Assessment of clinical efficacy of 445 nm Diode laser as an adjunct to Kirkland flap surgery in the management of periodontitis - a split mouth randomized clinical trial.

Aim of this study is to assess the clinical efficacy of 445 nm Diode laser as an adjunct to Kirkland flap surgery in management of periodontitis. Type of study is a Split mouth clinical trial in which a total of 13 patients were recruited based on specific inclusion and exclusion criteria. In each participant, random allocation of selected sites into test and control in contralateral quadrants was done. Clinical parameters such as probing depth and clinical attachment loss was measured in control and test sites using occlusal stents. Flap surgery was carried out 6 weeks after phase I therapy and the selected contralateral sites with a probing depth of > 5mm were subjected to surgical therapy. In a test quadrant, 445 nm diode laser with a power of 0.8 W, CW mode, 320 µm fiber, in non-contact mode was used as an adjunct to flap surgery. Primary outcome variable assessed was change in PPD between baseline, pre-operative, 1-, 3- and 6-months post-surgery. Secondary outcomes variables assessed were Clinical attachment loss at baseline, pre-operative, 1, 3 and 6 months, visual analog scale at days 3 and 7 and patient satisfaction index at day 7 post surgery. Surgery for the second site (Test/control) in the contralateral quadrants was performed 1 week after the first surgery. A higher reduction in probing depth and gain in CAL was observed in test site at 1, 3 and 6 months follow up amongst all the included participants. VAS score was lower at the test site as compared to the control sites. PSI scores were similar in both the sites. The adjunctive use of 445nm diode laser to surgical periodontal therapy contributed to improved short term clinical outcomes as assessed at the end of 6 months post- surgery. VAS score indicative of post -surgical discomfort were also lower for the laser treated sites. Hence adjunctive use of laser (445 nm wavelength) can be recommended for achieving more predictable clinical outcomes.

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.

Diode Laser Transscleral Cyclophotocoagulation With a Novel Low-Cost Torchlight Method of Trans-Corneal Transillumination in Refractory Pediatric Glaucoma.

PRCIS: Trans-corneal transillumination (TI) aided transscleral cyclophotocoagulation (TSCPC) for intraocular pressure control of refractory pediatric glaucoma was found to be effective at 1 year. PURPOSE: To study 1-year outcomes of diode laser TSCPC with trans-corneal TI using a novel low-cost torchlight method in refractory pediatric glaucoma. METHODS: This prospective interventional study included children with refractory glaucoma who underwent TSCPC with the Oculight laser system (IRIS Medical Instruments) with trans-corneal TI (TSCPC-TI) using a novel low-cost torchlight method. Children completing a minimum 1-year follow-up were analyzed. They were compared with a historical control group of children who underwent TSCPC without TI (TSCPC-No-TI) at the 1-year follow-up period. We analyzed the mean laser energy delivered, post-laser intraocular pressure reduction, number of antiglaucoma medications (AGM), the requirement of retreatment and complications of the procedure in both groups. RESULTS: Forty-two eyes of 35 patients comprised the TSCPC-TI group and were compared with 31 eyes of 21 patients in the TSCPC-No-TI group. The TSCPC-TI group required lower energy than the TSCPC-No-TI group (24.7±7.8 J vs. 47.2±10.9 J, P <0.0001). Mean topical antiglaucoma drug requirement decreased from 2.9±0.08 before treatment to 0.66±0.8 at the end of 1 year in TSCPC-TI and from 2.6±1.0 before treatment to 0.6±0.77 in the TSCPC-No-TI groups, respectively ( P =0.15). There was a significantly reduced dependence of oral acetazolamide in the TSCPC-TI group at 1-year follow-up [5.7% vs. 61.9%, respectively ( P <0.001%)]. No adverse event of hypotony or choroidal detachment was noted in any group. CONCLUSIONS: TSCPC aided by TI with a low-cost torchlight for pediatric refractory glaucoma was found to be effective at 1 year in reducing intraocular pressure and the burden of medication.

Assessment of clinical outcomes and patient response to gingival depigmentation using a scalpel, ceramic bur, and diode laser 980 nm.

OBJECTIVE: This research compares the clinical outcomes of gingival depigmentation procedures with conventional scalpel, ceramic trimmer bur, and diode laser techniques. MATERIALS AND METHODS: Twenty-four individuals with physiologic gingival hyperpigmentation received random allocation to one of three treatment groups: scalpel, ceramic bur, or diode laser. Pain score, operation time, bleeding index, degree of epithelialization, wound healing, Dummett-Gupta Oral Pigmentation Index (DOPI), and Takashi Index score changes were all investigated at different time points. RESULTS: At 12-h follow-up, significant variations in pain scores were seen between the laser and scalpel groups (p = 0.003) but not between the laser and ceramic bur groups. The diode laser group completed the procedure significantly quicker than the scalpel and ceramic bur groups (p = 0.004 and p = 0.001, respectively). The ceramic trimmer bur and diode laser groups showed significantly less bleeding tendency than the scalpel group. Wound healing and the degree of epithelialization were similar in all groups. DOPI and Takashi indices significantly decreased compared to baseline in all groups, with no significant difference recorded between all groups. CONCLUSION: While diode lasers are a safe and effective treatment option for gingival hyperpigmentation, providing optimal aesthetics with reduced discomfort to patients, a ceramic trimmer bur can also be used as a simple and affordable alternative to a laser in gingival depigmentation procedures. CLINICAL RELEVANCE: Gingival hyperpigmentation is a major aesthetic issue for many individuals. Laser and ceramic trimmer bur treatments produce equivalent aesthetic outcomes for gingival hyperpigmentation.

Bioburden assessment of necrotic teeth disinfected with sodium hypochlorite, diode laser, and photodynamic therapy using flow cytometry-a randomized double-blinded clinical trial.

This study aimed to comparatively evaluate the disinfecting potential of sodium hypochlorite, diode laser, and photodynamic therapy in non-vital teeth with or without periapical rarefaction. Forty-five patients with the diagnosis of pulp necrosis with apical rarefaction were randomly assigned to three groups (n = 15) based on the disinfection protocol. Access cavities were prepared and pre-instrumentation microbial samples were taken using a paper point. Working length determination followed by cleaning and shaping with rotary files was performed. The canals were lubricated with ethylenediaminetetraacetic acid (EDTA) during instrumentation and finally rinsed with copious amounts of saline. Canals in group 1 were irrigated with 5 mL of 5.25% NaOCl, those in group 2 received irradiation with 808-nm diode laser (30 s, 7W), and those in group 3 were soaked with methylene blue photosensitizer (5 min) before irradiation with 660-nm diode laser (3 min). Post-disinfection microbial samples were collected using a paper point. Pre- and post-disinfection live bacterial counts were analyzed using a flow cytometer. The data were statistically analyzed using one-way ANOVA and Student's t-test. Comparison of pre-instrumentation mean live bacterial count showed no significant difference between the groups (p > 0.05). The mean live bacterial count post-disinfection was 41.07%, 46.99%, and 34.45% in groups 1-3 respectively. A significant reduction in the bacterial count was seen following disinfection in all the groups (p < 0.05). It can be concluded that both diode laser and photodynamic therapy were equally effective as 5.25% NaOCl in reducing the bioburden in root canals. TRIAL REGISTRATION: CTRI/2018/03/012667.

Alveolar Ridge Augmentation Assessment Using a Minimalistic Approach, with and without Low-Level Laser Therapy (LLLT)-A Comparative Clinical Trial.

Background and Objective: A narrow alveolar ridge is an obstacle to optimal rehabilitation of the dentition. There are several complex and invasive techniques to counter the ridge augmentation dilemma, with most of them exhibiting low feasibility. Hence, this randomized clinical trial aims to evaluate the effectiveness of a Minimalistic Ridge Augmentation (MRA) technique, in conjunction with low-level laser therapy (LLLT). Materials and Methods: A total of 20 patients (n = 20) were selected, with 10 assigned to the test group (MRA+LLLT) and the other 10 to the control group (MRA). A vertical incision of approximately 10 mm was placed mesial to the defect and tunneled to create a subperiosteal pouch across the entire width of the defect. At the test sites, a diode laser (AnARC FoxTM Surgical Laser 810 nm) was used to deliver LLLT (parameters: 100 mW, with a maximum energy distribution of 6 J/cm2 in the continuous wave mode for 60 s per point) to the exposed bone surface inside the pouch, followed by graft (G-Graft, SurgiwearTM, Shahjahanpur, India) deposition with a bone graft carrier. The control sites were not irradiated with a laser. Results: A horizontal ridge width gain of >2 mm was observed in both groups. The changes in bone density for the test and control groups were -136 ± 236.08 HU and -44.30 ± 180.89 HU, respectively. Furthermore, there was no statistically significant difference between the test and control groups in these parameters. Conclusion: The study findings reveal that the MRA technique is relatively simple and feasible for alveolar ridge augmentation. The role of LLLT in the process requires further elucidation.

Disinfection of caries-affected dentin using activated vitamin B2 and diode laser with total-etch technique. An assessment of adhesive bond.

AIM: The present study aims to evaluate the bond integrity of composite restoration bonded to CAD after disinfection using pineapple peel extract (PPE) Diode laser (DL) and riboflavin (RF) activated by photodynamic therapy (PDT). MATERIAL AND METHODS: Forty human permanent mandibular molars were collected, disinfected, and mounted in poly-vinyl pipes. Carious infected dentin was removed and CAD was disinfected. Samples were divided into 4 groups based on disinfection. Group 1: CAD disinfected with CHX; group 2: CAD disinfected with diode laser; CAD disinfected with PPE and CAD sterilized with riboflavin. Following disinfection, CAD surfaces were applied with the etch-and-rinse adhesive system and bonding agent and restored with a composite restoration. Samples were placed in a thermocycler to simulate oral aging and then mounted on the universal testing machine (UTM) for shear bond strength (SBS) testing. Failure mode was assessed using a steriomicroscoscope at 40X magnification. One-way analysis of variance (ANOVA) compared the mean SBS and failure type obtained to identify intergroup differences. Similarly, for multiple group comparison, the Tukey HSD test was used keeping the level of significance at 0.05. RESULTS: CAD disinfected with chlorhexidine (CHX) established the highest bond integrity of the restoration. However, group 2 CAD disinfected with DL displayed the lowest bond values. It was also observed that dentin disinfected using CHX demonstrated comparable SBS values to CAD disinfected with PPE and CAD disinfected with RF. CONCLUSION: RF and PPE displayed comparable outcomes of SBS of composite restoration bonded to CAD to that of CHX. DL displayed lower bond integrity than the other investigated groups. Further studies are recommended to deduce the findings of the existing study.

Assessment of chemical, ultrasonic, diode laser, and Er:YAG laser application on debonding of ceramic brackets.

BACKGROUND: Risk of enamel damage that often accompanies ceramic brackets debonding raises the demand of finding an optimal method for debonding of them without adverse effects. Different techniques were proposed in an attempt to facilitate their debonding. Comparison of these techniques is crucial. The aim of this study was to evaluate and compare different techniques for debonding of ceramic brackets in terms of shear bond strength and adhesive remnant index. MATERIALS AND METHODS: A total of 100 extracted premolars were randomly allocated into 5 groups. Ceramic brackets were then bonded to teeth using light cure composite resin. Among test groups; group I: served as control, group II: chemical aided debonding via peppermint oil, group III: ultrasonic aided debonding, group IV: diode laser aided debonding, and group V: Er:YAG laser aided debonding. Brackets were shear tested using universal testing machine followed by ARI assessment and evaluation of enamel microstructure was performed using scanning electron microscopy. RESULTS: A significantly lower shear bond strength was found in ultrasonic, diode, and Er:YAG laser groups. However, no significant difference was found in the chemical group. A significantly higher adhesive remnant index was found solely in Er:YAG laser group with minimal enamel microstructure alterations. CONCLUSIONS: Er:YAG laser is a promising tool in debonding ceramic brackets. Ultrasonic and diode laser significantly reduced shear bond strength. Yet, adhesive remnant index in both groups revealed no difference. Chemical aided debonding had little effect and hence, it cannot be recommended without further development.

Radicular canal disinfection using photon-induced photoacoustic streaming and riboflavin photosensitizer to silver diamine fluoride and diode laser bonded to fiber post: An assessment of extrusion bond strength.

AIM: The present study aimed to estimate and compare the effectiveness of different innovative canal cleansing approaches photon induced photoacoustic streaming (PIPS) Riboflavin Photosensitizer (RF), Diode Laser, and silver diamine fluoride (SDF) on push out bond strength (PBS) of fiber post cemented to radicular dentin MATERIAL AND METHODS: Forty extracted premolars were disinfected and decoronated up to the cement-o-enamel junction. Canals of all specimens were cleaned and shaped utilizing a reciprocating system. Post space was created by employing peso-reamers and samples were randomized into four groups based on methods of disinfection (n = 10). Group 1 (PIPS), group 2 (Diode Laser), group 3 (RP), and group 4 (SDF) canal disinfection. Fiber posts were cemented via Self etch resin cement (SERC) in a radicular dentin post space area and root was segmented at three levels (coronal, middle and apical). PBS analysis was performed, and a stereomicroscope was used to assess the failure mode. The means and standard deviations of PBS among studied groups were measured using one-way analysis of variance (ANOVA) after exposure. The means of bonding strength were compared by Tukey multiple comparison tests (p > 0.05). RESULTS: RF had the highest PBS at all three root levels, coronal (8.31 ± 0.64 MPa), middle (8.13 ± 0.11 MPa) and apical (5.68 ± 0.54 MPa) while group 4 SDF samples showed lowest PBS at all root portions, coronal (6.14 ± 0.78 MPa), middle (5.18 ± 0.15 MPa) and apical (3.15 ± 0.19 MPa), respectively. Intergroup comparison unveiled comparable PBS at all three root levels for group 1 (PIPS) and group 3 RF (p > 0.05). Intragroup comparison displayed a significant decline in PBS values from coronal, middle to the apical direction in all studied groups CONCLUSION: Disinfection of radicular dentin with Riboflavin Photosensitizer and photon-induced photoacoustic streaming bonded to fiber post have the greatest PBS at all three levels cervical, middle and apical.

Diode Laser Spectrometer for Diagnostic Assessment of Exhaled Air Components.

The main requirements for a screening test are simplicity, non-invasiveness, safety of testing procedures, high processing speed, and ability to detect diseases at an early stage. A multichannel gas analyzer for assessment of exhaled air composition (diode laser spectrometer), non-invasive screening, and biomedical testing was developed on the basis of near-infrared diode lasers with fiber output. The device measures the following exhaled air components: 12CO2, 13CO2, CH4, NH3, H2O, and H2S. The concentration of molecules was measured in a multi-pass Herriot cell with a reference length of 40 cm, 1.8 L volume, and a total optical path length of 26 m. Three diode lasers manufactured by NTT Electronics (Japan) were used in the work. Detection of CH4 was carried out in the 1.65 µm wavelength range, 12CO2, 13CO2, and H2S levels were measured in the 1.60 µm range, NH3 and H2O in the 1.51 µm range. All measurements were taken in real time. Clinical testing of the spectrometer was carried out at V.M. Buyanov City Clinical Hospital of Moscow Department of Health. More than 150 patients were examined. The tests included analysis and measurement of these molecular components in the exhaled air of patients with various diseases. The content of these components was studied in conditions of various changes in the human physiological state (dosed physical activity, relaxation, psychoemotional stress, etc.). The studies have demonstrated efficacy of using the developed hardware system for assessment of exhaled air components in order to reveal functional disorders in various diseases of the digestive system, cardiorespiratory system, diseases caused by impaired nitrogen-excreting function of the kidneys, etc.

Does a short lingual frenulum affect body posture? Assessment of posture in the sagittal plane before and after laser frenulotomy: a pilot study.

The factors that characterize posture are neurophysiological, biomechanical, psychoemotional. Neurophysiological factors concern the modulation of tone, muscle tone is the result of a series of neuropsychological processes within the tonic-postural system. The tonic-postural system can become unbalanced for various reasons, including a tight lingual frenum. The aim of this pilot study was to evaluate the benefits of frenulectomy by laser on body posture and on the scapular (shoulders) anteroposterior movement. Twenty-four healthy subjects were selected, between the ages of 10 and 26 years (mean age 15.22) who presented a short lingual frenum and a low posture of the tongue and jaw. They were examined using the Marchesan Protocol for Lingual Frenum and the Spinometry® Formetric and underwent laser frenectomy by diode laser (Siro Laser Blu. 660 nm) without any post-surgery complications. The release of the frenulum immediately brought benefits to patients, reorganizing the physiological modulation, and the movement of the tongue within the normal parameters of temporomandibular kinematics which were within physiological parameters. Frenectomy improved the anterior-posterior flexion of the scapulas (shoulders) in the sagittal plane but a larger sample is required to have statistically significant results.

Economic Evaluation of 1470 nm Diode Laser Enucleation vs Bipolar Transurethral Resection of the Prostate.

Purpose: Large meta-analyses demonstrate the noninferiority of laser enucleation to transurethral resection of the prostate (TURP) with regard to long-term efficacy and reoperation rate. Although the 1470 nm diode laser enucleation of the prostate (DiLEP) is superior in hemostasis and surgical visibility, its complexity and associated longer operative time limit its widespread usage. The objective of this study was to generate long-term cost estimates for bipolar TURP and DiLEP, taking into account perioperative and adverse event costs. Materials and Methods: This is a retrospective review of patients who underwent DiLEP (n = 114; November 2016 to February 2020) or TURP (n = 194; January 2016 to December 2018). A decision analysis model was constructed to compare costs of the primary procedure and subsequent complications taking into account disposable costs, operating room time, length of stay, reoperation rates, and readmissions. Costs were estimated from internal data, published literature and Medicare procedure costs. Markov modeling was used to create cost projections up to 10 years. Results: DiLEP was associated with shorter length of stay and fewer total complications, but longer operative times and greater initial costs. Cost were recuperated at 8 years postoperatively. At 10 years postoperatively, DiLEP represented approximately $664 cost savings per patient over TURP. Conclusions: DiLEP is a cost-effective alternative to TURP for the treatment of benign prostatic hyperplasia in the properly selected patient. DiLEP has greater initial costs due to longer operative times. Costs are recuperated by 10 years postoperatively due to higher rate of same-day discharges, and lower complication and reoperation rates, incurring a $664 cost savings per patient treated by DiLEP relative to TURP.

Air Bubble Test Versus Endoscopic Jones I Test in Assessment of Anatomical and Functional Success After Diode Laser Transcanalicular Dacryocystorhinostomy.

PURPOSE: To compare the accuracy and positive predictive values of the air bubble test (ABT) and endoscopic Jones I test for assessment of anatomical and functional success after diode laser transcanalicular dacryocystorhinostomy (T-DCR). METHODS: This cross-sectional study included 60 eyes of 56 patients who underwent T-DCR by a single surgical team from January 2016 to December 2018. All the 56 patients (60 eyes) underwent lacrimal syringing, endoscopic Jones I test, and ABT. Anatomical success was considered as a free passage of fluid with no reflux on the irrigation test. Functional success was defined as the resolution or improvement of epiphora (Munk score of 0 or 1). The results of irrigation test, endoscopic Jones I test, and ABT were used to calculate the accuracy and positive predictive values (PPVs) of ABT and endoscopic Jones I test for assessment of anatomical and functional success (Munk score of 0 or 1) after T-DCR. A value of p < 0.05 was considered statistically significant. All statistical evaluations were performed using SPSS software. RESULTS: There were 60 T-DCR procedures in 56 patients (82.1% women; 46 patients) with a mean age of 56.4 years (standard deviation: 15.7; range from 29 to 92). The mean follow up was 8.1 months. Overall anatomical and functional success rates were 83.3% (50/60) and 73.3% (44/60), respectively. The PPV of endoscopic Jones I test in anatomical success and functional success was 100% and 88%, respectively. The accuracy of this test in anatomical and functional success was 100% and 81.25%, respectively. The PPV of ABT in anatomical success and functional success was 100% and 90.4%, respectively. The accuracy of this test in anatomical and functional success was 92% and 80.65%, respectively. CONCLUSIONS: In conclusion, both endoscopic Jones I test and ABT showed PPV of 100% to detect anatomical success after T-DCR; the endoscopic Jones I test and ABT had 88% and 90.4% of PPV on evaluation of functional success, respectively. Both tests showed good accuracy in the assessment of anatomical and functional success after T-DCR. These outcomes may indicate that ABT could substitute Jones I test on postoperative DCR assessment.

Investigating the transmission profiles of 808 nm laser through different regions of the rat's head.

Studying light penetration in biological tissues became a very important concern in various medical applications. It is an essential factor required to resolve the optical dose in many diagnostic and therapeutic procedures. The absorption and scattering properties of the inspected tissue control how deep the light will travel inside the tissue. However, these optical properties are highly dependent on the wavelength of the light source. In this work, the light transmission through different regions of the rat's head was investigated and the minimum laser power required to reach different parts of the head is also determined using 808-nm semiconductor laser diode. The power variation in different regions of the head is estimated using Monte Carlo simulation. Absorption and scattering coefficients of the head layers were calculated using integrating sphere measurements and Kubelka-Munk model. The absorption coefficient of the skin was 0.19 ± 0.071 mm-1, 0.024 ± 0.11 mm-1 for skull, and 0.35 ± 0.13 mm-1 for the brain, while the scattering coefficients were 7.35 ± 1.09, 2.71 ± 0.37, and 13.04 ± 0.36 mm-1 for skin, skull, and brain, respectively. The obtained results provide a relationship between laser incident power and the depth in the rat's head showing a higher optical transmission at the frontal part of the head than the middle or back regions due to the variations in the skull thickness. Therefore, the study revealed that the transmitted power of 808 nm laser at different incident locations on the head is nonlinear and variable due to different skull's thickness.

Utilización de láser diodo en tejidos blandos: reporte de 3 casos / Use of diode laser in soft tissue: report of 3 cases

Existen diversas condiciones anatómicas o alteraciones mucogingivales que pueden afectar tanto el normal funcionamiento como la estética gingival de piezas dentarias e implantes dentales. Si bien los tratamientos de estas condiciones se han realizado tradicionalmente con bisturí, el desarrollo tecnológico ha permitido que actualmente se pueden realizar con láser. Existen diferentes tipos de láser, siendo el diodo uno de los más utilizados debido a su menor tamaño, portabilidad, fácil configuración y menor costo. El láser ha adquirido mayor popularidad en cirugías de tejido blando dado sus múltiples beneficios: menor tiempo operatorio, control del sangrado y de la hemostasia, reducción de la cantidad de anestesia, posibilidad de no requerir suturas y minimización del dolor e inflamación postquirúrgica. El propósito de este trabajo es presentar la resolución de tres casos clínicos a los cuales se les realizaron los procedimientos de frenectomía labial, remoción de melanosis gingival y resección de fibroma irritativo mediante el uso de láser diodo. Para desarrollar todos los procedimientos se utilizó un equipo de láser diodo de 940 nm (Biolase®, USA) con una potencia que varió entre 2 y 2.5 W en modo continuo utilizando una pieza quirúrgica con una punta de 300 µm (E 3-4), la que fue activada antes de empezar. Posterior a la cirugía se bioestimuló para disminuir el dolor y edema postoperatorio utilizando la punta de dolor a 4 W por 30 segundos a una distancia de 1 cm directo en la zona intervenida a todos los casos. La conclusión arroja que en todos los casos, el láser de diodo permitió un resultado exitoso. El procedimiento fue seguro, la técnica fue sencilla y de tiempo clínico reducido. El postoperatorio ocurrió con ausencia de dolor o molestias, generando una mayor satisfacción del paciente. Cabe señalar que la técnica depende de la habilidad del profesional que la realiza.

There are various anatomical conditions or mucogingival alterations that can affect the normal functioning and the gingival aesthetics of teeth and dental implants. Although the treatments of these conditions have been traditionally performed with a scalpel, technological development has allowed that they can be now performed with lasers. There are different types of lasers, being the diode one of the most used due to its smaller size, portability, easy configuration, and lower cost. The laser has become more popular in soft tissue surgeries due to its multiple benefits: shorter operating time, control of bleeding and hemostasis, reduction in the amount of anesthesia, possibility of not requiring sutures, and minimization of post-surgical pain and inflammation. The purpose of this work is to present the resolution of three clinical cases which underwent labial frenectomy procedures, removal of gingival melanosis and resection of irritative fibroma using diode laser. To develop all the procedures, a 940 nm diode laser equipment (Biolase®, USA) was used with a power that varied between 2 and 2.5 W in continuous mode, using a 300 µm tip (E 3-4), which was activated before starting. After surgery, biostimulation was carried out to reduce postoperative pain and edema using the pain tip at 4 W for 30 seconds at a distance of 1 cm directly in the operated area in all cases. In all cases, the diode laser allowed a successful result. The procedure was safe, the technique was simple, and the clinical time was short. The postoperative period occurred with the absence of pain or discomfort, generating greater patient satisfaction. It should be noted that the technique depends on the skill of the professional who performs it.

Assessment of efficacy and safety of micropulse diode laser treatment in glaucoma: One year follow-up. / Evaluación de la eficacia y seguridad del diodo láser micropulsado en el tratamiento de glaucoma: un año de seguimiento.

OBJECTIVE: To determine the effectiveness and safety of the micropulse transscleral technique in lowering intraocular pressure in patients with glaucoma. MATERIALS AND METHODS: A retrospective cohort study was conducted on 143 eyes with various glaucoma subtypes between October 2016 and December 2018. Patients were grouped for analysis based on glaucoma subtypes, preoperative demographics, previous surgical procedures, and postoperative results. The data collected was based on intra- and post-operative complications, intraocular pressure, visual acuity, the need of micropulse re-treatment, incisional glaucoma surgery, and increasing the dose/quantity of medications. A logistic and Cox regression model was performed to determine predictors of therapeutic failure, in addition to building Kaplan-Meier curves. RESULTS: The mean follow-up was 268 days, and 63% of the patients completed one year. The micropulse procedure achieved a mean intraocular pressure decline of 7.3mmHg (excluding neovascular glaucoma), independent of the glaucoma subtype. The percentage of patients who achieved intraocular pressure less than 20mmHg at 24h was 78%, with 80% at 3 months, 77% at 6 months, and 78% at 12 months. During the follow-up, 29.6% of the patients required additional treatment or a dose increase. Only 2patients presented with minimal postoperative complications. CONCLUSION: The treatment with transscleral micropulse is a safe and efficient technique for use in glaucoma, attaining a reduction in intraocular pressure and decrease in need of antihypertensive medications within the first year following the procedure.

Assessment of photobiomodulation therapy by an 8l0-nm diode laser on the reversal of soft tissue local anesthesia in pediatric dentistry: a preliminary randomized clinical trial.

During the injection of local anesthesia in pediatric dental procedures, from the injection time until the elimination of tissue anesthesia, inevitable problems were reported. According to the encouraging results of previous studies addressing the positive effects of laser therapy on increasing the microcirculation, we aimed to investigate the clinical effect of photobiomodulation therapy on the reversal of soft tissue anesthesia in children. Using a split-mouth design, 34 children aged 4 to 8 years old, candidate for receiving local infiltration injection at both right and left side in mandible, were enrolled in the study. The mandibular right and left quadrants were randomly assigned to groups of laser or sham laser: in laser side, patients received 810-nm laser irradiation, and in the sham laser group, the patients had the laser in off mode at 45 min after injection with an interval of 7-10 days between two sessions of each quadrant treatments. The degree of anesthesia was evaluated using the palpation technique alternately every 15 min. Data were analyzed using paired sample t test and multiple linear regression test. The mean duration of anesthesia expressed in minutes was equal to 145.15 ± 23.27 and 188.82 ± 12.31 for the laser group and sham laser group, respectively. There was a significant difference in duration of anesthesia between two groups (P < 0.001). Considering the results and limitations of the present study, photobiomodulation therapy by 810-nm diode laser can be proposed as a non-invasive method in order to reduce the duration of anesthesia in pediatric patients.

Clinical outcomes of adjunctive indocyanine green-diode lasers therapy for treating refractory periodontitis: A randomized controlled trial with in vitro assessment.

BACKGROUND/PURPOSE: It is still challengeable to treat periodontal pockets refractory to mechanical debridement. This study is to evaluate the potential of indocyanine green (ICG)-diode laser-based photothermal therapy (PTT) for solving this dilemma. METHODS: Bone marrow-derived mesenchymal stem cells (BMSCs) and periodontal ligament cells (PDLCs) were incubated with phosphate-buffered saline, chlorhexidine, or ICG, non-irradiated or irradiated with 810-nm diode lasers, and the cell viability was evaluated. Patients with teeth refractory to mechanical periodontal debridement on different quadrants were recruited. At baseline (T0), all examined teeth received scaling and root planing, and those on the test quadrant (PTT group) received ICG-diode laser treatment. The outcome was evaluated using clinical parameters and cytokines in the gingival crevicular fluids at 4-6 weeks (T1) and 6 months (T2). RESULTS: In ICG-treated cultures, the viability of BMSCs and PDLCs was recovered on day 4, and laser irradiation inhibited the metabolic activities of BMSCs. 22 patients with 30 control teeth and 35 PTT-treated teeth were examined. All examined teeth showed modest reductions in probing pocket depth (PPD), clinical attachment loss (CAL), bleeding upon probing (BOP), and plaque score at T1 and T2 and significant reductions in IL-1ß and MMP-8 at T2. Compared with controls, BOP was reduced more prominently, IL-1ß and MMP-8 were significantly lower, and reductions in PPD and CAL were slightly greater in the PTT group at T1 (0.05-0.19 mm). CONCLUSION: ICG-diode laser-based PTT is compatible to periodontium and assists in faster resolution of gingival inflammation in periodontal pockets refractory to mechanical debridement.

Assessment of sensitivity of selected Candida strains on antimicrobial photodynamic therapy using diode laser 635 nm and toluidine blue - In vitro research.

BACKGROUND: Photodynamic therapy is believed to be a promising treatment for Candida infections. This study evaluated the efficacy of antimicrobial photodynamic therapy (aPDT) using the 635 nm diode laser light and toluidine blue (TB) in the elimination of selected Candida species cultured on acrylic surface. METHODS: 108 acrylic plates (Methyl Methacrylate Polymer, routinely used for the production of prosthetic dentures) were placed in three sterile Petri dishes and poured with prepared suspensions of Candida strains: C. albicans, C. glabrata, and C. krusei. After all procedures of fungi incubation, fungal biofilm was visible on the plates' surfaces. The acrylic plates were divided into nine study groups (B) and nine control groups (K) for further experiments. In the study groups, the acrylic plates with fungal biofilm were immersed in TB and afterwards laser irradiation was applicated with different exposure parameters (groups: B1 - 400 mW, 24 J/cm2, 30 s; B2 - 300 mW, 18 J/cm2, 30 s; B3 - 200 mW, 12 J/cm2, 30 s) separately for each Candida species. The control groups contained following parameters: no exposure to laser light or TB, treatment only with TB without laser irradiation, or only laser irradiation without previous immersion in TB. Calculations of colony forming units (CFUs) were conducted by using aCOlyte (Synbiosis). Differences in CFUs were analyzed by the Wilcoxon test. RESULTS: In all study groups, the reduction in CFUs was statistically significant. The differences in CFUs before and after intervention were insignificant. The K3 C.a. control group showed a statistical reduction of Candida albicans after laser irradiation. CONCLUSION: Our study confirmed the efficacy of aPDT against C. albicans, C. glabrata and C. krusei being dependent on the laser parameters and the type of fungus. The advantage of this study is the validation of aPDT effectiveness in in vitro studies to transpose this data into future clinical trials using photodynamic therapy in the treatment of oral candidiasis.

The Cost and Economics of Endoscopic Cyclophotocoagulation in the United Kingdom: A Tertiary Center Experience.

PRECIS: As the only microinvasive glaucoma surgery (MIGS) with a reusable component, the cost per procedure of endoscopic cyclophotocoagulation (ECP) diminishes with each successive use. We present a cost comparison of ECP with other MIGS devices, based on our clinical practice. PURPOSE: ECP delivers diode laser via a reusable probe to the ciliary processes under direct visualization. The aim of our study is to evaluate the direct cost of ECP based on a retrospective review of cases and compare the cost per procedure with other MIGS devices. METHODS: We conducted a retrospective review of ECP procedures performed at St Thomas' Hospital over 4.5 years. The cost of the ECP endoscope and diode laser consoles, reusable probes, and maintenance contracts were obtained from the hospital procurement log. The on-site Central Sterile Services Department was contacted for probe sterilization and repackaging costs. The cost per device for ECP and commonly performed MIGS procedures were obtained from the product specialists of each company. RESULTS: A total of 332 procedures were performed using 37 ECP probes during the study period. Each reusable ECP laser probe was found to give an average of 8.97 laser treatments. The cost per procedure decreased over the course of 4.5 years from £819.43 for the first 42 cases to £341.50 after 332 cases. Compared with other MIGS devices, the cost per procedure of ECP after 100 procedures is second lowest to the Kahook Dual Blade and reduces with each successive procedure performed. CONCLUSION: The ability to reuse each ECP probe significantly lowers the cost per procedure compared with other MIGS devices in the United Kingdom. The cost per procedure continues to reduce with each successive procedure.