Page 90 - Veterinary Laser Therapy in Small Animal Practice

76 Veterinary Laser Therapy in Small Animal Practice

LT has been used in clinical studies with human
patients to reduce gingival inflammation, decrease

dentin hypersensitivity, [227] and improve mucosal

healing after oral surgery. The majority of studies have
been performed with low power devices, though, in a
variety of protocols (most of them using 2–10 J/cm ),
2
and sometimes some of the parameters are not spec-

ified. Laser improved clinical and biometrical param-
eters of mucosal healing after gingivectomy in human
patients with bilateral procedures in which one side
served as control and the other received treatment at
4 J/cm . In a double-blind clinical study in which,
2 [228]
again, one side served as a control, the addition of LT to
scaling and root planing reduced probing pocket depth,
plaque, and gingival indices. [229] In cases with conserva-
tive treatment, LT also improved plaque index, gingival
index, and bleeding on probing index in a case–control
study. [230] Cytomorphometric analysis of gingivitis
in children improves after LT. [231] Recent systematic
reviews conclude that LT improves management of
chronic periodontitis, [232] mucosal healing, and dental
pain. [233] Sometimes higher doses (not necessarily
power, especially if there is high sensitivity) are used for
immediate postoperative pain and inflammation treat-

ment than for tissue proliferation. [234]
LT has also been used in human implantology to
improve implant integration. In vitro studies show laser
Figure 7.16 (a) This 15-year-old hypothyroid dog shows

hyperkeratosis and chronic inflammation of the lateral elbow can enhance the attachment to the titanium implants

skin. (b) The change after two treatments, once a week, with and proliferation of human gingival fibroblasts in a
2
4 J/cm and average power 3 W, was notable. dose-dependent manner. [235] In vivo models demon-
strate laser increases osteocyte count and viability and
accelerates osteogenesis and integration of titanium
tissues, whether we are talking about stomatitis, peri- dental implants, [236] while reducing the inflammation.

odontal disease, or wounds in the oral cavity, all very [237]
frequent conditions presented in canine and feline Radiotherapy- and chemotherapy-induced oral
practice. Of course, gingivitis and/or stomatitis is very mucositis is a common problem in patients undergo-
varied in its causes and usually multifactorial: from ing oncological treatment. There are several clinical

dental plaque or tooth malposition, to feline viruses trials in humans reporting both the efficacy [64] of LT

and overreaction of the immune system, among and the lack of it [238] in preventing the development of
others. mucositis, but once the mucositis appears, LT seems

LT as an adjunctive treatment sometimes leads to a to significantly decrease its duration. [65] This has many
decrease in the need for medication, especially in cats consequences, including patient comfort among others,
with chronic stomatitis, and helps provide better pain and the possibility of eating better and maintaining a
management. Very often you may notice a reduction better nutritional status. [66, 67]
in pain, which translates as a better ability to eat, even The treatment plan will change according to the

without an improvement in the macroscopic lesions. affected area, the clinical status, and the handling of

Animal clinical studies are missing in this field, but our particular patient. The gingiva can often be quite

let’s have a look at what has been published in human well exposed in cooperative patients by manipulating
medicine. the lips and slightly opening the mouth (Figs 7.17 and

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