk than those submitted to laser therapy. One study reported a significantly smaller lesion size in the laser therapy group than in the acyclovir group. The certainty of the evidence was very low for the outcomes. No side effects have been reported with laser therapy. Conclusions: Laser therapy reported better results in the disappearance of symptoms and signs than conventional treatment. Although, we should cautiously interpret the findings due to the certainty of the evidence being very low for the outcomes.
... Thus, due to a closer relationship with accelerated wound healing, pain reduction and a possible stimulation of the patients' immune response, the use of low-level laser has gained prominence as a therapeutic option for these patients [4,[11][12][13][14][15]. However, although the low-level laser represents a promising alternative for the treatment of HSL, there is still no consensus on the standardization of its use and which wavelength or period of application is more effective for the treatment of this clinical condition [10,[15][16][17][18]. Thus, the objective of this systematic review is to answer the following research question: Is low-level laser therapy effective in the treatment of herpes labialis? ...
... All articles selected were prospective studies, 07 of which were randomized clinical trials and 01 clinical trial. The eight were submitted for evaluation of bias through RoB 2. Through the tool's criteria, it was observed that three articles had a high risk of bias [18,28,29], four articles had some concerns at risk of bias [15][16][17]27], and only one with a low risk of bias [30]. The complete data can be seen in Fig. 2. ...
... The selected studies worked together with a sample of 928 patients, 295 (31.8%) men, and 333 (35.9%) women and 300 not reported (32.3%). Two studies used oral acyclovir [18,27], and one of them used topical acyclovir [27], with a total of four studies using topical acyclovir [15,18,28,29]. Regarding the use of placebo laser in control groups, five of the 09 studies reported use. ...
The objective of this systematic review is to evaluate the effectiveness of low-level laser therapy in the treatment of herpes labialis. The searches were carried out independently by 2 researchers and the articles were selected through the electronic databases according to the inclusion and exclusion criteria previously established. Initially, 480 articles were found, of which 7 randomized clinical trials and 1 clinical trial were selected. In total, 928 patients were included. In the meta-analysis, the mean healing time for laser use was significant, showing a mean reduction of 1.37 [CI 95% = 0.92 to 1.82] days for tissue healing (p < 0.0001). In the meta-analysis to evaluate the time for crust formation, there was no significant difference between the groups and no significant reduction in the mean time for crust formation (p = 0.150). Only one of the selected studies had a low risk of bias. The use of low-level laser proved to be effective in the treatment of herpes labialis. However, due to the high risk of bias in the included studies, there is a need to carry out new standardized studies to prove the effectiveness of this therapy.
... High-power and low-power lasers were used for treatment of herpes labialis [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29], and in some of them, the results were similar or better than topical acyclovir [26,27]. ...
... This study compared the efficacy of low-level and highpower defocused lasers for treatment of herpes labialis. Since the efficacy of laser and pharmaceutical therapy (as the control group) has been previously compared for treatment of herpes labialis [16][17][18][19], we did not have a control group of acyclovir cream in this study. Dougal and Lee [16] used 1072-nm diode laser in comparison with placebo light therapy and reported that the time to recovery was shorter in laser group. ...
... Dougal and Lee [16] used 1072-nm diode laser in comparison with placebo light therapy and reported that the time to recovery was shorter in laser group. Simunovic [17] (compared photobiomulation (PBM) therapy with HeNe 632.8 nm, 2 J/cm 2 for 3-5 days with acyclovir), Sanchez et al. [18] (compared PBM therapy with 670 nm with acyclovir), and de Carvalho et al. [19] (compared laser phototherapy 780 nm, 60 mW, 3.0 J/cm 2 or 4.5 J/cm 2 in comparison with acyclovir cream) reported that laser had higher efficacy than antiviral pharmaceutical therapy for faster recovery, prevention of recurrence, and reduction of sizing the lesion. Moreover, Marotti et al. [20] reported two cases treatment with Er,Cr:YSGG laser (power output 0.75 W, a pulse duration of 140-200 ms, and a fixed repetition rate of 20 Hz, sapphire tip 600 mm, air-and-water spray was set at 10% and 15%, spot size at the tip was 0.0028 cm 2 ) and after 1 day a 660-nm wavelength diode laser (3.8 J/cm 2 per point, power output of 15 mW, and 0.15 J of energy per point, delivered in three points through the punctual technique, in contact for 4 sessions). ...
PurposeLaser therapy has been studied as a treatment for herpes labialis for some years. This study aimed to compare the efficacy of 660-nm low-level laser to defocused 810-nm high-power laser for treatment of herpes labialis.Methods
In this single-blinded clinical trial study, evaluated 32 patients with herpes labialis in prodromic and early vesicle phase (first 48 h) were divided into two same groups by inclusion-extrusion criteria consideration and ethic codes. For group A low-level 660-nm diode laser (6 J/cm2, 100 mW, 0 Hz, 60 s, near contact, focal point of laser unit was 1 cm2) and for group B high-power defocused 810-nm diode laser (2 W, CW, 300-µ fiber, at 0.5-cm distance, 60 s, screening method from the center toward outer for 1-cm2 area) were used. Pain score changes, time of pain relief, lesion size changes, time of clinical healing, recurrence rate within 6 months, and the recurrence interval were recorded. Data were analyzed using the t-test, Chi-square test, Mann–Whitney test, and ANOVA.ResultsThe pain intensity significantly decreased in both groups (P < 0.001) with no significant difference between them (P = 0.14). The time of pain relief was significantly shorter in group B (P = 0.003). The difference for the size of the lesion (P = 0.6) and time of clinical healing (P = 0.21) were not significant. The reduction in frequency of recurrence was not significantly different between the two groups (P = 0.55). The mean recurrence interval was significantly longer in group B (P = 0.002).Conclusion
Two treatment methods had similar effects, but the defocused 810-nm high-power laser had better efficacy for shorter time of pain relief and longer recurrence interval in treatment of herpes labialis in this study.
... The experimental group showed a significant reduction in healing time. Muñoz Sanchez et al. (7) conducted a study in 2012 in which they compared the effect of LLLT, 670 nm, on herpes labialis with acyclovir. They reported that LLLT was an effective therapy with no side effects. ...
... Acyclovir and penciclovir have a similar mechanism of antiviral action against HSV, as extensively reported in the literature (16,22,23) . The resistance of HSV to acyclovir can happen, and almost all resistance occurs as a result of adeficiency in thymidine kinase (7) . Nearly all clinical HSV isolated with resistance to acyclovir have been obtained from patients who have received prolonged acyclovir therapy (7,(24)(25)(26)(27) . ...
... The resistance of HSV to acyclovir can happen, and almost all resistance occurs as a result of adeficiency in thymidine kinase (7) . Nearly all clinical HSV isolated with resistance to acyclovir have been obtained from patients who have received prolonged acyclovir therapy (7,(24)(25)(26)(27) . Essential to a successful therapeutic intervention for RHL is an accurate anamnesis for assessment of the patient's overall health and the extent of clinical disease (20,28) . ...
Abstract 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 in comparison to the effect of acyclovir. The literature was searched with the aim of identifying the effects on healing time, pain relief, interval of recurrence. According to the literature, none of the laser treatment modalities is able to completely eliminate the lesion and its recurrence. However, laser phototherapy appears to strongly decrease pain and the interval of recurrences without causing any side effects.
... Other limitations of these drugs include their relatively short half-life, frequent topical use, risk of nephrotoxicity on systemic administration, and emergence of drugresistant HSV strains [6]. The use of low-level laser therapy (LLLT), also known as laser phototherapy, has been suggested as an alternative treatment modality for the management and prevention of RHL [6,9,10]. The principle of LLL is based on its analgesic, antiinflammatory, anti-infective, and bio-stimulating effects [11][12][13]; it stimulates fibroblast proliferation, tissue regeneration, immune response, and neovascularization [11]. ...
... Honarmand et al. [10] found that treatment with a diode laser reduced the length of recovery time and pain severity in RHL patients, which was significantly faster than treatment with acyclovir cream. Moreover, Sanchez et al. [9] reported a significant decrease in healing time and recurrence rate of RHL with laser compared with acyclovir cream. In contrast, de Carvalho et al. [14] did not find significant differences between laser and acyclovir in reducing pain and recurrence rate of RHL. ...
... An overview of the excluded studies and the reason for exclusion is shown in Table 1. Ultimately, six studies [9,10,14,[26][27][28] were included in the systematic review and processed for data extraction. ...
Recurrent herpes labialis (RHL) is a highly prevalent viral infection that affects the oro-facial region. Current treatment options have limited efficacy in reducing healing time and recurrence rate of the disease. Recently, low-level laser therapy has been proposed as a potential treatment alternative for the management of RHL with no side effects. This systematic review aims to evaluate the effectiveness of laser therapy in the management and prevention of RHL. A comprehensive search of Medline/PubMed, Scopus, and Web of Science was carried out to identify published clinical trials comparing laser intervention to active and/or non-active controls for the treatment of RHL. Due to marked heterogeneity of available data, studies were assessed qualitatively, and no statistical analysis was performed. Of the retrieved 227 articles, six clinical trials met the eligibility criteria. The wavelengths, the power output, and energy density ranged between 632.5–870 nm, 5–80 W, and 2.04–48 J/cm², respectively. All included studies found laser to be effective in the management and prevention of RHL, without any side effects. The findings of this review suggest that laser is potentially a safe and effective treatment alternative for the management of RHL. However, due to high variability in study designs and inconsistency in laser parameters among the included studies, more well-designed randomized clinical trials with standardized laser parameters are highly warranted.
... The experimental group showed a significant reduction in healing time. Muñoz Sanchez et al. (7) conducted a study in 2012 in which they compared the effect of LLLT, 670 nm, on herpes labialis with acyclovir. They reported that LLLT was an effective therapy with no side effects. ...
... Low level laser therapy has physiological effects such as anti-inflammatory, analgesic and healing-stimulating characteristics (6). Many studies have evaluated different wavelengths of low level laser on herpes labialis (7)(8)(9)(10). This study also aimed to evaluate the effect of diode laser on treatment of patients with herpes labialis compared with acyclovir. ...
Background
Recently alternative therapies such as the use of diode laser therapy have been introduced for recurrent herpes labial infection. The aim of this study was to evaluate the effectiveness of diode laser for treatment of recurrent herpes labialis.
Material and Methods
This was single-blind randomized clinical trial to evaluate the efficacy of diode laser for the treatment of recurrent herpes labial. In total, 60 patients whit recurrent herpes simplex labialis were selected and randomly divided in to three groups. 20 patients received treatment whit diode laser (at a wavelength of 870 nm, energy density 4.5 j/cm2), 20 patients were treated with acyclovir cream 5%, 20 patients received treatment with laser-off (placebo). The end point was lesions crusting. Data analyzed by Tukey HSD Test and One-way ANOVA (at a significance level of 0.05) in SPSS-20 software.
Results
The mean length of recovery time (day) in the laser, off laser, and acyclovir groups was 2.20±0.41, 4.30±1.03, and 3.4±1.142, respectively. There is a significant difference between three groups in this regard (P<0.0001). The mean duration of pain (day) was 1.35±0.74, 2.65±1.27, and 2.30±0.92 for laser, off laser, and acyclovir groups, respectively (P<0.0001).
Conclusions
Treatment with diode laser reduced the length of recovery time and pain severity faster than treatment with acyclovir cream.
Key words:Recurrent herpes labial, Acyclovir, Low level laser therapy.
... The weekly administration of LLLT over 8 weeks resulted in the resolution of pain during a 14month follow-up. LLLT has also been reported to be beneficial in treating recurrent herpes simplex infections, 16,17 possibly via the immune system rather than direct virus inactivation. Because LLLT appears to play a role in neuropathic pain relief, and indirect virus deactivation, we hypothesized that LLLT reduces PHN incidence during the early stage of herpes zoster. ...
... 26 Furthermore, it has also been reported as having an effect of indirect viral deactivation. 16,17 Because the increased cytokine levels in the acute phase of herpes zoster are assumed to be a potential mechanism for inducing PHN, the early suppression of these cytokines by LLLT may help prevent the development of PHN. It may also explain why early application may reduce the incidence of PHN but is less effective in the subacute group. ...
Background:
Postherpetic neuralgia (PHN) is difficult to treat, and currently there are no available treatments that effectively reduce its incidence. Low-level laser therapy (LLLT) has been proposed for indirect virus deactivation in treating recurrent herpes simplex infections.
Objective:
This study seeks to investigate whether LLLT could reduce the incidence of PHN.
Methods:
We retrospectively reviewed the incidence of PHN at the first, third, and sixth months after rash outbreak in 3 groups: the acute group of patients who received LLLT during the first 5 days; the subacute group of patients who received LLLT during days 6 to 14 of the eruption; and the control group of patients who did not receive LLLT.
Results:
There were 48, 48, and 154 patients in the acute, subacute, and control groups, respectively. After adjusting for confounding factors, including age, sex, and use of famciclovir, the incidence of PHN was significantly lower in the acute group versus the control group after 1 month (odds ratio [OR] 0.21, P = .006, 95% confidence interval [CI] 0.068-0.632), 3 months (OR 0.112, P = .038, 95% CI 0.014-0.886), and 6 months (OR 0.123, P = .021, 95% CI 0-0.606). The subacute group only had a lower incidence (OR 0.187, P = .032, 95% CI 0.041-0.865) after 3 months when compared with the control group.
Limitations:
This is a retrospective study lacking double-blind randomization, and the placebo effect may be a major concern. Lack of standardized and prospective evaluation measures is also a limitation of this study.
Conclusion:
Applying LLLT within the first 5 days of herpes zoster eruption significantly reduced the incidence of PHN. LLLT may have the potential to prevent PHN, but further well-designed randomized controlled trials are required.
... The current therapy includes the use of anti-viral drugs to control the recurrent occurrence, but they result temporarily. LLLT has been suggested for accelerated healing, reducing symptoms and influencing the length of the recurrence period [22][23][24]. The 2012 updated protocol included the use of a 670nm laser, setting the power at 51 mW/cm 2 daily applied for two weeks [24]. ...
... LLLT has been suggested for accelerated healing, reducing symptoms and influencing the length of the recurrence period [22][23][24]. The 2012 updated protocol included the use of a 670nm laser, setting the power at 51 mW/cm 2 daily applied for two weeks [24]. ...
Laser devices are powerful instruments and are fully integrated in a dentist’s life
working. They are mostly known for the thermal cutting properties, therapeutic lasers
find a wide application in the regenerative and adjuvant medicine. The aim of this
short review is to provide the definition of Laser Biostimulation, its last updates and
applications in dentistry. Employing the photochemical interactions, Laser Biostimulation
is widely used to improve the patient comfort, treatment and life quality. Among
clinicians, though, this topic can result confusing and not fully understandable. This is
because this kind of therapy is relative new and because the exact mechanism of
light-tissue interaction is not clarified yet. Even though more randomized clinical trials
are needed to verify the real benefit of Laser Biostimulation, understanding the
photochemical interactions is fundamental for a more conscious use of therapeutic
lasers in dentistry.
... Kada su u pitanju preventivni efekti laseroterapije, ona se može koristiti za vreme latentne faze kada nema prisutnih znakova infekcije, a povećanje intervala između pojave novog herpetičnog napada se povećava 23,24 . Dakle, laserska svetlost se koristi kako u prodromalnoj fazi da bi se smanjila ekstenzija lezija tako i u latentnoj fazi za povećanje intervala između dva recidiva. ...
... In fact, the subjects treated with the laser had significantly lower mean value of the pain as compared to subjects treated with aciclovir (p<0,05). When it comes to preventive effects of laser treatment, it can be used during the latent phase when there are no signs of infection, and the interval between the appearance of a new herpetic attack extends 23,24 . Therefore, laser light is used in prodromal stage in order to reduce the extension of lesions, as well as in the latent phase in order to increase the interval between two recurrences. ...
Introductio: Soft laser could be used for the treatment of different painful diseases and conditions in the oral cavity. One of them is Herpes labialis. The aim of the paper was to study the efficiency of soft laser in the treatment of Herpes labialis. Material and method: The study included 43 patients. Laser therapy was applied in 23 patients, whereas 20 patients were treated by Ung. Acycklovir. Results: The level of statistical significance of differences in mean values of pain between the groups was maximum (p <0.001). Patients with herpetic lesions benefit from laser therapy in terms of shortening the progression of the disease, pain, tingling and burning. The patients treated with laser had significantly lower mean value of the pain compared to those treated with Ung. Acyklovir (p <0.05). Conclusion: Based on the obtained results, it can be concluded that the soft laser proved to be an effective therapy in the treatment of Herpes labialis, and, therefore, is recommended in its treatment.
... Light therapy was utilized to treat a variety of illnesses, including pain and skeletal muscle diseases [27,28] , as well as ulcerous ailments [29] . Numerous research in dentistry have shown that LLLT is effective in treating a variety of oral disorders, including aphthous ulcers [30] , oral mucositis [31] , pathological states of the saliva [32] , and herpetic lesions [33], [34] . LLLT can decrease inflammation by lowering levels of PGE2 and inhibiting cyclooxygenase-2 in cell cultures, according to controlled laboratory research [35,36,37,38] . ...
... Despite this, their study did not yield any statistically significant results in reducing the recurrence of herpes labialis using PBMT. This contrasts with the findings of Muñoz Sanchez et al. [17], who applied photobiomodulation therapy to the C2-C3 vertebrae where the resident ganglion of the virus is reported to be located during the latent periods, in addition to daily irradiation of existing lesions until they heal. As well as in the study of Schindl et al. [18], who applied PBMT during the absence of lesions at the site of the original chronic herpes infection daily for 2 weeks. ...
This study is aimed at assessing the therapeutic efficacy of photobiomodulation therapy (PBMT) for the management of recurrent herpes labialis (RHL) by evaluating both pain and clinical recovery.
A randomized, double-blind, controlled trial was conducted on 40 patients with RHL, and they were randomly divided into two groups, where 20 patients received treatment with PBMT (650 nm, 100 mW, 4.7 J/cm2), continuous mode, for 120 s, and placebo cream, while another 20 patients (control group) were treated with acyclovir cream 5% (5 times/5 days) and passive laser. Pain was assessed at five different times. The day when the complete disappearance of the pain was observed and the day when the crust fell off spontaneously were also recorded.
The pain level in the control group was significantly higher than that in the PBMT group after the second application of the laser, while the differences were not significant between the two groups at other times. The pain in the PBMT group disappeared faster than that in the control group, but the difference was not significant in terms of clinical recovery.
Photobiomodulation therapy of herpes labialis reduced pain significantly faster than acyclovir, but there was no difference in healing time between the groups in light of the parameters used in this study.
PBMT is a promising treatment that may be an effective alternative to acyclovir in the management of recurrent herpes labialis.
Trial registration
isrctn.com ID: ISRCTN87606522.
... The key outcome was an extension of the intercurrent period for up to three years. 26 The continuous IR LILI procedure is less common. Nonetheless, good results have been demonstrated in the treatment of children with herpes simplex (wavelength 780 nm, power 70 mW, PD 62.5 mW/cm 2 , exposure 80 seconds on each of four lesions), 27 as well as in adults. ...
Introduction: Herpesvirus infection has a variety of clinical forms and is extremely widespread in the world while existing treatment methods are not always quite effective. The search for new treatment modalities is a relevant problem and numerous studies show the therapeutic effect of low level laser therapy (LLLT) on different herpesvirus types.
Methods: The mechanisms of laser light action and the impact of LLLT on the pathological pathways of herpes infections are described. A narrative review of the relevant papers is conducted.
Results: The reviewed studies confirm that LLLT is a potential prospective treatment method for patients infected with the herpes virus. However, it is necessary to improve the methodology and optimize the combination of laser action with antiviral medications.
Conclusion: The review shows that it is most effective to combine laser impact on skin lesions with the application of topical antiviral gels or creams, additionally using a combined procedure of laser ultraviolet blood illumination (LUVBI, 365-405 nm) + intravenous laser blood irradiation (ILBI, 525nm).
... According to a study conducted on HIV-1 infected and uninfected TZM-bl cells, laser irradiation did not show an inhibitory effect in uninfected cells, but triggered cell damage in infected cells in a dose-dependent manner [19]. Furthermore, the effect of low-energy red laser (670 nm) on Herpes Simplex Type 1 (HSV-1) revealed that LLLT appears to be an effective treatment against (HSV-1) without observed side effects [20] and is proposed to act in the final stage of HSV-1 replication by limiting viral spread from cell to cell with modulation of the host's immune response [21]. ...
HBV patients experience chronic oxidative stress, triggering mitochondrial dysfunction. Low-level laser therapy (LLLT) using a red diode laser has shown potential in clinical practice, yet its application as an adjuvant therapy for persistent HBV infection remains underexplored. This study investigates the impact of LLLT at various dosages on hepatoma cell lines, shedding light on its effects on HBV production.
In this study, the effects of LLLT irradiation on hepatoma cells were comprehensively examined, encompassing morphological, viability, and ultrastructural aspects, with a specific focus on HBV synthesis.
The results reveal a remarkable reduction in cell viability, proliferation, and HBV synthesis following LLLT irradiation in both HepG2.2.15 and HepG2 cell lines. Mitochondrial and nuclear membrane ultrastructural changes were also observed, indicating a dose-dependent, cell type-specific, and time-dependent effect of LLLT.
These findings suggest that LLLT holds promise as a therapeutic approach for HCC and HBV patients, with the potential to suppress cell proliferation, HBV production, and modulate critical cellular structures implicated in cell death.
... LLLT is a promising method for reducing herpes simplex infection and virus activation [41]. Schindl [43]. The medical efficacy of green light in producing depigmentation, brightening the skin tone, and decreasing melanin has been reported [39]. ...
Computer-aided diagnosis using dermoscopy images is a promising technique for improving the efficiency of facial skin disorder diagnosis and treatment. Hence, in this study, we propose a low-level laser therapy (LLLT) system with a deep neural network and medical internet of things (MIoT) assistance. The main contributions of this study are to (1) provide a comprehensive hardware and software design for an automatic phototherapy system, (2) propose a modified-U 2 Net deep learning model for facial dermatological disorder segmentation, and (3) develop a synthetic data generation process for the proposed models to address the issue of the limited and imbalanced dataset. Finally, a MIoT-assisted LLLT platform for remote healthcare monitoring and management is proposed. The trained U 2 -Net model achieved a better performance on untrained dataset than other recent models, with an average Accuracy of 97.5%, Jaccard index of 74.7%, and Dice coefficient of 80.6%. The experimental results demonstrated that our proposed LLLT system can accurately segment facial skin diseases and automatically apply for phototherapy. The integration of artificial intelligence and MIoT-based healthcare platforms is a significant step toward the development of medical assistant tools in the near future.
... Along these lines, a next study by Muñoz Sanchez et al revealed a lower number of recurrences in laser-treated RHL patients versus affected individuals submitted to conventional therapy after 1 year of therapeutic intervention. 29 This treatment also led to a decrease in the frequency of lesions. It must be noted one more time, however, that this study was designed to evaluate the potential efficacy of PBMT in treating such lesions, not in preventing them. ...
Objective: The present study aimed to evaluate the effectiveness of the application of photobiomodulation therapy (PBMT) in the prevention of recurrent herpes labialis (RHL) through a randomized controlled clinical trial. Background data: RHL is a lifelong infection that effects patients' quality of life. In the literature PBMT has shown positive results preventing RHL, decreasing recurrences and severity of lesions. Despite the good results reported, there are still few controlled clinical studies published on the subject. Methods: For this study, 158 volunteers were recruited and were randomly divided into three study groups: Laser 1-1 J/point (L1J): n = 61, Laser 2-2 J/point (L2J): n = 50, and placebo-0 J/point: n = 47. The treatment consisted of a protocol of 15 sessions throughout 6 months and 2 years of follow-up posttreatment. Results: The results showed that L1J presented the most satisfactory results concerning the reduction of the number of lesions per year and less severity of recurrences in the long-term evaluation when compared with L2J. Both Laser Groups (L1J and L2J) were statistically more efficient than placebo in all aspects analyzed. All patients who received laser treatment (L1J and L2J) and presented recurrences had significant improvement in frequency and/or severity of lesions. No patient had side effects from treatment. Conclusions: PBMT can be effective in the reduction of the frequency of recurrences of RHL and in the severity of postirradiation lesions that may appear.
... In our protocol we irradiated the lesion in a noncontact mode, Eduardo Cde et al. [13] used an activated laser tip to rupture the vesicles and eliminate the infective stage accelerating the healing time which can be another useful alternative in that stage. Muñoz et al. [17] in a clinical randomized study irradiate between C2 and C3 vertebrae with 1.2 J in each session in an attempt to inhibit viral reactivation, noticing lower relapse rates in the irradiated group. Nevertheless, the efficacy of this irradiation point is uncertain due to the low energy dose given and the absence of previous human studies to support its effectiveness, but it can be considered for future investigations. ...
Introduction: The present study aimed to describe parameters used with 808- to 980-nm wavelength
diode lasers for managing dentin hypersensitivity and analyze their results.
Methods: The inclusion criteria were based on randomized controlled clinical trials using diode
lasers at an 808-980 nm wavelength range in patients with dentine hypersensitivity with a minimum
of 1-month follow-up. An electronic search for articles on Medline, PubMed and Cochrane databases
was performed. The risk of bias was assessed with the Cochrane collaboration tool.
Results: Our electronic search resulted in 130 papers, of which 11 articles met the inclusion criteria.
A majority of the studies assessed dentine hypersensitivity using the Visual Analogue Scale, which
ranged between 2.3 and 8.8 before treatment and significantly reduced to a mean value of 0.45-3.7
after diode laser application. The power settings ranged between 1.5 mW and 3 W with an emission
mode of continuous wave, except for 2 authors who used chopped mode. The energy density varied
from 2.5 to 128 J/cm2
, and the exposure time was between 10 and 120 seconds. The authors applied
a minimum of 1 to 4 treatment sessions with a 2-day to 1-week interval between them. Most of
the studies mentioned the tooth surface as the treatment site but without describing the specific
irradiation points.
Conclusion: Despite the heterogeneity of the analyzed variables, a statistically significant
improvement in all laser groups was described. However, they cannot be compared homogenously.
... In our protocol we irradiated the lesion in a noncontact mode, Eduardo Cde et al. [13] used an activated laser tip to rupture the vesicles and eliminate the infective stage accelerating the healing time which can be another useful alternative in that stage. Muñoz et al. [17] in a clinical randomized study irradiate between C2 and C3 vertebrae with 1.2 J in each session in an attempt to inhibit viral reactivation, noticing lower relapse rates in the irradiated group. Nevertheless, the efficacy of this irradiation point is uncertain due to the low energy dose given and the absence of previous human studies to support its effectiveness, but it can be considered for future investigations. ...
Aims: Describe the use of the diode laser in the treatment of recurrent herpes labialis (RHL) to alleviate the symptoms, accelerate healing and delays recurrences. Presentation of Case: A female patient with a history of 3-4 episodes of RHL per year for the last 5 years was treated with a 940 nm diode laser. Two applications were done during 60 seconds covering the whole area. The Pain was significantly reduced with a complete healing after 7 days and no recurrences have been seen up to now. Discussion: Photobiomodulation has been proposed as a good alternative for this lesion despite the heterogeneity in the application protocols and parameters among the literature and its effects over the recurrent herpes labialis have been proved. Conclusion: The use of photobiomodulation can prevent recurrent relapses in this pathology and improve the quality of life of the patients.
... Honarmand et al. found that semiconductor laser treatment shortened the recovery time and relieved the pain severity of RHL patients [44]. Sanchez et al. found that compared with acyclovir cream and tablets, laser treatment has fewer side effects and prolongs the recurrence time [45]. Amira et al. conducted follow-up treatment on a young patient with recurrent mucous cysts and also found that the use of 980 nm diode laser treatment can significantly reduce the recurrence rate of mucous cysts. ...
Physical stimulation has been widely used in clinical medicine and healthcare due to its noninvasiveness. The main applications of physical stimulation in the oral cavity include laser, ultrasound, magnetic field, and vibration, which have photothermal, cavitation, magnetocaloric, and mechanical effects, respectively. In addition, the above four stimulations with their unique biological effects, which can play a role at the gene, protein, and cell levels, can provide new methods for the treatment and prevention of common oral diseases. These four physical stimulations have been used as important auxiliary treatment methods in the field of orthodontics, implants, periodontal, dental pulp, maxillofacial surgery, and oral mucosa. This paper systematically describes the application of physical stimulation as a therapeutic method in the field of stomatology to provide guidance for clinicians. In addition, some applications of physical stimulation in specific directions are still at the research stage, and the specific mechanism has not been fully elucidated. To encourage further research on the oral applications of physical stimulation, we elaborate the research results and development history of various physical stimuli in the field of oral health.
... Several studies reported that red (633 nm) light is effective for improving skin texture, reducing melanin levels, and healing inflammatory lesion [4,5]. Furthermore, 670-nm low-level laser therapy (LLLT) with 40 mW/cm 2 irradiation has been suggested as a new method to accelerate the healing process and reduce the spread of herpes simplex virus (HSV) infections [6,7]. Lee at al. investigated the clinical efficacy of blue light (415 ± 5 nm, 40 mW/cm 2 ) and red light (633 ± 6 nm, 80 mW/cm 2 ) combination to treat acne vulgaris [8]. ...
The biological effects of a light-emitting diode (LED) light therapy device are determined by irradiation parameters, mainly wavelength and power density. However, using a battery to provide power causes a problem in the variation of LED power density during battery discharge. As a result, maintaining a stable LED power density, along with extending battery life and operating time, are the primary concerns in designing a LED light therapy device. The present study aims to introduce a LED light therapy device design with different LED color power density control. A Fuzzy logic, based on the relationship between LED power density and operating time, was proposed to control constant power density in this design. The experimental results demonstrate that by using the designed controller, the LED light therapy device’s power3 density (40 mW/cm2, 50 mW/cm2, 60 mW/cm2 for red, blue, and green light, respectively) can be controlled. The newly designed LED light therapy device could be considered an advanced version with energy savings and stabilized LED power emitting property under a broad range voltage variation.
... LLLT has been used for pain relief stimulation of tissue regeneration and for the reduction of swelling and inflammation [18,19,20,21]. LLLT has also been successfully used to treat herpes simplex virus-1 (HSV-1) infections [22,23]. ...
Background
Human immunodeficiency virus (HIV) infection remains a global health challenge despite the use of antiretroviral therapy, which has led to a significant decline in the mortality rates. Owing to the unavailability of an effective treatment to completely eradicate the virus, researchers continue to explore new methods. Low level laser therapy (LLLT) has been widely used to treat different medical conditions and involves the exposure of cells or tissues to low levels of red and near infrared light. The study aimed to determine the effect of combining two unrelated therapies on HIV infection in TZM-bl cells.
Methods
In the current study, LLLT was combined with efavirenz, an HIV reverse transcriptase inhibitor to establish their impact on HIV infection in TZM-bl cells. Both the HIV infected and uninfected cells were laser irradiated using a wavelength of 640 nm with fluencies of 2-10 J/cm².
Results
The impact of HIV, efavirenz and irradiation were determined 24 hours post irradiation using biological assays. Luciferase assay results showed that the combination of LLLT and efavirenz significantly reduced HIV infection in cells, despite the undesirable effects observed in the cells as demonstrated by cell morphology, proliferation and cell integrity assay. Flow cytometry results demonstrated that cell death was mainly through necrosis while fluorescence microscopy showed the production of reactive oxygen species (ROS) in HIV infected cells.
Conclusion
Efavirenz and LLLT significantly reduced HIV infection in TZM-bl cells. Furthermore, the death of HIV infected cells was due to necrosis.
... Famciclovir is also proposed successfully but side effects like headache and nausea are connected with its use and data for its use in childhood and pregnancy are limited (Mubareka, 2010). Studies on HLLT and LLLT shows that these devices are effective for treatment of oral HSV but they are very few and overall case reports (Marotti, 2010;Ferreira, 2011;Muñoz Sanchez et al., 2012). Works on photodynamic therapy for oral HSV therapy demonstrates that this type of treatment is effective and safe (Marotti et al., 2009;Ramalho, 2015). ...
... Oral lichen planus (OLP), recurrent aphthous stomatitis (RAS), hyposalivation, pemphigus vulgaris (PV), bullous pemphigoid, recurrent herpes simplex, burning mouth syndrome (BMS), medicationrelated osteonecrosis of the jaws (MRONJ), bisphosphonaterelated osteonecrosis of the jaw (BRONJ), trigeminal neuralgia (TN), facial nerve paralysis, geographic tongue, and chronic sinusitis are some of the oral diseases, in which laser therapy has been studied as a therapeutic method. [1][2][3][4][5][6][7][8][9][10][11][12] The history of using light as a therapeutic approach (Helio, Chroma, or Phototherapy) dates back to the BC. Many people of ancient civilizations, including Egyptians and Hindus, have long been familiar with this method of treatment. ...
Objective:
To provide a review of the literature about the photobiomodulation therapy (PBMT) dental treatment protocols in oral medicine based on validated clinical studies that have been published so far.
Background data:
The lack of effective therapies for the treatment of various types of oral diseases or the presence of invasive therapeutic methods along with the use of a wide range of medications has had a significant impact on the quality of life of these patients. PBMT as a noninvasive and nondrug method can play an influential role in the treatment of oral diseases.
Methods:
In this study, published clinical studies up to April 2019 were reviewed from library sources, Google Scholar, PubMed and Medline, Elsevier, Embase, Cochrane, Scopus, and Web of science (ISI).
Results:
In general, the findings of this study showed that PBMT has had a positive effect on the treatment of oral lichen planus, recurrent aphthous stomatitis, hyposalivation, pemphigus vulgaris, recurrent herpes simplex, burning mouth syndrome, bisphosphonate-related osteonecrosis of the jaw, trigeminal neuralgia, facial nerve paralysis, geographic tongue, and chronic sinusitis.
Conclusions:
PBMT can be effective (as an alternative treatment or in combination with other therapies) in improving symptoms or in the complete treatment of oral diseases. However, further clinical studies are still necessary to achieve more robust results.
... According to them, the combination of monocaprin and low dose doxycycline offers an effective treatment for herpes labialis in both healing time and pain reduction. According to Munoz Sanchez et al. [36], 670nm low level laser therapy seemed to be an effective treatment without side effect for herpes labialis. Unfortunately, they did not perform a statistical analysis because of the large sample size, according to what they wrote. ...
This manuscript aims to highlight all the clinical features of the herpes virus, with a particular focus on oral manifestations and in the maxillofacial district about Herpes Simplex Virus-1 (HSV-1) and Herpes Simplex Virus-2 (HSV-2). Oral herpes virus is a very common and often debilitating infectious disease for patients, affecting oral health and having important psychological implications. The collection of relevant data comes from the scientific databases Pubmed, Embase; initially this collection obtained an extremely high number of results, 1415. After applying the inclusion and exclusion criteria, as well as a manual screening, the results included in this review were limited to 14. The results were expressed by evaluating all the signs and symptoms that this pathology entails during the study, paying attention to the characteristics linked to the quality of life and the psychological implications. This pathology has numerous therapies, which often make the healing phase of the manifestations of this viral pathology more comfortable. The therapies currently used for the treatment of this viral infection are pharmacological, topical, systemic, or instrumental, for example with laser devices.
... Endodoncia -Hipersensibilidad de dentina y pulpa -Reduce la sensibilidad térmica -Mejora la formación de dentina y pulpa dental -Promociona la mineralización de las células de hdp [9][10] Maxilofacial -Bifosfonatos relacionados con la osteonecrosis mandibular -Distracción mandibular -Avance mandibular -Desórdenes temporomandibulares -Trauma mandibular -Reduce el dolor, el edema, el pus y las fístulas, mejora la curación -Mejora la osificación del hueso trabeculado -Mejora la formación de hueso en la región condilar -Mejora la osteogénesis -Reduce el dolor -Mejora el rango del movimiento mandibular -Mejora la curación de hueso [11][12] Patología oral -Síndrome de la boca ardiente -Liquen plano -Mucositis oral -Xerostomía -Reduce los síntomas, disminuye el dolor -Reduce el tamaño de la lesión, disminuye el dolor -Tan eficaz como los corticoesteroides -Reduce la incidencia, duración y severidad -Regeneración de las células epiteliales de los conductos salivales -Mejora el flujo salival y las características antimicrobianas [13][14] Cirugía oral -Curación -Parestesia/nervio alveolar -Extracción del tercer molar -Mejora la curación después de la gingivectomía, reduciendo la inflamación gingival -Mejora la percepción sensorial mecánica -Reduce el dolor, la hinchazón y mejora el trismus [15][16] Ortodoncia -Dolor ortodóntico -Implantes de titanio -Movimiento dental -Reduce el dolor rápido remodelado -Mejora la curación -Mejora la osteointegración -Acelera el movimiento dental -Mejora la actividad de los osteoblastos y osteoclastos -Mejora el depósito de colágeno [17][18] Pediatría -Preparación de la cavidad -Distracción mandibular -Gingivitis -Reduce el dolor -Rápida curación [19][20] Periodoncia -Gingivitis crónica -Ligamento periodontal -Periodontitis -Reduce la inflamación -Mejora la curación -Aumento de la hialinización temprana -Mejora la profundidad de la bolsa -Disminuye la inflamación [21][22] Prostodoncia -Estomatitis protésica -Implantes -Reducción de las colonias de levadura inflamación palatina reducida -Formación ósea más rápida -Mejora resistencia entre hueso-implante -Mejora la osteointegración [23][24] Tabla 1. Mecanismos de acción y parámetros del lllt Fuente: [1] La acción del láser terapéutico depende de la intensidad y de las características relacionadas con el tejido a fotoestimular [25]. Moore et al. [26] evaluaron la eficacia del láser con diferentes longitudes de onda (625, 635, 645, 655, 665, 675 y 810 nm) en la proliferación de los fibroblastos y las células endoteliales en un periodo de 72 horas. ...
Introducción: El uso del láser terapéutico de baja intensidad (Low-level-laser therapy LLLT) ha traído consigo la evolución de los tratamientos antiinflamatorios, analgésicos y procicatrizantes debido a la fotoestimulación celular sobre la mitocondria, lo cual incrementa la generación de energía (ATP), acelerando la microcirculación sanguínea y produciendo cambios en la presión hidrostática del capilar. Presentación del caso: Este es el Reporte de Caso de un paciente de sexo femenino de 25 años de edad, que asiste al servicio de cirugía oral en las clínicas odontológicas de una entidad universitaria para la exodoncia de los terceros molares inferiores retenidos. Al examen radiográfico se observó el diente 48 asintomático en posición mesioangularsegún clasificación de Winter y Clase B II según clasificación Pell y Gregory. Método: La paciente recibió tratamiento con láser intensidad terapéutico post-exodoncia. Resultados: El efecto logrado con la aplicación de LLLT en el caso dio como resultado un control de dolor a las 48 horas, un efecto antiinflamatorio al tercer día y una regeneración tisular evidente al séptimo día. Conclusiones: La terapia de láser de baja podría ser una alternativa de control posquirúrgico en exodoncia de terceros molares incluidos que evitaría suministrar en algunos casos antiinflamatorios y analgésicos.
... We also found that this reduction in viral count was not due to the effect of ICG itself and it should be activated by laser to exert its antiviral effect. Many studies have used 660 nm laser with methylene blue photosensitizer and one study used 670 nm laser without photosensitizer for treatment of recurrent herpes labialis [32,[36][37][38][39][40]. ...
... However, there was no correlation between HSV-1 oral shedding and onset or worsening of xerostomia as well as no correlation with RT times either. A possible hypothesis for this lack of correlation with the degrees of xerostomia may be the control of the oral excretion of HSV-1 by the application of low-level laser, with similar results to the control of herpes labialis lesions [27][28][29][30][31][32][33]. ...
Background: Xerostomia is a very relevant and frequent complication of radiotherapy, causing the irradiated oral mucosa to be affected by bacterial, fungal and viral infections.
Objective: The objective of this study was to evaluate a possible relationship between oral shedding of human herpesviruses and xerostomia in patients with squamous cell carcinoma of head and neck submitted to radio/chemotherapy.
Methods: In this study, oral rinse samples were collected weekly from 20 patients during radiotherapy. The samples were submitted to PCR and enzymatic digestion for detection of human herpesviruses. Xerostomia was evaluated according to the Seminars in Radiation Oncology criteria.
Results: There was a higher frequency of grade 1 xerostomia (51.4%), observed first in the 1st week of radiotherapy. In the 4th week of radiotherapy, all patients presented some degree of xerostomia. Analysis of herpesviruses showed oral shedding of EBV, HHV-6 and HHV-7 in all weeks. Considering all the periods, the highest frequency was in patients with EBV excretion (55.0%), which was significantly higher than that of other viruses.
Conclusion: We observed that oral shedding of herpesviruses was not affected by xerostomia as there was a progression in their excretion, even with the evolution of xerostomia. This suggested that there is a local replication in the oral cavity that is not completely dependent of salivary excretion.
... Herpes simplex virus type 1 (HSV-1) is a nuclear replicating enveloped virus, usually acquired through direct contact with infected lesions or body fluids (typically saliva) (Arduino & Porter, 2008). It generally presents as a primary lesion, with periods of latency and a tendency to relapse (Munoz Sanchez, Capote Femenias, Diaz Tejeda, & Tuner, 2012). Initial oral HSV infection can be treated with topical, oral, or intravenous acyclovir (a synthetic acyclic purinenucleoside analogue). ...
This narrative review on the use of biophotonics therapies for management of oral diseases is written as a tribute to Prof. Crispian Scully. His seminal contributions to the field are highlighted by the detailed, comprehensive description of clinical presentations of oral diseases. This has enabled a more thorough, fundamental understanding of many of these pathologies by research from his group as well as inspired mechanistic investigations in many groups globally. In the same vein, a major emphasis of this narrative review is to focus on the evidence from human case reports rather than in vitro or in vivo animal studies that showcases the growing and broad impact of biophotonics therapies. The similarities and differences between two distinct forms of low-dose biophotonics treatments namely photodynamic therapy and photobiomodulation therapy are discussed. As evident in this review, a majority of these reports provide promising evidence for their clinical efficacy. However, a lack of adequate technical details, precise biological rationale, and limited outcome measures limits the current utility of these treatments. Future investigations should attempt to address these shortcomings and develop better designed, rigorous, controlled studies to fully harness the tremendous potential of low-dose biophotonics therapies.
... Famciclovir is also proposed successfully but side effects like headache and nausea are connected with its use and data for its use in childhood and pregnancy are limited (Mubareka, 2010). Studies on HLLT and LLLT shows that these devices are effective for treatment of oral HSV but they are very few and overall case reports (Marotti, 2010;Ferreira, 2011;Muñoz Sanchez et al., 2012). Works on photodynamic therapy for oral HSV therapy demonstrates that this type of treatment is effective and safe (Marotti et al., 2009;Ramalho, 2015). ...
ntroduction: Oral and perioral herpes simplex virus (HSV) infection is one of the most common oral so lation. Many topical and systemic therapies are reported to be effective in lesions treatment. Scientifc Literature reported many cases of recurrent herpes lesions successfully treated with photodynamic therapy (PDT). PDT is based on the interaction of a photosensitizer and light irradiation in oxygenated tissue. This combination leads to a related bacterial cell damage. Methylene blue (MB) and Toluidine blue are the most used photosensitizers. We want to propose a pilot study with 10 patients for the treatment of Herpes simplex infection with photodynamic therapy effected by a 630nm diode lamp and associated photosensitizer.
... We can also raise the possibility of controlling the HSV1 oral shedding by means of low-level laser therapy. The use of this therapy has proven to be effective in controlling of active infections of herpes labialis as well as in the control of HSV1 reactivation, thus preventing their recurrence [31][32][33][34][35][36][37]. For other herpesviruses, we found no scientific evidence to support the possible effectiveness of low-level laser therapy in controlling oral shedding. ...
Objective
Opportunistic infections may affect the oral mucosa of patients undergoing radio/chemotherapy through exacerbation of oral mucositis. The aim of this study is to evaluate the oral shedding of all eight human herpesviruses and its possible association with oral mucositis. Materials and methodsIn this prospective cohort study, we analyzed oral rinse samples, collected weekly, from 20 patients during radiotherapy treatment. Serologic status to HSV1 and HSV2, EBV, CMV, and VZV in three different periods was performed by ELISA assay. PCR and enzymatic digestion was performed to detect HSV1, HSV2, EBV, CMV, VZV, HHV6, HHV7, and HHV8. Oral mucositis was evaluated according to the WHO criteria. ResultsOral shedding of EBV, HHV6, and HHV7 was observed in all weeks of radiotherapy. Considering the episodes of shedding, the highest frequency was found in patients with EBV excretion (55.0%). No virus reactivation was observed by serological analysis. EBV oral shedding frequency was significantly higher than that of other viruses and showing a positive correlation with oral mucositis grade ≥2. Conclusions
There was a positive correlation between EBV oral shedding and oral mucositis grade ≥2, particularly after 3 weeks of radiotherapy, a period in which the severity of mucositis was statistically higher. These findings allow us to infer that the local inflammatory environment in mucositis grade ≥2 is more favorable for EBV replication. Clinical relevanceMucositis is a frequent and important side effect of radio/chemotherapy treatment. Understanding the possible participation of viruses in the mechanism of this condition is important to develop strategies for treatment and prevention.
... Medical interest in PBM has increased progressively in the last decade. In oral surgery in particular, PBM has shown promising results in accelerating the healing of oral ulcers, chemotherapy-and radiotherapy-induced mucositis, bisphosphonate-related osteonecrosis of the jaw, and oral lichen planus, as well as shortening the clinical course of herpes simplex [16,17,[30][31][32]. Furthermore, PBM is already used in clinical practice in dentistry, to reduce symptoms after a variety of procedures [33][34][35]. ...
The aim of the present study was to evaluate the effects of photobiomodulation (PBM) on cytokine levels and angiogenesis during oral wound healing. Ulcers were made on the dorsum of the tongue in 48 Wistar rats. Irradiation with an indium-gallium-aluminum-phosphide (InGaAlP) laser (660 nm; output power, 40 mW; spot size, 0.04 cm(2)) was performed once a day on two points of the ulcer for 14 days. Two different energy densities were used: 4 J/cm(2) (energy per point 0.16 J, total energy 0.32 J) and 20 J/cm(2) (energy per point 0.8 J, total energy 1.6 J). Tissue levels of interleukin (IL)-1β and tumor necrosis factor (TNF)-α were investigated by enzyme-linked immunosorbent assay (ELISA). Image analysis of CD31-immunostained sections was used to investigate microvessel density (MVD). PBM increased the tissue levels of IL-1β at the early stage of oral wound healing (p < 0.01) and increased the tissue levels of TNF-α during all stages of oral wound healing (p < 0.05). PBM at a dose of 4 J/cm(2) produced more significant results regarding cytokine modulation and was associated with higher MVD at day 5. Collectively, these findings indicate that cytokine modulation and increased angiogenesis are among the basic mechanisms whereby PBM improves oral wound repair.
... Nevertheless, the monthly recurrence rate was not statistically significant between the two groups, showing that LLLT was as good as topical acyclovir. In a 5-year followup study, Munoz Sanchez et al. (2012) reported that 322 patients receiving LLLT in the blister and the prodromal stage had obvious reduction in HSV-1 recurrent rate as compared to the pretreatment period. DeLand et al. (2007) evaluated the potential of LED in reducing acute radiation-induced dermatitis after lumpectomy. ...
Background
The secondary or recurrent herpetic infections (RHIs) are caused by herpes simplex virus (HSV) type-1 and type-2. low-power laser therapy 940 nm may consider one of the best and most optimistic and optional local therapeutic and biological options.
Objectives
To determine both molecular detection and viral load of HSV-1 and HSV-2 by real-time polymerase chain reaction (PCR) pre- and post-diode laser therapy 940 nm for evaluating the laser efficacy.
Materials and Methods
Thirty patients in age range 6–48 years have participated in this clinical trial study complaining from RHI. Sixty viral swabs were taken for those thirty participant patients including 30 swabs pre and 30 swabs post 3–5 days. Diode laser therapy 940 nm for biostimulation, real-time PCR for accurate detection of both HSV-1 and HSV-2.
Results
The results in this present study showed mean age range of RHI patients was 25.7 ± 12.1 years with a male ratio more than the female 1.5:1. Overall participants were infected with HSV type-1, whereas 3 (10%) of the participants were noninfected with HSV type-2. There was a significant increase in HSV type-1 PCR threshold cycle (Ct) mean of RHI patients after treatment with diode laser therapy 940 nm which means decreasing in the viral load.
Conclusions
The real-time PCR technique is a highly efficient, reliable, and rapid technique for accurate diagnosis and viral load measuring of HSV-1 and HSV-2. Low-power laser therapy is utilized to reduce pain levels, change the state of disease from pro-inflammatory to anti-inflammatory, and may reduce the viral load.
Photobiomodulation therapy (PBMT), formerly known as low-level laser therapy, is the targeted application of light for therapeutic purposes at a low level below that associated with damage to structural proteins. This may be a laser or a broader spectrum light source such as a light-emitting diode (LED), which may selectively achieve changes in subcellular, local, regional and centrally mediated systemic processes associated with healing, repair and the regeneration of tissues [1, 2]. In addition to the potential benefits of the promotion of an increase in cellular numbers by mitosis and a corresponding increase in the production of important matrix materials such as collagen and bone along with an enhanced vasculature, there can also be seen resolution of inflammation and the mitigation, up to inhibition of pain [3, 4]. Furthermore, therapeutic photonic conditioning of tissues as a prequel or synchronous to exposure to a noxious stimulus such as chemotherapy or radiotherapy can increase cellular stress resistance against apoptosis [5, 6]. Given the very wide range of possible applications, PBMT has excited considerable interest across a multitude of possible applications, as an adjunct to augment the normal procedures in clinical dentistry [7, 8]. Following over 50 years of research at the level of cellular, animal and more recently human clinical trials, there is a considerable published evidence base. To date the broader integration of this approach as a tool to assist the dental team to optimise a clinical intervention has been slow to be adopted. Given the extent of the current knowledge base which is rapidly expanding due to the heightened awareness of the potential value of this approach to enhanced healing and tissue management, it is inevitable that PBMT will in time become a standard evidence-based procedure in daily clinical practice. In this chapter we provide a contemporary overview of this important subject with a particular view to help guide the clinician with an interest in learning the processes involved to safely and successfully explore the potential merits of this approach to patient care.
Purpose:
Meibomian gland dysfunction (MGD) is the leading cause of dry eye syndrome. It is a frequent and underdiagnosed condition with a significant socioeconomic impact. We propose here the evaluation of a platform combining intense pulsed light and photo-biomodulation in the treatment of Meibomian gland dysfunction.
Methods:
We conducted a retrospective study at Brest University Hospital analyzing a cohort of 74 eyes (37 patients) at 1 month and 3 months after a protocol of 3 Eye-Light® (Espansione Group, Italy) sessions 14 days apart between January 2019 and April 2020. The primary outcome was the change in OSDI quality of life score. Secondary outcomes were the SPEED questionnaire score; tear break-up time (BUT), Oxford score, non-invasive break-up time (NIBUT), lipid layer thickness, lacrimal meniscus height and Meibomian gland atrophy rate. Tolerance of the treatment was also evaluated.
Results:
We found a significant improvement in OSDI scores at 1 month (-17.32; 95% CI (-25.84; -8.79), P<0.0001) and 3 months (-16.95; 95% CI (-25.26; -8.64), P<0.0001). The SPEED score, BUT, Oxford score, Meibomian gland atrophy and NIBUT were also statistically significantly improved. Tolerance to treatment was very good despite two cases of herpetic keratitis, which resolved on treatment.
Conclusion:
Treatment with the Eye-Light® in three sessions every two weeks significantly reduced symptoms and ocular surface damage in patients with MGD. This data suggests that the use of Eye-Light® may represent a good option for patients with MGD.
Photobiomodulation therapy (PBMT) employing laser light has been emerging as a safe strategy to challenge viruses. In this study the effect of blue and near‐infrared (NIR) laser light was assessed in an in vitro model of SARS‐CoV‐2 infection. PBMT at blue wavelength inhibited viral amplification when the virus was directly irradiated and then transferred to cell culture and when cells already infected were treated. The NIR wavelength resulted less efficacious showing a minor effect on the reduction of the viral load. The cells receiving the irradiated virus or directly irradiated rescued their viability to level comparable to not treated cells. Virion integrity and antigenicity were preserved after blue and NIR irradiation, suggesting that the PBMT antiviral effect was not correlated to viral lipidic envelope disruption. Our results suggested that PBMT can be considered a valid strategy to counteract SARS‐CoV‐2 infection, at least in vitro. This article is protected by copyright. All rights reserved.
A infecção pelo vírus do herpes simples tipo 1 (HSV-1) é considerada comum em todo o mundo e clinicamente manifesta sinais e sintomas na região oral. A história natural da doença compreende as fases de infecção primária, latência e infecção recorrente. O herpes labial é a manifestação clínica da infecção recorrente, caracterizada por pequenas e numerosas pápulas eritematosas e dolorosas, que constituem conglomerados de vesículas que se rompem e formam crostas. Entre as alternativas terapêuticas, estão os antivirais, terapias naturais e a laserterapia de baixa potência (TFBM). O presente estudo objtiva avaliar a eficácia da TFBM no tratamento de lesões de herpes labial, através de uma revisão integrativa da literatura. Foi realizada uma busca por artigos nas bases de dados eletrônicas MEDLINE via PubMed, LILACS via BVS, Web of Science e Cochrane Library publicados entre 2011 e 2021 que abordassem estudos de herpes labial com ensaios clínicos randomizados associando os descritores: “Low-intensity light therapy” OR “Photobiomodulation” OR “Laser” OR “Herpes Labialis”, sem restrição de idioma. Foram encontrados 60 estudos, dos quais, após a exclusão dos duplicados e dos que não atendiam aos critérios de inclusão, 5 foram selecionados para análise. Assim, a presente revisão destaca que a TFBM é um recurso terapêutico eficaz, reduzindo o tempo de cicatrização, a sintomatologia e a recorrência das lesões.
Introduction: Recurrent Herpes Labialis (RHL) is a common infection and occurs in 20 to 40% of the general population. Risk for transmission exists in dental treatments. There are several different treatments for it. The purpose of this study is a comparison between low-level Laser therapy (LLLT) and acyclovir cream for the treatment of it. Materials & Methods: This performed study was a semi-blind clinical trial in the Oral Medicine Department, Dental School, Islamic Azad University Isfahan Branch (Khorasgan) in the year 2015- 2016. 30 patients got divided into 2 similar groups. Patients in LLLT group, treated in 3 sessions every other day, received 660 nm laser irradiation,100mW,4 J/cm2, continuous, located at a distance of 1 mm from the lesion for 40 seconds. Patients in the medication group treated with 5% acyclovir cream five times a day. In both groups severity of pain and lesion size during treatment and healing time recorded. The collected data were analyzed using statistical tests including independent T-test and Repeated Measures ANOVA ( p value < 0.05). Results: The laser group had better statistically findings for the median time for pain relief (p value < 0.001), and the median time for healing (p value < 0.001), the median lesions size two days after treatment (p value = 0.03), and four days after treatment (p value = 0.003). Conclusion: According to data analysis, laser 660 nm is more effective in pain relief and lesions size reduction and healing time than topical acyclovir in patients with herpes labialis.
Diabetic foot ulcers (DFUs) incidence is increasing with the rising global prevalence of diabetes. In spite of following best practice standard of care, most DFU are slow to heal. Photobiomodulation (PBM), previously known as low-level laser therapy, has been shown to accelerate healing of acute or chronic wounds, and specifically diabetic foot ulcers. However, the frequent applications required, translates to frequent visits at the clinic which are difficult for patients with DFU. In the following case series, we present our preliminary experience with a recently approved (Health-Canada) consumer home-use PBM device as an adjuvant to standard treatment. Four male patients presented at the clinic (67-84 years old) with diabetic leg/foot ulcers. The PBM treatment (808nm, 250mW peak power, 15KHz, 5J/min, ray size 4.5×1.0cm2) was applied by the patients themselves at the clinic or at home. In the cases presented here all wounds closed within 1-3 weeks with no reported adverse events. Patients found routine easy to follow and painless, and in wounds that involved pain reported pain reduction after 1-3 treatments. Based on our previous experience with these patients self-applied PBM as an adjunct therapy, led to accelerated healing and rapid pain alleviation compared to standard care alone. In summary, hard-to-heal diabetic wounds are a burden for patients, caregivers, and costly for the healthcare system. These observations support the view that the home-use device can be easily integrated as an adjuvant treatment to standard care at the clinic or home and most importantly, encouraged patient’s involvement in his/her own care.
Objective: Perform systematic literature review on photobiomodulation (PBM) devices used at home for
nonesthetic applications. Background: Home-use PBM devices have been marketed for cosmetic and therapeutic purposes. This is the
first systematic literature review for nonesthetic applications.
Methods: A systematic literature search was conducted for PBM devices self-applied at home at least thrice a week. Two independent reviewers screened the articles and extracted the data. Treatment dosage appropriateness was compared to the World Association for Laser Therapy (WALT) recommendations. The efficacy was evaluated according to the relevant primary end-point for the specific indication.
Results: Eleven studies were suitable. Devices were applied for a range of indications, including pain, cognitive dysfunction, wound healing, diabetic macular edema, and postprocedural side effects, and were mostly based on near-infrared, pulsed light-emitting diodes with dosages within WALT recommendations. Regarding efficacy, studies reported mostly positive results. Conclusions: Home-use PBM devices appear to mediate effective, safe treatments in a variety of conditions
that require frequent applications. Conclusive evaluation of their efficacy requires additional, randomized controlled studies.
Objective:
Perform systematic literature review on photobiomodulation (PBM) devices used at home for nonesthetic applications.
Background:
Home-use PBM devices have been marketed for cosmetic and therapeutic purposes. This is the first systematic literature review for nonesthetic applications.
Methods:
A systematic literature search was conducted for PBM devices self-applied at home at least thrice a week. Two independent reviewers screened the articles and extracted the data. Treatment dosage appropriateness was compared to the World Association for Laser Therapy (WALT) recommendations. The efficacy was evaluated according to the relevant primary end-point for the specific indication.
Results:
Eleven studies were suitable. Devices were applied for a range of indications, including pain, cognitive dysfunction, wound healing, diabetic macular edema, and postprocedural side effects, and were mostly based on near-infrared, pulsed light-emitting diodes with dosages within WALT recommendations. Regarding efficacy, studies reported mostly positive results.
Conclusions:
Home-use PBM devices appear to mediate effective, safe treatments in a variety of conditions that require frequent applications. Conclusive evaluation of their efficacy requires additional, randomized controlled studies.
Low-level laser therapy (LLLT), nowadays also known as photobiomodulation, consists of the therapeutic use of monochromatic coherent (laser) or noncoherent (LED) light sources.
Due to its analgesic, anti-inflammatory, and biostimulating effects, low-level laser therapy (LLLT) has been widely used for oral disorders, such as oral lichen planus (OLP), xerostomia, recurrent aphthous stomatitis (RAS), herpes labialis, burning mouth syndrome (BMS), and oral mucositis (OM). The research team for the present study has reviewed the literature on the subject, with an emphasis on the applicability of LLLT in general and of its various clinical protocols for the management of those oral disorders. In lesions such as the ones occurring in OM, RAS, herpes labialis, and OLP, the course of wound healing and the pain have been shown to decrease, with a few, or most often, no adverse side effects. The literature shows that LLLT can also be effective in reducing symptoms in patients with BMS. For the treatment of hyposalivation and xerostomia, the use of LLLT has been described in the literature, but no consensus has resulted. Very few controlled clinical studies with well-established therapeutic protocols have occurred, except for OM, for which LLLT has been widely researched. Although information on the use of the laser for some lesions has already been consolidated, further research is needed, especially randomized, controlled clinical trials with long-term follow-up. Those studies will allow the safe use of LLLT, permitting the creation of care protocols for the management of oral disorders.
Besides extensive data about the effects of low-level laser therapy (LLLT) on different cell types, so far, these results were obtained from monolayer cell culture models, which have limitations in terms of cell morphology and phenotype expression. Therefore, for better in vitro evaluation of the effects of LLLT, this study was performed with a 3D cell culture model, where gingival fibroblasts were seeded in collagen matrix. Cells isolated from a healthy patient were seeded in wells of 24-well plates with culture medium (DMEM) supplemented with 10 % fetal bovine serum and collagen type I solution. After 5 days, a serum-free DMEM was added to the matrices with cells that were subjected or not to three consecutive irradiations of LLLT by means of the LaserTABLE diode device (780 nm, 25 mW) at 0.5, 1.5, and 3 J/cm(2). Twenty-four hours after the last irradiation, cell viability and morphology as well as gene expression of growth factors were assessed. Histological evaluation of matrices demonstrated uniform distribution and morphology of gingival fibroblasts within the collagen matrix. LLLT at 3 J/cm(2) increased gingival fibroblast viability. Enhanced gene expression of hCOL-I and hEGF was observed for 0.5 J/cm(2), while no significant changes were detected for the other irradiation densities tested. In conclusion, LLLT promoted biostimulation of gingival fibroblasts seeded in a 3D cell culture model, demonstrating that this model can be applied for phototherapy studies and that LLLT could penetrate the collagen matrix to increase cell functions related to tissue repair.
The therapeutic properties of the laser are threefold: analgesic, anti-inflammatory and regenerative. Analgesic mechanisms include not only free nerve endings, but also inhibitory controls in the medullar (gate control) and brainstem. The hypersensitivity of peripheral nociceptors is also reduced, contributing to multimodal anti-inflammatory action. Muscle relaxation induced by increased ATP production contributes to pain relief by removing tension and stimulation of trigger points. The regenerative action is a source of healing for epithelial, tendon and bony tissues.
Low Level Light (Laser) Therapy (LLLT) is the direct application of light to stimulate cell and tissue responses (photobiomodulation) to promote healing, reduce inflammation and induce analgesia. Studies have demonstrated its application and efficacy for the treatment of a range of injuries and diseases at many sites within the body. However, its application in dentistry and for oral disease treatment has been limited. This review aims to provide background information on LLLT which relates to its current application in medicine, its mechanism of action and delivery parameters, while considering its potential for dental and oral therapeutic applications.
Clinical Relevance: Low level light therapy has the potential to have substantial impact for the treatment and management of oral diseases and pain.
Background:
Herpes simplex labialis (HSL), also known as cold sores, is a common disease of the lips caused by the herpes simplex virus, which is found throughout the world. It presents as a painful vesicular eruption, forming unsightly crusts, which cause cosmetic disfigurement and psychosocial distress. There is no cure available, and it recurs periodically.
Objectives:
To assess the effects of interventions for the prevention of HSL in people of all ages.
Search methods:
We searched the following databases up to 19 May 2015: the Cochrane Skin Group Specialised Register, the Oral Health Group Specialised Register, CENTRAL in the Cochrane Library (Issue 4, 2015), MEDLINE (from 1946), EMBASE (from 1974), LILACS (from 1982), the China National Knowledge Infrastructure (CNKI) database, Airiti Library, and 5 trial registers. To identify further references to relevant randomised controlled trials, we scanned the bibliographies of included studies and published reviews, and we also contacted the original researchers of our included studies.
Selection criteria:
Randomised controlled trials (RCTs) of interventions for preventing HSL in immunocompetent people.
Data collection and analysis:
Two authors independently selected trials, extracted data, and assessed the risk of bias. A third author was available for resolving differences of opinion.
Main results:
This review included 32 RCTs, with a total of 2640 immunocompetent participants, covering 19 treatments. The quality of the body of evidence was low to moderate for most outcomes, but was very low for a few outcomes. Our primary outcomes were 'Incidence of HSL' and 'Adverse effects during use of the preventative intervention'.The evidence for short-term (≤ 1 month) use of oral aciclovir in preventing recurrent HSL was inconsistent across the doses used in the studies: 2 RCTs showed low quality evidence for a reduced recurrence of HSL with aciclovir 400 mg twice daily (risk ratio (RR) 0.26, 95% confidence interval (CI) 0.13 to 0.51; n = 177), while 1 RCT testing aciclovir 800 mg twice daily and 2 RCTs testing 200 mg 5 times daily found no similar preventive effects (RR 1.08, 95% CI 0.62 to 1.87; n = 237; moderate quality evidence and RR 0.46, 95% CI 0.20 to 1.07; n = 66; low quality evidence, respectively). The direction of intervention effect was unrelated to the risk of bias. The evidence from 1 RCT for the effect of short-term use of valaciclovir in reducing recurrence of HSL by clinical evaluation was uncertain (RR 0.55, 95% CI 0.23 to 1.28; n = 125; moderate quality evidence), as was the evidence from 1 RCT testing short-term use of famciclovir.Long-term (> 1 month) use of oral antiviral agents reduced the recurrence of HSL. There was low quality evidence from 1 RCT that long-term use of oral aciclovir reduced clinical recurrences (1.80 versus 0.85 episodes per participant per a 4-month period, P = 0.009) and virological recurrence (1.40 versus 0.40 episodes per participant per a 4-month period, P = 0.003). One RCT found long-term use of valaciclovir effective in reducing the incidence of HSL (with a decrease of 0.09 episodes per participant per month; n = 95). One RCT found that a long-term suppressive regimen of valaciclovir had a lower incidence of HSL than an episodic regimen of valciclovir (difference in means (MD) -0.10 episodes per participant per month, 95% CI -0.16 to -0.05; n = 120).These trials found no increase in adverse events associated with the use of oral antiviral agents (moderate quality evidence).There was no evidence to show that short-term use of topical antiviral agents prevented recurrent HSL. There was moderate quality evidence from 2 RCTs that topical aciclovir 5% cream probably has little effect on preventing recurrence of HSL (pooled RR 0.91, 95% CI 0.48 to 1.72; n = 271). There was moderate quality evidence from a single RCT that topical foscarnet 3% cream has little effect in preventing HSL (RR 1.08, 95% CI 0.82 to 1.40; n = 295).The efficacy of long-term use of topical aciclovir cream was uncertain. One RCT found significantly fewer research-diagnosed recurrences of HSL when on aciclovir cream treatment than on placebo (P < 0.05), but found no significant differences in the mean number of participant-reported recurrences between the 2 groups (P ≥ 0.05). One RCT found no preventive effect of topical application of 1,5-pentanediol gel for 26 weeks (P > 0.05). Another RCT found that the group who used 2-hydroxypropyl-β-cyclo dextrin 20% gel for 6 months had significantly more recurrences than the placebo group (P = 0.003).These studies found no increase in adverse events related to the use of topical antiviral agents.Two RCTs found that the application of sunscreen significantly prevented recurrent HSL induced by experimental ultraviolet light (pooled RR 0.07, 95% CI 0.01 to 0.33; n = 111), but another RCT found that sunscreen did not prevent HSL induced by sunlight (RR 1.13, 95% CI 0.25 to 5.06; n = 51). These RCTs did not report adverse events.There were very few data suggesting that thymopentin, low-level laser therapy, and hypnotherapy are effective in preventing recurrent HSL, with one to two RCTs for each intervention. We failed to find any evidence of efficacy for lysine, LongoVital® supplementation, gamma globulin, herpes simplex virus (HSV) type I subunit vaccine, and yellow fever vaccine in preventing HSL. There were no consistent data supporting the efficacy of levamisole and interferon, which were also associated with an increased risk of adverse effects such as fever.
Authors' conclusions:
The current evidence demonstrates that long-term use of oral antiviral agents can prevent HSL, but the clinical benefit is small. We did not find evidence of an increased risk of adverse events. On the other hand, the evidence on topical antiviral agents and other interventions either showed no efficacy or could not confirm their efficacy in preventing HSL.
Inflammation of many different aetiologies is a condition affecting almost 100% of all patients presenting at dental clinics, and the complete management of inflammation is often extremely important before any orthodontic surgery can be carried out. The lymphatic system is one of the body´s main lines of defence against inflammation, with the lymph nodes playing an extremely major role. laser therapy, or LLLT, has become much more common indental offices, and isassociated with pain attenuation, wound healing and anti-inflammatory properties. The last of these is mediated amongst others by the effect of LLLT on the lymphatic system, which has been shown to enhance lymphatic drainage concomitantly with increasing local blood flow to the treated area. Infected areas and those with viral contamination have been suggested as contraindications for laser therapy. The possibility of treating these difficult-to-manage entities through laser therapy-accelerated drainage of the affected lymphatics offers anotherapproach. Although lymphatic drainageisfrequently usedinthe clinical setting, its application in dentistry is less common than it should be. An illustrated review of the lymphatic system of the head and neck is presented, with relevance to the use of infrared diode laser therapy ininducing lymphatic drainage in the management of inflammation associated with acute infectious processes such as pericoronitis, endodontic abscesses, alveolitis and herpes. A case report is presented illustrating the success of this therapeutic approach for labial herpes simplex. Infrared diode laser therapy-mediated lymphatic drainage offers an interesting and efficacious approach in the management of infectious and contaminated areas, without actually irradiating the areas themselves. © 2005, International Phototherapy Association. All rights reserved.
Alternative treatment for recurrent labial infection by herpes simplex virus (HSV) have been considered. The aim of this study
was to evaluate the effectiveness of laser phototherapy in prevention and reduction of severity of labial manifestations of
herpes labialis virus. Seventy-one patients, divided into experimental (n = 41) and control (n = 30) groups were followed up for 16months. Patients in the control group were treated topically with aciclovir and patients
in the experimental group were subjected to laser phototherapy (one session per week, 10weeks): 780nm, 60mW, 3.0J/cm2 or 4.5J/cm2 on healthy (no HSV-1 infection) and affected (with HSV-1 infection) tissues. Patients in the experimental group presented
a significant decrease in dimension of herpes labialis lesions (P = 0.013) and inflammatory edema (P = 0.031). The reduction in pain level (P = 0.051) and monthly recurrences (P = 0.076) did not reach statistical significance. This study represents an in vivo indication that this treatment should be
further considered as an effective alternative to therapeutic regimens for herpes labialis lesions.
KeywordsLow intensity laser-Herpes labialis-Prevention
Herpes labialis are the most frequent clinical manifestations of HSV-1 infection. Epithelial cells are able to respond to HSV-1 presence inducing the expression of IL-6, IL-1, TNF-α and IL-8. These proinflammatory cytokines have a function in the acute-phase response mediation, chemotaxis, inflammatory cell activation and antigen-presenting cells. In the human epithelial cell models, it has been demonstrated that, after an early induction of proinflammatory host response, HSV-1 down-modulates the proinflammatory cytokine production through the accumulation of two viral proteins, ICP4 and ICP27, whose transcription is induced by tegument protein VP16. These viral proteins, through the decreasing of stabilizing the mRNAs of proinflammatory genes, delay cytokine production to an extent that allows the virus to replicate. Moreover, viral transactivating proteins, ICP-0 and VP-16 induce IL-10 expression. The conventional treatment of herpes labialis involves the topical and systemic use of antiviral drugs but it is necessary to find new therapies that can act in a selective and non-cytotoxic manner in viral infection. Laser diode therapy has been considered as a non-invasive alternative treatment to the conventional treatment of herpes labialis in pain therapy, in modulation of inflammation and in wound healing. This study aims to report a possible mechanism of action of laser diode irradiation in prevention and reduction of severity of labial manifestations of herpes labialis virus. We investigated, in an in vitro model of epithelial cells HaCat, the laser-effect on HSV-1 replication and we evaluated the modulation of expression of certain proinflammatory cytokines (TNF-α, IL-1β and IL-6), antimicrobial peptide HBD2, chemokine IL-8 and the immunosuppressive cytokine, IL-10. Our results lead us to hypothesize that LD-irradiation acts in the final stage of HSV-1 replication by limiting viral spread from cell to cell and that laser therapy acts also on the host immune response unblocking the suppression of proinflammatory mediators induced by accumulation of progeny virus in infected epithelial cells.
Laser phototherapy has been widely used to relieve pain for more than 30 years, but its efficacy remains controversial. To ascertain the overall effect of phototherapy on pain, we aggregated the literature and subjected the studies to statistical meta-analysis.
Relevant original studies were gathered from every available source and coded. Articles that met preestablished inclusion criteria were subjected to statistical meta-analysis, using Cohen's d statistic to determine treatment effect sizes.
Fifty-two effect sizes were computed from the 22 articles that met the inclusion criteria. The resulting overall mean effect size was highly significant; d = +0.84 (95% confidence interval = 0.44-1.23). The effect size remained significant even when a high outlying d value was conservatively excluded from the analysis; d = +0.66 (95% confidence interval = 0.46-0.86). The fail-safe number associated with the overall treatment effect, that is, the number of additional studies in which phototherapy has negative or no effect on pain needed to negate the overall large effect size of +0.84, was 348.
These findings warrant the conclusion that laser phototherapy effectively relieves pain of various etiologies; making it a valuable addition to contemporary pain management armamentarium.
There are substantial difficulties involved in carrying out clinical studies of recurrent herpes labialis, since the disease has a rapid onset, short-lasting viral shedding period and is rapidly self-healing. The aim of this paper was to critically assess published reports of episodic treatment of herpes labialis and to review biological and methodological problems involved in such studies. Limited, but statistically significant, results have been shown with topical antivirals, such as acyclovir and penciclovir, improving healing times by approximately 10%. Orally administrated antivirals, such as valaciclovir and famciclovir, have subsequently found clinical use. However, these two oral medications have different profiles in phase 3 studies. Famciclovir showed additional improvement of efficacy in terms of lesion healing time, but no effect on prevention of ulcerative lesions, while valaciclovir appeared to have similar efficacy to that of acyclovir cream on lesion healing, but some additional efficacy with respect to prevention of ulcerative lesions. A formulation of acyclovir/hydrocortisone showed further improvement in prevention of ulcerative lesions, while retaining efficacy with respect to lesion healing.
The aim of this study was to report the treatment of recurrent herpes labialis (RHL) using a high-intensity laser or methylene blue (MB)-mediated photodynamic therapy (PDT) in combination with low-level laser therapy (LLLT).
Four clinical cases of patients diagnosed with RHL are described in this report. Two patients were subjected to high-intensity laser therapy (HILT) followed by LLLT, and two patients received MB-mediated PDT, again followed by LLLT. LLLT was conducted at 24, 48, 72 h, and 7 d after HILT or PDT. Patients were followed up after 6 mo.
Throughout the follow-up period, all patients reported pain relief and did not show any signs or symptoms of RHL. A favorable healing process was observed in all cases. None of the patients reported pain as a consequence of the treatment.
These results suggest that HILT and MB-mediated PDT, in combination with LLLT, may constitute a benefit when treating vesicles in RHL.
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.
O uso do laser de baixa intensidade na supressão de infecções pelos vírus Herpes simplex 1 e 2 foi avaliado após uma a cinco aplicações, sendo observada uma redução gradual na replicação dos vírus Herpes simplex 1 e 2 com 68,4% e 57,3% de inibição, respectivamente, após 5 aplicações, indicando o seu uso clínico.The use of low-level laser to suppress infections caused by Herpes simplex viruses 1 and 2 was evaluated after one to five applications. A gradual reduction in replication of Herpes simplex viruses 1 and 2 was observed, with 68.4% and 57.3% inhibition, respectively, after five applications, thus favoring its clinical use.
We made our aim to investigate the effect of the low intensive laser
with λ=630 nm in the visible red spectrum of light at Herpes
simplex treatment. For this purpose we carried out a clinical research
upon 62 persons with Herpes simplex lesions which have been divided into
two groups of 31 persons. At the first group the effect of laser with
power density 100 mW/cm2 +/- 5 mW/cm2 and time of
exposure 3 min. on field was traced out. At the second group the low
intensive laser with the same characteristics has been used but in
combination with the patent medicine Granofurin H as a
photosensibilizer. The clinical approbations of this method showed high
therapeutical effectiveness. The obtained results showed that at both
groups there is an expressed anaesthetic, anti-inflammatory and
regeneration stimulating effect and at the second group with the use of
Granofurin H the reconvalescent period is shorter.
The effects of phototherapy on herpes lesions have been clinically demonstrated by either preventing the lesion formation or speeding their repair. The aim of this in vitro study was analyze the effect of phototherapy on epithelial cells and HSV-1 in culture. Cultures of HSV-1 and epithelial cells (Vero cell line) were used. The irradiations were done using a GaAlAs laser (660 e 780 nm, 4.0 mm(2)). One, two and three irradiations with 6 h-intervals were done. The experimental groups were: Control: non-irradiated; 660 nm and 3 J/cm(2) (2.8 sec); 660 nm and 5 J/cm(2) (3.8 sec); 781) nm and 3 J/cm(2) (1.9 sec), and 780 nm and 5 J/cm(2) (2.5 sec). The HSV-1 cytopatic effect and the cell viability of irradiated cultures and controls were analyzed in four different conditions: irradiation of non-infected epithelial cells; epithelial cells irradiated prior infection; virus irradiated prior infection; irradiation of HSV infected cells. The mitochondrial activity and cytopathic effects were assessed. The number of irradiations influenced the cell growth positively and proportionally, except for the 660 nm/3 J/cm(2) group. Any variation in cytopathic effects was observed amongst the experimental groups. The viability of infected cells prior irradiation was significantly higher than that of non-irradiated cultures when 2 irradiations were done. Under the experimental conditions of this study we concluded that phototherapy is capable of enhancing epithelial cell growth and prolonging cell viability of HSV-1 infected cells. Positive benefits of phototherapy could be resultant from prolongation of infected cells viability, corroborating with host defenses.
This study sought to evaluate the clinical outcome of patients who had been diagnosed with recurrent herpes labialis (RHL) after treatment with photodynamic therapy (PDT) associated with low-level laser therapy (LLLT). PDT has shown great effectiveness for treating already-established RHL vesicles, compared to ordinary treatments involving antiviral compounds. Two patients with vesicles on their lips were treated with PDT, followed by irradiation with LLLT. Both patients reported pain relief immediately after the procedure; at a six-month follow-up, neither patient showed signs or symptoms that related to RHL.
Red light of a krypton laser (lambda = 647 nm) was used for treatment of patients suffering from herpes zoster (n = 4), postherpetic neuralgias (n = 8) and herpes simplex recidivans in loco (n = 13). The afflicted skin was irradiated daily for ten days (laserpower 50 mw, exposure time 90 sec). Improvement was observed in 7 out of the 12 patients suffering from herpes zoster and postherpetic neuralgias respectively, and in 8 out of 13 patients afflicted with recurrent herpes simplex.
Low power Laser irradiation is used in medical practice for different indications. Several firms which commercialise Laser claim that Laser irradiation may be beneficial towards Herpes virus pathogenicity. We observe that, in the ear experimental model of HSV latency [3], repeated exposure to infrared Laser radiation of cervical ganglia following HSV inoculation appears to specifically hinder the establishment of virus latency in mouse.
Recurrent infection with herpes simplex virus is a common disease. Recently, alternative therapies have been introduced. Among those, low-intensity laser therapy mainly used for the acceleration of wound healing and in pain therapy has previously been shown to be of benefit in herpes zoster infections. In this study we evaluated the influence of low-intensity laser therapy (wavelength 690 nm, intensity: 80 mW per cm2, dose: 48 J per cm2) in 50 patients with recurrent perioral herpes simplex infection (at least once per month for more than 6 mo) in a randomized, double-blind placebo-controlled trial design. Patients in the laser group received daily irradiations for 2 wk, whereas patients in the placebo group were sham-irradiated. After completion of the laser/sham treatment, patients were asked to return to the Department of Dermatology, University of Vienna Medical School at the time of recurrence. All except two patients completed the study and were monitored for 52 wk. The median recurrence-free interval in the laser-treated group was 37.5 wk (range: 2-52 wk) and in the placebo group 3 wk (range: 1-20 wk). This difference was found to be statistically significant (p < 0.0001; Wilcoxon's Rank Sum Test). In conclusion, we demonstrated that a total of 10 irradiations with low-intensity laser therapy significantly lowers the incidence of local recurrence of herpes simplex infection. Since this athermic phototherapeutic modality represents a safe, noninvasive treatment, it might be considered as an alternative to established therapeutic regimens in this indication.
It has been suggested that low-level laser therapy (LLLT) can modulate inflammatory processes. The aim of this experiment was to investigate what effects red laser irradiation with two different wavelengths (660 nm and 684 nm) on carrageenan-induced rat paw edema and histology. Thirty two male Wistar rats were randomly divided into four groups. One group received a sterile saline injection, while inflammation was induced by a sub-plantar injection of carrageenan (1 mg/paw) in the three other groups. After 1 h, LLLT was administered to the paw in two of the carrageenan-injected groups. Continuous wave 660 nm and 684 nm red lasers respectively with mean optical outputs of 30 mW and doses of 7.5 J/cm(2) were used. The 660 nm and 684 nm laser groups developed significantly (p<0.01) less edema (0.58 ml [SE+/-0.17] ml and 0.76 ml [SE+/-0.10] respectively) than the control group (1.67 ml [SE+/-0.19]) at 4h after injections. Similarly, both laser groups showed a significantly lower number of inflammatory cells in the muscular and conjunctive sub-plantar tissues than the control group. We conclude that both 660 nm and 684 nm red wavelengths of LLLT are effective in reducing edema formation and inflammatory cell migration when a dose of 7.5 J/cm(2) is used.
Buccal Pathology. Diagnosis and Treat-ment
- L R Eversole
Eversole, L.R. (1985). Buccal Pathology. Diagnosis and Treat-ment. Havana: Editorial Scientific-Technique.
Studio ultrastrutturale di colture cellulari ''vero'' infettate con virus Herpes Simplex e sottoposte all'-azione Laser [In Italian]. . [Ultrastructural study of cell cul-tures infected with herpes simplex virus and subjected to the action of laser
- G Gilioli
- F Taparelli
- A Fornaciari
- B Palmieri
- M Celani
Gilioli, G., Taparelli, F., Fornaciari, A., Palmieri, B., and Celani, M. (1985). Studio ultrastrutturale di colture cellulari ''vero'' infettate con virus Herpes Simplex e sottoposte all'-azione Laser [In Italian].. [Ultrastructural study of cell cul-tures infected with herpes simplex virus and subjected to the action of laser]. Med. Laser Rep. 3, 28–31.
Atlas of Pathology of the Buccal Complex
- J C Santana
Santana, J.C. (1985). Atlas of Pathology of the Buccal Complex. Havana: Editorial Scientific-Technique.
Effect of low power laser over cells in-fected by herpes simplex virus (HSV)
- J P Tardivo
Tardivo, J.P. (1989). Effect of low power laser over cells in-fected by herpes simplex virus (HSV). Lasers Surg. Med. Suppl 1, 31.