MyomiRs in cultured muscle cells from patients with idiopathic inflammatory myopathy are modulated by disease but not by 6-month exercise training.

OBJECTIVES: Idiopathic inflammatory myopathies/IIM are associated with changes in muscle-specific microRNA/miR. Exercise improves muscle function and metabolism in parallel with changes in miR expression. We investigated the effects of disease and exercise on miRs in differentiated muscle cells/myotubes from IIM patients and controls. METHODS: Samples of m. vastus lateralis were obtained by needle biopsy from IIM patients before/after 6-month training and from matched sedentary healthy controls. Muscle cell cultures were established and exposed to saturated fatty acid during differentiation. MiR-133a,-133b,-206,-1 and their target genes (qPCR), fat oxidation (FOx), lipids (chromatography) and mitochondrial oxidative phosphorylation (OxPHOS) complexes (immunoblotting) were measured. Interrelations between in vitro miRs and metabolism of myotubes as well as clinical parameters and disease activity/MITAX were explored. RESULTS: Levels of miRs were higher in myotubes derived from IIM patients compared to healthy controls (up to 3.5-fold, p<0.05). Neither 6-month training (IIM patients) nor in vitro palmitate treatment modulated myomiRs in myotubes. However, miR-133a,-133b, and miR-1 correlated negatively with FOx (p<0.01), triacylglycerols (p<0.05) and OxPHOS complex-V (p<0.05) and positively with OxPHOS complex-I (p<0.05) in myotubes. MiR-133a and miR-133b in myotubes were related to disease activity and fasting glycaemia in vivo (both p<0.05). CONCLUSIONS: Upregulation of microRNAs involved in myogenesis and regeneration in muscle cells derived from IIM patients indicates activation of compensatory epigenetic mechanisms, potentially aimed to counteract disease progression. Relationships of microRNAs with in vitro metabolic profile of muscle cells as well as with clinical parameters support the role of muscle-specific microRNAs in modulating muscle metabolism and clinical state of patients.

The Use of the Er:YAG Laser for Bracket Debonding and Its Effect on Enamel Damage.

OBJECTIVE: The aim of the study was to evaluate the influence of Er:YAG laser irradiation on the debonding of metal and ceramic brackets and enamel damage ex vivo. BACKGROUND DATA: The principle of safe bracket debonding is to degrade the adhesive resin strength connecting the tooth and bracket. Removal of adhesive resin from tooth surfaces without iatrogenic damage (enamel loss) is generally the main problem of the otherwise very successful method of aesthetic straightening of teeth. METHODS: Forty ceramic and metal brackets (Clarity™ Advanced and Victory Series™; 3M Unitek, Monrovia, CA) were standardly bonded to buccal polished enamel surfaces of 30 caries-free human third molars. Two types of adhesive resins (Transbond™ XT Light Cure Adhesive; 3M Unitek, and Variolink II Professional Set; Ivoclar Vivadent AG) were used. Before debonding, the brackets in the laser group were irradiated with the Er:YAG laser (FJFI CVUT) 280 mJ, 250 µs long, repetition rate 6 Hz, spot focus 1 mm, and 140 sec. The control group was debonded without the laser irradiation. During the bracket irradiation, temperature changes inside the tooth were monitored using a thermal image infrared camera. The enamel surface was investigated by SEM. RESULTS: It has been observed that bracket removal was easier after the Er:YAG laser irradiation, and temperature rise was limited (from 2.0°C to 3.2°C) also for metal brackets. As against the nonirradiated samples, SEM investigation has confirmed no damage to enamel. CONCLUSIONS: Irradiation with Er:YAG laser radiation before debonding of ceramic brackets significantly decreases the bonding failure and amount of remaining adhesive.

Ceramic bracket debonding by Tm:YAP laser irradiation.

OBJECTIVE: The aim of this study was to prepare a simple and reliable method for ceramic bracket debonding, ensuring minimal changes in the enamel structure and an acceptable temperature rise in the pulp. BACKGROUND DATA: Ceramic bracket debonding is based on the principle of degrading the strength of adhesive resin between the tooth and ceramic bracket. The search for a safe and efficient method of adhesive resin removal following debonding has resulted in the introduction of a wide range of instruments and procedures, among which proper use of laser irradiation can be promising. METHODS: The debonding of two types of ceramic brackets utilized a diode-pumped Thulium:Ytterbium-Aluminium-Perovskite (Tm:YAP) microchip laser generating irradiation at a wavelength of 1998 nm (spot size 3 mm; focused by lens), with two power settings (1-2 W). Loss of enamel and residual resin on teeth, as well as rise in temperature inside the tooth were subsequently investigated in detail. RESULTS: A 1W power of irradiation during a 60-sec period resulted in a temperature rise from 3 to 4°C in the approximate root location. This power is also suitable for debracketing from the point of view of damage to enamel lying below the bracket. Only a slight damage to the enamel was registered by SEM compared to conventional bracket removal. CONCLUSIONS: Use of a Tm:YAP laser (wavelength 1998 nm, power 1 W, irradiance 14 W/cm(2), interacting time 60 sec) which is at the same time compact and small enough to be used in the dental practice, together with moderate cooling, could be an efficient tool for debracketing.

X-ray opaque waveguide for dentistry.

OBJECTIVE: The aim of this study is the design, realization, and examination of a new x-ray contrast hollow waveguide which will be suitable for x-ray diagnostics or treatment required in medicine, as dentistry, maxiollofacial surgery or oncology. BACKGROUND DATA: With the growing usefulness of laser radiation therapeutic interventions, a strong demand for radiation delivery from the laser source to the interaction place has appeared. For more complicated surgery, especially for internal intervention, an x-ray is necessary. In such cases, as a minimum, the end of the delivery system must be x-ray contrasted to distinguish where the interaction of radiation with tissue would take place. Up to now, neither fiber, hollow waveguide, nor other delivery system have been x-ray opaque. MATERIALS AND METHODS: A new type of hollow glass waveguide was designed, fabricated, and examined as a delivery system for an endodontic treatment. The system is composed from the cyclic olefin polymer coated silver hollow glass waveguide with special covering for x-ray visibility. The inner diameter of the waveguide was 320 microm, the outer diameter was 630 microm, and its length was 100 mm. After the delivery system was created, the hollow waveguide was checked under an x-ray machine and its opacity was measured. For actual treatment, an Er:YAG laser system generating a mid-infrared radiation was used. The root canals of 10 molars were treated endodontically, and the result of that treatment was compared with the common cleaning methods. During treatment, digital x-ray images were taken with conventional files, using this new designed hollow waveguide. RESULTS: The position of a metal instrument demonstrates the quality of opacity after conventional step-back technique. The hollow waveguide is visible in the left tooth canal. A bone density analysis shows no differences between a left (waveguide) and right (tooth) canal. CONCLUSION: It was demonstrated that no differences exist between x-ray opacity of the metal instrument used for endodontic treatment and a special hollow waveguide. The digitalized, three-dimensional image helps to detect a precise position of customary instrument or waveguide in root canal.

Diode laser-activated bleaching.

This study describes a preclinical investigation with laser-activated bleaching agent for discolored teeth. Bleaching techniques involve a broad-spectrum approach utilizing hydrogen peroxide (3-38%) with or without heat or laser, carbamide peroxide (10-30%), or a mixture of sodium perborate and hydrogen peroxide. Extracted human maxillary central incisors were selected. In the bleaching experiment, 38% hydrogen peroxide was used. Two different laser systems and light emission diodes for activation of the bleaching agent were used: diode laser, wavelength 970 nm, and infra-red diode laser, wavelength 790 nm, with eight blue light emission diodes, wavelength 467 nm. The enamel surface was evaluated with the scanning electron microscope. The method of chemical oxidation resulted in a 2-3 shade change in one treatment (15 min). Shorter time (5 min) was not effective. The diode laser, wavelength 970 nm, and the bleaching agent produced the same effect but with a shorter time of bleaching process (5 min - 1 W, 2.5 min - 2 W). Infra-red diode laser, wavelength 790 nm with eight blue light emission diodes, wavelength 467 nm, and the bleaching agent reached the desired color shade also after a shorter time (5 min - 40 mW). Slight surface modification after the bleaching process was detected with scanning electron microscopy. Currently, the laser has been proven the most valuable energy source for power bleaching with simple and short application in the dental office.

Erbium:YAG laser lithotripsy by use of a flexible hollow waveguide with an end-scaling cap.

An Er:YAG laser light delivery system composed of a polymer-coated silver hollow waveguide and a quartz sealing cap has been developed for calculus fragmentation. Sealing caps with various distal-end geometries were fabricated, and the focusing effects of these caps for Er:YAG laser light were measured both in air and in water. Owing to the high power capability of the quartz a beam of sealing caps, Er:YAG laser light with an output energy of 200 mJ and a repetition rate of 10 Hz was successfully transmitted in saline solution by use of the system. Calculus fragmentation experiments conducted in vitro showed that the delivery system is suitable for medical applications in lithotripsy. We also found that the cap with a focusing effect is more effective in cutting calculi. The deterioration of the sealing caps after calculus fragmentation is also discussed.

Endodontic treatment with application of Er:YAG laser waveguide radiation disinfection.

OBJECTIVE: The objective of this study is to examine the ability of Er:YAG laser radiation. Using a movable waveguide helps to obtain an antibacterial effect, not only in root canal walls but also in the surrounding tissues. BACKGROUND DATA: Conventional endodontic treatment is not fully effective due to microbial colonization of root canal walls dentin in premolars and molars. Various laser systems seem to be effective to kill the remaining microbial content in the root canal. The problem is in the flexibility of laser system tips. MATERIALS AND METHODS: The Er:YAG laser system was designed with a fluorocarbon polymer-coated silver hollow glass waveguide. Root canal systems of 44 premolars and molars were treated endodontically, using a step-back technique; 10 teeth were then treated with calcium hydroxide paste, and 22 teeth were irradiated by a movable waveguide. Before and after treatment, the colony-forming units were counted to determine 21 various microorganisms. RESULTS: Classical enlargement and shaping of the root canal is effective in 60%. Application of calcium hydroxide prepares sterile root canal in 80%. Er:YAG laser irradiation via movable waveguide (energy of 100 mJ, 30 pulses, repetition rate 4 Hz) can ensure residual disinfection of the root canal. CONCLUSION: Application of Er:YAG laser radiation through a flexible waveguide helps to attain antibacterial effect, not only in the root canal walls, but also in the surrounding tissues. Therapeutic doses of laser radiation guarantee one-step disinfection, including of anaerobic microorganisms.