A Comparative Histological Study of Gingival Depigmentation by 808 and 445 nm Diode Lasers.

Introduction: Using lasers in melanin depigmentation is one of the main fields of interest for dental practitioners and patients. However, it is important to know what would happen inside the tissue and how the cells would interact inside the tissue with a laser. Methods: In this study, we used both wavelengths of 445 nm and 808 nm on sheep gingiva to find out the effects and side effects of these diode lasers while using them for gingival depigmentation. Results: After microscopic evaluation, we concluded that 808 nm and 445 nm lasers with a power of 1 W are safe enough to use in the depigmentation of gingiva, and both lasers are highly effective in melanin pigments which are located in basal membrane. Conclusion: The 445 nm blue laser produced a less thermal effect, which means it is safer to be used in gingival hyperpigmentation than a diode laser.

Comparison of the Diode Laser Wavelengths 445 nm and 810 nm in Gingival Depigmentation - A Clinical Evaluation.

Introduction: Nowadays, esthetic appearance plays an important role in the field of dentistry. Discolorations and pigmentations of the gingiva reduce the appearance of a healthy-looking smile. On this occasion, the use of lasers shows a promising approach for a fast and non-aggressive treatment in this field. Different laser wavelengths are being used for gingival depigmentation this clinical study aimed to investigate the effect of the novel laser wavelength (445 nm) in this field and compare it with an 810 nm diode laser. Methods: Two diode laser wavelengths (445 nm and 810 nm) were used for depigmentation. The laser output power chosen was 1 W. An optical fiber with a diameter of 400 µm was used. 21 patients with pigmented gingiva were selected. Depigmentation was carried out in a split-mouth design for a direct comparison of the clinical effect. Outcomes were documented by photograph after one month and six months of follow-up. Results: For each wavelength, 21 volunteers evaluated 21 clinical cases of depigmentation, which means that 441 comparisons were carried out in total regarding the color change from brownish to pinkish. A 100% clarification was achieved for 445 nm. In the 810 nm group, the color change in 44 of 441 cases (10%) could not be clearly identified. No statistically significant difference in pain experience was reported for both laser treatments. Conclusion: The clinical evaluation showed that within the limitations of this study, most of the clinical outcome parameters were highly acceptable by the patients due to mild pain and discomfort for both laser systems.

Oro-facial manifestations of 100 leprosy patients.

OBJECTIVES: To verify the frequency of oral and facial involvement in diagnosed leprosy patients. STUDY DESIGN: This study was performed on 100 leprosy patients (62 male, 38 female, mean ages 51.86±6.1). After explaining the study design, we studied descriptive information including: patient' s sex, age, job, place of birth, familial history of leprosy, types of disease (lepromatous, borderline and tuberculoid leprosy), ocular and oral lesions, facial involvement and neuropathy. The statistical signification was measured by chi-square test. RESULTS: A total of 46 (23 lepromatous, 15 borderline, and 8 tuberculoid leprosy) out of 100 patients with leprosy had oral lesions. Statistical analysis did not show any significant difference in frequency of oral lesions between different types of disease. Facial lesions were presented in 57 (39 lepromatous, 10 borderline, and 8 tuberculoid leprosy) patients. There was a statistical significant difference in frequency of facial manifestations between different types of leprosy. It has to be mentioned that, atrophy of nasal spine, facial nerve involvement, ocular lesions and facial deformity were seen in 15%, 17%, 22% and 44% of leprosy patients, respectively. CONCLUSION: Examination of leprosy patients should be extended to the oral mucosa because oral mucosa may be a secondary source of M.Leprae transmission and infection.

The efficacy of low-level diode laser versus laser acupuncture for the treatment of myofascial pain dysfunction syndrome (MPDS).

BACKGROUND: Myofascial pain dysfunction syndrome (MPDS) is the most common type of temporomandibular disorder. This study compared the efficacies of low-level diode laser therapy (LLLT) and laser acupuncture therapy (LAT) in the treatment of MPDS. METHODS: This double-blind randomized controlled clinical trial included 24 patients with MPDS who were randomly divided into two equally sized groups. Patients in the LLLT group received 12 sessions of low-level diode laser irradiation applied to the trigger points of the masticatory muscles during 1 month. The same protocol was also used in the LAT group according to the specific trigger points. We measured pain intensity and maximum mouth opening in both groups at baseline, during treatment, and 2 months after treatment completion. RESULTS: The pain intensities decreased from 6.58 ± 1.31 to 0.33 ± 0.65 and from 7.08 ± 1.37 to 0 in the LLLT and LAT groups, respectively. The maximum mouth openings increased from 32.25 ± 8.78 mm to 42.58 ± 4.75 mm and from 33 ± 6.57 mm to 45.67 ± 3.86 mm in the LLLT and LAT groups, respectively. Pain intensity (P = 0.839) and level of maximum mouth opening (P = 0.790) did not differ significantly between the groups. CONCLUSION: Our results showed similar efficacy between LLLT and LAT in the treatment of MPDS signs and symptoms.

Investigating the Antibacterial Effect of Passive Ultrasonic Irrigation, Photodynamic Therapy and Their Combination on Root Canal Disinfection.

Introduction: Enterococcus faecalis is a gram-positive, facultative anaerobic bacterium associated with persistent endodontic infections. Conventional disinfection methods may not completely eradicate the bacteria within the root canal system. Therefore, novel modalities have been suggested to optimize root canal disinfection. The aim of this study was to evaluate and compare the antibacterial effect of photodynamic therapy (PDT), passive ultrasonic irrigation (PUI) and their combination in addition to conventional endodontic irrigation against E. faecalis biofilms in root canals. Methods: Root canals of 50 single-rooted extracted human teeth were prepared and incubated with E. faecalis for 21 days. They were then divided into 4 treatment groups and a control group as follows: (1) NaOCl-Syringe irrigation with 2.5% NaOCl, (2) PUI-Passive ultrasonic irrigation with NaOCl, (3) NaOCl+PDT-Photodynamic therapy following syringe irrigation with NaOCl, (4) PUI+PDT, (5) Control-Syringe irrigation with saline. Colony-forming units were counted and bacterial reduction was calculated for each treatment group. Results: All treatments led to significant reductions in the bacterial load compared to the control group. PUI and PUI+PDT led to the complete elimination of the bacteria from the root canals. NaOCl and NaOCl+PDT treatments reduced the bacteria by 99.9% and 99.5% respectively. NaOCl+PDT was significantly less effective in reducing the bacteria compared to other treatment groups. There were no significant differences between the NaOCl, PUI, and PUI+PDT groups. Conclusion: Passive ultrasonic irrigation with or without the combination of Photodynamic therapy completely eradicated the bacteria. The use of PDT as an adjunction to NaOCl syringe irrigation and PUI did not enhance their antibacterial effect.

Comparing the Efficacy of Toluidine Blue, Methylene Blue and Curcumin in Photodynamic Therapy Against Enterococcus faecalis.

Introduction: Antimicrobial photodynamic therapy (aPDT) as a supplement to the conventional root canal preparation has shown promising results. Previous studies have adopted various combinations of light sources and photosensitizers, which makes it difficult to compare the disinfection efficacy of different PDT protocols. The aim of the present study was to compare the efficacy of three photosensitizers (toluidine blue, methylene blue, and curcumin) in PDT using LED against Enterococcus faecalis in root canal disinfection. Methods: Root canals of 54 single-rooted extracted teeth were prepared using the ProTaper Gold rotary system and were incubated with E. faecalis for three weeks. They were then randomly divided into five experimental groups and a control group: (1) Irrigation with 2.5% NaOCl for 30 seconds, (2) NaOCl irrigation followed by TB-PDT, (3) NaOCl irrigation followed by MB-PDT, (4) NaOCL irrigation followed by curcumin-PDT, (5) Curcumin solvent (1% ethanol+1% BSA), (6) Control (irrigation with normal saline). Sampling was done by collecting dentin shavings from the root canals, and colony-forming units were determined for each treatment group. The data were analyzed by Kruskal-Wallis and Mann-Whitney U tests. The significance level was set at P<0.05. Results: In all treatment groups, the mean values of colony forming unit (CFU) decreased by 99% compared to the control group. The lowest mean values of CFU were observed in groups 2 and 4, followed groups 3, 1, and 5 respectively. The mean CFU count in group 2 was significantly lower than that of group 1 (P value=0.011), while there were no significant differences among groups 1, 3, and 4 (P value >0.05). Conclusion: The adjunction of toluidine blue-mediated PDT by means of a light-emitting diode to NaOCl irrigation increased its antibacterial efficacy against E. faecalis and could be an effective complementary method in root canal disinfection.

Comparison of Antibacterial Effects of Photodynamic Therapy and an Irrigation Activation System on Root Canals Infected With Enterococcus faecalis: An In Vitro Study.

Introduction: Enterococcus faecalis is a resistant bacterium which is the most abundant species in infected root canals. Photodynamic therapy (PDT) is a method for killing the bacteria with active Oxygen radicals generated in a photosensitizer when exposed to centralized light. Furthermore, as a new method of canal disinfection, a variety of irrigation activation systems have been introduced, one of which is GentleFile (GF) with rotary movements and spiral effects for antibacterial action. This study aimed to compare the effectiveness of the two mentioned methods when used with and without Sodium Hypochlorite in eliminating E. faecalis from infected root canals. Methods: Fifty-eight uniradicular teeth were randomly divided into 4 experimental groups of 14. Two specimens were selected for later scanning electron microscopy in order to screen the procedure steps. In each experimental group, 10 samples were selected to be treated with GF or PDT; 3 of them were selected as positive controls and the other one sample was chosen as a negative control. Experimental groups were as follows: (1) Irrigation activation system, (2) Irrigation activation system + sodium hypochlorite, (3) PDT, and (4) PDT+ sodium hypochlorite. The specimens were then cultured for a bacterial colony count. Results: The decrease in the bacterial count after the treatment with the irrigation activation system was 99.8% (P =0.011) and when the system was used with sodium hypochlorite, it was 100% (P =0.001). The antibacterial effect of PDT was 90.08% (P =0.011) and it was 99.7% when PDT was combined with sodium hypochlorite (P =0.011). Conclusion: All four methods can be administered as complementary methods in root canal disinfection. According to the results of disinfection in the experimental groups of current study it is concluded that integration of new technologies such as activation irrigation system or PDT in Combination with NaOCl ameliorates disinfection of root canal and can provide several advantages in the endodontic outcome.

The Viewpoints of Last-Year Dentistry Students of Shahid Beheshti University on the Application of Lasers as an Independent Credit in the Education of General Dentistry.

Introduction: Enhancing students' pragmatic skills as an enabling means brings about changes in their curriculum, which should be reconciled with the students' educational needs. Thus, this study seeks to examine the viewpoints of last-year dentistry students on the need for the instruction of laser application as an independent credit in the general dentistry curriculum. The findings of this study can help determine the educational priorities of students while providing and compiling their curriculum. Methods: This descriptive study was done on 91 last-year dentistry students of Shahid Beheshti University in a full census manner. The data collection tool was a fieldwork questionnaire, the validity and reliability of which were evaluated. To report the findings, frequency distribution, frequency percentage, and average tableaux were utilized. Results: Amongst the 91 participants, regarding the average figures of value assignment from 1 to 10 to respond to questions, the highest value was assigned to learning the side effects of lasers (7.99 ± 0.01) and the lowest value was assigned to learning about the history of lasers and light physics (4.53 ± 0.47). Conclusion: The findings indicate that students have a positive attitude toward the incorporation of an independent laser credit in their curriculum and thus the necessity of incorporating this credit in their curriculum can be posed.

Antimicrobial Activity of Cold Plasma Treatment on Acrylic Denture Bases: An In Vitro Evaluation.

Introduction: Cross-contamination between dental office and prosthetic laboratories is of utmost importance. The dental prosthesis could harbor tones of microorganisms harmful to health staff. It has been estimated that more than 60% of the prostheses delivered to clinics from laboratories or vice versa are contaminated with pathogenic microorganisms. Several disinfection methods and chemicals have been proposed for sanitizing prostheses. Cold plasma, or nonthermal plasma, has been introduced as a new method in medical equipment disinfection. The current study aimed to compare the antimicrobial effect of cold plasma and the routinely used alcohol-based impression disinfectant ASEPTOPRINT® on disinfecting dentures. Methods: In this experimental study, 30 maxillary complete dentures were used as the microbial source. Dentures were randomly divided into 3 groups: (1) cold plasma treatment for 30 seconds, (2) cold plasma for 60 seconds, (3) ASEPTOPRINT® spray. Microbial culturing was taken before and after disinfection in each group on both Blood Agar plates and Soborou Dextrose Agar (SDA) plates. After 48 hours incubation at 37°C, the number of colonies was counted using a digital colony counter and differences between the groups were analyzed. Results: A significant reduction in microbial colonies was observed after using all disinfection methods. ASEPTOPRINT® spray showed more antimicrobial effects comparing to cold plasma. Conclusion: The antimicrobial effect of ASEPTOPRINT® spray solution is more than cold plasma application on both microbial and fungal microorganisms. The time of plasma application was not accompanied by any significant differences in the results.

A Comparison of 940 nm Diode Laser and Cryosurgery With Liquid Nitrogen in the Treatment of Gingival Physiologic Hyperpigmentation Using Split Mouth Technique: 12 Months Follow Up.

Introduction: Gingival hyperpigmentation is excessive deposition of melanin pigments in the epithelium of gingiva which affects facial esthetics. Various surgical methods for gingival depigmentation have been used to treat the darkened color of pigmented gingiva. This study compared the use of 940 nm diode laser and liquid nitrogen cryosurgery in the treatment of gingival physiologic hyperpigmentation in terms of gingival depigmentation, postoperative pain, healing duration, pigmentation recurrence, and patients' satisfaction. Methods: Fifteen systemically healthy patients (11 females and 4 males; 17-35 years of age) with bilateral gingival physiologic hyperpigmentation were enrolled in this split-mouth randomized study. Maxillary anterior labial gingiva of each patient was divided into left and right halves, and each half was randomly depigmented by either laser or cryosurgery. Patients were given questionnaires to evaluate the procedures and were followed up in 3, 7, 10, 17 and 21 days postoperatively for the assessment of gingival healing and 1, 3, 6 and 12 months after the treatments to detect any sign of pigmentation recurrence. Results: The severity of post-op pain measured by visual analogue scale (VAS) was mild to average and showed no significant difference between the 2 modalities (P>0.05). There was no considerable swelling or hemorrhage after the treatment procedures and the healing duration was significantly shorter in laser (P<0.05). The degree of pigmentation in all gingival sites treated by laser reached and remained at zero until the last follow up (1 year) and reached zero in 9 out of 15 cryosurgerytreated sites. All patients were completely satisfied with the laser, and 9 out of 15 were completely satisfied with cryosurgery. No pigmentation recurrence was observed during any follow-up periods. Conclusion: Removal of gingival physiologic hyperpigmentation by laser therapy and cryotherapy was effective and safe. The efficiency of the laser was better than cryotherapy.

Comparison of Antibacterial Effects of Photodynamic Therapy, Modified Triple Antibiotic Paste and Calcium Hydroxide on Root Canals Infected With Enterococcus faecalis: An In Vitro Study.

Introduction: A pivotal issue to achieve success in the treatment of the root canal is root canal disinfection. One of the most important bacteria that infect the root canal is Enterococcus faecalis. This study seeks to examine the effectiveness of 3 methods for disinfecting the root canal: photodynamic therapy, modified triple antibiotic paste (MTAP), and calcium hydroxide. Methods: Sixty-two single-rooted extracted anterior teeth were collected. After cleaning and disinfecting the teeth, their crowns were cut at the CEJ point. The root canals were shaped to the working length up to file F3 ProTaper (F1, F2, F3). EDTA 17% and sodium hypochlorite 2.5% were used for 5 minutes to wash and remove the smear layer, and then the apical foramen was sealed using composite. After that, the teeth were sterilized in an autoclave at 121°C for 15 minutes. Then 10 samples were taken randomly as the negative control. The remaining samples were immersed and cultivated in a suspension containing E. faecalis for 21 days. Then the samples were divided into 5 groups: 2 positive control groups, 1 group treated with the antibiotic paste with the concentration of 1 mg/mL, 1 group treated with calcium hydroxide, and 1 group treated with photodynamic therapy. Then, to collect the biofilm, the ProTaper file F4 was used. After that, the microbial suspension was provided and counting the colonies was carried out to compare the groups. Results: The findings indicated that the amount of CFU/mg of MTAP samples, including clindamycin, metronidazole, ciprofloxacin in the concentration of 1 mg/mL and photodynamic therapy and calcium hydroxide was lower than that in the control group. Antibiotic paste cleansed the root canal up to 99.9%. Photodynamic therapy reduced the amount of CFU/mg to 98.8%, and calcium hydroxide reduced the amount of CFU/mg to 94.13%. Conclusion: Using photodynamic therapy causes a reduction in the biofilm and inhibits the growth of the E. faecalis bacterium. In addition, in this study, MTAP with a concentration of 1 mg/mL was used, which expunged the bacteria completely. Meanwhile, calcium hydroxide had the weakest effect of all on the E. faecalis bacterium.

Laser Assisted Treatment of Extra Oral Cutaneous Sinus Tract of Endodontic Origin: A Case Report.

Introduction: Sinus tract (or fistula) is a common manifestation of pulpal necrosis with periapical pathosis that requires conventional or rarely surgical- endodontic treatment in order to heal. It is mainly identified intraorally and in rare cases manifestation is extra orally, which may frequently be misdiagnosed with cutaneous lesion and incorrectly treated. New technologies such as lasers have been developed as adjuncts to standard endodontic antimicrobial procedures in order to increase the success rate of endodontic therapy while complying with the desire of saving a natural tooth. Case Presentation: Herein, we present a clinical case of extra oral sinus tract with periodic pus drainage that was successfully treated by combining conventional endodontic therapy, intra canal photodynamic therapy (PDT), extra oral low level laser therapy (LLLT) and laser treatment for extra oral fistula. Conclusion: Treatment of the odontogenic lesion among with the extra oral lesion was an ingenious and successful technique which was achieved via laser technology and winded up to patient's consent and satisfactory results.

Management of Post Endodontic Retreatment Pain With Low Level Laser Therapy.

Introduction: Pharmacotherapy with analgesics and non-steroidal anti-inflammatory drugs has been traditionally used to relief post-operative pain of endodontic treatments. However, due to the side effects reported for these drugs, some efforts have been made to decrease the post-operative pain of the endodontic treatments through laser irradiation. The present study aimed to evaluate the effects of low level laser therapy (LLLT) on the reduction of pain after root canal retreatment. Methods: In this clinical trial, 61 patients requiring endodontic retreatments in posterior teeth were selected. A single visit endodontic retreatment was performed. After biomechanical preparation, low level laser was irradiated to the buccal and lingual mucosa overlying the apices of the target tooth in the experimental group. In the control group patients received placebo laser to eliminate the probable psychological effects of laser. Laser irradiation was done with a single dose of 808 nm wavelength (Whitening Lase II- Laser DMC, Samsung, Korea) with 100 mW power, and dose of 70 J/cm2 for 80 seconds. Pain severity was recorded before, immediately after and 4, 8, 12, 24 and 48 hours after the treatment by visual analogue scale (VAS). The pain scores were statistically analyzed by chi-square test between 2 groups. The effects of different variables on the post-operative pain experience were also studied by means of Logistic regression. Results: Pain scores decreased significantly through time until 48 hours after treatment. No significant differences were observed between the 2 modalities regarding pain scores at any time. According to regression analysis, pain severity scores were lower in the laser-irradiated specimens than control groups (OR = 5.69); however, this difference was not statistically significant. Consumption of analgesics after the treatment had significant effect in decreasing post-operative pain experience (OR = 56) while factors of age, gender, laser irradiation, pre-treatment pain scores and education level did not. Conclusion: Low level laser irradiation had limited effects to decrease pain associated with the endodontic retreatments in the first and second molars; however, more studies are required to assess the effects of different parameters of low level laser in this regard.

Comparing clinical effects of photodynamic therapy as a novel method with topical corticosteroid for treatment of Oral Lichen Planus.

BACKGROUND: Oral lichen planus is an autoimmune disorder with several challenges in treatment. Photodynamic therapy has been proposed as a new treatment option for the disease. AIM: The present study compared the clinical effects of photodynamic therapy to dexamethasone mouthwash in the treatment of oral lichen planus lesions. MATERIALS AND METHODS: In this randomized clinical trial, 30 patients with oral lichen planus were included.15 patients were treated with 5% methylene blue mediated photodynamic therapy using Fotosan device for 30s (630nm wavelength and 7.2-14.4J/cm2 dose) for 4 sessions in the days 1, 4, 7, 14. In another group, the treatment was done on 15 patients by 0.5mg tab dexamethasone solution in 5cc water, rinsed 4 times in a day within two weeks. The sign score, symptoms scores (pain), clinical severity and treatment efficacy were measured at the days 15, 30, 60, 90 after beginning of the treatment. The results were subjected to Mann-whitney U test in both groups. RESULTS: No significant difference existed between the two modalities regarding the treatment efficacy index, sign score, symptom score and clinical severity on the 15, 30, 60 and 90 post-treatment days. Decreases in patient's symptoms were statistically significant in both groups. CONCLUSION: Photodynamic therapy was as effective as the dexamethasone mouth wash in the treatment of oral lichen planus. It could be used as a safe modality in the treatment of oral lichen planus lesions without identified side effects.

A comparison of the antibacterial activity of the two methods of photodynamic therapy (using diode laser 810 nm and LED lamp 630 nm) against Enterococcus faecalis in extracted human anterior teeth.

BACKGROUND: Failure of endodontic treatment is usually due to an inadequate disinfection of the root canal system. Enterococcus faecalis has been widely used as a valuable microbiological marker for in-vitro studies because of its ability to colonize in a biofilm like style in root canals, invading dentinal tubules and resistance to some endodontic treatments. The aim of this study was to investigate the antibacterial effects of two methods of photodynamic therapy using a light emitting diode lamp (LED lamp, 630 nm) and a diode laser (810 nm) on E. faecalis biofilms in anterior extracted human teeth. METHODS: Fifty six single-rooted extracted teeth were used in this study. After routine root canal cleansing, shaping and sterilization, the teeth were incubated with E. faecalis for a period of two weeks. Teeth were then divided into two experimental groups (nu=23) and two control groups (nu=5). Teeth in one experimental group were exposed to a diode laser (810 nm), and in the other group samples were exposed to a LED lamp (630 nm). Intracanal bacterial sampling was done, and bacterial survival rate was then evaluated for each group. RESULTS: The Colony Forming Unit (CFU) in LED group (log10 CFUs=4.88±0.82) was significantly lower than the laser group (log CFUs=5.49±0.71) (p value=0.021). CFUs in positive control group (Log10 CFUs=10.96±0.44) were significantly higher than the treatment group (p˂0.001). No bacterial colony was found in negative control group. CONCLUSION: The results of this research show that photodynamic therapy could be an effective supplement in root canal disinfection. PDT using LED lamp was more effective than diode laser 810 nm in reducing CFUs of E. faecalis in human teeth.

Comparison of the Antibacterial Effect of 810 nm Diode Laser and Photodynamic Therapy in Reducing the Microbial Flora of Root Canal in Endodontic Retreatment in Patients With Periradicular Lesions.

INTRODUCTION: The aim of this study was to compare the antibacterial efficacy of diode laser 810nm and photodynamic therapy (PDT) in reducing bacterial microflora in endodontic retreatment of teeth with periradicular lesion. METHODS: In this in vivo clinical trial, 20 patients who needed endodontic retreatment were selected. After conventional chemo mechanical preparation of root canals, microbiological samples were taken with sterile paper point (PP), held in thioglycollate broth, and then were transferred to the microbiological lab. In the first group, PDT with methylene blue (MB) and diode laser (810 nm, 0.2 W, 40 seconds) was performed and in the second group diode laser (810 nm, 1.2 W, 30 seconds) was irradiated. Then second samples were taken from all canals. RESULTS: CFU/ml amounts showed statistically significant reduction in both groups (P < 0.001). CFU/ml amounts were compared between the two groups and there was no statistical difference. CONCLUSION: PDT and diode laser 810 nm irradiation are effective methods for root canal disinfection. PDT is a suitable alternative for diode laser 810 nm irradiation, because of lower thermal risk on root dentin.

Low Level Laser Therapy Versus Pharmacotherapy in Improving Myofascial Pain Disorder Syndrome.

INTRODUCTION: Temporomandibular disorders (TMD) lead to masticatory muscle pain, jaw movement disability and limitation in mouth opening. Pain is the chief complaint in 90% of the TMD patients which leads to disability and severe socioeconomic costs. The purpose of this study was to evaluate the therapeutic effects of low level laser therapy (LLLT) compared to pharmacotherapy with NSAIDs (naproxen) in myofascial pain disorder syndrome (MPDS). METHODS: In this randomized controlled clinical trial, 40 MPDS patients were divided into two groups. One group received naproxen 500 mg bid for 3 weeks as treatment modality and also had placebo laser sessions. The other group received active laser (diode 810 nm CW) as treatment and placebo drug. Pain intensity was measured by visual analogue scale (VAS) and maximum painless mouth opening was also measured as a functional index every session and at 2 months follow up. Data was collected and analyzed with SPSS software. Independent t test was used to analyze the data. A P < 0.05 was considered significant. RESULTS: Low level laser caused significant reduction in pain intensity (P < 0.05) and a significant increase in mouth opening. In naproxen group neither pain intensity nor maximum mouth opening had significant improvement. Pain relief, in subjective VAS was observed in third session in LLLT group, but did not occur in naproxen group. Maximum mouth opening increased significantly in laser group compared to the naproxen group from the eighth session. CONCLUSION: Treatment with LLLT caused a significant improvement in mouth opening and pain intensity in patients with MPDS. Similar improvement was not observed in naproxen group.

The Relationship between Anger Expression and Its Indices and Oral Lichen Planus.

Oral lichen planus (OLP) is a common inflammatory disease with unknown etiology. Depression, stress and anxiety are psychological factors that their influence on the expression of lichen planus by affecting the immune system's function has been confirmed. There is a probable relationship between anger and OLP expression. Therefore, the present study aimed to evaluate the association of "anger" and OLP. In this descriptive study 95 subjects were included in 3 groups. A: patients with oral lichen planus, B: positive control, C: negative control. Anger and its indices were assessed by the State-Trait Anger Expression Inventory-2 (STAXI-2) questionnaire, and pain was measured via the Visual Analogue Scale (VAS). The collected data were analyzed statistically using SPSS 18 software. The lichen planus and positive control groups bore higher total anger index (AX index) values compared with the negative control. Comparing anger expression-in (AXI) among the lichen planus and negative control groups revealed higher grades in lichen planus group. Evaluating the pain severity index (VAS) data and anger indices in lichen planus group, Spearman's Rank Correlation Test revealed a significant correlation between TAngR (reactional anger traits) and pain severity. The findings of this study indicated that there was a significant correlation between anger control and suppression of lichen planus development. On the other hand, the patients with more severe pain mostly expressed their anger physically. Based on the findings, we can make the claim that anger suppression and its control-in (gathering tension) may play a role in the development of lichen planus as a known psychosomatic disorders.

Expedited removal of pyogenic granuloma by diode laser in a pediatric patient.

INTRODUCTION: Pyogenic granuloma (PG) is one of the inflammatory hyperplasia seen in the oral cavity. It is a reactional response to minor trauma or chronic irritation. The most common treatment of PG is surgical excision but alternative approaches such as laser excision have also been proposed especially for pediatric patients. CASE REPORT: Herein, we present a case of gingival pyogenic granuloma in a 6-year-old patient. The lesion was excised successfully with diode laser as a conservative and non-stressful method in a pediatric patient. RESULTS AND CONCLUSION: The use of laser as modern medicine offers a new tool for treatment of oral lesions as comfortable as possible in pediatric patients, which results in less stress and fear in children.

Posthaste outgrow of lip pyogenic granuloma after diode laser removal.

INTRODUCTION: Pyogenic granuloma (PG) is one of the inflammatory hyperplasia seen in the oral cavity. It is a reactional response to minor trauma or chronic irritation and also might be related to hormonal changes. Rarely, PG occurs extragingivally.The most common treatment of PG is surgical excision but alternative approaches such as laser excision have also been proposed. CASE REPORT: Herein, we present a case of lip pyogenic granuloma in a 15-year-old male whom had been under orthodontic treatment. The lesion was first excised with diode laser as a conservative method, but the lesion had immediately recurred and was excised with surgical blade as the traditional method. No recurrence or scarring was observed in 6 months follow-up. RESULTS AND CONCLUSION: Although the use of laser as modern medicine offers a new tool for treatment of oral lesions, scalpel (blade) surgical excision still seems to be the successful treatment of choice in minimizing the recurrence of lesion especially when exacerbating factors such as hormonal imbalances exist.