The purpose of this study is to explore the possibilities for the application of laser therapy in medicine and dentistry by analyzing lasers’ underlying mechanism of action on different cells, with a special focus on stem cells and mechanisms of repair. The interest in the application of laser therapy in medicine and dentistry has remarkably increased in the last decade. There are different types of lasers available and their usage is well defined by different parameters, such as: wavelength, energy density, power output, and duration of radiation. Laser irradiation can induce a photobiomodulatory (PBM) effect on cells and tissues, contributing to a directed modulation of cell behaviors, enhancing the processes of tissue repair. Photobiomodulation (PBM), also known as low-level laser therapy (LLLT), can induce cell proliferation and enhance stem cell differentiation. Laser therapy is a non-invasive method that contributes to pain relief and reduces inflammation, parallel to the enhanced healing and tissue repair processes. The application of these properties was employed and observed in the treatment of various diseases and conditions, such as diabetes, brain injury, spinal cord damage, dermatological conditions, oral irritation, and in different areas of dentistry.

Standard dental procedures, when using a water coolant and rotary instruments, generate aerosols with a significantly higher number of various dangerous pathogens (viruses, bacteria, and fungi). Reducing the amount of aerosols to a minimum is mandatory, especially during the new coronavirus disease, COVID-19. The study aimed to evaluate the amount of aerosol generated during standard dental procedures such as caries removal (using dental bur on a high and low-speed handpiece and Er:YAG laser), ultrasonic scaling, and tooth polishing (using silicon rubber on low-speed handpiece) combined with various suction systems. The airborne aerosols containing particles in a range of 0.3–10.0 μm were measured using the PC200 laser particle counter (Trotec GmbH, Schwerin, Germany) at three following sites, manikin, operator, and assistant mouth, respectively. The following suction systems were used to remove aerosols: saliva ejector, high volume evacuator, saliva ejector with extraoral vacuum, high volume evacuator with extraoral vacuum, Zirc^® evacuator (Mr.Thirsty One-Step®), and two customized high volume evacuators (white and black). The study results showed that caries removal with a high-speed handpiece and saliva ejector generates the highest amount of spray particles at each measured site. The aerosol measurement at the manikin mouth showed the highest particle amount during caries removal with the low and high-speed handpiece. The results for the new high volume evacuator (black) and the Zirc^® evacuator showed the lowest increase in aerosol level during caries removal with a high-speed handpiece. The Er:YAG laser used for caries removal produced the lowest aerosol amount at the manikin mouth level compared to conventional dental handpieces. Furthermore, ultrasonic scaling caused a minimal aerosol rise in terms of the caries removal with bur. The Er:YAG laser and the new wider high volume evacuators improved significantly suction efficiency during dental treatment. The use of new suction systems and the Er:YAG laser allows for the improvement of biological safety in the dental office, which is especially crucial during the COVID-19 pandemic.

Introduction. Various procedures in dental implantology are performed to enhance the bone healing process and implant stability. One of these methods can be a low-level laser therapy (LLLT).Objectives. The aim of our study was to evaluate the stabilization (primary and secondary) and bone density in peri-implant zone after LLLT protocol using a 635 nm diode laser.Material and Methods. The research included 40 implants placed in the posterior region of a mandible in 24 patients (8 women and 16 man; age: 46.7 ± 8.7 years). The patients were randomly divided into 2 groups G1 (n=12, 18 implants) and G2 (n=12, 22 implants) according to the treatment procedure; G1 (test): 635 nm laser, with handpiece diameter: 8mm, output power: 100mW, spot area: 0.5024cm², average power density: 199.04mW/cm², continuous mode, dose: 4J per point (8J/cm²), time: 40 sec per point, 2 points (irradiation on a buccal and a lingual side of the alveolus/implant), and total energy per session 8J; G2 (control): no laser irradiation. The G1 (test) group’s implants were irradiated according to the following protocol: 1 day before surgery, immediately after the surgery and 2, 4, 7, and 14 days after. The total energy after all therapeutic sessions was 48J. The implants stability was measured employing a Periotest device (Periotest Test Value: PTV) (measured immediately after the surgery, 7 days, 2 weeks, 4 weeks, and 2 and 3 months after the surgery) and the bone density using cone-beam computed tomography (grayscale value) (measured immediately after the surgery, 4 weeks and 12 weeks after the treatment).Results. The average implant stability at different time points showed lower PTV value (higher stability) at2ndand4thweek after 635 nm laser irradiation (G1) compared with a control (G2) group (p0.05). The mean grayscale value at the apical, middle, and cervical level of the titanium implants showed the reduction of pixel grayscale value after 2 weeks and was lower for the G1 group in contrast to the G2 group (p<0.01). The value of grayscale after 12 weeks was significantly higher at the middle and apical level of the implants in the G1group in contrast to the G2 group (p<0.01).Conclusion. The application of the 635 nm diode laser enhanced secondary implant stability and bone density. However, to assess the impact of the LLLT on peri-implant bone with different bone densities, further well-controlled long-term trials on larger study groups are needed.

Objective: To evaluate the effects of bracket removal using an erbium laser on the pulp temperature and enamel surface. Background: Removal of orthodontic brackets with conventional debonding pliers may result in enamel cracks. To avoid damage to the enamel surface and effectively remove metal or ceramic brackets, different types of lasers, such as Nd:YAG, CO ₂ , TM:YAP, diode laser, or Er:YAG, have been introduced for debonding. Materials and methods: A total of 55 brackets ( n = 55; 20 metal and 35 ceramic ones) were bonded to 55 caries-free premolars extracted for orthodontic indications. Brackets were irradiated with Er:YAG laser (Morita, Irvine, CA) with a wavelength of 2940 nm at a power of 3.4 W, energy 170 mJ, frequency 20 Hz, pulse duration 300 μs, tip diameter 0.8 mm, air/fluid cooling 3 mL/s, and time of irradiation: 6 sec. Debonding was made by scanning ( n = 15; 6 sec irradiation at distance of 2 mm from the bracket with an “S” shape movement) and circular ( n = 15; 6 sec irradiation at distance of 1 mm from the bracket) motion technique in ceramic brackets or the circular motion technique in metal brackets ( n = 15). The number of 10 nonirradiated teeth with ceramic ( n = 5) or metal brackets ( n = 5) was used as a control in SEM test and EDS analysis. The damage in tooth enamel surface and the calcium percentage were analyzed by means of scanning electron microscope (JEOL 6610LV, JEOL, Japan) and energy dispersive X-ray spectroscopy (EDS, Oxford, United Kingdom). Temperature changes in the pulp were measured by K-type thermocouple. Evaluation of the Adhesive Remnant Index (ARI) on the enamel surface of each tooth was examined after bracket debonding. Results: The scanning method has caused significantly lower temperature increase (mean: 0.83°C) compared with circular motion technique around the ceramic brackets (mean: 1.78°C; p = 0.0001) or the metal brackets (mean: 1.29°C; p = 0.015). ARI score showed no differences between the study groups ( p = 0.57). SEM analysis revealed no cracks on enamel surface after laser-assisted debonding in comparison with the control samples where cracks were found. EDS showed a higher mean percentage of the calcium (30.7–85.8%) for all test groups compared with control samples (mean: 7%; p = 0.0002). The amount of the calcium elements was higher for metal brackets in comparison with ceramic ones ( p = 0.0002). Conclusions: Er:YAG laser-assisted debonding causes a minor increase in the pulp temperature and reduced the risk of enamel damage compared with conventional bracket removal.

The effectiveness of antimicrobial photodynamic therapy (aPDT) in the treatment of oral yeast infections was examined many times in recent years. The authors of this review tried to address the question: “Should TBO (toluidine blue ortho)-mediated aPDT be considered a possible alternative treatment for oral candidiasis?”. PubMed/Medline and the Cochrane Central Register of Controlled Trials (CEN-TRAL) databases were searched from 1997 up to the 27th of October 2020 using a combination of the following keywords: (Candida OR Candidiasis oral OR Candidosis oral OR denture stomatitis) AND (toluidine blue OR photodynamic therapy OR aPDT OR photodynamic antimicrobial chemotherapy OR PACT OR photodynamic inactivation OR PDI). Animal studies or in vitro studies involving Candida albicans (C. albicans) and/or nonalbicans stain, randomized clinical trials (RCT) involving patients with oral candidiasis or denture stomatitis published solely in English language were included. Candida elimination method in animal, in vitro studies and RCT used was TBO-mediated aPDT. Exactly 393 studies were taken into consideration. Then, after analyzing titles and abstracts of said studies, 361 were excluded. Only 32 studies ended up being selected for in-depth screening, after which 21 of them were included in this study. All studies reported the antifungal effectiveness of aPDT with TBO against C. albicans and non-albicans Candida. In studies conducted with planktonic cells, only one study showed eradication of C. albicans. All others showed partial elimination and only one of them was not statistically significant. Experiments on yeast biofilms, in all cases, showed partial, statistically significant cell growth inhibition and weight reduction (a reduction in the number of cells—mainly hyphae) and the mass of extracellular polymeric substance (EPS). In vivo aPDT mediated by TBO exhibits antifungal effects against oral Candida spp.; however, its clinical effectiveness as a potent therapeutic strategy for oral yeast infections requires further investigation.