In 2021, our group published a laboratory study on the impact of PBM on human gingival fibroblasts. The in vitro results confirmed the fact that the appropriately selected wavelength and properly selected parameters of the laser settings can increase cell proliferation, modulate inflammatory markers, and decrease the susceptibility of human gingival fibroblasts to apoptosis. Therefore, this case report was aimed at the clinical evaluation of the proposed settings and treatment regimen in a very difficult situation of an immunocompromised patient with extensive changes and stagnation of symptoms for many weeks. A 65-year-old man, during his oncological treatment, was diagnosed with oral mucositis grade 3 according to the World Health Organization and National Cancer Institute scales. Due to pain sensation, long-lasting and not healing oral lesions, and problems with solid food intake, he was qualified for laser photobiomodulation therapy. For the management of oral lesions, a diode laser 635 nm (SmartMPro, Lasotronix, Poland) was intraorally applied at an energy density of 4 J/cm2, the 20 s of irradiation, the output power of 100 mW, and in continuous wave mode. Seven treatment procedures were performed two times a week using the spot technique in contact and non-contact mode. Within 21 days of monotherapy, all ailments disappeared. The patient was also able to reuse dental dentures and return to a solid diet. The obtained results confirm the efficiency of at least 3 PBM protocols. Our case shows that the use of PMB therapy contributes to faster healing of painful oral lesions in oncological patients, and thus the treatment time and return to the appropriate quality of life is shorter.
Background
Long-term diabetes predisposes to pathological changes in periodontal tissues. Improvement in this respect can be expected in patients after pancreas transplantation.
The aim of this study was to assess and compare the intensity of periodontium pathological lesions and inflammation markers concentration in gingival crevicular fluid (GCF) in patients with type 1 diabetes (T1D) after kidney (KTx) or simultaneous pancreas and kidney transplantation (SPK).
Material/Methods
The study included 20 T1D patients after SPK and 16 after KTx, and 15 non-diabetic kidney recipients (control). Periodontal clinical parameters and concentration of selected biochemical markers of inflammation in GCF were assessed. The following tests were used in statistical data analysis: Shapiro-Wilk test, the
t
test, the Mann-Whitney U tests, one-way ANOVA with Tukey’s post hoc test, and χ
2
test (also with Yate’s correction). Moreover, linear regression and Pearson or Spearman correlation coefficient was used.
Results
There were no differences in modified Sulcus Bleeding Index (mSBI) and GCF volume between the SPK group and control group, whereas values of these parameters in the KTx group were higher than in the SPK and control groups. Maximal clinical attachment loss and pocket depth and Periotest values were higher in diabetic recipients compared to controls, and did not differ between SPK and KTx.
The concentration of IL-1β, MMP-8, resistin, TNFα, and YKL40 in the GCF in the KTx group was higher than in the SPK and control groups.
In the combined group of T1D patients, there was a correlation between blood HbA1c and mSBI, GCF volume, and resistin, TNF-α and YKL40 concentrations, and between resistin concentration and mSBI.
Conclusions
T1D patients after SPK show lower levels of inflammatory markers in GCF and present reduced intensity of periodontitis compared to kidney recipients treated with insulin.
The severity of morphological changes in periodontium in T1D patients after KTx or SPK is higher than in non-diabetic kidney recipients.
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