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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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First-Hand Experience and Result with New Robot-Assisted Laser LeFort-I Osteotomy in Orthognathic Surgery: A Case Report. J Pers Med 2023; 13:jpm13020287. [PMID: 36836521 PMCID: PMC9962026 DOI: 10.3390/jpm13020287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND We report the world's first developer-independent experience with robot-assisted laser Le Fort I osteotomy (LLFO) and drill-hole marking in orthognathic surgery. To overcome the geometric limitations of conventional rotating and piezosurgical instruments for performing osteotomies, we used the stand-alone robot-assisted laser system developed by Advanced Osteotomy Tools. The aim here was to evaluate the precision of this novel procedure in comparison to the standard procedure used in our clinic using a computer-aided design/computer-aided manufacturing (CAD/CAM) cutting guide and patient-specific implant. METHODS A linear Le-Fort-I osteotomy was digitally planned and transferred to the robot. The linear portion of the Le-Fort I osteotomy was performed autonomously by the robot under direct visual control. Accuracy was analyzed by superimposing preoperative and postoperative computed tomography images, and verified intraoperatively using prefabricated patient-specific implant. RESULTS The robot performed the linear osteotomy without any technical or safety issues. There was a maximum difference of 1.5 mm on average between the planned and the performed osteotomy. In the robot-assisted intraoperative drillhole marking of the maxilla, which was performed for the first time worldwide, were no measurable deviations between planning and actual positioning. CONCLUSION Robotic-assisted orthognathic surgery could be a useful adjunct to conventional drills, burrs, and piezosurgical instruments for performing osteotomies. However, the time required for the actual osteotomy as well as isolated minor design aspects of the Dynamic Reference Frame (DRF), among other things, still need to be improved. Still further studies for final evaluation of safety and accuracy are also needed.
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Razavi P, Jafari A, Vescovi P, Fekrazad R. Efficacy of Adjunctive Photobiomodulation in the Management of Medication-Related Osteonecrosis of the Jaw: A Systematic Review. Photobiomodul Photomed Laser Surg 2022; 40:777-791. [PMID: 36507770 DOI: 10.1089/photob.2022.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Medication-related osteonecrosis of the jaw (MRONJ) is a severe adverse medication response that manifests as progressive bone necrosis in the craniofacial area. There is still no clear treatment protocol for the management of MRONJ. The purpose of this study was to conduct a systematic review to assess the efficacy of photobiomodulation (PBM) as an adjunct to MRONJ therapy. Methods: In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, a literature search was performed on PubMed/MEDLINE, Scopus, Web of Science, and Cochrane databases. Two examiners examined eligibility and risk of bias separately before extracting data. Results: Two hundred sixty-nine articles were found through electronic search, out of which only 11 met the inclusion criteria and were included in qualitative synthesis (9 retrospectives, 1 prospective, and 1 case series). A total number of 759 patients and a mean age ranging from 54 to 74 years were reviewed. Females were the most frequent gender in all of the selected studies (72% females to 28% males), and the most frequent stage in the studies mentioned above was stage II (66%). Most of the studies had shown a significant improvement when PBM was used as an adjunctive treatment. Conclusions: Based on the results of this study, PBM as an adjuvant therapy can significantly improve the outcomes of each treatment plan. However, surgical intervention for the complete healing of the lesions is suggested.
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Affiliation(s)
- Pouyan Razavi
- Student Research Committee, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Aryan Jafari
- Student Research Committee, Dental Faculty, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Paolo Vescovi
- Unit of Oral Medicine, Oral Surgery and Laser therapy, Department of Medicine and Surgery, University Center of Dentistry, University of Parma, Parma, Italy
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran.,International Network for Photo Medicine and Photodynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
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Natarajan D, Ye Z, Wang L, Ge L, Pathak JL. Rare earth smart nanomaterials for bone tissue engineering and implantology: Advances, challenges, and prospects. Bioeng Transl Med 2022; 7:e10262. [PMID: 35111954 PMCID: PMC8780931 DOI: 10.1002/btm2.10262] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/09/2021] [Indexed: 12/18/2022] Open
Abstract
Bone grafts or prosthetic implant designing for clinical application is challenging due to the complexity of integrated physiological processes. The revolutionary advances of nanotechnology in the biomaterial field expedite and endorse the current unresolved complexity in functional bone graft and implant design. Rare earth (RE) materials are emerging biomaterials in tissue engineering due to their unique biocompatibility, fluorescence upconversion, antimicrobial, antioxidants, and anti-inflammatory properties. Researchers have developed various RE smart nano-biomaterials for bone tissue engineering and implantology applications in the past two decades. Furthermore, researchers have explored the molecular mechanisms of RE material-mediated tissue regeneration. Recent advances in biomedical applications of micro or nano-scale RE materials have provided a foundation for developing novel, cost-effective bone tissue engineering strategies. This review attempted to provide an overview of RE nanomaterials' technological innovations in bone tissue engineering and implantology and summarized the osteogenic, angiogenic, immunomodulatory, antioxidant, in vivo bone tissue imaging, and antimicrobial properties of various RE nanomaterials, as well as the molecular mechanisms involved in these biological events. Further, we extend to discuss the challenges and prospects of RE smart nano-biomaterials in the field of bone tissue engineering and implantology.
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Affiliation(s)
- Duraipandy Natarajan
- Affiliated Stomatology Hospital of Guangzhou Medical UniversityGuangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative MedicineGuangzhouChina
| | - Zhitong Ye
- Affiliated Stomatology Hospital of Guangzhou Medical UniversityGuangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative MedicineGuangzhouChina
| | - Liping Wang
- Affiliated Stomatology Hospital of Guangzhou Medical UniversityGuangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative MedicineGuangzhouChina
| | - Linhu Ge
- Affiliated Stomatology Hospital of Guangzhou Medical UniversityGuangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative MedicineGuangzhouChina
| | - Janak Lal Pathak
- Affiliated Stomatology Hospital of Guangzhou Medical UniversityGuangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative MedicineGuangzhouChina
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Comprehensive and Sequential Gene Expression Analysis of Bone Healing Process Following Er:YAG Laser Ablation. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:100-112. [DOI: 10.1089/photob.2020.4833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Cold Ablation Robot-Guided Laser Osteotome (CARLO ®): From Bench to Bedside. J Clin Med 2021; 10:jcm10030450. [PMID: 33498921 PMCID: PMC7865977 DOI: 10.3390/jcm10030450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background: In order to overcome the geometrical and physical limitations of conventional rotating and piezosurgery instruments used to perform bone osteotomies, as well as the difficulties in translating digital planning to the operating room, a stand-alone robot-guided laser system has been developed by Advanced Osteotomy Tools, a Swiss start-up company. We present our experiences of the first-in-man use of the Cold Ablation Robot-guided Laser Osteotome (CARLO®). Methods: The CARLO® device employs a stand-alone 2.94-µm erbium-doped yttrium aluminum garnet (Er:YAG) laser mounted on a robotic arm. A 19-year-old patient provided informed consent to undergo bimaxillary orthognathic surgery. A linear Le Fort I midface osteotomy was digitally planned and transferred to the CARLO® device. The linear part of the Le Fort I osteotomy was performed autonomously by the CARLO® device under direct visual control. All pre-, intra-, and postoperative technical difficulties and safety issues were documented. Accuracy was analyzed by superimposing pre- and postoperative computed tomography images. Results: The CARLO® device performed the linear osteotomy without any technical or safety issues. There was a maximum difference of 0.8 mm between the planned and performed osteotomies, with a root-mean-square error of 1.0 mm. The patient showed normal postoperative healing with no complications. Conclusion: The newly developed stand-alone CARLO® device could be a useful alternative to conventional burs, drills, and piezosurgery instruments for performing osteotomies. However, the technical workflow concerning the positioning and fixation of the target marker and the implementation of active depth control still need to be improved. Further research to assess safety and accuracy is also necessary, especially at osteotomy sites where direct visual control is not possible. Finally, cost-effectiveness analysis comparing the use of the CARLO® device with gold-standard surgery protocols will help to define the role of the CARLO® device in the surgical landscape.
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Temperature Threshold Values of Bone Necrosis for Thermo-Explantation of Dental Implants-A Systematic Review on Preclinical In Vivo Research. MATERIALS 2020; 13:ma13163461. [PMID: 32781597 PMCID: PMC7476012 DOI: 10.3390/ma13163461] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE Very high or low temperatures will lead to bone damage. The objective of this review was to analyze threshold values for thermal bone necrosis. METHODS Histological animal studies evaluating thermal effects on bone necrosis were selected via electronic and hand searches in English and German language journals until 1 November 2019. The outcome measures were temperature-exposure intervals and laser settings effecting bone damage. Furthermore, investigated parameters were the bone-to-implant contact ratios (BIC) and infrabony pockets around dental implants after thermal treatment. For quality assessment of studies, the CAMARADES study quality checklist was applied. RESULTS A total of 455 animals in 25 animal studies were included for data extraction after screening of 45 titles from 957 selected titles of the MEDLINE (PubMed), The Cochrane Library, Embase and Web of Science search. The threshold values for bone necrosis ranged between 47 °C and 55 °C for 1 min. A threshold value for cryoinsult and laser treatment has not yet been defined. However, temperatures in the vicinity of 3.5 °C produce a histologically proven effect on the bone and in the surrounding tissue. At 50 °C for 1 min, BIC values significantly decreased and infrabony pockets increased. Bone quality had an influence on the outcome, as cancellous bone suffered higher bone damage from thermal treatment compared to cortical bone. CONCLUSION No clear threshold value for bone necrosis is available according to the current literature for warm and cold stimuli. More in-depth and clinical studies are required to provide further insights in assessing the potential of thermal necrosis for implant removal.
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Ohsugi Y, Katagiri S, Hirota T, Niimi H, Hatasa M, Watanabe K, Shimohira T, Mizutani K, Kitazawa M, Matsuzawa A, Kadokura H, Yokose S, Iwata T, Aoki A. Laser irradiation decreases sclerostin expression in bone and osteogenic cells. FASEB J 2020; 34:12877-12893. [DOI: 10.1096/fj.202001032r] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/16/2020] [Accepted: 07/16/2020] [Indexed: 01/25/2023]
Affiliation(s)
- Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Tomomitsu Hirota
- Division of Molecular Genetics, Research Center for Medical Science The Jikei University School of Medicine Tokyo Japan
| | - Hiromi Niimi
- Department of Periodontology, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Masahiro Hatasa
- Department of Periodontology, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Kazuki Watanabe
- Department of Periodontology, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Tsuyoshi Shimohira
- 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
| | - Moe Kitazawa
- Department of Epigenetics, Medical Research Institute Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Ayumi Matsuzawa
- Department of Epigenetics, Medical Research Institute Tokyo Medical and Dental University (TMDU) Tokyo Japan
| | - Hiroshi Kadokura
- Division of Endodontic and Operative Dentistry, Department of Restorative and Biomaterials Sciences, School of Dentistry Meikai University Saitama Japan
| | - Satoshi Yokose
- Division of Endodontic and Operative Dentistry, Department of Restorative and Biomaterials Sciences, School of Dentistry Meikai University Saitama Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU) Tokyo 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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Niimi H, Ohsugi Y, Katagiri S, Watanabe K, Hatasa M, Shimohira T, Tsuchiya Y, Maekawa S, Hirota T, Kadokura H, Yokose S, Iwata T, Aoki A. Effects of Low-Level Er:YAG Laser Irradiation on Proliferation and Calcification of Primary Osteoblast-Like Cells Isolated From Rat Calvaria. Front Cell Dev Biol 2020; 8:459. [PMID: 32656208 PMCID: PMC7324552 DOI: 10.3389/fcell.2020.00459] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 05/18/2020] [Indexed: 12/14/2022] Open
Abstract
Several reports have shown that the photo-bio-modulation of cells by various lasers has favorable biological effects. However, the effects of low-level Er:YAG laser irradiation on osteoblasts remain unclear. The purpose of this study was to evaluate the effects of low-level Er:YAG laser irradiation on proliferation and osteogenic differentiation of primary osteoblast-like cells isolated from the calvariae of 3-5-day-old Wistar rats. Cells were irradiated by Er:YAG laser at energy fluences of 2.2, 3.3, and 4.3 J/cm2, respectively. After irradiation, cell surface temperatures were measured and cell proliferation was evaluated by flow cytometry and CCK-8. Calcification was evaluated by measuring areas of Alizarin red S staining after 7, 14, and 21 days culture in osteoinductive medium. Gene expression in non-irradiated and laser-irradiated cells was evaluated by qPCR at 3, 6, and 12 h, as well as 1, 3, 7, and 14 days after irradiation. Microarray analysis was performed to comprehensively evaluate the gene expression of non-irradiated and irradiated cells at 3.3 J/cm2 at 6 h after irradiation. No pronounced increase of cell surface temperature was induced by irradiation. Irradiation did not affect osteoblast-like cell proliferation. Osteoblast-like cell calcification was significantly increased 7 days after Er:YAG laser irradiation at 3.3 J/cm2. Bglap expression was significantly increased in cells irradiated at 3.3 J/cm2 6 h post-irradiation. Microarray analysis showed that irradiation at 3.3 J/cm2 caused an upregulation of inflammation-related genes and downregulation of Wisp2. Gene set enrichment analysis also clarified enrichment of inflammation-related and Notch signaling gene sets. In conclusion, low-level Er:YAG laser irradiation at 3.3 J/cm2 enhanced calcification of primary osteoblast-like cells via enhanced Bglap expression and enriched Notch signaling.
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Affiliation(s)
- Hiromi Niimi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuki Watanabe
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiro Hatasa
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tsuyoshi Shimohira
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yosuke Tsuchiya
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shogo Maekawa
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomomitsu Hirota
- Division of Molecular Genetics, Research Center for Medical Sciences, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroshi Kadokura
- Division of Endodontic and Operative Dentistry, Department of Restorative and Biomaterials Sciences, School of Dentistry, Meikai University, Saitama, Japan
| | - Satoshi Yokose
- Division of Endodontic and Operative Dentistry, Department of Restorative and Biomaterials Sciences, School of Dentistry, Meikai University, Saitama, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Momesso GAC, Lemos CAA, Santiago-Júnior JF, Faverani LP, Pellizzer EP. Laser surgery in management of medication-related osteonecrosis of the jaws: a meta-analysis. Oral Maxillofac Surg 2020; 24:133-144. [PMID: 32056052 DOI: 10.1007/s10006-020-00831-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 01/10/2020] [Indexed: 06/10/2023]
Abstract
PURPOSE The aim of this study was to perform a systematic review and meta-analysis to evaluate the efficacy of laser therapy on medication-related osteonecrosis of the jaw (MRONJ) treatment. METHODS This study followed PRISMA standards, and an electronic search was performed on the PubMed/MEDLINE, Scopus, and Cochrane databases. Eighty-nine articles were found. After reading the manuscripts, 15 articles remained for the review. Three of them were selected for meta-analysis. RESULTS Female gender was predominant (72.5%), and mean age was 66.5 years. Follow-up varied between 3 and 80 months, and the most used bisphosphonate was zoledronic acid (71.6%). Stage II of MRONJ was the most prevalent (68.9%), and the mandible was the most affected site (64.5%). Qualitative data showed that treatment with laser surgery (Er:YAG) was most effective regarding complete healing of the lesion (90%) compared with other treatments. Meta-analysis data showed that low-level laser therapy (LLLT) was more effective than medical treatment (P = 0.006), and surgical treatment was more effective than LLLT (P = 0.008). CONCLUSION Laser surgery was significantly superior to LLLT (p < 0.00001). Therefore, laser surgical therapy seems to be a great management strategy for MRONJ treatment from stage II. LLLT was shown to improve conservative management in earlier MRONJ stages.
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Affiliation(s)
| | - Cleidiel Aparecido Araújo Lemos
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Sao Paulo, Brazil
| | | | - Leonardo Perez Faverani
- Department of Diagnosis and Surgery, Aracatuba Dental School, São Paulo State University (UNESP), Sao Paulo, Brazil.
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Sao Paulo, Brazil
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Huang W, Gao C, Lan Y, Zeng S, Pathak JL, Zhou M, Ge L, Zhang J. Optical coherence tomography characterizes the roughness and thickness of the heterogeneous layer on cortical bone surface induced by Er:YAG laser ablation at different moisture contents. Quant Imaging Med Surg 2020; 10:713-726. [PMID: 32269931 DOI: 10.21037/qims.2020.02.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background As an innovative bone ablation tool, pulsed erbium: yttrium-aluminum-garnet (Er:YAG) laser is being used in clinical practice. It faces the same problems as traditional tools: the water content of bone usually changes with the position, while the amount of water spray in the process of laser irradiation is also uncertain. Real-time monitoring of the effects of laser bone ablation is necessary, but effective tools are still lacking. In this study, we examined the feasibility of rapidly and non-destructively evaluating the surface properties of bone after Er:YAG laser irradiation at different moisture contents by optical coherence tomography (OCT). Methods Bone specimens (n=90) collected from pig cortical bone were used in this study. All bone specimens had similar volume and surface characteristics after machining. To display the baseline level before Er:YAG laser ablation, a control group (n=10) without dehydration or Er:YAG laser ablation was examined with OCT, scanning electron microscopy (SEM), and energy dispersive X-ray (EDX) spectroscopy. The remaining specimens were randomly divided into four groups (n=20/group) with different moisture content: dried (Group 2 and Group 4) or not dried (Group 1 and Group 3). Pulsed Er:YAG laser (120 mJ/pulse, 20 Hz, 100 µs) was used for perpendicular irradiation with (Group 1 and Group 2) or without (Group 3 and Group 4) water spray. The treated specimens were subjected to SEM, EDX spectroscopy, OCT, and then processed for histological evaluation. Results After Er:YAG laser ablation, the melting effect was obvious in the SEM results of the dry groups and non-sprayed groups (Groups 2-4). EDX spectroscopy showed that the content of calcium and phosphorus and their ratios remained unchanged in the undried and with water spray group (Group 1) were the closest to the control group. Three-dimensional (3D) OCT could evaluate the depth and shape of ablation grooves. The roughness of the laser-ablated surface could be visualized by extracting the surface lines from cross-sectional OCT images. The results illustrated that the laser ablation with water spray could achieve a smoother surface. Furthermore, OCT results demonstrated that a layer with high image intensity was generated on the bone surface after laser irradiation. The thickness of these layers showed a correlation with whether or not the laser irradiation was sprayed with water. Histology showed that thin eosin-stained layers were created in all experimental groups, which matched well with OCT results of the layers with high image intensity. No denatured layer was observed in the non-irradiated areas of bone tissues. Conclusions OCT could rapidly and non-destructively visualize the bone surface before and after Er:YAG laser ablation at four different moisture contents. The morphology of ablation grooves, as well as the roughness and thickness of the heterogeneous layer on the bone surface, could be characterized quantitatively with good correlation with SEM and histology. This study will promote the development of OCT as an efficient and accurate tool for evaluating laser ablation of bone.
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Affiliation(s)
- Wenyan Huang
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510140, China
| | - Chudan Gao
- Department of Biomedical Engineering, School of Basic Medical Science, Guangzhou Medical University, Guangzhou 511436, China
| | - Yintao Lan
- Department of Biomedical Engineering, School of Basic Medical Science, Guangzhou Medical University, Guangzhou 511436, China
| | - Sujuan Zeng
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510140, China
| | - Janak L Pathak
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510140, China
| | - Miao Zhou
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510140, China
| | - Lihong Ge
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510140, China.,Department of Pediatric Dentistry, Stomatology Hospital of Peking University, Beijing 100081, China
| | - Jian Zhang
- Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510140, China.,Department of Biomedical Engineering, School of Basic Medical Science, Guangzhou Medical University, Guangzhou 511436, China.,State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Medical University, Guangzhou 510120, China
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Li FL, Wu CB, Sun HJ, Zhou Q. Effectiveness of laser-assisted treatments for medication-related osteonecrosis of the jaw: a systematic review. Br J Oral Maxillofac Surg 2020; 58:256-267. [DOI: 10.1016/j.bjoms.2019.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 12/05/2019] [Indexed: 12/20/2022]
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13
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Kakar A, Kakar K, Leventis MD, Jain G. Immediate Implant Placement in Infected Sockets: A Consecutive Cohort Study. J Lasers Med Sci 2020; 11:167-173. [PMID: 32273958 DOI: 10.34172/jlms.2020.28] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: Immediate placement of implants in a fresh post-extraction socket is an increasingly popular and established treatment option. However, active infection in the extraction site may adversely affect the outcome of this procedure. This study was designed to assess the clinical results of immediate placement of dental implants in infected extraction sockets using a standardized protocol, which included (a) the use of an Er,Cr:YSGG laser for the decontamination of the infected socket prior to implant insertion, and (b) the utilization of an in situ hardening alloplastic bone graft substitute to augment the gap between the implant surface and the labial plate of bone. Patients and Methods: A retrospective record review was used to identify 68 patients who had implants placed as per the described protocol. A total of 126 implants were placed in 68 patients (65 implants in the maxilla, 61 implants in the mandible). The implants were loaded 136 ± 73 days (mean ± standard deviation; range: 37–400 days) after implant placement. Eight patients (16 implants) were subsequently lost to follow up. Results: 105 of the 110 implants (95.45%) placed immediately in the infected sites using the described protocol survived after prosthetic loading. Conclusion: Immediate implant placement in previously infected sites using the protocols mentioned in our study with laser decontamination of the socket, grafting with an in situ hardening alloplastic bone graft material and non-submerged healing shows a similar survival rate to the published success rates for immediate implants placed in non-infected sites.
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Affiliation(s)
- Ashish Kakar
- Sr. Consultant Indraprastha Apollo Hospitals and Private Practice, New Delhi, India
- Adjunct Assistant Professor- Rutgers School of Dental Medicine, Newark, NJ, USA
- Visiting Professor, Yenepoya University, Mangalore, India
| | | | - Minas D. Leventis
- Department of Oral & Maxillofacial Surgery, Dental School, University of Athens, Athens, Greece
| | - Gaurav Jain
- Clinical Associate, Dental Surgery, Indraprastha Apollo Hospitals and Private Practice, New Delhi, India
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14
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Pantawane MV, Ho YH, Robertson WB, Khan RJK, Fick DP, Dahotre NB. Thermal Assessment of Ex Vivo Laser Ablation of Cortical Bone. ACS Biomater Sci Eng 2020; 6:2415-2426. [PMID: 33455309 DOI: 10.1021/acsbiomaterials.9b01559] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
As a potential osteotomy tool, laser ablation is expected to provide rapid machining of bone, while generating minimal thermal damage (carbonization) and physical attributes within the machined region conducive to healing. As these characteristics vary with laser parameters and modes of laser operation, the clinical trials and in vivo studies render it difficult to explore these aspects for optimization of the laser machining parameters. In light of this, the current work explores various thermal and microstructural aspects of laser-ablated cortical bone in ex vivo study to understand the fundamentals of laser-bone interaction using computational modeling. The study employs the Yb-fiber Nd:YAG laser (λ = 1064 nm) in the continuous wave mode to machine the femur section of bovine bone by a three-dimensional machining approach. The examination involved thermal analysis using differential scanning calorimetry and thermogravimetry, phase analysis using X-ray diffractometry, qualitative analysis using X-ray photoelectron spectroscopy, and microstructural and semiquantitative analysis using scanning electron microscopy equipped with energy-dispersive spectrometry. The mechanism of efficient bone ablation using the Nd:YAG laser was evaluated using the computational thermokinetics outcome. The use of high laser fluence (10.61 J/mm2) was observed to be efficient to reduce the residual amorphous carbon in the heat-affected zone while achieving removal of the desired volume of the bone material at a rapid rate. Minimal thermal effects were predicted through computational simulation and were validated with the experimental outcome. In addition, this work reveals the in situ formation of a scaffold-like structure in the laser-machined region which can be conducive during healing.
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Affiliation(s)
- Mangesh V Pantawane
- Laboratory for Laser Aided Additive and Subtractive Manufacturing, Virtual Center for Advanced Orthopedics, Department of Materials Science and Engineering, University of North Texas, 1155 Union Circle-305310, Denton, Texas 76203-5017, United States
| | - Yee-Hsien Ho
- Laboratory for Laser Aided Additive and Subtractive Manufacturing, Virtual Center for Advanced Orthopedics, Department of Materials Science and Engineering, University of North Texas, 1155 Union Circle-305310, Denton, Texas 76203-5017, United States
| | - William B Robertson
- Laboratory for Laser Aided Additive and Subtractive Manufacturing, Virtual Center for Advanced Orthopedics, Department of Materials Science and Engineering, University of North Texas, 1155 Union Circle-305310, Denton, Texas 76203-5017, United States.,Australian Institute of Robotics Orthopedics, 2 Centro Avenue, Subiaco, Western Australia 6008, Australia.,Department of Computing School of Electrical Engineering and Computing, Curtin University, Kent Street, Bentley, Western Australia 6102, Australia
| | - Riaz J K Khan
- Laboratory for Laser Aided Additive and Subtractive Manufacturing, Virtual Center for Advanced Orthopedics, Department of Materials Science and Engineering, University of North Texas, 1155 Union Circle-305310, Denton, Texas 76203-5017, United States.,Australian Institute of Robotics Orthopedics, 2 Centro Avenue, Subiaco, Western Australia 6008, Australia.,Department of Computing School of Electrical Engineering and Computing, Curtin University, Kent Street, Bentley, Western Australia 6102, Australia.,The Joint Studio, Hollywood Medical Centre, 85 Monash Avenue, Nedlands, Western Australia 6009, Australia
| | - Daniel P Fick
- Laboratory for Laser Aided Additive and Subtractive Manufacturing, Virtual Center for Advanced Orthopedics, Department of Materials Science and Engineering, University of North Texas, 1155 Union Circle-305310, Denton, Texas 76203-5017, United States.,Australian Institute of Robotics Orthopedics, 2 Centro Avenue, Subiaco, Western Australia 6008, Australia.,Department of Computing School of Electrical Engineering and Computing, Curtin University, Kent Street, Bentley, Western Australia 6102, Australia.,The Joint Studio, Hollywood Medical Centre, 85 Monash Avenue, Nedlands, Western Australia 6009, Australia
| | - Narendra B Dahotre
- Laboratory for Laser Aided Additive and Subtractive Manufacturing, Virtual Center for Advanced Orthopedics, Department of Materials Science and Engineering, University of North Texas, 1155 Union Circle-305310, Denton, Texas 76203-5017, United States
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15
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Evolution of surface morphology of Er:YAG laser-machined human bone. Lasers Med Sci 2019; 35:1477-1485. [PMID: 31828574 DOI: 10.1007/s10103-019-02927-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 11/27/2019] [Indexed: 10/25/2022]
Abstract
The extensive research on the laser machining of the bone has been, so far, restricted to drilling and cutting that is one- and two-dimensional machining, respectively. In addition, the surface morphology of the laser machined region has rarely been explored in detail. In view of this, the current work employed three-dimensional laser machining of human bone and reports the distinct surface morphology produced within a laser machined region of human bone. Three-dimensional laser machining was carried out using multiple partially overlapped pulses and laser tracks with a separation of 0.3 mm between the centers of consecutive laser tracks to remove a bulk volume of the bone. In this study, a diode-pumped pulse Er:YAG laser (λ = 2940 nm) was employed with continuously sprayed chilled water at the irradiation site. The resulting surface morphology evolved within the laser-machined region of the bone was evaluated using scanning electron microscopy, energy dispersive spectroscopy, and X-ray micro-computed tomography. The distinct surface morphology involved cellular/channeled scaffold structure characterized by interconnected pores surrounded by solid ridges, produced within a laser machined region of human structural bone. Underlying physical phenomena responsible for evolution of such morphology have been proposed and explained with the help of a thermokinetic model.
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16
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Using Er:YAG laser to remove lithium disilicate crowns from zirconia implant abutments: An in vitro study. PLoS One 2019; 14:e0223924. [PMID: 31689289 PMCID: PMC6830778 DOI: 10.1371/journal.pone.0223924] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/01/2019] [Indexed: 01/04/2023] Open
Abstract
Background When implants are restored with cement-retained restorations, prosthetic retrievability can be difficult and often requires sectioning using rotary instruments. Sometimes repeated removals of a cement-retained implant crown are needed such as for treatment of peri-implantitis or immediate implant provisionalization. The purpose of this study was to evaluate the effect of erbium-doped yttrium aluminum garnet (Er:YAG) laser as a non-invasive treatment modality to remove lithium disilicate crowns from zirconia implant abutments following long-term cementation, repetitive debonding and re-cementation, and short-term retrieval. Material and methods Twenty identical lithium disilicate crowns were cemented onto zirconia prefabricated abutments using composite resin cement. Ten cemented crowns were removed at 48 hours after cementation as a short-term group (ST), while another 10 were removed 6 months after cementation as a long-term group (LT). To mimicking repetitive recementation and retrieval, the LT crowns were then recemented and removed after 48 hours as a long-term recemention (LTR) group. The LTR crowns were then again recemented and removed after 48 hours as a long-term repeated recemention (LTRR) group. Er:YAG laser was used to facilitate the retrieval of these crowns. recorded and analyzed using ANOVA and t-test. The surfaces of the crown and the abutment were further examined using light microscopy and scanning electron microscopy (SEM). Temperature changes of the abutment and crown upto 10 minutes were also measured and statistically analyzed (paired t-test). Results The average times of crown removal from zirconia abutments were 4 minutes (min) and 42 second (sec) in LT to 3 min 24 sec in LTR, and 3 min 12 sec in LTRR and ST groups. LTR took the longest time to remove, statistically (ANOVA and t-test, p < .001). No statistical differences were observed among the removal times of LTR, LTRR, and ST groups (t-test, p = .246, .246 and 1). SEM examination of the material surface showed no visual surface damaging from treatment with Er:YAG laser. The temperatures during irradiation ranged from 18.4°C to 20°C and 22.2°C to 24.5°C (Paired t-test, p < .0001) for the abutment and the crown during irradiation from 1 min to 10 mins. Conclusions Long-term cementation can increase time in lithium disilicate crown removal from zirconia abutment using Er:YAG. Er:YAG laser is a non-invasive tool to remove cement-retained implant prostheses and should be considered as a viable alternative to rotary instruments.
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17
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Auto-Fluorescence and Histopathologic Evaluation of Medication-Related Osteonecrosis of the Jaws. J Craniofac Surg 2019; 30:1039-1043. [DOI: 10.1097/scs.0000000000004705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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18
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Ohsugi Y, Aoki A, Mizutani K, Katagiri S, Komaki M, Noda M, Takagi T, Kakizaki S, Meinzer W, Izumi Y. Evaluation of bone healing following Er:YAG laser ablation in rat calvaria compared with bur drilling. JOURNAL OF BIOPHOTONICS 2019; 12:e201800245. [PMID: 30324711 DOI: 10.1002/jbio.201800245] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/11/2018] [Accepted: 10/12/2018] [Indexed: 06/08/2023]
Abstract
The Er:YAG laser is currently used for bone ablation. However, the effect of Er:YAG laser irradiation on bone healing remains unclear. The aim of this study was to investigate bone healing following ablation by laser irradiation as compared with bur drilling. Rat calvarial bone was ablated using Er:YAG laser or bur with water coolant. Er:YAG laser effectively ablated bone without major thermal changes. In vivo micro-computed tomography analysis revealed that laser irradiation showed significantly higher bone repair ratios than bur drilling. Scanning electron microscope analysis showed more fibrin deposition on laser-ablated bone surfaces. Microarray analysis followed by gene set enrichment analysis revealed that IL6/JAK/STAT3 signaling and inflammatory response gene sets were enriched in bur-drilled bone at 6 hours, whereas the E2F targets gene set was enriched in laser-irradiated bone. Additionally, Hspa1a and Dmp1 expressions were increased and Sost expression was decreased in laser-irradiated bone compared with bur-drilled bone. In granulation tissue formed after laser ablation, Alpl and Gblap expressions increased compared to bur-drilled site. Immunohistochemistry showed that osteocalcin-positive area was increased in the laser-ablated site. These results suggest that Er:YAG laser might accelerate early new bone formation with advantageous surface changes and cellular responses for wound healing, compared with bur-drilling.
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Affiliation(s)
- Yujin Ohsugi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akira Aoki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koji Mizutani
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sayaka Katagiri
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motohiro Komaki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Highly Advanced Stomatology, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Masahiro Noda
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toru Takagi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sho Kakizaki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Walter Meinzer
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Erbium Yttrium–Aluminum–Garnet Laser Versus Traditional Bur in the Extraction of Impacted Mandibular Third Molars: Analysis of Intra- and Postoperative Differences. J Craniofac Surg 2018; 29:2282-2286. [DOI: 10.1097/scs.0000000000004574] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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20
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Biocompatibility of erbium chromium-doped yattrium-scandium-gallium-garnet (Er,Cr:YSGG 2780 nm) laser-treated titanium alloy used for dental applications (in vitro study). ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s41547-018-0029-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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21
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Merigo E, Cella L, Oppici A, Cristina Arbasi M, Clini F, Fontana M, Fornaini C. Combined Approach to Treat Medication-Related Osteonecrosis of the Jaws. J Lasers Med Sci 2018; 9:92-100. [PMID: 30026893 DOI: 10.15171/jlms.2018.19] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: The proper therapeutic plan for medication-related osteonecrosis of the Jaw (MRONJ) is still lacking long-term data up to today. They were several high-technological appliances proposed for the different intervention steps, in addition to tissue repair promoters. The reason for proposing an integrated technique is justified, beyond better compliance of the patients associated to the pain and inflammation reduction and bleeding control, there is also achieving better hard and soft tissues healing. Methods: Patients diagnosed with bisphosphonates-related osteonecrosis of the jaws (BRONJ) at the Odontostomatology and Maxillo-Facial Surgery Unit of the Hospital of Piacenza undergone surgical intervention. The intervention was performed by using different devices: Piezosurgery for removing the necrotic bone tissue and for obtaining the bone specimen essential for histological analysis; Er:YAG laser (2940 nm) to vaporize necrotic hard tissue until reaching the bleeding bone; platelet-rich plasma (PRP) to stimulate hard and soft tissue healing; and finally diode laser (808 nm) to perform a biostimulation of the surgical site. Results: All treated patients demonstrated a good postoperative comfort even without using painkillers, no bleeding, and a fast healing process. Most of the patients (92.85%) reached complete healing with a minimum follow up at 6 months. Histological exams demonstrated a good quality without artifacts. Conclusion: Sequential utilization of different high-technologies devices during all the steps of MRONJ treatment allows to perform a faster and less invasive surgery with a more comfortable postoperative healing process and it may represent a new and original approach for treating this severe adverse event.
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Affiliation(s)
- Elisabetta Merigo
- MICORALIS Laboratory EA7354, Faculty of Dentistry, Université "Côte d'Azur", 24 Avenue des Diables Bleus, 06357 Nice, France.,Odontostomatology and Maxillo-Facial Surgery Unit - "Special care dentistry", "Guglielmo da Saliceto" Hospital - Via Taverna, 10 - 29100, Piacenza, Italy
| | - Luigi Cella
- Odontostomatology and Maxillo-Facial Surgery Unit - "Special care dentistry", "Guglielmo da Saliceto" Hospital - Via Taverna, 10 - 29100, Piacenza, Italy
| | - Aldo Oppici
- Odontostomatology and Maxillo-Facial Surgery Unit - "Special care dentistry", "Guglielmo da Saliceto" Hospital - Via Taverna, 10 - 29100, Piacenza, Italy
| | - Maria Cristina Arbasi
- Immunohematology and Transfusion Medicine "Guglielmo da Saliceto" Hospital - via Taverna, 10 - 29100, Piacenza, Italy
| | - Fabio Clini
- Odontostomatology and Maxillo-Facial Surgery Unit - "Special care dentistry", "Guglielmo da Saliceto" Hospital - Via Taverna, 10 - 29100, Piacenza, Italy
| | - Matteo Fontana
- Odontostomatology and Maxillo-Facial Surgery Unit - "Special care dentistry", "Guglielmo da Saliceto" Hospital - Via Taverna, 10 - 29100, Piacenza, Italy
| | - Carlo Fornaini
- MICORALIS Laboratory EA7354, Faculty of Dentistry, Université "Côte d'Azur", 24 Avenue des Diables Bleus, 06357 Nice, France.,Odontostomatology and Maxillo-Facial Surgery Unit - "Special care dentistry", "Guglielmo da Saliceto" Hospital - Via Taverna, 10 - 29100, Piacenza, Italy
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22
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Schneiderian Membrane Perforation Rate and Increase in Bone Temperature During Maxillary Sinus Floor Elevation by Means of Er: YAG Laser-An Animal Study in Pigs. IMPLANT DENT 2018; 26:238-244. [PMID: 27893513 DOI: 10.1097/id.0000000000000520] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To assess the time of preparation, bone temperature increase, and the Schneiderian membrane perforation rate during maxillary sinus floor elevation. MATERIALS AND METHODS The research included 30 maxillary sinuses (n = 30) of a pig, divided into 2 groups (n = 15). The lateral bony windows were created using Er:YAG laser (200 mJ, 15 Hz, energy density: 25.48 J/cm) and a diamond bur (control). The membrane was elevated using laser (50 mJ, 50 Hz) and hand instruments. The bone temperature was measured by K-type thermocouple. RESULTS Significantly lower rates of the Schneiderian membrane perforation were found in the laser group (6.67%) compared with the bur (33%) (P < 0.05). The significant higher increase in temperature (mean 7.6°C) was found in the experimental group as compared with the control group (mean 2°C) (P = 0.0000033). The average time necessary for the laser bony window osteotomy was 10 minutes and 37 seconds, whereas using the bur required middling 5 minutes and 50 seconds (P = 0.000283). CONCLUSION The application of Er:YAG laser may significantly reduce the risk of iatrogenic perforation of the Schneiderian membrane and does not cause an irreversible thermal damage in a pig model.
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23
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Rohde M, Mehari F, Klämpfl F, Adler W, Neukam FW, Schmidt M, Stelzle F. The differentiation of oral soft- and hard tissues using laser induced breakdown spectroscopy - a prospect for tissue specific laser surgery. JOURNAL OF BIOPHOTONICS 2017; 10:1250-1261. [PMID: 27875030 DOI: 10.1002/jbio.201600153] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 09/12/2016] [Accepted: 10/26/2016] [Indexed: 06/06/2023]
Abstract
Compared to conventional techniques, Laser surgery procedures provide a number of advantages, but may be associated with an increased risk of iatrogenic damage to important anatomical structures. The type of tissue ablated in the focus spot is unknown. Laser-Induced Breakdown-Spectroscopy (LIBS) has the potential to gain information about the type of material that is being ablated by the laser beam. This may form the basis for tissue selective laser surgery. In the present study, 7 different porcine tissues (cortical and cancellous bone, nerve, mucosa, enamel, dentine and pulp) from 6 animals were analyzed for their qualitative and semiquantitative molecular composition using LIBS. The so gathered data was used to first differentiate between the soft- and hard-tissues using a Calcium-Carbon emission based classifier. The tissues were then further classified using emission-ratio based analysis, principal component analysis (PCA) and linear discriminant analysis (LDA). The relatively higher concentration of Calcium in the hard tissues allows for an accurate first differentiation of soft- and hard tissues (100% sensitivity and specificity). The ratio based statistical differentiation approach yields results in the range from 65% (enamel-dentine pair) to 100% (nerve-pulp, cancellous bone-dentine, cancellous bone-enamel pairs) sensitivity and specificity. Experimental LIBS measuring setup.
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Affiliation(s)
- Maximilian Rohde
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Straße 6, 91052, Erlangen, Germany
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstraße 11, 91054, Erlangen, Germany
| | - Fanuel Mehari
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Straße 6, 91052, Erlangen, Germany
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Konrad-Zuse-Straße 3/5, 91052, Erlangen, Germany
| | - Florian Klämpfl
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Straße 6, 91052, Erlangen, Germany
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Konrad-Zuse-Straße 3/5, 91052, Erlangen, Germany
| | - Werner Adler
- Institute of Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstraße 6, 91054, Erlangen, Germany
| | - Friedrich-Wilhelm Neukam
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstraße 11, 91054, Erlangen, Germany
| | - Michael Schmidt
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Straße 6, 91052, Erlangen, Germany
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Konrad-Zuse-Straße 3/5, 91052, Erlangen, Germany
| | - Florian Stelzle
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Straße 6, 91052, Erlangen, Germany
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstraße 11, 91054, Erlangen, Germany
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Talebi-Ardakani MR, Torshabi M, Karami E, Vajar N, Rezaei Esfahrood Z, Meimandi M, Mojahedi SM. Comparison of Er:YAG Laser and Hand Instrumentation on the Attachment of Cultured Human Gingival Fibroblasts to Periodontally Involved Root Surfaces. J Lasers Med Sci 2017; 8:S51-S55. [PMID: 29071036 DOI: 10.15171/jlms.2017.s10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Introduction: The present study compared the effects of erbium-doped yttrium aluminium garnet (Er:YAG) laser and hand instrumentation on the attachment of human gingival fibroblast (HGF) cells to periodontally involved root surfaces. Methods: A total of 40 tooth specimens were collected and treated in four distinct groups: scaled and root planed with hand instruments, scaled with Er:YAG laser, treated with a combination of hand instruments and Er:YAG laser and non-treated control group. The attachment and proliferation rate of HGF were assessed using MTT assay and scanning electron microscope (SEM) examination was used for cell morphological evaluation. Results: The MTT (3-[4, 5-dimethylthiazol-2-yl]-2, 5 diphenyl tetrazolium bromide) assay showed significant decrease in HGF cell viability in both hand instruments only and combination treated teeth specimens compared to control specimens (P<0.05), 24 hours after cell seeding. However, at time 48, the cell viability of attached cells in these 2 treated groups was almost similar to control. In contrast, at 24 and 48 hours after cell seeding, viability of attached cells was higher than control in Er:YAG laser treated only specimens (P<0.05). According to SEM study, the laser treated specimens showed more surface roughness. Conclusion: Er:YAG laser increased attachment and proliferation of HGF cells in comparison to the hand instruments method.
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Affiliation(s)
| | - Maryam Torshabi
- Department of Dental Biomaterials, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elahe Karami
- Department of Periodontics, School of Dentistry, Yazd University of Medical Sciences, Yazd, Iran
| | - Nazanin Vajar
- School of Dentistry, International Branch, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Rezaei Esfahrood
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mansour Meimandi
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Clinical Differences in Autofluorescence Between Viable and Nonvital Bone: A Case Report With Histopathologic Evaluation Performed on Medication-Related Osteonecrosis of the Jaws. J Oral Maxillofac Surg 2017; 75:1216-1222. [DOI: 10.1016/j.joms.2016.12.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 12/03/2016] [Accepted: 12/03/2016] [Indexed: 12/21/2022]
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26
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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: 195] [Impact Index Per Article: 27.9] [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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Fornaini C, Cella L, Oppici A, Parlatore A, Clini F, Fontana M, Lagori G, Merigo E. Laser and Platelet-Rich Plasma to treat Medication-Related Osteonecrosis of the Jaws (MRONJ): a case report. Laser Ther 2017; 26:223-227. [PMID: 29133970 DOI: 10.5978/islsm.17-cr-04] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 06/20/2017] [Indexed: 12/11/2022]
Abstract
Aims The appropriate management of Medication-Related OsteoNecrosis of the Jaw (MRONJ) is still a challenge for dentists and oral surgeons and in these last years high-technology instruments have been proposed at the different steps of interventions, also combined with promoters of tissue repair.The aim of this report is to show the advantages of a combined approach (laser and PRP) for the treatment of MRONJ. Methods It is described the case of a patient positive for MRONJ observed at the Odontostomatology and Maxillo-Facial Surgery Unit of the Hospital of Piacenza where surgical approach was performed by using different devices: Er:YAG laser (2940 nm) to remove and vaporize necrotic hard tissue until bleeding bone; Platelet-Rich Plasma (PRP) to stimulate hard and soft tissue healing; diode laser (808 nm) to biostimulate the surgical site. Results At the time of suture removal, wound closure was observed and the complete healing of the MRONJ site was observed for the 2 years follow up. Conclusion This case may suggest that this kind of combined approach during all the steps of MRONJ treatment allows to perform a faster and less invasive surgery with a more comfortable postoperative healing process and it represents an innovative approach in this severe adverse event.
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Affiliation(s)
- Carlo Fornaini
- Odontostomatology and Maxillo-Facial Surgery Unit - Special care dentistry "Guglielmo da Saliceto" Hospital - Piacenza - Italy.,UFR Odontologie - Université de Nice "Sophia Antipolis" - Nice - France
| | - Luigi Cella
- Odontostomatology and Maxillo-Facial Surgery Unit - Special care dentistry "Guglielmo da Saliceto" Hospital - Piacenza - Italy
| | - Aldo Oppici
- Odontostomatology and Maxillo-Facial Surgery Unit - Special care dentistry "Guglielmo da Saliceto" Hospital - Piacenza - Italy
| | - Anna Parlatore
- Immunohematology and Transfusion Medicine "Guglielmo da Saliceto Hospital - Piacenza - Italy
| | - Fabio Clini
- Odontostomatology and Maxillo-Facial Surgery Unit - Special care dentistry "Guglielmo da Saliceto" Hospital - Piacenza - Italy
| | - Matteo Fontana
- Odontostomatology and Maxillo-Facial Surgery Unit - Special care dentistry "Guglielmo da Saliceto" Hospital - Piacenza - Italy
| | - Giuseppe Lagori
- Odontostomatology and Maxillo-Facial Surgery Unit - Special care dentistry "Guglielmo da Saliceto" Hospital - Piacenza - Italy
| | - Elisabetta Merigo
- Odontostomatology and Maxillo-Facial Surgery Unit - Special care dentistry "Guglielmo da Saliceto" Hospital - Piacenza - Italy.,UFR Odontologie - Université de Nice "Sophia Antipolis" - Nice - France
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Vescovi P, Giovannacci I, Otto S, Manfredi M, Merigo E, Fornaini C, Nammour S, Meleti M. Medication-Related Osteonecrosis of the Jaw: An Autofluorescence-Guided Surgical Approach Performed with Er:YAG Laser. Photomed Laser Surg 2016. [PMID: 26226174 DOI: 10.1089/pho.2015.3927] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to propose an autofluorescence (AF)-guided surgical approach performed with Er:YAG laser and Nd:YAG low-level laser therapy (LLLT). BACKGROUND DATA Medication-related osteonecrosis of the jaw (MRONJ) therapy remains an unresolved problem. The proposed conservative and surgical treatment regimens are associated with contradictory success rates. However, the increased experience with MRONJ management suggests that surgical therapy can halt disease progression, and can allow a histology-based diagnosis of osteonecrosis. Surgical approach with Er:YAG laser is associated with significantly better results compared with medical treatment and traditional surgical approaches. One of the difficulties encountered during surgical removal of a MRONJ is the precise individuation of necrotic bone margins. PATIENT AND METHODS A case of Stage III maxillary osteonecrosis treated with a new surgical approach is presented. RESULTS After 7 months of follow-up, complete mucosal healing was evident, and the patient was free of symptoms. Such a technique allowed a highly accurate and minimally invasive approach through the selective ablation of the non-/hypofluorescent areas. CONCLUSIONS Taking into account the advantages of laser therapy and the possible effectiveness of AF in highlighting surgical margins, this approach would probably achieve excellent outcomes.
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Affiliation(s)
- Paolo Vescovi
- 1 Department of Biomedical, Biotechnological and Translational Sciences - Center of Oral Laser Surgery and Oral Pathology, Dental School, University of Parma , Parma, Italy
| | - Ilaria Giovannacci
- 1 Department of Biomedical, Biotechnological and Translational Sciences - Center of Oral Laser Surgery and Oral Pathology, Dental School, University of Parma , Parma, Italy
| | - Sven Otto
- 2 Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians Universität München , Munich, Germany
| | - Maddalena Manfredi
- 1 Department of Biomedical, Biotechnological and Translational Sciences - Center of Oral Laser Surgery and Oral Pathology, Dental School, University of Parma , Parma, Italy
| | - Elisabetta Merigo
- 1 Department of Biomedical, Biotechnological and Translational Sciences - Center of Oral Laser Surgery and Oral Pathology, Dental School, University of Parma , Parma, Italy
| | - Carlo Fornaini
- 1 Department of Biomedical, Biotechnological and Translational Sciences - Center of Oral Laser Surgery and Oral Pathology, Dental School, University of Parma , Parma, Italy
| | - Samir Nammour
- 3 Department of Dental Sciences, Faculty of Medicine, University of Liege , Liege, Belgium
| | - Marco Meleti
- 1 Department of Biomedical, Biotechnological and Translational Sciences - Center of Oral Laser Surgery and Oral Pathology, Dental School, University of Parma , Parma, Italy
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Rajitha Gunaratne GD, Khan R, Fick D, Robertson B, Dahotre N, Ironside C. A review of the physiological and histological effects of laser osteotomy. J Med Eng Technol 2016; 41:1-12. [DOI: 10.1080/03091902.2016.1199743] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Evaluation of Bone Healing After Osteotomies Prepared With Er:YAG Laser in Contact and Noncontact Modes and Piezosurgery—An Animal Study. J Oral Maxillofac Surg 2016; 74:18-28. [DOI: 10.1016/j.joms.2015.08.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/14/2015] [Accepted: 08/17/2015] [Indexed: 12/23/2022]
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Osteoradionecrosis of the Posterior Maxilla: A New Approach Combining Erbium: Yttrium Aluminium Garnet Laser and Bichat Bulla Flap. J Craniofac Surg 2015; 26:e627-9. [PMID: 26468848 DOI: 10.1097/scs.0000000000002136] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Osteoradionecrosis (ORN) of the jaw is a complication of radiation therapy for head and neck cancers. We report a case of ORN of the posterior maxilla treated with Er: YAG laser and a pedicled buccal fat pad (bichat bulla adipose) flap. A 69-year-old man presented complaining of pain on left maxilla. He had received high-dose radiotherapy (90 Gy) for squamous cell carcinoma of the left soft palate 2 years earlier. Clinical and radiographic examinations revealed ORN of the left maxillary molar region and maxillary sinusitis. Daily home care consisted of 0.9% saline irrigation and 0.8% H2O2 gel application. Sequestrectomy and tooth extraction were followed by debridement with Er: YAG laser and repair with a pedicled buccal fat pad flap. Complete resolution of ORN and maxillary sinusitis was established one year postsurgically. The excellent clinical outcome suggests that Er: YAG laser debridement and pedicled buccal fat pad flap are a viable option to treat ORN of the posterior maxilla.
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Er:YAG Laser Assisted Treatment of Central Odontogenic Fibroma of the Mandible. Case Rep Dent 2015; 2015:230297. [PMID: 26457211 PMCID: PMC4592713 DOI: 10.1155/2015/230297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 08/19/2015] [Accepted: 08/27/2015] [Indexed: 11/30/2022] Open
Abstract
Central odontogenic fibroma is a very rare benign odontogenic tumour characterized by a fibrous mature stroma with variable strands or islands of inactive-looking odontogenic epithelium. Our aim is to report a case of a central odontogenic fibroma and describe the clinical usefulness of Er:YAG laser for the surgical treatment of this tumour. A 74-year-old woman presented with an expansive lesion located in a mandible with multilocular and mixed radiographic appearance. A conservative excision using Er:YAG laser was performed. Complete removal was obtained. There were no postoperative complications. The histopatologic features were consistent with the diagnosis of central odontogenic fibroma of rich-epithelium type. No recurrence was observed during follow-up.
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Şalvarcı A, Altınay S. Mandibular osteonecrosis due to bisphosphonate use. Turk J Urol 2015; 41:43-7. [PMID: 26328198 DOI: 10.5152/tud.2015.90277] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 06/23/2014] [Indexed: 11/22/2022]
Abstract
Due to their efficient osteoclastic inhibitor effect in bone metabolism and antiangiogenic activity, bisphosphonates are widely used in many cancer diseases particularly in prostate cancers with bone metastasis, lung cancer, breast cancer and multiple myeloma, as well as in systemic diseases such as osteoporosis, osteopenia, Paget disease and osteogenesis imperfect for the last 13 years. Prostate cancer is a common cancer in males and it is the leading cause of bone metastasis. Mandibular metastasis is rarely encountered during the course of prostate cancer. Mandibular osteonecrosis as well has begun to be observed along with the availability of more efficient and stronger formulations developed following the use of bisphosphonates. Zolendronic acid, which has been used also by our patient, has widely come into practice as a 3(rd) generation bisphosphonate. Because of prostate cancer and widespread bone metastases, our patient has been receiving zolendronic acid with maximum androgen blockage for 4 years. Tomography of the patient, who has undergone intensive treatment because of submandibular abscess, demonstrated extensive osteonecrosis in the fovea sublingual region of the mandible corpus. In large series, although, mandibular osteonecrosis was widely seen due to bisphosphonate use for the metastases of lung and breast cancers, this rate was between 9.6% and 11% for prostate cancer within the series. Although our patient had no mandibular metastasis before, mandibular necrosis was observed due to long-term bisphosphonate use. We are going to present our patient who had this rare complication with his clinical picture.
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Affiliation(s)
| | - Serdar Altınay
- Department of Pathology, Bağcılar Training and Research Hospital, İstanbul, Turkey
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Mehari F, Rohde M, Knipfer C, Kanawade R, Klämpfl F, Adler W, Stelzle F, Schmidt M. Laser induced breakdown spectroscopy for bone and cartilage differentiation - ex vivo study as a prospect for a laser surgery feedback mechanism. BIOMEDICAL OPTICS EXPRESS 2014; 5:4013-23. [PMID: 25426327 PMCID: PMC4242035 DOI: 10.1364/boe.5.004013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 10/16/2014] [Accepted: 10/16/2014] [Indexed: 05/04/2023]
Abstract
Laser surgery enables for very accurate, fast and clean modeling of tissue. The specific and controlled cutting and ablation of tissue, however, remains a central challenge in the field of clinical laser applications. The lack of information on what kind of tissue is being ablated at the bottom of the cut may lead to iatrogenic damage of structures that were meant to be preserved. One such example is the shaping or removal of diseased cartilaginous and bone tissue in the temporomandibular joint (TMJ). Diseases of the TMJ can induce deformation and perforation of the cartilaginous discus articularis, as well as alterations to the cartilaginous surface of the condyle or even the bone itself. This may result in restrictions of movement and pain. The aim of a surgical intervention ranges from specific ablation and shaping of diseased cartilage, bone or synovial tissues to extensive removal of TMJ structures. One approach to differentiate between these tissues is to use Laser Induced Breakdown Spectroscopy (LIBS). The ultimate goal is a LIBS guided feedback control system for surgical laser systems that enables real-time tissue identification for tissue specific ablation. In the presented study, the authors focused on the LIBS based differentiation between cartilage tissue and cortical bone tissue using an ex-vivo pig model.
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Affiliation(s)
- Fanuel Mehari
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Strasse 6, 91052 Erlangen,
Germany
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Konrad-Zuse-Straße 3/5, 91052 Erlangen,
Germany
| | - Maximilian Rohde
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstrasse 11, 91054 Erlangen,
Germany
| | - Christian Knipfer
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstrasse 11, 91054 Erlangen,
Germany
| | - Rajesh Kanawade
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Strasse 6, 91052 Erlangen,
Germany
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Konrad-Zuse-Straße 3/5, 91052 Erlangen,
Germany
| | - Florian Klämpfl
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Strasse 6, 91052 Erlangen,
Germany
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Konrad-Zuse-Straße 3/5, 91052 Erlangen,
Germany
| | - Werner Adler
- Chair of Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstraße 6, 91054 Erlangen,
Germany
| | - Florian Stelzle
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Strasse 6, 91052 Erlangen,
Germany
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstrasse 11, 91054 Erlangen,
Germany
| | - Michael Schmidt
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Strasse 6, 91052 Erlangen,
Germany
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Konrad-Zuse-Straße 3/5, 91052 Erlangen,
Germany
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Pavone C, Perussi LR, de Oliveira GJPL, Scardueli CR, Cirelli JA, Cerri PS, Junior EM, Spolidorio LC, Marcantonio RAC. Effect of Er,Cr:YSGG laser application in the treatment of experimental periodontitis. Lasers Med Sci 2014; 30:993-9. [PMID: 24477391 DOI: 10.1007/s10103-014-1526-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 01/13/2014] [Indexed: 11/24/2022]
Abstract
The purpose of this study was to evaluate the influence of an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser in the absence or presence of manual scaling and root planning (SRP) for the treatment of induced periodontitis in rats. Ligatures were placed in the subgingival region of the maxillary first molar. After a 7-day period, the ligatures were removed, and 40 rats were randomly divided into four groups (G), as follows: (GI) no treatment, (GII) scaling and root planning (SRP) with curettes, (GIII) Er,Cr:YSGG laser irradiation and (GIV) SRP with curettes followed by Er,Cr:YSGG laser irradiation. Seven and 30 days after the treatment, the animals were sacrificed and histologic, histometric and immunohistochemistry analyses were performed. All groups showed similar histopathological characteristics during the evaluation period. The histometric analysis was confirmed using Bonferroni and paired t tests. At 7 and 30 days, groups II, III and IV exhibited greater bone formation in the furcation area when compared to group I (p < 0.0001; p < 0.05). During the 7-day period, the groups irradiated with the laser (III and IV) showed a statistically larger new bone area than the group treated with SRP (II) (p < 0.01). Immunohistochemistry analysis revealed that the control group exhibited a higher expression of tartrate-resistant acid phosphatase (TRAP) and the receptor activator of nuclear factor κΒ ligand (RANKL) when compared to groups II, III and IV (p < 0.05). All treatments were able to reduce the inflammatory processes, consequently enabling the repair of periodontal tissues. The results achieved with the application of the Er,Cr:YSGG laser suggest that this laser can stimulate greater bone formation, especially over a shorter period of time.
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Affiliation(s)
- Chaine Pavone
- Araraquara Dental School-São Paulo State University "Júlio de Mesquita Filho", Araraquara, São Paulo, Brazil
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Plötz C, Schelle F, Bourauel C, Frentzen M, Meister J. Ablation of porcine bone tissue with an ultrashort pulsed laser (USPL) system. Lasers Med Sci 2014; 30:977-83. [PMID: 24458532 DOI: 10.1007/s10103-014-1520-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 01/08/2014] [Indexed: 11/29/2022]
Abstract
Ultrashort pulsed lasers (USPLs) represent a new generation of laser systems in the field of biophotonical applications. In terms of a pilot project, the study was carried out to evaluate the ablation parameters of bone tissue regarding the medical use of such a laser technology in dentistry. Specimens from ribs of freshly slaughtered pigs were assembled and irradiated with an USP Nd:YVO4 laser (pulse duration 8 ps at 1,064 nm with repetition rates between 50 and 500 kHz) using eligible average output powers in the range of 3.5-9 W and fluences between 1 and 2.5 J/cm(2). Square-shaped cavities of 1-mm edge length in the bone compacta were created employing a scanner system. Cavities were analyzed with an optical profilometer to determine the ablated volume. Ablation rate was calculated by the ablated volume and the recorded irradiation time by the scanner software. Additionally, samples were examined histologically to investigate side effects of the surrounding tissue. Formed cavities showed a precise and sharp-edged appearance in bone compacta. Optimized ablation rate of 5.2 mm(3)/min without any accompanying side effects was obtained with an average output power of 9 W, a pulse repetition rate of 500 kHz, and an applied fluence of 2.5 J/cm(2). Provided that the used laser system will be advanced and adjusted for clinical applications, the outcome of this study shows auspicious possibilities for the use of USPL systems in the preparation of bone tissue.
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Affiliation(s)
- Christina Plötz
- Department of Operative and Preventive Dentistry, Dental Faculty, Bonn University, Welschnonnenstrasse 17, 53111, Bonn, Germany
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Efficacy of Bone Healing in Calvarial Defects Using Piezoelectric Surgical Instruments. J Craniofac Surg 2014; 25:149-53. [DOI: 10.1097/scs.0000000000000382] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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A report on the use of Er:YAG laser for pilot hole drilling prior to miniscrew insertion. Lasers Med Sci 2013; 30:605-9. [PMID: 23793415 DOI: 10.1007/s10103-013-1374-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 06/10/2013] [Indexed: 10/26/2022]
Abstract
The aim of the present in vitro study was to investigate the required time period of the Er:YAG laser that is used for drilling through cortical bone when pilot hole drilling is needed before miniscrew insertion. Even though Er:YAG laser is used in various in vivo and in vitro studies, there is no accepted procedure of laser for depth control during drilling through cortical bone. The study sample consisted of 120 cortical bone segments having 1.5 and 2.0 mm of cortical bone thickness. An Er:YAG laser, with a spot size of 1.3 mm and an air-water spray of 40-50 ml/min, was used. The laser was held 2 mm away from and perpendicular to the bone surface with different laser settings. Twelve specimens were prepared for each subgroup. As the cortical bone thickness increased, the time needed to drill through the bone increased. Frequency increase directly caused a decrease in irradiation duration. When three different frequency, three different energy, and four different power values were tested for both the 1.5- and 2-mm cortical bone thicknesses, the shortest duration needed to drill through cortical bone was seen in the 3.6-W (300 mJ-12 Hz) setting. When pilot holes are drilled prior to miniscrew placement in 1.5 to 2 mm of cortical bone using Er:YAG laser, the most appropriate value is found with the 3.6-W (300 mJ-12 Hz) setting.
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Histological and SEM analysis of root cementum following irradiation with Er:YAG and CO2 lasers. Lasers Med Sci 2012; 28:203-13. [PMID: 22580557 DOI: 10.1007/s10103-012-1110-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 04/17/2012] [Indexed: 12/15/2022]
Abstract
Recently, the Er:YAG and CO(2) lasers have been applied in periodontal therapy. However, the characteristics of laser-irradiated root cementum have not been fully analyzed. The aim of this study was to precisely analyze the alterations of root cementum treated with the Er:YAG and the CO(2) lasers, using non-decalcified thin histological sections. Eleven cementum plates were prepared from extracted human teeth. Pulsed Er:YAG laser contact irradiation was performed in a line at 40 mJ/pulse (14.2 J/cm(2)/pulse) and 25 Hz (1.0 W) under water spray. Continuous CO(2) laser irradiation was performed in non-contact mode at 1.0 W, and ultrasonic instrumentation was performed as a control. The treated samples were subjected to stereomicroscopy, scanning electron microscopy (SEM), light microscopy and SEM energy dispersive X-ray spectroscopy (SEM-EDS). The Er:YAG laser-treated cementum showed minimal alteration with a whitish, slightly ablated surface, whereas CO(2) laser treatment resulted in distinct carbonization. SEM analysis revealed characteristic micro-irregularities of the Er:YAG-lased surface and the melted, resolidified appearance surrounded by major and microcracks of the CO(2)-lased surface. Histological analysis revealed minimal thermal alteration and structural degradation of the Er:YAG laser-irradiated cementum with an affected layer of approximately 20-μm thickness, which partially consisted of two distinct affected layers. The CO(2)-lased cementum revealed multiple affected layers showing different structures/staining with approximately 140 μm thickness. Er:YAG laser irradiation used with water cooling resulted in minimal cementum ablation and thermal changes with a characteristic microstructure of the superficial layer. In contrast, CO(2) laser irradiation produced severely affected distinct multiple layers accompanied by melting and carbonization.
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Jung MK, Kim SG, Oh JS, Jin SC, Lee SY, Jang ES, Piao ZG, Lim SC, Jeong MA. A Comparative Histological Study of Bone Healing in Rat Calvarial Defect Using the Erbium-Doped Yttrium Aluminum Garnet Laser and Rotary Instruments. JAPANESE JOURNAL OF APPLIED PHYSICS 2012. [DOI: 10.1143/jjap.51.01ae02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Bolortuya G, Ebihara A, Ichinose S, Watanabe S, Anjo T, Kokuzawa C, Saegusa H, Kawashima N, Suda H. Initial fibroblast attachment to Erbium:YAG laser-irradiated dentine. Int Endod J 2011; 44:1134-44. [PMID: 21851368 DOI: 10.1111/j.1365-2591.2011.01934.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AIMS To evaluate the effects of Erbium (Er):YAG laser irradiation on the morphology of resected dentine surfaces, and to investigate fibroblast attachment to laser-irradiated dentine surfaces. METHODOLOGY Dentine blocks obtained from single-rooted human teeth were divided into the following groups after sterilization in an autoclave: (i) Laser group treated with Er:YAG laser irradiation (30 mJ per pulse, 10 pps, 60 s); (ii) L-MTAD group treated with laser irradiation as in (i) plus a mixture of doxycycline, tetracycline isomer and citric acid; (iii) RC-Prep group treated with EDTA gel or cream (RC-Prep) and (iv) Control group left untreated. After each treatment, the dentine blocks were incubated with NIH/3T3 fibroblasts cultured to subconfluency in Dulbecco's modified Eagle's medium supplemented with 10% foetal bovine serum and antibiotics. The number of attached cells amongst the groups was analysed statistically at the 5% significance level. The dentine surface morphologies and cell attachments were evaluated by counting assays, histological observations and scanning electron microscopy (SEM). RESULTS The number of attached cells was significantly higher (P < 0.05) in the Laser group than in the RC-Prep and Control groups at 16 h. Dendritic cell extension of the fibroblasts was only observed in the Laser group at 8 h by SEM. In the histological analyses, significantly more attached cells were found on the dentine surfaces treated with laser irradiation. CONCLUSIONS Er:YAG laser irradiation induced morphological alterations in dentine surfaces, which may improve the attachment of fibroblasts to dentine.
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Affiliation(s)
- G Bolortuya
- Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Mozzati M, Martinasso G, Cocero N, Pol R, Maggiora M, Muzio G, Canuto RA. Influence of superpulsed laser therapy on healing processes following tooth extraction. Photomed Laser Surg 2011; 29:565-71. [PMID: 21631375 DOI: 10.1089/pho.2010.2921] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE This research studied the effects of laser therapy on healing processes following tooth extraction in healthy human subjects, evaluating some inflammation, osteogenesis, and clinical parameters. BACKGROUND DATA Alveolar healing following tooth extraction is a complex repair process involving different types of tissues, including epithelium and bone. Therefore, it can be advantageous to use techniques able to influence the healing of all tissues. PATIENTS AND METHODS Ten healthy human subjects with indications for bilateral tooth extraction entered the split-mouth study. The subject/patient becomes his/her own control, thereby eliminating all individual differences in response to laser treatment. This consisted of: 904-nm laser, 33 W peak power, 30 KHz, 200 ns, average power 200 mW, illuminated area 1 cm(2), 200 mW/cm(2), 15 min, 180 J, 180 J/cm(2). In each patient, one post-extraction site was treated with laser radiation, whereas the other was left untreated as a control. Soft-tissue specimens were removed from the extraction site before tooth extraction (T0) and 7 days after from extraction (T7); expression of inflammatory and osteogenesis parameters was evaluated on these specimens. The clinical parameter "pain" was evaluated for each subject. RESULTS Superpulsed laser irradiation prevented the increase of interleukin (IL)-1β, IL-6, IL-10, and cyclooxygenase-2 (COX-2), and induced an insignificant increase in collagen at 7 days after extraction, versus levels on day of extraction; no changes were found in the other parameters examined. Patients reported less pain at the site treated with superpulsed laser irradiation than at the control site. CONCLUSIONS This study suggests that superpulsed laser irradiation may be a treatment of choice for patients scheduled for tooth extraction, as it provides clinical efficacy, is safe and well tolerated, and is able to prevent inflammation.
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Affiliation(s)
- Marco Mozzati
- Oral Surgery Unit, Dentistry Section, Department of Biomedical Sciences and Human Oncology, School of Dentistry, University of Turin, Turin, Italy
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Luomanen M, Alaluusua S. Treatment of bisphosphonate-induced osteonecrosis of the jaws with Nd:YAG laser biostimulation. Lasers Med Sci 2011; 27:251-5. [PMID: 21597949 DOI: 10.1007/s10103-011-0929-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 04/18/2011] [Indexed: 11/28/2022]
Affiliation(s)
- Marita Luomanen
- Institute of Biomedicine/Anatomy, University of Helsinki, Helsinki, Finland.
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Izumi Y, Aoki A, Yamada Y, Kobayashi H, Iwata T, Akizuki T, Suda T, Nakamura S, Wara-Aswapati N, Ueda M, Ishikawa I. Current and future periodontal tissue engineering. Periodontol 2000 2011; 56:166-87. [DOI: 10.1111/j.1600-0757.2010.00366.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Kesler G, Shvero DK, Tov YS, Romanos G. Platelet Derived Growth Factor Secretion and Bone Healing After Er:YAG Laser Bone Irradiation. J ORAL IMPLANTOL 2011; 37 Spec No:195-204. [DOI: 10.1563/aaid-joi-d-09-00120.1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Er:YAG laser irradiation has been reported to enhance wound healing. However, no studies have evaluated the synthesis of growth factors after laser irradiation. The present study investigated the effects of laser irradiation on the amount of secretion of platelet derived growth factor (PDGF) in the wound, clarifying the effects of the Er:YAG laser on the bone healing. Osteotomies were prepared in the tibiae of 28 rats using an Er:YAG laser (test group). Maximum power of 8 watts, energy per pulse of 700 mJ, and frequency up to 50 Hz were used. The laser was used with external water irrigation, a spot size of 2 mm, energy per pulse of 500 to 1000 mJ/pulse, and energy density of 32 J/cm2. Twenty eight additional rats served as a control group and their osteotomies were prepared with a drill 1.3 mm in diameter at 1000 rpm, with simultaneous saline irrigation. Two rats from the tested group and 2 from the control group were sacrificed on each day following surgery (1–14 days), and the tissue specimens were prepared for histologic evaluation. Immunohistochemical staining with anti-PDGF was performed after histologic examination. The difference between the PDGF staining intensities of the 2 treatment groups was analyzed using a multivariate logistic regression test. A significant rise in PDGF staining occurred in both groups 2–3 days following surgery. However, while high PDGF counts remained for the 2-week experimental period in the laser group, PDGF levels in the control group returned to baseline levels 8 days post surgery. The 2 groups (laser and control) were found to be different throughout the experiment, and the rat type was found to be a significant predictor (P = .000011). The present study demonstrated that Er:YAG laser irradiation seems to stimulate the secretion of PDGF in osteotomy sites in a rat model. It is possible that the high levels of PDGF are part of the mechanism that Er:YAG irradiation enhances and improves the healing of osteotomy sites.
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Affiliation(s)
- Gavriel Kesler
- Dental Laser Clinic, Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | | | - George Romanos
- Eastman Dental Center, Division of Periodontology, Unit of Laser Dentistry, University of Rochester, Rochester, NY
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Rugani P, Acham S, Truschnegg A, Obermayer-Pietsch B, Jakse N. Bisphosphonate-associated osteonecrosis of the jaws: surgical treatment with ErCrYSGG-laser. Case report. ACTA ACUST UNITED AC 2011; 110:e1-6. [PMID: 21112522 DOI: 10.1016/j.tripleo.2010.08.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 07/13/2010] [Accepted: 08/08/2010] [Indexed: 11/25/2022]
Abstract
Bisphosphonates (BP) play an important role in concomitant therapy of certain types of cancer and multiple myeloma as well as in treatment of osteoporosis. The administration of BP has great therapeutic benefits, but correlates with a specific kind of osteonecrosis of the alveolar bone. The so-called bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a rare, but often severe adverse side effect of high-dosage and long-term BP therapy. Thus far, no consensus for treatment of BRONJ has been achieved. All strategies have to take into account the insecure prognosis and danger of recurrence of clinically apparent necrosis and progression of disease. At the Department of Oral Surgery and Radiology, Medical University of Graz, an ErCrYSGG laser was successfully applied in surgical treatment of BRONJ. Stable mucosal coverage could be achieved in all of 5 cases. Laser surgery can be considered as a promising technique for the effective treatment of BRONJ.
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Affiliation(s)
- Petra Rugani
- Department of Oral Surgery and Radiology, Medical University of Graz, Graz, Austria.
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Superpulsed laser therapy on healing process after tooth extraction in patients waiting for liver transplantation. Lasers Med Sci 2011; 27:353-9. [DOI: 10.1007/s10103-010-0880-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 12/29/2010] [Indexed: 11/26/2022]
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Gomes PS, Fernandes MH. Rodent models in bone-related research: the relevance of calvarial defects in the assessment of bone regeneration strategies. Lab Anim 2010; 45:14-24. [PMID: 21156759 DOI: 10.1258/la.2010.010085] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In vivo research with animal models has been a preferred experimental system in bone-related biomedical research since, by approximation, it allows relevant data gathering regarding physiological and pathological conditions that could be of use to establish more effective clinical interventions. Animal models, and more specifically rodent models, have been extensively used and have contributed greatly to the development and establishment of a wide range of translational approaches aiming to regenerate the bone tissue. In this regard, the calvarial defect model has found great application in basic and applied research, nonetheless the controversial rationalization for the use of critical size defects - defects that are unable to report spontaneous healing - or subcritical size defects in the proposed applications. Accordingly, this work aims to review the advantages and limitations of the use of rodent models in biomedical bone-related research, emphasizing the problematic issues of the use of calvarial critical and subcritical size defects. Additionally, surgical protocols for the establishment of both defects in rat calvarial bone, as well as the description and exemplification of the most frequently used techniques to access the bone tissue repair, are portrayed.
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Affiliation(s)
- P S Gomes
- Laboratory of Pharmacology and Cellular Biocompatibility, Faculty of Dental Medicine, U Porto, R Dr Manuel Pereira da Silva, 4200-393 Porto, Portugal.
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Cloutier M, Girard B, Peel SA, Wilson D, Sándor GK, Clokie CM, Miller D. Calvarial bone wound healing: a comparison between carbide and diamond drills, Er:YAG and Femtosecond lasers with or without BMP-7. ACTA ACUST UNITED AC 2010; 110:720-8. [DOI: 10.1016/j.tripleo.2010.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 03/21/2010] [Accepted: 04/05/2010] [Indexed: 10/19/2022]
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