Effects of low-level laser therapy on autogenous bone graft stabilized with a new heterologous fibrin sealant

Abstract

Autogenous bone grafts are used to repair bone defects, and the stabilization is needed for bone regeneration. Laser photobiomodulation is a modality of treatment in clinical practice for tissue regeneration, and it has therapeutic effects as an anti-inflammatory, analgesic and modulating cellular activity. The aim of the present study was to evaluate the effects of low-level laser therapy (LLLT) on an autogenous bone graft integration process stabilized with a new heterologous fibrin sealant. Forty rats were divided into two groups: Autogenous Fibrin Graft (AFG, n=20), in which a 5mm dome osteotomy was conducted in the right parietal bone and the graft was adhered to the left side using fibrin sealant; and Autogenous Fibrin Graft Laser (AFGL, n=20), which was subjected to the same procedures as AFG with the addition of LLLT. The treatment was performed immediately following surgery and then three times a week until euthanasia, using an 830nm laser (30mW, 6J/cm(2), 0.116cm(2), 258.6mW/cm(2), 2.9J). Five animals from each group were euthanized at 10, 20, 30 and 40days postoperative, and the samples were submitted to histomorphological and histomorphometric analysis. Partial bone regeneration occurred, with new bone tissue integrating the graft to the recipient bed and small areas of connective tissue. Comparative analysis of the groups at the same intervals revealed minor interfaces in group AFGL, with statistically significant differences (p<0.05) at all of the analyzed intervals (10days p=0.0087, 20days p=0.0012, 30days p<0.0001, 40days p=0.0142). In conclusion, low-level laser therapy stimulated bone regeneration and accelerated the process of integration of autogenous bone grafts.

Photobiomodulation Therapy (PBMT) in Peripheral Nerve Regeneration: A Systematic Review

“…Its effects are related to tissue biostimulation, presenting therapeutic responses from photoelectric, photoenergetic, and photochemical reactions [1]. Scientific research has shown the application of PBMT in bone tissue and peripheral nerves with good results whether or not it is associated with other supporting methods in tissue repair [2,3,4,5,6,7]. …”

Low-Level Laser Therapy (LLLT) Improves the Repair Process of Peripheral Nerve Injuries: A Mini Review

“…The literature evidences the application of PBMT in other tissues or regions, such as bone [12,35], cartilage and orthopedic disorders [36], cells in vitro culture [37], Central Nervous System [38,39] and also in cases such as cerebral palsy in children [40]. In addition to PBMT, there are other physical agents that can be used in clinical practice as auxiliary methods in the treatment of tissue repair, such as lowintensity pulsed ultrasound [41].…”

“…Fibrin sealant derived from snake venom (Crotalus durissus terrificus) has been highlighted in the international literature [10][11][12][13]. Produced by the research group of the Center for the Study of Venoms and Venomous Animals (CEVAP, UNESP/Botucatu-SP, Brazil), it presents three individual solutions that must be homogenized before application: fibrinogen originated from buffalo blood; calcium chloride and a thrombin-like fraction.…”

Avaliação do efeito do laser de baixa intensidade na regeneração de defeitos ósseos de tamanho crítico preenchidos com osso autógeno ou xenógeno associados à membrana colágena

“…Existem muitas condições nas quais o tecido ósseo não é capaz de se regenerar espontaneamente, como fissura labiopalatina, infecções crônicas e retirada de grandes tumores, nas quais grande quantidade de tecido é removido ou ausente, promovendo um defeito cirúrgico crítico, que não se regenera sem ajuda de materiais para preencher o espaço criado (LITCHE et al, 2011;GONÇALVES et al, 2016). (BUSER et al, 1990;DAHLIN, 1991;DONOS, 2010;KITAYAMA et al, 2016).…”

“…A terapia com LBI é utilizada em alvéolos pós-extração, fraturas ósseas, tratamento ortodôntico, em disfunções temporomandibulares, pós-operatório de cirurgias e coadjuvante ao tratamento periodontal e terapias com implabntes principalmente em pacientes com problemas sistêmicos (PINHEIRO et al, 2003;KATO et al, 2006;PEREIRA et al, 2009;DE PAULA EDUARDO et al, 2010;MONEA et al, 2015;CAVALCANTI et al, 2016), porém ainda não há um consenso sobre o protocolo ideal para a aplicação do laser na regeneração óssea (PINHEIRO et al, 2003, SILVA et al, 2010BOSCO et al, 2016;SANTINONI et al, 2017). SCALIZE et al, 2015;TIM et al, 2015;BOSCO 2016;GONÇALVES, 2016;ZEIN et al, 2017;FREITAS et al, 2018;MOREIRA et al, 2018). O LBI promove uma melhora na vascularização e início precoce da resposta inflamatória, que por sua vez é solucionada mais rapidamente e permite que a fase de proliferação do reparo ósseo inicie mais cedo resultando em uma cicatrização mais acelerada (PRETEL et al, 2007;HUSSEIN et al, 2011;MONEA et al, 2015;BOSCO et al, 2016).…”