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CONNECTIVE TISSUE / CARTILAGE / LIGAMENT / BONE REPAIR RESEARCH STUDIES
CONNECTIVE TISSUE REPAIR
THE BIOLOGICAL EFFECTS OF LASER THERAPY AND OTHER PHYSICAL MODALITIES ON CONNECTIVE TISSUE REPAIR PROCESSES
Chukuka S. Enwemeka, P.T., Ph.D., FACSM, G. Kesava Reddy, Ph.D.,
Connective tissue injuries, such as tendon rupture and ligamentous strains, are common. Unlike most soft tissues that require 7-10 days to heal, primary healing of tendons and other dense connective tissues take as much as 6 - 8 weeks during which they are inevitably protected in immobilization casts to avoid re-injury. Such long periods of immobilization impair functional rehabilitation and predispose a multitude of complications that could be minimized if healing is quickened and the duration of cast immobilization reduced.
In separate studies, we tested the hypothesis that early function, ultrasound, 632.8 nm He-Ne laser, and 904 nm Ga-As laser, when used singly or in combination, promote healing of experimentally severed and repaired rabbit Achilles tendons as evidenced by biochemical, biomechanical, and morphological indices of healing. Our results demonstrate that: (1) appropriate doses of each modality, i.e., early functional activities, ultrasound, He-Ne and Ga-As laser therapy augment collagen synthesis, modulate maturation of newly synthesized collagen, and overall, enhance the biomechanical characteristics of the repaired tendons. (2) Combinations of either of the two lasers with early function and either ultrasound or electrical stimulation further promote collagen synthesis when compared to functional activities alone. However, the biomechanical effects measured in tendons receiving the multi-therapy were similar, i.e., not better than the earlier single modality trials.
Although tissue repair processes in humans may differ from that of rabbits, these findings suggest that human cases of connective tissue injuries, e.g., Achilles tendon rupture, may benefit from appropriate doses of He-Ne laser, Ga-As laser, and other therapeutic modalities, when used singly or in combination. Our recent meta-analysis of the laser therapy literature further corroborate these findings.
EFFECT OF LOW-LEVEL LASER ON CALVARIAL BONE DEFECT
M. KHADRA1, N. KASEM2, H.R. HAANÆS1, and S.P. LYNGSTADAAS1
Objective: The purpose of the present study was to evaluate by animal means the effect of laser therapy with GaAlAs diode laser device on bone healing and growth in rat calvarial bone defects.
Methods: The study was performed as an animal trial of 4 weeks duration with blinded, placebocontrolled design. 20 rats had a standardised round osseous defect 2,7 mm in diameter made in each parietal bone (2 defects). The animals were then randomly divided into two equal groups. A GaAlAs diode laser (wavelength 830 nm, output power 75 mw and energy density 23 J/cm2) was used immediately after surgery and carried out daily for 7 consecutive days. The rats were thereafter sacrificed at day 14 and 28 after surgery. Levels of calcium, phosphorous and protein were determined in 20 bone defects, while the histological analyses were performed in the other 20 defects. Statistical analyses between the test and control were performed using Student's t-test.
Results: The results indicate that calcium, phosphorous and protein contents were significantly higher in the laser-irradiated healing tissues than in the sham group on both time-points. The histological analyses showed that proliferation of fibroblasts, osteoid tissue and bone were more prominent in the irradiated group.
Conclusion: The findings suggest that Laser Therapy may promote metabolism and/or mineralisation in bone forming tissues during the healing of bone defects.
BONE REPAIR OF THE PERIAPICAL LESIONS TREATED OR NOT WITH LOW INTENSITY LASER (WAVELENGHT=904 NM).
Laser Surg Med. Abstract Issue 2002. abstract 303.
The effect of bone repair in periapical lesions has been studied by Sousa. 15 patients with atotal of 18 periapical lesions were divided into two groups. One group received endodontic treatment and/or periapical surgery. The patients in the other group were submitted to the same procedure and in addition the lesions were irradiated by GaAs laser, 11 mW, 9 J/cm2. This therapy was performed during 10 sessions with an interval of 72 hours. Bone regeneration was evaluated through X-ray examination. The results showed a significant difference between the laser and the control group in favour of the laser group.
THE INFLUENCE OF LOW LEVEL INFRA RED LASER THERAPY ON THE
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