Zuzanna Grzech-Leśniak

Repair of aged resin composites requires additional surface conditioning and an adhesive protocol capable of limiting interfacial leakage. This in vitro study evaluated three additional conditioning methods and two adhesive systems at aged composite–new composite repair interfaces. Ninety extracted posterior teeth were restored, thermocycled, and partially prepared with a diamond bur to create standardized repair surfaces. The surfaces then received additional diamond-bur roughening, 50-µm Al₂O₃ airborne-particle abrasion, or Er:YAG laser irradiation and were treated with Clearfil SE Bond or Clearfil Universal Bond Quick 2 (n = 15 per combination). After repair and additional thermocycling, maximum linear dye penetration was measured as the primary outcome; a derived ordinal grade was analyzed as a supportive, exploratory secondary outcome. A two-factor permutation analysis detected no significant effect of conditioning method (p = 0.142), adhesive system (p = 0.606), or their interaction (p = 0.341) on linear microleakage. In the ordinal proportional-odds analysis, the method effect was not statistically significant (p = 0.053); neither the adhesive effect (p = 0.763) nor the interaction (p = 0.754) was significant. Under the tested conditions, statistically significant differences in microleakage were not detected among the evaluated combinations.

Purpose: This in vitro study aimed to evaluate the antimicrobial effects of a 1064 nm Nd:YAG laser delivered through a novel handpiece designed to provide a flat-top, homogeneous energy distribution profile (MarcoM handpiece) against key oral pathogens: Candida albicans, Candida glabrata, and Streptococcus mutans, in both planktonic and biofilm forms, in single- and dual-species cultures. Methods: Microorganisms were cultured individually and in dual-species combinations and irradiated using two irradiance settings (T1: 0.2 W/cm², T2: 0.6 W/cm²) corresponding to clinically established photobiomodulation parameters for wound healing and analgesia. Colony-forming units (CFU/mL) were quantified immediately and 24 hours post-irradiation to assess laser-induced antimicrobial effects.Results: Streptococcus mutans exhibited the highest susceptibility in planktonic form, with CFU reductions of 79.0 ± 5.6% (T1) and 86.3 ± 4.2% (T2) immediately after irradiation (p < 0.05). After 24 hours, a 92.0 ± 3.5% reduction was observed, though viability partially recovered in dual-species cultures with C. albicans (T1: 4.7 ± 6.6%, T2: 0.0 ± 0.0%). C. albicans showed greater reduction after 24 hours (T2: 68.2 ± 9.7%) than immediately post-irradiation (32.1 ± 6.7%) (p < 0.05). In biofilm forms, the greatest effect was observed for C. albicans at T2 (91.7 ± 2.8%), while C. glabrata biofilms showed no significant difference between settings (p > 0.05). Dual-species biofilms required higher irradiance (T2, p < 0.05) for significant eradication.Conclusion: Under the specific in vitro conditions tested, 1064 nm Nd:YAG irradiation delivered with a flat-top, homogeneous beam profile reduced CFU counts and biofilm biomass of the tested oral microbial isolates. The effect depended on laser parameters, microbial species, culture model, and time point. Because only one clinical isolate per species was used and no positive antimicrobial comparator was included, these findings should be interpreted as preliminary proof-of-concept data requiring validation in expanded strain panels and comparator-controlled studies.

Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication associated with antiresorptive and antiangiogenic therapies. Laser-based approaches, including photobiomodulation therapy (PBMT) and erbium laser-assisted surgery, have been proposed as adjunctive interventions to improve healing and clinical outcomes. This consensus-based review aimed to synthesize evidence from systematic reviews and meta-analyses evaluating laser-based therapies in the prevention and treatment of MRONJ, and to translate these findings into clinical recommendations developed by the World Federation for Laser Dentistry (WFLD) and the Polish Society for Laser Dentistry (PTSL).The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and Joanna Briggs Institute (JBI) guidance, and was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO). An electronic search of the PubMed/MEDLINE, Embase, Scopus, and Cochrane Library databases was conducted for systematic reviews and meta-analyses published between January 2015 and October 2025. Study selection, data extraction and methodological assessment were performed independently by 3 reviewers.Eighty-five records were identified, and 14 reviews met the inclusion criteria. These included several hundred primary studies, mainly observational studies and case series. Laser-based interventions were primarily used as adjuncts to conventional MRONJ management. Photobiomodulation therapy was associated with pain reduction and improved soft tissue healing, while erbium-doped yttrium aluminum garnet (Er:YAG) laser-assisted surgery enabled the precise removal of necrotic bone. Combined protocols showed generally favorable trends. However, substantial heterogeneity in study design, laser parameters and outcome definitions precluded quantitative synthesis.Laser-based therapies may provide beneficial adjunctive effects in MRONJ management, particularly within multimodal treatment strategies. However, the strength of these conclusions is limited due to substantial heterogeneity in study design, laser protocols and outcome reporting.

The objective of the study was to comprehensively synthesize and critically evaluate the effectiveness, safety and clinical applicability of various laser therapies in the management of oral lichen planus (OLP), including photodynamic therapy (PDT), photobiomodulation therapy (PBMT) and high-intensity laser therapy (HILT), and to provide guidelines for clinicians.A structured literature review was conducted following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines, and recommendations were formulated. A total of 23 relevant studies published between 2015 and 2025 were identified through searches of multiple biomedical databases. The risk of bias and quality of evidence were assessed, focusing on clinical outcomes such as reduction in lesion severity, pain relief, mucosal healing, and recurrence rates.Laser therapies demonstrated effectiveness in reducing lesion size and pain, with safety profiles comparable to or superior to those of conventional corticosteroid treatments. Photobiomodulation therapy and HILT showed particularly favorable outcomes, including lower recurrence rates and fewer adverse effects. However, heterogeneity in treatment protocols and laser parameters limited direct comparisons, with corticosteroids remaining the first-line treatment.Laser-based therapies are valuable adjuncts or alternatives for patients with OLP who are intolerant to corticosteroids. Standardized treatment protocols and further large-scale randomized controlled trials with longer follow-up periods are needed to optimize clinical guidelines and enable personalized therapy. Photobiomodulation therapy is recommended as the safest and most effective modality for erosive OLP.

Temporomandibular disorders (TMDs) are the prevalent causes of orofacial pain and dysfunction of the temporomandibular joint (TMJ) and masticatory muscles. Previous studies have revealed that proinflammatory cytokines play a key role in promoting inflammation, pain, and degeneration within the TMJ. In this context, the present systematic review synthesizes current evidence on various cytokines involved in the pathophysiology of TMDs and evaluates their associations with clinical signs and structural TMJ damage. A PRISMA-guided search (PROSPERO: CRD420251163290) was conducted in PubMed/MEDLINE, Embase, Scopus, and the Cochrane Library to identify human-based, in vivo, and in vitro studies (January 2014 to September 2025) that assessed the roles of proinflammatory cytokines in TMDs. The following data were extracted from the identified studies: cytokine profiles, sampling methods, clinical outcomes, and TMJ structural changes. Study quality and risk of bias were systematically evaluated. A total of 15 studies (clinical, animal, and mechanistic) were included in the review. Tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), and interleukin-17 (IL-17) consistently emerged as the major contributors to synovitis, cartilage degradation, nociceptive sensitization, and bone resorption. Human studies showed that high levels of TNF-α, IL-1β, and IL-6 and chemokines such as C-C motif chemokine ligand 2 (CCL2) and regulated on activation, normal T-cell expressed and secreted (RANTES) were associated with TMJ pain, restricted mandibular motion, crepitus, malocclusion, and erosive changes on imaging. An increased ratio of TNF to soluble TNF receptor in synovial fluid correlated with both pain and condylar damage, suggesting that loss of cytokine control contributes to progressive joint destruction. TMDs, particularly inflammatory and degenerative subtypes, are cytokine-driven pathologies rather than purely mechanical disorders. TNF-α, IL-1β, and IL-6 are the promising candidate biomarkers of local inflammation and structural joint pathology. Standardized longitudinal studies are required to validate cytokine-based diagnostics and develop anti-cytokine therapeutics.

Oral mucositis (OM) is a common and debilitating side effect of cancer therapy that impairs nutrition, increases infection risk, and often disrupts oncologic treatment. Photobiomodulation therapy (PBMT) has emerged as an effective, non-invasive method for OM prevention and management.This umbrella review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines and the Joanna Briggs Institute (JBI) methodology. A comprehensive search of PubMed®/MEDLINE, Embase, Scopus, and Cochrane Library identified systematic reviews and meta-analyses on laser therapy for OM published through July 2025. The data extraction process centered on clinical outcomes, laser parameters and safety.Twenty-two reviews met the inclusion criteria. Photobiomodulation therapy significantly reduced the incidence of OM, disease severity, pain, and healing time across adult and pediatric populations. Preventive PBMT decreased the risk of severe OM (grade 3-4) by 40-80%, while therapeutic PBMT shortened ulcer duration by 4-7 days. The combination of PBMT and photodynamic therapy (PDT) enhanced mucosal healing and alleviated pain. Optimal outcomes were achieved when wavelengths of 630-670 nm (intraoral) and 780-850 nm (extraoral) were used, with fluences of 2-6 J/cm2. No serious adverse events were reported.Photobiomodulation therapy demonstrates strong efficacy and safety in the management of OM, improving quality of life and treatment continuity in oncology patients. The Polish Society for Laser Dentistry (PTSL) endorses PBMT as a standard supportive care modality, particularly in the context of hematopoietic stem cell transplantation (HSCT) and head and neck chemoradiation. Protocol adherence and parameter standardization are essential to ensure the reproducibility and clinical effectiveness of research findings.

(1) Background: This study aimed to compare alveolar bone preservation and early healing outcomes following a comprehensive laser-assisted post-extraction protocol compared to conventional extraction alone. In addition, the potential influence of serum vitamin D levels on bone regeneration was assessed. (2) Methods: Thirty tooth extractions were performed and randomized into two groups: a test group (G1, n =15) and a control group (G2, n = 15). G1 received a laser-assisted protocol using Er:YAG and Nd:YAG lasers for granulation tissue removal, socket disinfection, clot stabilization, de-epithelialization, and photobiomodulation (PBM) with the Genova handpiece (LightWalker, Fotona, Slovenia). G2 underwent standard mechanical extractions and socket debridement without laser. (3) Results: Procedures in G1 were on average 8.7 min longer, but patients in this group reported significantly lower postoperative pain during the first three days (p < 0.05). A statistically significant difference in alveolar height was observed at the distal lingual site (25.4 mm vs. 21.7 mm; p = 0.046), with other sites showing a trend toward significance. Cumulative bone preservation, measured by Bone Loss Index (BLI4), was significantly better in the laser group. Notably, a positive correlation was found between serum vitamin D levels and bone preservation: each 1 ng/mL increase in vitamin D corresponded to a 0.18 mm gain in alveolar height (p = 0.021). (4) Conclusions: The comprehensive laser-assisted post-extraction protocol reduced postoperative pain and improved alveolar bone preservation, particularly at the lingual distal site. Serum vitamin D levels positively correlated with healing outcomes, suggesting a potential synergistic role of systemic and local regenerative factors.

Bcakground: The deepithelialized free gingival graft (DGG) technique provides high-quality connective tissue grafts (CTGs) with predictable outcomes for recession coverage. This study evaluates a novel method of free gingival graft (FGG) deepithelialization using an Er,Cr:YSGG laser (LDEE) for treating multiple gingival recessions. Methods: A split-mouth study was conducted on 46 (n = 46) recessions in nine patients (23 per test and control group). Sites were randomized. Full-thickness palatal grafts were harvested with a scalpel. In the test group (LDEE), deepithelialization was performed extraorally using an Er,Cr:YSGG laser (2780 nm; 2.5 W, 83.3 mJ, 30 Hz, 600 µm tip). In the control group (DEE), a 15c scalpel was used. All CTGs were applied using the modified coronally advanced tunnel (TUN) technique. Clinical parameters—recession depth (RD), keratinized tissue width (KT), gingival thickness (GT), pocket depth (PD), clinical attachment loss (CAL), pink esthetic score (PES), approximal plaque index (API), mean root coverage (MRC), and complete root coverage (CRC)—were assessed at baseline (T0), 3 months (T1), and 6 months (T2). Results: Both LDEE and DEE groups showed significant improvements in RD, KT, GT, PD, and CAL over time (p < 0.001). At T1 and T2, KT was significantly higher in the LDEE group (T1: 3.73 ± 0.72 mm; T2: 3.98 ± 0.76 mm) compared to the DEE group (T1: 3.21 ± 0.61 mm; T2: 3.44 ± 0.74 mm; p < 0.05). Other parameters (RD, GT, PD, CAL) showed no statistically significant intergroup differences at any time point (p > 0.05). After 6 months, MRC was 95% and CRC 82.6% for LDEE, compared to 94.8% and 82.6% for DEE (p > 0.05). PES scores were similar between groups at all time points (p > 0.05). Conclusions: Both laser- and scalpel-deepithelialized grafts effectively treated gingival recessions. LDEE combined with TUN resulted in significantly greater KT width compared to DEE + TUN.

Erbium family lasers have been used as an alternative method for the treatment of dental caries in deciduous teeth, in comparison to traditional methods. The study aimed to determine the most optimal erbium-doped yttrium-aluminum-garnet (Er:YAG) laser settings for carious lesions in deciduous teeth on different surfaces with the evaluation of treatment time and pain level on a visual analog scale (VAS). The randomized clinical trial involved 66 teeth with deep caries in 33 children aged 3-8 years, divided into 2 study groups: Er:YAG laser (test group); and conventional treatment with a dental turbine (control group). The time required for caries removal and cavity preparation using both methods was recorded. The inclusion criteria encompassed generally healthy pediatric patients, pain-free subjects, first-time dental appointment, and unicuspid primary teeth with caries. Dental caries treatment was performed without the administration of local anesthesia. The cavity preparation time was on average 2.5 times longer when the Er:YAG laser was used compared to the conventional method. The study demonstrated the effectiveness of the Er:YAG laser in hard tissue preparation of deciduous teeth with a pulse energy of 230 mJ for enamel preparation, mainly on occlusal and proximal surfaces, and with a pulse energy of 120 mJ and 150 mJ for dentin preparation. Optimum operating frequencies were 10 Hz and 20 Hz with corresponding water consumption. The level of discomfort among the laser-treated patients indicated 0 based on VAS, meaning no pain. Among patients treated with the traditional method, the pain level averaged 5.27. The use of the Er:YAG laser offers substantial advancements in comparison to traditional treatment with dental turbines by enhancing the overall comfort during caries therapy in children. It fosters better patient cooperation and reduces the need for intraoperative anesthetics due to its minimally invasive nature and the fact that it is a relatively quiet operation. This approach minimizes anxiety and discomfort often associated with dental procedures, making them more amenable to children.