Use of both the diode and Er: YAG lasers in esthetic crown lengthening with the aid of digitally guided dual technique: 3 years follow-up

OBJECTIVE

To explore the feasibility of the usage of digital guides in combination with low- and high-power lasers for the treatment of excessive gingival display, also known as "gummy smile".

CLINICAL CONSIDERATIONS

Excessive gingival display due to altered passive eruption can affect patient's perception of their own esthetics and consequently have an impact on self-confidence. Therefore, the management of this condition should offer a predictable and stable long-lasting solution. To attain these objectives, digital planning emerges as a tool in optimizing the outcomes of crown lengthening surgery for this condition by enhancing precision through the use of surgical guides. Additionally, the usage of high- and low-powered lasers can provide a safe approach because of their tissue selective removal properties.

CONCLUSIONS

The technique described showed satisfactory clinical results in the short- and long-term follow-up, leading to an improvement in patients' self-esteem. This approach integrates digital and laser technologies to deliver a surgical treatment characterized by precision, efficiency, and safety.

CLINICAL SIGNIFICANCE

Digital dentistry has contributed to innovative dental procedures, as personalizing surgical guides for patients, assisting and guiding incisions of the gingival margins, as well as the extension of the osteotomy, during the procedures for increasing the clinical crown. Furthermore, smile esthetics are directly related to an individual's improved emotional and social quality of life.

Comparison of pain and healing period after frenectomy using diode laser and Er:YAG laser: randomized controlled trial

OBJECTIVES

The frenum is a mucous membrane fold that attaches the lip and the cheek to the alveolar mucosa, the gingiva, and the underlying periosteum. Frenectomy is the surgical removal of the whole frenum, including the area connected to the bones. This study's purpose was to compare the healing period and postsurgical pain experienced by patients operated with diode and erbium:yttrium-aluminium-garnet (Er:YAG) lasers.

METHODS

Twenty referred patients need to excision of the abnormal upper labial frenum were included in this study. Patients were randomly assigned into two groups; Diode group (810 nm, 2W, continuous emission, initiated tip) and Er:YAG group (2940 nm, 2W, 200 mJ, 10 Hz). Both lasers were applied in contact mode. Post-operative pain was assessed with Numerical Rating Scale (NRS) at post-operative 3rd hour and every day during the first week. Epithelialization process of the wound surface was evaluated by hydrogen peroxide solution applied to the wound on days 7, 14, 30, 60 and 90 following operations.

RESULTS

The result shows mean values in Pain index after 3 hours (Diode Group 2.1±2.0, Er:YAG Group 2.6±1.4), 1st day (Diode Group 1.1±1.1, Er:YAG Group 1.9±1.4), and 2nd day (Diode Group 0, Er:YAG Group 0.9±1.1) and shows no significant difference after (3-7 days); p =1.00). In Healing index the results shows a significant difference between the Diode Group and the Er:YAG Group (after 7 days; p = 0.029 and 14 days; p = 0.001) and show no significant difference after (30-60-90 days; p = 1.00).

CONCLUSIONS

The Er:YAG laser has better clinical results in healing wounds, whereas the diode laser is better in decreasing pain after frenectomy during follow-up periods.

A Novel Therapeutic Approach of 980 nm Photobiomodulation Delivered with Flattop Beam Profile in Management of Recurrent Aphthous Stomatitis in Paediatrics and Adolescents-A Case Series with 3-Month Follow-Up

Background/Objectives: Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal lesions and a very debilitating lesion, especially in paediatric and adolescent patients. The current pharmacotherapy offers a pain relief but not without side effects, and therefore photobiomodulation (PBM) can be an alternative therapy. To the authors' best knowledge, no published study has explored the efficacy of λ 980 nm laser PBM in the management of all RAS subtypes in paediatric and adolescent patients, and therefore, this prospective observational clinical study was conducted to bridge this gap by evaluating λ 980 nm laser PBM efficacy in symptomatic RAS management in paediatric and adolescent patients. The objectives were to evaluate (1) pain intensity alleviation; (2) wound healing rate; (3) wound size closure; (4) a complete resolution; (5) evidence of recurrence; and (6) patients' treatment satisfaction. Methods: The study's variables were assessed at the following timepoints: T0: pre-treatment; T1: immediately after first PBM session; T2: 5 hours (h) post first PBM session (via telephone call); T3: immediately after second PBM session (three days post first PBM session); T4: three-day follow-up (after complete PBM treatments); T5: two-week follow-up; and T6: three-month follow-up. The following PBM dosimetry and treatment protocols were employed: λ 980 nm; 300 mW; 60 s; 18 J; CW; flattop beam profile of 1 cm2 spot size; 18 J/cm2; and twice-a-week irradiation (72 h interval). Results: At T1, significant immediate pain intensity relief was reported. 33.33% recorded "4" and 66.67% reported "5" on the quantitative numeric pain intensity scale (NPIS), and this continued to improve significantly (83.33%) at T2. All the subjects reported "0" on the NPIS at T3, T4, T5 and T6. There was a significant reduction in the lesion surface area (>50% complete healing) at T3 compared to T0. Complete healing (100%) with no evidence of scarring and lesion recurrence observed at T4, T5 and T6. Very good patients' satisfaction was reported at all timepoints. Conclusions: This is the first report demonstrating λ980 nm efficacy in all RAS subtype management in paediatric and adolescent patients with a 3-month follow-up, whereby its PBM dosimetry and treatment protocols were effective from scientific and practical standpoints, and hence multicentre RCTs with large data are warranted to validate its reproducibility and to enrich the knowledge of PBM application in all RAS subtypes.

Injectable platelet rich fibrin effect on laser depigmented gingiva: a clinical randomized controlled split mouth trial with histological assessment

OBJECTIVE

To determine whether intra-mucosal injection of injectable platelet-rich fibrin (i-PRF) can promote healing after Diode Laser Gingival Depigmentation (DLGD).

METHODOLOGY

A total of 20 arch sites of hyperpigmented gingiva of 10 patients underwent DLGD. For each patient, two arch sites were randomly assigned for either intra-mucosal injection of i-PRF (G1-i-PRF) (n=10 sites) or no treatment (G2-Control): (n=10 sites). Wound Healing Score (WHS), patient satisfaction, and Pigmentation Index (DOPI) were measured at 1 week and 1 and 3 months postoperatively. Histological assessment of tissue specimens was performed at baseline and 1 week.

RESULTS

The percentage change in WHS at 1 week was significantly higher in G1 (58.34±15.43) compared to G2 (37.50±11.79). At day 1, 50% of patients in G1 were pain free compared with 75% in G2, who had mild pain. Mean DOPI decreased significantly at 3 months in both groups (P-value <0.001), without significant differences between groups. G1 specimens showed significantly higher epithelial thickness (P-value <0.001), as well as a higher number of blood vessels and less percentage of inflammatory cells.

CONCLUSIONS

i-PRF demonstrated better clinical and histological healing potential and less patient discomfort compared to sites without treatment after DLGD. Registered at https://clinicaltrials.gov/ as (NCT05283668).

Trunk hair removal treatment with diode laser 810 nm in men population

In the last years, hair removal has been one of the most common treatments performed for aesthetic purposes, especially in women. Nevertheless, even if it is less popular, the demand within men population has risen. The study aimed to assess the acceptability of the diode 810 nm treatment for hair removal on the back and chest area in men thanks to the speed of treatment and the absence of undesirable effects. For this study, 20 patients were treated for hair removal. They were men with a mean age of 30.5 (±7.3). They underwent 4 treatment sessions at 40-day intervals on the trunk (chest and back area). Patients ranged between a Fitzpatrick phototype I (20%, 4/20) to IV (15%, 3/20) (40% were type II and 25% type III). Moreover, patients were asked to report pain intensity sensation with a visual analogue scale. Overall, in the study population, a hair reduction of 80.6% (±2.8) was registered in the treated areas. The device described in this study was demonstrated to be highly efficient in extended body areas and on difficult-to-treat hair follicles like on the back and chest in the men population.

Micropulse transscleral cyclophotocoagulation in canine glaucoma: A retrospective study evaluating sweep velocity

OBJECTIVE

To report preliminary results of MP-TSCP in canine patients with glaucoma while evaluating sweep velocity, treatment efficacy, and safety utilizing standardized surgical parameters.

ANIMAL STUDIED

Client-owned dogs that underwent MP-TSCP at a veterinary referral hospital.

PROCEDURE

Medical records of 19 eyes (14 dogs) treated with MP-TSCP were reviewed. Eleven eyes were treated with a 10 s/sweep (s) velocity and 8 eyes with a 20 s/s. Laser duty cycle was set at 31.3%, mean laser energy was 2766 mW, and mean duration was 120 s per hemisphere. Minimum post-operative follow-up was 6 months. Outcomes of intraocular pressure (IOP), vision status, degree of antiglaucoma medications, and complications were evaluated.

RESULTS

There was a significantly lower median (IQR) IOP (<25 mmHg) at each timepoint postoperatively compared to IOP pre-operatively (p < 0.05). The overall success rate for IOP control at 6 months was 84%, 100% for the 10 s/s and 62.5% for the 20 s/s. Vision was preserved in 10/11 (90%) eyes from the 10 s/s group and 4/8 (50%) eyes from the 20 s/s group at 6 months. Average number of glaucoma medications in the 10 s/s group decreased from 4.4 to 1.5 and from 3.3 to 2.5 in the 20 s/s group. Post-operative complications were mild and resolved within 1 week.

CONCLUSIONS

MP-TSCP is a non-invasive treatment alternative for canine glaucoma. Employing higher energy levels rendered long-term IOP control while retaining a high safety profile with minimal postoperative complications. There was no statistical difference between a 10 s/s and 20 s/s surgical velocity, both leading to successful surgical outcomes up to 6 months post-operatively.

The outcomes of diode laser transscleral cyclophotocoagulation in refractory primary angle-closure glaucoma in a South Indian population

BACKGROUND

The surgical intervention of refractory primary angle-closure glaucomas (PACGs) is a big challenge to any ophthalmologist since the efficacy of lens extraction in eyes with a long duration of angle closure is limited. Also, trabeculectomy in such eyes is not without vision-threatening complications.

PURPOSE

To evaluate the efficacy and safety of diode laser transscleral cyclophotocoagulation (CPC) in eyes with refractory PACG.

METHODS

A retrospective study analyzing all patients who underwent CPC for refractory PACG in the year 2019 was conducted. Out of the 68 patients recruited, 56 PACG patients fulfilled the study criteria.

RESULTS

The mean age of the participants was 58.5 years. The mean (standard deviation [SD]) intraocular pressure (IOP) at baseline was 38.91 (14.86) mmHg, and it ranged from 21 to 74 mmHg. Participants' mean (SD) follow-up duration was 11.87 (7.83) months. Almost 90.9% of eyes showed IOP reduction from baseline during the follow-up period. There was also a reduction in the mean antiglaucoma medications (AGM) to 2.67 (1.29) in the final follow-up visit compared to the baseline of 3.30 (0.81). Chronic hypotony was noted in four eyes, out of which phthisis bulbi occurred in one eye. Six eyes underwent additional incisional surgical procedures.

CONCLUSION

The outcomes from our study support the role of transscleral diode laser CPC in the interim optimization of IOP in PACG eyes refractory to other modalities. This is emerging as a primary treatment option to optimize IOP to safer limits before any planned incisional procedure. Though complications like chronic hypotony occur as anticipated, vision-threatening complications are rare.

Evaluation and Comparison for the Efficacy of 810 nm Diode Laser, Nano Carbonate Apatite and Their Combination Over Dentinal Tubules Occlusion: An In Vitro Scanning Electron Microscopic Study

BACKGROUND

Dentin hypersensitivity (DH) involves sensitive symptoms, because of exposure of the dentinal tubules. Various materials have been utilized to occlude dentinal tubules for the treatment of DH. Here is a comparative evaluation of nano-carbonate apatite (n-CAP), diode laser, and their combination over the occlusion of dentinal tubules.

MATERIALS AND METHOD

Ten intact first premolars were used in this study, out of which 40 dentin disk specimens were obtained by hard tissue microtomy. Four study groups were formulated out of which one was the control group and the remaining three were test groups. Scanning electron microscopy (SEM) was done to evaluate the diameter of the dentinal tubules in each group.

RESULTS

On examining data, it was observed that the mean diameter of dentinal tubules in four study groups of control, laser, n-CAP, and n-CAP + laser was found to be 3.40, 2.00, 0.46, and 0.02 respectively. This shows the significant reduction in the diameter of dentinal tubules in the test groups when compared with the control group.

CONCLUSION

Among all the measures used to see for a reduction in the diameter of dentinal tubules, the combination group was found to be most occluding, though each of the groups also had a significant reduction in the diameter of dentinal tubules. The present study showed that combination therapy offers a promising means of treating DH in a clinical setting when compared with the treatment of DH n-CAP containing dentifrice or laser irradiation alone.

Red/Orange Autofluorescence in Selected Candida Strains Exposed to 405 nm Laser Light

BACKGROUND

Candida albicans and similar species are significant pathogens in immunocompromised and hospitalized individuals, known for mucosal colonization and bloodstream/organ invasion. Many pathogenic fungi, including these species, exhibit autofluorescence (R/OF) under specific light conditions, a feature crucial for their detection.

AIM

We investigated the use of a 405 nm diode laser for the direct observation of red/orange autofluorescence of Candida spp., common in the oral cavity, exploring its potential in health screenings.

METHODS

This study utilized cultures of Candida spp. on Sabouraud dextrose agar with Qdot 655 and 685 for fluorescence benchmarking, illuminated using a 405 nm diode laser (continuous wave, power 250 mW, 0.0425 J/cm² fluence, 0.0014 W/cm² power density). Images were captured using a yellow-filter camera at set intervals (48 to 144 h). Visual and computational analyses evaluated the R/OF in terms of presence, intensity, coloration, and intra-colony variation.

RESULTS

Most Candida strains displayed red/orange autofluorescence at all observation times, characterized by varied coloration and intra-colony distribution. Initially, there was an increase in R/OF intensity, which then stabilized in the later stages of observation.

CONCLUSIONS

The majority of the Candida strains tested are capable of emitting R/OF under 405 nm laser light. This finding opens up new possibilities for integrating R/OF detection into routine dental screenings for Candida spp.

Use of Diode Laser in Hysteroscopy for the Management of Intrauterine Pathology: A Systematic Review

Background: Hysteroscopy currently represents the gold standard for the diagnosis and treatment of intrauterine pathologies. Recent technological progress has enabled the integration of diagnostic and operative time, leading to the "see and treat" approach. Diode laser technology is emerging as one of the most innovative and intriguing techniques in this context. Methods: A comprehensive search of the literature was carried out on the main databases. Only original studies reporting the treatment of intrauterine pathologies using diode laser were deemed eligible for inclusion in this systematic review (PROSPERO ID: CRD42023485452). Results: Eight studies were included in the qualitative analysis for a total of 474 patients undergoing laser hysteroscopic surgery. Eighty-three patients had female genital tract abnormalities, 63 had submucosal leiomyomas, 327 had endometrial polyps, and one patient had a scar pregnancy. Except for leiomyomas, whose technique already included two surgical times at the beginning, only seven patients required a second surgical step. Cumulative rates of intraoperative and postoperative complications of 2.7% and 0.6%, respectively, were reported. Conclusions: Diode laser through "see and treat" hysteroscopy appears to be a safe and effective method. However, additional studies with larger sample sizes and improved designs are needed to consolidate the evidence currently available in the literature.

Diode Laser-Assisted Pulp Polyp Excision and Canal Disinfection in a Primary Molar: A Case Report

This case report presents the successful application of diode laser technology in the management of a pulp polyp in a primary molar, showcasing its efficacy in both excision of the proliferative tissue and subsequent canal disinfection. An eight-year-old patient with a symptomatic primary molar exhibiting a pulp polyp was selected for this intervention. The diode laser, with its specific wavelength and precise tissue interaction, allowed for a minimally invasive and efficient removal of the pulp polyp. Additionally, the laser was utilized for thorough disinfection of the root canals, targeting bacterial pathogens while preserving surrounding healthy tissue. The case was monitored over a three-month follow-up period, demonstrating favorable clinical and radiographic outcomes. This report emphasizes the potential of diode laser technology as a feasible adjunct in the treatment of pulp polyps in primary molars, showcasing its benefits in terms of reduced invasiveness, enhanced precision, and effective canal disinfection in pediatric endodontics.

Lingual Frenotomy in Pediatric Ankyloglossia: A Diode Laser Approach in Two Case Reports

Ankyloglossia can be related to a number of complications, such as breastfeeding difficulties or alterations in craniofacial development. Treatment can involve surgery to correct the altered lingual frenulum and can be performed by various techniques. The purpose of this paper is to present two case reports of ankyloglossia in pediatric patients of different ages, the diagnostic criteria, and the treatment decision rationale, which led to a lingual frenotomy performed with a diode laser.

Excision of Solitary Non-syndromic Oral Plexiform Neurofibroma Utilizing a Diode Laser: A Case Report

Plexiform neurofibroma is a benign peripheral nerve sheath tumor known to be pathognomonic for neurofibromatosis type 1. However, solitary plexiform neurofibroma in the oral cavity is extremely rare. Herein, we presented a 73-year-old Saudi male with solitary plexiform neurofibroma located on the maxillary alveolar ridge, which was excised successfully using a 940 nm diode laser. Microscopic examination revealed a multinodular arrangement of benign spindle cells in a haphazard pattern. Immunohistochemical analysis showed positive staining for S100 and CD34 in the tumor cells.

MicroPulse™ transscleral cyclophotocoagulation in the equine patient: A case series of four horses

OBJECTIVE

To describe the clinical application and outcome of MicroPulse™ transscleral cyclophotocoagulation (MP-TSCPC) treatment in horses with glaucoma.

ANIMALS STUDIED

Four client-owned horses with primary (n = 2) or secondary (n = 2) glaucoma.

METHODS

Horses were treated with MP-TSCPC under standing sedation with a minimum of 30 days of follow-up (range 30-1241 days). Affected eyes were treated with a 31.3% duty cycle and 3000 mW laser power for a total of 180 s. Data collected included signalment, pre- and post-procedure intraocular pressures (IOPs), laser settings, medications, complications, and repeat therapy.

RESULTS

Four horses (5 eyes) received at least one treatment with MP-TSCPC. Mean preoperative IOP was 44 mmHg (range 33-49 mmHg). The immediate mean postoperative IOP was 34 mmHg (4 eyes; range 19-55 mmHg). At 1 week, IOP was 38 mmHg (5 eyes; range 21-80 mmHg), at 2 weeks was 40 mmHg (3 eyes, range 17-80 mmHg), at 1 month was 35 mmHg (5 eyes; range 20-50 mmHg), at 3 months was 18 mmHg (2 eyes; range 14-21 mmHg), at 6 months was 35 mmHg (2 eyes; range 30-39 mmHg), and at >300 days was 24 mmHg (3 eyes; range 18-29 mmHg). Complications included corneal ulceration (n = 1 eye), uncontrolled IOP (n = 3 eyes), and need for repeat treatment (n = 2 eyes).

CONCLUSIONS

MP-TSCPC used with the above-described settings was unsuccessful in treating the majority of cases. Future studies should be targeted at primary glaucoma cases and with use of alternative laser settings.

Laser-Assisted Surgical Management of Oral Mucocele: A Case Report

This case represents mucocele of extravasation phenomenon associated with a lower lip on the right side in the last 15 days. A 19-year-old male patient visited the outpatient department with a history of constant trauma due to lip biting and due to soft and flocculent consistency on palpation, mucocele was considered under the provisional diagnosis. The borders of the lesion were marked following all the protocols of asepsis and sterilization and laser-assisted surgical excision was undertaken resulting in total removal of the lesion with a diode laser by resecting it from the base to reduce chances of re-occurrence. The specimen that was resected was sent for histopathological examination, which confirmed the final diagnosis of mucous extravasation cyst or mucocele. The following report underlines that laser-assisted resection offers a minimally invasive and precision approach for the treatment of mucocele.

Diode laser ablation of progressive pigmented iris lesions in 317 cats (356 eyes) appears overall safe and effective in decreasing progression of iris pigmentation

OBJECTIVE

To describe a novel scoring system of feline pigmented iris lesions prior to utilization of diode laser ablation of progressive pigmented iris lesions and to retrospectively evaluate short- and long-term patient outcomes following transcorneal diode laser ablation.

ANIMALS

317 client-owned cats (356 eyes) were included.

CLINICAL PRESENTATION

Records of cats undergoing diode laser ablation from January 2000 to December 2018 were retrospectively reviewed. A novel clinical grading system to describe severity of feline iris hyperpigmentation was developed. Recorded parameters included signalment, operated-upon eye, presurgical iris pigmentation score, intraocular pressure, visual status, postoperative complications, repeat laser surgery, patient status at last follow-up, time to death, and presumptive or known cause of death.

RESULTS

Complications included corneal ulceration (25/356 [7%]), glaucoma (18/356 [5%]), uveitis (4/356 [1.1%]), and corneal edema (3/356 [0.8%]). Enucleation was performed in 12 eyes due to blindness and secondary glaucoma. Repeat laser due to continued progression of pigment was performed in 18.5% of eyes. Two study patients were euthanized due to presumptive metastatic disease. Of the 250 cats for whom confirmation was available via phone call or medical records, 240 (96%) were alive at 1 year.

CLINICAL RELEVANCE

Diode laser ablation appears safe overall and may be effective in decreasing progression of feline iris pigmentation. Complication risks appear minimal.

Gingival Zenith Correction by Laser Gingivectomy

A healthy gingival structure showcases a knife-edged gingival margin, firmly adherent to the tooth surface, accompanied by a cone-shaped or pointed interdental papilla, mirroring the lowest point in the gingival margin, termed the gingival zenith. Tooth transposition denotes an anomaly in tooth positioning, commonly involving the canine and the first maxillary premolar. It represents a form of ectopic eruption, wherein two adjacent teeth interchange positions within the same quadrant of the dental arch. Laser wavelengths are utilized for precise incision of gingival tissues to address restorative, cosmetic, and periodontal needs. Post-operatively, rapid healing and diminished discomfort are frequently observed, often eliminating the necessity for periodontal packing or sutures. Gingivectomy is the accepted modality for the establishment of esthetics in situations with abnormal gingival contour. This study highlights the use of contemporary technology namely a 940 nm diode laser for correction of gingival zenith to achieve optimal esthetics post orthodontic treatment.

Development of a cost-effective compact diode-laser-based photoacoustic sensing instrument for breast tissue diagnosis

Significance

The photoacoustic (PA) technique, a noninvasive pump-probe technique, has found interesting applications in biomedical tissue diagnosis over the last decade. To take it a step further to clinical applications, the PA technique needs to be designed as an instrument focusing on a compact design, reducing the cost, and quickly providing a quantitative diagnosis.

Aim

This work presents a design and characterization of a cost-effective, compact PA sensing instrument for biomedical tissue diagnosis.

Approach

A compact laser diode case design is developed to house several laser diodes for PA excitation, and a pulsed current supply unit is also developed in-house to power the laser diodes to generate a 25 ns current pulse at a frequency of 20 kHz. After PA experimental data acquisition, the signal's frequency spectra were calculated to characterize the tissue quantitatively and correlated with their mechanobiological properties.

Results

The corresponding dominant frequency peak in the PA spectral response (PASR) study was low in the fibrofatty normal breast tissue 0.26 ± 0.03    MHz , compared to the dominant frequency peak of 1.60 ± 0.016    MHz in the fibrocystic disease tissue, which had increased glandular and stromal elements, thereby increased tissue density. The histopathological findings correlated with the PASR results, and the fibrocystic breast disease tissue exhibited a higher dominant frequency peak and energy compared to the normal breast tissue.

Conclusions

We experimented with an in vitro PASR study of fibrocystic human breast tissues and successfully differentiated different tissue types using quantitative spectral parameters peak frequency, mean frequency, and spectral energy. This gives the potential to take this technique further for cost-effective and quick clinical applications.

The Outcome of GaAlAs Diode Laser (980 Nm) Pulpotomy in Patients with Symptomatic Irreversible Pulpitis Assessed Using CBCT - Randomised Controlled Trial with an 18-Month Follow-up

OBJECTIVE

To evaluate the effect of diode laser (GaAlAs-980 nm) for full coronal pulpotomy (FCP) compared to conventional crown pulpotomy (CCP) in mature teeth with symptomatic irreversible pulpitis (SIP) and assess dentine bridge formation after FCP using CBCT.

METHODS

A total of 86 patients (43 per group) with SIP in permanent mandibular molars were included. Access opening and FCP were done, after which haemostasis was achieved with 2.5% NaOCl in the CCP group and a diode laser (GaAlAs-980 nm) in the laser crown pulpotomy group (LCP). Biodentine (Septodont, Saint-Maur-des-Fossés, France) was placed, and the cavity was sealed. Clinical and radiographic follow-ups were done at 6, 12, and 18 months, with additional CBCT evaluation at 18 months. Statistical analysis was performed using the Mann-Whitney U test, and survival rates were assessed using Kaplan-Meier analysis. The Cox proportional model was used to determine the effect of possible covariates on pulpotomy outcomes. P<0.05 was considered to be statistically significant.

RESULTS

The overall success rate for CCP and LCP at 18 months was 88.4% and 93% respectively. At the end of 18 months, 8 cases (5 in CCP, 3 in LCP) failed. The postoperative pain score at 48 hours was significantly higher for CCP (mean +- standard deviation: 1.7+-1.4; p<0.001). CBCT analysis at 18 months revealed thicker dentine bridge formation for LCP (Median & IQR: 0.89, 1.06) compared to CCP (p=0.0479). The Kaplan-Meier curve showed a more rapid decline in the survival rate of CCP (0.89) compared to that of LCP (0.93). Postoperative pain at 48 hours, PAI scores at 6, 12, 18 months, and age were found to affect the hazard ratio based on the Cox regression model.

CONCLUSION

Within the limitations of this trial, there was no significant difference in the outcome between diode laser and conventional pulpotomy. However, LCP resulted in lesser postoperative pain at 48 hours and thicker dentine bridge formation at 18 months, with a longer estimated survival rate. (EEJ-2023-01-011).

Laser-Assisted Gingival Depigmentation: A Case Report

The gingiva's colour varies in different individuals and is assumed to be related to cutaneous pigmentation. The most frequent natural pigment causing endogenous gingival pigmentation is melanin, a brown pigment. Depigmentation is a therapy of choice when individuals are concerned about their appearance and demand it for their aesthetic satisfaction. It is not a clinical indication. This article demonstrates gingival depigmentation using a laser diode with a 90-day follow‑up. A 23-year-old male patient visited the Periodontology Department, complaining of poor aesthetics owing to dark-coloured gums. Depigmentation with a laser diode was selected as the treatment plan for both the maxillary and mandibular arches, at an interval of a week. The choice of a procedure is largely influenced by the gingival thickness, the clinician's experience, the patient's preferences, and the rate of recurrence. According to reports, using lasers produces better aesthetic outcomes and has a low recurrence rate.

Biological effect of laser-assisted scar healing (LASH) on standardized human three-dimensional wound healing skin models using fractional non-ablative 1540 nm Er:Glass or 1550 nm diode lasers

PURPOSE

In postoperative wound healing after surgical operations or ablative laser treatments, recent studies suggest the timely use of non-ablative fractional laser treatments with the aim to improve wound healing and prevent pathological scar formation. However, the underlying molecular mechanisms are poorly understood. The aim of this study was to investigate the effects of laser-assisted scar healing (LASH) at the molecular level and to combine it with already established wound healing-promoting local treatments.

METHODS

We irradiated full-thickness 3D skin models with a fractional ablative Er:YAG laser to set standardized lesions to the epidermal and upper dermal layer. Subsequently, LASH was induced by irradiating the models with either a fractional non-ablative 1540 nm Er:Glass or 1550 nm diode laser. In addition, we tested the combination of non-ablative fractional laser treatment and topical aftercare with a dexpanthenol-containing ointment (DCO).

RESULTS

Histological analysis revealed that models irradiated with the 1540 nm Er:Glass or 1550 nm diode laser exhibited accelerated but not complete wound closure after 16 h. In contrast, additional topical posttreatment with DCO resulted in complete wound closure. At gene expression level, both non-ablative laser systems showed similar effects on epidermal differentiation and mild anti-inflammatory properties. The additional posttreatment with DCO enhanced the wound-healing effects of LASH, especially the upregulation of epidermal differentiation markers and anti-inflammatory cytokines at the gene expression level.

CONCLUSION

This in vitro study deciphers the biological effects of LASH with a fractional non-ablative 1540 nm Er:Glass or a 1550 nm diode laser in 3D skin models. These data help to better understand the biological properties of the LASH technique and is important to optimize its application.

Photobiomodulation Activates Microglia/Astrocytes and Relieves Neuropathic Pain in Inferior Alveolar Nerve Injury

Objective: This study aimed to determine microglial/astrocyte changes and their associated analgesic effect in inferior alveolar nerve injury (IANI) model rats treated with photobiomodulation therapy (PBMT) using a 940-nm diode laser. Background: Very few basic studies have investigated microglial/astrocyte dynamics following PBMT aimed at relieving neuropathic pain caused by IANI. Methods: Rats were divided into an IANI-PBM group, IANI+PBM group, and sham+PBM group. Observations were made on the day before IANI or the sham operation and on postoperative days 3, 5, 7, 14, and 28. PBMT was delivered for 7 consecutive days, with an energy density of 8 J/cm2. Behavioral analysis was performed to determine pain thresholds, and immunohistological staining was performed for the microglia marker Iba1 and astrocyte marker glial fibrillary acidic protein, which are observed in the spinal trigeminal nucleus. Results: Behavioral analysis showed that the pain threshold returned to the preoperative level on postoperative day 14 in the IANI+PBM group, but decreased starting from postoperative day 1 and did not improve thereafter in the IANI-PBM group (p ≤ 0.001). Immunological analysis showed that microglial and astrocyte cell counts were similar in the IANI+PBM group and IANI-PBM group shortly after IANI (day 3), but the expression area was larger (p ≤ 0.001) and hypertrophy of microglia and astrocyte cell bodies and end-feet extension (i.e., indicators of activation) were more prominent in the IANI+PBM group. Conclusions: PBMT after IANI prevented hyperalgesia and allodynia by promoting glial cell activation shortly after injury.

Diode laser use in hysteroscopic surgery: current status and future perspectives

Recent advances in surgical technology and innovative techniques have revolutionized surgical gynecology, including transcervical hysteroscopic procedures. Surgical lasers (Nd-Yag, Argon, diode, and CO2 lasers) have been promoted to remove a variety of gynecological pathologies. For hysteroscopic surgery, the diode laser represents the most versatile and feasible innovation, with simultaneous cut and coagulate action, providing improved hemostasis compared with CO2 laser. The newest diode laser devices exhibit increased power and a dual wavelength, to work precisely with reduced thermal dispersion and minimal damage to surrounding tissues. Their efficacy and safety have been validated both in the hospitals as well as in the office setting. Updated evidence reports that several hysteroscopic procedures, including endometrial polypectomies, myomectomies and metroplasties can be successfully performed with a diode laser. Therefore, this review aimed to give a deeper understanding of the role of laser energy in gynecology and subsequently in hysteroscopy in order to safely incorporate this technology into clinical practice.

Management of gingival hyperpigmentation induced by increased ferritin level in a HbS-β+ thalassemia patient using diode laser

Diode lasers can be employed for the treatment of gingival hyperpigmentation in HbS-β+ thalassemia patients due to the advantages that lasers provide including good hemostatic effect and less postoperative complications.

Effects of Photobiomodulation Therapy on Hard Tissue Healing in Rat Tooth Extraction Sockets

Objective: To investigate the effects of photobiomodulation therapy (PBMT) on hard tissue healing in rat maxillary first molar extraction sockets. Methods: A total of 20 male Wistar rats were used in the study. The right extraction sockets were irradiated with a Ga-Al-As laser (500 mW, 980 nm) for 51.7 J/cm2 every 24 h for 7 days, while the left sockets served as controls. Rats were sacrificed on days 3, 7, 14, and 28 after tooth extraction, and microcomputed tomography (CT) analysis, histopathological evaluation, and enzyme-linked immunosorbent assay (ELISA) were conducted at different time points. Results: Micro-CT analysis showed that the percentage of bone volume/tissue volume (TV) and bone mineral density were significantly higher in the experimental group compared to the control group on day 28 (p < 0.05). Histopathological evaluation revealed that PBMT promoted new bone formation and accelerated bone remodeling. ELISA demonstrated a significant increase in alkaline phosphatase expression in the laser sides on days 7 and 14 (p < 0.05). Conclusions: One application postextraction followed by seven consecutive daily applications of PBMT can effectively promote hard tissue healing in rat maxillary first molar extraction sockets.

Laser Therapy for Vulvar Lichen Sclerosus, a Systematic Review

Lichen sclerosus (LS) is a chronic inflammatory disease that mainly affects the anogenital area, with a higher incidence in post-menopausal women. In the long term, it can lead to loss of vulvar architecture or progress to squamous cell carcinoma. The evidence-based treatment involves high-potency topical corticosteroids in long regimens. However, second-line treatments are not well-established, including laser therapy. This current study aims to assess the level of evidence supporting this therapy. We conducted a search for primary-level studies published before April 2023 through MEDLINE/PubMed, Embase, Web of Science, Scopus, and CENTRAL, with no restrictions on the publication language or date. The methodological quality and risk of bias of the included studies were evaluated using the updated Cochrane Collaboration's tool for assessing risk of bias (RoB-2). Six studies (177 patients) met our eligibility criteria. Laser therapy was compared to topical corticosteroid treatment in five out of six studies. No significant histological differences were found, except for an increase in collagen production in the laser group. A greater reduction in itching, pain, and dyspareunia at 1 and 3 months of treatment in the laser group, as well as in the Skindex-29 at 6 months, was reported. Patient satisfaction was significantly higher among those who received laser therapy. Tolerability was excellent. No significant differences were observed in any of the previous aspects in the study compared to the placebo. In conclusion, there is not enough evidence to recommend laser therapy as a standalone treatment.

Efficacy of a Diode Vaginal Laser in the Treatment of the Genitourinary Syndrome of Menopause

INTRODUCTION

Genitourinary syndrome of menopause (GSM) and vulvovaginal atrophy (VVA) are the most frequent menopause-related clinical entities and are consistently included in the definition of pelvic floor disorders (PFDs). Nonhormonal therapies, such as lubricants and moisturizers, are indicated as first-line treatments, while the "gold standard'' is represented by topical estrogen products; however, in cancer survivors hormonal treatment is not indicated. For this reason, energy-based therapeutic approaches-for instance, through laser technologies-may be employed as alternative options in this kind of patient; however, there are no studies evaluating the efficacy of a pure diode vaginal laser in the treatment of GSM. As a consequence, with our study, we aimed to evaluate outpatient nonablative diode laser treatment in sexually active women, with contraindications, no response, or refusal of local estrogenic therapy.

METHODS

This prospective study included patients with GSM, aged ≥ 18 years old, with contraindications, or refusal of local estrogen therapies. Women were evaluated via the use of their Vaginal Health Index (VHI) scores, which consists of five measures: elasticity, fluid volume, pH, epithelial integrity, and moisture. Moreover, the intensity of VVA symptoms (vaginal burning, vaginal itching, vaginal dryness, dyspareunia, and dysuria) was measured using a 10 cm visual analog scale (VAS), where the left extreme of the scale (score = 0) indicated "absence of symptom" and the right indicated "symptom as bad as it could be" (score = 100). Sexual function was evaluated with the Female Sexual Function Index (FSFI-19) questionnaire. The treatment was performed using a Leonardo Dual diode laser (Biolitec Italia Srl, Milano, Italy). The laser treatment consisted of three sessions, one per month. One month after the third session, the VHI, symptom VAS, and FSFI-19 were re-evaluated. In addition, the Patient Global Impression of Improvement (PGI-I) questionnaire was collected.

RESULTS

Our study enrolled a total of 26 consecutive patients. All patients were either in menopause or under treatment with gonadotropin-releasing hormone (GnRH). None of the patients reported adverse effects after laser treatment. In total, 19 (73.1%) patients referred improvements of their symptoms according to PGI-I scores. All domains of the FSFI-19 questionnaire, significantly improved after the diode laser treatment. The mean VHI score increased by 3.2 points, from 12.2 to 15.4 (p < 0.001). Additionally, we documented a significant improvement in symptoms affecting the VAS score, from 69.2 to 43.5 points (p < 0.001).

CONCLUSION

A diode vaginal laser is an effective and easily tolerated ambulatory procedure for vaginal functional restoration in the treatment of GSM and VVA.

The effect of the irrigant activation protocol on postoperative pain in maxillary incisors with asymptomatic apical periodontitis: A three-arm randomized clinical trial

OBJECTIVES

This study aimed to compare the effects of three irrigation activation systems (IAS) on postoperative pain (PP) in activating three final irrigants: sodium hypochlorite 5.25%, ethylenediaminetetraacetic acid 17%, and chlorhexidine 2%.

MATERIALS AND METHODS

This parallel randomized clinical trial included referred patients with asymptomatic large-sized apical lesion incisors. A standard method was followed in the canal cleaning and shaping for all included patients in the study. Then, the patients were randomly assigned (1:1 allocation) into three groups: G1 (n = 20) with passive ultrasonic irrigation activation; G2 (n = 20) with XP-Endo Finisher file activation; and G3 (n = 20) with diode laser (810 nm) activation. PP was estimated in all groups using a visual analog scale after 1, 3, 7, and 14 days of treatment. Comparisons between the groups were made using the Kruskal-Wallis test, whereas the Mann-Whitney U test was used in the pairwise comparisons.

RESULTS

Sixty patients were followed-up in this trial. There were significant differences between the groups in terms of PP After 1, 3, and 7 days of treatment (p = 0.002, p = 0.017, and p = 0.006, respectively). On the first day of treatment, G3 showed the lowest PP compared with G1 and G2 (p = 0.007 and p = 0.001, respectively). On the third day of treatment, G3 showed less PP compared with G2 (p = 0.005). On the seventh day of treatment, G2 showed the highest PP compared with G1 and G3 (p = 0.012 and p = 0.003, respectively).

CONCLUSIONS

The XP-Endo Finisher file caused the highest PP level especially in the next day and 3 days of the treatment, whereas the diode laser had the lowest PP level during the first week of treatment. It is noteworthy that PP disappeared completely after 2 weeks of treatment with all three IASs.

TRIAL REGISTRATION

The trial was registered in the ISRCTN registry (Trial ID: SRCTN99457940).

Efficacy of two diode lasers in the removal of calculus from the root surface: An in vitro study

INTRODUCTION

Scaling and root planning (SRP) is still the gold standard of nonsurgical periodontal therapy, and it has been accompanied by several supportive therapies in recent years. One of the most studied methods is the diode laser, thanks to its thermal and bactericidal properties. Our trial intended to verify whether it could influence the chemical bond between calculus and the root surface.

OBJECTIVES

The aim of the study was to assess the efficacy of the diode laser prior the mechanical removal of calculus in an in vitro application. The reduction in time and the number of strokes required to clean the untreated root surfaces were evaluated as primary outcomes. The pressure was considered as a secondary outcome.

METHODS

A total of 75 extracted human teeth with subgingival calculus were assigned equally among three treatment groups (n = 25) according to the size of the occupied areas, which were classified by evaluating the pixel numbers. The groups were assigned to either no pretreatment application (A), Laser Diode Fox III (Sweden & Martina) (B) or Wiser Laser Evolution (Doctor Smile) (C). The weight for instrumentation was calibrated for an After Five curette (Hu-Friedy, Chicago). A new set of tools was used for each group, and the curettes were sharpened after each use with the Sidekick sharpener (Hu-Friedy, Chicago).

RESULTS

A Kruskal-Wallis test was used to assess the significance for each considered parameter. The results were statistically significant for each parameter for the two groups where the laser was used compared to the control group.

CONCLUSIONS

Despite the limitations of an in vitro study, data showed that the diode laser had an overall positive effect on root debridement, facilitating SRP in terms of stroke count, time, and pressure.

Conventional Scalpel and Diode Laser Approach for the Management of Traumatic Fibroma

An oral fibroma is a benign scar-like reaction frequently resulting from chronic mouth irritation. It is also called an oral polyp, fibrous nodule, localised intraoral fibrous hyperplasia, and traumatic fibroma. Chronic irritation from things like biting one's lips or cheek, orthodontic treatments, rubbing against a hard tooth, or wearing dentures or other dental prostheses is frequently the cause. It is often the same colour as the surrounding mouth lining, but occasionally, it can be paler or appear darker if it has bled. Trauma can cause the surface to become rough and scaly or ulcerated. It is primarily dome-shaped and similar to a pedunculated polyp. A traumatic fibroma most frequently occurs on the inside of the cheek. The inside of the lower lip, the gingiva, and the sides of the tongue are other frequent locations. The given case series reported traumatic fibroma associated with anterior teeth and buccal mucosa treated with a conventional scalpel and diode laser techniques, respectively. Diagnosing and treating the aetiology and educating the patient about the same is essential in fibroma cases. The clinical features of both claims and mere aetiology confirmed the diagnosis. The sole option available when therapy is needed is a surgical fibroma excision. Surgical excision is the most popular method for treating oral or traumatic fibromas. Two ways are available for the surgical removal of an oral fibroma: with a scalpel or using a diode laser. Both case presentations demonstrate that surgical excision with a scalpel and diode laser was discovered to be a simple, efficient, and affordable method for treating traumatic fibroma in this report, which presents two traumatic fibromas with different locations with varying aetiology. Traumatic fibromas reported here were in the aesthetic zones, which need to be treated as they can cause traumatic occlusion and difficulty chewing and speech. The patients reviewed for the next three months revealed complete satisfactory healing and no recurrence in both cases.

Effect of Dentin Conditioning with EDTA and Diode Lasers on Expression of Odontoblast-like Cell Markers of Dental Pulp Stem Cells

Regenerative endodontic procedures rely on the delivery of mesenchymal stem cells into the root canal and on the effect of local growth factors from the dentin and blood clot. The aim of this study was to assess the effect of dentin conditioning with ethylenediamine tetraacetic acid (EDTA) and diode lasers with different wavelengths (808 nm and 980 nm) on the expression of odontoblast-like cell markers. Forty dentin cylinders were divided into four groups according to the irrigation protocol: EDTA, EDTA + 808 nm diode laser, EDTA + 980 nm diode laser, and phosphate-buffered saline as the control group. Dental pulp stem cells were seeded into the previously conditioned cylinders and incubated for 14 days. The quantitative real-time polymerase chain reaction was used to evaluate the expression of dentin sialophosphoprotein (DSPP), dentin morphoprotein-1 (DMP-1), and transforming growth factor-beta 1 (TGF-β1). Data analysis was performed using the Kruskal-Wallis test. The activation of EDTA with 980 nm and 808 nm diode lasers resulted in lower DSPP and DMP-1 expression than that for EDTA alone (p < 0.05 and p < 0.01, respectively). The expression of TGF was similar among all groups. The highest level of expression of odontoblast-like differentiation markers was observed with EDTA alone. However, the use of an 808 nm diode laser during EDTA irrigation reduced the expression of odontoblastic differentiation markers.

Remarkable Improvements After Cataract Surgery in a Presumed "End-Stage" Glaucoma Patient: A Case Report

Predicting the visual outcome after cataract extraction can be challenging in glaucoma patients who develop cataracts. Here, we demonstrate the case of a patient with advanced glaucoma and a mild-to-moderate cataract at initial presentation, who demonstrated remarkable improvement in visual acuity following a period of controlled intraocular pressure (IOP) and the removal of a matured cataract at the time of surgery. A 64-year-old Haitian woman with severe mixed-mechanism glaucoma and hand motion vision in both eyes (OU) presented with intraocular pressures of 38 mmHg OD (oculus dexter/right eye) and 41 mmHg OS (oculus sinister/left eye) while on three IOP-lowering agents. Her medications were escalated to six IOP-lowering medications, and she underwent bilateral transscleral laser cyclophotocoagulation with both micropulse and continuous wave probes simultaneously. Postoperatively, IOPs dropped to 7 and 9 mmHg in the right and left eyes, respectively, and remained at or below target on three topical agents for the remainder of her follow-up. Contrastingly, the patient's cataract had progressed, and the decision was made to undergo cataract extraction OU sequentially. The subsequent clinical course demonstrated progressive visual improvement with 20/80 best-corrected visual acuity OU and increased independence with activities of daily living. This case illustrates the potential for visual improvement in an advanced glaucoma patient after removing a matured cataract despite limited prior expectations. Ocular comorbidities complicate but do not necessarily preclude appropriate interventions that may improve patients' vision-related quality of life.

The Use of Diode Laser for the Surgical Removal of Pyogenic Granuloma of the Dorsum of the Tongue: A Case Report

Pyogenic granuloma (PG) is a common reactive oral lesion predominantly involving the gingiva and rarely occurring on the dorsum of the tongue. It can develop at any age but more commonly in the second decade with a female predilection. Numerous factors are associated with its development, and surgical removal is the standard treatment. Various surgical modalities have been used to excise it. Herein, we report a case of a female patient in her late 60s who presented with an exophytic lesion involving the dorsum of the tongue, which was excised using a 940 nm diode laser. In addition, it discusses the advantages of diode laser as a surgical modality and describes this lesion's clinical features and pathogenesis.

Gingivectomy with Diode Laser Versus the Conventional Scalpel Surgery and Nonsurgical Periodontal Therapy in Treatment of Orthodontic Treatment-Induced Gingival Enlargement: A Systematic Review

Background and objective: Some studies support the superiority of diode laser gingivectomy to scalpel surgery and nonsurgical treatments. However, a systematic review on this topic is lacking. This study aimed to compare gingivectomy with diode laser versus the conventional scalpel surgery and nonsurgical periodontal therapy (NSPT) in the treatment of orthodontic treatment-induced gingival enlargement (GE). Materials and methods: In this systematic review, an electronic search of the relevant literature was conducted in Web of Science, Medline/PubMed, Scopus, Cochrane Central Register of Controlled Trials, and ProQuest with no language restriction. Randomized clinical trials published between 1985 and 2020 on comparative treatment of orthodontic treatment-induced GE by diode laser gingivectomy and scalpel surgery or NSPT regarding intraoperative and postoperative bleeding and/or pain were included. Risk of bias was assessed by the Cochrane 1 tool. Results: Of the initially retrieved 288 articles, 40 were duplicates and excluded; 236 articles were excluded following title and abstract screening, and 5 others were excluded following full-text assessment. Finally, 7 studies underwent systematic review. In the risk-of-bias assessment, 5 studies scored 2, and 2 studies scored 3 out of 6. Intraoperative and postoperative bleeding and pain were found to be significantly lower in the laser group. Conclusions: Within the limitations of this systematic review and with respect to the quality of evidence, the present results revealed lower level of pain and bleeding in diode laser gingivectomy compared with the conventional scalpel surgery and NSPT for treatment of orthodontic treatment-induced GE.

The Long-Term Observation of the Beneficial Effects of Treatment: 0.12 mg Anti-VEGF Monotherapy or Anti-VEGF Combined Therapy and Diode-Laser in Various Stages of Retinopathy of Prematurity-Series of Cases

Background 2-year observations of ranibizumab monotherapy and combined therapy with diode laser for severe ROP in extremely prematures. Materials and methods: In a group of 18 prematures (n = 36 eyes; 5 study groups); 25.8 ± 1.5 Hbd, birth weight 796.5 ± 166.1 g. Apgar 4.62 ± 1.88) with A-ROP (n = 22; 61%) and 3 ROP (plus) (n = 14; 39%), ranibizumab monotherapy (n = 4 eyes) in dose 0.12 mg/0.12 mL or with diode laser (n = 32 eyes) were applied. The first intervention was carried out in PMA of 33 (gr. 4 and 5) and 34 in (gr. 1, 2, 3), mean follow-up time 21.44 ± 8.7 months. One-way analysis of variance (ANOVA) with Welch's correction, non-parametric Kruskal-Wallis test, Chi square test of independence were used. A retrospective observational study based on a case series. Results Retinal attachment was achieved in 92.3% of the studied eyes. Bilateral retinal detachment was noted in 1 infant (2 eyes). Myopization (-0.75 to -7.5 D) was observed in 5 infants (45%); mild hyperopia (+0.5 to +4.5 D) was observed in the rest infants (55%). Conclusions Individualization strategies in severe ROP with lower dose 0.12 mg Ranibizumab or combined laser-therapy resulted in effective outcomes. Myopia has not been reported in patients where Ranibizumab was the first drug administered in the ROP treatment strategy.

Morphological Evaluation of Transscleral Laser Retinopexy in Rabbits: Comparison of Optical Coherence Tomography and Histologic Examinations

Transscleral retinopexy is a preventive technique used against retinal detachment. Fundus examination can allow the monitoring of morphological retinal changes in the progression of photocoagulation lesions, without offering details on the morphological changes by the retinal lesion. The aim of the study was to assess the progression of photocoagulation lesions induced by transscleral retinopexy (840 nm diode laser), by comparing the optical coherence tomography (OCT) and histological images over a period of six weeks on eight pigmented New Zealand healthy rabbits (four males and four females; n = 16 eyes). All rabbits underwent transscleral retinopexy on their left eye on day 0 (D0). Measurements of the photocoagulation lesions were obtained in vivo on D0, D7, D15, D21, and D42 by acquiring OCT images of both eyes from all rabbits. On D1, D7, D21, and D42, two rabbits were euthanized, and their eyes were enucleated. A significant effect by time on the decrease in the central retinal thickness of the photocoagulation lesion was observed from D1 to D7 (p = 0.001); however, no such effect was observed on the horizontal length ((HL) p = 0.584) of the lesion surface. The reliability between the OCT and histological measurements, which were evaluated using intraclass correlation coefficients, was excellent for measuring the retinal thickness at the center (ICC = 0.91, p < 0.001), moderate for the right side of the retinal lesions (ICC = 0.72, p = 0.006), and not significant for the left side and HL (p = 0.055 and 0.500, respectively). The morphological changes observed in the OCT and histopathological images of the photocoagulation lesions were qualitatively described over time. OCT is an effective tool for monitoring changes in photocoagulation lesions. Some measurements and qualitative changes showed an adequate correlation between the OCT and histological findings.

A Comparative Analysis of Post-Retraction Changes in Gingival Height after Conventional and Surgical Gingival Displacement: Rotary Curettage, Diode and Er:YAG Laser Troughing

The aim of the current article is to analyze and compare post-retraction gingival height changes resulting from six different types of gingival-displacement methods, encompassing both conventional and surgical approaches. The study involved a comparative analysis of 263 teeth (consisting of 128 front teeth, 69 premolars, and 66 molars) from 23 patients. For the investigation, three classic retraction methods were utilized, namely the single-cord technique, retraction paste Expasyl, and retraction paste Astringent. Additionally, three surgical techniques were employed, which included ceramic bur rotary curettage, Er:YAG laser troughing, and diode laser troughing. A randomized split-mouth design was implemented, and a significance level of 0.05 was used for the study. The recovery of the free gingival margin height was assessed on gypsum models that were scanned using an intraoral scanner during the first and second week after the retraction procedure. The results revealed that all retraction methods, except for ceramic bur rotary curettage, led to clinically insignificant levels of gingival recession. The article provides insights into the effectiveness and safety of various gingival-displacement techniques, highlighting that most methods tested in the study resulted in minimal or negligible gingival recession post-retraction.

Efficiency of diode laser and ultrasonic-activated irrigation in retreatment of gutta percha and bioceramic sealer: An in vitro study

This study was to determine the effectiveness of diode laser (LI) and ultrasonic (UI)-activated irrigation with or without a surfactant as adjunct techniques during the retreatment of gutta-percha and tricalcium silicate-based sealer (BC) sealer. Forty-two single-rooted premolars were instrumented and filled with gutta-percha and BC sealer, then retreated using NiTi retreatment rotary files. Teeth were randomly divided into three equal groups: Control (manual irrigation), UI and LI groups. Each group was subdivided into 2.5% NaOCl irrigant and ChlorCid™️ Surf subgroups. The amount of material removed following UI and LI was significantly greater than that of manual irrigation (p < 0.0001). However, there was no significant difference between the surfactant subgroups, irrespective of irrigation technique (p = 1.00, p = 0.535, p = 0.805). The use of UI and LI adjuncts to NiTi rotary retreatment techniques showed significant improvement in gutta-percha with BC sealer removal. However, surfactants had no effect on the efficacy.

Long-term outcomes of transcanalicular laser dacryocystorhinostomy versus endonasal dacryocystorhinostomy and a review of the literature

Objective

The aim of this study was to compare the efficacy of endonasal dacryocystorhinostomy (EDCR) compared with transcanalicular laser DCR (TL-DCR).

Materials and Methods

This retrospective study and systematic review included patients that underwent DCR for nasolacrimal duct obstruction at our tertiary academic care hospital between January 2013 and December 2017. TL-DCR and EDCR were performed on 42 (group 1) and 45 (group 2) patients, respectively. All patients were followed up for a minimum of 4 years after DCR. Success was defined as the complete disappearance of epiphora and the observation of fluid flow without any anatomic obstruction during lacrimal system irrigation.

Results

This study included 87 patients who underwent DCR. Fourteen patients (18.7%) were male, and 61 (81.3%) were female. Groups 1 and 2 consisted of 42 and 45 patients who underwent TL-DCR and EDCR, respectively. Success was achieved by 78.5% and 84.4% in groups 1 and 2, respectively. Patients in both groups were followed up for at least 4 years. There was a significant difference in mean surgery time between groups: 33.8 ± 10.5 min vs. 69.9 ± 15.9 min for groups 1 and 2, respectively (P < 0.001).

Conclusion

EDCR and TL-DCR without silicone stent have offered a high success rate in the long term. Furthermore, endonasal procedures have less surgery time and leave no scar. We observed that EDCR and TL-DCR are favorable methods in cases of nasolacrimal duct obstruction.

Effectiveness of Two Intensity Levels of Diode Laser in Debonding Metallic Brackets Regarding Enamel Surface Integrity and Pulpal Temperature: An Ex-Vivo Study

INTRODUCTION

The traditional methods of deboning metal brackets exert excessive force, resulting in enamel scratches, fractures, and patient discomfort. The objective of this study was to evaluate the effectiveness of using two intensity levels of a diode laser for debonding metallic orthodontic brackets as an alternative to the conventional debonding method.

MATERIALS AND METHODS

Sixty intact, extracted human premolar teeth were used in this study, and metal orthodontic brackets were bonded to the buccal surface of these teeth. The teeth were divided into three groups for the experiment: (1) the control group, where conventional bracket debonding was performed using a debonding plier, (2) the first experimental group, where a diode laser (2.5W, 980nm) was utilized for laser debonding, and (3) the second experimental group, where a diode laser (5W, 980nm) was used for laser debonding. The laser was applied using a sweeping movement for 5 seconds. After debonding, the adhesive remnant index (ARI), the lengths, and the frequency of enamel cracks were compared among the groups. Additionally, an increase in intra-pulpal temperature was measured.

RESULTS

In all groups, there were no instances of enamel fractures. Laser debonding resulted in a significant reduction in both the frequency and length of newly formed enamel cracks compared to the conventional debonding method. The laser debonding group exhibited increases in intra-pulpal temperature of 2.37°C and 3.60°C in the second and third groups, respectively. These temperature increases were significantly lower than the threshold of 5.5°C. There were no significant differences observed in the ARI scores among the groups.

CONCLUSION

With all debonding methods, an increase in the length and frequency of enamel cracks should be anticipated. However, laser-assisted debonding of metal brackets offers the advantage of reducing the risk of enamel damage while avoiding thermal damage to the pulp.

Effect of 940 nm diode laser irradiation and dentin bonding agent on permeability of furcation area in primary molars

Purpose

Multiple accessory canals make furcation area of primary molars the most common port of entry of bacterial endotoxins to periradicular area. Reduction in permeability can improve prognosis of these teeth. Therefore, this study was designed to compare the effect of 940 nm diode laser and dentin bonding agent on the dye penetration of furcation area in primary molars.

Material and Methods

Thirty teeth were divided into three groups, that is, Group 1 (control group), Group 2 (dentin bonding agent applied over floor of pulp chamber), and Group 3 (diode laser irradiated over floor of pulp chamber). The samples were prepared and seven from each group were tested by dye penetration and three were sent for scanning electron microscopy. Rise in temperature in the perifurcal area was also recorded at the time of laser irradiation. Dunn's pair-wise comparison analysis was used for the analysis for the difference in dye penetration among the group.

Results

: The maximum rise in temperature recorded postirradiation was 6.90C. Dye penetration was significantly reduced in Group 2 Dentin bonding group (DBG) as compared to control group (P = 0.0025). Reduction in permeability was observed in Group 3 Laser group (LG) but this was not statistically significant (P = 0.197). Scanning electron microscope revealed open dentinal tubules in Group 1. There were no open dentinal tubules in Group 2, while Group 3 had sealed dentinal tubules with glass-like surface over the region.

Conclusion

Dentin bonding agent led to substantial decrease in dye penetration of furcation area of primary molars. This method should be evaluated clinically to improve successful pulpectomy procedures of primary molars.

To Evaluate the Clinical Efficacy of 940 nm Diode Laser and Propolis Gel (A Natural Product) in Adjunct to Scaling and Root Planing in Treatment of Chronic Periodontitis

Background

Recently, various adjunctive treatment options along with Scaling and root planing (SRP) such as local drug delivery, medications, and lasers have been introduced for the treatment Chronic periodontitis (CP) but literature is limited.

Aim

To evaluate the clinical efficacy of 940 nm diode laser and propolis gel in adjunct to Scaling and root planing (SRP) in the treatment of CP.

Subjects and Methods

Randomized clinical trial was conducted among 30 CP patients with a probing depth of ≥5 mm was allocated randomly into Group 1 (SRP), Group 2 (SRP + diode laser), and Group 3 (SRP + propolis gel). Plaque index, gingival index, pocket probing depth, and clinical attachment level were assessed at baseline, one and three months. Data analysis was performed using SPSS version 17 for windows, and statistical techniques employed were repeated measures by using One-way ANOVA, Tukey's HSD, independent t-test, and paired t-test.

Results

Post-treatment sites among all the three groups showed statistically significant reduction in Periodontal index (PI), Probing pocket depth (PPD), and Clinical attachment level (CAL), whereas gingival inflammation was significantly reduced in groups 2 and 3 from baseline to one and three months. On comparison, at baseline, all clinical parameters were statistically insignificant. At one month, the mean difference of PI, Gingival index (GI) was statistically significant between group 1 and 2 whereas the mean difference of CAL and PPD were statistically significant from group 1 to groups 2 and 3.

Conclusions

Lasers with SRP were greatly effective in reducing gingival inflammation, PPD, and CAL. Propolis gel also offered encouraging and promising clinical results but still needs further long-term studies to establish its precise role in the treatment of CP.

Immediate Response of Diode Laser on the Microbial Load in Subjects with Chronic Periodontitis

Background

Chronic periodontitis is the most common dental disease reported globally as well as in India. Periodontal pathogens are usually seen in samples of gingival tissues, crevicular blood, GCF (gingival crevicular fluid), and dental plaque. Apart from the conventional mechanical treatment, laser disinfection is a recent advancement that change shows greater efficacy in reducing the disease progression and changing the bacterial flora.

Aim

The present study aimed to assess the Immediate response of diode laser on the microbial load in subjects with chronic Periodontitis as assessed in saliva, crevicular blood, and GCF (gingival crevicular fluid) samples.

Materials and Methods

The study recruited 90 subjects with chronic periodontitis. For split-mouth fashion, the mouth, of each participant was divided into two halves and was divided into two groups randomly. Group I (test group) subjects underwent laser disinfection (970 ± 15 nm). Group II subjects served as controls and underwent saline irrigation. For all participants, crevicular blood, saliva, and GCF samples were collected before and immediately following disinfection for microbial analysis.

Results

Microbial load reduction was seen in both groups following treatment. However, a significantly higher reduction was seen in the test group with laser disinfection. Compared to the crevicular blood sample, a greater reduction was seen in saliva and GCF samples.

Conclusion

The present study concludes that Diode Laser (970 ± 15 nm) application shows an immediate reduction of the bacterial load in subjects with chronic periodontitis.

Antibiofilm activity of ultrasonic and diode laser activated sodium hypochlorite, chitosan, and chlorhexidine: A confocal laser scanning microscopic in vitro study

Aim

The aim of this study was to assess and compare the effect of ultrasonic and diode laser-activated sodium hypochlorite (NaOCl), chitosan, and chlorhexidine (CHX) on the removal of Enterococcus faecalis biofilm adherent to the root canal using a confocal laser scanning microscope (CLSM).

Materials and Methods

Root canals in 112 single-rooted teeth were instrumented using a rotary Ni-Ti system. Biofilms of E. faecalis were generated based on an established protocol. Samples were randomly divided into three experimental (n = 28) and one control (n = 28) group based on the irrigation protocol employed and the three experimental groups were further subdivided into subgroups based on the activation protocol (subgroup A - ultrasonic activated and subgroup B - diode laser activated). The groups were Group 1 (control), Group 2 (3% NaOCl for 6 min; subgroup A - activated using a diode laser, subgroup B - ultrasonic activation), Group 3 (2% CHX for 6 min; subgroup A - activated using a diode laser, subgroup B - ultrasonic activation), and Group 4 (0.2% chitosan for 6 min; subgroup A - activated using a diode laser, subgroup B - ultrasonic activation. Confocal laser scanning microscopy was used to assess bacterial viability in situ. Data were analyzed by appropriate statistical analyses with P = 0.05.

Results

All experimental irrigation protocols destroyed the biofilm in the root canal lumen. Within the dentinal tubules, all groups had a significantly higher percentage of dead bacteria than the saline control (P < 0.05). There was no significant difference between CHX activated with ultrasonics, CHX activated with a diode laser, chitosan activated with ultrasonics and chitosan activated with diode laser groups (P > 0.05), whereas NaOCl ultra and NaOCl diode groups brought about more bacterial reduction than other groups (P < 0.05). The mean effectiveness and the bacterial kill ability were seen highest for the NaOCl activated with the ultrasonics group. There was no significant difference between diode laser activation and ultrasonic activation in CHX activated with ultrasonics, CHX activated with a diode laser, chitosan activated with ultrasonics and chitosan activated with diode laser groups (P > 0.05), but there was a significant difference between diode laser and ultrasonic activation in NaOCl group. Ultrasonic activation of the NaOCl was more effective than diode activation in reducing E. feacalis biofilms (P < 0.05).

Conclusions

The use of NaOCl with the activation by ultrasonics caused the greatest reduction of E. faecalis. Ultrasonic activation was found superior to diode laser activation in dentinal tubule disinfection.

Adverse Events of Light-Assisted Hair Removal: An Updated Review

BACKGROUND

With light-assisted hair removal becoming widely used, reports of adverse effects are increasing.

OBJECTIVE

To review all the reported optical incidents and cutaneous complications of laser or intense pulse light-assisted hair removal.

METHODS

A PubMed database systematic search was performed to identify studies reporting such adverse events before July 2022 using the Mesh terms "adverse effects" AND "hair removal" AND ("laser" OR "intense pulse light").

RESULTS

Altogether, 358 references were identified. After excluding duplicates, unrelated articles, guidelines, and conference abstracts, then adding references from studies bibliography, 104 publications were included. Ocular incidents consisted of anterior uveitis, iritis and iris atrophy, pupillary distortion, posterior synechiae, anterior chamber pigment, and cataracts in the anterior subcapsular region. Cutaneous complications consisted of pain, burns, folliculitis, leukotrichia, paradoxical hypertrichosis, pigmentary changes, changes in nevi, pili bigemini, herpes infection, hyperhidrosis, bromhidrosis, Fox-Fordyce disease, and frostbite from the cooling system. They were mostly correlated to skin type and body area as well as to light device and set parameters. Intense pulse light devices were found to be less painful than alexandrite laser, yet more painful than diode laser; Nd:YAG laser had the highest pain score.

CONCLUSION

Optical incidents can be systematically avoided. Cutaneous complications are usually related to professional errors and patient characteristics. Better knowledge of laser physics and adequate training of laser operators are key recommendations to avoid undesirable side effects. Safety recommendations help prevent most of the reported complications.

Effect of Various Lasers With or Without Systemp.desensitizer on Dentine Tubules: An In Vitro Scanning Electron Microscopy Analysis

Objective: The current study was carried out to evaluate the effects of laser and Systemp.desensitizer therapy. Further, scanning electron microscopy (SEM) was used to determine the effects of individual or combined desensitizers on human dentinal tubules. Background: The most common clinical condition that makes people uncomfortable is dentin hypersensitivity (DH). Both lasers and drugs that reduce sensitivity have been used to treat DH. Materials and methods: A total of 100 dentinal samples were taken from newly extracted third molars (affected) and divided into 10 groups (A to J), that is, control (A); Systemp.desensitizer (B); diode laser (980 nm) (C); Nd:YAG laser (D); Er:YAG laser (E); Er,Cr:YSGG laser (F); Systemp.desensitizer + diode laser (G); Systemp.desensitizer + Nd:YAG laser (H); Systemp.desensitizer + Er:YAG laser (I); and Systemp.desensitizer + Er,Cr:YSGG laser (J). SEM was used to evaluate the dentinal specimens in each group (longitudinal and transverse portions), and then images of each sample were captured (20 images/sample). In addition, the number of open dentinal tubules was counted and then the occlusion depth in dentinal tubules was measured. Mann-Whitney and Kruskal-Wallis tests were employed to analyze the obtained data. Results: All treatment procedures and protocols were effective in blocking dentinal tubules (p < 0.05). Compared with the other groups, dentinal tubules in the laser and laser combination therapy groups were significantly obstructed (p < 0.05). Diode and Nd:YAG lasers with or without Systemp.desensitizer showed significantly more tubule occlusion and greater sealing depth than Er:YAG and Er,Cr:YSGG lasers with or without Systemp.desensitizer (p < 0.05). Conclusions: In summary, lasers alone or in combination can play a significant role in occluding the dentinal tubules. However, combining the diode or Nd:YAG laser with Systemp.desensitizers is a more effective treatment strategy and may have immediate and long-lasting effects.

Umbilical seborrheic keratosis-like lesion developing after diode laser hair removal in an 18-year-old patient

OBJECTIVE

to report a possibly novel complication of laser hair removal.

CASE REPORT

a white-skinned 18-year-old patient discovered an umbilical, brown, and raised lesion while shaving before his second diode laser hair removal session. He sought consultation before his fourth laser session since the lesion further thickened and darkened. Dermoscopy showed no pigmented network, but a few comedo-like openings within an erythematous-light brown scaly and fissured papule, "moth-eaten" borders, and a central crust due to manipulation, suggesting the diagnosis of seborrheic keratosis. We noted that the laser fluence was increased on the umbilical region where hair seemed resistant to treatment. The patient denied a recent history of local sun tanning, sunburns, inflammation, drainage, or manipulation. The lesion cleared, with no short-term relapse, after one session of cryotherapy.

CONCLUSION

the development of a seborrheic keratosis-like lesion on a densely haired non-sun-exposed umbilicus of a young patient, following pre-laser shaving and high-fluence hair removal diode laser sessions, could have implicated triggering irritation and/or keratinocyte stimulation by red light-engendered reactive oxygen species (ROS) in the skin with silent epidermal mosaicism.

Analysis of Temperatures Generated during Conventional Laser Irradiation of Root Canals-A Finite Element Study

The success of endodontic treatment is dependent on the removal of bacteria. A modern strategy to reduce bacterial load is laser irradiation. During this procedure, there is a local increase in temperature with possible side effects. The aim of this study was to determine the thermal behavior of a maxillary first molar when performing the conventional irradiation technique using a diode laser. For this study, a 3D virtual model of a maxillary first molar was created. The preparation of the access cavity, the rotary instrumentation of the palatal root canal and the laser irradiation protocol were simulated. The model was exported in a finite element analysis program where the temperature and heat flux were studied. Temperature and heat flux maps were obtained, and the temperature increase on the internal wall of the root canal was analyzed. The maximum temperature value exceeded 400 °C and was maintained for less than 0.5 s. The obtained temperature maps support the bactericidal effect of diode laser and the limitation of damage to surrounding tissues. On internal root walls, the temperature reached several hundred degrees Celsius, but for very short durations. Conventional laser irradiation is an adjuvant method of decontamination of the endodontic system.

Implant Surface Topography Following Different Laser Treatments: An In Vitro Study

Background Although dental implants have demonstrated very high success rates, they are susceptible to complications such as peri-implantitis that can lead to failure. Methods Twenty implants with surfaces grit-blasted using hydroxyapatite and acid-etched were randomly divided into four groups (five in each group). Three groups were assigned to laser treatments: Group I (erbium, chromium-doped: yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser), Group II (650-nm diode laser), and Group III (808-nm diode), and one control group, Group IV. The surface roughness parameters (roughness average(Ra) and root mean square roughness(Rq)) were measured using a non-contact optical profilometer and scanning electron microscope to evaluate the surface topography after the laser treatments. Results Significant differences were observed between the laser groups regarding the surface roughness Ra (3.56±0.26, 3.45±0.19, 3.77±0.42, p_c=0.0004, p_e=0.0002, p_f=0.001) and Rq values (4.49±0.34, 4.35±0.26, 4.72±0.56, p_c=0.0007, p_e=0.0006, p_f=0.002) and the control group (2.81±0.10; 3.57±0.19). However, no significant difference was observed between the different laser treatment modalities. The scanning electron microscope images revealed some morphological changes on the implant surfaces following laser treatment, but no melted morphology was observed. Conclusions The application of Er,Cr:YSGG, 650-nm diode laser, and 808-nm diode did not show melting changes on implant topography. However, some increase in surface roughness was detected. Further studies are recommended to assess the effectiveness of these laser settings on bacterial reduction and osseointegration.

Diode Laser Therapy for Radiation-Induced Vascular Ectasia: Long-Term Results and Cost Analysis

BACKGROUND

Collateral damage to surrounding healthy tissues has been reported in patients who undergo radiation therapy for pelvic malignancies. This study aimed to evaluate the safety, efficacy and cost efficiency of endoscopic diode laser therapy in patients diagnosed with chronic radiation proctitis (CRP).

METHODS

The data of 24 patients (median age 78, range 67-90 years) who presented rectal bleeding and were diagnosed with CRP after undergoing high-dose radiotherapy for prostatic cancer and underwent diode laser therapy were evaluated retrospectively. Non-contact fibers were used in the patients who underwent the procedure without sedation in an outpatient setting.

RESULTS

The patients underwent a median of two sessions; overall, a mean of 1591 J of laser energy per session was used. No complications were noted during or after the procedures. Bleeding was completely resolved in 21/24 (88%) patients, and two patients showed improvement (96%). It was not necessary to suspend antiplatelet (six patients) or anticoagulant (four patients) therapy during the treatment course. The mean cost per session was EUR 473.4.

CONCLUSIONS

The study findings demonstrated that endoscopic non-contact diode laser treatment in CRP patients is safe, effective and cost efficient. For this procedure, antiplatelet and anticoagulant therapy suspension, intraprocedural sedation and hospital admission are not required.