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Laser Therapy for Wound Healing: A Review of Current Techniques and

Mechanisms of Action

Article in Biosciences Biotechnology Research Asia · March 2015

DOI: 10.13005/bbra/1626

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BIOSCIENCES BIOTECHNOLOGY RESEARCH ASIA, March 2015. Vol. 12(Spl. Edn. 1), p. 217-223

Laser Therapy for Wound Healing: A Review of

Current Techniques and Mechanisms of Action
Rashidi Samaneh, Yadollahpour Ali*, Jalilifar Mostafa,
Naraqi Arani Mahmud and Rezaee Zohre

Department of Medical Physics, School of Medicine,

Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

DOI: http://dx.doi.org/10.13005/bbra/1626

(Received: 05 February 2015; accepted: 10 March 2015)

Along with conventional medications, different techniques have been used for
wound healing such as ultrasound, electric field, magnetic field, pressure relieving beds,
cushions, etc. These methods are usually utilized for prevention and healing of pressure
wounds. One of these methods with great potential is LASER (Light Amplification by
Stimulated Emission of Radiation) therapy. Different parameters can affect the efficiency
of laser therapy. Several studies have attempted to develop this technique in different
medical applications. This paper aims to provide a review of the LASER techniques for
wound healing, sketch their background, determine the biological effects that support
the use of LASER sources in the treatment of wounds and as well as the optimal light
parameters such as wavelength and dose for wound healing.

Key words: Laser, Wound Healing, Mechanism of Action.

Wound is a physical injury specified by Recently, applications of laser as a non-

disruption of the normal structures of body. Wound surgical technique have gained great attention for
can injure some superficial cutaneous and basic accelerating the wound healing procedure.
structures of skin1. To manage wounds preventive Nevertheless, the effects of laser in decreasing pain
measures such as health professional continuous and repairing tissue have not been completely
education, family counseling and guidelines should understood4. It was reported that applying laser
be provided to the people. Different therapeutic could facilitate repairing the injured biological
approaches such as conventional medications, tissue5. One of the great approaches for treating
pressure relieving beds, cushions, medicinal plants lesions of wounds is applying low-power light
have been developed for wounds treatment. therapy which promoted by light devices such as
Physical treatments such as therapeutic ultrasound LASER (Light Amplification by Stimulated
and electromagnetic therapies have been Emission of Radiation)
introduced as alternative or adjunctive treatment The history of using LASER in the
in wound healing2, 3. Although these techniques healing of wounds have drawn back to 19606,7.
have some advantages, their results are not always Nevertheless, the results are very contradictory
promising. due to lack of standardization in the experiments.
The effectiveness of LASER therapy is widely
depends on the Selection of the appropriate
* To whom all correspondence should be addressed.
parameter.
Tel.: +989125144130
E-mail: [email protected]
218 SAMANEH et al., Biosci., Biotech. Res. Asia, Vol. 12(Spl. Edn. 1), 217-223 (2015)

Since the introduction of biological effects were revealed at dose of greater

photobiomodulation in healthcare, different than 5 J/cm2 21. Sommer et al (2001) reported
studies have investigated the feasibility and biological effects are not observed at very low
efficacy of light resources for the skin wounds doses, whereas at higher doses cellular function
treatment. However, the exact biological was inhibited22.
mechanisms of low intensity light in tissues are Some studies have demonstrated that
still not explained. In this regard, some researches cytochrome c oxidase can absorb wavelengths in
demonstrated that applying light can enhance the range of red to near infrared23, 24. Lasers which
cellular proliferation of several cell types such as are used for therapeutic applications have a thermic
fibroblasts, endothelial cells and keratinocytes, procedure with a negligible heat transfer. Thus,
conflicting. the photonic energy is directly delivered to the
There are different parameters which target cells without producing thermal damage20,
25
affect the interaction of light and the biological . Monochromatic light with the range of
tissues such as the wavelength and dose as well wavelength of 630 to 905 nm is utilized in therapeutic
as the optical properties of the tissue. With respect lasers26. In order to survey the biological effects of
to the features of light devices, LASER consists of light, it can be divided into 3 categories including:
a resonant optical cavity and various types of (1): primary (induced by light), (2): secondary (is
active media including liquid, solid, or gaseous occurred in response to the primary effects) and
materials. The light is produced through the (3): tertiary effects known as systemic effects18, 26,
passage of an electric current from these materials8. 27
.
There are various laser systems such as Primary reactions are only associated with
He-Ne, AlGaAs, InGaAlP, etc9-12, different laser the absorption of photons in the other means, they
parameters (wavelength, power, energy, pulse are considered as the interactions between photons
frequency, pulse duration)13, 14 and irradiation and the photoreceptor, and also they are appeared
conditions (exposure time, frequency and duration in a few seconds or minutes after the light
of treatment)15, 16 which produce wide range of exposing23, 28. These primary reactions of light are
therapeutic protocols17. not still clearly established, however there are
The common parameters of LASER light hypotheses. Indeed, the primary mechanism of
include power in the range of 10-3 to 10-1 W, action of laser which leads to production biological
wavelength from 300 to 10,600 nm, as well as in the effects in tissue is Energy absorption. Absorption
continuous mode at 5,000 Hz frequency, pulse of laser is widely depending on the range of
duration of 1 to 500 milliseconds, total radiation of wavelength play an important role in the absorption
10-3000 seconds, intensity between 10 -2 and of laser light. In addition to wavelength, tissue
100 Wcm-1 and dose from 10-2 to 102 Jcm-2 18. It was chromophores (hemoglobin and melanin) can affect
reported that laser therapy can affect wounded energy absorption. Due to the highly absorption
cells or cells with suboptimal growth, while with of light with wavelength of shorter than 600 nm by
no effects on normal cells19. chromophores, a therapeutic window is introduced
This paper aims to comprehensively in the optical spectral range of red and infrared,
review LASER techniques for wound healing and wherein the light penetration in the tissue is
their underpinning principles. In addition, laser- maximum29.
tissue interactions and optimal light parameters After the absorption of light in the
such as wavelength and dose in wound healing irradiated wavelength, cytochrome c oxidase
are discussed. displays an electronically excited status, from
Effects of Photon on Cell Level which it alters its redox status and causes the
The light of laser has some unique acceleration of electron transfer in the respiratory
characteristics such as monochromaticity (has a chain30. Another hypothesis is that a part of the
single wavelength), coherent and collimation electronically excited status energy is converted
(travels in a single direction without divergence)20 into heat, causing a localized and transient heating
which cause to penetration this light into the skin in photoreceptors31.
surface non-invasively18,20. The most considerable Secondary reactions can reinforce the
 SAMANEH et al., Biosci., Biotech. Res. Asia, Vol. 12(Spl. Edn. 1), 214-223 (2015) 219

primary effect of photon. Secondary effects are leads to enhancing superoxide anions O 2
not only depends on the adsorption of photon but production. It was reported that laser irradiation
also associated with the cell sensitivity. For this reversed the cytochrome c oxidase inhibition which
reason, secondary effects are less predictable as increased the rate of respiration with consequently
compared with primary effects27. They are observed more ATP synthesis37.
in several hours or even days after exposing. Effective parameters
In this stage, various metabolic effects As mentioned, several parameters can
are occurred which lead to production of different affect the efficiency of phototherapy. These
physiological changes at the cellular level i.e. parameters can determine an effective therapeutic
changes in the permeability of cell membrane19, 27, modality for the treatment of superficial wounds
32
. Releasing calcium from mitochondria into the or musculoskeletal injuries:
cytoplasm is occurred. This induces with changes Lasers
in intracellular calcium levels 5, 19 which leads to Different studies investigated the
stimulation the metabolism of cell and also therapeutic effect of each lasers. It was reported
adjusting the signaling pathways responsible for that coherent length of light which is exposed from
significant events required for wound repair such He-Ne laser are longer as compared with diode
as cell migration, RNA and DNA synthesis, cell laser. Furthermore, the biological effects of light
mitosis, protein secretion and cell proliferation25, which emitted from diode laser at 663 nm are less
33
. obvious as compared with the light from a HeNe
Tertiary effects are influenced by the laser. Also it was reported that when a diode laser
internal and external environment and as well as act at a higher power (25- 50 mW) and higher dose,
intracellular interactions. So, these effects are the its effect is similar with He-Ne laser5, 32.
least predictable than other effects. The tertiary Wavelength
effect expresses that why healing of one part of It was demonstrated that the wavelength
wounds leads to develop the treating to the both range can widely affected the efficiency of
directly stimulated area of wound and other phototherapy. For example applying laser at
lesions27. wavelength of 630 produces bacterial inhibition38.
As mentioned above, during primary In this regard, it was proved that the most effective
responses, the photon energy is transferred to the wavelength of light was 660nm39.
mitochondria25 and cell membranes of low lying Energy density
cells (fibroblasts, keratinocytes or endothelial). It was reported that effective doses of
Afterward chromophores adsorb this photonic near-IR light may be much higher than 10 J/cm2 in
energy and as well as convert it to the chemical particular for deep injuries. Too low doses produce
kinetic energy within the cell20, 32. This event leads negligible effect. On the other hands, prescribing
to changing the permeability of cell membrane, a dose above the highest one suitable leads to
improved the signaling between mitochondria, production negative effect40. Also even greater
nucleus and cytosol, shaping nitric oxide and also dose can induce a biosuppressive or inhibitory
enhances the oxidative metabolism in order to effect41.
create more ATP34-36 which causes to healing Power
wounds and also pain relief20, 27, 32. The power density is considered as an
Other mechanisms may be induced in intensity of the light on the tissue surface, and
laser therapy. After photon absorption, some also is expressed in mW/cm2. Indeed, it expresses
molecules such as porphyrins can convert into a the dividing power by the target tissue area18.
long-lived triplet state. This triplet state can interact Applying stronger power of LASER leads to
with ground-state oxygen with energy transfer reducing the treatment time.
leading to the production of a reactive singlet Continuous and pulsed wave
oxygen species37. Continuous wave is considered as a light
Another possible mechanism is that the source which has constant intensity while pulsed
change in the metabolism of mitochondrial and also light is a light source that emits light at various
activation of the respiratory chain by photon. This intensity32. If a pulsed laser is used, the power of
220 SAMANEH et al., Biosci., Biotech. Res. Asia, Vol. 12(Spl. Edn. 1), 217-223 (2015)

laser light is not constant. So, in order to determine the interstitial fluid absorption and also improve s
the dose, the average power is considered whereas tissue regeneration by enhancing the lymphatic
continuous wave lasers utilize the output power. circulation and drainage25, (5) Improves blood
Contact and non-contact circulation which is beneficial in blood-related
A laser can be employed in two different conditions such as Buerger’s and Raynaud’s
ways including Contact and non-contact32, 42. In injuries, (6) enhance autoimmune response in
order for providing great penetration into the skin, immune-deficient conditions such as psoriasis,
the laser probe must be used be in the direct rheumatoid arthritis and atopic dermatitis49, (7) and
contact with the skin and also at an incident angle can restore the normal pigment in anti-natural
of 90 degrees. This leads to minimization of any colored cutaneous lesions.
reflection from the surface of skin and great Laser therapy for superficial wound healing
penetration into the tissue is occurred13, 32. In surveying the therapeutic applications
Therapeutic applications of laser of LASER, healing of various wounds such as
Some investigators reported both pressure sores and ulcers, burns, skin donor areas
inhibitory and excitatory effect of LASER on the and postoperative wounds are considered32, 42, 52.
wound healing process40. Nevertheless, it was It was found that applying LASER following the
revealed that applying LASER can produce initial treatment with necrotic clearance lead to
beneficial effect on wound treatment. Due to the reducing infection signs, decreasing the amount
lack of knowledge about optimal therapeutic and smell of fluid in exuding wounds, decreasing
parameters, dosimetry and action mechanism of the pain and as well as resuming the immune
LASER, the exact mechanism is not thoroughly response which is initiated by the inflammatory
understood19, 41, 43. In this regard, some studies phase. In this regard, it was revealed that LASER
demonstrated Contradictory results which may due therapy produced beneficial effects on the
to lack of quality control5. It was reported that using cutaneous wound healing. Also it was suggested
LASER can reduce the duration of wound healing that applying LASER at dose of 8 J/cm2 were more
process as compared with other techniques effective than those at 4 J/cm2 48. In another study,
although it was reported that applying LASER it was found that applying HeNe laser at dose of 5
reduces pain and decreases the healing time44, J/cm2 accelerate the wound closure by
some scientists demonstrated that HeNe laser could normalization the cell function and stimulation the
not produce significant effect on wound healing45, cell proliferation and migration of wounded
46
. It was demonstrated that LASER can produce fibroblasts which were induced by exhibiting the
some effects such as: biostimulatory, analgesic, activity of mitochondria whereas they reported
anti-exudative, antihaemorrhagic, anti- molecular damage using LASER at dose of 10 J/
inflammatory, anti-neuralgic, anti-oedematous, cm2 53, 54. As well as it was demonstrated that GaAs
anti-spasmotic and vasodilatory 47. Similarly, LASER at 3 J/cm2 can stimulate the proliferation of
Medrado et al, (2003) found LASER therapy fibroblast55. Another study reported that optimal
decreased the inflammatory reaction and also effect of Er:YAG laser were achieved at dose of
enhanced the collagen deposition with a greater 3.37 J/cm2 56.
proliferation of myofibroblasts in experimental It has been reported that a visible light at
cutaneous wounds48. In addition, LASER has other wavelength of 630-780 nm can penetrate to a depth
clinical efficacies including: (1) Decreases swelling of 0.5-50 mm. this light has shown great potential
and inflammation related to the acute wounds in for wound healing and superficial skin conditions32,
superficial muscles, tendons, and sheaths19, 49, 50, 57
. In this regard, Karu et al (1993) reported that the
(2) Reduces the pain of some acute and chronic most effective wavelength of light was 660nm39.
wounds particularly related to abnormalities in Various studies revealed that applying light at 660
nerves, muscles, soft tissue, tendons and bone, nm improves superficial wounds and skin
(3) Increases tissue oxygenation which leads to conditions 40, acne, scar tissue and small lesions.
facilitation healing wounds which are nonhealing In order to treating large wounds or burns which
or have a slow healing rate particularly in soft the treatment area need a deeper effect, using large
tissues, tendons and bone4, 25, 49, 51, (4) Increases cluster probes have gained better efficiency. For
 SAMANEH et al., Biosci., Biotech. Res. Asia, Vol. 12(Spl. Edn. 1), 214-223 (2015) 221

healing wounds which are placed at a medium red, continuous or pulsed), the treatment
depth, the probe should be pressed against the parameters can be changed. In order to achieve
skin. In order to heal open wounds, the laser probe full acceptance as a authentic medical technique,
is held 1-2cm from the wound, whereas in order to high quality studies are required.
expose the periphery of the wound, the probe must
be contacted directly. In addition, the skin periphery ACKNOWLEDGEMENTS
of the wound should gained more dose than its
open area 5. Usually the functional probes of The present study was financially
LASER are existed in the form of single or cluster. supported by Ahvaz Jundishapur University of
A single laser probe (660 nm) is utilized around the Medical Sciences (Grant No.: U-93184).
margin of superficial wounds whereas a cluster
probe (visible red and infra-red laser light) is utilized REFERENCES
for the treatment of inflammation of soft tissue.
To heal wound, the periphery of the wound requires 1. Maiya, G.A., P. Kumar, and L. Rao, Effect of
higher dose (3-4 J/cm2) while the open wound low intensity helium-neon (He-Ne) laser
requires a lower dose (0.5 J/cm2) 5, 32. It was irradiation on diabetic wound healing dynamics.
demonstrated that for open wound, a lower dosage Photomedicine and Laser Therapy, 2005; 23(2):
p. 187-190.
are used as compared with the skin-covered
2. Poltawski, L. and T. Watson, Transmission of
periphery because the laser light is more absorbed therapeutic ultrasound by wound dressings.
in the unprotected wound. Wounds, 2007.
It was revealed that applying LASER at 3. Cutting, K.F., Electric stimulation in the
wavelength of 630 nm caused to bacterial inhibition treatment of chronic wounds. WOUNDS UK,
which may be an important consideration when 2006; 2(1): p. 62.
selecting the correct wavelength for infected 4. Enwemeka, C.S., et al., The efficacy of low-
wounds38. An infected ulcer can be treated twice power lasers in tissue repair and pain control: a
weekly until the infection clears. meta-analysis study. Photomedicine and Laser
Therapy, 2004; 22(4): p. 323-329.
It was found that LASER should expose
5. Tuner, J. and L. Hode, Laser therapy: clinical
acute wounds daily whereas chronic wounds practice and scientific background: a guide for
should be healed 1-2 times a week32. In order to research scientists, doctors, dentists,
healing chronic wound, it requires more treatment veterinarians and other interested parties within
intervals, as two or three times during a week are the medical field. 2002; Prima Books AB.
considered as the maximum32. 6. Mester, E., et al., Lasers in clinical practice. Acta
Tunér et al(2002) reported that it is more chirurgica Academiae Scientiarum Hungaricae,
beneficial to apply 3-4 treatments a week with 1967; 9(3): p. 349-357.
moderate doses as compared with utilizing higher 7. Yeh, N.G., C.-H. Wu, and T.C. Cheng, Light-
emitting diodes—Their potential in biomedical
doses and fewer treatments time5.
applications. Renewable and Sustainable Energy
Reviews, 2010. 14(8): p. 2161-2166.
CONCLUSION 8. Dias, I.F.L., et al., Efeitos da luz em sistemas
biológicos. Semina: Ciências Exatas e
This paper shows that laser is an effective Tecnológicas, 2009; 30(1): p. 33-40.
therapeutic modality to promote healing of some 9. Houreld, N. and H. Abrahamse, In vitro exposure
wounds. The main biological effects of this of wounded diabetic fibroblast cells to a helium-
therapeutic technique are related to the decrease neon laser at 5 and 16 J/cm2. Photomedicine
in inflammatory cells, increased fibroblast and laser surgery, 2007; 25(2): p. 78-84.
10. Whelan, H.T., et al., Effect of NASA light-
proliferation, angiogenesis stimulation, formation
emitting diode irradiation on wound healing.
of granulation tissue and also increased collagen Journal of clinical laser medicine & surgery,
synthesis. Also biological effects of laser will be 2001; 19(6): p. 305-314.
affected by some parameters such as energy 11. Gál, P., et al., Histological assessment of the
density, wavelength and amount of dose. With effect of laser irradiation on skin wound healing
respect to the type of applied laser (visible or infra- in rats. Photomedicine and Laser Therapy, 2006.
222 SAMANEH et al., Biosci., Biotech. Res. Asia, Vol. 12(Spl. Edn. 1), 217-223 (2015)

24(4): p. 480-488. 51(5-6): p. 245-249.

12. Bisht, D., et al., Effect of helium-neon laser on 26. Stadler, I., et al., Alteration of skin temperature
wound healing. Indian journal of experimental during low-level laser irradiation at 830 nm in a
biology, 1999; 37: p. 187-189. mouse model. Photomedicine and laser surgery,
13. Mendez, T.M., et al., Dose and wavelength of 2004; 22(3): p. 227-231.
laser light have influence on the repair of 27. Dyson, M. Primary, secondary and tertiary
cutaneous wounds. Journal of clinical laser effects of phototherapy: a review. in Proc. SPIE.
medicine & surgery, 2004; 22(1): p. 19-25. 2006.
14. Almeida Lopes, L., et al., Comparison of the 28. Karu, T., Photobiological fundamentals of low-
low level laser therapy effects on cultured power laser therapy. Quantum Electronics, IEEE
human gingival fibroblasts proliferation using Journal of, 1987; 23(10): p. 1703-1717.
different irradiance and same fluence*. Lasers 29. Huang, Y.-Y., A.C.-H. Chen, and M. Hamblin,
in surgery and medicine, 2001; 29(2): p. 179- Low-level laser therapy: an emerging clinical
184. paradigm. SPIE Newsroom, 2009; 9: p. 1-3.
15. Hawkins, D. and H. Abrahamse, Effect of 30. Karu, T., Molecular mechanism of the
multiple exposures of low-level laser therapy therapeutic effect of low-intensity laser
on the cellular responses of wounded human radiation. Lasers Life Sci, 1988; 2(1): p. 53-74.
skin fibroblasts. Photomedicine and Laser 31. Karu, T., et al., Comparison of the effects of
Therapy, 2006; 24(6): p. 705-714. visible femtosecond laser pulses and continuous
16. Al-Watban, F.A. and X. Zhang, The comparison wave laser radiation of low average intensity on
of effects between pulsed and CW lasers on the clonogenicity of Escherichia coli. Journal of
wound healing. Journal of clinical laser medicine Photochemistry and Photobiology B: Biology,
& surgery, 2004; 22(1): p. 15-18. 1991; 10(4): p. 339-344.
17. Franek, A., P. Król, and M. Kucharzewski, Does 32. Ohshiro, T., R.G. Calderhead, and J.B. Walker,
low output laser stimulation enhance the healing Low level laser therapy: a practical introduction.
of crural ulceration? Some critical remarks. 1988: John Wiley & Sons.
Medical engineering & physics, 2002; 24(9): p. 33. Klepeis, V.E., A. Cornell-Bell, and V. Trinkaus-
607-615. Randall, Growth factors but not gap junctions
18. Schindl, A., et al., Low-intensity laser therapy: play a role in injury-induced Ca2+ waves in
a review. Journal of investigative medicine: the epithelial cells. Journal of Cell Science, 2001;
official publication of the American Federation 114(23): p. 4185-4195.
for Clinical Research, 2000; 48(5): p. 312-326. 34. Morimoto, Y., et al., Effect of low intensity
19. Smith, K.C. Light and life: the photobiological argon laser irradiation on mitochondrial
basis of the therapeutic use of radiation from respiration. Lasers in surgery and medicine,
lasers. in International Laser Therapy Association 1994; 15(2): p. 191-199.
Conference, Osaka. 1990. 35. Yu, A.C.H., et al., Changes of ATP and ADP in
20. Mati, M., et al., [Low level laser irradiation and cultured astrocytes under and after in vitro
its effect on repair processes in the skin]. ischemia. Neurochemical research, 2002;
Medicinski pregled, 2002; 56(3-4): p. 137-141. 27(12): p. 1663-1668.
21. Chaves, M.E.d.A., et al., Effects of low-power 36. Karu, T.I., Photobiology of low-power laser
light therapy on wound healing: LASER x LED. therapy. 1989; 8: Taylor & Francis.
Anais brasileiros de dermatologia, 2014; 89(4): 37. Hamblin, M.R. and T.N. Demidova.
p. 616-623. Mechanisms of low level light therapy. in
22. Sommer, A.P., et al., Biostimulatory windows Biomedical Optics 2006. 2006. International
in low-intensity laser activation: lasers, scanners, Society for Optics and Photonics.
and NASA’s light-emitting diode array system. 38. Lucas, C., M. Van Gemert, and R. De Haan,
Journal of clinical laser medicine & surgery, Efficacy of low-level laser therapy in the
2001; 19(1): p. 29-33. management of stage III decubitus ulcers: a
23. Karu, T.I., Low-power laser therapy. Biomedical prospective, observer-blinded multicentre
photonics handbook, 2003; 48: p. 1-25. randomised clinical trial. Lasers in medical
24. Karu, T., Primary and secondary mechanisms science, 2003; 18(2): p. 72-77.
of action of visible to near-IR radiation on cells. 39. Karu, T., T. Andreichuk, and T. Ryabykh,
Journal of Photochemistry and photobiology B: Suppression of human blood chemiluminescence
Biology, 1999; 49(1): p. 1-17. by diode laser irradiation at wavelengths 660,
25. Takac, S. and S. Stojanovi, [Diagnostic and 820, 880 or 950 nm. Laser Therapy, 2004.
biostimulating lasers]. Medicinski pregled, 1997; 14(0_Pilot_Issue_2): p. 0_29-0_34.
 SAMANEH et al., Biosci., Biotech. Res. Asia, Vol. 12(Spl. Edn. 1), 214-223 (2015) 223

40. Kipshidze, N., et al., Low power helium: Neon inflammatory effect of 830nm laser light using
laser irradiation enhances production of vascular C-reactive protein levels. Braz Dent J, 2001;
endothelial growth factor and promotes growth 12(3): p. 187-90.
of endothelial cells in vitro. Lasers in surgery 51. Kubota, J., Defocused diode laser therapy (830
and medicine, 2001; 28(4): p. 355-364. nm) in the treatment of unresponsive skin ulcers:
41. Coombe, A., et al., The effects of low level laser a preliminary trial. Journal of cosmetic and laser
irradiation on osteoblastic cells. Clinical therapy, 2004; 6(2): p. 96-102.
orthodontics and research, 2001; 4(1): p. 3-14. 52. Baxter, C.D. and G.W. Waylonis, Therapeutic
42. Pontinen, P., Guidelines for LLLT. Low Level, lasers: theory and practice. American Journal
1992. of Physical Medicine & Rehabilitation, 1995;
43. Karu, T., et al., Biostimulating Action of Low- 74(4): p. 327.
Intensity Monochromatic. Laser Chem, 1984; 53. Hawkins, D. and H. Abrahamse, Biological
5: p. 19-25. effects of helium-neon laser irradiation on normal
44. Baxter, D., Low intensity laser therapy. and wounded human skin fibroblasts.
Electrotherapy, Evidence Based Practice, 2008; Photomedicine and Laser Therapy, 2005; 23(3):
p. 171-189. p. 251-259.
45. Allendorf, J.D., et al., Helium neon laser 54. Hawkins, D.H. and H. Abrahamse, The role of
irradiation at fluences of 1, 2, and 4 J/cm2 failed laser fluence in cell viability, proliferation, and
to accelerate wound healing as assessed by both membrane integrity of wounded human skin
wound contracture rate and tensile strength. fibroblasts following helium neon laser
Lasers in surgery and medicine, 1997; 20(3): p. irradiation. Lasers in Surgery and Medicine,
340-345. 2006; 38(1): p. 74-83.
46. Colver, G. and G. Priestley, Failure of a helium 55. Pereira, A.N., et al., Effect of low power laser
neon laser to affect components of wound healing irradiation on cell growth and procollagen
in vitro. British Journal of Dermatology, 1989; synthesis of cultured fibroblasts. Lasers in
121(2): p. 179-186. surgery and medicine, 2002; 31(4): p. 263-267.
47. Trelles, M., et al., The action of low reactive 56. Pourzarandian, A., et al., Effect of low-level Er:
level laser therapy (LLLT) on mast cells. Laser YAG laser irradiation on cultured human gingival
Therapy, 1989; 1(1): p. 27-30. fibroblasts. Journal of periodontology, 2005;
48. Medrado, A.R., et al., Influence of low level laser 76(2): 187-193.
therapy on wound healing and its biological 57. Moore, P., et al., Effect of wavelength on low
action upon myofibroblasts. Lasers in surgery intensity laser irradiation stimulated cell
and medicine, 2003; 32(3): p. 239-244. proliferation in vitro. Lasers in surgery and
49. Woodruff, L.D., et al., The efficacy of laser medicine, 2005; 36(1): p. 8-12.
therapy in wound repair: a meta-analysis of the 58. Greppi, I., Diode laser hair removal of the black
literature. Photomedicine and laser surgery, patient. Lasers in surgery and medicine, 2001;
2004; 22(3): p. 241-247. 28(2): p. 150-155.
50. Freitas, A., et al., Assessment of anti-

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