Effect and clinical implications of the low-energy diode laser on bone cell proliferation

The impact of 980nm diode laser irradiation on the proliferation of mesenchymal stem cells derived from the umbilical cord's

Various cell types can have their growth accelerated by using low-intensity laser radiation. The study is intended to look at the impacts of laser radiation at low energy intensity on the ability of mesenchymal stem cells (MSCs) generated from umbilical cords to proliferate as well as survive in low-nutrient conditions. The study applied two different energy densities, 2.5 j/cm2 and 5 j/cm2, using a 980 nm diode laser radiation. This allowed for the observation of the effects of these specific elements on the behavior of the cells in a controlled environment at various concentrations of fetal bovine (7.5 %, 10 %, 12.5 %, and 15 %). The cells were grown in a medium lacking in nutrients and were enriched with varying quantities of serum from fetal bovines. The MTT test was used to evaluate the mitochondrial activity of the cell. Following 72 hours, it was shown that cells treated with 2.5 j/cm2 and 10 % fetal bovine serum had significantly higher MTT test activity than cells treated with 5 j/cm2.The results of this study show that even in the presence of dietary deficiencies, low-intensity laser radiation therapy can stimulate the growth of mesenchymal stem cells isolated from umbilical cords.

The Future of Bone Repair: Emerging Technologies and Biomaterials in Bone Regeneration

Bone defects and fractures present significant clinical challenges, particularly in orthopedic and maxillofacial applications. While minor bone defects may be capable of healing naturally, those of a critical size necessitate intervention through the use of implants or grafts. The utilization of traditional methodologies, encompassing autografts and allografts, is constrained by several factors. These include the potential for donor site morbidity, the restricted availability of suitable donors, and the possibility of immune rejection. This has prompted extensive research in the field of bone tissue engineering to develop advanced synthetic and bio-derived materials that can support bone regeneration. The optimal bone substitute must achieve a balance between biocompatibility, bioresorbability, osteoconductivity, and osteoinductivity while simultaneously providing mechanical support during the healing process. Recent innovations include the utilization of three-dimensional printing, nanotechnology, and bioactive coatings to create scaffolds that mimic the structure of natural bone and enhance cell proliferation and differentiation. Notwithstanding the advancements above, challenges remain in optimizing the controlled release of growth factors and adapting materials to various clinical contexts. This review provides a comprehensive overview of the current advancements in bone substitute materials, focusing on their biological mechanisms, design considerations, and clinical applications. It explores the role of emerging technologies, such as additive manufacturing and stem cell-based therapies, in advancing the field. Future research highlights the need for multidisciplinary collaboration and rigorous testing to develop advanced bone graft substitutes, improving outcomes and quality of life for patients with complex defects.

Radioreparative Effect of Diode Laser on Leukopoiesis Recovery: A Pilot Study

The aim of the present study was to investigate the effect of laser therapy on leukopoiesis recovery after irradiation with ionizing radiation. A dose of ionizing radiation was used that induced the hematological form of radiation sickness, reducing the number of blood cells. Subsequently, mice were treated with non-ionizing laser radiation. Based on the examination of the peripheral blood, the study found that laser therapy significantly impacted the number of eosinophils and basophils two weeks after irradiation. Laser therapy also led to the faster reparation of the lymphocyte lineage of white blood cells (WBCs). The research showed that the examined therapeutic laser had a long-term radioreparative effect on gamma-irradiated mice, improving the absolute counts of different lines of WBCs. The results of this study could have implications for the treatment of radiation sickness in humans.

Influence of Three Laser Wavelengths with Different Power Densities on the Mitochondrial Activity of Human Gingival Fibroblasts in Cell Culture

Phototherapy plays a key role in wound healing and tissue regeneration. The use of lasers has the potential to become an effective and minimally invasive treatment in periodontal and peri-implant disease. The aim of this study was to evaluate the influence of three laser wavelengths with the combination of parameters such as power density and energy density on human gingival fibroblasts (hGFs) in vitro culture. Isolated cells were seeded in 96-well plates with culture medium (DMEM, Dulbecco's modified Eagle's medium) supplemented with 10% fetal bovine serum (FBS). After 24 h cells were irradiated (1064, 980 and 635 nm, various energy density value). After 24, 48 and 72 h, cells were evaluated for viability. Data were analyzed by ANOVA followed by Tukey's HSD test. We found the best outcomes for hGFs irradiated with laser 1064 nm for all combinations of power output (50/400/1000 mW) and energy dose (3/25/64 J/cm²) after 48 h and 72 h compared with control group. Cell viability increase ranged from 0.6× (3 J/cm², 50 mW) to 1.3× (64 J/cm², 1000 mW). Our findings indicate that the appropriate use of low-level laser irradiation (LLLI) can increase the proliferation rate of cultured cells. The use of LLLI can be extremely useful in tissue engineering and regenerative medicine.

NIR irradiation of human buccal fat pad adipose stem cells and its effect on TRP ion channels

The effect of near infrared (NIR) laser irradiation on proliferation and osteogenic differentiation of buccal fat pad-derived stem cells and the role of transient receptor potential (TRP) channels was investigated in the current research. After stem cell isolation, a 940 nm laser with 0.1 W, 3 J/cm² was used in pulsed and continuous mode for irradiation in 3 sessions once every 48 h. The cells were cultured in the following groups: non-osteogenic differentiation medium/primary medium (PM) and osteogenic medium (OM) groups with laser-irradiated (L +), without irradiation (L -), laser treated + Capsazepine inhibitor (L + Cap), and laser treated + Skf96365 inhibitor (L + Skf). Alizarin Red staining and RT-PCR were used to assess osteogenic differentiation and evaluate RUNX2, Osterix, and ALP gene expression levels. The pulsed setting showed the best viability results (P < 0.05) and was used for osteogenic differentiation evaluations. The results of Alizarin red staining were not statistically different between the four groups. Osterix and ALP expression increased in the (L +) group. This upregulation abrogated in the presence of Capsazepine, TRPV1 inhibitor (L + Cap); however, no significant effect was observed with Skf96365 (L + Skf).

Effect of low-level laser therapy on condylar growth in children treated with functional appliance: a preliminary study

Purpose

This study aimed to evaluate the skeletal and dentoalveolar changes achieved by combining low-level laser irradiation applied on the condyle area with twin-block therapy in growing class II malocclusion patients.

Methods

Fourteen patients (9 males, 5 females; mean age, 11.4 ± 2 years) with skeletal class II mandibular deficiency were recruited. They were divided into two groups (G 1: twin-block + low-level laser therapy, G 2: twin-block only). A semiconductor diode laser with a wavelength of 940 nm was applied on the condyle area (100 mW, 2.5 J, 3.9 J/cm²). The laser was applied twice a week in the first month and once a week in the second and third months, totalizing 16 sessions. Skeletal, dental, and soft-tissue cephalometric parameters were measured and compared at different treatment points.

Results

Mandibular length (Co-Gn) was significantly increased by 3.6 mm in the experiment group (3.16 SD) and 4.3 mm (4.4 SD) in the control group, with no significant difference between groups at every time point (P-value 0.949 at T2). Similarly, a statistically significant positive effect of treatment was found in both groups on ramus height (Co-Go), upper lip to E-Line, SNA angle, ANB angle, and U1/SN angle with no significant difference between groups.

Conclusion

Based on the results of this preliminary study, low-level laser irradiation with the used parameters seems to have no synergetic impact on the skeletal and dental outcomes of twin-block therapy over 9 months. However, more studies are needed to investigate the effect of low-level laser therapy on condylar growth during functional orthodontic treatment.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41547-022-00158-x.

Photobiomodulation Therapy Affects the Elastic Modulus, Cytoskeletal Rearrangement and Migration Capability of Human Osteosarcoma Cells

Photobiomodulation (PBM) therapy utilizes low-power lasers to modulate the viability of living human cells and leads to changes in proliferation, differentiation, adhesion and gene expression, even though the rearrangement of cytoskeleton was not previously studied. The present study aims to evaluate the photobiological effects on the elastic behavior of human osteosarcoma cells (MG-63) and their morphological changes. Fluorescence staining, confocal imaging and atomic force microscopy (AFM) topography were performed to study the effects of PBM therapy with the exposure of 532 nm-25mW, 650 nm-3mW, 650 nm-150mW and 780 nm-70mW beams following the 5-min continuous irradiation. The area of each beam was 3.14cm² with a source-surface distance of 20 cm. Besides the cell proliferation assessment, the migratory potential of MG-63 was determined with the wound healing technique. The results indicated an increase in stiffness and shape index of radiation-induced cells 24 h after exposure along with the obvious F-actins changes. But, cell stiffening was not observed 72 h after 532 nm laser irradiation. Also, a decrease in the migration rate was seen in all of the groups after 72 h of irradiation except cells treated with 532 nm wavelength. However, 532 nm laser beams increase the migratory potential 24 h after exposure. Within 72 h after irradiation, the cell proliferation was only affected by applying 532 nm and 650 nm-150mW laser beams. It was concluded that applying photobiomodulation with wavelengths of 650 nm (at both utilized powers) and 780 nm alters the migration capability and provides a quantitative description of cytoskeletal changes. Moreover, membrane stiffening can be considered as the biological marker of PBM treatments.

Low-Level Laser Irradiation Promotes Proliferation and Differentiation on Apical Papilla Stem Cells

Introduction: Low-level laser therapy (LLLT) has been reported to improve cell proliferation and differentiation. The stem cells derived from dental apical papilla (SCAPs) are a promising therapy because they are easily obtained from immature human teeth. The effect of LLLT over SCAPs is still unknown. This study aimed to evaluate the proliferation and osteogenic potential of the SCAPs stimulated with LLLT. Methods: SCAPs were isolated from the third molars of a healthy donor and characterized according to the minimum established criteria. SCAPs were cultured for 24 hours before being exposed to LLLT. Cells were exposed to different doses, energy, and wavelengths for selecting the irradiation parameters. SCAPs proliferation was evaluated with the MTT assay at 24 hours and 7-day post-laser exposure. VEGF and TGFβ2 expression were assessed with a specific enzyme-linked immunosorbent assay (ELISA). The osteogenic differentiation potential was analyzed with alizarin red staining, and the nodule quantification was performed by the relative optical density (ROD) analysis using ImageJ software. Results: The cells isolated from the apical papilla showed phenotype and stem cell properties. SCAPs irradiated with one dose at 6 J/m2 and 650 nm exhibited significantly higher proliferation (P>0.05) than the controls nonirradiated. LLLT stimulated SCAPs' expression of factors VEGF and TGFβ2. Also, SCAPs irradiated showed higher osteogenic activity (P<0.05). Conclusion: LLLT promotes proliferation, osteogenic differentiation, and VEGF and TGFβ2 expression on SCAPs. LLLT is a practical approach for the preconditioning of SCAPs in vitro for future regenerative therapies. More studies are needed to determine the underlying molecular processes that determine the mechanism of the LLLT.

Biological Responses of Stem Cells to Photobiomodulation Therapy

BACKGROUND

Stem cells have attracted the researchers interest, due to their applications in regenerative medicine. Their self-renewal capacity for multipotent differentiation, and immunomodulatory properties make them unique to significantly contribute to tissue repair and regeneration applications. Recently, stem cells have shown increased proliferation when irradiated with low-level laser therapy or Photobiomodulation Therapy (PBMT), which induces the activation of intracellular and extracellular chromophores and the initiation of cellular signaling. The purpose of this study was to evaluate this phenomenon in the literature.

METHODS

The literature investigated the articles written in English in four electronic databases of PubMed, Scopus, Google Scholar and Cochrane up to April 2019. Stem cell was searched by combining the search keyword of "low-level laser therapy" OR "low power laser therapy" OR "low-intensity laser therapy" OR "photobiomodulation therapy" OR "photo biostimulation therapy" OR "LED". In total, 46 articles were eligible for evaluation.

RESULTS

Studies demonstrated that red to near-infrared light is absorbed by the mitochondrial respiratory chain. Mitochondria are significant sources of reactive oxygen species (ROS). Mitochondria play an important role in metabolism, energy generation, and are also involved in mediating the effects induced by PBMT. PBMT may result in the increased production of (ROS), nitric oxide (NO), adenosine triphosphate (ATP), and cyclic adenosine monophosphate (cAMP). These changes, in turn, initiate cell proliferation and induce the signal cascade effect.

CONCLUSION

The findings of this review suggest that PBMT-based regenerative medicine could be a useful tool for future advances in tissue engineering and cell therapy.

In Vitro Cytological Responses against Laser Photobiomodulation for Periodontal Regeneration

Periodontal disease is a chronic inflammatory disease caused by periodontal bacteria. Recently, periodontal phototherapy, treatment using various types of lasers, has attracted attention. Photobiomodulation, the biological effect of low-power laser irradiation, has been widely studied. Although many types of lasers are applied in periodontal phototherapy, molecular biological effects of laser irradiation on cells in periodontal tissues are unclear. Here, we have summarized the molecular biological effects of diode, Nd:YAG, Er:YAG, Er,Cr:YSGG, and CO₂ lasers irradiation on cells in periodontal tissues. Photobiomodulation by laser irradiation enhanced cell proliferation and calcification in osteoblasts with altering gene expression. Positive effects were observed in fibroblasts on the proliferation, migration, and secretion of chemokines/cytokines. Laser irradiation suppressed gene expression related to inflammation in osteoblasts, fibroblasts, human periodontal ligament cells (hPDLCs), and endothelial cells. Furthermore, recent studies have revealed that laser irradiation affects cell differentiation in hPDLCs and stem cells. Additionally, some studies have also investigated the effects of laser irradiation on endothelial cells, cementoblasts, epithelial cells, osteoclasts, and osteocytes. The appropriate irradiation power was different for each laser apparatus and targeted cells. Thus, through this review, we tried to shed light on basic research that would ultimately lead to clinical application of periodontal phototherapy in the future.

Evidence from systematic reviews on photobiomodulation of human bone and stromal cells: Where do we stand?

This study summarizes the available evidence from systematic reviews on the in vitro effects of photobiomodulation on the proliferation and differentiation of human bone and stromal cells by appraising their methodological quality. Improvements for future studies are also highlighted, with particular emphasis on in vitro protocols and cell-related characteristics. Six reviews using explicit eligibility criteria and methods selected in order to minimize bias were included. There was no compelling evidence on the cellular mechanisms of action or treatment parameters of photobiomodulation; compliance with quality assessment was poor. A rigorous description of laser parameters (wavelength, power, beam spot size, power density, energy density, repetition rate, pulse duration or duty cycle, exposure duration, frequency of treatments, and total radiant energy), exposure conditions (methods to ensure a uniform irradiation and to avoid cross-irradiation, laser-cell culture surface distance, lid presence during irradiation) and cell-related characteristics (cell type or line, isolation and culture conditions, donor-related factors where applicable, tissue source, cell phenotype, cell density, number of cell passages in culture) should be included among eligibility criteria for study inclusion. These methodological improvements will maximize the contribution of in vitro studies on the effects of photobiomodulation on human bone and stromal cells to evidence-based translational research.

Human Fibroblast Gene Expression Modulation Using 940 NM Diode Laser

Low-Level Laser Therapy is used as regenerative therapy in different clinical fields. This is due to its photobiomodulation effect via cell signaling on different cell populations, Including fibroblasts, cells involved in tissue regeneration and healing. The aim was to analyze the effect of 940 nm diode laser on the gene expression of different markers involved in fibroblast growth, differentiation, and migration. Real-time polymerase chain reaction (q-RT-PCR) was used to quantify the expression of fibroblast growth factor (FGF), connective tissue growth factor (CTGF), vascular-endothelial growth factor (VEGF), transforming growth factor β1 (TGF-β1), TGFβ-receptors (TGFβR1, TGFβR2, and TGFβR3), discoidin-domain receptor-2 (DDR2), matrix metalloproteinase-2 (MMP2), α-actin, fibronectin, decorin, and elastin on human fibroblast, treated with single dose (T1) or two doses (T2) of diode laser at 0.5 Watts and 4 J/cm². A significant increase in the expression of FGF, TGF-β1, TGFβR1, TGFβR2, α-actin, fibronectin, decorin, DDR2 and MMP2 was observed after both treatments. A decrease was observed in expression of elastin (T1 and T2), and CTGF (T2). These changes underlie the biostimulatory effect of laser on fibroblasts, which translates into an increase in short-term proliferation and in long-term differentiation to myofibroblasts. These data support the therapeutic potential of diode laser for wound repair.

Molecular impacts of photobiomodulation on bone regeneration: A systematic review

Photobiomodulation (PBM) encompasses a light application aimed to increase healing process, tissue regeneration, and reducing inflammation and pain. PBM is specifically aimed to modify the expression of cellular molecules; however, PBM impacts on cellular and molecular pathways especially in bone regenerative medicine have been investigated in scattered different studies. The purpose of the current study is to systematically review evidence on molecular impact of PBM on bone regeneration. A comprehensive electronic search in Medline, Scopus, EMBASE, EBSCO, Cochrane library, web of science, and google scholar was conducted from January 1975 to October 2018 limited to English language publications on administrations of photobiomodulation for bone regeneration which evaluated biological factors. In addition, hand search of selected journals was done to retrieve all articles. This systematic review was performed based on PRISMA guideline. Among these studies, five articles reported in vitro results, twelve articles were in vivo, and three of them were clinical trials. The data tabulated according to the type of markers (osteogenic markers, angiogenic markers, growth factors, and inflammation mediators). PBM's effects depend on many parameters which energy density is more important than the others. PBM can significantly enhance expression of osteocalcin, collagen, RUNX-2, vascular endothelial growth factor, bone morphogenic proteins, and COX-2. Although since the heterogeneity of the studies and their limitations, an evidence-based decision for definite therapeutic application of PBM is still unattainable, the findings of our review can help other researchers to ameliorate their study design and elect more efficient approach for their investigation.

A Comparative Study Between the Effectiveness of 980 nm Photobiomodulation Delivered by Hand-Piece With Gaussian vs. Flat-Top Profiles on Osteoblasts Maturation

Photobiomodulation (PBM) is a clinically accepted tool in regenerative medicine and dentistry to improve tissue healing and repair and to restore the functional disability. The current in vitro study aimed to investigate the photobiomodulatory effects of 980 nm wavelength (the real energy at the target: ~0.9 W, ~0.9 W/cm2, 60 s, ~55 J/cm2 and a single energy ~55 J in CW) on MC3T3-E1 pre-osteoblast, delivered with flattop profile in comparison to the standard profile. The laser groupings and their associated energies were: Group 1 - once per week (total energy 110 J); Group 2 - three times per week (alternate day) (total energy 330 J); Group 3 - five times per week (total energy 550 J). The metabolic activity and the osteoblasts maturation were analyzed by alkaline phosphatase assay, alizarin red S histological staining, immunoblot and/or double immunolabeling analysis for Bcl2, Bax, Runx-2, Osx, Dlx5, osteocalcin, and collagen Type 1. Our data, for the first time, prove that laser irradiation of 980 nm wavelength with flat-top beam profile delivery system, compared to standard-Gaussian profile, has improved photobiomodulatory efficacy on pre-osteoblastic cells differentiation. Mechanistically, the irradiation enhances the pre-osteoblast differentiation through activation of Wnt signaling and activation of Smads 2/3-βcatenin pathway.

Near infrared low-level laser therapy and cell proliferation: The emerging role of redox sensitive signal transduction pathways

Lasers devices are widely used in various medical fields (eg, surgery, dermatology, dentistry, rehabilitative medicine, etc.) for different applications, ranging from surgical ablation of tissues to biostimulation and pain relief. Laser is an electromagnetic radiation, which effects on biological tissues strongly depends on a number of physical parameters. Laser wavelength, energy output, irradiation time and modality, temperature and tissue penetration properties have to be set up according to the clinical target tissue and the desired effect. A less than optimal operational settings, in fact, could result in a null or even lethal effect. According to the first law of photobiology, light absorption requires the presence of a specific photoacceptor that after excitation could induce the activation of downstream signaling pathways. Low-level lasers operating in the red/near infrared portion of the light spectra are generally used for biostimulation purposes, a particular therapeutic application based on the radiant energy ability to induce nonthermal responses in living cells. Biostimulation process generally promotes cell survival and proliferation. Emerging evidences support a low-level laser stimulation mediated increase in "good" reactive oxygen species, able to activate redox sensitive signal transduction pathways such as Nrf-2, NF-kB, ERK which act as key redox checkpoints.

Low power laser irradiation and human adipose-derived stem cell treatments promote bone regeneration in critical-sized calvarial defects in rats

Both stem cell therapy and physical treatments have been shown to be beneficial in accelerating bone healing. However, the efficacy of combined treatment with stem cells and physical stimuli for large bone defects remains uncertain. The aim of this study was to evaluate the bone regeneration effects of low-power laser irradiation (LPLI) and human adipose-derived stem cell (ADSC) treatments during fracture repair using a comparative rat calvarial defect model. We evaluated the viability of human ADSCs, which were cultured on a porous PLGA scaffold using an MTS assay. The critical-sized calvarial bone defect rats were divided into 4 groups: control group, LPLI group, ADSC group, and ADSC+LPLI group. Bone formation was evaluated using micro-CT. New bone formation areas and osteogenic factor expression levels were then examined by histomorphological analysis and immunohistochemical staining. Our data showed that PLGA had no cytotoxic effect on human ADSCs. Micro-CT analyses revealed that both the LPLI and ADSC groups showed improved calvarial bone defect healing compared to the control group. In addition, the ADSC+LPLI group showed significantly increased bone volume at 16 weeks after surgery. The area of new bone formation ranked as follows: control group < LPLI group < ADSC group < ADSC+LPLI group. There were significant differences between the groups. In addition, both ADSC and ADSC+LPLI groups showed strong signals of vWF expression. ADSC and LPLI treatments improved fracture repair in critical-sized calvarial defects in rats. Importantly, the combined treatment of ADSCs and LPLI further enhances the bone healing process.

Comparison of the in vitro effects of low-level laser therapy and low-intensity pulsed ultrasound therapy on bony cells and stem cells

To compare the in vitro effectiveness of Low-Level Laser Therapy (LLLT) and Low Intensity Pulsed Ultrasound (LIPUS) on bony cells and related stem cells. In this study, we aim to systematically review the published scientific literature which explores the use of LLLT and LIPUS to biostimulate the activity or the proliferation of bony cells or stem cells in vitro. We searched the database PubMed for LLLT or LIPUS, with/without bone, osteoblast, osteocyte, stem cells, the human osteosarcoma cell line (MG63), bone-forming cells, and cell culture (or in vitro). These studies were subdivided into categories exploring the effect of LLLT or LIPUS on bony cells, stem cells, and other related cells. 75 articles were found between 1987 and 2016; these included: 50 full paper articles on LLLT and 25 full papers on LIPUS. These articles met the eligibility criteria and were included in our review. A detailed and concise description of the LLLT and the LIPUS protocols and their individual effects on bony cells or stem cells and their results are presented in five tables. Based on the main results and the conclusions of the reviewed articles in the current work, both, LLLT and LIPUS, apply a biostimulatory effect on osteoblasts, osteocytes, and enhance osteoblast proliferation and differentiation on different bony cell lines used in in vitro studies, and therefore, these may be useful tools for bone regeneration therapy. Moreover, in consideration of future cell therapy protocols, both, LLLT and LIPUS (especially LLLT), enhnce a significant increase in the initial number of SCs before differentiation, thus increasing the number of differentiated cells for tissue engineering, regenerative medicine, and healing. Further studies are necessary to determine the LLLT or the LIPUS parameters, which are optimal for biostimsulating bony cells and SCs for bone healing and regenerative medicine.

Cultured Human Fibroblast Biostimulation Using a 940 nm Diode Laser

Background: Fibroblasts are the main cells involved in regeneration during wound healing. The objective was to determine the effect of 940 nm diode laser on cultured human fibroblasts using different irradiation regimens. Methods: The CCD-1064Sk human epithelial fibroblast cell line was treated with a 940 nm diode laser at different energy doses (power: 0.2–1 W and energy density: 1–7 J/cm²) using different transmission modes (continuous or pulsed). The effect on cell growth at 24 and 72 h post-treatment was examined by measuring the proliferative capacity, the impact on the cell cycle, and the effect on cell differentiation. Results: fibroblast proliferative capacity was increased at 24 and 72 h post-treatment as a function of the energy dose. The greatest increase was observed with a power of 0.2 or 0.5 W and energy density between 1 and 4 J/cm²; no difference was observed between continuous and pulsed modes. There were no significant differences in cell cycle between treated groups and controls. α-actin expression was increased by treatment, indicating enhanced cell differentiation. Conclusion: The 940 nm diode laser has biostimulating effects on fibroblasts, stimulating proliferative capacity and cell differentiation without altering the cell cycle. Further researches are necessary to explore its potential clinical usefulness in wound healing.

In quest of optimal drug-supported and targeted bone regeneration in the cranio facial area: a review of techniques and methods

Craniofacial bone structures are frequently and extensively affected by trauma, tumors, bone infections and diseases, age-related degeneration and atrophy, as well as congenital malformations and developmental anomalies. Consequently, severe encumbrances are imposed on both patients and healthcare systems due to the complex and lengthy treatment duration. The search for alternative methods to bone transplantation, grafting and the use of homologous or heterologous bone thus responds to one of the most significant problems in human medicine. This review focuses on the current consensus of bone-tissue engineering in the craniofacial area with emphasis on drug-induced stem cell differentiation and induced bone regeneration.

Tenogenic induction of equine mesenchymal stem cells by means of growth factors and low-level laser technology

Tendons regenerate poorly due to a dense extracellular matrix and low cellularity. Cellular therapies aim to improve tendon repair using mesenchymal stem cells and tenocytes; however, a current limitation is the low proliferative potential of tenocytes in cases of severe trauma. The purpose of this study was to develop a method useful in veterinary medicine to improve the differentiation of Peripheral Blood equine mesenchymal stem cells (PB-MSCs) into tenocytes. PB-MSCs were used to study the effects of the addition of some growth factors (GFs) as TGFβ3 (transforming growth factor), EGF2 (Epidermal growth factor), bFGF2 (Fibroblast growth factor) and IGF-1 (insulin-like growth factor) in presence or without Low Level Laser Technology (LLLT) on the mRNA expression levels of genes important in the tenogenic induction as Early Growth Response Protein-1 (EGR1), Tenascin (TNC) and Decorin (DCN). The singular addition of GFs did not show any influence on the mRNA expression of tenogenic genes whereas the specific combinations that arrested cell proliferation in favour of differentiation were the following: bFGF2 + TGFβ3 and bFGF2 + TGFβ3 + LLLT. Indeed, the supplement of bFGF2 and TGFβ3 significantly upregulated the expression of Early Growth Response Protein-1 and Decorin, while the use of LLLT induced a significant increase of Tenascin C levels. In conclusion, the present study might furnish significant suggestions for developing an efficient approach for tenocyte induction since the external administration of bFGF2 and TGFβ3, along with LLLT, influences the differentiation of PB-MSCs towards the tenogenic fate.

The effect of low-level diode laser therapy on early differentiation of osteoblast via BMP-2/TGF-β1 and its receptors

OBJECTIVES

The objective of this study was to determine the effect of LLDL therapy on the gene expression of osteoblast markers of growth and differentiation.

MATERIALS AND METHODS

The MG-63 cell line was exposed to diode laser (ezLase) of 940 nm at 1-1.5 W and 3-4 J, and gene expressions (Runx-2, alkaline phosphatase [ALP], type I collagen [Col-I], osterix [OSX], osteocalcin [OSC], osteoprotegerin [OPG], bone morphogenetic protein [BMP]-2 and -7, transforming growth factor-β1 [TGF-β1], and TGF-β receptors [TGF-β R1, TGF-β R2; TGF-β R3]) were evaluated by quantitative RT-PCR.

RESULTS

LLDL treatment stimulated the expression of osteoblast differentiation markers ALP, Col-I, Runx-2, and OSX in relation to the doses applied (P < 0.05), but no changes were detected in OSC, OPG, or BMP-7 at any study dose. This effect may be mediated by TGF-β1 and BMP-2, given that the treatment increased their expression and that of TGF-β receptors R1, R2, and R3 (P < 0.001).

CONCLUSION

These results suggest that the biostimulatory effect of laser therapy on osteoblasts may be attributable to the release of autocrine factors in response to the irradiation. A clinical trial is warranted to test its therapeutic usefulness in bone tissue regeneration and to define a treatment protocol.

Photobiomodulation with low-level diode laser promotes osteoblast migration in an in vitro micro wound model

Laser photobiomodulation can improve bone healing, but well-defined treatment parameters are lacking. Saos-2 human osteoblast-like cells were subjected to an in vitro scratch-wound healing assay and irradiated by a 915-nm gallium-aluminum-arsenide diode laser for 0, 48, 96, and 144 s using doses of, respectively, 0, 5, 10, and 15 J/cm(2) . Wound area was measured after 4, 24, 48, and 72 h. Cell viability, DNA content, gene expression, and release of bone-related proteins were evaluated after 24, 48, and 72 h. Laser significantly improved wound healing compared with nonirradiated controls. Cells treated with laser doses of 5 and 10 J/cm(2) reached wound closure after 72 h, followed by 15 J/cm(2) after 96 h. With the cell proliferation inhibitor Mitomycin C, the doses of 10 and 15 J/cm(2) maintained an improved wound healing compared with controls. Laser increased collagen type 1 gene expression with higher doses inducing a longer-lasting effect, whereas transforming growth factor-beta 1 showed comparable or decreased levels in irradiated versus nonirradiated groups, with no effect on protein release. This study demonstrated that laser photobiomodulation at 915 nm promoted wound healing mainly through stimulation of cell migration and collagen deposition by osteoblasts.

The influence of laser radiation on human osteoblasts cultured on nanostructured composite substrates

BACKGROUND AND AIMS

Carbon-based nanomaterials such as carbon nanotubes, graphene oxide and graphene have been explored by researchers as well as the industry. Graphene is a new nanomaterial which has commercial and scientific advantages. Laser therapy has proven highly useful in biomedicine, with the use of different laser types and energies for distinct purposes. The low level laser therapy (LLLT) can have anti-inflammatory, analgesic and biostimulant effects. Recent research has shown that laser radiation has different effects on osteoblasts. The aim of this study was to identify the influence of laser radiation on human osteoblastic cells cultured on nanostructured composite substrates.

MATERIALS AND METHODS

Four types of substrates were created using colloidal suspensions of nanostructured composites in PBS at a concentration of 30 μg/ml. We used human osteoblasts isolated from patella bone pieces harvested during arthroplasty. Irradiation of osteoblasts cultured on nanostructured composite substrates was made with a semiconductor laser model BTL-10 having a wavelength of 830 nm. The proliferation activity of osteoblast cells was assessed using the MTT assay. After laser irradiation procedure the viability and proliferation of osteoblast cells were analyzed using fluorescein diacetate (FDA) staining.

RESULTS

The osteoblast cells viability and proliferation were evaluated with MTT assay at 30 minutes, 24 hours, 5 days and 10 days after laser irradiation. In the first 30 minutes there were no significant differences between the irradiated and non-irradiated cells. At 24 hours after laser irradiation procedure a significant increase of MTT values in case of irradiated osteoblasts cultivated on nanostructured hydroxyapatite, nanostructured hydroxyapatite with gold nanoparticles and 1.6% and 3.15% graphenes composites substrates was observed. A more marked proliferation rate was observed after 10 days of irradiation for irradiated osteoblasts seeded on nanostructured hydroxyapatite with gold nanoparticles and graphenes containing substrate. Using FDA staining we obtained very similar results with MTT test.

CONCLUSIONS

The association between the 830 nm laser irradiation of osteoblasts and their long-term cultivation of the nanostructured composite substrates induces the cell proliferation and differentiation and therefore it will be a useful alternative for bone regeneration therapy.

Protective effect of 940 nm laser on gamma-irradiated mice

OBJECTIVE

The purpose of this study was to investigate the radioprotective features of 940 nm laser on the life span of mice, and absolute counts of blood cells and their proportions in gamma-irradiated mice.

BACKGROUND DATA

An important feature of laser light is activation of mitotic division and differentiation of cells, which may be useful in activation of hematopoiesis in gamma-irradiated organisms.

MATERIALS AND METHODS

Mice were randomly assigned to 11 groups according to the type(s) of influence. Generally, mice were irradiated in three different ways: with laser at different fluences, with gamma irradiation, or by combination of laser at different fluences and gamma irradiation in a different order. Mice were treated with 940 nm laser at 3, 12, or 18 J/cm(2) and/or a lethal dose of gamma irradiation (8.7 Gy). Each group was randomly subdivided into two subgroups, in which the life span of the mice and blood cell counts (on 12th and 45th day after gamma irradiation) were analyzed.

RESULTS

Laser (940 nm) at a fluence of 3 J/cm(2) significantly prolonged the life span of gamma-irradiated mice (p<0.05). In the same group, counts of white blood cells, lymphocytes, and neutrophils were higher on day 12 than in the gamma group. On day 45 after gamma irradiation, some signs of hematopoiesis repair were found in blood. There were no significant differences in counts of erythrocytes, monocytes, neutrophils, or the proportion of neutrophils between this group and the control group.

CONCLUSIONS

In summary, 940 nm laser at a fluence of 3 J/cm(2) demonstrates radioprotective features in an experiment with lethally irradiated mice. Mechanisms responsible for this effect will be investigated in further studies.

Laser-induced osteoblast proliferation is mediated by ROS production

Low-level laser therapy (LLLT) is widely used in regenerative medicine and in dental therapy by virtue of its beneficial effects in a plethora of pathological conditions. In this study, the effect of a 980 nm diode laser on pre-osteoblasts proliferation has been evaluated, along with reactive oxygen species (ROS) production. We hypothesized that ROS were a key factor in LLLT-induced pre-osteoblasts proliferation, as it is known that ROS can induce the activation of many biological pathways, leading to cell proliferation, differentiation or apoptosis. Murine pre-osteoblasts MC3T3 cells were irradiated with different energy outputs (1-50 J) in the absence or presence of the antioxidant N-Acetyl-L-cysteine (NAC). Laser treatment, in the absence of NAC, was able to induce a fluence-dependent statistically significant increase in ROS generation, while the presence of NAC strongly inhibited it. Cell proliferation, measured after laser stimulation, was significantly increased both at low and higher energy, with a peak at 10 J in the absence of the antioxidant. On the contrary, in the presence of NAC, laser irradiation was not able to induce any cell proliferation, suggesting a crucial role of ROS in this laser-induced cell effect. These results suggest that LLLT may be a useful tool for bone regeneration therapy and an effective range of fluences to be used is indicated.