This PDF file contains the front matter associated with SPIE Proceedings Volume 10477, including the Title Page, Copyright information, Table of Contents, and Conference Committee listing.

Photobiomodulation (PBM) describes the use of red or near-infrared light to stimulate, heal, regenerate, and protect tissue that has either been injured, is degenerating, or else is at risk of dying. One of the organ systems of the human body that is most necessary to life, and whose optimum functioning is of most concern to humans in general, is the brain. The brain suffers from many different disorders that can be classified into three broad groupings: sudden events (stroke, traumatic brain injury, and global ischemia), degenerative diseases (dementia, Alzheimer’s and Parkinson’s), and psychiatric disorders (depression, anxiety, post traumatic stress disorder, autism). There is some evidence that all these seemingly diverse conditions can be beneficially affected by applying light to the head. There is even the possibility that PBM could be used for cognitive enhancement in normal healthy people. In this transcranial PBM (tPBM) application, near-infrared (NIR) light is often applied to the forehead because of the better penetration (no hair, longer wavelength). Some workers have used lasers, but recently the introduction of inexpensive light emitting diode (LED) arrays has allowed the development of light emitting helmets or “brain caps”. Transcranial LED light sources are ideally suited to be home use devices. This review will cover the mechanisms of action of photobiomodulation to the brain, and summarize some of the key pre-clinical studies and clinical trials that have been undertaken for diverse brain disorders.

Spinal cord injury (SCI) can result in complete or partial loss of sensation and motor function due to interruption along the severed axonal tract(s). SCI can result in tetraplegia or paraplegia, which can have prohibitive lifetime medical costs and result in shorter life expectancy. A promising therapeutic technique that is currently in experimental phase and that has the potential to be used to treat SCI is Low-level light therapy (LLLT). Preclinical studies have shown that LLLT has reparative and regenerative capabilities on transected spinal cords, and that LLLT can enhance axonal sprouting in animal models. However, despite the promising effects of LLLT as a therapy for SCI, it remains difficult to compare published results due to the use of a wide range of illumination parameters (i.e. different wavelengths, fluences, beam types, and beam diameter), and due to the lack of a standardized experimental protocol(s). Before any clinical applications of LLLT for SCI treatment, it is crucial to standardize illumination parameters and efficacy of light delivery. Therefore, in this study we aim to evaluate the light fluence distribution on a 3D voxelated SCI rat model with different illumination parameters (wavelengths: 660, 810, and 980 nm; beam types: Gaussian and Flat; and beam diameters: 0.1, 0.2, and 0.3 cm) for LLLT using Monte Carlo simulation. This study provides an efficient approach to guide researchers in optimizing the illumination parameters for LLLT spinal cord injury in an experimental model and will aid in quantitative and qualitative standardization of LLLT-SCI treatment.

Photobiomodulation or low level laser therapy (LLLT) has been utilized in various areas of medical practice including pain relief, wound healing, and inflammation treatment. Some recent animal studies have reported that near-infrared laser irradiation to the lumbosacral nerves transcutateously relieves neuropathic pain by controlling activity of lumbosacral nerves. However, transcutaneous laser penetration to the nerves has not yet been fully elucidated. Our aim is to determine the light penetration to lumbosacral nerves when near-infrared laser was irradiated transcutateously to lumbosacral nerves. We implanted photodiodes near the lumbosacral nerves of rats and connected the photodiodes to an oscilloscope through an amplifier. Near-infrared lasers (wavelengths: 808 nm and 830 nm) were irradiated through the skin at 2, 5 and 10 W pulses (Duty 10%, 5 Hz) and outputs of photodiodes were collected. After irradiation, the depth of the photodiodes and the nerves from the skin surface were determined by micro-CT device. The result showed that the fluence rate at the lumbosacral nerves was 179±19.2 mW/cm² and 232±20.7 mW/cm² when the 808-nm and 830-nm laser was irradiated at 10 W respectively. These findings would be beneficial for following study of photobiomodulation.

Low-level lighy therapy (LLLT) using red or near-infrared light is generally used clinically for patients suffering from various diseases. LLLT is known to stimulate, treat, regenerate and protect the dying tissue that has been damaged or degenerated. Photomodulation using low-level light emitting diode (LED) therapy has been widely used to treat neuropsychiatric disorders. However, the effect of photomodulation using LED on the status epilepticus has been unknown. Status epilepticus is the serious neurological diseases caused by the abnormal electrical activity, leading to severe and widespread cell damage in the brain. Pharmacological models include kainic acid and pilocarpine that induced synapse loss and subsequent neuronal death in cultured rat hippocampal neurons. In this study, we investigated the effect of LLLT at 660 nm on status epilepticus-induced synapse loss of cultured rat hippocampal neurons. The optimum energy irradiation in cell viability experiments using PC12 cells was estimated to be 30 Joules. Synaptic activity of neurons was measured by quantifying green fluorescence intensity expressing postsynaptic density 95 (PSD95), which is widely used as a marker of excitatory postsynaptic sites. As a result, LLLT at 660 nm showed synapto-protective effect on both kainic acid and pilocarpine-induced synapse loss. Furthermore, LLLT prevented neuronal death caused by kainic acid or pilocarpine. These studies indicate that LLLT has synapto-protective effects at early phase of status epilepticus via distinct mechanism. These results suggest that photomodulation using LLLT at 660 nm can be useful for preventing neurodegenerative diseases, especially status epilepticus.

Transcutaneous photobiomodulation of the spinal cord in rodent models has shown therapeutic effects to spinal cord injury. For translation to human medicine; however, it remains unknown if a therapeutic dose can reach the spinal cord with a non-invasive treatment protocol that does not cause collateral tissue damage. Our previous pilot test on a cadaver dog using a single photo-diode-sensor demonstrated that the transcutaneous transmission of 980nm light to the spinal canal through the shallowest section of the vertebrae was comparable to the transcranial transmission. The use of a single sensor to measure at multiple positions along the spinal canal challenged correlations of the results, due to variations of sensor-tissue geometry after repositioning the sensor within the spinal canal and closing the tissue for light transmission. To identify a potential transmission window for delivering an effective photobiomodulation therapy dose to the spinal cord, and to evaluate inter-subject variations, it is essential to maintain consistency in intra-spinal measurements at multiple positions for any one subject and across multiple subjects. We developed a flexible multi-channel photo-detector-array specifically for measuring the transmission of light to the spinal canal at multiple sites under fixed surface irradiation. The probe, with a 1/4" stem, contains 9 photo-diodes spaced 1cm apart allowing measurement over an 8cm length. Multi-site dosimetry at 980nm was tested in one cadaver dog at a fixed surface (shaved skin) irradiance of 3.18 W/cm2 by deploying the applicator-probe in the spinal canal after hemilaminectomy, and will be repeated in a total of six dogs.

Low level light/laser therapy (LLLT) is considered as a novel, non-invasive, and potential therapy in a variety of psychological and physical conditions, due to its effective intricate photobiomodulation. The mechanism of LLLT is that when cells are stimulated by photons, mitochondria produce a large quantity of ATP, which accelerates biochemical responses in the cell. It is of great significance to gain a clear insight into the change or interplay of various physiological parameters. In this study, we used functional near-infrared spectroscopy (fNIRS) and venous-occlusion plethysmography to measure the LLLT-induced changes in blood flow, oxygenation, and oxygen consumption in human forearms in vivo. Six healthy human participants (4 males and 2 females) were administered with 810-nm light emitted by LED array in ten minutes and blood flow, oxygenation and oxygen consumption were detected in the entire experiment. We found that LLLT induced an increase of blood flow and oxygen consumption on the treated site. Meanwhile, LLLT took a good role in promoting oxygenation of regional tissue, which was indicated by a significant increase of oxygenated hemoglobin concentration (Δ[HbO2]), a nearly invariable deoxygenated hemoglobin concentration (Δ[Hb]) and a increase of differential hemoglobin concentration (Δ[HbD] = Δ[HbO2] - Δ[Hb]). These results not only demonstrate enormous potential of LLLT, but help to figure out mechanisms of photobiomodulation.

Blue LED light irradiation is currently under investigation because of its effect in wound healing improvement. In this context, several mechanisms of action are likely to occur at the same time, consistently with the presence of different light absorbers within the skin. In our previous studies we observed the wound healing in superficial abrasions in an in vivo murine model. The results evidenced that both inflammatory infiltrate and myofibroblasts activity increase after irradiation. In this study we focused on evaluating the consequences of light absorption in fibroblasts from human cells culture: they play a key role in wound healing, both in physiological conditions and in pathological ones, such as keloid scarring. In particular we used keloids fibroblasts as a new target in order to investigate a possible metabolic or cellular mechanism correlation. Human keloid tissues were excised during standard surgery and immediately underwent primary cell culture extraction. Fibroblasts were allowed to grow in the appropriate conditions and then exposed to blue light. A metabolic colorimetric test (WST-8) was then performed. The tests evidenced an effect in mitochondrial activity, which could be modulated by the duration of the treatment. Electrophysiology pointed out a different behavior of irradiated fibroblasts. In conclusion, the Blue LED light affects the metabolic activity of fibroblasts and thus the cellular proliferation rate. No specific effect was found on keloid fibroblasts, thus indicating a very basic intracellular component, such as cytochromes, being the target of the treatment.

Low level light therapy (LLLT) using light from red and near infrared LEDs or Lasers have been reported effective as noninvasive methods for reducing spot fat. A total of 55 subjects were randomly divided into test groups and control groups for abdominal fat reduction clinical trial using red and near infrared LED phototherapy devices. Red and near infrared light with irradiance of 10 mW/cm² were irradiated over the abdominal area to the test group for 30 minutes followed by 30 minutes of aerobic exercise, 3 times a week for 4 weeks. Control group used sham devices for 30 minutes and followed by 30 minutes of aerobic exercise. It is expected that red and near infrared LED phototherapy combined with aerobic exercise would be effective and safe for abdominal fat reduction without any side effects.

It remains significant challenges to extend a shelf life of platelets beyond the conventional five days. Unlike red blood cells that can be stored at 4°C for a few weeks, platelets are stored at room temperature only, which results in a gradual loss of their quality owing to a switch of energy metabolism from aerobic oxidative phosphorylation toward anaerobic glycolysis. Given the well-documented beneficial effect of near infrared low-level laser (LLL) on mitochondrial functions in a variety of cells under stress, we explored a potential for LLL to extend the shelf life of platelets beyond the five days. We found that exposure of a platelet-containing storage bag to LLL at 830nm at 0.5J/cm² prior to storage could significantly retain a pH value and viability of the platelets stored within the bag under a standard condition for eight days with improved quality compared to those platelets stored similarly for five days in controls. LLL inhibited reactive oxygen species (ROS) and lactate production, but sustained ATP production, mitochondrial membrane potential, and morphology in the stored platelets. While preserving their metabolic activity, LLL didn’t activate platelets but increased their aggregation capacity and in vivo survival as suggested by similar levels of surface CD62p expression and enhanced agonist-induced aggregation and recovery following infusion in the presence compared to the absence of LLL treatment. This simple, addition-free, cost-effective, noninvasive laser illumination can be readily incorporated into the current platelet storage system to prolong shelf life of platelets with improved quality of stored platelets.

Myocardial ischemic reperfusion (MIR) injury results from coronary revascularization and cardiac intervention procedures. It is a negative pathophysiological event that may result in cardiac cell apoptosis. The resulting loss of cardiomyocyte cells and the formation of scar tissue, impair heart function and this is a major prognostic determinant of long-term cardiac outcomes. Photobiomodulation (PBM) is potential cardiac surgery intervention that could prevent myocardial ischemic reperfusion related myocardial injury. A growing body of evidence supporting the use of photobiomodulation in myocardial infarct models (tissues, animal models and a limited number of clinical trials) has implicated multiple molecular pathways of PBM action. PBM has been shown to decrease infarct size, both when delivered transthoracically and to remote areas of the body. PBM has also been shown to decrease the complications of hearts surgery including arrhythmias, to reduced restenosis, to accelerate wound healing, both superficial and deep, and to improve subjective well-being. One important factor in negative impact of injury is the spread of proteotoxic stress across compartments within the cell and across tissues. PBM is known to modify redox stress, to alter membrane ion channel stability, to affect cytoskeleton rescue and catastrophe and to alter the fluidity and stability of membranes and lipid rafts. A simple window into this is erythrocytes stability. The use of this measurement will be discussed, including its relevance to cardiac injury and its modification by PBM and the broader implications of the importance of PBM to cardioprotection and neuroprotection.

The aim of the present study was to assess, by means of Raman spectroscopy, the repair of complete surgical tibial fractures fixed with wire osteosynthesis or miniplates treated or not with infrared laser (λ780 nm) or infrared LED (λ850 ± 10 nm) lights, 142.8 J/cm² per treatment, associated or not to the use of mineral trioxide aggregate (MTA) cement. Surgical fractures were created on 36 rabbits and fixed with WO or miniplates and some groups were grafted with MTA. Irradiated groups received lights at every other day for 15 days and sacrifice occurred after 30 days. The results showed that only irradiation with either laser or LED influenced the peaks of phosphate (~960 cm^-1) and carbonated (~1,070 cm^-1) hydroxyapatite. Collagen peak (1,450 cm^-1) was influenced by both the use of MTA and irradiation with either laser or LED. It is concluded that the use of either laser or LED phototherapy associated to MTA cement was efficacious on improving the repair of complete tibial fractures treated with wire osteosynthesis or miniplates.

Background: Oral mucositis (OM) often occurs after myeloablative hematopoietic cell transplantation. We explore extra-oral photobiomodulation therapy (PBMT) for the prevention of OM in children. Objectives: Our objective was to use modeling of PBMT to determine optimal treatment sites and parameters for a safe and efficacious treatment. Methods: MRI images were analyzed to obtain morphological information on the extent of tissues along the six trajectories passing through the cheek; lips; submandibular and submental regions; neck, transversely and anteroposteriorly. For each treatment site we performed 18 simulations using morphological information from 18 subjects with ages between 5 and 20 years. The simulation technique uses Monte Carlo method to calculate light distribution and finite difference method to solve the heat transfer equation. Our model accounts for the geometry of emitter, optical, thermal, and morphological tissue properties, as well as possible changes of the optical properties during the therapy. We have used a layered tissue model. The optical and thermal properties of tissues were assigned to each pixel individually using published data on the properties of relevant tissues. We evaluated spatially resolved fluence rate, absorbed power, temperature increase and thermal damage. Results and Conclusions: At 850nm and 399mW/cm2, the median dose transmitted ranged from 0.18–2.4J/cm2. As presence of blood hinders light penetration, treatment sites should be chosen to avoid major blood vessels. There was no temperature increase and damage to the tissue. Our results reveal that extra-oral PBMT is safe and shows promise for the prevention of OM in children.

Can we treat ‘light as a drug’ for Photobiomodulation therapy? To satisfy the definition of an active pharmaceutical agent, the substance should be absorbed and capable of changing bodily function that light satisfies. Our understanding of our visual cycle and Vitamin D metabolism are clear evidences for this phenomenon. Advances in optophotonic technologies along with a better understanding of light-tissue interactions, especially in in vivo optical imaging and optogenetics, are spearheading the popularity of biophotonics in biology and medicine. This therapy is defined as the non-thermal use of non-ionizing forms of photonic devices including lasers, LEDs and broad-band light to alleviate pain, inflammation, modulate immune responses and promote wound healing and tissue regeneration. This presentation will provide a brief overview of the two most well understood phenomenon namely, an intracellular mechanism involving cytochrome c oxidase in the mitochondria and an extracellular mechanism involving activation of a latent growth factor, TGF-β1. Surprisingly, despite vast volumes of scientific literature from both clinical and laboratory studies noting the phenomenological evidences for this innovative therapy, there has been inconsistent, non-reproducible clinical outcomes. It is hoped that outlining the molecular mechanism will enable development of more robust, safe and efficacious PBM clinical regimens.

Photobiomodulation (PBM) refers to the beneficial effects of low doses of light whether mediating therapeutic effects for pathophysiological processes, or stimulating resistance to physiological challenges. While much is known about beneficial outcomes, our understanding of the molecular mechanisms underlying these observed effects is still limited. It has been hypothesized that increases in ATP stimulate downstream signaling through transcription factors. However, it is also known that PBM can induce elevated levels of nitric oxide (NO) in cells, which is thought to occur by release of NO bound to cytochrome-c oxidase (COX). NO is a powerful signaling molecule involved in a host of biological responses; however, the mechanisms of NO production and the role of NO in the PBM response have received little attention. Utilizing human retinal pigmented epithelium cells (RPE) in vitro, coupled with a multi-laser exposure set-up, we have begun to systematically investigate the mechanism of NO production and function in the PBM response. Our data indicates that while NO levels are elevated following single exposures to 447, 532, 635 or 808 nm, the strength of the response is wavelength-dependent, and the response can be modulated by sequential exposures to two different wavelengths. Additionally, this wavelength-dependent rise in NO is independent of the function of nitric oxide synthase, and highly dependent on the source of electrons feeding the electron transport chain of the light-exposed cells. In sum, these results provide a roadmap for interrogating the molecular mechanisms of PBM, and provide novel tools and methods for dissecting NO signaling networks.

The effect of near infrared light (940 nm) on the conversion of 5-aminolevulinic acid (5-ALA) to PpIX, a compound involved in photodynamic therapy (PDT), was examined. The back skin of three test subjects was irradiated with continuous wavelength and pulsed infrared light at 940 nm. These irradiations took place 50-53, 24-29, and 8-14 hours prior to the application of the 5-ALA. After a three-hour incubation period with 5-ALA, a FluoDerm™device was used to measure the fluorescence of the skin (emitting wavelength: 400-420 nm; measuring excitation wavelength: 610-720 nm), a direct indication of the activity of 5-ALA. 5-ALA must penetrate the skin and then be converted to PpIX before any fluorescence increase can be observed. Results: For two patients (one was disqualified), the continuous wavelength, 50 hour pre-irradiation condition, the FluoDerm readings showed a 19 to 23% increase in fluorescence (p = 0.05) compared to the no-irradiation, 5-ALA only control.

Photobiomodulation therapy has been around for several decades with a number of applications increasing every year. However, the exact mechanisms of energy/signal transduction, which lead to the observed changes, and the lack of those in living cells, is still poorly understood. We propose and experimentally implement a novel research platform, which uses a microfluidic chip and controllable excitation condition to precisely initiate the process of photobiomodulation. Resonance Raman spectroscopy is employed to assess the structural transformational stages on different time-scales. We will present our first experimental results and discuss those results with respect to potential therapeutic applications.

INTRODUCTION: In our practice Platelet Rich Plasma (PRP) injections effectively reduce pain in most but not all arthritic patients. However, for patients who fail PRP treatment, no good alternative currently exists except total joint replacement surgery. Low level laser therapy (LLLT) on the surface of the skin has not been helpful for arthritis patients in our experience. However, we hypothesized that intra-articular laser treatment would be an effective augmentation to PRP injection and would increase its efficacy in patients who had failed prior PRP injection alone. METHODS: We offered Intra-articular Low Level Laser Therapy (IAL) treatment in conjunction with repeat PRP injection to patients who had received no benefit from PRP injection alone at our center. They were the treatment group. They were not charged for PRP or IAL. They also served as a historical control group since they had all had failed PRP treatment alone. 28 patients (30 joints) accepted treatment after informed consent. 22 knees, 4 hips, 2 shoulder glenohumeral joints and 1 first carpo-metacarpal (1st CMC) joint were treated RESULTS: All patients were followed up at 1 month and no adverse events were seen from the treatment. At 6 months post treatment 46% of patients had good outcomes, and at 1 year 17% still showed improvement after treatment. 11 patients failed treatment and went on to joint replacement. DISCUSSION: A single treatment of IAL with PRP salvaged 46% of patients who had failed PRP treatment alone, allowing avoidance of surgery and good pain control.

Acupuncture has a long history of more than 2000 years in China. However, traditional acupuncture adopts metallic needles which may bring discomfort and pricking to patients. Laser acupuncture (LA) is a non-invasive and painless way to achieve some therapeutic effects. And compared to traditional acupuncture, LA is free from infection. Taking these advantages of LA into consideration, we innovatively developed a portable laser acupuncture device with therapy part and detection part together. Therapy part sends out laser at the wavelength of 650 nm onto special acupoints of patients. And detection part includes integrated light-emitting diode (LED, 735/805/850 nm) and photodiode (OPT101). The detection part is used for the data collection for calculation of hemodynamic parameters based on near-infrared spectroscopy (NIRS). In this work, we carried out current-power test for sensitivity of therapy part. And we also conducted liquid-model optical experiment and arm blocking test for the sensitivity and effectiveness of detection part. The final results demonstrated great potential and reliability of the novel laser acupuncture device. In the future, we will apply this device in clinical applications to verify the effectiveness of the device and improve the reliability for more treatment of diseases.

Different kinds of light irradiation has been used for several decades in clinical therapy. Among them low level light therapy (LLLT) is found to modulate signaling pathways, via production of ROS, ATP, Ca+2 and NO, which could be an important tool in a combination with other kind of therapy1. We have found some benefits of the combined LLLT and photodynamic therapy (PDT) using a metal-based compound, as an alternative treatment that combines photosensitizer, reactive oxygen and nitrogen species (RONS) and light irradiation against cancer2. Two types of ruthenium compounds were used in those studies ([Ru(Pc)], Pc = phthalocyanine) (I) and [RuNO(Pc)NO2] (II). Herein, we present the synthesis, characterization and photobiological properties of both ruthenium complexes. Both complexes present UV-Vis spectral peaks in 650 nm region. Light irradiation on the Q-band using (II) 0,5 µM provokes a decrease in the percentage of viable cells in human melanoma (A431) around 40 % in comparison to (I). We have hypothesized that those results are coming from the synergistic effect between singlet oxygen and nitric oxide. Similar experiment performed with the combination of PDT (660 nm) +LLLT (850 nm) induced more active photocytotoxicity of (I) and (II), which were interpreted as a function of the increase of cell metabolism and consequently increase of the uptake of the ruthenium-phthalocyanine compounds. The use of metal-based photosensitizers and combination of light therapy described in this work maybe constitutes in an advance in the field of clinical work related to photodynamic therapy.

Resonance Raman spectroscopy of cytochrome c was used to follow reduction/oxidation (redox) states of isolated mitochondria in response to blue or red laser exposure. Mitochondria were isolated from hTERT-RPE1 cells and were kept in a buffer formulation known to be conducive to electron transport chain (ETC) activity. Using either pyruvate or succinate as substrates for ETC, we found differences in the redox responses of cytochrome c for different exposure laser irradiance and excitation wavelength. We anticipate that the proposed new method will be valuable in the study of metabolic processes in mitochondria in response to low level laser exposure, and thus aid in elucidating the mechanism(s) of photobiomodulation.

Bacterial resistance to antibiotics is reality and need for alternative treatments is urgent. The aim of this work was to evaluate, in vitro, the effect of LED photochemotherapy on Staphylococcus aureus (ATCC 23529) using 25 μg / mL of phenothiazine compound combined with LED light (λ632 ± 2ηm) using 12 J/cm² energy density. The experiments were carried out in triplicate and the samples were divided into groups: Control, Irradiated (treated only with light), Photosensitizer (treated only in the presence of the dye), LED-Photochemotherapy (treatment with light associated with dye). Counts of the colony forming units and the data obtained were statistically analyzed (ANOVA, Tukey’s test, p<0.05). The present study demonstrated that the efficacy of LED-Photochemotherapy as the use of 25 μg/mL x 12 J/cm² caused 91.57 % of inhibition of bacterial growth. It is concluded that using energy density of 12 J/cm² associated to 25 μg/mL caused high in vitro inhibition of S. aureus.

The use of nanoparticle on dental light cure resin is not new, currently several compounds (nanoadditives) are used to promote better communication between the restorative material and biological tissues. The interest for this application is growing up to enhance mechanical proprieties to dental tissue cells regeneration. Bioactive nanoparticles and complex compounds with multiple functions are the major target for optimizing the restorative materials. In this work, we incorporate [Ru(bipy)₃]²⁺ nanoparticles, that absorbs energy at 450 nm (blue-light) and emits strongly at ~620 nm (red-light), in PLGA Microspheres and insert it in Dental Light Cure Resin to promote the Photobiomodulation Therapy (PBM) effects to accelerate dental pulp repair by in vitro using cytotoxicity and proliferation assay.

Photobiomodulation therapy uses light from a laser and is, therefore, a non-invasive, non-thermal treatment that is effective in reducing chronic pain and inflammation, stimulating wound healing and tissue regeneration. Due to its accessibility and ease of use, it is also being explored as an alternative to lipoplasty for fat removal. This review covers literature focusing on the applications of photobiomodulation therapy, with particular emphasis on the safety and efficacy of this therapy on fat loss. Based on the studies reported, photobiomodulation therapy is a safe technique that showed promising results in reducing the circumference of treated body parts. Also, photobiomodulation therapy is particularly effective when used in combination with exercise and physical therapy. The mechanism of action of how photobiomodulation therapy removes fat from the cells is controversial and requires further investigation. Very little scientific indication endures in support of the claims that infrared light, whether dispensed by laser, lamp, or while in a body wrap, can assist people to lose extra weight or shape their physique. Moreover, additional studies demonstrating the efficacy of photo modulation therapy in larger groups would be helpful in establishing this technique for regular clinical use.

Physiological aging leads to dysfunction of the stomatognatic system. Photo-kinesiotherapy (PKT) is a program using photobiomodulation (PBM) in combination with different kinesiotherapies. PBM can slow down and manage aging process resulting in orofacial dermal-neuro-muscle rehabilitating. We are searching for a new more efficient therapy to decrease and manage velocity of senescence and dysfunction of stomatognatic system. Under Ethical Comittee approval (CAAE no. 45390715.2.0000.5419), fifteen female patients were selected and divided into 5 groups: G1 - Control group (cosmetics); G2 - Light group (cosmetics + PBM); G3 - Exercises Group (Cosmetics+ PBM + orofacial exercises); G4 - Electrotherapy Group (Cosmetics+ PBM + Electrotherapy - Aussie current); and, G5 - Taping Group (Cosmetics+ PBM + kinesiotherapy). Muscle evaluation was performed using electromyography, ultrasonography and bite force. Skin evaluation was performed in terms of skin hydration and viscoelasticity, skin echogenicity using ultrasonography and standardized high resolution photographies. Measures were done before (baseline values) and after 7 days and 30 days of treatment. The pilot phase (fifhteen patients) was concluded using Kruskal-Wallis statistical tests that showed non-significant differences between groups. However, all treatments affected muscle tone, cutaneous elasticity and dermis echogenicity resulting in interesting individual clinical observations.We suggest that the combination of cosmetics, mechanical and optical stimulus to all kind of different tissues from stomatognathic system can be an efficient choice to orofacial functional and aesthetic rehabilitation. (CNPq - 114735/2015-8)