Utility of High-Intensity Laser Therapy Combined with Photobiomodulation Therapy for Socket Preservation After Tooth Extraction

Abstract

Objective: High-intensity laser therapy (HILT) combined with photobiomodulation therapy (PBMT) using a diode or CO 2 laser was administered after extraction of the left first molar in rats. Effects on socket preservation (preservation of the alveolar bone and healing time after extraction) were evaluated histopathologically. Background: Irradiation using a diode or CO 2 laser has been shown to hasten wound healing, but the effects remain controversial. Methods: Five-week-old male Wistar rats that underwent extraction of the left maxillary first molar were divided into three groups: diode laser irradiation (diode group), CO 2 laser irradiation (CO 2 group), and no laser irradiation (control group). HILT (27 J) was performed immediately after tooth extraction to enhance blood coagulation, followed by PBMT (0.7 J) 1 day later to enhance healing. Tissues, including the extraction socket, were removed en bloc 3, 5, 7, 10, and 21 days postextraction to determine the morphological characteristics of wound healing and the distribution of myofibroblasts involved in scar formation. Results: In the diode and CO 2 groups, new bone formation and cancellous bone maturation were observed at an early stage of wound healing. The number of myofibroblasts was significantly lower in the laser treatment groups than the control (p < 0.001), and both treatment groups had a significantly higher alveolar crest height (p < 0.01), with almost no concavity in the mucosa of the extraction wound. Conclusions: Combined HILT and PBMT following tooth extraction hastened wound healing and preserved alveolar crest height, suggesting a role in socket preservation.

Initial treatment for patients with temporomandibular disorders: pain relief and muscle tone relief by photobiomodulation therapy using carbon dioxide laser

“…Regarding the pain relief effect of lasers, there are many and very few reports of semiconductor [23-25, 28, 29] and CO 2 laser, respectively. As a CO 2 laser is mostly absorbed on the tissue surface [22][23][24][25][26][27][28][29][30][31][32][33], it is not considered to cause a direct pain-relieving effect but rather to have a secondary effect, such as increased blood flow [22]. Nevertheless, the irradiation method called NACLT or NTCLT, which also use CO 2 lasers, has been reported to have a pain-relieving effect [31][32][33], so the possibility of analgesic relief for temporomandibular disorders cannot be ruled out.…”

“…Moreover, the semiconductor laser can irradiate the temporal muscle region even with hair present [23-25, 28, 29], but it is difficult to irradiate the same region with a CO 2 laser [22][23][24][25][26][27][28][29][30][31][32][33]. This is a drawback of tissue absorption lasers such as CO 2 lasers.…”

“…It reportedly has pain-relieving effects on conditions that involve chronic pain such as TMD and dentin hypersensitivity [1][2][3][10][11][12][13][14][15][16][17][18][19][20][21]. Semiconductor lasers [6,[10][11][12][13][14][15][16][17][18][19][20][21] and carbon dioxide (CO 2 ) lasers [22][23][24][25][26][27][28][29][30][31][32][33] have both been used to elicit such effects. Among them, the CO 2 laser is used not only for surgical procedures [23][24][25], such as incision and transpiration of tissue, but also as necessary application for tooth-extraction wounds [26,27] and promotion of healing of aphthous stomatitis treatment [28][29][30]…”

“…Semiconductor lasers [6,[10][11][12][13][14][15][16][17][18][19][20][21] and carbon dioxide (CO 2 ) lasers [22][23][24][25][26][27][28][29][30][31][32][33] have both been used to elicit such effects. Among them, the CO 2 laser is used not only for surgical procedures [23][24][25], such as incision and transpiration of tissue, but also as necessary application for tooth-extraction wounds [26,27] and promotion of healing of aphthous stomatitis treatment [28][29][30][31]. CO 2 laser has a long wavelength and is absorbed by water, so it is considered to only have a reaction on tissue surface [6,[22][23][24][25][26][27][28][29][30].…”

“…Among them, the CO 2 laser is used not only for surgical procedures [23][24][25], such as incision and transpiration of tissue, but also as necessary application for tooth-extraction wounds [26,27] and promotion of healing of aphthous stomatitis treatment [28][29][30][31]. CO 2 laser has a long wavelength and is absorbed by water, so it is considered to only have a reaction on tissue surface [6,[22][23][24][25][26][27][28][29][30]. Furthermore, recent modalities such as the non-thermal, nonablative CO 2 laser therapy (NACLT) or non-thermal, CO 2 laser therapy (NTCLT) have been reported to have pain relief effects on mucosal diseases such as Pemphigus vulgaris and Behcet's disease [31][32][33].…”