Shear bond, wettability and AFM evaluations on CO2 laser-irradiated CAD/CAM ceramic surfaces.

The purpose of this study is to determine the CO2 laser irradiation in comparison with sandblasting (Sb), hydrofluoric acid (Hf) and silane coupling agent (Si) on shear bond strength (SBS), roughness (Rg) and wettability (Wt) of resin cement to CAD/CAM ceramics. Sixty (CAD/CAM) ceramic discs were prepared and distributed into six different groups: group A, control lithium disilicate (Li); group B, control zirconia (Zr); group C, Li: CO2/HF/Si; group D, Li: HF/Si; group E, Zr: CO2/Sb/Si; group F, Zr: Sb/Si. Result showed significant difference between irradiated and non-irradiated in terms of shear bond strength for zirconia ceramics (p value = 0.014). Moreover, partial surface wettability for irradiated and non-irradiated ceramics. Irradiated surface demonstrated more rough surface in lithium disilicate than zirconia ceramics. CO2 irradiation could increase shear bond strength, surface roughness and wettability for both CAD/CAM ceramics.

450 nm Blue Laser and Oral Surgery: Preliminary ex vivo Study.

INTRODUCTION: Dental diode lasers were started to be used at the end of the 1990s and were shown to possess several important characteristics, such as small size and low cost, as well as the advantage of optic fibers delivering system. Although only two wavelengths (810 and 980 nm) had been the most used dental diode lasers, a wavelength emitting in the blue portion of the spectrum has recently been proposed. AIM: The aim of this ex vivo study was to compare the effectiveness of five different fiber-delivered laser wavelengths (450, 532, 808, 1064, and 1340 nm) in the oral soft tissue ablation. MATERIALS AND METHODS: Specimens were surgically collected from the dorsal surface of four bovine tongues and, while deep thermal increase was measured by two thermocouples at 0.5 and 2 mm depth, surface temperature was recorded by an infrared thermometer. Subsequently, specimens were fixed in 10% buffered formalin solution, cut into slices, and embedded in paraffin blocks, and a pathologist made a morphological analysis by optic microscope assigning a score based on the quality of the cut and tissue damage. RESULTS: The analysis showed the best quality of the cut and the lowest temperature increase on the specimens obtained with the shortest laser wavelength (450 nm). CONCLUSION: Even considering this as preliminary study, the use of 450 nm blue diode laser in oral surgery may be suggested to the clinician in their daily practice. CLINICAL SIGNIFICANCE: This study opens a new perspective in oral surgery. Blue diode laser has demonstrated a good quality of the cut with a low energy causing a minimal thermal damage to the tissue, promising a better comfort to patients.

Er:YAG 2,940-nm laser fiber in endodontic treatment: a help in removing smear layer.

Cleaning and disinfection of the root canal system are some of the most important goals in endodontic therapy. The aim of this preliminary study is to assess the effectiveness of Er:YAG laser fiber in removing the smear layer produced during root canal walls instrumentation. Forty-eight single-rooted teeth were prepared with manual and rotary Ni-Ti instruments, in addition to 2.5% NaOCl irrigation. Samples were randomly subdivided into groups and treated with: three irradiations of 5 s each, with 300-µm Er:YAG endodontic fiber, 1 W and 2.5% NaOCl solution (A Group); two laser irradiations with 17% EDTA solution and 2.5% NaOCl solution (B Group); laser irradiation plus 17% EDTA solution and 2.5% NaOCl (C Group); only in the final wash of 17% EDTA (control group D). During laser treatment, temperature variations were analyzed by using thermocouple and thermal camera devices in order to test both deep and superficial temperatures. Each sample was finally observed by scanning electron microscope (SEM) at the coronal, medium, and apical thirds at ×500 magnification and blindly scored depending on the amount of smear layer. Statistical analysis of the results was conducted using the Kruskal-Wallis and Mann-Whitney test to determine the eventual significant differences between the quantity of smear layer in each group and between the groups at coronal, medium, and apical third: a p value <0.05 was considered significant. The thermal analysis realized by thermocouple with the used parameters demonstrated that laser endodontic fiber produces an average deep temperature increase of 3.5 ± 0.4 °C; analysis performed with a thermal camera showed an average superficial temperature increase of 1.3 ± 0.2 °C produced by laser endodontic fiber use. Deep and superficial temperatures fall immediately after irradiation possibly without causing structural damage or anatomical alteration inside the root canal and neither on periodontal tissues. SEM analysis showed that specimens of group B had the highest level of cleaning in every third, with a significant difference with groups D and A; group C samples showed a good percentage of cleaned tubules in apical and middle thirds, while group D teeth showed open dentinal tubules in coronal third, with a statistical difference with group A samples which were the worst cleaned. The Er:YAG fiber double irradiation with EDTA 17% and NaOCl 2.5% has been demonstrated to be effective in removing smear layer, even in the apical third which is described as the hardest area to clean during endodontic treatment.

In vitro bactericidal effect of Nd:YAG laser on Actinomyces israelii.

A bactericidal effect has been reported by the use of near-infrared laser light on both Gram-positive and Gram-negative bacteria. The aim of this study was to evaluate the effect of Nd:YAG laser on Actinomyces israelii, filamentous bacteria causing cervicofacial actinomycosis. Experiments were realized on bacterial cells in saline suspension or streaked on Mueller-Hinton (MH) agar plates with or without India ink. Laser application was performed in Eppendorf tubes with different powers and frequencies for 40 s; bacterial suspensions were then streaked on agar plates and incubated at 35 °C in proper conditions for 5 days before colony enumeration. A reduction of colony number variable from 60.13 to 100 % for powers of 2, 4, and 6 W at 25-50 Hz of frequency was observed in comparison with growth control. For agar plates, laser application was performed with different powers at 50 Hz for 60 s. A growth inhibition was observed after 5 days of incubation on MH plates with powers of 6 W and on MH-ink plates with all applied powers. This preliminary study showed a bactericidal effect caused by Nd:YAG laser application worthy to be evaluated in further experiments in vivo.

Laser-assisted surgery with different wavelengths: a preliminary ex vivo study on thermal increase and histological evaluation.

Since the introduction of laser in clinical practice, different wavelengths have been used for oral surgery on the basis of the different characteristics and affinities of each one. The aim of this study was a comparison of different laser wavelengths in relation to both thermal increase and "histological quality" in a model of soft tissue surgery procedures. Thermal evaluation was realized, during laser-assisted surgery excision performed on a bovine tongue, by a thermal camera device to evaluate thermal increase on the surface of the sample and with four thermocouples to evaluate thermal increase on the depth of the specimen; temperature was recorded before starting surgical procedure and at the peak of every excision. The quality of excision, in terms of tissue damage and regularity, was realized by two blind examiners on the basis of established criteria. The highest superficial thermal increase was recorded for Superpulse 5-W CO2 laser, the lowest one for Er:YAG laser. The highest in depth thermal increase was recorded for 5 W Diode laser, the lowest one for Er:YAG laser. The best quality of incision was obtained with a 3-W CO2 laser and 3-W diode laser; epithelial, stromal, and vascular damages were evaluated with different degrees for all the used wavelengths with the best result, in terms of "tissue respect," for Er:YAG laser. In all the surgical procedures performed, thermal increase was evaluated until the end of the procedure; at remaining tissue level, thermal decrease was evaluable in the few seconds after surgery. The Er:YAG laser was the device with a lower influence on thermal increase; CO2 and diode lasers revealed a good histological quality. Further studies may be necessary to test the reliability of laser devices for the excision of all the types of specimens needing histological evaluation and diagnosis.

Patient responses to Er:YAG laser when used for conservative dentistry.

The utilization of laser technology in conservative dentistry offers several advantages compared with traditional instruments, but one of the still unsolved problems is the difficulty in describing and explaining these advantages to patients. The aims of this study were to verify the efficacy of the way patients are informed and to evaluate their satisfaction with laser-assisted treatment. Before treatment, 100 patients were given a brochure that explained the relevant laser-assisted dental procedures, and after dental treatment an 11-item questionnaire was administered to the patients to evaluate their satisfaction with the treatment. Statistical analysis showed high levels of satisfaction for all the questions, especially those regarding the choice between laser therapy and traditional instruments (100%), choosing laser in the future (89%), and recommending it to family and friends (84%). This study may be relevant when determining the overall satisfaction of patients with this new technology.

Thermal increase in the oral mucosa and in the jawbone during Nd:YAG laser applications. Ex vivo study.

OBJECTIVE: Literature reports bactericidal and biostimulant effects for Nd:YAG laser procedures on bone and oral mucosa but the possible overheating can cause damage to anatomical structures. The aim of the study was to evaluate the is the evaluation of thermal increase in different levels of oral tissues: mucosa, periosteum and bone during defocused application of Nd:YAG laser at different parameters. STUDY DESIGN: Superficial thermal evaluation was performed in pig jaws with a thermal camera device; deep thermal evaluation was realized by 4 thermocouples placed at a subperiosteal level and at 1,2 and 4 mm depth in the jaw bone. Laser applications of 1 minute were performed 5 times (with a pause of 1 minute) on a surface of 4 cm² with a Nd:YAG laser (MSP mode, 320 micrometer fiber, defocused mode) with different parameters. Temperatures were recorded before and after laser applications and after each pause in order to evaluate also the thermal relaxation of tissues. RESULTS: At submucosal level, mean thermal increase was between 1.1°C and 13.2°C, at 1 mm depth between 1.1°C and 8.5°C, at 2 mm depth between 1.1°C and 6.8°C, at 4 mm depth between 1.0°C and 5.3°C. Temperature decrease during the rest time period was variable between 0°C and 2.5°C. CONCLUSIONS: Temperatures reached during clinical procedures with parameters reported in the literature in biostimulation protocols (1.25-2 Watts) for the five minutes of application are not dangerous for biological structures. The decrease in temperature during the rest time period is less considerable in the bone in comparison to oral mucosa.

Relevance of Teledentistry: Brief Report and Future Perspectives.

Teledentistry is a type of telemedicine and telehealth that aims to make all major specialties of the discipline easier through a remote approach to prevention and treatment of oral and dental issues. This new method enables distant access to individuals instead of direct, face-to-face, doctor-patient contact and has been made possible thanks to developments in information technology. Teledentistry was described in 1997 as "… the practice of using video-conferencing technologies to diagnose and provide advice about treatment over a distance", and today it represents a modern way to practice dentistry by integrating digital imaging, electronics, health records, and telecommunications technology via an internet connection. This approach facilitates patients' access to care in remote settings and also enables specialists at distant locations to arrive at a correct diagnosis as well as to propose proper therapy or refer patients, where warranted. The current brief report aims to describe the present and future of this modern approach in dentistry and its advantages in patient management from prevention to diagnosis to treatment.

Intraoral laser welding: ultrastructural and mechanical analysis to compare laboratory laser and dental laser.

The Nd:YAG laser has been used since 1970 in dental laboratories to weld metals on dental prostheses. Recently in several clinical cases, we have suggested that the Nd:YAG laser device commonly utilized in the dental office could be used to repair broken fixed, removable and orthodontic prostheses and to weld metals directly in the mouth. The aim of this work was to evaluate, using scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS) and dynamic mechanical analysis (DMA), the quality of the weld and its mechanical strength, comparing a device normally used in dental laboratory and a device normally used in the dental office for oral surgery, the same as that described for intraoral welding. Metal plates of a Co-Cr-Mo dental alloy and steel orthodontic wires were subjected to four welding procedures: welding without filler metal using the laboratory laser, welding with filler metal using the laboratory laser, welding without filler metal using the office laser, and welding with filler metal using the office laser. The welded materials were then analysed by SEM, EDS and DMA. SEM analysis did not show significant differences between the samples although the plates welded using the office laser without filler metal showed a greater number of fissures than the other samples. EDS microanalysis of the welding zone showed a homogeneous composition of the metals. Mechanical tests showed similar elastic behaviours of the samples, with minimal differences between the samples welded with the two devices. No wire broke even under the maximum force applied by the analyser. This study seems to demonstrate that the welds produced using the office Nd:YAG laser device and the laboratory Nd:YAG laser device, as analysed by SEM, EDS and DMA, showed minimal and nonsignificant differences, although these findings need to be confirmed using a greater number of samples.

Use of Blue and Blue-Violet Lasers in Dentistry: A Narrative Review.

Introduction: Blue and blue-violet diode lasers (450 and 405 nm) seem to represent an interesting approach for several clinical treatments today. The aim of this narrative review is to describe and comment on the literature regarding the utilization of blue and blue-violet lasers in dentistry. Methods: A search for "blue laser AND dentistry" was conducted using the PubMed database, and all the papers referring to this topic, ranging from 1990 to April 2020, were analyzed in the review. All the original in vivo and in vitro studies using 450 nm or 405 nm lasers were included in this study. All the articles on the LED light, laser wavelengths other than 405 and 450 nm and using lasers in specialties other than dentistry, as well as case reports, guideline papers and reviews were excluded. Results: From a total of 519 results, 47 articles met the inclusion criteria and were divided into 8 groups based on their fields of application: disinfection (10), photobiomodulation (PBM) (4), bleaching (1), resin curing (20), surgery (7), periodontics (1), endodontics (1) and orthodontics (3). Conclusion: Blue and blue-violet diode lasers may represent new and effective devices to be used in a large number of applications in dentistry, even if further studies will be necessary to fully clarify the potentialities of these laser wavelengths.

"At-Home" Photobiomodulation: A New Approach for Bell's Palsy Treatment.

OBJECTIVE: This report is the first one to describe the possibility to use "self-administered" photobiomodulation (PBM) for Bell's palsy (BP) treatment. BACKGROUND: BP is a peripheral disorder of the facial nerve causing sudden paralysis of unilateral facial muscles, and PBM has been successfully suggested for its treatment without any side effect. This is the first case report where a laser device was successfully used at home by the patient herself to treat BP opening new perspectives on the therapy of this disease. METHODS: This report describes the "at-home PBM" treatment performed on a 15-year-old girl who presented BP consisting of acute pain on the right side of her face, difficulty in biting and dripping saliva from the right side of her lips. The treatment was performed twice a day by cutaneous applications, each of 15 minutes (total fluence 48 J/cm2) in an area corresponding to the parotid gland by a device emitting at 808 nm at 250 mW output power. RESULTS: Two weeks after PBM treatment, performed at home twice a day by the patient herself without any kind of pharmacological therapy, the complete disappearing of the disease was noticed with no side effects. CONCLUSION: With the limitations due to a single case report and with the need of further clinical trials to confirm it, "at-home PBM" seems to represent a good and safe approach to the treatment of BP.

Bactericidal effect of Er,Cr:YSGG laser irradiation on endodontic biofilm: An ex vivo study.

AIM: This ex vivo study aimed to evaluate the of Er,Cr:YSGG laser effectiveness in the decontamination of an endodontic biofilm. MATERIALS AND METHODS: Seventy-three single rooted human teeth, freshly were chosen. Each tooth was exposed to four associated species in an endodontic biofilm (Enterococcus faecalis, Streptococcus salivarius, Porphyromonas gingivalis, and Prevotella intermedia) and randomly allocated to one of the seven experimental groups. The group 1 (7 teeth) was used to finalize the reliable biofilm-forming technique. The groups 2 and 3 (15 teeth each group) were irradiated with two different Er;Cr:YSGG laser settings (0,75 W - 40 Hz and 4 W - 40 Hz, respectively). The groups 4 and 5 (15 teeth each group) were irrigated with two different solutions and laser irradiated with the same settings (1,5 W - 15 Hz). The group 6 (6 teeth) was the control group treated only with 4 ml 2,5% NaOCl irrigation during 60 s. RESULTS: The observations of group 2 and 3 specimens showed the ripeness of the biofilm with the presence of Enterococcus faecalis and Streptococcus salivarius in chains but in group 3 thermal edge effects produced by the optic fiber in the canal walls were present. The group 4 specimens observation showed an average cleaning of the root canal walls while on the canal walls of group 5 samples the apical third presented several debris and smear layer and in the centre cracks and melting dentin of the radicular wall were observed. CONCLUSION: In those experimental conditions, this study, demonstrated that Er,Cr:YSGG laser has a canals decontamination ability when associated to NaOCl irrigation.

Nanosecond pulsed fiber laser irradiation for enhanced zirconia crown adhesion: Morphological, chemical, thermal and mechanical analysis.

The increasing demand for aesthetics, together with advancements in technology, have contributed to the rise in popularity of all-ceramic restorations. In the last two decades, the continuous progression in ceramic materials science for dental applications has permitted the fabrication of high-strength materials. Amongst these, zirconia-based ceramics have improved in terms of fracture resistance and long-term viability in comparison with other silica-based materials. Unfortunately, while bonding of resin cement-silica ceramics can be strengthened through creation of a porous surface by applying hydrofluoric acid (5%-9.5%) and a subsequent silane coupling agent, the glass-free polycrystalline microstructure of zirconia ceramics does not allow such a reaction. The aim of the present in vitro study was to observe the effect of 1070 nm fiber nanosecond pulse laser irradiation on zirconia samples through morphological analysis (profilometry, SEM), thermal recording with Fiber Bragg Gratings (FBGs), elemental composition analysis (EDX) and bond strength testing (mechanical tests) in order to evaluate the possible advantages of this kind of treatment on zirconia surfaces, as well as to show the potential side effects and changes in chemical composition. Despite laser irradiation with a 1070 nm wavelength fiber laser and correct process parameters demonstrating suitable outcomes in terms of improved surface roughness and minimal thermal damage, comparison between irradiated and unirradiated samples did not exhibit statistically significant differences in terms of bonding strength.

Non-surgical periodontal therapy assisted by potassium-titanyl-phosphate laser: a pilot study.

As the American Academy of Periodontology indicates, the treatment of chronic periodontitis should be achieved in the least invasive manner through non-surgical periodontal therapy. However, complete removal of subgingival plaque and calculus is hindered with increasing probing depth (PD) and furcation involvement using hand, sonic or ultrasonic instruments. Many authors have suggested that the use of laser as an adjunct to scaling and root planing (SRP) might improve the effectiveness of conventional periodontal treatment. The aim of this study was to evaluate potassium-titanyl-phosphate (KTP) laser in non-surgical periodontal therapy. Seven hundred and thirty sites with probing depths of 4-6 mm were involved in the study. The sites were divided into four groups: control (SRP, chlorhexidine gel 0.5%), group A (SRP, chlorhexidine gel 0.5%, three sessions of KTP laser irradiation); group B (SRP, three sessions of KTP laser irradiation) and group C (SRP, irrigation with povidone-iodine 10%, three sessions of KTP laser irradiation). KTP laser was used with the following parameters: output power 0.6 W, time on 10 ms, time off 50 ms, 30 s per irradiation, fluence 19 J/cm(2). All the sites showed improvement in all clinical parameters. Clinical attachment loss (CAL), pocket probing depths (PPDs) and bleeding on probing (BOP), especially in the lased groups, showed significant results (P < 0.001). Our experience showed KTP laser to be a significant help in SRP; nevertheless, more studies are necessary to confirm our results.

Nd:YAG laser versus traditional scalpel. A preliminary histological analysis of specimens from the human oral mucosa.

Hyperplastic fibro-epithelial lesions are the most common tumor-like swellings in the mouth. The neodymium yttrium aluminium garnet (Nd:YAG) laser appears to be useful for the surgical treatment of these lesions. Some controversies of laser surgery concern the accuracy of pathological diagnosis as well as the control of thermal damage on the target tissue. The aim of this study was to establish if the thermal changes induced by the Nd:YAG laser may affect the histopathological diagnosis and the evaluation of the resection margins. Furthermore, we compared the histological features of oral benign fibro-epithelial lesions excised through Nd:YAG laser and traditional scalpel. Twenty-six benign fibro-epithelial oral lesions from 26 patients, localized in the same oral subsites (cheek and buccal mucosa), were collected at the Unit of Oral Pathology and Oral Laser-assisted Surgery of the Academic Hospital of the University of Parma, Italy. Specimens were subclassified into three groups according to the tool used for the surgical excision. Group 1 included six specimens excised through Nd:YAG laser with an output power of 3.5 W and a frequency of 60 Hz (power density 488,281 W/cm2); Group 2 included nine specimens excised through Nd:YAG laser with an output power of 5 W and a frequency of 30 Hz; Group 3 included 11 specimens excised through a Bard-Parker scalpel blade no. 15c. Epithelial changes, connective tissue modifications, presence of vascular modifications, incision morphology and the overall width of tissue modification were evaluated. Differences between specimens removed with two different parameters of Nd:YAG laser were not significant with regard to stromal changes (p=0.4828) and vascular stasis (p=0.2104). Analysis of regularity of incision revealed a difference which was not statistically significant (p=1.000) between group 1 and group 2. Epithelial and stromal changes were significantly more frequent in specimens with a mean size less than 7 mm (p<0.0001). Nd:YAG laser induced serious thermal effects in small specimens (mean size less than 7 mm) independently from the frequency and power employed. The quality of incision was better and the width of overall tissue injuries was less in the specimens obtained with higher frequency and lower power (group 1: Nd:YAG laser at 3.5 W and 60 Hz).

Intraoral metal laser welding: a case report.

The possibility of laser welding of dental prostheses offers great advantages: first, the operator has the possibility of welding on the master model, which decreases the number of passages and thus the possibility of errors and damage, and secondly, the patient attends only a few sessions, and, due to the possibility of fixing the damaged prostheses, there is no need to resort to the technician's laboratory. In a previous study we described the experimental phases of intraoral welding, from the in vitro model on animal jaws with evaluations of the temperature variations during welding through thermal chamber and type K thermocouples. In this study we describe the intraoral welding in vivo on human subjects by using, as in the previous study, a fibre-delivered neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. The in vivo phase allowed a restored prosthesis to be positioned and intraorally welded in the upper central sector with optimal results both in patient's comfort and in aesthetic effects. This first in vivo test confirmed that the use of a laser technique for the intraoral welding of metal prostheses is possible, with no particular problems and risks for the biological structures close to the welding zone.

Surgical approach with Er:YAG laser on osteonecrosis of the jaws (ONJ) in patients under bisphosphonate therapy (BPT).

Osteonecrosis of the jaw (ONJ) in patients on long-term bisphosphonate Therapy (BPT) has been reported with increasing frequency in literature over the past 4 years. Therapy for this condition is still a dilemma. Temporary suspension of BPT offers no short-term benefits; hyperbaric oxygen has no proven efficacy and therefore is not recommended. Intermittent or continuous antibiotic therapy with surgical debridement can be beneficial to palliate the symptoms. Er:YAG laser can be used to eliminate necrotic bone portions by partial or total resection as an alternative to conventional rotary devices. In our study, 91 patients affected by ONJ-BP lesion, for a total of 115 ONJ sites were observed between January 2004 and May 2008 (Department of Odontostomatology, University of Parma). Fifty-five ONJ sites were considered for this study in four different groups, retrospectively identified on the basis of treatment performed (G1-G4). G1: 13 ONJ-BP sites were treated with medical therapy (amoxicillin 1gr x 3/die per os with metronidazole 250 mg x 2/die per os) for at least 2 weeks; G2: 17 ONJ-BP sites received medical treatment in association with cycles of low-level laser therapy (LLLT) applications performed using an Nd:YAG laser (1,064 nm) once a week for 2 months; G3: 13 ONJ-BP sites were surgically treated (sequestrectomy of necrotic bone, debridement, corticotomy/surgical removal of alveolar and/or cortical bone); G4: 12 ONJ-BP sites were treated with surgical therapy performed using an Er:YAG laser (2,940 nm) in association with LLLT. Clinical success has been defined for each treatment performed as: (a) complete mucosal healing free from signs and symptoms (classified as stage "0") or (b) transition from a higher to a lower stage (Ruggiero staging) for at least 3 months. All the ONJ-BP sites treated with Er:YAG laser (G4 group) had a clinical improvement (100%) and 87.5% of sites had a complete mucosal healing with a mean follow-up of 13 months. The result obtained in the G4 is extremely significant in comparison with those obtained by medical treatment alone or in a traditional surgical approach. Thanks to the high degree of affinity of this wavelength for water and hydroxyapatite, both soft and bone tissues can be easily treated. This technique can also be used for conservative operations whereby necrotic bone is vaporized until healthy bone is reached. In addition, an additional advantage of the Er:YAG laser is its bactericidal and possible biostimulatory action, accelerating the healing of both soft tissues and bone tissues, in comparison to conventional treatments. In conclusion, from our experience, it is possible to observe that an early conservative surgical approach with Er:YAG laser associated with LLLT, for BP-induced ONJ could be considered as more efficient in comparison with medical therapy or other conventional techniques.

Focal Infection and Periodontitis: A Narrative Report and New Possible Approaches.

The "focal infection theory" is a historical concept based on the assumption that some infections may cause chronic and acute diseases in different districts of the body. Its great popularity spanned from 1930 to 1950 when, with the aim to remove all the foci of infection, drastic surgical interventions were performed. Periodontitis, a common oral pathology mainly of bacterial origin, is the most evident example of this phenomenon today: in fact, bacteria are able to migrate, develop and cause health problems such as cardiovascular and respiratory diseases, diabetes, and osteoporosis. The aim of this narrative report is to verify the hypothesis of the association between oral infections and systemic diseases by different ways of approach and, at the same time, to propose new kinds of treatment today made possible by technological progress. The analysis of the literature demonstrated a strong relationship between these conditions, which might be explained on the basis of the recent studies on microbiota movement inside the body. Prevention of the oral infections, as well as of the possible systemic implications, may be successfully performed with the help of new technologies, such as probiotics and laser.

Auto-Administered Photobiomodulation on Diabetic Leg Ulcers Treatment: A New Way to Manage It?

BACKGROUND: Peripheral arterial disease is a dramatic consequence of an uncontrolled diabetic condition causing an increase of morbidity and mortality and its treatment is currently medical or surgical, finally requiring, in the 7-20% of cases, major or minor amputation. Photobiomodulation therapy (PBM) is a laser treatment used in medicine, thanks to its ability to stimulate the wound healing, the acceleration of inflammatory process, and the modulation of pain. Recently, the self-administration of the treatment has been suggested for different purposes in medicine and dentistry with a great number of advantages and no side effects. METHODS: A 84-year-old woman affected by diabetes type 2 and positive for diabetes complications had diagnosis for an ulcerative lesion of 1 cm diameter on her right leg and started a treatment of the lesion applying the B-Cure Laser Pro (Erika Carmel, Haifa, Israel) on her own with a fluence per minute of 3.2 J/cm2 for 2 sessions of 15 minutes by cutaneous application. RESULTS: After a week of treatment, the ulcer dried and crusted, finally providing complete healing after 30 days of treatment. CONCLUSION: With this short case report, we think to add a further contribution by suggesting this kind of treatment for successful management of the leg ulcers in diabetic patients.