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The aim of this study was to evaluate the effects of dual-wavelength photobiomodulation (PBMT) compared with antibiotic therapy with amoxicillin on postoperatory healing and symptoms after third molar extraction . Sixty patients were randomly allocated in a parallel model according to the adjunctive therapy applied after extraction of all 4 third molars in one single session ( n = 15): CTR: no adjunctive therapy; ATB3: amoxicillin for 3 days; ATB7: amoxicillin for 7 days; PBMT: PBMT at dual wavelengths (λ 660 nm and λ 808 nm, 200 mW). Clinical analyses (assessment of oedema, mouth opening variation, and soft tissue healing) and patient-centred analyses (application of a visual analogue scale (VAS) to assess pain, inflammation, bleeding, difficulty during opening the mouth, and chewing) were performed at 3, 7, 14, 30, and 90 days after the surgical procedure. Radiographic analysis was performed to evaluate bone repair by observing the radiographic density and fractal dimension immediately and 90 days after tooth extraction. PBMT reduced the loss of mouth opening amplitude and the sensation of pain and oedema. There were no differences between the ATB and CTR groups. PBMT has a beneficial effect on postoperative control (reduction in inflammation and pain) after third molar extraction, and ATB does not have a beneficial effect on postoperative control after these surgeries. PBMT reduces morbidity after third molar extraction, whereas antibiotic therapy has no beneficial effect. Trial registration Brazilian Registry of Clinical Trials (REBEC—RBR- 4bct2 km—Date of registration: 12/06/2021) under number U1111 - 1263–9675.

Purpose The purpose of this study was to compare the modulation effects of Microcurrent Therapy (MT) and Low-Level Laser Therapy (LLLT) on Matrix Metalloproteinases (MMPs) and tissue inhibitors of Metalloproteinases (TIMPs) expressions during healing of surgical wounds using appendectomy wound as a model. Methods Ninety patients who recently underwent appendectomy were randomly divided into 3 main groups of equal numbers. All cases in the three groups received ordinary medical therapy. Moreover, group A (MT group) received Microcurrent Therapy for 20 min. In addition to a designed physical therapy treatment protocol for 20 min. Group B (LLLT group) received Low-Level Laser Therapy for 20 min., plus the same designed physical therapy treatment protocol for 20 min. Group C (placebo group) received placebo shame LLLT for 20 min. plus the same designed physical therapy treatment protocol for 20 min. Enzyme-linked immunosorbent assay (ELISA) and Western Blot Technique (WBT) were used to determine expression levels of MMP-8, MMP-9, and TIMP-1 at the beginning of treatment and after the end of twelve successive sessions. Results Following therapies, results showed a statistically significant decrease in the MMP-8 and MMP-9 expressions with significantly increased expression levels of TIMP-1 in each group separately ( P  < 0.05). These changes in the expression levels towards proper healing of surgical wounds were more obvious in MT and LLLT groups compared to the placebo group, with significantly better effect in the LLLT group compared to the MT group . Conclusion Microcurrent therapy and low-level laser therapy have a notable impact in improving wound healing process as they can significantly affect the expression levels of matrix metalloproteinases and tissue inhibitors of metalloproteinases towards good prognosis of healing process and decreasing possible wound healing complication, with superior effect of low-level laser therapy.

Background Blepharoplasty is the most prevalent cosmetic surgery procedure in Asia. There are three main types of blepharoplasty procedures: incision, threading, and spotting, with incision being the most common procedure. However, after incisional surgery, patients experience prolonged periorbital swelling, bruising, and scarring. In order to help patient reduce periorbital swelling and erythema and ease the discomfort. In this research, the authors introduce a photobiomodulation therapy and to investigate the efficacy and safety of 830 nm light-emitting diode (LED) phototherapy in improving complications after incisional blepharoplasty. Method Participants were randomly assigned 830 nm LED phototherapy (novel care model) or traditional care model for postoperative care. The efficacy of different care measures on postoperative complications after incisional blepharoplasty was assessed using swelling score, pain score (VAS), wound healing grading, and anxiety scale (SAS). Results A total of 145 patients were included, including 73 in the novel care model group and 72 in the traditional care model group. The new care model based on 830 nm LED phototherapy could significantly improve the swelling, pain, wound healing, and anxiety self-assessment scale assessment of the patients compared with the traditional care model, and the difference was statistically significant (P<0.05). Conclusion Photobiomodulation using 830 nm LED can markedly reduce postoperative swelling and pain, promote effective wound healing, lessen postoperative patient anxiety, and have no negative side effects. Level of Evidence I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Purpose: This study aimed to examine the impact of a 904 nm photobiomodulation (PBM) on diabetic ulcers using varying dosages. Methods: The study was a randomized, double-blind, placebo-controlled clinical trial that compared treatments using PBM (GaAs 904 nm 30w) with three different energy densities (4 J/cm2; 8 J/cm2; 10 J/cm2) in the healing process of non-infected diabetic foot ulcers. Eighty volunteers (48.75% female; 58.5 ± 11.1 years) were randomized into three intervention groups treated with PBM and one control group (PBM placebo). Volunteers performed up 20 interventions with PBM, either placebo or actual, in conjunction with conventional therapy, which involved dressing the wound with Helianthus annuus vegetable oil. The primary variable was the ulcer size reduction rate. Results: GaAs 904 nm PBM yielded a clinically and significant ulcer size rate reduction of diabetic foot ulcers, independently of energy density range (p < 0.05). However, 10 J/cm² had 60% of completely healed ulcers and the highest proportion of patients reaching 50% of ulcer reduction rate after 5 weeks of treatment. In addition, only 10 J/cm² showed a significant difference between control group after a 10-week follow-up (p < 0.05). Conclusion: GaAs 904 nm PBM was effective in treating diabetic foot ulcers in this study and a dosage of 10 J/cm², after a 10-week follow-up, proved to be the most effective compared to the other groups. Clinical Trial Registration number: NCT04246814.

Assessing the responses to the application of photobiomodulation using red and infrared spectrum light-emitting diodes (LED) on diabetic foot ulcers. Diabetic volunteers, of both genders, aged between 30 and 65 years, with grade I or II ulcers, were randomized into the groups: red LED, infrared LED, LED associated, and control. Home-based interventions took place on a daily basis for 12 weeks. Assessments of sample characterization were performed on day 1 and 90, and the variables wound healing index, mean skin temperature, sensitivity and pain in the wound area were measured at the pre-intervention time on days 1, 30, 60 and 90, with subsequent follow-up 30 days after the end of treatment. For statistical analysis, the software SPSS, version 17.0, intention-to-treat analysis, data normality was tested, and the linear mixed effects model, with a significance level of 5%. Magnitudes of clinical effect by Cohen’s d. At the pre vs post intervention time of 90 days, we found a large clinical effect of G-LED V (d=1.7) and G -LED IV (d=1.6) in relation to G-C, where these intervention groups showed a tendency for faster wound healing compared to G-C. We also observed small clinical effect of G-LED IV, which showed greater reduction in the area in relation to G-LED V (d=0.4) and G-LED A (d=0.3). Conclusion: The use of individually applied red and infrared LED phototherapy clinically tended to be more effective for the reduction of diabetic foot ulcer areas, and infrared LED was the most effective. Trial registration: NCT03250533 (clinicaltrials.gov).

High-intensity laser therapy (HILT) has recently been incorporated into wound management therapeutic protocols (Mosca RC et al. (2019) Photobiomodulation Therapy for Wound Care: A Potent, Noninvasive, Photoceutical Approach. Adv Skin Wound Care 32(4):157–167. https://doi.org/10.1097/01.ASW.0000553600.97572.d2). Laser therapy is increasingly used as an adjunct to therapeutic interventions in clinical practice (Dundar U et al. (2015) Effect of high-intensity laser therapy in the management of myofascial pain syndrome of the trapezius: a double-blind, placebo-controlled study. Lasers Med Sci 30(1):325–332. https://doi.org/10.1007/s10103-014-1671-8). This study aimed to evaluate the efficacy of HILT and the potential benefits of incorporating co- interventions alongside HILT in wound management. The following databases were searched up to April 2023: Embase, MEDLINE, PubMed, and Cinahl, as well as manual searches. The search keywords included high- intensity laser therapy, high-power laser therapy, laser therapy, wound, ulcer, and wound healing. The primary measures were decreased wound surface area (WSA) and improved wound appearance (WA) or other objective wound assessment tools containing these two values. Six human studies investigating HILT in wound healing treatment and one animal study assessing the wound-healing effects of HILT in acute wounds of mice were selected (Thabet AAE, Mahran HG, Ebid AA, Alshehri MA. Effect of pulsed high intensity laser therapy on delayed caesarean section healing in diabetic women. J Phys Ther Sci.;30(4):570–575. doi:, Ebid AA, Thabet A, Helal O (2018) (2011) Efficacy of pulsed high intensity Nd: Yag Laser in Treatment of Chronic Diabetic Foot Ulcer. Energy for Health pp. 25–30); (Ebid AA, El-Kafy EM, Alayat MS (2013) Effect of pulsed Nd: YAG laser in the treatment of neuropathic foot ulcers in children with spina bifida: a randomized controlled study. Photomed Laser Surg 31(12):565–570. https://doi.org/10.1089/pho.2013.3533); (Hong SE et al. (2016) Effects of neodymium-yttrium-aluminum garnet (Nd: YAG) pulsed high-intensity laser therapy on full thickness wound healing in an experimental animal model. J Cosmet Laser Ther 18(8):432–437. https://doi.org/10.1080/14764172.2016.1202421); (Lu Q et al. (2021) Clinical effects of high-intensity laser therapy on patients with chronic refractory wounds: a randomised controlled trial. BMJ Open 11(7):e045866. https://doi.org/10.1136/bmjopen-2020-045866); (Pereira FLC et al. (2020) Use of a High-Power Laser for Wound Healing: A Case Report. J Lasers Med Sci 11(1):112–114. https://doi.org/10.15171/jlms.2020.19); (Thabet AAE et al. (2018) Effect of pulsed high intensity laser therapy on delayed caesarean section healing in diabetic women. J Phys Ther Sci 30(4):570–575. https://doi.org/10.1589/jpts.30.570); (Nussbaum EL, Baxter GD, Lilge L (2003) A Review of Laser Technology and Light-Tissue Interactions as a Background to Therapeutic Applications of Low Intensity Lasers and Other Light Sources. Phys Therapy Reviews 8(1):31–44. https://doi.org/10.1002/lsm.20769). This limited number of studies exhibited varying treatment parameters, blinding procedures, wound etiologies, irradiation protocols, and testing areas (Thabet AAE, Mahran HG, Ebid AA, Alshehri MA. Effect of pulsed high intensity laser therapy on delayed caesarean section healing in diabetic women. J Phys Ther Sci. ;30(4):570–575. doi:, Ebid AA, Thabet A, Helal O (2018) (2011) Efficacy of pulsed high intensity Nd: Yag Laser in Treatment of Chronic Diabetic Foot Ulcer. Energy for Health pp. 25–30); (Ebid AA, El-Kafy EM, Alayat MS (2013) Effect of pulsed Nd: YAG laser in the treatment of neuropathic foot ulcers in children with spina bifida: a randomized controlled study. Photomed Laser Surg 31(12):565–570. https://doi.org/10.1089/pho.2013.3533); (Hong SE et al. (2016) Effects of neodymium-yttrium-aluminum garnet (Nd: YAG) pulsed high-intensity laser therapy on full thickness wound healing in an experimental animal model. J Cosmet Laser Ther 18(8):432–437. https://doi.org/10.1080/14764172.2016.1202421); (Lu Q et al. (2021) Clinical effects of high-intensity laser therapy on patients with chronic refractory wounds: a randomised controlled trial. BMJ Open 11(7):e045866. https://doi.org/10.1136/bmjopen-2020-045866); (Pereira FLC et al. (2020) Use of a High-Power Laser for Wound Healing: A Case Report. J Lasers Med Sci 11(1):112–114. https://doi.org/10.15171/jlms.2020.19); (Thabet AAE et al. (2018) Effect of pulsed high intensity laser therapy on delayed caesarean section healing in diabetic women. J Phys Ther Sci 30(4):570–575. https://doi.org/10.1589/jpts.30.570); (Nussbaum EL, Baxter GD, Lilge L (2003) A Review of Laser Technology and Light-Tissue Interactions as a Background to Therapeutic Applications of Low Intensity Lasers and Other Light Sources. Phys Therapy Reviews 8(1):31–44. https://doi.org/10.1002/lsm.20769). All selected studies demonstrated favorable results in improving wound conditions (Thabet AAE, Mahran HG, Ebid AA, Alshehri MA. Effect of pulsed high intensity laser therapy on delayed caesarean section healing in diabetic women. J Phys Ther Sci. ;30(4):570–575. doi:, Ebid AA, Thabet A, Helal O (2018) (2011) Efficacy of pulsed high intensity Nd: Yag Laser in Treatment of Chronic Diabetic Foot Ulcer. Energy for Health pp. 25–30); (Ebid AA, El-Kafy EM, Alayat MS (2013) Effect of pulsed Nd: YAG laser in the treatment of neuropathic foot ulcers in children with spina bifida: a randomized controlled study. Photomed Laser Surg 31(12):565–570. https://doi.org/10.1089/pho.2013.3533); (Hong SE et al. (2016) Effects of neodymium-yttrium-aluminum garnet (Nd: YAG) pulsed high-intensity laser therapy on full thickness wound healing in an experimental animal model. J Cosmet Laser Ther 18(8):432–437. https://doi.org/10.1080/14764172.2016.1202421); (Lu Q et al. (2021) Clinical effects of high-intensity laser therapy on patients with chronic refractory wounds: a randomised controlled trial. BMJ Open 11(7):e045866. https://doi.org/10.1136/bmjopen-2020-045866); (Pereira FLC et al. (2020) Use of a High-Power Laser for Wound Healing: A Case Report. J Lasers Med Sci 11(1):112–114. https://doi.org/10.15171/jlms.2020.19); (Thabet AAE et al. (2018) Effect of pulsed high intensity laser therapy on delayed caesarean section healing in diabetic women. J Phys Ther Sci 30(4):570–575. https://doi.org/10.1589/jpts.30.570); (Nussbaum EL, Baxter GD, Lilge L (2003) A Review of Laser Technology and Light-Tissue Interactions as a Background to Therapeutic Applications of Low Intensity Lasers and Other Light Sources. Phys Therapy Reviews 8(1):31–44. https://doi.org/10.1002/lsm.20769). Although insufficient data support using HILT in wound management, the promising results encourage further research. HILT appears effective in wound healing, but more high-quality studies are needed to identify optimal laser protocols.

To evaluate Nd: YAG 1064 nm photobiomodulation as a therapeutic adjunct for non-surgical management of trauma-induced periapical bone defects. The present study was a parallel‐group, double arm, single‐centre clinical, prospective, pilot study. Thirty systematically healthy individuals with radiographic evidence of trauma-induced periapical bone defects in anterior teeth were recruited. Twenty-four patients meeting the inclusion criteria were selected and randomly placed in two treatment groups. Group A: Non-surgical endodontic treatment with intracanal calcium hydroxide-iodoform paste (CH-I), and Group B: Non-surgical endodontic treatment with intracanal calcium hydroxide and adjunctive extracanal Nd:YAG 1064 nm photobiomodulation therapy (PBMT). Improvement in vascular perfusion, reduction in size, volume, area and echogenicity of the lesion was assessed with ultrasound and colour Doppler imaging. The peak systolic velocity increased statistically significantly ( p  < 0.05) from baseline to 3 and 6 months, suggesting PBMT as a facilitator of neoangiogenesis. Compared to the calcium hydroxide group, the PBM group showed a more significant mean reduction in size, volume, and surface area of the periapical lesion and lower post-operative pain scores, though not statistically significant. Also, the PBM group presented with more remarkable hard tissue development, as seen by an improvement in echogenicity from hypoechoic to predominantly hyperechoic or hyperechoic. Results suggest that PBMT with Nd: YAG can accelerate healing, enhance perfusion of periapical lesions, provide analgesia, and reduce the need for pharmacological drugs. Although the sample size is limited, this research offers a foundation for further clinical studies with larger sample sizes to evaluate the additional benefits of laser therapy in periapical healing. The study was submitted to the Clinical Trails Registry-India (CTRI), under reference no/2023/02/063428, with a registration number/2023/09/057848, before the commencement of the study.

This study examined the effects of 222-nm UVC on pressure injury (PI) wound healing in ICU patients, focusing on wound condition, bacterial count, and PI area. Adult ICU patients at a medical center in Taiwan. A total of 70 adult ICU patients in northern Taiwan were randomly assigned to either a 222-nm UVC group (n = 35) or a control group (n = 35). The UVC group received daily 60-second exposures (5 cm distance) before dressing changes from Day 1 to 7, then standard care from Day 8 to 14. The control group received standard care throughout. Data were collected at baseline (T0), Day 8 (T1), and Day 15 (T2), including Pressure Sore Status Tool (PSST) scores, bacterial counts, and PI area. After excluding patients transferred or needing special care before Day 15, 65 remained for final analysis (irradiation: n = 33; control: n = 32). Generalized estimating equations showed significant group × time interaction effects. The irradiation group had greater PSST improvement at T1 (B = −3.01, p = 0.006) and T2 (B = −4.79, p < 0.001), greater bacterial count reduction at T2 (B = −2214.33, p = 0.038), and PI area reduction at T1 (B = −7.04, p = 0.036). The irradiation group exhibited significantly better improvements in PSST scores, bacterial count, and PI area than did the control group, suggesting potential benefits of 222-nm UVC in infection control and wound healing. However, the single-center design and small sample limit generalizability. Further large-scale, multi-center studies are needed to confirm its role in routine care. The preliminary findings of this study indicate that 222-nm UVC may facilitate PI wound healing in ICU patients, which shows that it has potential value for auxiliary application in clinical nursing care. The current evidence is still preliminary in nature and requires more empirical validation.

Objectives The aim of this study was to compare leukocyte and platelet-rich fibrin (L-PRF) and photobiomodulation (PBM) applications, which have been repeatedly reported to be superior to control groups, in terms of pain, soft tissue and bone healing in tooth extraction sockets. Materials and methods This double-blind, randomized clinical study was completed with 34 patients, who had an indication for extraction of their bilaterally impacted teeth. The right and left teeth of the patients were randomly divided into L-PRF and PBM groups. L-PRF group was treated with the blood product centrifuged for 12 min at 2700 rpm, and the PBM group was treated with a diode laser at different points for 60 s with a wavelength of 940 nm in repeated sessions. Postoperative pain was evaluated using Visual Analogue Scale (VAS), soft tissue healing with Landry Index (LI), tissue healing in the distal region of mandibular second molar by probing depth measurement, and bone healing via panoramic x-ray using the Image J program. Results No statistically significant difference was found for any variable compared between the groups. Conclusion L-PRF and PBM applications provide similar support in the healing of extraction sockets. Nevertheless, the advantages and disadvantages of both methods determine their usage areas. Clinical relevance While L-PRF is advantageous in the early healing of extraction sockets, PBM may be preferred in terms of bone trabeculation in the long term.

Chronic wounds, especially in diabetic patients, represent a challenging health issue. Since standard treatment protocols often do not provide satisfactory results, additional treatment methods—like phototherapy using low-level light therapy—are being investigated. The aim of our study was to evaluate the effect of phototherapy with light-emitting diodes on chronic wound treatment in diabetic and non-diabetic patients. Since a sufficient blood supply is mandatory for wound healing, the evaluation of microcirculation in the healthy skin at a wound’s edge was the main outcome measure. Forty non-diabetic patients and 39 diabetics with lower limb chronic wounds who were referred to the University Medical Center Ljubljana between October 2012 and June 2014 were randomized to the treated and control groups. The treated group received phototherapy with LED 2.4 J/cm 2 (wavelengths 625, 660, 850 nm) three times a week for 8 weeks, and the control group received phototherapy with broadband 580–900 nm and power density 0.72 J/cm 2 . Microcirculation was measured using laser Doppler. A significant increase in blood flow was noted in the treated group of diabetic and non-diabetic patients ( p  = 0.040 and p  = 0.033), while there was no difference in the control groups. Additional Falanga wound bed score evaluation showed a significant improvement in both treated groups as compared to the control group. According to our results, phototherapy with LED was shown to be an effective additional treatment method for chronic wounds in diabetic and non-diabetic patients.