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Purpose There is a large body of evidence supporting the efficacy of low level laser therapy (LLLT), more recently termed photobiomodulation (PBM), for the management of oral mucositis (OM) in patients undergoing radiotherapy for head and neck cancer (HNC). Recent advances in PBM technology, together with a better understanding of mechanisms involved, may expand the applications for PBM in the management of other complications associated with HNC treatment. This article (part 1) describes PBM mechanisms of action, dosimetry, and safety aspects and, in doing so, provides a basis for a companion paper (part 2) which describes the potential breadth of potential applications of PBM in the management of side-effects of (chemo)radiation therapy in patients being treated for HNC and proposes PBM parameters. Methods This study is a narrative non-systematic review. Results We review PBM mechanisms of action and dosimetric considerations. Virtually, all conditions modulated by PBM (e.g., ulceration, inflammation, lymphedema, pain, fibrosis, neurological and muscular injury) are thought to be involved in the pathogenesis of (chemo)radiation therapy-induced complications in patients treated for HNC. The impact of PBM on tumor behavior and tumor response to treatment has been insufficiently studied. In vitro studies assessing the effect of PBM on tumor cells report conflicting results, perhaps attributable to inconsistencies of PBM power and dose. Nonetheless, the biological bases for the broad clinical activities ascribed to PBM have also been noted to be similar to those activities and pathways associated with negative tumor behaviors and impeded response to treatment. While there are no anecdotal descriptions of poor tumor outcomes in patients treated with PBM, confirming its neutrality with respect to cancer responsiveness is a critical priority. Conclusion Based on its therapeutic effects, PBM may have utility in a broad range of oral, oropharyngeal, facial, and neck complications of HNC treatment. Although evidence suggests that PBM using LLLT is safe in HNC patients, more research is imperative and vigilance remains warranted to detect any potential adverse effects of PBM on cancer treatment outcomes and survival.

Previous clinical studies have shown that pulsed dye laser (PDL) and intense pulsed light (IPL) are effective for treating erythematotelangiectatic rosacea(ETR). This article aims to compare the efficacy and safety of PDL and IPL at three different wavelength bands (broad-band, single-narrow-band, and dual-narrow-band) in treating ETR. Sixty subjects with ETR were randomly categorized into four groups and received one of the following laser treatments: PDL (595 nm), IPL with Delicate Pulse Light (DPL, 500–600 nm), IPL with M22 590 (590–1200 nm), or IPL with M22 vascular filter (530–650 nm and 900–1200 nm). Four treatment sessions were administered at 4-week intervals, with one follow-up session 4 weeks after the final treatment. The efficacy of the four lasers was evaluated by comparing the clinical symptom score, total effective rate, VISIA red area absolute score, and RosaQoL score before and after treatment. The safety was evaluated by comparing adverse reactions such as pain, purpura, erythematous edema, and blister. All 60 subjects completed the study. Within-group effects showed that the clinical symptom score, VISIA red area absolute score, and RosaQoL score of all four groups were significantly reduced compared to before treatment (p < 0.001). Between-group effects showed no statistically significant difference among the four laser groups. Safety analysis showed that all four lasers were safe, but the incidence of blister was higher in the M22 vascular group. Nonpurpurogenic PDL, DPL, M22 590, and M22 vascular were equally effective in treating ETR and were well-tolerated. ClinicalTrial.gov Identifier: NCT05360251.

PurposeTo systematically review the literature and update the evidence-based clinical practice guidelines for the use of photobiomodulation (PBM), such as laser and other light therapies, for the prevention and/or treatment of oral mucositis (OM).MethodsA systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO) using PubMed and Web of Science. We followed the MASCC methods for systematic review and guidelines development. The rigorously evaluated evidence for each intervention, in each cancer treatment setting, was assigned a level-of-evidence (LoE). Based on the LoE, one of the following guidelines was determined: Recommendation, Suggestion, or No Guideline Possible.ResultsRecommendations are made for the prevention of OM and related pain with PBM therapy in cancer patients treated with one of the following modalities: hematopoietic stem cell transplantation, head and neck (H&N) radiotherapy (without chemotherapy), and H&N radiotherapy with chemotherapy. For each of these modalities, we recommend 1–2 clinically effective protocols; the clinician should adhere to all parameters of the protocol selected. Due to inadequate evidence, currently, No Guideline Possible for treatment of established OM or for management of chemotherapy-related OM. The reported clinical settings were extremely variable, limiting data integration.ConclusionsThe evidence supports the use of specific settings of PBM therapy for the prevention of OM in specific patient populations. Under these circumstances, PBM is recommended for the prevention of OM. The guidelines are subject to continuous update based on new published data.

ABSTRACT Objective The primary aim of this systematic review and meta‐analysis was to synthesize and compare the clinical efficacy of intense pulsed light (IPL) and pulsed‐dye laser (PDL) therapies for the management of rosacea. Methods The literatures were searched in the Web of Science, PubMed, Embase, and Cochrane Library databases to identify relevant studies investigating the use of IPL and PDL for the treatment of rosacea. Screening of the retrieved articles and data extraction were performed as per the pre‐established inclusion and exclusion criteria. The primary outcome measures evaluated in this meta‐analysis included clearance rates, erythema scores, and pain scores. Results The meta‐analysis incorporated data from four studies involving a total of 141 participants. The meta‐analysis did not reveal a statistically significant difference between IPL and PDL in the rate of achieving greater than 50% clearance (RR = −0.07, 95% CI: −0.19, 0.05). However, the IPL group demonstrated a significantly higher rate of clearance exceeding 75% compared to the PDL group (RR = −0.13, 95% CI: −0.23, −0.04). The change in erythema index, a key measure of rosacea severity, was similar between the two treatment modalities (SMD = −0.15, 95% CI: −0.55, 0.26). Interestingly, the PDL group reported a notably lower VAS pain score than the IPL group (SMD = 1.54, 95% CI: 0.08, 3.00). Conclusion Either PDL or IPL appears to be effective modalities for the management of rosacea. IPL exhibits a slight advantage in achieving a higher rate of substantial (>75%) clearance, while PDL may be preferable for patients with lower tolerance for post‐treatment discomfort. However, the existing literature directly comparing these two laser/light‐based therapies is limited, warranting further well‐designed, large‐scale studies to establish the optimal treatment algorithm for this chronic inflammatory skin condition.

Brain photobiomodulation (PBM) therapy using red to near-infrared (NIR) light is an innovative treatment for a wide range of neurological and psychological conditions. Red/NIR light is able to stimulate complex IV of the mitochondrial respiratory chain (cytochrome c oxidase) and increase ATP synthesis. Moreover, light absorption by ion channels results in release of Ca2+ and leads to activation of transcription factors and gene expression. Brain PBM therapy enhances the metabolic capacity of neurons and stimulates anti-inflammatory, anti-apoptotic, and antioxidant responses, as well as neurogenesis and synaptogenesis. Its therapeutic role in disorders such as dementia and Parkinson’s disease, as well as to treat stroke, brain trauma, and depression has gained increasing interest. In the transcranial PBM approach, delivering a sufficient dose to achieve optimal stimulation is challenging due to exponential attenuation of light penetration in tissue. Alternative approaches such as intracranial and intranasal light delivery methods have been suggested to overcome this limitation. This article reviews the state-of-the-art preclinical and clinical evidence regarding the efficacy of brain PBM therapy.

Sleep is an essential component of overall human health but is so tightly regulated that when disrupted can cause or worsen certain ailments. An important part of this process is the presence of the well-known hormone, melatonin. This compound assists in the governing of sleep and circadian rhythms. Previous studies have postulated that dysregulation of melatonin rhythms is the driving force behind sleep and circadian disorders. A computer-aided search spanning the years of 2015–2020 using the search terms melatonin, circadian rhythm, disorder yielded 52 full text articles that were analyzed. We explored the mechanisms behind melatonin dysregulation and how it affects various disorders. Additionally, we examined associated therapeutic treatments including bright light therapy (BLT) and exogenous forms of melatonin. We found that over the past 5 years, melatonin has not been widely investigated in clinical studies thus there remains large gaps in its potential utilization as a therapy.

Background Photobiomodulation is a process by which the absorption of red light energy produces a series of physiological effects at the cellular level such as the enhancement of mitochondrial Adenosine Triphosphate (ATP) production, cell signaling and growth factor synthesis, and the reduction of oxidative stress. Light emitting diodes (LEDs) photobiomodulation is an increasingly popular therapy for treating skin problems, especially for reversing the signs of skin aging. Objective The objective of this study is to demonstrate the effectiveness of a photobiomodulation treatment using red LEDs on the facial skin at a rate of two sessions per week for 3 months. The LED mask used is the Skin Light Dior x Lucibel mask diffusing a cold red light with a wavelength of 630 ± 10 nm and a power of 15.6 J/cm2 for a duration of 12 min. Method In order to demonstrate the effectiveness of the mask in reversing the signs of skin aging, a clinical study was conducted on 20 healthy Caucasian women: the antiwrinkle effect by measuring the depth of the crow's feet wrinkle, the relaxation of the oval of the face by clinical scoring, the firmness and elasticity of the skin by cutometric measurement, the density of the dermis by ultrasound analysis, the smoothness of the skin by measuring the roughness at the cheek, the homogeneity of the complexion by chromametric measurement, the diameter of the pores by macrophotographs and finally the sebo‐regulating effect by measurement of the rate of sebum and quantification of the number of pores containing porphyrin in the subjects presenting a mixed to oily skin. The satisfaction of the volunteers was also evaluated at the end of the study via a self‐questionnaire. Results The efficacy results measured after 1, 2, and 3 months of use are progressive and confirm the interest of LED photobiomodulation to reverse the visible signs of skin aging. All the volunteers observed an overall improvement in skin quality. Conclusion All the results observed confirm the interest of using photobiomodulation to reverse the visible signs of aging. These results last for up to 1 month after stopping the use of the mask, which is a sign of lasting structural and functional rejuvenation of the skin.

Recently, surface-enhanced Raman scattering nanoprobes have shown tremendous potential in oncological imaging owing to the high sensitivity and specificity of their fingerprint-like spectra. As current Raman scanners rely on a slow, point-by-point spectrum acquisition, there is an unmet need for faster imaging to cover a clinically relevant area in real-time. Herein, we report the rational design and optimization of fluorescence-Raman bimodal nanoparticles (FRNPs) that synergistically combine the specificity of Raman spectroscopy with the versatility and speed of fluorescence imaging. DNA-enabled molecular engineering allows the rational design of FRNPs with a detection limit as low as 5 × 10 −15  M. FRNPs selectively accumulate in tumor tissue mouse cancer models and enable real-time fluorescence imaging for tumor detection, resection, and subsequent Raman-based verification of clean margins. Furthermore, FRNPs enable highly efficient image-guided photothermal ablation of tumors, widening the scope of the NPs into the therapeutic realm. Currently available Raman scanners are limited in speed to acquire images of clinically relevant sizes in cancer imaging. Here, the authors developed a DNA based design principle for Raman-Fluorescence bimodal nanoparticles and demonstrate real-time, high precision image-guided tumor resections and photothermal ablation of cancer.

This study aims to evaluate the cost-effectiveness of photobiomodulation applied after third molar extraction. Materials and Methods: To evaluate cost-effectiveness, 15 studies were selected for a systematic review and 8 studies for a meta-analysis to determine the effectiveness of photobiomodulation after surgery. In the present study, as a measure of effectiveness, the pain scale (visual analog scale) was used. The laser value was extracted from the Unified Terminology of Supplementary Health (Brazilian Health System) according to the laser application protocol most common among the clinical trials selected for the meta-analysis. As for drugs, they were determined from those most used among the works included in the meta-analysis and within the protocols established by the Brazilian Ministry of Health. Results: The results of the overall analysis show a significant reduction in pain on the second day after surgery for the experimental group compared to the control (MD, −1.15; 95% CI, −1.73, −0.57). The control group has a lower cost and lower effectiveness, while laser treatment has a higher cost and higher effectiveness. Faced with this situation, the professional must clinically assess whether the cost of USD 34.62 for controlled pain intensity using the laser is worth the extra health benefit. Conclusions: Regarding the cost-effectiveness assessment, the control group has a lower cost and lower effectiveness, while laser treatment has a higher cost and higher effectiveness The decision of which treatment to choose must consider whether the cost of the therapeutic alternative outweighs the clinical gain caused by the treatment. Clinical Relevance: One of the most executed procedures in dentistry is the extraction of third molars. To reduce the negative post-surgical effects, anti-inflammatory drugs are prescribed, which can generate unwanted effects. Photobiomodulation is a technique to modulate inflammation, accelerate tissue repair, and reduce pain and discomfort in different clinical situations.

Researches have been performed to investigate the effects of phototherapy on improving performance and reduction of muscular fatigue. However, a great variability in the light parameters and protocols of the trials are a concern to establish the efficacy of this therapy to be used in sports or clinic. The aim of this study is to investigate the effectiveness, moment of application of phototherapy within an exercise protocol, and which are the parameters optimally effective for the improvement of muscular performance and the reduction of muscular fatigue in healthy people. Systematic searches of PubMed, PEDro, Cochrane Library, EMBASE, and Web of Science databases were conducted for randomized clinical trials to March 2017. Analyses of risk of bias and quality of evidence of the included trials were performed, and authors were contacted to obtain any missing or unclear information. We included 39 trials (861 participants). Data were reported descriptively through tables, and 28 trials were included in meta-analysis comparing outcomes to placebo. Meta-analysis was performed for the variables: time until reach exhaustion, number of repetitions, isometric peak torque, and blood lactate levels showing a very low to moderate quality of evidence and some effect in favor to phototherapy. Further investigation is required due the lack of methodological quality, small sample size, great variability of exercise protocols, and phototherapy parameters. In general, positive results were found using both low-level laser therapy and light-emitting diode therapy or combination of both in a wavelength range from 655 to 950 nm. Most of positive results were observed with an energy dose range from 20 to 60 J for small muscular groups and 60 to 300 J for large muscular groups and maximal power output of 200 mW per diode.