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Aoki A, Mizutani K, Taniguchi Y, Lin T, Ohsugi Y, Mikami R, Katagiri S, Meinzer W, Iwata T. Current status of Er:YAG laser in periodontal surgery. JAPANESE DENTAL SCIENCE REVIEW 2024; 60:1-14. [PMID: 38148873 PMCID: PMC10750110 DOI: 10.1016/j.jdsr.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 11/01/2023] [Accepted: 11/14/2023] [Indexed: 12/28/2023] Open
Abstract
Lasers have numerous advantageous tissue interactions such as ablation or vaporization, hemostasis, bacterial killing, as well as biological effects, which induce various beneficial therapeutic effects and biological responses in the tissues. Thus, lasers are considered an effective and suitable device for treating a variety of inflammatory and infectious conditions of periodontal disease. Among various laser systems, the Er:YAG laser, which can be effectively and safely used in both soft and hard tissues with minimal thermal side effects, has been attracting much attention in periodontal therapy. This laser can effectively and precisely debride the diseased root surface including calculus removal, ablate diseased connective tissues within the bone defects, and stimulate the irradiated surrounding periodontal tissues during surgery, resulting in favorable wound healing as well as regeneration of periodontal tissues. The safe and effective performance of Er:YAG laser-assisted periodontal surgery has been reported with comparable and occasionally superior clinical outcomes compared to conventional surgery. This article explains the characteristics of the Er:YAG laser and introduces its applications in periodontal surgery including conventional flap surgery, regenerative surgery, and flapless surgery, based on scientific evidence from currently available basic and clinical studies as well as cases reports.
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Affiliation(s)
- Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Yoichi Taniguchi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
- Taniguchi Dental Clinic, Kita 7−17, 18-chome, Nango-dori, Shiroishi-ku, Sapporo, Hokkaido, Japan
| | - Taichen Lin
- School of Dentistry, Chung Shan Medical University (CSMU), No.110, Section 1, Jianguo N. Rd., South Dist, Taichung 402, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, No.110, Section 1, Jianguo N. Rd., South Dist, Taichung 402, Taiwan
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Risako Mikami
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Walter Meinzer
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
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Bakr NM, Balbola GA, Gawad Mohamed NA, Ahmed NA, Sapri AM, Mously EA, Felemban D, Elsayed SA, Hassan S. The effectiveness of Moringa oleifera in the preservation of periodontium after radiation therapy: An experimental animal study. Heliyon 2024; 10:e27495. [PMID: 38510057 PMCID: PMC10950587 DOI: 10.1016/j.heliyon.2024.e27495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 03/22/2024] Open
Abstract
Background Radiation therapy produces reactive oxygen species, which have been linked to various degenerative conditions in periodontal attachment. This study aimed to assess the beneficial effects of aqueous Moringa oleifera leaf extract on the periodontium of albino rats exposed to fractionated gamma radiation. Materials and methods This experimental study involved 24 adult male albino rats divided into three groups: Group M received M. oleifera leaf extract (300 mg/kg) intraperitoneally for 14 days; Group R received 20 Gy fractionated gamma irradiation; and Group MR received the same M. oleifera regimen as Group M and then fractionated gamma irradiation dose as Group R. On the first and seventh days post-radiation, bone, cementum, and periodontal ligament samples were histologically and histomorphometrically examined. Results The periodontal ligament, alveolar bone, and cementum showed structural damage in Group R. A relative persistence of normal periodontal tissue structures was seen in Group MR, showing less disruption of the periodontal ligament and greater trabecular bone thickness than Group R. The histomorphometric analysis showed that the mean periodontal ligament width was highest in Group R7 (245.20 μm) and lowest in Group M7 (54.55 μm). In addition, the mean cementum width was highest in Group R1 (88.99 μm) and lowest in Group M1R1 (17.87 μm) and differed significantly between groups. Conclusion Within the limitations of this study, Moringa oleifera leaf aqueous extract showed the potential to reduce the adverse effects of radiation, control inflammation, and support tissue healing in a rat model.
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Affiliation(s)
- Noura Mohammed Bakr
- Department of Oral and Dental Biology, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Gihan A. Balbola
- Department of Oral and Dental Pathology, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Nora Abdel Gawad Mohamed
- Department of Oral Medicine and Periodontology, Diagnosis and Radiology Department, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Nehad A. Ahmed
- Department of Oral and Dental Biology, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Ahmed Mohammed Sapri
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Egypt
| | - Eihab A. Mously
- Department of Preventive Dental Sciences and Periodontology, College of Dentistry, TaibahUniversity, Saudi Arabia
| | - Doaa Felemban
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, Taibah University, Saudi Arabia
| | - Shadia A. Elsayed
- Department of Oral and Dental Biology, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt
- Department of Oral and Maxillofacial Diagnostic Sciences, College of Dentistry, Taibah University, Saudi Arabia
| | - Sandy Hassan
- Department of Oral Medicine, Periodontology & Oral Diagnosis, Faculty of Dentistry, Fayoum University, Fayoum, Egypt
- Ahram Canadian University (ACU), Egypt
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Nahas P, Houeis S, Chamboredon R, Heysselaer D, Zeinoun T, Nammour S. Assessment of the Periodontal Cementum Ablation Depth during Root Planing by an Er:YAG Laser at Different Energy Densities: An Ex Vivo Study. Dent J (Basel) 2023; 11:dj11050116. [PMID: 37232767 DOI: 10.3390/dj11050116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/11/2023] [Accepted: 04/25/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION An important and non-adapted delivered energy of Er:YAG laser can eliminate the total thickness of root cementum during root planing. Conversely, the preservation of a partial layer of cementum covering the roots is vital for any periodontal ligament regeneration. Thus, the assessment of the cementum ablation depth produced by each energy density of Er:YAG laser is essential before considering its use for the periodontal planing and treatment of the cementum and root surfaces. AIM OF THE STUDY Assessment of the cementum ablation depth at different energy densities of the Er:YAG laser is the aim of this study. MATERIALS AND METHODS A total of 48 human caries free molars were collected and used in this study. Areas to be irradiated were delimited by two longitudinal grooves (0.5 mm depth). Roots were divided randomly into four groups (4 × n = 12). An Er:YAG laser (2.94 µm) was used with a side-firing tip (R600T) with a 600 µm diameter and a frequency of 20 Hz combined with a cooling system of air 6 mL/min and water 4 mL/min. We used a super short pulse mode (SSP: pulse duration: 50 μs). We used a single irradiation passage backward from apex to cervical parts at 1 mm/s with a slight contact and at an angle of 15° to 30° between the tip and the root surface. Different energies were selected: 30 mJ, 40 mJ, 50 mJ, and 60 mJ. RESULTS Microscopic observations showed that the average of the ablation depth increased with the increase of the delivered energy from 30 mJ to 60 mJ. Mean values of the ablation depths were respectively as follows: 43.75 ± 4.89 µm for the energy of 30 mJ, 50.05 ± 3.72 µm for 40 mJ, 65.56 ± 10.35 µm for 50 mJ, and 74.80 ± 15.23 µm for 60 mJ. A statistically significant difference existed between the ablation depth of all groups. CONCLUSION Based on our results, the depth of cementum debridement is related to the level of the delivered energy. The lowest energy levels (30 mJ and 40 mJ) can ablate the root cementum surface for a variable depth from 43.75 ± 4.89 μm to 50.05 ± 3.72 μm.
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Affiliation(s)
- Paul Nahas
- Department of Restorative and Esthetic Dentistry, Faculty of Dental Medicine, Lebanese University, Hadath campus, Beirut 1003, Lebanon
| | - Saad Houeis
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| | - Remi Chamboredon
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| | - Daniel Heysselaer
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
| | - Toni Zeinoun
- Department of Oral and Maxillo-Facial Surgery, Dean of Faculty of Dental Medicine, Lebanese University, Beirut 1003, Lebanon
| | - Samir Nammour
- Department of Dental Science, Faculty of Medicine, University of Liege, 4000 Liege, Belgium
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Liu R, Sun K, Wang Y, Jiang Y, Kang J, Ma H. Clinical comparison between Er: YAG and CO2 laser in treatment of oral tumorous lesions: A meta-analysis. Medicine (Baltimore) 2020; 99:e20942. [PMID: 32791674 PMCID: PMC7387021 DOI: 10.1097/md.0000000000020942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/06/2020] [Accepted: 05/26/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To compare clinical effect between Er: YAG and CO2 laser in treatment of oral tumorous lesions. METHODS A comprehensive search was conducted from 2000 to 2019. The quality assessment was performed by the QUADAS-2 tool (The Cochrane Collaboration, 2011). The clinical value of comparison between Er: YAG and CO2 laser was evaluated by using the pooled estimate of sensitivity and specificity. In addition, sensitivity analysis and bias analysis were applied to ensure the accuracy of the results. RESULTS Finally, 268 patients were enrolled in 6 studies and ultimately met the eligibility criteria. The Er: YAG and CO2 groups were 141 and 127, respectively. The meta-analysis showed significant difference in success (risk ratio = 21.29, 95% confidence interval [1.09, 1.52], P = .002; P for Heterogeneity = .99, I = 0%) and time of surgery ((P of heterogeneity = .29, I = 20%, Z = 25.69, P of over effect < .00001). The recurrence and complications of CO2and Er: YAG groups had no difference. CONCLUSION Er: YAG laser had better effects than CO2 laser in eliminating oral tumorous lesions while it needed longer operation time than CO2 laser.
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Agoob Alfergany M, Nasher R, Gutknecht N. Calculus Removal and Root Surface Roughness When Using the Er:YAG or Er,Cr:YSGG Laser Compared with Conventional Instrumentation Method: A Literature Review. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 37:197-226. [PMID: 31050960 DOI: 10.1089/photob.2018.4465] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: The purpose of this literature review was to evaluate the effectiveness of using Er:YAG (erbium-doped yttrium/aluminum/garnet) laser or Er,Cr:YSGG (erbium, chromium-doped yttrium/scandium/gallium/garnet) laser on calculus removal and their effect on the topography and roughness of root surface in comparison with the conventional instruments in the nonsurgical periodontal therapy. Background data: One of the most challenging problems in treatment of periodontal disease is the elimination of plaque and calculus, leaving a clean and smooth root surface to decrease plaque and calculus retention, and for good gingival reattachment. Materials and methods: PubMed and Google Scholar were searched for available literature. The electronic search was limited to articles published in the period between January 2007 and April 2017, in the English language. Results: A total of 47 publications fulfilled the inclusion criteria of this systematic review and screened according to the research questions. Calculus removal using the ultrasonic instrument showed remaining calculus compared with the hand instrument, whereas, on the contrary, erbium lasers revealed no remaining calculus or smaller amounts compared with the conventional instruments when used in appropriate settings. The results of this review showed that ultrasonic instrumentation produced effects on the root surface almost similar to that of hand instrumentation. Er:YAG laser and Er,Cr:YSGG laser clarify a little more surface roughness when compared with conventional instruments. Conclusions: The present systematic review indicates that a combination of scaling and root planing (SRP) using the erbium lasers as an adjunctive therapy at certain parameters can be appropriate to remove residual debris from the root surface and at the same time have little or no negative thermal effect on the root surface. The Er:YAG laser also seems to be the most suitable for nonsurgical periodontal therapy. Additional new good-designed studies are needed to evaluate the effectiveness of erbium lasers with SRP in nonsurgical periodontal therapy.
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Affiliation(s)
- Muftah Agoob Alfergany
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Aachen, Germany
| | - Riman Nasher
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Aachen, Germany
| | - Norbert Gutknecht
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University Hospital, Aachen, Germany
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Er:YAG Laser Irradiation Reduces Microbial Viability When Used in Combination with Irrigation with Sodium Hypochlorite, Chlorhexidine, and Hydrogen Peroxide. Microorganisms 2019; 7:microorganisms7120612. [PMID: 31775309 PMCID: PMC6955693 DOI: 10.3390/microorganisms7120612] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 11/15/2019] [Accepted: 11/23/2019] [Indexed: 12/20/2022] Open
Abstract
The erbium-doped yttrium aluminum garnet (Er:YAG) laser is used to treat periodontal disease; however, its effectiveness at killing oral bacteria is not well known. Furthermore, the compounding effect of the combination of a laser treatment and irrigation methods with antimicrobials on bacterial viability is yet to be determined. The purpose of this in vitro study was to evaluate the effect of the Er:YAG laser with irrigation using chlorhexidine (CHX), hydrogen peroxide (H2O2), or sodium hypochlorite (NaOCl) on the viability of oral bacteria. Three bacterial species were used in our study: Streptococcus gordonii, Fusobacterium nucleatum, and Porphyromonas gingivalis. Bacteria were grown in an anaerobic chamber in brain heart infusion broth and incubated at 37 °C. Bacterial samples with an OD of 0.5 were irradiated with the Er:YAG laser at 2940 nm using a 400-µm Varian tip. The experiment was repeated four times using these parameters: 40 mJ, 40 Hz, and 1.6 W for 20 seconds with the 300 µs short pulse duration in contact mode. Treatment groups consisted of the following: (1) no treatment, (2) 0.5% H2O2 alone, (3) 0.5% NaOCl alone, (4) 0.03% CHX alone, (5) Er:YAG irradiation alone, (6) Er:YAG irradiation with 0.5% H2O2, (7) Er:YAG irradiation with 0.5% NaOCl, and (8) Er:YAG irradiation with 0.03% CHX. Microbial viability was determined through plating and colony counts and calculated into CFU/ml. Statistical analysis was done using a two-tailed paired t-test. The use of the Er:YAG laser alone failed to show statistically significant antibacterial activity against any of bacteria. The most effective mono-treatment with irrigation solutions for all three bacteria were 0.5% H2O2 and 0.5% NaOCl (p < 0.001 for each solution). Irrigation with 0.03% CHX was most effective against F. nucleatum (p < 0.01) and less against P. gingivalis and S. gordonii and showed the least antibacterial action alone but improved significantly in combination therapy (p < 0.05). The combined treatment with the Er:YAG showed the greatest and most significant improvement in the reduction of bacterial viability compared to any other treatment group (p < 0.05 for each combined treatment). Irradiation with the Er:YAG laser with the addition of 0.5% H2O2, 0.5% NaOCl, or 0.03% CHX under a short working time (20 s) resulted in a significant reduction of bacterial viability for all three bacterial species compared with any single treatment option. The combination of irradiation with the Er:YAG laser with the addition of 0.5% H2O2, 0.5% NaOCl, or 0.03% CHX resulted in a larger reduction of bacterial survival when compared to monotherapies with antimicrobial solutions or laser. The combination of the Er:YAG laser with a low concentration irrigant solution of 0.5% H2O2, 0.5% NaOCl, or 0.03% CHX could be an effective treatment protocol for the reduction of periodontal pathogens and thus suitable treatment for non-surgical periodontal therapy.
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Liu J, Zhou Z, Zhang S. Effects of Er:YAG Laser on the Attachment of Human Periodontal Ligament Fibroblasts to Denuded Root Surfaces Simulating Delayed Replantation Cases: An In Vitro Study. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 38:145-150. [PMID: 31742487 DOI: 10.1089/photob.2019.4699] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To investigate the effects of Er:YAG laser on the attachment of human periodontal ligament fibroblasts (hPDLFs) to denuded root surfaces simulating delayed replantation cases. Background data: Dental avulsion is one of the most severe dental traumas, which is often treated with replantation. In delayed replantation scenarios, poor prognosis, including root resorption, usually occurs due to poor root surface conditioning and nonviable hPDLF attachment. Methods: Thirty-six root fragments (5 × 5 × 2 mm) were obtained from periodontium tissue-free premolar root surfaces. Specimens were randomly and equally assigned to the following: Group A, untreated control; Group B, 25 J/cm2 and 10 Hz of Er:YAG laser irradiation; and Group C, 50 J/cm2 and 10 Hz of Er:YAG laser irradiation. Some specimens in each group were then prepared for surface topography visualization under SEM, others were subjected to coculture with hPDLF suspension, and cell adhesion was further evaluated by SEM. Results: Group A presented homogenous smooth root surface, with fewer and round-shaped cells attached; Group B and C exhibited rather rough and irregular morphologies, and spindle-shaped fibroblasts were firmly attached by numerous lamellipodia and extensions. After a 3-day coculture, the number of fibroblasts attached in Group A was significantly lower compared with the other two laser-treated groups (p = 0.008 < 0.05). No significant alterations were observed between the two laser groups (p = 0.135 > 0.05). Conclusions: Er:YAG laser-treated root surfaces are compatible for the attachment of PDLFs, which suggests that Er:YAG laser irradiation may be used as a promising strategy for root surface conditioning in delayed replantation cases.
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Affiliation(s)
- Jingyi Liu
- Department of Stomatology, China-Japan Friendship Hospital, Beijing, People's Republic of China
| | - Zhixiong Zhou
- Department of Pediatric Dentistry, Peking University, School and Hospital of Stomatology, Beijing, People's Republic of China
| | - Sun Zhang
- Department of Pediatric Dentistry, Peking University, School and Hospital of Stomatology, Beijing, People's Republic of China
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Laser reduction of specific microorganisms in the periodontal pocket using Er:YAG and Nd:YAG lasers: a randomized controlled clinical study. Lasers Med Sci 2018; 33:1461-1470. [PMID: 29766330 DOI: 10.1007/s10103-018-2491-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 03/21/2018] [Indexed: 12/13/2022]
Abstract
The objective of this study was to evaluate the microbiological and clinical outcomes following nonsurgical treatment by either scaling and root planing, combination of Nd:YAG and Er:YAG lasers, or by Er:YAG laser treatment alone. The study involved 60 patients with generalized chronic periodontitis, randomly assigned into one of three treatment groups of 20 patients. The first group received scaling and root planing by hand instruments (SRP group), the second group received Er:YAG laser treatment alone (Er group), and the third group received combined treatment with Nd:YAG and Er:YAG lasers (NdErNd group). Microbiological samples, taken from the periodontal pockets at baseline and 6 months after treatments, were assessed with PET Plus tests. The combined NdErNd laser (93.0%), followed closely by Er:YAG laser (84.9%), treatment resulted in the highest reduction of all bacteria count after 6 months, whereas SRP (46.2%) failed to reduce Treponema denticola, Peptostreptococcus micros, and Capnocytophaga gingivalis. Full-mouth plaque and bleeding on probing scores dropped after 6 months and were the lowest in both laser groups. The combination of NdErNd resulted in higher probing pocket depth reduction and gain of clinical attachment level (1.99 ± 0.23 mm) compared to SRP (0.86 ± 0.13 mm) or Er:YAG laser alone (0.93 ± 0.20 mm) in 4-6 mm-deep pockets. Within their limits, the present results provide support for the combination of Nd:YAG and Er:YAG lasers to additionally improve the microbiological and clinical outcomes of nonsurgical periodontal therapy in patients with moderate to severe chronic periodontitis.
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Carvalho FSR, Feitosa VP, Silva PGDB, Soares ECS, Ribeiro TR, Fonteles CSR, Costa FWG. Evaluation of different therapeutic Carnoy's formulations on hard human tissues: A Raman microspectroscopy, microhardness, and scanning electron microscopy study. J Craniomaxillofac Surg 2018; 46:749-758. [PMID: 29655532 DOI: 10.1016/j.jcms.2018.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 02/07/2018] [Accepted: 02/14/2018] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To evaluate different therapeutic Carnoy's solution formulations on hard human tissues. MATERIALS AND METHODS An in vitro study was performed with human teeth (n = 36) and bone fragments (n = 18), randomly divided into two experimental groups (Group I = Carnoy solution with chloroform; Group II = Carnoy solution without chloroform) and a control group (saline solution). The groups were subdivided into pre-conditioning, post-conditioning, and post-conditioning with saline washing. Raman microspectroscopy, Knoop microhardness test, and scanning electron microscopy with energy dispersive X-ray spectroscopy were used. RESULTS There was demineralization of dental structures regarding mineral/matrix and carbonate/phosphate ratios (GI versus GII, p < 0.05). The presence of chloroform resulted in a statistically significant reduction of the teeth surface microhardness (p = 0.036), but not exceeding 0.01 μm. Both GI and GII showed significant structural changes by using scanning electron microscopy with energy dispersive X-ray spectroscopy. CONCLUSION Carnoy's solution altered the organic and inorganic matrix of the human calcified specimens analyzed in vitro, and its effect was more pronounced when chloroform was present.
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Affiliation(s)
- Francisco Samuel Rodrigues Carvalho
- Division of Oral and Maxillofacial Surgery, Federal University of Ceará, Fortaleza, Brazil; Division of Oral and Maxillofacial Morphology and Oral and Maxillofacial Surgery, UNIFOR, Fortaleza, Brazil.
| | | | | | - Eduardo Costa Studart Soares
- Division of Oral and Maxillofacial Surgery, Walter Cantídio University Hospital, Federal University of Ceará, Fortaleza, Brazil
| | | | | | - Fábio Wildson Gurgel Costa
- Division of Oral Radiology, Walter Cantídio University Hospital, Federal University of Ceará, Fortaleza, Brazil
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Liu J, Andrukhov O, Laky M, Nürnberger S, Moritz A, Lyu P, Rausch-Fan X. Behavior of human periodontal ligament cells on dentin surfaces ablated with an ultra-short pulsed laser. Sci Rep 2017; 7:12738. [PMID: 28986527 PMCID: PMC5630637 DOI: 10.1038/s41598-017-12871-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 09/15/2017] [Indexed: 12/20/2022] Open
Abstract
This study aimed to evaluate the effects of an ultrashort pulsed laser (USPL) (1064 nm, 20 ps, 100 kHz) with different laser fluences (F, 4, 6, 8 J/cm2) and pulse overlaps (PO, 0, 50%) on human periodontal ligament cells (hPDLs) behavior. Dentin samples were ablated with USPL with different combinations of fluences and pulse overlaps; some samples were ablated with an Er:YAG laser (2940 nm, 150 µs, 100 mJ/pulse, 5 J/cm2) and some samples were ground with a carbide bur. Then hPDLs were grown on the samples after different treatments. Dentin morphology and cell adhesion were observed with SEM and gene expressions were measured by RT-PCR. The results showed dentin surfaces ablated with USPL when F = 4 J/cm2, PO = 0, and F = 6 J/cm2, PO = 0 were partially intact with obvious ridges and valleys and cells on these surfaces grew mostly along the valleys. USPL ablated surfaces in other groups were entirely ablated and cell cluster formation was observed. The RT-PCR results showed an upregulation of osteocalcin of cells grown on the dentin after some laser treatment. It can be concluded that USPL could improve the attachment and differentiation of hPDLs and thus potentially promote periodontal tissue regeneration.
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Affiliation(s)
- Jing Liu
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, China.,Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria.,Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, China.,Research Center of Engineering and Technology for Digital Dentistry, Ministry of Health, Beijing, 100081, China
| | - Oleh Andrukhov
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Markus Laky
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Sylvia Nürnberger
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Austrian Cluster for Tissue Regeneration, AUVA Research Center, Vienna, Austria
| | - Andreas Moritz
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Peijun Lyu
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, 100081, China. .,Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, 100081, China. .,National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, China. .,Research Center of Engineering and Technology for Digital Dentistry, Ministry of Health, Beijing, 100081, China.
| | - Xiaohui Rausch-Fan
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria.
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Everett JD, Rossmann JA, Kerns DG, Al-Hashimi I. Laser Assisted Non-surgical Periodontal Therapy: A Double Blind, Randomized Clinical Trial. Open Dent J 2017; 11:79-90. [PMID: 28357001 PMCID: PMC5345326 DOI: 10.2174/1874210601711010079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 12/18/2016] [Accepted: 12/22/2016] [Indexed: 12/04/2022] Open
Abstract
The objective of this study was to examine potential benefits of using laser therapy for secular decontamination in conjunction with scaling and root planing in the treatment of chronic periodontitis. The study was performed on 173 teeth in 14 patients in a split-mouth design, one side received scaling and root planing followed by laser therapy using a carbon dioxide (CO2) laser with an ablative handpiece (test group); the contralateral side received scaling and root planing without laser (control group). Clinical and laboratory parameters were evaluated prior to treatment and at 3 and 6 months following therapy; clinical measurements were performed by two blinded examiners. The clinical parameters included measurement of gingival recession (REC), bleeding on probing (BOP), clinical attachment level (CAL), pocket depth (PD), furcation involvement (FUR), and tooth mobility (MOB). Laboratory testing to determine the levels of periodontal pathogens was performed using PCR techniques. The results of the study revealed statistically significant differences in clinical and laboratory parameters at 3 and 6 months after therapy for both test and control groups, but no significant difference was observed between the two groups. However, sites receiving laser therapy tended to show a greater decrease in probing depths, gain in clinical attachment level, and reduced bacterial levels. In conclusion, the overall results of the study suggest a potential benefit of using laser therapy in conjunction with scaling and root planing for the treatment of chronic periodontitis.
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Affiliation(s)
- Joseph D. Everett
- Department of Periodontics, Texas A&M University Baylor College of Dentistry, Dallas, TX 75246, USA
| | - Jeffrey A. Rossmann
- Department of Periodontics, Texas A&M University Baylor College of Dentistry, Dallas, TX 75246, USA
| | - David G. Kerns
- Department of Periodontics, Texas A&M University Baylor College of Dentistry, Dallas, TX 75246, USA
| | - Ibtisam Al-Hashimi
- Department of Periodontics, Texas A&M University Baylor College of Dentistry, Dallas, TX 75246, USA
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12
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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: 199] [Impact Index Per Article: 28.4] [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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13
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Lin T, Aoki A, Saito N, Yumoto M, Nakajima S, Nagasaka K, Ichinose S, Mizutani K, Wada S, Izumi Y. Dental hard tissue ablation using mid-infrared tunable nanosecond pulsed Cr:CdSe laser. Lasers Surg Med 2016; 48:965-977. [PMID: 27020165 DOI: 10.1002/lsm.22508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVE Mid-infrared erbium: yttrium-aluminum-garnet (Er:YAG) and erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers (2.94- and 2.78-μm, respectively) are utilized for effective dental hard tissue treatment because of their high absorption in water, hydroxide ion, or both. Recently, a mid-infrared tunable, nanosecond pulsed, all-solid-state chromium-doped: cadmium-selenide (Cr:CdSe) laser system was developed, which enables laser oscillation in the broad spectral range around 2.9 μm. The purpose of this study was to evaluate the ablation of dental hard tissue by the nanosecond pulsed Cr:CdSe laser at a wavelength range of 2.76-3.00 μm. STUDY DESIGN/MATERIALS AND METHODS Enamel, dentin, and cementum tissue were irradiated at a spot or line at a fluence of 0-11.20 J/cm2 /pulse (energy output: 0-2.00 mJ/pulse) with a repetition rate of 10 Hz and beam diameter of ∼150 μm on the target (pulse width ∼250 ns). After irradiation, morphological changes, ablation threshold, depth, and efficiency, and thickness of the structurally and thermally affected layer of irradiated surfaces were analyzed using stereomicroscopy, scanning electron microscopy (SEM), and light microscopy of non-decalcified histological sections. RESULTS The nanosecond pulsed irradiation without water spray effectively ablated dental hard tissue with no visible thermal damage such as carbonization. The SEM analysis revealed characteristic micro-irregularities without major melting and cracks in the lased tissue. The ablation threshold of dentin was the lowest at 2.76 μm and the highest at 3.00 μm. The histological analysis revealed minimal thermal and structural changes ∼20 μm wide on the irradiated dentin surfaces with no significant differences between wavelengths. The efficiency of dentin ablation gradually increased from 3.00 to 2.76 μm, at which point the highest ablation efficiency was observed. CONCLUSION The nanosecond pulsed Cr:CdSe laser demonstrated an effective ablation ability of hard dental tissues, which was remarkably wavelength-dependent on dentin at the spectral range of 2.76-3.00 μm. These results demonstrate the potential feasibility of the use of pulsed Cr:CdSe laser as a novel laser system for dental treatment. Lasers Surg. Med. 48:965-977, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Taichen Lin
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Photonics Control Technology Team, Advanced Photonics Technology Development Group, RIKEN Center for Advanced Photonics, Riken, Wako, Saitama, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.,Photonics Control Technology Team, Advanced Photonics Technology Development Group, RIKEN Center for Advanced Photonics, Riken, Wako, Saitama, Japan
| | - Norihito Saito
- Photonics Control Technology Team, Advanced Photonics Technology Development Group, RIKEN Center for Advanced Photonics, Riken, Wako, Saitama, Japan
| | - Masaki Yumoto
- Photonics Control Technology Team, Advanced Photonics Technology Development Group, RIKEN Center for Advanced Photonics, Riken, Wako, Saitama, Japan
| | - Sadahiro Nakajima
- Photonics Control Technology Team, Advanced Photonics Technology Development Group, RIKEN Center for Advanced Photonics, Riken, Wako, Saitama, Japan
| | - Keigo Nagasaka
- Photonics Control Technology Team, Advanced Photonics Technology Development Group, RIKEN Center for Advanced Photonics, Riken, Wako, Saitama, Japan
| | - Shizuko Ichinose
- Research Center for 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
| | - Satoshi Wada
- Photonics Control Technology Team, Advanced Photonics Technology Development Group, RIKEN Center for Advanced Photonics, Riken, Wako, Saitama, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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14
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Phanombualert J, Chimtim P, Heebthamai T, Weera-Archakul W. Microleakage of Self-Etch Adhesive System in Class V Cavities Prepared by Using Er:YAG Laser with Different Pulse Modes. Photomed Laser Surg 2015; 33:467-72. [PMID: 26270129 DOI: 10.1089/pho.2015.3926] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE In vitro studies evaluated cementum surface morphology and microleakage of three different energy density parameters of Erbium: Yttrium Aluminum Garnet (Er:YAG) laser compared with diamond bur preparation on class V cavities with self-etch adhesive system and composite resin restoration. MATERIAL AND METHODS Standard class V cavities were prepared at cervical area below the cementoenamel junction (CEJ) in 80 extracted premolars, by using a diamond bur on the buccal surface. All teeth were randomly allocated into four groups: Group 1, diamond bur; Group 2, Er:YAG 50 mJ/15 Hz, 3.77 J/cm(2); Group 3, Er:YAG 75 mJ/15 Hz, 5.65 J/cm(2); and Group 4, Er:YAG 100 mJ/15 Hz, 7.53 J/cm(2). Five cavities from each group were evaluated by scanning electron microscopy (SEM). The 15 remaining cavities from each group were restored with self-etch adhesive and nano-hybrid composite. After thermocycling, all sample teeth were immersed in 0.2% methylene blue dye and sectioned buccolingually. Statistics were analyzed using the one way ANOVA and Mann-Whitney U tests with Bonferroni correction. RESULTS The morphology showed micro-irregularities in the cementum surface of the laser group with the absence of a smear layer. The microstructure characteristics were increased surface roughness followed by increasing laser energy transmission. The Er:YAG laser groups were statistically significant, with less microleakage than the diamond bur group (p<0.05). There was statistically significant difference between the occlusal and gingival microleakage in all the groups (p<0.05). When the laser groups were compared, the lowest microleakage was achieved with energy density at 3.77 J/cm(2) on the occlusal and gingival cementum margin, which showed less microleakage than at energy densities of 5.65 and 7.53 J/cm(2) with Er:YAG laser. CONCLUSIONS These observations indicate that the micro-irregularities of the cementum surface could facilitate the formation of a hybridization zone with a self-etch adhesive system. Therefore, the microleakage of Er:YAG laser irradiation was significantly decreased compared with diamond bur cavities.
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Affiliation(s)
- Jutipond Phanombualert
- 1 Department of Hospital Dentistry, Khon Kaen University , Khon Kaen, Thailand .,2 Lasers in Dentistry Research Group, Faculty of Dentistry, Khon Kaen University , Khon Kaen, Thailand
| | - Pijitta Chimtim
- 2 Lasers in Dentistry Research Group, Faculty of Dentistry, Khon Kaen University , Khon Kaen, Thailand
| | - Thitirat Heebthamai
- 2 Lasers in Dentistry Research Group, Faculty of Dentistry, Khon Kaen University , Khon Kaen, Thailand
| | - Wilawan Weera-Archakul
- 3 Department of Community Dentistry, Faculty of Dentistry, Khon Kaen University , Khon Kaen, Thailand
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15
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Lavu V, Sundaram S, Sabarish R, Rao SR. Root Surface Bio-modification with Erbium Lasers- A Myth or a Reality?? Open Dent J 2015; 9:79-86. [PMID: 25713635 PMCID: PMC4333616 DOI: 10.2174/1874210601509010079] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 12/03/2014] [Accepted: 12/10/2014] [Indexed: 12/19/2022] Open
Abstract
The objective of this literature review was to critically review the evidence available in the literature regarding the expediency of erbium family of lasers for root bio modification as a part of periodontal therapy. The literature search was performed on the Pubmed using MeSH words such as "lasers/therapeutic use, scaling, dental calculus, tooth root/anatomy and histology, ultrasonic therapy". The studies were screened and were grouped as follows: those evaluating a) efficacy for calculus removal with the Erbium family of laser b) root surface changes following Er YAG and Er Cr YSGG application c) comparative studies of the Er YAG, Er Cr YSGG lasers versus conventional methods of root surface modification d) Bio compatibility of root surface following Erbium laser treatment e) Studies on the combined efficacy of laser root modification with conventional methods towards root surface bio-modification f) Studies on effectiveness of root surface bio-modification prior to root coverage procedures. In conclusion, the erbium family has a proven anti-bacterial action, predictable calculus removal, minimal root substance removal, and appears to favor cell attachment. The Erbium family of lasers appears to be a useful adjunct for the management of periodontal disease.
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Affiliation(s)
- Vamsi Lavu
- Department of Periodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Tamil Nadu, Chennai, India
| | - Subramoniam Sundaram
- Department of Periodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Tamil Nadu, Chennai, India
| | - Ram Sabarish
- Department of Periodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Tamil Nadu, Chennai, India
| | - Suresh Ranga Rao
- Department of Periodontics, Faculty of Dental Sciences, Sri Ramachandra University, Porur, Tamil Nadu, Chennai, India
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16
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Melo MAS, Lima JPM, Passos VF, Rodrigues LKA. The Influence of Dentin Demineralization on Morphological Features of Cavities Using Er:YAG Laser. Photomed Laser Surg 2015; 33:22-8. [DOI: 10.1089/pho.2014.3758] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mary A. S. Melo
- Department of Endodontics, Prosthodontics, and Operative Dentistry, University of Maryland Dental School, Baltimore, Maryland
| | - Juliana P. M. Lima
- Post-graduation Program, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Lidiany K. A. Rodrigues
- Post-graduation Program, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil
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17
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Belal MH, Watanabe H. Comparative Study on Morphologic Changes and Cell Attachment of Periodontitis-Affected Root Surfaces Following Conditioning with CO2and Er:YAG Laser Irradiations. Photomed Laser Surg 2014; 32:553-60. [DOI: 10.1089/pho.2014.3769] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Mahmoud Helmy Belal
- Department of Oral Medicine, Periodontology & Oral Diagnosis, Faculty of Oral & Dental Medicine, Fayoum University, Bahaariy Region, Al-Fayoum, Egypt
| | - Hisashi Watanabe
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Bunkyo-ku, Tokyo, Japan
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