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Sayar F, Garebigloo A, Saberi S, Etemadi A. In Vitro Photobiomodulation Effects of Blue and Red Diode Lasers on Proliferation and Differentiation of Periodontal Ligament Mesenchymal Stem Cells. J Lasers Med Sci 2024; 15:e5. [PMID: 38655041 PMCID: PMC11033857 DOI: 10.34172/jlms.2024.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 01/29/2024] [Indexed: 04/26/2024]
Abstract
Introduction: This study aimed to assess the photobiomodulation effects of blue and red lasers on the proliferation and osteogenic differentiation of periodontal ligament mesenchymal stem cells (PDLMSCs). Methods: PDLMSCs were cultured and tested in 4 groups. The first two groups were exposed to 445 nm diode laser irradiation (200 mW, 6 and 12 J/cm2 ), and the third group was exposed to 660 nm diode laser irradiation (50 mW, 4 J/cm2 ). The fourth group was also considered as the control group without irradiation. Cell viability/proliferation was assessed by MTT assay. RUNX2, alkaline phosphatase (ALP), collagen type 1 (col1), and osteocalcin (OCN) were evaluated by RT-PCR, and Alizarin red was used to evaluate the colonization. The data were analyzed by means of one-way analysis of variance. Results: The results of our study showed that cell survival/proliferation in the second group was significantly lower than that in the control group on days 1 and 7 (P<0.05). RT-PCR showed a significant increase in osteogenic genes in all three laser groups compared to the control group (P<0.05). All groups showed a significant increase in calcium content compared to the control group (P<0.05). ALP activity also confirmed the osteoblastic differentiation of cells in laser groups. Conclusion: 445 nm and 660 nm lasers with the studied parameters showed positive effects on the proliferation and osteoblastic differentiation of PDLMSCs.
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Affiliation(s)
- Ferena Sayar
- Department of Periodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | | | - Sogol Saberi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ardavan Etemadi
- Department of Periodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Medhat A, El-Zainy MA, Fathy I. Photo biomodulation of dental derived stem cells to ameliorate regenerative capacity: In vitro study. Saudi Dent J 2024; 36:347-352. [PMID: 38419992 PMCID: PMC10897600 DOI: 10.1016/j.sdentj.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 03/02/2024] Open
Abstract
Background Dental regeneration benefits from improving the features of dental derived stem cells. Gallium-aluminum-arsenide laser had a significant role in modification of cell behavior in different cell lines and culture conditions. Hence, exploring its mechanism and effect on dental derived stem cells would benefit prospective regenerative dental therapies. Objectives To assess the impact of photo biomodulation by Low-Level-Laser on isolated Dental Pulp derived Stem Cells and Periodontal Ligament derived Stem Cells regarding their proliferation and osteogenic differentiation. Methods Isolated DPSCs and PDLSCs from impacted third molars were subjected to Gallium-aluminum-arsenide laser for 12 sec and 3.6 J/cm2. The proliferative capacity was evaluated via 3-(4,5-dimethylthiazol-2-yl),2,5-diphenyltetrazolium bromide (MTT) Assay and Trypan blue stain. Cell osteogenic differentiation potentials were assessed by alkaline phosphatase assay and alizarin red stain, polymerase chain reaction was performed to quantify Nuclear factor Kappa gene expression. Results DPSCs subjected to laser bio-stimulation showed the best results regarding cell viability (MTT) and osteogenic differentiation (ALP assay), and calcium deposition at 3 intervals (3, 7, 14 days), meanwhile, PDLSCs subjected to laser bio-stimulation showed better result than control but less than DPSCs. While NF-KB gene expression was proven to be approximately comparable for both groups. Generally, the Photo-bio modulated groups showed better results than their control groups. Conclusion Low-level laser bio-stimulation (LLL) therapy improves DPSC and PDLSC osteogenic differentiation and proliferation via the activation of the NF-KB pathway. Also, the DPSCs outperformed PDLSCs in terms of performance. Clinical significance These results can be beneficial information and a reference database for more research in tissue engineering, dental therapy, and regeneration.
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Affiliation(s)
- Alaa Medhat
- Department of Oral Biology, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
| | - Medhat A El-Zainy
- Department of Oral Biology, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
| | - Iman Fathy
- Department of Oral Biology, Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
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Gonçalves A, Monteiro F, Oliveira S, Costa I, Catarino SO, Carvalho Ó, Padrão J, Zille A, Pinho T, Silva FS. Optimization of a Photobiomodulation Protocol to Improve the Cell Viability, Proliferation and Protein Expression in Osteoblasts and Periodontal Ligament Fibroblasts for Accelerated Orthodontic Treatment. Biomedicines 2024; 12:180. [PMID: 38255285 PMCID: PMC10813108 DOI: 10.3390/biomedicines12010180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Numerous pieces of evidence have supported the therapeutic potential of photobiomodulation (PBM) to modulate bone remodeling on mechanically stimulated teeth, proving PBM's ability to be used as a coadjuvant treatment to accelerate orthodontic tooth movement (OTM). However, there are still uncertainty and discourse around the optimal PBM protocols, which hampers its optimal and consolidated clinical applicability. Given the differential expression and metabolic patterns exhibited in the tension and compression sides of orthodontically stressed teeth, it is plausible that different types of irradiation may be applied to each side of the teeth. In this sense, this study aimed to design and implement an optimization protocol to find the most appropriate PBM parameters to stimulate specific bone turnover processes. To this end, three levels of wavelength (655, 810 and 940 nm), two power densities (5 and 10 mW/cm2) and two regimens of single and multiple sessions within three consecutive days were tested. The biological response of osteoblasts and periodontal ligament (PDL) fibroblasts was addressed by monitoring the PBM's impact on the cellular metabolic activity, as well as on key bone remodeling mediators, including alkaline phosphatase (ALP), osteoprotegerin (OPG) and receptor activator of nuclear factor κ-B ligand (RANK-L), each day. The results suggest that daily irradiation of 655 nm delivered at 10 mW/cm2, as well as 810 and 940 nm light at 5 mW/cm2, lead to an increase in ALP and OPG, potentiating bone formation. In addition, irradiation of 810 nm at 5 mW/cm2 delivered for two consecutive days and suspended by the third day promotes a downregulation of OPG expression and a slight non-significant increase in RANK-L expression, being suitable to stimulate bone resorption. Future studies in animal models may clarify the impact of PBM on bone formation and resorption mediators for longer periods and address the possibility of testing different stimulation periodicities. The present in vitro study offers valuable insights into the effectiveness of specific PBM protocols to promote osteogenic and osteoclastogenesis responses and therefore its potential to stimulate bone formation on the tension side and bone resorption on the compression side of orthodontically stressed teeth.
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Affiliation(s)
- Aline Gonçalves
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (A.G.); (I.C.); (T.P.)
- Center for MicroElectroMechanical Systems (CMEMS), University of Minho, Campus Azurém, 4800-058 Guimarães, Portugal; (S.O.); (S.O.C.); (Ó.C.); (F.S.S.)
| | - Francisca Monteiro
- Center for MicroElectroMechanical Systems (CMEMS), University of Minho, Campus Azurém, 4800-058 Guimarães, Portugal; (S.O.); (S.O.C.); (Ó.C.); (F.S.S.)
- ICVS/3B’s-PT Government Associate Laboratory, 4710-057 Braga, Portugal
| | - Sofia Oliveira
- Center for MicroElectroMechanical Systems (CMEMS), University of Minho, Campus Azurém, 4800-058 Guimarães, Portugal; (S.O.); (S.O.C.); (Ó.C.); (F.S.S.)
| | - Inês Costa
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (A.G.); (I.C.); (T.P.)
| | - Susana O. Catarino
- Center for MicroElectroMechanical Systems (CMEMS), University of Minho, Campus Azurém, 4800-058 Guimarães, Portugal; (S.O.); (S.O.C.); (Ó.C.); (F.S.S.)
- LABBELS—Associate Laboratory, 4710-057 Braga, Portugal
| | - Óscar Carvalho
- Center for MicroElectroMechanical Systems (CMEMS), University of Minho, Campus Azurém, 4800-058 Guimarães, Portugal; (S.O.); (S.O.C.); (Ó.C.); (F.S.S.)
- LABBELS—Associate Laboratory, 4710-057 Braga, Portugal
| | - Jorge Padrão
- Centre for Textile Science and Technology (2C2T), Department of Textile Engineering, University of Minho, Azurém Campus, 4800-058 Guimarães, Portugal; (J.P.); (A.Z.)
| | - Andrea Zille
- Centre for Textile Science and Technology (2C2T), Department of Textile Engineering, University of Minho, Azurém Campus, 4800-058 Guimarães, Portugal; (J.P.); (A.Z.)
| | - Teresa Pinho
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (A.G.); (I.C.); (T.P.)
- IBMC—Instituto Biologia Molecular e Celular, i3S—Instituto de Inovação e Investigação em Saúde, Universidade do Porto, 4200-135 Porto, Portugal
| | - Filipe S. Silva
- Center for MicroElectroMechanical Systems (CMEMS), University of Minho, Campus Azurém, 4800-058 Guimarães, Portugal; (S.O.); (S.O.C.); (Ó.C.); (F.S.S.)
- LABBELS—Associate Laboratory, 4710-057 Braga, Portugal
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Ponnaiyan D, Rughwani RR, Shetty G, Mahendra J. The effect of adjunctive LASER application on periodontal ligament stem cells. Front Cell Dev Biol 2024; 11:1341628. [PMID: 38283989 PMCID: PMC10811063 DOI: 10.3389/fcell.2023.1341628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/18/2023] [Indexed: 01/30/2024] Open
Abstract
Periodontal regeneration involves the composite action of cell, scaffolds and signaling molecules. There are numerous autologous sources of regenerative cells which are present close to the vicinity of the periodontally debilitated site, the primary one being the periodontal ligament stem cell, which is believed to have a key role in regeneration. Various methods can be harnessed to optimize and enhance the regenerative potential of PDLSCs such as the application of LASERs. In the last few years there have been various studies which have evaluated the effect of different types of LASERs on PDLSCs and the present review summarizes the photo-biomodulative activity of LASERs in general and its beneficial role in the stimulation of PDLSC specifically.
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Affiliation(s)
| | | | | | - Jaideep Mahendra
- Meenakshi Academy of Higher Education and Research, Chennai, Tamil Nadu, India
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Yong J, Gröger S, VON Bremen J, Martins Marques M, Braun A, Chen X, Ruf S, Chen Q. Photobiomodulation therapy assisted orthodontic tooth movement: potential implications, challenges, and new perspectives. J Zhejiang Univ Sci B 2023; 24:957-973. [PMID: 37961799 PMCID: PMC10646401 DOI: 10.1631/jzus.b2200706] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 05/15/2023] [Indexed: 09/29/2023]
Abstract
Over the past decade, dramatic progress has been made in dental research areas involving laser therapy. The photobiomodulatory effect of laser light regulates the behavior of periodontal tissues and promotes damaged tissues to heal faster. Additionally, photobiomodulation therapy (PBMT), a non-invasive treatment, when applied in orthodontics, contributes to alleviating pain and reducing inflammation induced by orthodontic forces, along with improving tissue healing processes. Moreover, PBMT is attracting more attention as a possible approach to prevent the incidence of orthodontically induced inflammatory root resorption (OIIRR) during orthodontic treatment (OT) due to its capacity to modulate inflammatory, apoptotic, and anti-antioxidant responses. However, a systematic review revealed that PBMT has only a moderate grade of evidence-based effectiveness during orthodontic tooth movement (OTM) in relation to OIIRR, casting doubt on its beneficial effects. In PBMT-assisted orthodontics, delivering sufficient energy to the tooth root to achieve optimal stimulation is challenging due to the exponential attenuation of light penetration in periodontal tissues. The penetration of light to the root surface is another crucial unknown factor. Both the penetration depth and distribution of light in periodontal tissues are unknown. Thus, advanced approaches specific to orthodontic application of PBMT need to be established to overcome these limitations. This review explores possibilities for improving the application and effectiveness of PBMT during OTM. The aim was to investigate the current evidence related to the underlying mechanisms of action of PBMT on various periodontal tissues and cells, with a special focus on immunomodulatory effects during OTM.
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Affiliation(s)
- Jiawen Yong
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China
- Department of Orthodontics, Faculty of Medicine, Justus Liebig University Giessen, Giessen 35392, Germany
| | - Sabine Gröger
- Department of Orthodontics, Faculty of Medicine, Justus Liebig University Giessen, Giessen 35392, Germany
| | - Julia VON Bremen
- Department of Orthodontics, Faculty of Medicine, Justus Liebig University Giessen, Giessen 35392, Germany
| | | | - Andreas Braun
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Aachen 52074, Germany
| | - Xiaoyan Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China
| | - Sabine Ruf
- Department of Orthodontics, Faculty of Medicine, Justus Liebig University Giessen, Giessen 35392, Germany
| | - Qianming Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou 310000, China.
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6
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Moon KS, Bae JM, Park YB, Choi EJ, Oh SH. Photobiomodulation-Based Synergic Effects of Pt-Coated TiO 2 Nanotubes and 850 nm Near-Infrared Irradiation on the Osseointegration Enhancement: In Vitro and In Vivo Evaluation. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:1377. [PMID: 37110962 PMCID: PMC10142112 DOI: 10.3390/nano13081377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 06/19/2023]
Abstract
Photobiomodulation (PBM) therapy is known to have the potential to improve bone regeneration after implant surgery. However, the combinatory effect of the nanotextured implant and PBM therapy on osseointegration has not yet been proved. This study evaluated the photobiomodulation-based synergistic effects of Pt-coated titania nanotubes (Pt-TiO2 NT) and 850 nm near-infrared (NIR) light on osteogenic performance in vitro and in vivo. The FE-SEM and the diffuse UV-Vis-NIR spectrophotometer were used to perform the surface characterization. The live-dead, MTT, ALP, and AR assays were tested to perform in vitro tests. The removal torque testing, the 3D-micro CT, and the histological analysis were used to conduct in vivo tests. The live-dead and MTT assay resulted in Pt-TiO2 NTs being biocompatible. The ALP activity and AR assays demonstrated that the combination of Pt-TiO2 NT and NIR irradiation significantly enhanced osteogenic functionality (p < 0.05). The results of in vivo test, employing the removal torque testing, the 3D-micro CT, and histological analysis, showed overall improved outcomes; however, no significant difference was observed between the control and experimental groups (p > 0.05). Therefore, we confirmed the possibility of the combination of Pt-TiO2 NT and NIR light as a promising technology for implant surgery in dentistry.
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Affiliation(s)
- Kyoung-Suk Moon
- Department of Dental Biomaterials and the Institute of Biomaterial and Implant, College of Dentistry, Wonkwang University, Iksan 54538, Republic of Korea; (K.-S.M.)
| | - Ji-Myung Bae
- Department of Dental Biomaterials and the Institute of Biomaterial and Implant, College of Dentistry, Wonkwang University, Iksan 54538, Republic of Korea; (K.-S.M.)
| | - Young-Bum Park
- Department of Prosthodontology, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea
| | - Eun-Joo Choi
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Wonkwang University, Iksan 54538, Republic of Korea
| | - Seung-Han Oh
- Department of Dental Biomaterials and the Institute of Biomaterial and Implant, College of Dentistry, Wonkwang University, Iksan 54538, Republic of Korea; (K.-S.M.)
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7
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Amato M, Santonocito S, Viglianisi G, Tatullo M, Isola G. Impact of Oral Mesenchymal Stem Cells Applications as a Promising Therapeutic Target in the Therapy of Periodontal Disease. Int J Mol Sci 2022; 23:ijms232113419. [PMID: 36362206 PMCID: PMC9658889 DOI: 10.3390/ijms232113419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022] Open
Abstract
Periodontal disease is a chronic inflammatory condition affecting about 20–50% of people, worldwide, and manifesting clinically through the detection of gingival inflammation, clinical attachment loss, radiographically assessed resorption of alveolar bone, gingival bleeding upon probing, teeth mobility and their potential loss at advanced stages. It is characterized by a multifactorial etiology, including an imbalance of the oral microbiota, mechanical stress and systemic diseases such as diabetes mellitus. The current standard treatments for periodontitis include eliminating the microbial pathogens and applying biomaterials to treat the bone defects. However, periodontal tissue regeneration via a process consistent with the natural tissue formation process has not yet been achieved. Developmental biology studies state that periodontal tissue is composed of neural crest-derived ectomesenchyme. The aim of this review is to discuss the clinical utility of stem cells in periodontal regeneration by reviewing the relevant literature that assesses the periodontal-regenerative potential of stem cells.
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Affiliation(s)
- Mariacristina Amato
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
- Correspondence: (S.S.); (G.I.); Tel.: +39-0953782638 (S.S. & G.I.)
| | - Gaia Viglianisi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Marco Tatullo
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, 70122 Bari, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
- Correspondence: (S.S.); (G.I.); Tel.: +39-0953782638 (S.S. & G.I.)
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Gholami L, Afshar S, Arkian A, Saeidijam M, Hendi SS, Mahmoudi R, Khorsandi K, Hashemzehi H, Fekrazad R. NIR irradiation of human buccal fat pad adipose stem cells and its effect on TRP ion channels. Lasers Med Sci 2022; 37:3681-3692. [PMID: 36227520 DOI: 10.1007/s10103-022-03652-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/02/2022] [Indexed: 11/28/2022]
Abstract
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).
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Affiliation(s)
- Leila Gholami
- Department of Periodontics, Dental Implants Research Center, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Saeid Afshar
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Aliasghar Arkian
- Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Masood Saeidijam
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyedeh Sareh Hendi
- Department of Endodontics, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Roghayeh Mahmoudi
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Khatereh Khorsandi
- Department of Photodynamic, Medical Laser Research Center, Yara Institute, ACECR, Tehran, Iran.,Department of Biochemistry and Molecular Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
| | - Hadi Hashemzehi
- Department of Oral and Maxillofacial Surgery, Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran. .,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
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