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Kawamura R, Mizutani K, Lin T, Kakizaki S, Mimata A, Watanabe K, Saito N, Meinzer W, Iwata T, Izumi Y, Aoki A. Ex Vivo Evaluation of Gingival Ablation with Various Laser Systems and Electroscalpel. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 38:364-373. [PMID: 32175812 DOI: 10.1089/photob.2019.4713] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: The aim of this study was to perform a systematic and multifaceted comparison of thermal effects during soft tissue ablation with various lasers and an electroscalpel (ES). Materials and methods: Er:YAG, Er,Cr:YSGG, CO2, Diode, Nd:YAG lasers (1 W, pulsed or continuous wave), an ES, and a scalpel (Sc; control), were employed for porcine gingival tissue ablation. Temperature changes during ablation were measured by using an infrared thermal imaging camera and a thermocouple. After ablations, the wounds were observed using stereomicroscopy and scanning electron microscopy (SEM), and histological sections were analyzed. Compositional analysis was also performed on ablated sites by SEM wavelength dispersive X-ray spectroscopy. Results: The surface temperature during irradiation was highest with CO2 (over 500°C), followed by Diode (267°C) and Nd:YAG (258°C), Er:YAG (164°C), ES (135°C), and Er,Cr:YSGG (85°C). Carbonization was negligible (Er:YAG), slight (Er,Cr:YSGG), moderate (Nd:YAG and ES), and severe (CO2 and Diode). Under SEM observation, Er:YAG and Er,Cr:YSGG showed smooth surfaces but other devices resulted in rough appearances. Histologically, the coagulated and thermally affected layer was extremely minimal (38 μm in thickness) and free from epithelial collapse for Er:YAG. Compared with other devices, less compositional surface change was detected with Er:YAG and Er,Cr:YSGG; additionally, the use of water spray further minimized thermal influence. Conclusions: Among various power devices, Er:YAG laser showed the most efficient and refined gingival ablation with minimal thermal influence on the surrounding tissues. Er:YAG and Er,Cr:YSGG lasers with water spray could be considered as minimally invasive power devices for soft tissue surgery.
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Affiliation(s)
- Rie Kawamura
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Taichen Lin
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,School of Dentistry, Chung Shan Medical University, Taichung, Taiwan.,Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Sho Kakizaki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Ayako Mimata
- Research Core, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kowashi Watanabe
- Biomolecular Characterization Unit, Technology Platform Division, RIKEN Center for Sustainable Resource Science, Wako, Japan
| | - Norihito Saito
- Photonics Control Technology Team, Advanced Photonics Technology Development Group, RIKEN Center for Advanced Photonics, Riken, Wako, Japan
| | - Walter Meinzer
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Oral Care Perio Center, Southern TOHOKU Research Institute for Neuroscience, Southern TOHOKU General Hospital, Koriyama, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Aoki A, Mizutani K, Schwarz F, Sculean A, Yukna RA, Takasaki AA, Romanos GE, Taniguchi Y, Sasaki KM, Zeredo JL, Koshy G, Coluzzi DJ, White JM, Abiko Y, Ishikawa I, Izumi Y. Periodontal and peri-implant wound healing following laser therapy. Periodontol 2000 2017; 68:217-69. [PMID: 25867988 DOI: 10.1111/prd.12080] [Citation(s) in RCA: 192] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2014] [Indexed: 12/18/2022]
Abstract
Laser irradiation has numerous favorable characteristics, such as ablation or vaporization, hemostasis, biostimulation (photobiomodulation) and microbial inhibition and destruction, which induce various beneficial therapeutic effects and biological responses. Therefore, the use of lasers is considered effective and suitable for treating a variety of inflammatory and infectious oral conditions. The CO2 , neodymium-doped yttrium-aluminium-garnet (Nd:YAG) and diode lasers have mainly been used for periodontal soft-tissue management. With development of the erbium-doped yttrium-aluminium-garnet (Er:YAG) and erbium, chromium-doped yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, which can be applied not only on soft tissues but also on dental hard tissues, the application of lasers dramatically expanded from periodontal soft-tissue management to hard-tissue treatment. Currently, various periodontal tissues (such as gingiva, tooth roots and bone tissue), as well as titanium implant surfaces, can be treated with lasers, and a variety of dental laser systems are being employed for the management of periodontal and peri-implant diseases. In periodontics, mechanical therapy has conventionally been the mainstream of treatment; however, complete bacterial eradication and/or optimal wound healing may not be necessarily achieved with conventional mechanical therapy alone. Consequently, in addition to chemotherapy consisting of antibiotics and anti-inflammatory agents, phototherapy using lasers and light-emitting diodes has been gradually integrated with mechanical therapy to enhance subsequent wound healing by achieving thorough debridement, decontamination and tissue stimulation. With increasing evidence of benefits, therapies with low- and high-level lasers play an important role in wound healing/tissue regeneration in the treatment of periodontal and peri-implant diseases. This article discusses the outcomes of laser therapy in soft-tissue management, periodontal nonsurgical and surgical treatment, osseous surgery and peri-implant treatment, focusing on postoperative wound healing of periodontal and peri-implant tissues, based on scientific evidence from currently available basic and clinical studies, as well as on case reports.
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Alagha HZ, Gülsoy M. Photothermal ablation of liver tissue with 1940-nm thulium fiber laser: an ex vivo study on lamb liver. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:15007. [PMID: 26790641 DOI: 10.1117/1.jbo.21.1.015007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 12/09/2015] [Indexed: 06/05/2023]
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Kripal K, Sirajuddin S, Rafiuddin S, Mp R, Chungkham S. Iatrogenic Damage to the Periodontium Caused by Laser: An Overview. Open Dent J 2015; 9:210-3. [PMID: 26312089 PMCID: PMC4541307 DOI: 10.2174/1874210601509010210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/04/2015] [Accepted: 03/10/2015] [Indexed: 11/22/2022] Open
Abstract
Lasers have been used in dentistry since 1994 to treat a number of dental problems. A variety of lasers are now available for use in dentistry. Once stated as an intricate technology with restricted usage in clinical dentistry, there is a growing awareness of the usefulness of lasers in the armamentarium of the modern dental practice, where they can be used as an adjunct or alternative to various long-standing approaches.
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Affiliation(s)
- Krishna Kripal
- Department of Periodontology, Rajarajeswari Dental College & Hospital, Bangalore-560074.Karnataka, India
| | - Syed Sirajuddin
- Department of Periodontology, Rajarajeswari Dental College & Hospital, Bangalore-560074.Karnataka, India
| | - Syed Rafiuddin
- Department of Orthodontics, Sri Hasanamba Dental College and Hospital, Hassan, Karnataka, India
| | - Rakesh Mp
- Department of Periodontology, Rajarajeswari Dental College & Hospital, Bangalore-560074.Karnataka, India
| | - Sachidananda Chungkham
- Department of Periodontology, Rajarajeswari Dental College & Hospital, Bangalore-560074.Karnataka, India
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Ting CC, Fukuda M, Watanabe T, Sanaoka A, Mitani A, Noguchi T. Morphological Alterations of Periodontal Pocket Epithelium Following Nd:YAG Laser Irradiation. Photomed Laser Surg 2014; 32:649-57. [DOI: 10.1089/pho.2014.3793] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Chun-Chan Ting
- Department of Periodontology, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Mitsuo Fukuda
- Department of Periodontology, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Tomohisa Watanabe
- Department of Periodontology, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Atsushi Sanaoka
- Department of Periodontology, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Akio Mitani
- Department of Periodontology, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Toshihide Noguchi
- Department of Periodontology, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
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Das D, Reed S, Klokkevold PR, Wu BM. A high-throughput comparative characterization of laser-induced soft tissue damage using 3D digital microscopy. Lasers Med Sci 2012; 28:657-68. [PMID: 22669178 DOI: 10.1007/s10103-012-1126-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 05/17/2012] [Indexed: 11/28/2022]
Abstract
3D digital microscopy was used to develop a rapid alternative approach to quantify the effects of specific laser parameters on soft tissue ablation and charring in vitro without the use of conventional tissue processing techniques. Two diode lasers operating at 810 and 980 nm wavelengths were used to ablate three tissue types (bovine liver, turkey breast, and bovine muscle) at varying laser power (0.3, 1.0, and 2.0 W) and velocities (1-50 mm/s). Spectrophotometric analyses were performed on each tissue to determine tissue-specific absorption coefficients and were considered in creating wavelength-dependent energy attenuation models to evaluate minimum heat of tissue ablations. 3D surface contour profiles characterizing tissue damage revealed that ablation depth and tissue charring increased with laser power and decreased with lateral velocity independent of wavelength and tissue type. While bovine liver ablation and charring were statistically higher at 810 than 980 nm (p < 0.05), turkey breast and bovine muscle ablated and charred more at 980 than 810 nm (p < 0.05). Spectrophotometric analysis revealed that bovine liver tissue had a greater tissue-specific absorption coefficient at 810 than 980 nm, while turkey breast and bovine muscle had a larger absorption coefficient at 980 nm (p < 0.05). This rapid 3D microscopic analysis of robot-driven laser ablation yielded highly reproducible data that supported well-defined trends related to laser-tissue interactions and enabled high throughput characterization of many laser-tissue permutations. Since 3D microscopy quantifies entire lesions without altering the tissue specimens, conventional and immunohistologic techniques can be used, if desired, to further interrogate specific sections of the digitized lesions.
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Affiliation(s)
- Debobrato Das
- Department of Bioengineering, Henry Samueli School of Engineering, University of California at Los Angeles, 410 Westwood Plaza, Engineering V, Los Angeles, CA 90095, USA
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Vaderhobli RM, White JM, Le C, Ho S, Jordan R. In vitro study of the soft tissue effects of microsecond-pulsed CO2laser parameters during soft tissue incision and sulcular debridement. Lasers Surg Med 2010; 42:257-63. [DOI: 10.1002/lsm.20888] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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van Nimwegen SA, L'Eplattenier HF, Rem AI, van der Lugt JJ, Kirpensteijn J. Nd:YAG surgical laser effects in canine prostate tissue: temperature and damage distribution. Phys Med Biol 2008; 54:29-44. [DOI: 10.1088/0031-9155/54/1/003] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Amagai T, Kato J, Haruyama C, Ohsuka K, Takase Y, Hirai Y. An experimental pathologic study of gingivectomy using dual-wavelength laser equipment with OPO. Lasers Surg Med 2007; 39:51-8. [PMID: 17111413 DOI: 10.1002/lsm.20443] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES This study was conducted to evaluate how soft tissues respond to treatment by a tunable laser with an optical parametric oscillating (OPO) mechanism capable of simultaneously emitting two wavelengths. MATERIALS AND METHODS Marginal gingiva of dogs was incised by a prototype laser oscillator. The oscillator was set at two wavelengths known to effectively incise tissue and arrest hemorrhage with minimal invasiveness. Four laser irradiation conditions were set based on different combinations of the 1.67 and 2.94 microm wavelengths. The animals were sacrificed immediately after surgery, 7 days after surgery, and 28 days after surgery for histological examination. RESULTS When irradiation at 1.67 and 2.94 microm wavelengths was simultaneously applied, the former conferred an observable hemostatic effect and the latter incised the tissue. Wound healing was similar to that in conventional methods and no serious inflammation was observed. CONCLUSION Simultaneous irradiation at wavelengths of 1.67 and 2.94 microm can be an effective method in soft tissue surgery.
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Affiliation(s)
- Tetsuya Amagai
- Department of Operative Dentistry, Tokyo Dental College, Chiba, Japan.
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White JM, Gekelman D, Budd J. Lasers and dental soft tissues: reflections on our years of research. ACTA ACUST UNITED AC 2003. [DOI: 10.1016/s0531-5131(02)01289-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chen YJ, Jeng JH, Lee BS, Chang HF, Chen KC, Lan WH. Effects of Nd:YAG laser irradiation on cultured human gingival fibroblasts. Lasers Surg Med 2001; 27:471-8. [PMID: 11126441 DOI: 10.1002/1096-9101(2000)27:5<471::aid-lsm1008>3.0.co;2-q] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND OBJECTIVE The Nd:YAG laser has been proposed to apply in minor soft tissue surgery, including various periodontal procedures. However, little information is available regarding the direct effect of Nd:YAG laser on gingival fibroblasts, which play an important role in the early healing processes of periodontal repair. STUDY DESIGN/MATERIALS AND METHODS Nd:YAG laser irradiation was performed in pulsed mode on human gingival fibroblasts, which was derived from healthy human gingiva by an explant method. The size of laser diode was 400 microm in diameter. The parameters in laser delivery were pulse energy (50-150 mJ), power output (1.0-3.0 W), pulse rate (10-30 pps), and fixed duration of irradiation (10 seconds). The cell cultures were analysed by cytomorphologic examination under phase-contrast and scanning electron microscope. The vitality was also examined with the help of MTT staining. RESULTS The area of laser damage on cell culture was circular in shape, with diameter beyond the size of laser diode. By scanning electron microscopy, we observed the cellular damage of cultured gingival fibroblasts induced by Nd:YAG laser irradiation, comparable with the progressive increased power settings. The cytomorphologic changes ranged from disappearance of cellular boundary, loss of identifiable cellular nucleus, and finally cell contraction and vacuolization. Significant decrease in cellular vitality (14% approximately 44%) after laser treatment with irradiation distance of nearly contact was noted. However, 2 mm defocusing irradiation with the same power settings did not significantly decrease cellular vitality. CONCLUSION Our study demonstrated the cell damaging effects of Nd:YAG laser, ranging from degeneratively cytomorphologic change to cell death, on the cultured human gingival fibroblasts. It provided the dentist a chance to understand the potential hazard of laser application in periodontal treatment. If the energy output is enough for the clinical purposes, Nd:YAG laser with lower pulse energy and corresponding pulse rate should be selected to minimize the damage on adjacent soft tissue.
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Affiliation(s)
- Y J Chen
- School of Dentistry, College of Medicine, National Taiwan University, Taipei
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Goharkhay K, Moritz A, Wilder-Smith P, Schoop U, Kluger W, Jakolitsch S, Sperr W. Effects on oral soft tissue produced by a diode laser in vitro. Lasers Surg Med 1999; 25:401-6. [PMID: 10602132 DOI: 10.1002/(sici)1096-9101(1999)25:5<401::aid-lsm6>3.0.co;2-u] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND AND OBJECTIVES This investigation determined incision characteristics and soft-tissue damage resulting from standardized incisions using a wide range of laser modes and parameters of a diode laser at 810 nm. STUDY DESIGN/MATERIALS AND METHODS Histologic examinations were performed to verify vertical and horizontal tissue damage as well as incision depth and width. RESULTS Incision depth and width correlated strongly with average powers, but not with laser parameters or the used tips. No laser damage was visible to the naked eye in the bone underlying the incisions in the range between 0.5-4.5 W. CONCLUSION The remarkable cutting ability and the tolerable damage zone clearly show that the diode laser is a very effective and, because of its excellent coagulation ability, useful alternative in soft-tissue surgery of the oral cavity.
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Affiliation(s)
- K Goharkhay
- Department of Conservative Dentistry, Dental School, University of Vienna, A-1090 Vienna, Austria
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White JM, Chaudhry SI, Kudler JJ, Sekandari N, Schoelch ML, Silverman S. Nd:YAG and CO2 laser therapy of oral mucosal lesions. JOURNAL OF CLINICAL LASER MEDICINE & SURGERY 1998; 16:299-304. [PMID: 10204434 DOI: 10.1089/clm.1998.16.299] [Citation(s) in RCA: 124] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Experiences gained in the management of oral mucosal lesions by CO2 and Nd:YAG laser therapy in an outpatient clinic treated over an 80-year period are described. SUMMARY BACKGROUND DATA Lasers have indications for use in dentistry for incision, excision, and coagulation of intraoral soft tissue. Advances in laser technology have provided delivery systems for site-specific delivery of laser energy with short interaction items on tissue to be ablated. This study retrospectively evaluates a series of clinical case studies. METHODS Sixty-four patients with a variety of benign oral soft tissue lesions were treated by laser excision. Thirty-five patients were treated by a pulsed fiberoptic delivered Nd:YAG contact laser, and 29 by a continuous free-beam CO2 non-contact laser. The largest group of lesions treated were leukoplakia (39 cases). Other lesions excised and biopsied were lichen planus, squamous papilloma, pyogenic granuloma, focal melanosis, nonhealing traumatic ulceration, hemangioma, and lymphangioma. All patients were followed postoperatively (mean 6.8 months, range 1-36 months). RESULTS Laser excision was well tolerated by patients with no intraoperative or postoperative adverse effects. All patients healed postsurgically with no loss of function. CONCLUSIONS CO2 and Nd:YAG lasers are successful surgical options when performing excision of benign intraoral lesions. Advantages of laser therapy include minimal postoperative pain, conservative site-specific minimally invasive surgeries, and elimination of need for sutures.
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Affiliation(s)
- J M White
- Department of Restorative Dentistry, School of Dentistry, University of California, San Francisco, USA
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