Background Managing recalcitrant oral lichen planus (OLP) can be challenging. Laser therapy has been suggested as an alternative to corticosteroids for treatment. Photodynamic therapy (PDT) is a non-invasive technique that enables the removal of lesions without surgery. Photobiomodulation therapy (PBMT) can promote healing and recovery of the lesions. Case presentation The objective was to treat unresponsive bilateral OLP of the whole buccal mucosae with a combination of PDT and PBMT. Results A 43-year-old Thai male presented with the severe painful reticular type of OLP of bilateral buccal mucosae involving upper and lower vestibular areas. The lesions were not remitted with either prednisolone systemic steroids or fluocinolone topical corticosteroids. After undergoing ten sessions of PDT with 10% 5-Aminolevulinic acid (5-ALA) in the form of thermoplastic gel and a 635 nm diode laser at 100 to 400 mW with an energy density of 20 to 30 J/cm2 in continuous wave mode, combined with five interim-sessions of PBMT using a 635 nm diode laser at 200 to 300 mW with an energy density of 6 to 10 J/cm2 in continuous wave, the patient reported relief of burning sensation beside remission of lesions without any complications. Conclusion The wide-spreading recalcitrant OLP with burning sensation can be managed by combining PDT and PBMT.

Background/Objective: Laser therapy has gained attention in dental practice to minimize bleeding and enhance blood clot formation. This study aimed to explore the utilization and to compare the clinical efficacy of laser-mediated hemostasis for older patients receiving routine dental treatment. Methods: A prospective observational study was conducted across research networks between October 2023 and August 2024, involving 60 patients aged 50 years and older (average = 63.35 years) at risk of postoperative bleeding following dental treatments. Additionally, laser therapy for hemostasis was selected and provided among calibrated operators. A single researcher performed data collection. Before statistical analysis, data verification and clinical assessment were conducted by the operators and researcher. A clinical cut-off for hemostasis was set at 5 min. Two diode laser machines were used namely, an 810 nm and dual wavelengths of 635 nm and 980 nm. Results: There were 94 extraction sockets, 28 procedures of scaling and root planing and 18 procedures of minor oral surgery. Combining laser ablating sulcular fiber and photobiomodulation initiating blood clot formation was a preferable hemostatic technique for extraction socket, while photobiomodulation alone was a preferred technique for soft tissue hemostasis (p < 0.001). All operators confirmed that 97.86 percent of bleeding events achieved more rapid hemostasis. 61.43 percent of bleeding events clinically achieved hemostasis within 5 min by using laser-mediated hemostasis alone (p = 0.092). Full recovery of the extraction socket was significantly observed during the 2- to 4-week follow-up period (p = 0.005). No clinical complications were reported. Conclusions: Laser-mediated hemostasis effectively reduced hemostatic duration, prevented postoperative bleeding and promoted wound healing in older patients undergoing routine dental treatment.

Background/Objectives: Photobiomodulation therapy (PBMT) is a non-invasive therapeutic modality that enhances tissue healing, modulates inflammation, and reduces pain. Despite increasing clinical use, evidence regarding PBMT in geriatric oral conditions has not been comprehensively synthesized. This systematic review aimed to evaluate the clinical efficacy and safety of PBMT in managing orofacial conditions in older adults. Methods: A systematic search of PubMed, Embase, Scopus, and Google Scholar was conducted to identify randomized controlled trials (RCTs) published between January 2000 and March 2025. Eligible studies included patients aged ≥60 years receiving PBMT for orofacial conditions. Study selection followed predefined criteria. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and findings were narratively synthesized. Results: Twenty-three RCTs were included. Evidence for PBMT was most frequently reported in cancer therapy-induced oral mucositis (n = 8), with consistent reductions in lesion severity and pain. Studies on burning mouth syndrome (n = 7) and hyposalivation (n = 2) generally reported improvements in symptoms, although placebo effects were noted. Fewer studies evaluated postoperative pain (n = 2), oral lichen planus (n = 1), peri-implant conditions (n = 1), and implant osseointegration (n = 2). No clinically significant adverse events were reported. However, heterogeneity in PBMT parameters and outcome measures limited comparability. Conclusions: PBMT is a safe and clinically effective adjunctive therapy for managing orofacial conditions in older adults, particularly oral mucositis. These findings support its integration into geriatric oral care. Standardized protocols and well-designed RCTs are needed to determine optimal treatment parameters and long-term effectiveness.

Laser therapy effectively reduces the risk of excessive bleeding, a critical condition in rural healthcare units due to limited hemostatic tools and specialist availability. This research aimed to compare the clinical outcomes of utilizing lasers to enhance socket hemostasis in Thailand’s primary, secondary, and tertiary-level healthcare units. This prospective observational study involved a total of 27 patients, aged 50 and older, who were at risk of extraction socket bleeding due to medications or gingival inflammation. Each study unit provided routine dental treatments along with supplemental laser therapy, as chosen by the operators. A single researcher assessed the related clinical outcomes. Primary and secondary-level healthcare units utilized an 810 nm diode laser; in contrast, a tertiary-level healthcare unit employed a 653 nm and 980 nm diode laser. Soft-assisted tissue loosening was conducted using 810 nm or 980 nm diode lasers, with a power of 2.5 to 3 W delivered via a 320-micron optical fiber. To initiate blood clot formation, a 635 nm at 0.2 W, 5.08 J/cm2 via 8-mm diameter laser probe, or 810 nm at 0.8 W, 5.93 J/cm2 via 6-mm diameter biomodulation probe was applied for 10 s per session. Secondary and tertiary-level healthcare units often combined laser-assisted soft tissue loosening and photobiomodulation, whereas the primary-level healthcare unit generally opted for utilizing photobiomodulation alone (p<0.001). Laser therapies employed in this study achieved socket hemostasis in 72 out of 86 sockets, with 55 achieving hemostasis within 5 min. The operators confirmed the clinical efficacy in reducing hemostasis duration across all study units (p=0.702), without experiencing post-extraction bleeding or clinical complications. Our findings indicate that a combination of laser-assisted soft tissue loosening and photobiomodulation to induce blood clot formation is a safe and effective local measure for enhancing socket hemostasis.

Background Currently, there is no objective and quantified measurement for detecting blood clots during extraction socket hemostasis. It has relied solely on clinical observation, even when conducting clinical research by using extraction sockets as samples. This study aimed to assess the in vitro reliability and clinical-relevant validity of a new objective measurement providing quantified data called blood clot detection (BCD) using a standard capillary tube. Methods The in vitro part of the study was conducted using surplus blood samples from ten healthy participants. Two identical sets of blood samples in simulation reservoirs mimicking bleeding sockets were prepared for reliability tests. Then, the capillary tubes were concurrently placed in the reservoirs. The blood-filled distances were measured. The part of clinical-relevant validity study was conducted in sixteen extraction sockets from each healthy participant. Clinical observation and BCD measurement were evaluated by two calibrated assessors. The total duration of the assessment was a 30-minute. Results The distances of the blood-filled capillary tube were decreased by time. Test and retest reliability analysis of the BCD measurement showed an excellent intraclass correlation coefficient of 0.980 (0.968 to 0.988). The medians of blood-filled distance categorized by clinical observation into active bleeding, sluggish oozing, and clot formation were 13.0 mm (Q1 = 11.7, Q3 = 13.8), 5.6 mm (Q1 = 4.3, Q3 = 7.0), and 0.9 mm (Q1 = 0.5, Q3 = 1.3), respectively. The blood-filled distance of the clot formation group was significantly less than the active bleeding and sluggish oozing (p<0.001). Therefore, the BCD measurement also significantly indicated the completion of extraction socket hemostasis Conclusions A distance of blood-filled in capillary tube of 0.9 mm from the BCD measurement significantly ensured complete clot formation. The BCD measurement proved to be a quantified tool for objectively measuring hemostasis of bleeding socket.

Background/Objectives: Orofacial laserology is being increasingly incorporated into contemporary dental practice, yet its integration into dental education remains inconsistent. National evidence regarding institutional readiness for integrating orofacial laserology into dental curricula remains limited. This study examined the current status of orofacial laserology education in Thailand. Methods: A national cross-sectional survey was conducted between May and July 2026 among all accredited Thai dental schools. Academic leaders and full-time lecturers completed a structured online questionnaire addressing curriculum implementation, educational delivery, competency assessment, institutional readiness, perceived barriers, and future priorities. Descriptive and non-parametric statistical analyses were performed. Results: Fifteen of 18 dental schools (83.3%) participated, yielding 38 respondents. Undergraduate orofacial laserology education showed limited curricular integration, whereas postgraduate programs demonstrated broader implementation, particularly in hands-on, supervised clinical, and competency-based training. Institutional readiness did not differ between academic leaders and full-time lecturers (p > 0.05). Across historical phases of institutional establishment, perceived importance (p = 0.743) and interinstitutional collaboration (p = 0.800) were comparable, whereas institutional readiness differed significantly (p = 0.008), with regional pioneer dental schools reporting higher readiness than expansion-phase and contemporary dental schools. The principal barriers were insufficient qualified instructors, limited curriculum integration, and high equipment costs. Faculty development, funding and equipment support, and national competency frameworks were identified as the highest priorities. Conclusions: Orofacial laserology education in Thailand remains heterogeneous, with broader implementation in postgraduate than undergraduate programs. Strengthening faculty capacity, competency-based curricula, institutional support, and national collaboration may facilitate more consistent integration of orofacial laserology into dental curricula.