Background
There are both few non‐comparative studies investigating the efficacy of intraoral Er: YAG laser (SMOOTH mode) in rejuvenating nasolabial folds (NLFs) and lack of valid and objective ...wrinkles scales. In this prospective randomized split face comparative pilot study, we investigated the safety and efficacy of intraoral Er: YAG laser (SMOOTH MODE) compared with extraoral approach in rejuvenating NLFs using OCT as an objective evaluating tool.
Materials and Methods
Twenty adult women with notable NLFs were randomized in this study. The patients received 5 monthly sessions of Er: YAG laser (SMOOTH mode) using intraoral approach on one side and extraoral approach on the other side. Outcome was evaluated 2 weeks and 4 months post‐treatment by Global Aesthetic Improvement Scale (GAIS), OCT, and patients’ satisfaction. Side effects were also evaluated.
Results
Intraoral sides had significant increase in OCT evaluated dermal thickness at 4 months post‐treatment (P = .03) without side effects compared with extraoral sides. Extraoral approach had significantly higher patients’ satisfaction compared with intraoral approach at 2 weeks and 4 months post‐treatment (P = .03, .02, respectively). Insignificant differences between both approaches were found regarding GAIS scoring, OCT evaluated epidermal thickness at 2 weeks and 4 months post‐treatment, and OCT evaluated dermal thickness at 2 weeks post‐treatment (P < .05).
Conclusion
Intraoral Er: YAG laser (SMOOTH mode) is safer and more effective than extraoral approach in rejuvenating NLFs. OCT is a promising objective tool for evaluating facial wrinkles. Further studies are still needed.
Osteoradionecrosis (ORN) is a secondary complication from radiotherapy, which is difficult to manage and significantly reduces the life quality of the affected patients.
A 59-year-old female patient, ...diagnosed with infiltration by squamous cell carcinoma in the left cervical region, underwent adjuvant cervical-facial radiotherapy with a total dose of 66.6 Gy of radiation. Eight years after the diagnosis, the patient underwent multiple extractions and, subsequently, the installation of osseointegrated implants, evolving to extensive intraoral bone exposure associated with oral cutaneous fistula. The patient was initially exposed to photobiomodulation therapy (PBMT), with a low-power laser at wavelengths of 660 nm and 808 nm, and thereafter to antimicrobial photodynamic therapy (aPDT). After an improvement in the clinical condition and resolution of the oral cutaneous fistula, a surgical procedure with the Er: YAG laser was performed to remove the remaining necrotic bone. Once the ORN condition was completely treated, the patient's oral rehabilitation was implemented by the installation of an upper mucous-supported total prosthesis and a lower implant-supported prosthesis.
The patient is in a clinical follow-up and has no signs of bone necrosis recurrence, suggesting that low and high-power laser treatment can be an effective therapeutic alternative to resolve this condition.
Introduction: A variety of laser treatments have been applied in numerous medical fields. In dentistry, laser treatments are used for caries, root canals, and periodontal disease, as well as surgical ...resection. Numerous reports have recently been published on the use of lasers for bone regeneration. If laser irradiation is found to promote the activation of bone metabolism, it might also be effective for periodontal treatment, peri-implantitis, and bone regeneration. Therefore, the present in vitro study aimed to elucidate the mechanisms underlying the effects of erbium-doped yttrium aluminum garnet (Er: YAG) laser irradiation on the bone using osteoblast-like cells. Methods: Osteoblast-like Saos 2 cells (5.0×104 cells) were seeded in 24-well plates. 24 hours after being seeded, the cells were subjected to 0.3 W, 0.6 W, and 2.0 W Er: YAG laser irradiation and then allowed to recover for 48 hours. The expression levels of bone metabolism-related factors alkaline phosphatase (ALP), bone sialoprotein (BSP), and osteoprotegerin (OPG) were then evaluated using reverse transcription–quantitative polymerase chain reaction and western blot analyses. Results: Saos 2 cells subjected to Er: YAG laser irradiation at 0.3 W, 0.6 W, and 2.0 W showed normal growth. When the Er: YAG laser irradiation and control groups were compared after 48 hours, increases were observed in ALP, BSP, and OPG gene and protein expression in the 2.0 W group. Similar results were obtained in the western blot analysis. Conclusion: These findings suggest that the Er: YAG laser irradiation of osteoblast-like cells is effective for activating bone metabolism factors.
The aim of this study was to evaluate the remineralization and antibacterial effect of silver-containing mesoporous bioactive glass (MBG-Ag) sealing combined with Er:YAG laser irradiation on human ...demineralized dentin specimens in a Streptococcus mutans cultivated environment. A total of 48 human dentin specimens were randomly divided into four groups. The characteristics of MBG-Ag and the occlusion efficiency of the dentinal tubules were analyzed using X-ray diffraction patterns, Fourier-transform infrared spectroscopy, scanning electron microscope images and energy dispersive X-ray spectroscopy. Moreover, the antibacterial activity against Streptococcus mutans was evaluated by colony formation assay. The results showed that the dentin specimens with Er:YAG laser irradiation can form a melted occlusion with a size of 3–4 µm. MBG-Ag promoted the deposition of numerous crystal particles on the dentinal surface, reaching the deepest penetration depth of 70 μm. The results suggested that both MBG-Ag and laser have the ability to enhance the remineralization and precipitation of hydroxyapatite crystals. While the results showed that MBG-Ag sealing combined with the thermomechanical subablation mode of Er:YAG laser irradiation-induced dense crystalline deposition, reaching a penetration depth of more than 300 µm, silver nanoparticles without good absorption of the Er:YAG laser resulted in a heterogeneous radiated surface. Er:YAG laser irradiation with a low energy and pulse rate cannot completely inhibit the growth of S. mutans, but MBG-Ag sealing reached the bactericidal concentration. It was concluded that the simultaneous application of MBG-Ag sealing and Er:YAG laser treatment can prevent the drawbacks of their independent uses, resulting in a superior form of treatment for dentin hypersensitivity.
Background: The aim of this study is to compare the efficacy of XP-endo finisher R file and PIPS technique using Er: YAG laser on removal of gutta-percha in root canals obturated with two different ...obturation techniques. Methods: The root canals of sixty single-rooted teeth were prepared with ProTaper Next Rotary instruments up to X3 (Dentsply, Ballaigues, Switzerland). Half of the root canals were obturated with cold lateral condensation technique and the other half with System B technique (Kerr Corporation, CA, USA) and BioRoot RCS sealer (Setodent, Louisville, USA) was used in all groups as a root canal sealer. After one week, all root canals were retreated using Protaper Universal retreatment instruments (Dentsply, Ballaigues, Switzerland) and enlarged to ProTaper Next X5 File at the working length. Both groups were divided into 3 subgroups according to the additional cleaning methods: control group without an additional cleaning method, XP-endo Finisher R or PIPS technique using Er: YAG laser. Finally, all teeth were split longitudinally and images were taken using an operation microscope (Carl Zeiss, Heidelberg, Germany). The images were analyzed by Image J program. Two-way ANOVA and Tukey tests were used for statistical analysis. Results: There was a statistically significant difference between the canal filling techniques applied in the evaluation of remnants (p=0.010). There was no significant difference between additional cleaning methods (p=0.196). Conclusion: Within the limitations of this study, cleanliness is more difficult in root canals obturated with System B technique. Use of additional cleaning method was not effective in removal of root canal filling materials.
In non-vital tooth bleaching, dentin is in direct contact with the bleaching agent, 1 to 3-week delay is needed to eliminate free radicals from tooth structure. The present study aimed to evaluate ...the effect of irradiation of Er: YAG laser on immediate microtensile bond strength of bleached dentin to composite.
Sixty sounds human teeth were collected and randomly divided into 4 groups (n=15): no bleaching (NB), opalescence endo hydrogen peroxide (HP) gel bleaching, sodium perborate (SP) bleaching and laser bleaching with heydent gel (LB). The groups were divided into 3 subgroups (n=5): no surface treatment, Er: YAG laser irradiation and 10% sodium ascorbate (SA). All samples were restored and underwent microtensile bond strength testing. Statistical analysis was carried out using one-way and two-way ANOVA.
Bond strength in NB-SA group had a significant difference with the NB group (
<0.05) while no significant difference was noted between NB and NB-Er groups (
=0.55). Application of SA and Er: YAG laser after bleaching with SP did not enhance the bond strength (
=0.07).
Application of SA and Er: YAG laser after HP gel bleaching significantly enhanced the bond strength. Application of Er: YAG laser after internal bleaching with HP gel could enhance the bond strength.
Purpose: Every clinician encounter isses with problematic periodontal tissue around teeth intended to be treatet prosthetically. Swollen, reddish, with deeper periodontal pockets and and impossible ...to dry up with air flow. Such teeth should be treated rapidly and minimally invasive. The purpose of this study was to create an algorithm for periodontal tooth preparation with Er-YAG laser before prosthetic treatment. Material/Methods: It was used examination and diagnosis of teeth for the purpose of prosthodontic treatment according to the periodontal status by using UNC 15 perio-probe and electronic periodontal probe Pa-On and Er-YAG dental laser. There were examined 216 periodontal units, 106 of them treated according to the suggested protocol. An innovative approach was used by considering all treated teeth suitable for impression by the visual indicator –periodontal margin condition (lack of inflammatory symptoms, lack of bleeding, lack of redness, presence of pink, dense gingiva. Record of the day with “pink gingiva” appear was made. Results: 216 units measured with a conventional and electronic periodontal probe in inflammatory status and after periodontal treatment. It was registered a significant difference between the data from the conventional periodontal probe and the electronic one. Teeth prepared for prosthetic treatment were 106. By using a blind randomized clinical trial, 50% of them were prepared for prosthetic impression by using ultrasonic and the other half by using Er-YAG laser. Teeth prepared for Prosthodontic impression are heathy between 2nd and 7th day after preparation (61.54% -2nd day; 38.46% - 7th day) while the controlled group is between the 14th and the 21st day (33.33% -14th day; 62.96% - 21st day). The total amount of attachment gain in such a short period of time by the protocol suggested by the authors is 1mm. Conclusions: Considerable dental units show difference in periodontal pocket depth measurement to such degree that could lead to misdiagnosis and unnecessary treatment. Great difference is observed mainly between gingival pocket depth and superficial periodontitis.
: Titanium platelets with a sand‐blasted and acid‐etched surface were coated with bovine serum albumin and incubated with a suspension of Porphyromonas gingivalis (ATCC 33277). Four groups with a ...total of 48 specimens were formed. Laser irradiation of the specimens (n=12) was performed on a computer‐controlled XY translation stage at pulse energy 60 mJ and frequency 10 pps. Twelve specimens were treated with an air powder system. After the respective treatment, human gingival fibroblasts were incubated on the specimens. The proliferation rate was determined by means of fluorescence activity of a redox indicator (Alamar Blue® Assay) which is reduced by metabolic activity related to cellular growth. Proliferation was determined up to 72 h. Contaminated and non‐treated as well as sterile specimens served as positive and negative controls. Proliferation activity was significantly (Mann–Whitney U‐test, P<0.05) reduced on contaminated and non‐treated platelets when compared to sterile specimens. Both on laser as well as air powder‐treated specimens, cell growth was not significantly different from that on sterile specimens. Air powder treatment led to microscopically visible alterations of the implant surface whereas laser‐treated surfaces remained unchanged. Both air powder and Er : YAG laser irradiation have a good potential to remove cytotoxic bacterial components from implant surfaces. At the irradiation parameters investigated, the Er : YAG laser ensures a reliable decontamination of implants in vitro without altering surface morphology.
Résumé
Le but de cette étude in vitro a été d'examiner la biocompatibilité de surfaces implantaires contaminées après traitement avec un laser Er: YAG et un système de poudre soufflée. Des petites plaques de titane avec surface mordançée et sablée ont été recouvertes avec de l'albumine sérique bovine et incubée avec une suspension de Porphyromonas gingivalis. Quatre groupes avec un total de 48 espèces ont été formés. L'irradiation laser des espèces (n=12) a été effectuée à l'aide d'un ordinateur contrôlant la translation dans l'axe XY à des énergies de 60 mJ et une fréquence de 10 pps. Douze espèces ont été traitées par un système de poudre soufflée. Après le traitement respectif, des fibroblastes gingivaux humains ont été incubés sur les spécimens. Le taux de prolifération a été déterminéà l'aide de l'activité de fluorescence d'un indicateur redox (Alamar Blue®) qui est réduit par l'activité métabolique en relation avec la croissance cellulaire. La prolifération a été déterminée pendant 72 h. Les spécimens contaminés et non‐traités ainsi que des stériles ont servi de contrôles positifs et négatifs. L'activité de prolifération était significativement réduite (test‐U de Mann‐Whytney, P<0.05) sur les petites plaques contaminées et non‐traitées comparée aux spécimens stériles. Tant sur les spécimens laser que sur ceux traités par poudre soufflée, la croissance cellulaire n'était pas significativement différente de celle observée sur les spécimens stériles. Le traitement par poudre soufflée apportait des altérations microscopiquement visibles de la surface implantaire tandis que les surfaces traitées par laser n'étaient pas altérées. Tant le système poudre soufflée que l'irradiation par le laser Er:YAG ont donc un bon potentiel à enlever les composants bactériens cytotoxiques des surfaces implantaires. Au niveau de l'irradiation utilisée le laser Er:YAG apporte une décontamination sûre des implants in vitro sans altérer la morphologie de surface.
Zusammenfassung
Das Ziel dieser in vitro Studie war es, die Biokompatibilität einer kontaminierten Implantatoberfläche nach der Behandlung mit einem Er:YAG‐Laser und einem Pulverstrahlgerät zu untersuchen. Man beschichtete sandgestrahlte und säuregeätzte Titanplättchen mit einem Albumin aus Rinderserum und inkubierte sie in einer Suspension von Porphyromonas gingivalis (ATCC 33277). Aus 48 Testplättchen bildete man vier Gruppen. Eine Gruppe (n=12) wurde auf einer komputerkontrollierten Vorrichtung einer Laserbestrahlung (gepulster Strahl mit einer Energie von 60 mJ und einer Frequenz von 10 pps) ausgesetzt. 12 weitere Testplättchen wurden mit einem Pulverstrahlgerät behandelt. Nach der entsprechenden Behandlung inkubierte man die Plättchen mit menschlichen Gingivafibroblasten. Die Proliferationsrate bestimmte man mit Hilfe der Fluoreszenzaktivität eines Redoxindikators (Alamar Blue® Assay), der durch die metabolische Aktivität beim Zellwachstum reduziert wird. Die Proliferation beurteilte man während 72 Stunden. Als positive und negative Kontrolle dienten sterile sowie kontaminierte und unbehandelte Plättchen.
Die Proliferationsaktivität war bei den kontaminierten und unbehandelten, verglichen mit den sterilen Plättchen signifikant reduziert (Mann‐Whitney‐U‐Test, P<0.05). Sowohl bei den laser‐ wie auch bei den pulverstrahlbehandelten Plättchen war das Zellwachstum verglichen mit den sterilen Plättchen nicht signifikant anders. Die Pulverstrahlbehandlung führte zu mikroskopisch sichtbaren Veränderungen der Implantatoberflächen, währenddem die laserbehandelten Oberflächen keine Veränderung erfuhren.
Sowohl die Pulverstrahlbehandlung, wie auch der Er:YAG‐Laser können das bakterielle Zytotoxine erfolgreich von der Implantatoberfläche entfernen. Mit den für diese Arbeit festgelegten Bestrahlungswerten liefert der Er:YAG‐Laser in vitro eine verlässliche Dekontamination der Implantate, und das ohne Veränderung der Oberflächenmorphologie.
Resumen
La intención del presente estudio in vitro fue examinar la biocompatibilidad de superficies de implantes contaminadas tras un tratamiento con un láser Er : YAG y un sistema de polvo por aire a presión.
Se cubrieron placas de titanio con una superficie de pulverizada con arena y gravada con ácido con albúmina de suero bovino e incubada con una suspensión de P. gingivalis (ATCC 33277). Se formaron cuatro grupos con un total de 48 especímenes. Se llevó a cabo la irradiación por láser de los especímenes (n=12) en una fase de traslación XY controlada por ordenador con energía de pulso de 60 mJ y una frecuencia de 10 pps. Se trataron 12 especímenes con un sistema de polvo por aire a presión. Tras los tratamientos respectivos se incubaron fibroblastos humanos sobre los especímenes. Se determinó el índice de proliferación por medio de la actividad de fluorescencia de un indicador redox (Alamar Blue®) que se reduce por actividad metabólica relacionada con crecimiento celular. La proliferación se determinó hasta las 72 horas. Los especímenes contaminados y no tratados al igual que los especímenes estériles sirvieron de controles positivos y negativos.
La actividad de proliferación fue significativamente (Mann–Whitney–U test, P<0.05) reducida en placas contaminadas y no tratadas al compararlas con los especímenes estériles. Tanto en los especímenes tratados con láser como en los tratados con polvo a presión el crecimiento celular no fue significativamente diferente de los especímenes estériles. El tratamiento con polvo a presión llevó a alteraciones microscópicamente visibles de la superficie del implante mientras que las superficies tratadas con láser permanecieron inalteradas.
Tanto el polvo a presión como la irradiación por láser Er : YAG tuvieron un buen potencial para retirar los componentes bacterianos citotóxicos de las superficies de los implantes. Con los parámetros de irradiación investigados, el láser Er : YAG asegura una descontaminación fiable de los implantes in vitro sin alteración de la morfología de la superficie.
The erbium: yttrium-aluminum-garnet (Er: YAG) laser has been introduced as an effective method in the decontamination of implant surfaces. Data concerning the effects of the Er: YAG laser on the ...biological and surface properties of titanium are conflicting. Cellular behavior is greatly affected by surface properties, including composition, roughness, wettability, and morphology of the titanium surface. The aim of this study was to investigate the influence of the Er: YAG laser on the biocompatibility, surface roughness, and wettability of sandblasted and acid-etched (SLA) titanium surfaces. Twenty-one SLA titanium disks were irradiated by the Er: YAG laser at a pulse energy of 100 mJ, with a pulse frequency of 10 Hz under water irrigation for 1 min. Cell viability, surface roughness, and wettability alterations were evaluated. Thirteen nonirradiated SLA disks were used as the control groups. Human osteoblast-like SaOs-2 cells were seeded onto the disks in culture media. Cell viability was evaluated using the methylthiazol tetrazolium assay. The surface roughness and wettability of the test and control groups were measured using profilometer and tensiometer devices, respectively. A significantly higher cell viability rate was observed in the test group (
p
= 0.032). The surface roughness was significantly reduced in the test group compared with the control group (
p
= 0.008). The surface wettability was significantly higher in the test group (
p
= 0.004). Within the limits of this study, the application of the Er: YAG laser with the previously described properties did not appear to have adverse effects on the biocompatibility of the SLA titanium surfaces. Application of this laser decreased the surface roughness and increased the wettability of the SLA titanium surfaces.
PDF
