Frenectomia lingual com laser de diodo de alta potência: relato de caso / Lingual frenectomy with high-power diode laser: a case report / Frenectomía lingual con láser de diodo de alta potencia: informe de un caso

Introdução: A laserterapia de alta potência tem estabelecido proporções satisfatórias na odontologia e se tornando a primeira opção de conduta cirúrgica para procedimentos, trazendo qualidade de vida aos pacientes e praticidade aos Cirurgiões. Objetivo: Relatar caso clínico de frenectomia lingual com uso do laser de diodo de alta potência ressaltando os benefícios da conduta. Relato de caso: Paciente sexo feminino, leucoderma, sem alterações sistêmicas, chega à Clínica Escola de Odontologia da Universidade Federal de Campina Grande, com queixa principal de alterações na sua fonologia. No exame intraoral observou-se dificuldade de movimentação lingual e em formato de coração devido a inserção fibrosa do freio, sendo observado a Anquiloglossia. Após explicações da alteração, do tratamento, e assinatura do Termo de Consentimento, foi iniciado a cirurgia: antissepsia, anestesia com vasoconstrictor, e em modo contínuo utilizou-se o laser de diodo de alta potência (TW Surgical- MMO®) configurado em 2W de potência, fibra 600µm, no comprimento de onda infravermelho, de modo que as fibras fossem separadas uniformemente e promovesse mobilidade imediata da língua, por fim realizou-se uma sutura em ponto simples com fio reabsorvível. Para o pós-operatório foi prescrito Dipirona em caso de dor, e estabelecido o acompanhamento. No retorno de 7 dias observou-se cicatrização normal e não ingestão do medicamento, em 30 dias foi visto a completa cicatrização e mobilidade sem desconforto, além de relato da paciente de melhoria na condição de relacionamentos sociais, autoestima e deglutição. Conclusão: O resultado apresentado neste artigo ratifica a benefício da escolha do laser em comparação ao convencional, demonstrando que não há sangramento no trans e pós cirúrgico, além de favorecer o processo de reparação tecidual, da redução do tempo cirúrgico, aumento do conforto, e diminuição de uso de medicamento, desta forma associando o laser cirúrgico a melhoria da qualidade de vida.

Introduction: High-power laser therapy has established satisfactory proportions in dentistry and has become the first choice for surgical procedures, bringing quality of life to patients and convenience to surgeons. Objective: To report a clinical case of lingual frenectomy using high-power diode laser, highlighting the benefits of this approach. Case report: A female patient, leucoderma, without systemic alterations, arrived at the Dental School Clinic of the Federal University of Campina Grande with the main complaint of alterations in her phonology. In the intraoral examination, difficulty in lingual movement and a heart-shaped tongue due to fibrous insertion of the frenum were observed, indicating Ankyloglossia. After explanations of the condition, treatment, and signing of the Informed Consent Form, the surgery was initiated: antisepsis, anesthesia with vasoconstrictor, and continuous mode using a high-power diode laser configured at 2W of power, 600µm fiber, at an infrared wavelength, with the aim of uniformly separating the fibers and promoting immediate tongue mobility. Finally, a simple suture was performed using absorbable thread. For the postoperative period, Dipyrone was prescribed for pain relief, and follow-up was established. At the 7-day follow-up, normal healing was observed, and the patient did not require the medication. At 30 days, complete healing and discomfort-free mobility were observed, along with the patient's testimony of improvement in social relationships, self-esteem, and swallowing. Conclusion: The results presented in this article confirm the benefits of choosing laser therapy over conventional methods, demonstrating the absence of bleeding during and after surgery, promoting tissue repair, reducing surgical time, increasing comfort, and decreasing the use of medication. Therefore, the use of surgical laser is associated with an improvement in quality of life.

Introducción: La terapia láser de alta potencia se ha establecido en proporciones satisfactorias en odontología y se ha convertido en la primera elección para procedimientos quirúrgicos, aportando calidad de vida a los pacientes y practicidad a los cirujanos. Objetivo: Relatar un caso clínico de frenectomía lingual con láser de diodo de alta potencia, destacando los beneficios de este procedimiento. Relato del caso: Paciente del sexo femenino, leucoderma, sin alteraciones sistémicas, llegó a la Clínica de la Facultad de Odontología de la Universidad Federal de Campina Grande con la queja principal de alteraciones en su fonología. El examen intraoral reveló dificultad en el movimiento lingual y lengua en forma de corazón debido a la inserción fibrosa del freno, observándose anquiloglosia. Tras explicar la alteración, el tratamiento y firmar el consentimiento, se inició la cirugía: antisepsia, anestesia con vasoconstrictor y uso continuado de un láser de diodo de alta potencia (TW Surgical- MMO®) configurado a 2W de potencia, fibra de 600µm, a longitud de onda infrarroja, para que las fibras se separaran uniformemente y favorecieran la movilidad inmediata de la lengua, y finalmente una sutura de punto único con hilo reabsorbible. En el postoperatorio, se prescribió dipirona en caso de dolor y se estableció un seguimiento. En el seguimiento a los 7 días, se observó una cicatrización normal y no se tomó medicación. A los 30 días, se observó una cicatrización completa y movilidad sin molestias, así como el informe del paciente de una mejora de las relaciones sociales, la autoestima y la deglución. Conclusión: Los resultados presentados en este artículo confirman el beneficio de la elección del láser frente a la cirugía convencional, demostrando que no hay sangrado durante ni después de la cirugía, además de favorecer el proceso de reparación tisular, reducir el tiempo quirúrgico, aumentar el confort y reducir el uso de medicación, asociando así el láser quirúrgico a una mejor calidad de vida.

Dacriocistorrinostomía láser endocanalicular y sus modificaciones: revisión sistemática de técnicas y tasa de éxito / Endocanalicular Laser Dacryocystorhinostomy and its modifications: A systematic review of techniques and success rates

Objetivo El objetivo principal de este trabajo es revisar los artículos que hacen referencia a la técnica de la dacriocistorrinostomía láser (DCRL) para la obstrucción adquirida de la vía lagrimal (OACN), así como sus modificaciones, a través de una exhaustiva revisión bibliográfica. Material y método Se realizó una revisión sistemática de las publicaciones relacionadas con cirugía láser de la vía lagrimal desde el año 2000 hasta marzo de 2021 en las bases de datos MEDLINE, EMBASE y Cochrane Library. Los términos de búsqueda en idioma español e inglés fueron: «Endocanalicular laser», dacryocystorhinostomy or «primary DCR-L» or «laser» and «tear ducts». Resultados Tras someter los artículos a los criterios de inclusión y exclusión, obtuvimos 49 artículos: 21 estudios retrospectivos y 28 estudios prospectivos. El resultado bibliométrico obtenido garantiza, para la presente revisión, una recomendación de nivel C según la escala Scottish Intercollegiate Guidelines Network. Conclusiones Actualmente la DCRL clásica tiene tasas de éxito menores que las DCRL modificadas, por lo que sugerimos el uso de estas últimas. Preferimos la DCRL con MMC-IS o bien la DCRL con técnicas de endoscopia asociadas, sin poder decantarnos por ninguna opción en particular, puesto que las tasas de éxito son muy similares. Dejamos a criterio del cirujano la elección, dependiendo del manejo de las técnicas endonasales. Son necesarios más estudios, con mayor seguimiento, y mejor definidos para clarificar cuál es la mejor técnica DCRL (AU)

Objective The main objective of this work is to review the articles that refer to transcanalicular diode laser dacryocystorhinostomy (TCL-DCR) in acquired nasolacrimal duct obstruction (NLDO), as well as its modifications. Material and methods A systematic review of publications related to TCL-DCR of the lacrimal duct from 2000 to March 2021 was carried out in the MEDLINE, EMBASE and Cochrane Library databases. The search terms in Spanish and English were: «Endocanalicular laser», dacryocystorhinostomy or «primary DCR-L» or «laser» and «tear ducts». Results After subjecting the articles to the inclusion and exclusion criteria, we got 49 articles: 21 retrospective and 28 prospective studies. The bibliometric result obtained guaranteed, for this review, a level C recommendation according to the Scottish Intercollegiate Guidelines Network scale. Conclusions Currently, the classic TCL-DCR has lower success rates than its modifications, so we suggest using the latter. We prefer TCL-DCR with IS-MMC or TCDL associated with endoscopy techniques, without being able to opt for any option, since their success rates are very similar. We leave the choice to the discretion of the surgeon, depending on the management skills of endonasal techniques. More studies, with longer follow-up, and better defined criteria are necessary to clarify which is the best TCL-DCR technique (AU)

Endocanalicular Laser Dacryocystorhinostomy and its modifications: A systematic review of techniques and success rates.

OBJECTIVE: the main objective of this work is to review the articles that refer to transcanalicular diode laser dacryocystorhinostomy (TCL-DCR) in acquired nasolacrimal duct obstruction (NLDO), as well as its modifications. MATERIAL AND METHODS: A systematic review of publications related to TCL-DCR of the lacrimal duct from 2000 to March 2021 was carried out in the MEDLINE, EMBASE and COCHRANE LIBRARY databases. The search terms in Spanish and English were: «Endocanalicular laser¼, dacryocystorhinostomy or «primary DCR-L¼ or «laser¼ and «tear ducts¼. RESULTS: After subjecting the articles to the inclusion and exclusion criteria, we got 49 articles: 21 retrospective and 28 prospective studies. The bibliometric result obtained guaranteed, for this review, a level C recommendation according to the Scottish Intercollegiate Guidelines Network scale. CONCLUSIONS: Currently, the classic TCL-DCR has lower success rates than its modifications, so we suggest using the latter. We prefer TCL-DCR with IS-MMC or TCDL associated with endoscopy techniques, without being able to opt for any option, since their success rates are very similar. We leave the choice to the discretion of the surgeon, depending on the management skills of endonasal techniques. More studies, with longer follow-up, and better defined criteria are necessary to clarify which is the best TCL-DCR technique.

High-power laser for periodontal surgery in a patient with glanzmann thrombasthenia / Laser de alta potência para cirurgia periodontal em paciente com trombastenia de glanzmann

Background: Glanzmann thrombasthenia (GT) is a rare autosomal recessive disorder characterized by platelet function impairment. Considering that the oral cavity is highly vascularized and performing some local hemostatic maneuvers may be difficult, GT patients are at high risk for hemorrhage related to invasive oral procedures. This study aimed to present an alternative method for periodontal surgery in a young GT patient. Case Report: A 15-year-old female GT patient with a recent history of excessive bleeding following dental surgeries was referred to a public dental center, presenting gingival hyperplasia. The procedure was performed using a high-power laser (HPL), and except for local anesthesia with epinephrine, no further hemostatic agent was necessary. Conclusion: According to the case, the HPL seems to be an efficient tool for preventing perioperative bleeding in GT patients submitted to minor oral surgeries(AU)

Introdução: A trombastenia de Glanzmann (TG) é uma doença autossômica recessiva rara caracterizada por comprometimento da função plaquetária. Tendo em vista que a cavidade oral é altamente vascularizada e a realização de algumas manobras hemostáticas locais pode ser difícil, pacientes com TG apresentam alto risco de hemorragia relacionada a procedimentos orais invasivos. Este artigo teve como objetivo apresentar uma técnica alternativa para cirurgia periodontal em um paciente jovem com TG. Relato de Caso: Paciente com TG, sexo feminino, 15 anos, com história recente de sangramento excessivo relacionado a cirurgias odontológicas prévias, foi encaminhada a um centro odontológico público apresentando hiperplasia gengival. O procedimento de remoção foi realizado com laser de alta potência e, com exceção da anestesia local com epinefrina, nenhum outro agente hemostático foi necessário. Conclusão: De acordo com o caso, o laser de alta potência parece ser uma ferramenta eficiente na prevenção de sangramento perioperatório em pacientes com TG submetidos a pequenas cirurgias orais(AU)

Terapia láser transescleral de micropulsos en el manejo de los pacientes de glaucoma / MicroPulse® transscleral laser therapy in the management of glaucoma patients

Objetivo Evaluar la eficacia y seguridad de la terapia láser transescleral MicroPulse® (TLT) en el tratamiento de pacientes con glaucoma. Métodos Se llevó a cabo una serie de casos prospectiva, intervencionista y no comparativa en el Servicio de Oftalmología del Hospital Universitario Ain Shams en 61 ojos de 46 pacientes con diversos tipos de glaucoma y de gravedad, de leves a graves. Además de la agudeza visual mejor corregida, se registraron la presión intraocular (PIO) y el número de medicamentos para el glaucoma antes y después del tratamiento, junto con la necesidad postoperatoria de inhibidores sistémicos de la anhidrasa carbónica, las tasas de éxito, el número de sesiones de tratamiento y las complicaciones postoperatorias. El éxito se definió como una PIO de 6-18mmHg o una disminución de al menos el 30% de la PIO preoperatoria en ausencia de complicaciones que amenazaran la visión durante el periodo de seguimiento de 6 meses. Resultados Se realizó la TLT MicroPulse® en 61 ojos glaucomatosos. Se repitió la sesión de TLT MicroPulse® en 11 de los 61 ojos (18%) que no alcanzaron una PIO entre 6 y 18mmHg, o una disminución de al menos el 30% con respecto al valor inicial a los 6 meses. A los 6 meses de seguimiento tras una única sesión de TLT MicroPulse® la reducción media de la PIO fue del 35,9%±14,2%, y 6 meses después de la segunda sesión fue del 36,2%±17,5% (p<0,001). La tasa de éxito tras la primera sesión fue del 73,8%, que aumentó al 78,7% tras la segunda sesión. La reacción celular media de la cámara anterior fue de+1,9±0,8 al primer día,+1,0±0,7 a la primera semana y+0,2±0,4 al primer mes del postoperatorio. No se detectaron células en ninguno de los casos a los 3 y 6 meses de seguimiento (p<0,001). El número medio de colirios antiglaucomatosos antes del TLT MicroPulse® fue de 2,6±1,0 (AU)

Objective To evaluate the efficacy and safety of MicroPulse® transscleral laser therapy (TLT) in the management of glaucoma patients. Methods A prospective, interventional, non-comparative case series was conducted in the department of ophthalmology, Ain Shams University Hospital on 61 eyes of 46 patients with various glaucoma types and of severity, ranging from mild to severe. In addition to best-corrected visual acuity (BCVA), intraocular pressure (IOP) and the number of glaucoma medications were recorded before and after treatment, along with the postoperative need for systemic carbonic anhydrase inhibitors (CAI), success rates, number of treatment sessions and postoperative complications. Success was defined as an IOP of 6-18mmHg or at least a 30% decrease from preoperative IOP in the absence of any vision-threatening complications during the 6-month follow-up period. Results MicroPulse TLT was performed on 61 glaucomatous eyes. Eleven of the 61 eyes (18%) that did not achieve IOP between 6-18mmHg, or at least a 30% decrease from baseline at 6 months, had a repeat MicroPulse TLT session. At 6 months follow-up post a single MicroPulse TLT session, the mean IOP reduction was 35.9±14.2%; and 6 months after the second session, it was 36.2±17.5% (P<.001). The success rate after the first session was 73.8% which increased to 78.7% after the second session. The mean anterior chamber (AC) cell reaction was+1.9±.8 at 1 day,+1.0±.7 at 1 week, and+.2±.4 at 1 month postoperatively. No cells were detected in any of the cases at 3 and 6 months follow-up (P<.001). The average number of anti-glaucoma eye drops before MicroPulse TLT was 2.6±1.0. Postintervention, the average number of anti-glaucoma eye drops was 1.7±1.2, and sustained at 6 months follow-up after the last treatment session (P<.001). There were no significant complications were noted. One eye developed transient hypotony for 3 months after MicroPulse TLT (AU)

MicroPulse® transscleral laser therapy in the management of glaucoma patients.

PURPOSE: To evaluate the efficacy and safety of MicroPulse® transscleral laser therapy (TLT) in the management of glaucoma patients. METHODS: A prospective, interventional, non-comparative case series was conducted in the department of ophthalmology, Ain Shams University Hospital on 61 eyes of 46 patients with various glaucoma types and of severity, ranging from mild to severe. In addition to best-corrected visual acuity (BCVA), intraocular pressure (IOP) and the number of glaucoma medications were recorded before and after treatment, along with the postoperative need for systemic carbonic anhydrase inhibitors (CAI), success rates, number of treatment sessions and postoperative complications. Success was defined as an IOP of 6-18 mmHg or at least a 30% decrease from preoperative IOP in the absence of any vision-threatening complications during the 6-month follow-up period. RESULTS: MicroPulse TLT was performed on 61 glaucomatous eyes. Eleven of the 61 eyes (18%) that did not achieve IOP between 6-18 mmHg, or at least a 30% decrease from baseline at 6 months, had a repeat MicroPulse TLT session. At 6 months follow-up post a single MicroPulse TLT session, the mean IOP reduction was 35.9 ± 14.2%; and 6 months after the second session, it was 36.2 ± 17.5% (p < 0.001). The success rate after the first session was 73.8% which increased to 78.7% after the second session. The mean anterior chamber (AC) cell reaction was +1.9 ± 0.8 at 1 day, +1.0 ± 0.7 at 1 week, and +0.2 ± 0.4 at 1 month postoperatively. No cells were detected in any of the cases at 3 and 6 months follow-up (p < 0.001). The average number of anti-glaucoma eye drops before MicroPulse TLT was 2.6 ± 1.0. Postintervention, the average number of anti-glaucoma eye drops was 1.7 ± 1.2, and sustained at 6 months follow-up after the last treatment session (p < 0.001). There were no significant complications were noted. One eye developed transient hypotony for 3 months after MicroPulse TLT. CONCLUSIONS: MicroPulse TLT is safe and effective in lowering IOP in a variety of glaucoma types and severity.

MicroPulse® transscleral laser therapy in the management of glaucoma patients. / Terapia láser transescleral de micropulsos en el manejo de los pacientes de glaucoma.

OBJECTIVE: To evaluate the efficacy and safety of MicroPulse® transscleral laser therapy (TLT) in the management of glaucoma patients. METHODS: A prospective, interventional, non-comparative case series was conducted in the department of ophthalmology, Ain Shams University Hospital on 61 eyes of 46 patients with various glaucoma types and of severity, ranging from mild to severe. In addition to best-corrected visual acuity (BCVA), intraocular pressure (IOP) and the number of glaucoma medications were recorded before and after treatment, along with the postoperative need for systemic carbonic anhydrase inhibitors (CAI), success rates, number of treatment sessions and postoperative complications. Success was defined as an IOP of 6-18mmHg or at least a 30% decrease from preoperative IOP in the absence of any vision-threatening complications during the 6-month follow-up period. RESULTS: MicroPulse TLT was performed on 61 glaucomatous eyes. Eleven of the 61 eyes (18%) that did not achieve IOP between 6-18mmHg, or at least a 30% decrease from baseline at 6 months, had a repeat MicroPulse TLT session. At 6 months follow-up post a single MicroPulse TLT session, the mean IOP reduction was 35.9±14.2%; and 6 months after the second session, it was 36.2±17.5% (P<.001). The success rate after the first session was 73.8% which increased to 78.7% after the second session. The mean anterior chamber (AC) cell reaction was+1.9±.8 at 1 day,+1.0±.7 at 1 week, and+.2±.4 at 1 month postoperatively. No cells were detected in any of the cases at 3 and 6 months follow-up (P<.001). The average number of anti-glaucoma eye drops before MicroPulse TLT was 2.6±1.0. Postintervention, the average number of anti-glaucoma eye drops was 1.7±1.2, and sustained at 6 months follow-up after the last treatment session (P<.001). There were no significant complications were noted. One eye developed transient hypotony for 3 months after MicroPulse TLT. CONCLUSIONS: MicroPulse TLT is safe and effective in lowering IOP in a variety of glaucoma types and severity.

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.

Utilización de láser diodo en el tratamiento de la peri-implantitis: reporte de 3 casos / Use of diode laser in peri-implantitis treatment: report of 3 cases

Los implantes dentales son ampliamente usados para el reemplazo de piezas dentarias y se han convertido en el "gold standard" de las terapias protésicas en odontología. Dado el mayor uso de éstos, las investigaciones epidemiológicas recientes han demostrado elevadas tasas de prevalencia de enfermedad periimplantaria. En el presente estudio se presentan tres casos clínicos diagnosticados con periimplantitis. Todos los casos presentaron aumento de la profundidad al sondaje periimplantario en relación a controles anteriores, supuración, sangramiento al sondaje y pérdida ósea confirmada a través de tomografía computada cone beam. El tratamiento indicado para todos los casos fue una terapia conjunta entre un tratamiento mecánico mediante ultrasonido con la utilización de puntas plásticas (P.I EMS®, Suiza) y la terapia con láser. Para la laserterapia se utilizó un equipo de láser diodo de 940 nm (Biolase®, USA) con una potencia de 2 W en modo CW, utilizando una punta de 300 µm. El láser de diodo no daña la superficie de titanio y es capaz de descontaminar las superficies rugosas de los implantes. En este reporte, el uso de una terapia combinada mecánica y láser fue efectiva en todos los casos. En los controles clínicos, la mucosa periimplantaria no presentó signos de supuración ni sangramiento, y la profundidad al sondaje también se vió disminuída. El nivel óseo se controló a través de una tomografía computada cone beam y no se evidenciaron cambios significativos. En la actualidad, la evidencia clínica para el tratamiento periimplantario mediante la fototerapia todavía es limitada. Sin embargo, el láser ofrece un enfoque técnico novedoso que es completamente diferente de los instrumentos mecánicos y tiene varios efectos beneficiosos, por lo que puede desempeñar un papel importante, en la resolución de la peri-implantitis.

Dental implants are widely used for the replacement of teeth and have become the "gold standard" of prosthetic therapies in dentistry. Given the increased use of these, recent epidemiological investigations have shown high prevalence rates of peri-implant disease. In the present study, three clinical cases diagnosed with peri-implantitis are presented. All cases presented increased depth to peri-implant probing in relation to previous controls, suppuration, bleeding and bone loss confirmed by cone beam computed tomography. The treatment indicated for all cases was a joint therapy between a mechanical ultrasound treatment with the use of plastic tips (P.I EMS®, Switzerland) and laser therapy. For laser therapy, a 940 nm diode laser equipment was used (Biolase®, USA) with a power of 2W in continuous laser beam mode, using a 300 µm tip. The diode laser does not damage the titanium surface and is capable of decontaminating the rough surfaces of the implants. In this report, the use of a combined mechanical and laser therapy was effective in all cases. In clinical controls, the peri-implant mucosa did not show signs of suppuration or bleeding, and the depth on probing was decreased. The bone level was controlled through a cone beam computed tomography and no significant changes were evidenced. At present, the clinical evidence for peri-implant treatment using phototherapy is still limited. However, the laser offers a novel technical approach that is completely different from mechanical instruments and has several beneficial effects, so it can play an important role in the resolution of peri-implantitis.

Efficacy of diode laser and sonic agitation of Chlorhexidine and Silver-nanoparticles in infected root canals / Eficácia do laser de diodo e agitação sônica de clorexidina e nanopartículas de prata em canais radiculares infectados

Objective: To assess the efficacy of agitation of chlorohexidine (CHX) and Silver nanoparticles "AgNps" with 810nm diode laser or sonic endoactivator compared to side ­vented needle on infected root canals with Enterococcus "E" Faecalis biofilms. Material and Methods: Sixty-five extracted human premolars with single oval canals were instrumented by protaper system up to F3. Biofilms of E. faecalis were generated based on a previously established protocol. Two teeth were used to check the biofilm formation, then the remaining Teeth were randomly divided into three equal experimental groups according to agitation techniques used: group 1 (810 nm diode laser with 1 watt) , group 2 (sonic endoactivator) and group 3 (Side vented needle). Each group was further divided into three equal subgroups according to the irrigant solution into; subgroup A: chlorohexidine, subgroup B: silver nanoparticles and subgroup C: distilled water: Confocal laser scanning microscopy "CLSM" was used to assess bacterial viability. Data were analyzed by appropriate statistical analyses with P = 0.05. Results: Regarding the activation method, all groups had a significantly high percentage of dead bacteria (P < 0.05). However, Laser was significantly the highest and Endoactivator the least (P < = 0.001). Diode laser agitation of AgNps irrigant showed the highest reduction percentage of bacteria (78.1%) with a significant difference with both CHX and water irrigation, Conclusion: Under the condition of the present study; results reinforced that laser activation is a useful adjunct, 810 nm diode laser agitation of AgNps or chlorhexidine was more effective in disinfection of oval root canals than endoactivator and side vented needle techniques. (AU)

Objetivo: Avaliar a eficácia da agitação de clorohexidina (CHX) e nanopartículas de prata (AgNps) , com laser de diodo de 810 nm ou endoativador sônico, em comparação à agulha de ventilação lateral, em canais radiculares infectados com biofilmes de Enterococcus "E"; Faecalis. Material e Métodos: Sessenta e cinco pré-molares humanos com um único canal oval, extraídos, foram instrumentados pelo sistema protaper até F3. Os biofilmes de E. faecalis foram gerados com base em um protocolo previamente estabelecido. Foram utilizados dois dentes para verificar a formação do biofilme, e os dentes restantes foram divididos aleatoriamente em três grupos experimentais iguais, de acordo com as técnicas de agitação utilizadas: grupo 1 (laser de diodo 810 nm com 1 watt), grupo 2 (endoativador sônico) e grupo 3 (Agulha com ventilação lateral). Cada grupo foi dividido em três subgrupos iguais, de acordo com a solução irrigante; subgrupo A: clorohexidina, subgrupo B: nanopartículas de prata e subgrupo C: água destilada: A microscopia confocal de varredura a laser foi usada para avaliar a viabilidade bacteriana. Os dados foram analisados por análises estatísticas apropriadas com P = 0,05. Resultados: Em relação ao método de ativação, todos osgrupos apresentaram percentual significativamente alto de bactérias mortas (P < 0.05). No entanto, para o laser foi significativamente o mais alto e, para oendoativador, o menos alto (P < = 0.001). A agitação com laser de diodo doirrigante AgNps apresentou a maior porcentagem de redução de bactérias (78,1%), com diferença significativa tanto para irrigação com CHX quanto comágua. Conclusão: Sob as condições do presente estudo; os resultadosreforçaram que a ativação a laser é um complemento útil, a agitação por laserde diodo de 810 nm de AgNps ou clorexidina foi mais eficaz na desinfecção dos canais radiculares ovais do que as técnicas de endoativador e agulha com ventilação lateral. (AU)

Excision of a traumatic fibroma with diode laser in a pediatric patient: case report / Escisión de un fibroma traumático con láser de diodo en paciente pediátrico: reporte de caso

ABSTRACT Fibroma is currently considered the most common reactive hyperplasia of fibrous connective tissue in response to local trauma in the oral cavity. This case deals with the excision of a traumatic fibroma using diode laser (Epic X, wavelength of 940nm, continuous mode, 5W power), whose energy is absorbed by hemoglobin and melanin (chromophores) and is indicated in soft tissue surgeries, favoring coagulation. The results are consistent with the benefits demonstrated in the scientific literature: better visibility in the surgical act due to achieved hemostasis, excellent postoperative phase due to the absence of pain and inflammation, with no need for analgesic medication, no use of sutures, no scarring and no recurrence. It is a safe and fast procedure that also allows performing a histopathological study without altering the tissues to be examined. In the case presented here, the histopathological study confirmed the presumptive diagnosis of fibroma.

RESUMEN El fibroma es considerado actualmente como la más común hiperplasia reactiva de tejido conectivo fibroso en respuesta a un trauma local en la cavidad bucal. En este caso se menciona la escisión de un fibroma traumático utilizando laser de diodo (Epic X, longitud de onda de 940nm, modo continuo, potencia 5W), cuya energía es absorbida por la hemoglobina y la melanina (cromóforos), indicado en cirugías de tejidos blandos, favoreciendo la coagulación. Los resultados están acordes con los beneficios demostrados en la literatura científica: mejor visibilidad en el acto quirúrgico por la hemostasia lograda, postoperatorio excelente por la ausencia de dolor e inflamación, sin necesidad de medicación analgésica ni uso de suturas, no produce aparición de cicatriz y no recidiva; ofrece seguridad y rapidez en el procedimiento. Permite la realización de estudio histopatológico sin alterar los tejidos a examinar. En el caso presentado, el estudio histopatológico comprobó el diagnóstico presuntivo de fibroma.

Prospective evaluation of micropulse transscleral diode cyclophotocoagulation in refractory glaucoma: 1 year results / Avaliação prospectiva do laser de diodo micropulsado em pacientes com glaucoma refratário: resultados de um ano de seguimento

ABSTRACT Purpose: To evaluate the effectiveness in in­traocular pressure reduction and safety of micropulse trans­scleral diode cyclophotocoagulation in refractory glaucoma. Methods: We prospectively evaluated a case series of 21 eyes of 21 consecutive patients with refractory glaucoma treated with micropulse transscleral diode cyclophotocoagulation at 12-month follow-up. The total treatment time was at the discretion of the surgeon, considering baseline and target intraocular pressure and glaucoma diagnosis. Intraocular pressure, inflammation, visual acuity, and number of medications were monitored. Success was defined as intraocular pressure between 6 and 21 mmHg and/or 30% reduction from baseline intraocular pressure with or without the use of antiglaucoma medications. Visual acuity loss was defined as a loss of ≥2 lines of vision on the Snellen chart or a ≥2-level decrease in visual function in patients with nonmeasurable chart acuity. Results: The mean age was 61.04 ± 12.99 years, and 11 (52.4%) patients were male, with most (95%) patients showing low visual acuity at baseline (count fingers or worse). The mean intraocular pressure was 33.38 ± 15.95 mmHg, and the mean number of medications was 3.5 ± 1.1 at baseline. After 1, 3, 6, and 12 months, 76.19%, 57.14%, 55.56%, and 66.67%, respectively, of the patients were classified as treatment successes. Seven (33.3%) patients required new laser treatment and were considered treatment failures. The mean intraocular pressure reduction was 44.72% ± 29.72% in the first week and 41.59% ± 18.93% at the end of follow-up (p=0.006). The mean number of medications significantly dropped to 2.00 ± 1.7 at the 12-month visit (p=0.044). Complications included hypotony (4.8%), intraocular inflammation after 1 month (19%), and visual acuity loss (4.8%). Conclusions: Micropulse transscleral diode cyclophotocoagulation was safe and effective for reducing intraocular pressure in eyes with refractory and advanced glaucoma, with reduced need for ocular antihypertensive medication.

RESUMO Objetivo: Avaliar a eficácia na redução da pressão intraocular e na segurança da ciclofotocoagulação com laser de diodo transescleral em glaucoma refratário. Métodos: Avaliamos prospectivamente uma série de casos de 21 olhos de 21 pacientes com glaucoma refratário tratados com ciclofotocoagulação com laser de diodo transescleral com acompanhamento por 12 meses. O tempo total de tratamento ficou a critério do cirurgião, considerando a pressão intraocular inicial e alvo e o tipo de glaucoma. Pressão intraocular, inflamação, acuidade visual e número de medicamentos foram monitorados. O sucesso foi definido como pressão intraocular entre 6 e 21 mmHg e/ou redução de 30% da pressão intraocular basal com ou sem o uso de medicamentos glaucomatosos. Perda da acuidade visual foi definida como perda de ≥2 linhas de visão na tabela de Snellen ou uma diminuição de ≥ 2 níveis na função visual em pacientes com acuidade do gráfico não mensurável. Resultados: A idade média foi de 61,04 ± 12,99 anos e 11 (52,4%) pacientes eram do sexo masculino, com a maioria (95%) dos pacientes apresentando baixa acuidade visual inicialmente (conta dedos ou pior). A pressão intraocular média foi de 33,38 ± 15,95 mmHg, e o número médio de medicamentos foi de 3,5 ± 1,1, no início do estudo. Após 1, 3, 6 e 12 meses, 76,19%, 57,14%, 55,56% e 66,67%, respectivamente, dos pacientes foram classificados como sucesso do tratamento. Sete (33,3%) pacientes necessitaram de novo tratamento com laser e foram considerados falhas no tratamento. A redução média da pressão intraocular foi de 44,72% ± 29,72% na primeira semana e 41,59% ± 18,93% no final do seguimento (p=0,006). O número médio de medicamentos diminuiu significativamente para 2,00 ± 1,7 na visita de 12 meses (p=0,044). As complicações incluíram hipotonia (4,8%), inflamação intraocular após 1 mês (19%) e perda de acuidade visual (4,8%). Conclusões: A ciclofotocoagulação com laser de diodo transescleral foi segura e eficaz para reduzir a pressão intraocular em olhos com glaucoma refratário e avançado, com necessidade reduzida de hipotensores oculares.

Utilização do diodo emissor de luz (LED) na cicatrização de queimaduras: revisão sistemática da literatura / Use of light emitting diode (LED) in the healing of burns: systematic review of the literature

INTRODUÇÃO: O tratamento de vítimas de queimadura é desafiador pela gravidade da própria lesão e das complicações que podem ocorrer durante o processo de cicatrização. A fisioterapia dermatofuncional tem atuação no tratamento de cicatrizes, utilizando de terapias para acelerar o processo cicatricial e recuperação funcional adequada. O diodo emissor de luz ou LED tem sido descrita como uma possibilidade terapêutica valiosa para fisioterapia com o intuito de reduzir complicações funcionais e estéticas em processos cicatriciais de indivíduos queimados. OBJETIVOS: Revisar a literatura acerca da utilização da luz LED e seus efeitos na cicatrização tecidual na lesão por queimadura. MATERIAIS E MÉTODOS: Trata-se de uma revisão sistemática da literatura, realizada no mês de agosto de 2017, utilizando as bases de dados Bireme, PubMed e PeDro, baseado nos critérios PRISMA. Foram incluídos no estudo os artigos que abordassem a utilização do LED na cicatrização específica de queimaduras, publicados nos últimos cinco anos (2012 -2017), nos idiomas inglês e português. Os critérios de exclusão foram artigos que abordaram o uso do LED na cicatrização tecidual em geral. A seleção dos artigos foi realizada por dois autores, não havendo consenso entre ambos, um terceiro autor seria convocado, o que não foi necessário nesta busca. RESULTADOS: Foram encontrados 1.029 artigos na busca, destes foram incluídos 04 artigos, que abordaram a utilização do LED na cicatrização específica de queimaduras publicados de 2012 a 2017. Todos os estudos encontraram melhoras do processo cicatricial com uso do LED, mesmo sendo utilizados comprimentos de onda distintos nos trabalhos analisados. CONCLUSÃO: A utilização do LED no tratamento de queimaduras demonstrou favorecer o processo de cicatrização tecidual em animais e melhorar os aspectos histológicos nos tecidos tratados, porém ainda pouco utilizado na Fisioterapia.

INTRODUCTION: The treatment of burn victims is challenging because of the severity of the lesion itself and the complications that may occur during the healing process. Dermatofunctional physiotherapy works in the treatment of scars, using therapies to accelerate the cicatricial process and adequate functional recovery. The light emitting diode or LED has been described as a valuable therapeutic possibility for physiotherapy with the aim of reducing functional and aesthetic complications in the cicatricial processes of burned individuals. OBJECTIVES: To review the literature on the use of LED light and its effects on tissue healing in burn injury. MATERIALS AND METHODS: This is a systematic review of the literature, conducted in August 2017, using the Bireme, PubMed and PeDro databases, based on PRISMA criteria. The study included articles that addressed the use of LED in the specific healing of burns, published in the last five years (2012 -2017), in the English and Portuguese languages. The exclusion criteria were articles that addressed the use of LED in tissue healing in general. The selection of articles was carried out by two authors, and there was no consensus between the two, a third author would be called, which was not necessary in this search. RESULTS: A total of 1,029 articles were found in the search, of which 04 articles were included, which addressed the use of LEDs in the specific cicatrization of burns published from 2012 to 2017. All studies found improvements of the cicatricial process using LED, even though different wavelengths were used in the analyzed works. CONCLUSION: The use of LED in the treatment of burns has favored the healing process in animals and improve the histological aspects in the treated tissues, but still little used in physiotherapy.

Endodontic treatment of a large periapical cyst with the aid of antimicrobial photodynamic therapy: case report / Tratamento endodôntico de um grande cisto periapical com o auxílio de terapia fotodinâmica antimicrobiana: relato de caso

Introduction: Periapical cysts, especially those of great extension, represent a challenge for endodontics, due to the ineffectiveness of traditional root canal treatment (RCT) in such cases. The aim of this case report was to evaluate the effectivity of antimicrobial photodynamic therapy "aPDT" when associated with calcium hydroxide Ca(OH)2 in treating such cysts. Case report: A 40-years-old female patient complained of bulging in the upper anterior region of the mouth. The clinical examination showed an extensive swollen periodontal area, painful with digital palpation, with a negative response to thermal tests on teeth 11 and 21. After traditional RCT, the canals of teeth 11 and 21 were filled with photosensitizer methylene blue 0.005% for 5 min pre irradiation time (PIT) and irradiated by low power diode laser with visible red wavelength (660 nm) during 2 minutes without intervals, using an optical fiber delivering system with a helical movement from apical to cervical. Then the canals were filled with Ca(OH)2 paste for 45 days and had been changed each 15 days, and repeating the radiation. Results: After 45 days, the patient already had a bulging remission, with painless resistance to the apical pressure over the region and signs of bone repair confirmed with the radiographic examination, and total absence of signs or symptoms. Conclusion: the association of aPDT with Ca(OH)2 paste is effective in treating of periapical lesions of great extension and avoids surgical treatment. (AU)

Introdução: os cistos periapicais, especialmente os de grande extensão, representam um desafio para a endodontista, uma vez que não são reparados com o tratamento endodôntico tradicional. O objetivo deste relato de caso foi avaliar a efetividade da terapia fotodinâmica antimicrobiana "aPDT" quando associada ao hidróxido de cálcio Ca(OH)2 no tratamento desses cistos. Relato de caso: paciente do sexo feminino, 40 anos, com queixa de abaulamento na região ântero-superior da boca. O exame clínico evidenciou extensa área periodontal inchada, dolorosa com palpação digital, com resposta negativa aos testes térmicos dos dentes 11 e 21. Após o tratamento endodôntico tradicional, os canais dos dentes 11 e 21 foram preenchidos com fotossensibilizador de azul de metileno a 0,005% de tempo de pré-radiação de 5 min e irradiados por laser de diodo de baixa potência com comprimento de onda vermelho visível (660 nm) por 2 min sem intervalos, usando um sistema de fornecimento de fibra ótica com um movimento helicoidal do apical ao cervical. Em seguida, o canal foi preenchido com pasta de Ca(OH)2 por 45 dias sendo trocados a cada 15 dias e repetida a radiação. Resultados: Após 45 dias, o paciente já apresentava uma remissão volumosa, com resistência indolor à pressão apical na região e sinais de reparo ósseo ao exame radiográfico e ausência total de sinais ou sintomas. Conclusão: a associação de aPDT com Ca(OH)2 é eficaz no tratamento de lesões periapicais de grande extensão e evitar tratamento cirúrgico (AU)

Uso de Láser diodo de 1470 nm en el tratamiento del carcinoma escamoso de laringe (Tis, T1 y T2) en adultos mayores / 4170 nm diode Laser use in the treatment of laringeal squamous carcinoma (Tis, T1 and T2) in elderly adults / Usando diodo laser 1470 nm, no tratamento do carcinoma de celulas escamosas da laringe (Tis, T1 y T2) em idosos

Introducción: entre las diferentes modalidades terapéuticas para el carcinoma escamoso de laringe en estadios iniciales, la cirugía transoral láser (CTL) constituye el tratamiento de elección. El láser de CO2 es aceptado universalmente como la mejor herramienta terapéutica en este sentido. En situaciones de no poder acceder a esa tecnología, es posible utilizar otros instrumentos para resección en CTL (radiofrecuencia, electrobisturí). Entre estas, nuestro equipo de trabajo ha implementado el uso del láser de diodo de 1470 nm. En el presente trabajo describimos los resultados preliminares en el tratamiento de estadios tempranos del carcinoma escamoso de laringe con CTL. Materiales y métodos: Se utilizó el láser de diodo de 1470 nm en pacientes adultos mayores realizados entre enero de 2012 y diciembre de 2015 en el Servicio de Otorrinolaringología del Hospital Dr. C. Milstein. Resultados: Se trataron 32 pacientes con cáncer de laringe, de los cuales se incluyeron 21, todos mayores de 65 años, con carcinoma escamoso de laringe estadio Tis T1 y T2 sin compromiso cervical ni metastásico y sin tratamiento oncológico previo. De los 21 pacientes incluidos, a 19 se les realizó una única intervención y dos fueron reintervenidos con la misma técnica. Conclusiones: El uso del láser diodo de 1470 nm para el tratamiento del carcinoma escamoso de laringe en estadios iniciales ha permitido controlar la enfermedad en los 21 pacientes intervenidos con esta tecnología, en un tiempo medio de seguimiento de 21 meses. La CTL con láser de diodo se presenta como una opción válida para el tratamiento del cáncer de laringe en estadios iniciales.

Introduction: among the different therapeutic modalities for squamous carcinoma of the larynx in early stages, transoral laser surgery (CTL) is the treatment of choice. Materials and methods: CO2 laser is universally accepted as the best therapeutic tool in this regard. In situations of not being able to access that technology, it is possible to use other CTL resection instruments (radiofrequency, electro-scalpel). Among these, our work team has implemented the use of 1470 nm diode laser. In the present work we describe the preliminary results in the treatment of early stages of squamous carcinoma of the larynx with CTL using 1470 nm diode laser in elderly patients performed between January 2012 and December 2015 at the Otorhinolaryngology Service of Dr. Hospital C. Milstein. Results: Thirty-two patients with laryngeal cancer were treated, including 21, all over 65 years old, with squamous carcinoma of the Tis T1 and T2 larynx without cervical or metastatic involvement and without prior cancer treatment. Of the 21 patients included, 19 were given a single intervention and two were retreated with the same techniqu Conclusions: The use of laser 1470 nm diode for the treatment of squamous carcinoma of the larynx in early stages has allowed the control of the disease in the 21 patients operated with this technology, in an average follow-up time of 21 months. The CTL with diode laser is presented as a valid option for the treatment of laryngeal cancer in initial stages.

Introdução: entre os vários tratamentos para o carcinoma de células escamosas da laringe em modalidades estágios iniciais, laser cirurgia transoral (CTL) é o tratamento de escolha. O laser de CO2 é universalmente aceito como a melhor ferramenta terapêutica a este respeito. Em situações de não ter acesso a essa tecnologia, é possível usar outros instrumentos para CTL ressecção (radiofreqüência, eletrocautério). Materiais e métodos: Entre estes, a nossa equipa implementou o uso de diodo laser 1470 nm. Neste artigo descrevemos os resultados preliminares no tratamento do carcinoma de células escamosas da laringe, com CTL estágios iniciais utilizando o laser de diodo 1470 nm em pacientes idosos realizadas entre Janeiro de 2012 e Dezembro de 2015, Otorrinolaringologia do Hospital Dr. C. Milstein. Resultados: 32 pacientes com câncer de laringe, das quais 21 foram incluídos, todos com mais de 65 anos com carcinoma epidermóide de laringe Tis T1 e T2 sem ou compromisso de cancro cervical metastático e sem tratamento foram tratados. Dos 21 pacientes incluídos, 19 pacientes foram submetidos a uma única intervenção e dois eram reintevenidos com a mesma técnica. Conclusão: O uso de 1.470 nm diodo laser para o tratamento de carcinoma de células escamosas da laringe em estágios iniciais ajudou a controlar a doença em 21 pacientes tratados com esta tecnologia, em um seguimento médio de 21 meses. CTL diodo laser é apresentado como uma opção válida para o tratamento de carcinoma da laringe, em fases iniciais.

Virtual reality simulator for training on photoselective vaporization of the prostate with 980 nm diode laser and learning curve of the technique.

OBJECTIVE: The utility of a virtual reality simulator for training of the photoselective vaporization of the prostate with diode laser was studied. MATERIAL AND METHOD: Two experiments were performed with a simulator (VirtaMed AG, Zürich, Switzerland) with software for specific training in prostate vaporization in contact mode with Twister fiber (Biolitec AG, Jena, German). Eighteen surgeons performed ablation of the prostate (55 cc) twice and compared the score obtained (190 points efficacy and 80 safety) in the second one of them by experience groups (medical students, residents, specialists). They also performed a spatial orientation test with scores of 0 to 6. After, six of these surgeons repeated 15 ablations of the prostate (55 and 70 ml). Improvement of the parameters obtained was evaluated to define the learning curve and how experience, spatial orientation skills and type of sequences performed affects them. RESULTS: Global efficacy and safety score was different according to the grade of experience (P=.005). When compared by pairs, specialist-student differences were detected (p=0.004), but not specialist-resident (P=.12) or resident-student (P=.2). Regarding efficacy of the procedure, specialist-student (p=0.0026) and resident-student (P=.08) differences were detected. The different partial indicators in terms of efficacy were rate of ablation (P=.01), procedure time (P=.03) and amount of unexposed capsule (p=0.03). Differences were not observed between groups in safety (P=.5). Regarding the learning curve, percentage median on the total score exceeded 90% after performing 4 procedures for prostates of 55 ml and 10 procedures for prostate glands of 70 ml. This course was not modified by previous experience (resident-specialist; P=.6). However, it was modified according to the repetition sequence (progressive-random; P=.007). Surgeons whose spatial orientation was less than the median of the group (value 2.5) did not surpass 90% of the score in spite of repetition of the procedure. CONCLUSION: Simulation for ablation of the prostate with contact diode laser is a good learning model with discriminative validity, as it correlates the metric results with levels of experience and sills. The sequential repetition of the procedure on growing levels of difficulty favors learning.

Tratamiento de malformaciones vasculares bucofaciales por esclerosis endoluminal con diodo láser / Treatment of orofacial vascular malformations by endoluminal sclerosis with diodo laser

Introducción: la terapia con láser es una opción terapéutica para las malformaciones vasculares bucofaciales. Objetivo: se realizó este estudio con el objetivo de caracterizar la muestra socio-demográficamente, clasificar topográficamente las lesiones, determinar la eficacia del tratamiento de la esclerosis endoluminal con diodo láser y las modificaciones en diámetro y permanencia lesional e identificar los accidentes y complicaciones. Método: fue un estudio de serie de casos en 12 pacientes del total de diagnosticados con malformaciones vasculares de bajo flujo que acudieron al Departamento de Cirugía Maxilofacial de la Facultad de Estomatología "Raúl González Sánchez", en el período octubre 2011 a febrero 2012. Se trataron mediante esclerosis endoluminal con diodo láser. Se valoró edad, sexo, localización, diámetro y permanencia lesional cronológicamente. Resultados: de los 12 pacientes, 66.7% de la muestra fue del sexo femenino; 33.3% de los pacientes tenían entre 30-39 años. El 50% experimentó regresión de la lesión tras una sesión de tratamiento. El edema postoperatorio fue la complicación más frecuente. Conclusiones: la esclerosis endoluminal con láser de diodo resulta un método eficaz y seguro en el tratamiento de malformaciones vasculares bucofaciales de bajo flujo.

Introduction: the laser therapy is a therapeutical option to treat vascular malformations. Objective: this study was done with the objectives:, to characterize the sample social-demographically, to classify lesions topographically, to determine effectiveness of endoluminal diode laser sclerosis in the treatment of low flow vascular malformations, to determine changes in diameter and lesions presence, to identify accidents and complications. Method: a study of cases was carried out in 12 patients of the total of patients who attended with the diagnosis of low flow vascular malformations, at the Department of Maxillofacial Surgery, Faculty of Dentistry "Raúl González Sánchez", from October 2011 to February 2012.The patients were treated by endoluminal sclerosis with diodo laser. Was assessment age, sex, area, diameter, and lesion presence chronologically. Results: 12 patients was studied, the 66.7 % of the sample were female, the 33,3% of the patients were with age among 30-39 years. The 50% had regression of lesion after one session of treatment. The complication most frequent was swelling. Conclusions: the endoluminal laser sclerosis was a safe and efficacy method to treat low flow vascular orofacial lesions.

Tratamiento de malformaciones vasculares bucofaciales por esclerosis endoluminal con diodo láser / Treatment of orofacial vascular malformations by endoluminal sclerosis with diodo laser

Introducción: la terapia con láser es una opción terapéutica para las malformaciones vasculares bucofaciales.Objetivo: se realizó este estudio con el objetivo de caracterizar la muestra socio-demográficamente, clasificar topográficamente las lesiones, determinar la eficacia del tratamiento de la esclerosis endoluminal con diodo láser y las modificaciones en diámetro y permanencia lesional e identificar los accidentes y complicaciones. Método: fue un estudio de serie de casos en 12 pacientes del total de diagnosticados con malformaciones vasculares de bajo flujo que acudieron al Departamento de Cirugía Maxilofacial de la Facultad de Estomatología Raúl González Sánchez, en el período octubre 2011 a febrero 2012. Se trataron mediante esclerosis endoluminal con diodo láser. Se valoró edad, sexo, localización, diámetro y permanencia lesional cronológicamente.Resultados: de los 12 pacientes, 66.7 por ciento de la muestra fue del sexo femenino; 33.3 por ciento de los pacientes tenían entre 30-39 años. El 50 por ciento experimentó regresión de la lesión tras una sesión de tratamiento. El edema postoperatorio fue la complicación más frecuente. Conclusiones: la esclerosis endoluminal con láser de diodo resulta un método eficaz y seguro en el tratamiento de malformaciones vasculares bucofaciales de bajo flujo(AU)

Introduction: the laser therapy is a therapeutical option to treat vascular malformations. Objective: this study was done with the objectives:, to characterize the sample social-demographically, to classify lesions topographically, to determine effectiveness of endoluminal diode laser sclerosis in the treatment of low flow vascular malformations, to determine changes in diameter and lesions presence, to identify accidents and complications. Method: a study of cases was carried out in 12 patients of the total of patients who attended with the diagnosis of low flow vascular malformations, at the Department of Maxillofacial Surgery, Faculty of Dentistry Raúl González Sánchez, from October 2011 to February 2012.The patients were treated by endoluminal sclerosis with diodo laser. Was assessment age, sex, area, diameter, and lesion presence chronologically. Results: 12 patients was studied, the 66.7 percent of the sample were female, the 33,3 percent of the patients were with age among 30-39 years. The 50 percent had regression of lesion after one session of treatment. The complication most frequent was swelling. Conclusions: the endoluminal laser sclerosis was a safe and efficacy method to treat low flow vascular orofacial lesions(AU)

Efeitos do laser de baixa intensidade na sensibilidade dolorosa durante a movimentação ortodôntica / Effects of low intensity laser on pain sensitivity during orthodontic movement

OBJETIVO: avaliar a eficiência do laser diodo, infravermelho, na redução da dor no período pós-ativação da retração de caninos com molas fechadas de NiTi. MÉTODOS: doze pacientes que necessitavam de retração de caninos foram selecionados. Os caninos foram retraídos por meio de molas fechadas de NiTi, com força de 150g/lado. Um canino de cada paciente foi selecionado aleatoriamente para ser irradiado com laser, imediatamente após as ativações e depois de 3 e 7 dias. Os caninos homólogos foram utilizados como grupo controle e foi realizada somente a simulação de aplicação do laser. O laser irradiado foi o de diodo (ArGaAl), a um comprimento de onda de 780nm e uma potência de 20mW, densidade de energia na superfície do tecido alvo de 5J/cm², durante 10s por ponto, resultando numa energia de 0,2J por ponto e energia total (Et) de 2J. Para avaliação do efeito analgésico, foi utilizada a escala visual análoga (VAS), na qual os pacientes marcavam de 0 a 10, em consonância com a dor experimentada nos tempos de 12, 24, 48 e 72 horas pós ativação das molas e aplicação do laser.Todo o procedimento foi novamente realizado um mês depois, no momento da reativação da retração dos caninos. RESULTADOS E CONCLUSÕES: não houve diferença estatisticamente significativa entre os lados irradiado (GL) e controle (GC). Portanto, o laser de diodo infravermelho (780nm), no protocolo de aplicação utilizado, não foi eficiente em termos estatísticos para a diminuição da sensibilidade dolorosa provocada pela movimentação ortodôntica.

OBJECTIVE: To evaluate the efficiency of infrared diode laser on pain reduction during canine initial retraction. METHODS: Twelve patients in need of canine retraction were selected. The canines were retracted with closed NiTi coil springs activated to 150g per side. One canine of each patient was randomly selected for laser irradiation immediately after activation and after 3 and 7 days. The contralateral canines were taken as control group and were submitted only to simulation of laser application. Diode laser (ArGaAl) was employed at wavelength of 780nm, power of 20mW and energy density in the target tissue of 5J/cm², for 10 seconds per point, delivering an energy of 0.2J per point and total energy (TE) of 2J. The analgesic effect was evaluated with aid of a visual analogue scale (VAS), on which the patients indicated 0 to 10 according to the pain experienced at 12, 24, 48 and 72 hours after coil spring activation and laser application. The procedure was repeated after one month, upon reactivation of canine retraction. RESULTS AND CONCLUSIONS: There was no statistically significant difference between irradiated side (LG) and control side (CG). Thus, utilization of infrared diode laser (780nm) according to the present protocol was not statistically effective to reduce pain sensitivity caused by orthodontic movement.

Fluorescência na odontologia restauradora: laser de diodo / Fluorescence in restorative dentistry: diode laser

Nas últimas décadas, um declínio na prevalência da doença cárie tem sido constatado nos países industrailizados, no entanto, ainda representa umas das doenças que mais acomete os seres humanos, sendo considerada um problema de saúde pública. Uma nova visão da Odontologia, denominada Intervenção Mínima, tem determinado novas tendências no sentido de abranger procedimetos mais biológicos, preventivos e menos invasivos, visando a preservação de tecidos dentais. Essa filosofia é dependente de um diagnóstico precoce. Assim, como o diagnóstico difedigno do processo de cárie por inspeção visual é limitado, existe a necessidade de detectar a doença no seu estágio mais inicial, a fim de apoiar as decisões de tratamento. Dessa forma, nos últimos anos têm surgido métodos auxiliares de diagnóstico da doença e consequente aumento do interesse por analisar a eficácia desses métodos, uma vez técnicas baseadas apenas no exame visual e radiográfico não são tão eficazes em detectar níveis iniciais de perdas minerais do esmalte dental. O laser diodo para diagnóstico de cárie foi introduzido há alguns anos. Esses sistemas baseados na autofluorescência dos tecidos dentais parecem oferecer maior eficácia na realização de diagnóstico confiável e preciso das primeiras fases da desmineralização do esmalte dental. Para tanto, esta revisão avalia criticamente o diagnóstico de cárie por fluorescência a laser.

In recent decades, a decline in the prevalence of caries has been observed in industrialized countries, yet it represents one of the most common diseases in man and is considered a public health problem. A new approach or the treatment of dental caries is advocated by Mininmal Intervention Dentistry. It emphasizes a more biological preventive and less invasive procedures, in order to preserve more dental tissue. This philosophy dependents on early diagnosis. Since a reliable diagnosis of dental caries by visual inspection and radiographic examination is limited there is a need to detect the disease in its earlist stage, to suport treatment decisions. The diode laser for caries diagnosis was introduced some years ago. These systems are based on self-fluorescence of the tissues and appear to offer greater efficacy in achieving a reliable and occurate diagnosis of earlu stages of enamel demineralization. Thus, this rewiew critically evaluares caries diagnosis using laser flueorescence.