Lesson 5 Penetration & safety. Laserlessons.info

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Domenic Potter
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1 Lesson 5 Penetration & safety

3 But deep penetration is not always the best. For superficial conditions we want most of the energy to remain superficially and not far away from the target. For instance in an open wound.

4 Red laser penetrates dry bone easily, but clinically it is never dry. Blood is a major absorber of light.

$But what is coming out if only a fraction of the energy on the$

5 In the dark, red laser can be seen penetrating a hand. But what is coming out if only a fraction of the energy on the other side.

6 Penetration of laser light The light is quite unevenly distributed in the tissue

7 Fat and mucosa are rather transparent Bone is fairly transparent Muscles are less transparent (hemoglobin)

8 The depth of penetration is not only a function of the wavelength. The application mode is of great importance.

9 - Irradiation in non contact mode - Irradiation in contact mode - Irradiation with slight pressure - Irradiation with great pressure

10 Penetration and technique

11 When using pressure, two things happen: 1. The probe comes closer to the target area 2. The area is ischemic, less blood means deeper penetration

1. HeNe/Indium (633-770 nm) 2. GaAs (904 nm) 3.

12 1. HeNe/Indium ( nm) 2. GaAs (904 nm) 3. GaAlAs ( ) Optical penetration only tells us the penetration properties of the light itself, disregarding treatment techniques.

13 Actual penetration 1. Wavelength 2. Type of tissue 3. Contact/non contact 4. Superpulsing

14 Increased power does not increase penetration depth, but more photons can reach the deep layers quicker.

15 Power output and dose

16 Wavelength dependency

17 And not confounding commercialism like this! The opposite is true.

18 Dose at TARGET That is what counts. But normally we can only measure what is given at the surface, but that is a very rough information when standing alone.

19 Eye protection

20 Recommendations for Class 3 B lasers: For the patient: Use protective goggles. For the therapist: Use protective goggles.

21 Unless using a strong invisible lasers in the facial area, there is no risk. But the goggles make the patient feel safe and the impression of High Tech is reinforced. And the therapist is safe from complaints.

22 For the therapist, there is no risk at all. But staring at a laser beam for a long period can cause discomfort like when having been out in bright sunlight. Not dangerous, only unpleasant. But the goggles on the therapist will further underline the high tech of the treatment.

23 National regulations may require protective goggles for everybody. Then follow the requirements, but feel safe knowing that the requirements are overambitious. No eyes have ever been damaged by a Class 3B laser.

24 Ivandic B T, Ivandic T. Low- Level Laser Therapy Improves Vision in Patients with Age-Related Macular Degeneration. Photomed Laser Surg. 2008; 2 (3):

25 In fact, Class 3B laser can successfully be used for a variety of eye conditions. Saliba A, Du Y, Liu H, Patel S, Roberts R, Berkowitz BA, Kern TS. Photobiomodulation Mitigates Diabetes-Induced Retinopathy by Direct and Indirect Mechanisms: Evidence from Intervention Studies in Pigmented Mice. PLoS One Oct 1;10(10):e Geneva II. Photobiomodulation for the treatment of retinal diseases: a review. Int J Ophthalmol Jan 18;9(1): doi: /ijo ecollection Merry GF, Munk MR, Dotson RS, Walker MG, Devenyi RG. Photobiomodulation reduces drusen volume and improves visual acuity and contrast sensitivity in dry age-related macular degeneration. Acta Ophthalmol Dec 18.

26 Stye on day of treatment with HeNe laser

27 The following day

28 Does laser light cause cancer?

29 UVA and UVB, around 320 nm is the limit for ionizing radiation. Blue is not entirely safe, but above 600 nm it is perfectly safe.

30 But suppose there is an undiagnosed tumor in the area? Will it be stimulated? Important question.

31 Laser therapy, recently renamed as photobiomodulation, stands as a promising supportive treatment for oral mucositis induced by oncological therapies. However, its mechanisms of action and, more importantly, its safety in cancer patients, are still unclear. Here we explored the anti-cancer effect of 3 laser protocols, set at the most commonly used wavelengths, in B16F10 melanoma and oral carcinogenesis mouse models. While laser light increased cell metabolism in cultured cells, the in vivo outcome was reduced tumor progression. This striking, unexpected result, was paralleled by the recruitment of immune cells, in particular T lymphocytes and dendritic cells, which secreted type I interferons. Laser light also reduced the number of highly angiogenic macrophages within the tumor mass and promoted vessel normalization, an emerging strategy to control tumor progression. Collectively, these results set photobiomodulation as a safety procedure in oncological patients and open the way to its innovative use for cancer therapy.

32 Cell experiments show that some malignant cells are stimulated by PBM. But, as observed by McGuff in 1964, when the immune system is present, the laser light has an anti-cancerogenic effect.

33 However; treating a known malignancy is up to the oncologist only.

34 Summing up: 50 years of PBM and no serious side effects reported. Class 3B PBM is safe

35 PBM haiku A coherent light Absorbed by a struggling cell Victorious

Independent Clarification of Controversy - Class III vs. Class IV Lasers by Dr. Jan Tuner

Independent Clarification of Controversy - Class III vs. Class IV Lasers by Dr. Jan Tuner Dr. Tuner s article clearly delineates the efficacy of Class III vs. Class IV Lasers and describes the factors