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Introduction: Within the field of periodontology, there has been a proposal for the utilization of noninvasive laser therapy as a potential treatment for persistent periodontitis. The Laser-Assisted New Attachment Procedure (LANAP) employs an Nd:YAG laser as a specific technique. Through its interaction with endogenous chromophores, the Nd: YAG laser exhibits a selective effect on the evaporation of granulation tissue, therefore establishing a correlation with reduced bleeding. The study also examined Oxygen High-Level Laser Therapy (OHLLT). The OHLLT technique employs a high-power diode laser in combination with hydrogen peroxide solutions to facilitate the liberation of singlet oxygen, which possesses antibacterial attributes, within the periodontal pockets. The existing literature indicates their potential to promote the regeneration of tooth support tissues. Objective: The aim of this study is to assess the subjective pain levels reported by patients who have undergone surgery using the OHLLT protocol versus those who have undergone surgery using the LANAP technique. Methods: A total of 20 individuals with a stage III–IV periodontitis diagnosis were recruited for the study. The participants were randomly divided into two groups, each consisting of 10 individuals: Group 1, comprising patients treated according to the LANAP protocol, and Group 2, comprising patients treated according to the OHLLT protocol. After their initial session of nonsurgical periodontal therapy, individuals provided feedback regarding their level of pain, utilizing a Numerical Rating Scale (NRS) comprising time intervals of 0 h (T0), 6 h (T1), 12 h (T2), 24 h (T3), 48 h (T4), and 7 days (T5). The Wilcoxon–Mann–Whitney statistical test was employed to assess the variations in NRS scores between Group 1 and Group 2 at each recording period. (p ≤ 0.05). In addition, a microbiological assessment of the bacterial load in the periodontal region was conducted on all subjects using real-time PCR testing at two time points: prior to treatment (T0) and seven days post-treatment (T5). Results: The findings of this study indicate that the OHLLT group exhibited significantly lower pain levels compared to the LANAP group at all time intervals, except for the preoperative period, where no significant difference was observed (p < 0.05). Group 2 exhibited a more rapid decrease in pain, as demonstrated by a score test approaching zero within 24 h. The quantity of periodontal bacteria seen seven days post-treatment was similar between the two groups and was found to be decreased compared to the pre-treatment levels. Conclusions: The OHLLT and LANAP regimens have demonstrated efficacy in the nonsurgical management of periodontal disease. Nevertheless, it should be noted that the OHLLT approach does not subject the patient to any thermal hazards, unlike the LANAP method. The postoperative discomfort experienced following the OHLLT procedure is indeed reduced, as this technique is characterized by lower invasiveness and reduced dependence on the operator.

Despite the growing demand for improving smile aesthetics and occlusal functionality, a significant percentage of patients still refuse or discontinue orthodontic treatment because of pain and discomfort related to this therapy. As consequence, controlling the pain experienced by patients during the same therapy represents a primary concern for both patients and clinicians. Recent pieces of evidence have suggested that photobiomodulation can reduce pain experienced by patients during the decrowding stage or during specific protocols, for example, rapid maxillary expansion. PBM can be performed with lasers and also with a light-emitting diode (LED) device. Nonetheless, few studies on the latter are still present in the literature. The aim of this research is to evaluate the efficacy of photobiomodulation (PBM) with Laser devices in pain management in fixed orthodontic treatment. Only 14 of all articles met the inclusion and exclusion criteria and were therefore used to conduct the research. The different studies compared, in most cases, patients whose mouths were divided into a part treated with PBM and a placebo part. Most of their results show a statistically significant difference in perceived pain between the irradiated arch and the nonirradiated arch. Three authors did not find statistically significant results in favor of PBM, but they used different laser parameters. To obtain generally valid studies, with consistent and reproducible results, it is necessary to standardize the different laser parameters used. LED is less operator-dependent than laser and PBM using this technology seems to have a biological basis similar to that with lasers. In some studies, its clinical efficacy in pain reduction in some orthodontic therapies has been verified. Finally, this article aims to consider LED technology as a future prospect of research on PBM use in orthodontics.

Objective: The aim of this research was to assess how the application of an oral irrigator modifies the subgingival bacterial flora in patients undergoing periodontal maintenance therapy. We used a qualitative microbiological analysis with a phase contrast microscope that can differentiate a non-pathogenic (immobile) bacterial flora from a pathogenic (mobile). Methods: In this study, 60 patients with a diagnosis of moderate periodontitis were enrolled. They were treated with non-surgical laser-assisted causal therapy and after one month a re-evaluation was performed that established the stabilization of the periodontal pathology. They were instructed in the home oral hygiene protocol with sonic toothbrush, interdental brushes and oral irrigator, and were included in the periodontal maintenance therapy program with a phase contrast microscope control every 6 months. At T0 phase contrast–phase microscopic examinations, the existence of non-pathogenic bacterial flora was displayed in all patients. They were then randomly divided into two groups, A and B. After professional oral hygiene treatment, group B suspended the usage of oral irrigator. Patients of group A, after the professional oral hygiene treatment, were motivated to continue their oral hygiene protocol at home. After three months, the patients underwent microscopic analysis of the bacterial plaque. Results: At T1 in Group B, 90% of patients had undergone a pathogenic bacterial flora change. In group A, in which patients kept using the oral irrigator for the three months, 100% of them showed immobile plaque on phase contrast microscopic analysis. Conclusions: This research showed that oral irrigator in the practice of home hygiene protocols plays a role in the long-term maintenance of a non-pathogenic bacterial flora in periodontal patients.

Over the past 20 years, transalveolar techniques have progressively improved. They have become increasingly predictable and reliable, with the additional advantage of simplified procedures that are less operator dependent. The aim of this study is to evaluate the effectiveness of a new technique to lift the maxillary sinus through a transalveolar approach, Simple Minimal Safe (SMS), with use of activated plasma albumin gel (APAG). A total of 33 patients (22 female and 11 male), aged between 36 and 79, were consecutively operated on, with 44 implants positioned using the SMS technique. All were placed in the premolar or molar areas of the maxillary bone. No implant was lost during the follow-up period (6 months) and all implants were then prosthetically loaded. The average bone gain was 4.43 mm. In the first quadrant, sites 15, 16 and 17 were involved with an average bone gain of 3.5 mm, 4.6 mm and 4.5 mm, respectively. In the second quadrant the sites 24, 25, 26 and 27 were involved with an average bone gain of 4.25 mm, 4.5 mm, 4.4 mm and 4.5 mm, respectively. Analyzing the data considering the sex, implants in women had an average gain of 4.66 mm, while in men the average gain was 3.83 mm. With the SMS technique, we achieved a reduction in post-operatory morbidity and in the frequency of Schneiderian membrane perforation. In conclusion, maxillary sinus augmentation via the transalveolar approach has become a more predictable surgical procedure and an easier technique due to less operator-dependent processes.

The purpose of this study is to evaluate the efficacy of the combination of ozone gel and Er:YAG laser treatment in respect of medication-related osteonecrosis of the jaw (MRONJ) for normal procedures. Consequently, the following techniques are compared in the study: medical therapy (MT); MT + conservative surgery with rotary/piezoelectric instruments; MT + ozone therapy; MT + surgical treatment + laser Er:YAG; and MT + ozone therapy + surgical treatment + laser Er:YAG. Fifty-seven patients with MRONJ stages I, II, and III were treated. The protocol was different for each group of patients and included MT, the application of an ozone gel, an Er:YAG laser surgery session, conservative surgery with rotary/piezoelectric instruments, or surgical treatment, and then the monitoring of healing for at least 12 months. The protocols were performed once a week until complete recovery. Patients were reassessed weekly for the first month after treatment, monthly for the following quarter, and then every 3 months until the end of one year. The radiographic surveys were carried out 6 and 12 months after the last treatment. All of the patients in Group 4 (treated with medical therapy + ozone therapy + surgical treatment + laser Er:YAG) achieved complete clinical and radiographic recovery (100%) with complete remission of osteonecrosis. The proposed combined treatment of ozone therapy using laser Er:YAG and the MT + surgical treatment allowed us to obtain excellent results in the resolution of MRONJ. This success was explained by a series of characteristics specific to laser technology; in fact, thanks to its photoacoustic, photochemical, photothermal, and photomechanical properties, the laser made it possible to reduce the bacterial load at the intervention site.

In the past, complex rehabilitations, such as the rehabilitation of an entire arch with a prosthesis on implants, were reserved for the few patients who presented an optimal state of health as the interventions were long and traumatic. Nowadays, the use of devices such as the Magnetic Mallet and the laser allows us to perform the same interventions in less time and in a minimally invasive way. The case report we present shows how a fragile patient, subjected to the insertion of eight implants on the same day, had a positive response, thanks to the use of a Magnetic Mallet to prepare the implant sites, the application of the photodynamic therapy without dye (diode laser + hydrogen peroxide) to decontaminate the post-extraction alveoli and the use of an erbium laser to induce more bone bleeding and promote healing. The implants were then loaded in 48 h with a Toronto-type temporary total prosthesis. The patient had a pain-free and complication-free outcome. It is interesting to note how technological development, aimed at reducing the morbidity of surgery, makes it possible to perform almost all surgical therapies, even the most advanced, on any patient, regardless of general health conditions.

During implant restorative dentistry, common and crippling postoperative complications are pain and swelling of perioral soft tissues which engraving on patient quality of life. Concentrated growth factors (CGF), a novel generation of autologous platelet concentrate, and melatonin, endogenous indoleamine with also bone regenerative properties, may be useful for reconstruction of bony defects as well as in prosthetic and esthetic rehabilitation. We report a clinical case in which guided bone regeneration was performed combining CGF, melatonin and heterologous biomaterial. Great postoperative recovery without any complications was reported. In conclusion, in restorative dentistry the combined use of CGF and melatonin may have important roles in restoring bone defect, in improving implant osteointegration and, not less important, in preventing postoperative complications.

Objective: The purpose of this research is to assess the analgesic efficiency of Photobiomodulation (PBM) in pain reduction in young patients during rapid maxillary expansion therapy. Materials and Methods: Thirty patients were included and allocated to an experimental group [Rapid Palatal Expansion (RPE) and PBM] and a control group (RPE only) at random. Inclusion criteria were skeletal age from CVS1 to CVS3, examined on the cephalometric lateral teleradiography, with cervical vertebra staging and completed eruption of upper first molar. Exclusion criteria were previous orthodontic treatment, bone disease, disability, or skeletal age from CVS4. Patients referred the pain they felt using a Numerical scale rate (NRS), ranging from 0 to 10, with specific intervals of time: 6 h, 12 h, 24 h, and from days 2 to 7. The Wilcoxon-Mann-Whitney test was used to evaluate differences in NRS reported values between the two groups. Results: The final sample included 30 patients, 14 males and 16 females, with a mean age of 7.8 ± 1.2 years. The pain that was felt at each time interval and the maximum score of pain were significantly lower in the experimental group (p < 0.05) and decreased faster in the experimental group, with a score test near to 0 after 2/3 days. Conclusions: PBM is efficient in reducing the intensity and the time of pain felt by young patients that undergo rapid maxillary expansion.