Sajee Sattayut

Translation research into practice remains one of the critical yet underdeveloped aspects of scientific progress. This editorial explores how academic mediation can transform fragmented research activities into sustainable translational ecosystems. Drawing from Thailand's experience in laser dentistry, the paper illustrates a progression from individual projects to collective research networks and the institutionalization of the Hub of Knowledge in Orofacial Laserology (HKOL). The model demonstrates how innovation can move beyond diffusion and normalization to achieve implementation grounded in education and community relevance through structured collaboration, standardized protocols, and academic stewardship. By addressing theoretical gaps and aligning practice with governance, the academic mediator-driven model offers an adaptable framework for integrating research, clinical service, and policy. It underscores that effective translation is not a spontaneous outcome of evidence but the result of deliberate structure, shared accountability, and long-term academic continuity.

This article presents the global consensus report of the World Federation for Laser Dentistry (WFLD) on laser-assisted caries prevention and management. Laser-assisted caries removal is a minimally invasive approach based on selective ablation, targeting demineralized tissues while preserving the adjacent healthy enamel and dentin. This approach aligns with the principles of modern conservative dentistry. Erbium-doped yttrium aluminum garnet (Er:YAG) and erbium, chromium-doped yttrium scandium gallium garnet (Er,Cr:YSGG) lasers are highly absorbed by water and hydroxyapatite (HAP), enabling precise ablation with minimal thermal diffusion and collateral damage. Laser wavelengths can also exhibit bactericidal effects through thermal and photomechanical mechanisms, reducing the microbial load in carious lesions. The aim was to review, evaluate and consolidate the current evidence on the use of laser technologies in caries prevention and treatment, in light of the emerging scientific knowledge and clinical advancements. This summary is based on the current evidence from in vitro, ex vivo and clinical studies evaluating the interaction of erbium-based lasers (Er:YAG, Er,Cr:YSGG) with enamel and dentin, their effect on the microbial load, fluoride uptake and resin adhesion, and their use in photobiomodulation (PBM) therapy. Laser irradiation induces physicochemical changes in enamel, such as superficial melting and recrystallization, reducing porosity and increasing resistance to acid attacks. Fluoride uptake is enhanced through microstructural modifications, especially when combined with topical fluoride. Subablative laser settings synergize with fluoride to enhance retention without damaging enamel. Laser conditioning before fissure sealing improves surface energy and resin adhesion, reducing microleakage. Photobiomodulation promotes remineralization in early lesions via cellular stimulation. Laser-assisted caries treatment offers precise, minimally invasive management of dental caries with added benefits, such as microbial reduction, structural enhancement and improved adhesion. Careful control of parameters is essential to balance efficacy and safety. Further studies are needed to standardize protocols and confirm long-term outcomes in clinical practice.

Background/Objective: Laser therapy has gained attention in dental practice to minimize bleeding and enhance blood clot formation. This study aimed to explore the utilization and to compare the clinical efficacy of laser-mediated hemostasis for older patients receiving routine dental treatment. Methods: A prospective observational study was conducted across research networks between October 2023 and August 2024, involving 60 patients aged 50 years and older (average = 63.35 years) at risk of postoperative bleeding following dental treatments. Additionally, laser therapy for hemostasis was selected and provided among calibrated operators. A single researcher performed data collection. Before statistical analysis, data verification and clinical assessment were conducted by the operators and researcher. A clinical cut-off for hemostasis was set at 5 min. Two diode laser machines were used namely, an 810 nm and dual wavelengths of 635 nm and 980 nm. Results: There were 94 extraction sockets, 28 procedures of scaling and root planing and 18 procedures of minor oral surgery. Combining laser ablating sulcular fiber and photobiomodulation initiating blood clot formation was a preferable hemostatic technique for extraction socket, while photobiomodulation alone was a preferred technique for soft tissue hemostasis (p < 0.001). All operators confirmed that 97.86 percent of bleeding events achieved more rapid hemostasis. 61.43 percent of bleeding events clinically achieved hemostasis within 5 min by using laser-mediated hemostasis alone (p = 0.092). Full recovery of the extraction socket was significantly observed during the 2- to 4-week follow-up period (p = 0.005). No clinical complications were reported. Conclusions: Laser-mediated hemostasis effectively reduced hemostatic duration, prevented postoperative bleeding and promoted wound healing in older patients undergoing routine dental treatment.

* Background Currently, there is no objective and quantified measurement for detecting blood clots during extraction socket hemostasis. It has relied solely on clinical observation, even when conducting clinical research by using extraction sockets as samples. This study aimed to assess the in vitro reliability and clinical-relevant validity of a new objective measurement providing quantified data called blood clot detection (BCD) using a standard capillary tube. Methods The in vitro part of the study was conducted using surplus blood samples from ten healthy participants. Two identical sets of blood samples in simulation reservoirs mimicking bleeding sockets were prepared for reliability tests. Then, the capillary tubes were concurrently placed in the reservoirs. The blood-filled distances were measured. The part of clinical-relevant validity study was conducted in sixteen extraction sockets from each healthy participant. Clinical observation and BCD measurement were evaluated by two calibrated assessors. The total duration of the assessment was a 30-minute. Results The distances of the blood-filled capillary tube were decreased by time. Test and retest reliability analysis of the BCD measurement showed an excellent intraclass correlation coefficient of 0.980 (0.968 to 0.988). The medians of blood-filled distance categorized by clinical observation into active bleeding, sluggish oozing, and clot formation were 13.0 mm (Q1 = 11.7, Q3 = 13.8), 5.6 mm (Q1 = 4.3, Q3 = 7.0), and 0.9 mm (Q1 = 0.5, Q3 = 1.3), respectively. The blood-filled distance of the clot formation group was significantly less than the active bleeding and sluggish oozing (p<0.001). Therefore, the BCD measurement also significantly indicated the completion of extraction socket hemostasis Conclusions A distance of blood-filled in capillary tube of 0.9 mm from the BCD measurement significantly ensured complete clot formation. The BCD measurement proved to be a quantified tool for objectively measuring hemostasis of bleeding socket.

Laser therapy effectively reduces the risk of excessive bleeding, a critical condition in rural healthcare units due to limited hemostatic tools and specialist availability. This research aimed to compare the clinical outcomes of utilizing lasers to enhance socket hemostasis in Thailand’s primary, secondary, and tertiary-level healthcare units. This prospective observational study involved a total of 27 patients, aged 50 and older, who were at risk of extraction socket bleeding due to medications or gingival inflammation. Each study unit provided routine dental treatments along with supplemental laser therapy, as chosen by the operators. A single researcher assessed the related clinical outcomes. Primary and secondary-level healthcare units utilized an 810 nm diode laser; in contrast, a tertiary-level healthcare unit employed a 653 nm and 980 nm diode laser. Soft-assisted tissue loosening was conducted using 810 nm or 980 nm diode lasers, with a power of 2.5 to 3 W delivered via a 320-micron optical fiber. To initiate blood clot formation, a 635 nm at 0.2 W, 5.08 J/cm2 via 8-mm diameter laser probe, or 810 nm at 0.8 W, 5.93 J/cm2 via 6-mm diameter biomodulation probe was applied for 10 s per session. Secondary and tertiary-level healthcare units often combined laser-assisted soft tissue loosening and photobiomodulation, whereas the primary-level healthcare unit generally opted for utilizing photobiomodulation alone (p<0.001). Laser therapies employed in this study achieved socket hemostasis in 72 out of 86 sockets, with 55 achieving hemostasis within 5 min. The operators confirmed the clinical efficacy in reducing hemostasis duration across all study units (p=0.702), without experiencing post-extraction bleeding or clinical complications. Our findings indicate that a combination of laser-assisted soft tissue loosening and photobiomodulation to induce blood clot formation is a safe and effective local measure for enhancing socket hemostasis.

Oral lesions are a significant concern among older adults because they can progress to oral cancer if not diagnosed and treated promptly and effectively. Transportation to the hospital is a major barrier to oral healthcare for many older adults. The purpose of this editorial is to address the challenges of managing oral potentially malignant disorders in the older population, highlighting the barriers they face in accessing healthcare services, the potential use of laser therapy for management, and the direction of research in this area. Due to the limited access of the older to healthcare services, primary healthcare facilities within communities serve as their primary providers. Laser therapy is recommended for the management of oral potentially malignant disorders due to its favorable outcomes. This approach has been tested in several primary healthcare centers in Thailand. In our project, laser therapy was used to treat oral potentially malignant disorders in primary and secondary healthcare services. This includes photodynamic therapy for older patients with extensive lesions, as well as individuals with oral leukoplakia and erythroplakia who have declined curative surgery. It has also been used in cases of recalcitrant lichen planus to steroid or photobiomodulation therapy. This approach has been well accepted by both oral healthcare providers and patients. To expand access to these treatment options in such settings, it is critical to empower healthcare professionals, particularly dentists and dental nurses, to integrate laser techniques into geriatric care and oral cancer screening. Establishing a network foundation for orofacial laserology would also enhance the potential of such settings.

Background Currently, there is no objective and quantified measurement for detecting blood clots during extraction socket hemostasis. It has relied solely on clinical observation, even when conducting clinical research by using extraction sockets as samples. This study aimed to assess the in vitro reliability and clinical-relevant validity of a new objective measurement providing quantified data called blood clot detection (BCD) using a standard capillary tube. Methods The in vitro part of the study was conducted using surplus blood samples from ten healthy participants. Two identical sets of blood samples in simulation reservoirs mimicking bleeding sockets were prepared for reliability tests. Then, the capillary tubes were concurrently placed in the reservoirs. The blood-filled distances were measured. The part of clinical-relevant validity study was conducted in sixteen extraction sockets from each healthy participant. Clinical observation and BCD measurement were evaluated by two calibrated assessors. The total duration of the assessment was a 30-minute. Results The distances of the blood-filled capillary tube were decreased by time. Test and retest reliability analysis of the BCD measurement showed an excellent intraclass correlation coefficient of 0.980 (0.968 to 0.988). The medians of blood-filled distance categorized by clinical observation into active bleeding, sluggish oozing, and clot formation were 13.0 mm (Q1 = 11.7, Q3 = 13.8), 5.6 mm (Q1 = 4.3, Q3 = 7.0), and 0.9 mm (Q1 = 0.5, Q3 = 1.3), respectively. The blood-filled distance of the clot formation group was significantly less than the active bleeding and sluggish oozing (p<0.001). Therefore, the BCD measurement also significantly indicated the completion of extraction socket hemostasis Conclusions A distance of blood-filled in capillary tube of 0.9 mm from the BCD measurement significantly ensured complete clot formation. The BCD measurement proved to be a quantified tool for objectively measuring hemostasis of bleeding socket.

Background Managing recalcitrant oral lichen planus (OLP) can be challenging. Laser therapy has been suggested as an alternative to corticosteroids for treatment. Photodynamic therapy (PDT) is a non-invasive technique that enables the removal of lesions without surgery. Photobiomodulation therapy (PBMT) can promote healing and recovery of the lesions. Case presentation The objective was to treat unresponsive bilateral OLP of the whole buccal mucosae with a combination of PDT and PBMT. Results A 43-year-old Thai male presented with the severe painful reticular type of OLP of bilateral buccal mucosae involving upper and lower vestibular areas. The lesions were not remitted with either prednisolone systemic steroids or fluocinolone topical corticosteroids. After undergoing ten sessions of PDT with 10% 5-Aminolevulinic acid (5-ALA) in the form of thermoplastic gel and a 635 nm diode laser at 100 to 400 mW with an energy density of 20 to 30 J/cm2 in continuous wave mode, combined with five interim-sessions of PBMT using a 635 nm diode laser at 200 to 300 mW with an energy density of 6 to 10 J/cm2 in continuous wave, the patient reported relief of burning sensation beside remission of lesions without any complications. Conclusion The wide-spreading recalcitrant OLP with burning sensation can be managed by combining PDT and PBMT.

CO₂ lasers have been generally used in oral soft-tissue surgery. Although an increase in power enhances the depth of ablation, the specific correlation between units of power and ablative depth has not been stated. This study aimed to explore ablative depth and width affected by a power unit of 10,600-nm CO₂ laser continuous wave at 3 to 10 W in tissue blocks of the swine tongue. The 112 samples were randomly allocated into eight groups according to the power settings. The depth and width of the incision were measured by using the ImageJ program. The 3 W group showed the minimal depth of ablation [0.527 mm (0.474 and 0.817)] and width of ablation [0.147 mm (0.110 to 0.184)]. The maximal depth [3.750 mm (3.362 and 4.118)] and width [0.700 mm (0.541 to 0.860)] were in the 9 W group. The correlation between the ablative depth and power unit was 0.81 (p < 0.001). Based on the regression equation (p < 0.001), the ablative depth (mm) = (the power unit of laser in W × 0.491) − 0.731. In conclusion, the ablative depth of the CO₂ laser on soft tissue was strongly correlated to power units enabling the prediction equation.