Authors Indication LLLT + settings Treatment Outcome
Da Guarda et al. [12] 1 pat. PC GaAlAs diode; 860 nm; 70 mW; SS 4 mm2. Fl: 4.2 J/cm2; 5x – 10d STL EP:MH 1 case healed
Vescovi et al. [10] BM: Stage 1 (18), 2(48) and 3(3) MM: Stage 1(12), 2(44) and 3(3) Nd:YAG; 1.25 W; 15 Hz; fd320 μm; dist: 2 mm; 5x 1min, 1/w, 2 mo MT vs. MTL EP:MH 18.2% vs. 21.4 %
STL + LLLT as described above or Er:YAG – Laser supported ST ST vs. STL vs. Er:YAG-ST; EP: MH 53.8% vs. 70.6% vs. 90.3%;
Vescovi et al. [9] 128 pat.; MM(52), BM(53), OP(23); Stage 1 (17), 2 (92), 3 (19); 101 treated sites Nd:YAG 1064 nm; 1.25 W; 15 Hz; DC: 0.15%; fd320 μm; dist: 2 mm; 5x1 min (PD 268.81 W/cm2, Fl:14.37 J/cm2) MT vs. MTL; EP: CI 25% vs. 66%
ST vs.STL; EP: CI 53%vs 89%
Vescovi et al. [15] 151 pat.; 139 treated sites; MM (56); BM (65); OP (30) Nd:YAG 1064 nm, 1.25 W; 15 Hz; fd: 320 μm; 1/w, 2 mo MT vs. MTL EP: MH 7.85% (5/28) vs. 28.125% (9/32)
Nd:YAG laser; 1064 nm; 1.25 W; 15 Hz; fd: 320 μm; 1/w, 2 mo; ST vs. STL EP: MH 64.7% (11/17) vs. 72.72% (24/33) sign.
Martins et al. [13] 22 pat.; BC (13); PC (4); LC (1); MM (2) InGaAlP diode laser; 660 nm; 40 mW, SS 0.042 cm2, Fl: 6 J/cm2; 6 s; PD: 0.24 J/point; 1/d. MT (3) vs. ST (5) vs. PRP + LLLT+ suturing (14) 1/3 (33.3%) vs. 3/5 (60%) vs. 12/14 (85.7%)
Luomanen et al. [8] 1 pat., MM Nd: YAG 1,064 nm; 1.25 W; 15 Hz; fd: 320 μm; dist: 1-2 mm; 1 min; 9x in 6 mo; 5x/session, PD:1.555 W/cm2; Fl/min 167.94 J/cm2 LLLT MH(9 w)
Atalay [16] 20 pat.; BC (11); PC (1); MM(7); NEUR (1); stage 1 + 2, MT ineffective Nd:YAG; 1 min, dist: 4 cm; R24 950 μm fiber handpiece; 0.25 W, 10 Hz; 2.5 J. Fl: 6.25 J/cm2. ST vs. Er:YAG -STL 4/10 vs. 7/10, signif.
Romeo et al. [7] 12 pat.; MM (4); BM (7); OP (1); 7 pat with BRONJ Double diode, 650 nm + 904-910 nm; SS=8mm; Fl: 0.053J/cm2; 5x15min, 1/3d, 2w; dist: 1mm LLLT EP: CI Sign. pain reduction 6/7
Manfredi et al. [19] 25 pat.; OP; Stage 1 (4), 2 (19), 3 (2) Nd:YAG; 1064 nm, dist: 2 mm; 5×1 min; PD 268.57 W/cm2; 1.25 W; 15 Hz; fd: 320 nm; 1x/w, 2 mo; MT vs. MTL EP: MH (6mo) 3/5 (40%) vs. MTL: 4/7 (57%)
Pat. not responsive to 3 AB cycles Er:YAG laser (2940 nm) ST, LLLT as described above; 1/w, 1 mo; ST vs. STL EP: MH (6 mo) 4/4 vs. 6/6
Rugani et al. [14] 5 Pat.; BRONJ stage 2; 2 Pat. dehiscences BC + MM, ErCrYSGG-ST; PDT: diode laser; 75 mW; 680 nm, 90s, dist: 2 mm; PS: methylene blue MH after 12 mo 2/2 MH
Vescovi et al. [17] 91 pat.; 55 BRONJ sites MM (27), BM (18), OP(10), Stage 1(8), 2(41), 3(6) Nd:YAG; 1,064 nm; 1.25 W; 15 Hz; fd 320 μm; dist 2 mm; 1 min; 5x; PD: 268.57 W/cm2; Fl: 2.0175 J/cm2 MT vs. MTL 3 Mo EP: MH 0/13 vs. 7/17 (41%) (P= 0.033)
Er:YAG laser supported surgery Nd:YAG laser-irridation as above ST+ vs. Er:YAG – STL;EP: MH 6/13 (46%) vs. 10/12 (83.3%)
Scoletta et al. [6] 20 pat.; BC (6), MM (6), OP (5), PC (3); Stage 1 (2), 2 (16), 3 (2/20) Pulsed diode(GaAs); 904 nm; 50 kHz, Fl: 28.4 J/cm2; dc40%; SS 0.8 cm; 5 min: 59 J - 60 kHz + 10 min 120 J - 40 kHz 10x in 20 d LLLT; BRONJ symptoms EP: CI sign: pain, clinical size, edema, pus, fistulas
Vescovi et al. [18] 19 pat.; 20 sites; MM (9), BM (8), OP (2); 5 treated sites MT or MTL Nd:YAG; 1064 nm; 1.25 W, 15 Hz, fd 320 μm; dist 1-2 mm; 1 min; PD 1555: W/cm2, Fl/min 167.94 J/cm2); 5x/session; twice; Mucosal healing Follow-up at least 4 (to 9 months) Medical 1/3 vs. (33.3%) vs. Medical + LLLT 2/2 (100%)
15 sites ST after ineffective MT Nd:YAG as above; twice; (2 pat. some mo later) ST vs. STL EP: MH (4 mo) 4/8 (50%) vs. 6/7 (85.7%)
Miglorati et al. [58] 1 pat. PC, stage 0 diode laser 815 nm; 1.0 W; fd 400 μm; pockets 5 x + fistulas 3x 15s, after 4w CO2-Laser EP: CI Progress Stage 1
Merigo et al. [20] BM (14), MM (12), OP (3) Nd:YAG, settings not specified MT vs. ST vs. LLLT Partial success, not specified
Vescovi et al. [11] 26 pat., MM (9), BM (14), OP (3) Nd:YAG; 125 W, 15Hz, 60 s, 5 x; fd 320 μm 6 MT + 6 ST vs. 6 MTL + 6 STL EP: MH 4/12 (33.3%) vs. 9/14 (64.3%)
pat: Patient; BM: Bone metastasis; PC: Prostate cancer; BC: Breast cancer; LC: Lung cancer; MM: Multiple Myeloma; NEUR: Neuroendocrine tumor; AB: Antibiotics; fd: fibre diameter; dist: distance; PD: Power Density; Fl: Fluence; DC: duty cycle; SS: Spot size; PS: Photo sensitizer; iv. Intravenous; BP: Bisphosphonate; vs.: versus; MT: Medical therapy; MTL: Medical therapy and LLLT; LPM: Long pulse mode; ST: Surgical therapy; STL: Surgical therapy and LLLT; d: day(s); w week(s); mo: month(s); EP: Endpoint; MH: Mucosal healing; CI: Clinical improvement
Table 1: Published reports on use of low-level-laser therapy (LLLT), preferred endpoint: Mucosal healing.
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