الملخص
ABSTRACT Purpose: This study aimed to compare the safety and effectiveness of intraocular pressure reduction between micropulse transscleral cyclophotocoagulation and "slow cook" transscleral cyclophotocoagulation in patients with refractory primary open-angle glaucoma. Methods: We included patients with primary open angle glaucoma with at least 12 months of follow-up. We collected and analyzed data on the preoperative characteristics and postoperative outcomes. The primary outcomes were a reduction of ≥20% of the baseline value (criterion A) and/or intraocular pressure between 6 and 21 mmHg (criterion B). Results: We included 128 eyes with primary open-angle glaucoma. The preoperative mean intraocular pressure was 25.53 ± 6.40 and 35.02 ± 12.57 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean intraocular pressure was reduced significantly to 14.33 ± 3.40 and 15.37 ± 5.85 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups at the last follow-up, respectively (p=0.110). The mean intraocular pressure reduction at 12 months was 11.20 ± 11.46 and 19.65 ± 13.22 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The median preoperative logMAR visual acuity was 0.52 ± 0.69 and 1.75 ± 1.04 in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean visual acuity variation was −0.10 ± 0.35 and −0.074 ± 0.16 in the micropulse- and "slow cook" transscleral cyclophotocoagulation, respectively (p=0.510). Preoperatively, the mean eye drops were 3.44 ± 1.38 and 2.89 ± 0.68 drugs in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p=0.017), but those were 2.06 ± 1.42 and 1.02 ± 1.46 at the end of the study in the "slow cook" and micropulse transscleral cyclophotocoagulation groups, respectively (p<0.001). The success of criterion A was not significant between both groups. Compared with 11 eyes (17.74%) in the "slow cook" transscleral cyclophotocoagulation group, 19 eyes (28.78%) in the micropulse transscleral cyclophotocoagulation group showed complete success (p=0.171). For criterion B, 28 (42.42%) and 2 eyes (3.22%) showed complete success after micropulse- and "slow cook" transscleral cyclophotocoagulation, respectively (p<0.001). Conclusion: Both techniques reduced intraocular pressure effectively.
الملخص
Objetivo: Determinar as evidências científicas sobre a influência do uso de lasers de baixa e alta intensidade no tratamento da hipersensibilidade da dentina. Revisão de literatura: Foram realizadas buscas na Biblioteca Virtual em Saúde (BVS), incluindo as bases de dados: Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS); Bibliografia Brasileira de Odontologia (BBO); e National Library of Medicine (MEDLINE). A maioria dos estudos destacam a eficácia dos lasers na redução da HD, com o laser Nd:YAG mostrando-se eficaz na obliteração dos túbulos dentinários e proporcionando alívio a longo prazo. Apesar dos benefícios, alguns estudos alertam para possíveis danos à polpa dentária, especialmente com lasers de alta potência. Considerações finais: Embora os lasers tenham se mostrado eficazes na redução da HD, a escolha do laser deve ser personalizada para cada paciente, destacando a necessidade de aprimorar os protocolos clínicos e adquirir experiência relevante por parte dos profissionais especialistas.
Objective: To determine the scientific evidence on the influence of the use of low and high intensity lasers in the treatment of dentin hypersensitivity. Literature review: Searches were carried out in the Virtual Health Library (VHL), including the databases: Latin American and Caribbean Literature in Health Sciences (LILACS); Brazilian Bibliography of Dentistry (BBO); and National Library of Medicine (MEDLINE). Most studies highlight the effectiveness of lasers in reducing HD, with the Nd:YAG laser proving effective in obliterating dentinal tubules and providing long-term relief. Despite the benefits, some studies warn of possible damage to the dental pulp, especially with high-power lasers. Final considerations: Although lasers have been shown to be effective in reducing HD, the choice of laser must be personalized for each patient, highlighting the need to improve clinical protocols and acquire relevant experience on the part of specialist professionals.
الملخص
Laser-induced retinal damage is a gradual and progressive process, yet there remains a dire need for safe and effective therapeutic drugs and preventive measures to mitigate and treat this condition. Currently, the exploration of treatment options for laser-induced retinal damage is still in its experimental phase. This review delves into the histopathological, functional, and molecular expression levels of the retina after acute laser injury. It aims to uncover the acute changes that occur following laser injury, identify the optimal window period for intervention, and hypothesize the best time for treatment to rescue residual cells and preserve remaining vision.
الملخص
Objective:To explore the clinical efficacy and safety analysis of a novel laser localization technology assisted percutaneous puncture of trigeminal nerve microsphere capsule compression surgery for the treatment of primary trigeminal neuralgia.Methods:A retrospective selection was conducted on 63 patients with primary trigeminal neuralgia who underwent percutaneous puncture of the trigeminal nerve microsphere capsule compression surgery at the First Hospital of Hunan University of Chinese Medicine from January 2020 to December 2021. According to different surgical methods, they were divided into a new laser localization assisted puncture group (observation group) of 32 cases and a traditional barehanded localization puncture group (control group) of 31 cases. An analysis was conducted on the surgical time, puncture time, puncture frequency, intraoperative exposure to radiation, number of cases of poor balloon formation, and clinical efficacy within 6 months after surgery for two groups of patients. The prognosis of the patients was followed up at 6 months after surgery.Results:The surgical time, puncture time, puncture frequency, and intraoperative exposure of the observation group were all less than those of the control group, and the differences were statistically significant (all P<0.05). There was no statistically significant difference ( P>0.05) in the number of cases of poor balloon angioplasty between the observation group and the control group, as well as the pain score grading of the Barlow Neurological Institute (BNI) on the first day after surgery. Within 6 months after surgery, there was no statistically significant difference in the incidence of facial numbness, diplopia, masseter weakness, perilabial herpes, and recurrent pain between the two groups of patients (all P>0.05). Conclusions:Laser positioning technology can assist in precise puncture of the foramen ovale and accurate placement of balloons based on surgical experience, which helps to improve surgical safety, reduce postoperative complications and intraoperative radiation dose, and achieve satisfactory short-term follow-up results.
الملخص
The sample delivery method is one of the key steps in implementing serial femtosecond crystallography research using X-ray free-electron lasers. Serial femtosecond crystallography can effectively capture the ultrafast dynamic processes of biological molecules, such as protein conformational changes and intermediate states in chemical reactions. It is of great significance for scientists to better understand the structure and function of biological molecules, reveal the mechanisms of life activities, and provide important technical means for drug development and biotechnology. When conducting experiments at X-ray free-electron laser beamline station, it is crucial to transport the samples to the region where it interacts with the free-electron laser pulses. The choice of suitable sample delivery method plays a decisive role in the sample consumption and experimental efficiency, and it is also an important factor for the success or failure of the experiment. This article reviews the latest research progress and future development directions of sample delivery methods in serial crystallography. It also introduces commonly used sample delivery methods and their applicable ranges, aiming to provide reference and guidance for scientists engaged in serial crystallography research. The sample transport methods of free electron lasers mainly include liquid injection and fixed target sample transport. The liquid injection method is achieved through various liquid sample injectors. The aqueous solution is driven by a peristaltic pump on high performance liquid chromatography (HPLC) into a sample storage, and the aqueous solution pushes the piston in the sample storage to extrude the sample solution into the sample transport pipeline, and finally sprays it out through the nozzle to reach the XFEL interaction region. For micro-nano crystals,3 preparation methods are introduced, including free interface diffusion method, seeding method, and batch crystallization, and characterization methods are also introduced. For the requirements of high sample transmission efficiency and low sample consumption, a gas-based liquid flow transport method is introduced, which is based on the principle of focusing the sample jet by coaxial gas to form a jet with a small diameter and fast flow rate. At the same time, the extended double flow focusing nozzle and mixed injection nozzle are briefly described. For samples in viscous media, a high viscosity liquid injection device is introduced, and the advantages and disadvantages of different media are explained and exemplified. In addition, the principle and example of electrostatic spinning injector and piezoelectric driven droplet injection technology applied to low-velocity serial crystallography experiments are also introduced. For the above liquid injection methods, a characterization method using a coaxial microscope or side-view microscope to measure the diameter and stable length of the liquid flow is introduced. Compared with the liquid injection method, the fixed target method is to fix the crystal on a support chip with a periodic array structure, and collect data through scanning. The working principle, sample environment, support materials, etc. of the fixed target method are briefly introduced in the article. With the advancement and development of technologies such as free electron lasers and detectors, various sampling methods for serial crystallography are constantly being innovated and optimized. By selecting appropriate sample delivery methods, it will be possible to improve experimental efficiency, reduce sample consumption, and open up new possibilities for researchers in the field of structural biology of biomacromolecules.
الملخص
Objective:To investigate the clinical efficacy of a 1 064 nm picosecond laser combined with intense pulsed light in the treatment of melasma.Methods:From May to August 2022, ninety-two female patients with melasma were admitted to the Medical Cosmetology Center, Xi′an International Medical Center Hospital, aged 25-50 years, with an average age of (35.0±3.5) years. The were divided by random number table method. Forty-six cases were divided into laser combined group, which were treated with precise intense pulsed light combined with a 1 064 nm picosecond laser. Forty-six cases in the laser group were treated with a 1 064 nm picosecond laser. The area and severity score of melasma (MASI), VISIA score and clinical efficacy were evaluated.Results:The MASI scores of laser combined group were 12.58 (11.04, 13.99) before treatment, and the MASI scores of laser group were 13.16 (11.47, 14.14) before treatment. The MASI scores of laser combined group were 5.75 (3.79, 7.19), and the MASI scores of laser group were 7.15 (5.42, 5.85) after treatment. The MASI scores of the two groups were decreased compared with those before treatment, and the MASI score of the laser combined group was lower than that of the laser group. The difference was statistically significant ( Z=-4.05, P<0.01). The median VISIA scores of the laser combined group were (173.72±43.77), and the median VISIA scores of the laser group were (175.65±34.9) before treatment. The median VISIA scores of the laser combined group were (135.46±41.63), and the median VISIA scores ofthe laser group were (145.26±33.33) after treatment. The VISIA scores of the two groups were decreased compared with those before treatment. The scores of the laser combined group were lower than those of the laser group. The difference was statistically significant ( t=-2.52, P<0.05). The effective rate of the laser combined group (80.43%, 37/46) was higher than that of the laser group (69.56%, 22/46, P<0.05). Conclusions:The curative effect of 1 064 nm picosecond laser combined with precise intense pulsed light in the treatment of melasma is better than that of a 1 064 nm picosecond laser alone.
الملخص
Objective:Evaluation of the efficacy and safety of ultra-picosecond 1 064 nm laser treatment for enlarged facial pores.Methods:From November 2022 to April 2023, 31 female patients with enlarged facial pores, aged between 28 and 52 (35.2±5.5) years old, were treated at the Medical Aesthetics Center of Xi′an International Medical Center Hospital. They received ultra-picosecond 1 064 nm laser fractional handpiece treatment once every 4 weeks for a total of 3 times. One month after the last treatment, facial pore changes were evaluated using facial pore scores and VISIA pore feature count absolute values, and adverse reactions were assessed.Results:All 31 patients completed the treatment. The facial pore scores before and after treatment were 4 (4, 5) and 2 (2, 3), respectively, indicating a statistically significant ( Z=-4.99, P<0.001) decrease in facial pore scores compared to before treatment. The absolute values of VISIA facial pore counts before and after treatment were 859 (829, 1147) and 652 (632, 731), respectively. The absolute value of VISIA pore count after treatment was lower than that before treatment, and the difference was statistically significant ( Z=-4.86, P<0.05 ). Conclusions:Ultra-picosecond laser can effectively improve enlarged facial pores without significant adverse reactions.
الملخص
ABSTRACT Purpose: This study aimed to report an experiment designed to determine anatomical changes in porcine corneas following placement of a novel polymer implant into the cornea. Methods: An ex vivo porcine eye model was used. A novel type I collagen-based vitrigel implant (6 mm in diameter) was shaped with an excimer laser on the posterior surface to create three planoconcave shapes. Implants were inserted into a manually dissected stromal pocket at a depth of approximately 200 μm. Three treatment groups were defined: group A (n=3), maximal ablation depth 70 μm; Group B (n=3), maximal ablation depth 64 μm; and group C (n=3), maximal ablation depth 104 μm, with a central hole. A control group (D, n=3) was included, in which a stromal pocket was created but biomaterial was not inserted. Eyes were evaluated by optical coherence tomography (OCT) and corneal tomography. Results: Corneal tomography showed a trend for a decreased mean keratometry in all four groups. Optical coherence tomography showed corneas with implants placed within the anterior stroma and visible flattening, whereas the corneas in the control group did not qualitatively change shape. Conclusions: The novel planoconcave biomaterial implant described herein could reshape the cornea in an ex vivo model, resulting in the flattening of the cornea. Further studies are needed using in vivo animal models to confirm such findings.
RESUMO Objetivo: Relatar um experimento projetado para determinar alterações anatômicas em córneas porcinas após a colocação de um novo implante de polímero na córnea. Métodos: Foi utilizado olho de porco ex vivo. Um novo agente modelador biocompatível, de colágeno tipo 1, com 6mm de diâmetro foi moldado com excimer laser em sua face posterior, para criar três formatos planocôncavos. Os implantes foram inseridos dentro de um bolsão, dissecado manualmente, a 200 micrômetros (μm). Foram definidos três grupos de tratamento: grupo A (n=3), teve a profundidade máxima de ablação de 70 μm; o grupo B (n=3), profundidade máxima de ablação de 64 μm; e o grupo C (n=3), profundidade máxima de ablação de 104 μm, com buraco central. O grupo controle, D (n=3), foi incluído, com a criação do bolsão estromal, porém sem inserir o material. A avaliação desses olhos foi realizada por tomografia de coerência óptica (OCT) e por tomografia corneana. Resultados: A tomografia corneana mostrou uma tendência para diminuição da ceratometria média em todos os 4 grupos. A tomografia de coerência óptica mostrou córneas com implantes localizados no estroma anterior e aplanamento visível, enquanto as córneas não mudaram qualitativamente o formato no grupo controle. Conclusões: O novo implante de biomaterial planocôncavo descrito aqui foi capaz de remodelar a córnea em modelo de animal ex vivo, resultando no aplanamento corneano. Novos estudos são necessários usando modelos animais in vivo para confirmar tais achados.
الملخص
ABSTRACT Purpose: This study aimed to evaluate the long-term safety and efficacy of neodymium-doped yttrium aluminum garnet (Nd:YAG) vitreolysis for symptomatic vitreous floaters as it remains a controversial procedure due to insufficient robust evidence in the literature for the maintenance of the results and absence of adverse effects. Methods: This is an observational extension to the previously presented prospective, randomized, double-blind clinical trial. Eight of thirteen subjects who underwent vitreolysis with YAG laser returned for a late reevaluation, 18 months after the procedure, to evaluate the efficacy and safety of the procedure. Results: All patients maintained the improvement in symptomatology noted after the procedure, with 25% showing complete improvement and a similar proportion (37.5%) reporting significant or partial improvement. Objective improvement in opacity was similar to that found at 6 months follow-up. The NEI-VFQ 25 quality of life questionnaire showed no statistically significant difference in responses between the 6th and 18th month. No adverse effects were noted on clinical examination or reported by patients. Conclusion: Vitreolysis efficacy observed at 6 months of follow-up was maintained until the eighteenth month, with all patients reporting improvement from the pre-procedure state. No late adverse effects were noted. A larger randomized clinical trial is needed to confirm the safety of the procedure.
RESUMO Objetivos: Avaliar a segurança e eficácia a longo prazo da vitreólise com Nd:YAG laser para moscas volantes sintomáticas, uma vez que permanece como um procedimento controverso devido a falta de evidência científica robusta sobre a manutenção dos resultados e ocorrência de efeitos adversos. Métodos: Este estudo é uma extensão observacional de um ensaio clínico prospectivo, randomizado, duplo cego, previamente publicado. Oito de treze pacientes que foram submetidos a vitreólise com YAG laser foram acompanhados para uma reavaliação tardia, dezoito meses após o procedimento, para avaliar a eficácia e segurança do procedimento. Resultados: Todos os pacientes mantiveram a melhora na sintomatologia notada ao final do procedimento original, com 25% dos casos apresentando melhora completa, e uma proporção semelhante (37,5%) demonstrando melhora significativa ou parcial. A melhora objetiva na opacidade foi similar ao achado no seguimento original de 6 meses. O questionário de qualidade de vida NEI-VFQ 25 não demonstrou diferença estatisticamente significativa nas respostas entre o sexto e o décimo oitavo mês de acompanhamento. Nenhum efeito adverso foi notado no exame clínico ou reportado pelos pacientes. Conclusão: A eficácia da vitreólise observada ao sexto mês do acompanhamento foi mantida até o décimo oitavo mês, com todos os pacientes notando algum grau de melhora quando comparado ao estado pré procedimento. Nenhum efeito adverso tardio foi notado. Um ensaio clínico randomizado maior é necessário para confirmar a segurança do procedimento.
الملخص
ABSTRACT Purpose: This study aimed to compare an teriorchamber parameters acquired by a swept-source anteriorsegment optical coherence tomography before and after laser peripheral iridotomy. Methods: This study prospectively evaluated 14 patients with primary-angle closure and six patients with primary-angle closure glaucoma. Gonioscopy and anterior-segment optical coherence tomography using the DRI OCT Triton® were performed before and after laser peripheral iridotomy. Anterior-segment optical coherence tomography parameters were studied using scleral spur as reference: angle opening distance at 250, 500, and 750 µm, trabecular-iris space at 500 µm, trabecular-iris angle, trabecular-iris contact length, and iris curvature. Results: Anterior-segment optical coherence tomography identified 61% of the patients with two or more quadrants closed. Gonioscopy identified more closed angles than anterior-segment optical coherence tomography before laser peripheral iridotomy. In angle parameters, only the angle opening distance of 250 µm at the nasal quadrant was not significantly increased after laser peripheral iridotomy. The iris curvature and trabecular-iris contact length showed a significant reduction induced by the laser procedure. Even in eyes in which gonioscopy did not identify angular widening after laser peripheral iridotomy (n=7), the angle opening distance of 750 µm increased (nasal, 0.15 ± 0.10 mm to 0.27 ± 0.16 mm, p=0.01; temporal, 0.14 ± 0.11 mm to 0.25 ± 0.12 mm, p=0.001) and the iris curvature decreased (nasal, 0.25 ± 0.04 mm vs. 0.11 ± 0.07 mm, p=0.02; temporal, 0.25 ± 0.07 mm vs. 0.14 ± 0.08 mm, p=0.007). Conclusions: Anterior-chamber changes induced by laser peripheral iridotomy could be quantitatively evaluated and documented by DRI OCT Triton®
RESUMO Objetivo: Comparar os parâmetros de câmara anterior obtidos através da tomografia de coerência óptica de segmento anterior antes e após a iridectomia periférica a laser. Métodos: Quatorze pacientes com fechamento angular primário e seis com glaucoma primário de ângulo fechado foram prospectivamente avaliados neste estudo. Gonioscopia e tomografia de coerência óptica de segmento anterior com DRI OCT Triton® foram realizadas antes e após a iridectomia periférica a laser. Os seguintes parâmetros de tomografia de coerência óptica de segmento anterior, baseados na localização do esporão escleral, foram avaliados: ângulo de abertura angular a 250 µm, 500 µm e 750 µm, área do espaço entre a íris e o trabeculado a 500 µm, ângulo entre a íris e o trabeculado, extensão do contato entre a íris e o trabeculado e curvatura da íris. Resultados: A tomografia de coerência óptica de segmento anterior identificou 61% dos indivíduos com dois ou mais quadrantes fechados. A gonioscopia identificou mais quadrantes com ângulo fechado do que tomografia de coerência óptica de segmento anterior antes da iridectomia periférica a laser. Quanto aos parâmetros angulares, apenas ângulo de abertura angular a 250 µm no quadrante nasal não aumentou significativamente após a iridectomia periférica a laser. A curvatura da íris e a extensão do contato entre a íris e o trabeculado apresentaram redução significativa induzida pelo procedimento a laser. Mesmo nos olhos em que a gonioscopia não identificou aumento da amplitude angular após iridectomia periférica a laser (n=7), ângulo de abertura angular a 750 µm aumentou (nasal: 0,15 ± 0,10 mm para 0,27 ± 0,16 mm, p=0,01; temporal: 0,14 ± 0,11 mm para 0,25 ± 0,12 mm, p=0,001), e ICURVE diminuiu (nasal: 0,25 ± 0,04 mm vs. 0,11 ± 0,07 mm, p=0,02; temporal: 0,25 ± 0,07 mm vs. 0,14 ± 0,08 mm, p=0,007). Conclusões: As alterações na câmara anterior induzidas pelo iridectomia periférica a laser puderam ser avaliadas quantitativamente e documentadas pelo DRI OCT Triton®.
الملخص
ABSTRACT We present a case of a patient complaining of monocular diplopia due to a decentered ablation after LASIK. The patient underwent a wavefront-guided retreatment, which resulted in an epithelial ingrowth complication. Additionally, the patient developed cataract, with cataract surgery requiring reliable biometric measurements. Therefore, we opted for corneal treatment and corneal surface regularization. Although we attempted to lift the flap and wash the interface initially, the procedure proved unsuccessful, thereby necessitating immediate flap amputation. Once the corneal surface was regularized in the seventh postoperative month, transepithelial photorefractive keratectomy was successfully performed to homogenize the ocular surface, thereby significantly improving the patient's corrected visual acuity and resolving monocular diplopia. The surface and corneal curvature stabilized by the fifth month after the procedure. Phacoemulsification was then performed along with the implantation of a toric monofocal lens, which was selected using an appropriate formula, resulting in an excellent uncorrected visual acuity.
الملخص
ABSTRACT Purpose: The purpose of this study is to assess the long-term outcomes of modified transcanalicular diode laser dacryocystorhinostomy in a large cohort of patients affected by primary acquired nasolacrimal duct obstruction. Methods: This study, conducted from January 17 to June 2022, encompassed 141 patients (159 procedures) who underwent modified transcanalicular diode laser dacryocystorhinostomy (MT-DCR). The procedure employed an 810-nm diode laser. Patients were monitored for at least a year after the intervention. Anatomical success was determined by ostium patency upon irrigation, while functional success referred to epiphora resolution. Parameters studied included patient demographics, procedure duration, complications, and both anatomical and functional success. Statistical analysis was performed using the Statistical Package for the Social Sciences software, with results considered significant at a 95% confidence interval (p≤0.05). Results: A total of 159 lacrimal drainage systems (141 patients: 112 women and 29 men) were included in this study. Among them, 18 underwent bilateral procedures. The average patient age was 58 years (range: 34-91 years), and the average surgical duration was 24 minutes (range: 18-35 minutes). One year after the surgery, MT-DCR exhibited anatomical and functional success rates of 84.9% (135/159) and 83% (132/159), respectively. Conclusion: MT-DCR achieved an anatomical success rate of 84.9%, reflecting an excellent outcome. However, further extensive studies with larger sample sizes and longer follow-up periods are necessary to substantiate these findings.
الملخص
ABSTRACT Periodontitis is an inflammatory clinical condition caused by dysbiotic biofilm that results in progressive destruction of periodontal attachment and can lead to tooth loss if left untreated. Objective: To evaluate the clinical efficacy of high-power diode laser as an adjunct to mechanical instrumentation in periodontal pockets of a patient with generalized, stage III, grade C periodontitis. Methods: 126 sites of a patient were examined at the Clinical Research Laboratory (LabClin) of the Federal University of Campina Grande (UFCG), where the parameters of probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BoP) were evaluated at the beginning of the study and after 3 and 6 months of basic therapy. All sites received non-surgical periodontal treatment which corresponds to scaling and root planing (SRP) and coronary polishing. The deep periodontal pockets with PD ≥ 5 mm, received the adjuvant therapy with diode laser light. Results: There was a significant improvement of periodontal parameters of PD, CAL and BoP in all treated sites. In those with PD ≥ 5 mm, the results were similar, with statistically significant reduction of PD, CAL and BoP before and after treatment. After 6 months, all periodontal pockets with PD ≥ 5mm were reduced to values lower than 3. Conclusion: The irradiation of deep pockets with high-power diode laser proved to be effective as adjuvant therapy to SRP in patients with generalized, stage III, degree C periodontitis.
RESUMO A periodontite é uma condição clínica inflamatória causada por biofilme disbiótico que resulta em destruição progressiva da inserção periodontal e pode levar a perda do dente caso não seja tratada. Objetivo: Avaliar a eficácia clínica do laser de diodo de alta potência como coadjuvante à instrumentação mecânica em bolsas periodontais de um paciente com periodontite, estádio III, grau C e generalizada. Métodos: Foram examinados 126 sítios de uma paciente, no Laboratório de Pesquisas Clínicas (LabClin) da Universidade Federal de Campina Grande (UFCG) onde foram avaliados os parâmetros de profundidade de sondagem (PS), nível de inserção clínica (NIC) e sangramento à sondagem (SS) no início do estudo e após 3 e 6 meses da terapia básica. Todos os sítios receberam tratamento periodontal não cirúrgico o que corresponde a raspagem e alisamento coronorradicular (RACR) e polimento coronário. As bolsas periodontais profundas com PS ≥ 5 mm, receberam a terapia coadjuvante com luz laser de diodo. Resultados: Houve uma melhora significativa dos parâmetros periodontais de PS, NIC e SS em todos os sítios tratados. Nos que apresentavam PS ≥ 5 mm, os resultados foram similares, com redução estatisticamente significativa PS, PIC e SS antes e após a realização do tratamento. Após 6 meses, todas as bolsas periodontais com PS ≥ 5mm foram reduzidas a valores menores que 3. Conclusão: A irradiação de bolsas profundas, com laser de diodo de alta potência, mostrou-se eficaz como terapia coadjuvante à RACR em paciente com periodontite estádio III, grau C, generalizada.
الملخص
Abstract This study aimed to evaluate the influence of the Er,Cr:YSGG irradiation and 980-nm diode lasers on the surface roughness (SR) and volume loss (VL) of dentin subjected to cariogenic challenge. Subsequently, 130 specimens of bovine dentin were divided into the following 13 groups: NT: no treatment; FG: fluoride gel; FV: fluoride varnish; Di: 980-nm diode; Di + FG; Di + FV; FG + D; FV + Di; Er: Er,Cr:YSGG; Er + FG; Er + FV; FG + Er and FV + Er. Er,Cr:YSGG laser parameters were as follows: 0.25 W; 5.0 Hz; 4.46 J/cm2 without water and 55% air. Furthermore, the 980-nm diode laser parameters were 2.0 W; 2.0 Hz; 21.41 J/cm2. The samples from each group were subjected to pH cycling. A confocal laser scanning microscope was used to evaluate SR and VL. Difference between the volume of the reference and treated areas + DES/RE was used to determine SR and VL. The mean values of the different groups were subjected to analysis of variance and Tukey's post-hoc test. The VL values were analyzed using the Kruskal-Wallis and Dunn post-hoc test (p < 0.05). The SR of the reference area did not show a statistically significant 1807-3107-bor-38-e025treatment and cariogenic challenge (p > 0.05). Moreover, VL in the FV + Di and FV + Er groups showed a statistically significant difference compared with areas submitted to different types of treatment and cariogenic challenge (p > 0.05). Er,Cr:YSGG and 980-nm diode lasers associated with fluoride varnishes decreased dentin VL in bovine teeth submitted to cariogenic challenge.
الملخص
Purpose: To evaluate collagen fibers during the bone repair process in critical defects created in the tibias of rats, treated with zoledronic acid (AZ) associated with low-level laser therapy (LLLT). Methods: Ten rats were distributed according to treatment: group 1) saline solution; group 2) LLLT; group 3) AZ; group 4) AZ and LLLT. AZ was administered at the dose of 0.035 mg/kg at fortnightly intervals over eight weeks. Next, 2-mm bone defects were created in the tibias of all animals. The bone defects in groups 2 and 4 were irradiated LLLT in the immediate postoperative period. After periods 14 and 28 of application, the animals were euthanized, and birefringence analysis was performed. Results: Approximately 90% of the total area was occupied by collagen fibers within the red color spectrum, this area being statistically larger in relation to the area occupied by collagen fibers within the green and yellow spectrum, in the four groups. Over the 14-day period, there was no statistically significant difference between the groups. In the 28-day period, group 2 (14.02 ± 15.9%) was superior in quantifying green birefringent fibers compared to group 1 (3.06 ± 3.24%), with p = 0.009. Conclusions: LLLT associated with ZA is effective in stimulating the neoformation of collagen fibers. The LLLT group without the association with ZA showed a greater amount of immature and less organized matrix over a period of 28 days.
الموضوعات
Animals , Rats , Bone and Bones , Collagen , Low-Level Light Therapy , Zoledronic Acid/therapeutic useالملخص
Aim: This article aims to evaluate, using the best sources of evidence, the contribution of low-level lasers in treating oral mucositis in patients with oral cancer. Methods: This review, including the entire process of the selection of studies and preparation of results, complied with the PRISMA-ScR protocol guidelines. At the end of the predefined analyses (title, abstract, and full text), 02 studies were included that correctly fit the eligibility criteria. These were published in 2015 and 2019 and were classified according to level II of the Agency for Healthcare of Research and Quality (AHRG). After critically reading the study, the common topics addressed in this scoping review were defined. Results: Two works brought considerations about the laser therapy protocol, the use of the visible red wavelength, and energy densities between 3 and 4 J/cm². In addition, positive correlations were identified between painful symptoms and nutritional status with oral mucositis, as low-level laser therapy reduced pain and weight loss and improved the nutritional quality of cancer patients. Conclusion: Photobiomodulation proved effective in treating mucositis at higher degrees. Scientific evidence on this topic is still being developed, but it will be promising and valid if more research is conducted.
الموضوعات
Radiotherapy , Stomatitis , Therapeutics , Mouth Neoplasms , Laser Therapyالملخص
ABSTRACT Introduction: The aim of the study was to investigate clinical and surgical factors associated with early catheter replacement in patients treated with Holmium Laser Enucleation of the Prostate (HoLEP). Materials and Methods: Data of patients treated with HoLEP at our Institution by a single surgeon from March 2017 to January 2021 were collected. Preoperative variables, including non-invasive uroflowmetry and abdominal ultrasonography (US), were recorded. Bladder wall modifications (BWM) at preoperative US were defined as the presence of single or multiple bladder diverticula or bladder wall thickening ≥5 mm. Clinical symptoms were assessed using validated questionnaires. Only events occurred within the first week after catheter removal were considered. Results: Overall, 305 patients were included, of which 46 (15.1%) experienced early catheter replacement. Maintenance of anticoagulants/antiplatelets (AC/AP) therapy at surgery (p=0.001), indwelling urinary catheter (p=0.02) and the presence of BWM (p=0.001) were more frequently reported in patients needing postoperative re-catheterization. Intraoperative complications (p=0.02) and median lasing time (p=0.02) were significantly higher in this group. At univariate analysis, indwelling urinary catheter (p=0.02), BWM (p=0.01), ongoing AC/AP therapy (p=0.01) and intraoperative complications (p=0.01) were significantly associated with early catheter replacement. At multivariate analysis, indwelling urinary catheter (OR: 1.28; p=0.02), BWM (OR: 2.87; p=0.001), and AC/AP therapy (OR: 2.21; p=0.01) were confirmed as independent predictors of catheter replacement. Conclusions: In our experience the presence of indwelling urinary catheter before surgery, BWM and the maintenance of AC/AP therapy were shown to be independent predictors of early catheter replacement after HoLEP.
الملخص
Purpose: Compare the safety and efficacy of wavefront?guided photorefractive keratotomy (PRK) 6 months after cross?linking (CXL) to wavefront?guided PRK alone for refractive correction in patients with bilateral asymmetric corneal topography. Methods: Prospective randomized clinical trial with 16 patients (32 eyes). CXL with subsequent PRK after 6 months in one eye, and PRK alone was performed in contralateral eyes. The follow?up was 10 years. We analyzed visual outcomes, Scheimpflug topography, and corneal haze evaluation. Results: Eyes in the PRK group showed better results than in the CXL + PRK group. Mean postoperative CDVA was 0.044 logmar (SD, 0.073) in the PRK group and 0.1 logmar (SD, 0.21) in the CXL + PRK group, the mean sphere was + 0.21 (SD, 0.6) D in the PRK group and 0.87 (SD, 2.3) D in the CXL + PRK group, and mean SE was ?0.35 (SD, 0.65) D in the PRK group and 0.62 (SD, 2.32) D in the CXL + PRK group. In one patient, a steepening of 2.5 D and a thinning of 17 ?m occurred in PRK alone group. Two patients in the CXL + PRK group presented corneal haze. The overall complication rate was 18,75% (haze and ectasia). Conclusion: Non?simultaneous CXL and PRK procedures yielded good refractive results, but worse than those obtained with PRK alone. Although one patient in the PRK group developed corneal ectasia, the CXL + PRK group had a higher loss of vision lines, indicating less safety
الملخص
Introduction. Over time, efforts have been invested in the design of new instruments that overcome the disadvantages of the gold standard instrument in surgery, the scalpel. As a result, electronic equipment has emerged such as the electric scalpel and laser devices. The available evidence on these instruments suggests that the tissue response is related to each instrument's physical and biological cutting principles. Objective. To compare the histological changes in gingiva samples associated with surgical cutting performed with a 940 nm diode laser, a 2780 nm erbium, chromium: yttriumscandium-gallium-garnet (Er,Cr:YSGG) laser, and an electric scalpel, by presenting a series of cases. Case presentation. We present three cases of healthy patients undergoing cosmetic surgery. The clinical examination revealed exposure of a keratinized gingiva band greater than 4 mm, normal color and texture in gingival tissue, with a firm consistency and no bleeding on periodontal probing. Gingivectomy was indicated with the following protocols: Diode laser of 940 nm at 1 W, in continuous mode; Er,Cr:YSGG laser of 2780 nm at 2.5 W, 75 Hz, H mode, air 20, water 40, gold tip MT4); and electric scalpel in cutting mode at power level four. Gingival tissue samples were taken and stored in 10% formaldehyde for histological analysis. Conclusion. All the evaluated cutting instruments generated histological changes produced by the thermal effect, the main ones being collagen coagulation and carbonization. The depth of thermal damage caused by the 2780 nm Er,Cr:YSGG laser was much lesser than that induced by the electric scalpel and the 940 nm diode laser.
Introducción. Históricamente se ha invertido esfuerzo en el diseño de nuevos instrumentos que superen las desventajas del estándar de referencia en cirugía, el bisturí. Como consecuencia de esto, han surgido equipos electrónicos como el electrobisturí y los diferentes dispositivos de tecnología láser. La información disponible sobre estos instrumentos sugiere que la respuesta del tejido intervenido está influenciada por los principios físicos y biológicos de corte del instrumento. Objetivo. Comparar los cambios histológicos en muestras de encía asociados al corte quirúrgico realizado con láser de diodo de 940 nm, láser de erbio, cromo: itrio-escandio-galio-granate (Er,Cr:YSGG) (2780nm) y electrobisturí mediante una presentación de serie de casos. Presentación de los casos. Se presentan tres casos de pacientes sanos sometidos a cirugía estética. El examen clínico reveló la exposición de una banda gingival queratinizada mayor de 4 mm, tejido gingival de color y textura normales, de consistencia firme y sin sangrado al sondaje periodontal. Se indicó gingivectomía con los siguientes protocolos: láser de diodo de 940 nm a 1 W, en modo continuo; láser de Er,Cr:YSGG de 2780 nm a 2,5 W, 75 Hz, modo H, aire 20, agua 40, punta de oro MT4; y bisturí eléctrico en modo de corte, a nivel de potencia cuatro. Se tomaron muestras de tejido gingival y se almacenaron en formaldehído al 10 % para su análisis histológico. Conclusión. Los tres instrumentos de corte generaron cambios histológicos producidos por el efecto térmico; los principales fueron coagulación del colágeno y carbonización. La profundización del daño térmico causada por el láser de Er,Cr:YSGG de 2780 nm fue mucho menor que la generada por el electrobisturí y por el láser de diodo de 940 nm.
الموضوعات
Gingivectomy , Artifacts , Lasers, Semiconductor , Lasers, Solid-State , Histologyالملخص
ABSTRACT Objective: To describe the technique of transurethral harvesting of bladder mucosal graft using the Holmium:YAG (Ho-YAG) laser and describe the preliminary results from 7 cases where this graft was used for urethroplasty. Materials and Methods: We performed a single-stage dorsal onlay urethroplasty using bladder mucosal graft in 7 patients with anterior urethral stricture. Transurethral harvesting was performed with the Ho-YAG laser. We performed a prospective and descriptive analysis with uroflowmetry performed at 30, 90 and 180 days after surgery and applied the PROM translated into Portuguese before and 6 months after urethroplasty. Results: Seven patients were included, 2 (28.5%) with penile urethral stricture, and 5 (71.5%) with bulbar urethral stricture. Mean stricture length was 50mm (range 35-60mm). Stricture etiology was trauma in 3 (42.9%) patients, iatrogenic in 1 (14.3%) patient, and idiopathic in 3 (42.9%) patients. Two patients (28.6%) had previously undergone ventral buccal mucosa urethroplasty. Mean bladder mucosal graft length was 52.86mm (± 13.801), and mean harvest time was 46.43min (± 14.639). Dorsal onlay urethroplasty using bladder mucosa was successfully completed in 5 patients (71.4%). Two patients (28.6%) couldn't have the procedure completed using bladder mucosa, one due to thermal damage of the graft during harvesting, and one due to insufficient graft length. In both cases the procedure was completed using buccal mucosa. Two patients (28.6%) experienced minor hematuria between the twelfth and eighteenth postoperative day, but neither required hospitalization and/or additional procedures. All patients achieved normalization of peak flow, and this was maintained throughout the follow-up period. Mean peak flow was 17.8 ml/s (± 3.271) at 30 days, 20.6 ml/s (± 5.413) at 90 days, and 19.6 ml/s (± 8.019) 180 days. Mean IPSS score decreased from 19.3 to 5.4. Similar improvements were also seen in the ICIQ-MLUTS Score (a mean drop from 3.8 to 2.0) and Peeling's Voiding Picture Score (a mean drop from 4.0 to 2.2). Quality of Life improved post urethroplasty, with increases in EQ-5D (from 0.6371 to 0.7285) and EQ-VAS (from 58.0 to 84.0). Conclusion: Transurethral harvesting of bladder mucosa using the Holmium laser (Ho-YAG) is feasible and reproducible. Our preliminary experience suggests that bladder mucosa grafts achieve comparable results to other grafts when used for dorsal onlay urethroplasty. Further research is needed to confirm these results.