Pubmed Abstracts

The effect of intraoral 2,940nm nonablative Erbium:YAG laser on…

Natacha Quezada Gaón, Fernanda Binfa

INTRODUCTION: Increased distance between the base of the nose and lip’s vermilion is difficult to treat, and often there are restrictions for the use of botulinum toxin and cutaneous fillers.
OBJECTIVE: To describe a new technique for the treatment of the upper lip ptosis.
METHODS: A prospective pilot study was conducted with 15 female patients bearing increased distance between the base of the nose and the labial cutaneous-mucosal transition line. Five weekly sessions of intraoral non-ablative 2,940nm Er:YAG laser were performed. For the evaluation of outcomes, standardized records were performed with a 3D photographic camera, and comparative measurements of the philtrum’s height and the nasolabial angle were taken before and after the treatment.
RESULTS: There was a shortening ranging from 2 to 4 mm in the philtrum’s measurements, and a decrease in the nasolabial angle, in addition to increased firmness of the skin in the upper lip.
CONCLUSION: Intraoral non-ablative 2,940nm Er:YAG laser can be a therapeutic option for the treatment of upper lip ptosis.

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Pubmed Abstracts

Optical coherence tomographic (OCT) evaluation of intraoral non-ablative erbium:…

Nayera Moftah, Nevien Samy, Riham S. H. M. Allam, Shaza A. H. El Tagy, Rania Abdelghani

BACKGROUND: There are both few non-comparative studies investigating the efficacy of intraoral Er: YAG laser (SMOOTH mode) in rejuvenating nasolabial folds (NLFs) and lack of valid and objective wrinkles scales. In this prospective randomized split face comparative pilot study, we investigated the safety and efficacy of intraoral Er: YAG laser (SMOOTH MODE) compared with extraoral approach in rejuvenating NLFs using OCT as an objective evaluating tool.
MATERIALS AND METHODS: Twenty adult women with notable NLFs were randomized in this study. The patients received 5 monthly sessions of Er: YAG laser (SMOOTH mode) using intraoral approach on one side and extraoral approach on the other side. Outcome was evaluated 2 weeks and 4 months post-treatment by Global Aesthetic Improvement Scale (GAIS), OCT, and patients’ satisfaction. Side effects were also evaluated.
RESULTS: Intraoral sides had significant increase in OCT evaluated dermal thickness at 4 months post-treatment (P = .03) without side effects compared with extraoral sides. Extraoral approach had significantly higher patients’ satisfaction compared with intraoral approach at 2 weeks and 4 months post-treatment (P = .03, .02, respectively). Insignificant differences between both approaches were found regarding GAIS scoring, OCT evaluated epidermal thickness at 2 weeks and 4 months posttreatment, and OCT evaluated dermal thickness at 2 weeks post-treatment (P < .05).
CONCLUSION: Intraoral Er: YAG laser (SMOOTH mode) is safer and more effective than extraoral approach in rejuvenating NLFs. OCT is a promising objective tool for evaluating facial wrinkles. Further studies are still needed.

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Pubmed Abstracts

Correction of nasolabial folds wrinkle using intraoral non-ablative Er:YAG…

Howyda M. Ebrahim and Khaled Gharib

BACKGROUND: The accentuated nasolabial folds (NLFs) is the most pronounced sign of aging. Nonablative erbium:yttrium aluminum garnet laser (ER:YAG), Smooth mode was used for the treatment of mucosal tissue. It was reported that it is effective in facial rejuvenation.
AIM: To assess the safety and the effectiveness of intraoral ER:YAG Smooth mode laser in the treatment of NLFs wrinkle.
MATERIALS AND METHOD: A total of 20 patients with different grades of NLFs wrinkle treated with 2940 nm Er:YAG laser intraorally. Six sessions were done every 2 weeks. The efficacy was assessed by two blinded dermatologists. Photographs were taken at the baseline, end of treatment and 6 months after the final session to document visible changes in NLFs wrinkle. The assessment was based on Modified Fitzpatrick Wrinkle Scale (MFWS) and by comparing the photographs. Patient’s self-assessment and patient’s satisfaction were used for assessment of final results and any side effects associated to treatment were observed.
RESULTS: There was significant reduction of the NLFs wrinkle. The MFWS was significantly improved 6 months after treatment compared to before treatment (p < 0.001). At the end of the follow-up period, there was improvement in overall appearance of the wrinkles. Patient’s self -assessment and satisfaction demonstrated better cosmetic outcomes.
CONCLUSION: Intraoral Er:YAG laser is safe, painless, and effective treatment option for NLFs wrinkle.

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Pubmed Abstracts

Histological Effects of Er:YAG Laser Irradiation with Snoring Handpiece…

Unver T, Aytugar E, Ozturan O, Kiran T, Ademci E, Usumez A
Photomed Laser Surg. 2016 May 19.
PMID: 27196421

Abstract

OBJECTIVE: The aim of this study was to assess the effects of laser irradiation with a novel snoring handpiece on the histological structures of the soft palate in a rat model.
BACKGROUND: Snoring is a common problem and studies have shown that 20-50% of the population is affected. An apnea-hypopnea index of <5/h without daytime somnolence is documented as simple snoring. No snoring treatment should ever be attempted until a sleep study has been completed to rule out sleep apnea.
METHODS: Twenty adult Wistar rats, weighing 200-250 g, were used in this study. Rats were randomized into two groups: experimental group (n = 10) and control group (n = 10). Laser energy was delivered in a horizontal direction to the surface of the soft palate of each rat in the experimental group for 2 min with an Er:YAG laser (LightWalker AT, Fotona) with snoring handpiece (PS04) in a noncontact mode (1.15 W, 2 Hz, 1.5 J/cm2). The animals were sacrificed after 24 h, 1 week, 3 weeks, or 5 weeks. The soft palate of each rat was removed by excisional biopsy. The specimens underwent histological examination. Contractions and fibrosis were reported as grading from 1+ to 3+, while edema and hyperemia were evaluated according to the absence (0) or presence (1) of any changes. Statistical analysis was done with the Mann-Whitney U and Spearman’s rho tests. RESULT: A noticeable contraction of the soft palate occurred immediately after laser application. Inflammatory changes were observed histologically at 3 weeks postoperatively. Keratinization appeared after the procedure in both groups and decreased gradually. Statistically, there was a strong correlation among inflammation and time and also keratinization and time (p < 0.05).
CONCLUSION: The present study indicates that Er:YAG laser irradiation with snoring handpiece (PS04) causes acute shrinkage of the mucosa. This contraction decreases gradually but is still present at the end of fifth week.

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Pubmed Abstracts

808-nm laser therapy with a flat-top handpiece photobiomodulates mitochondria…

Amaroli A, Ravera S, Parker S, Panfoli I, Benedicenti A, Benedicenti S
Lasers Med Sci. 2016 May,31(4):741-7. doi: 10.1007/s10103-016-1901-3. Epub 2016
PMID: 26984347

Abstract

Photobiomodulation is proposed as a non-linear process, and only low-level laser therapy (LLLT) is assumed to stimulate exposed cells, whereas high powered laser and fluences can cause negative effects, exhausting the cell’s energy reserve as a consequence of excessive photon-based stimulation. In our work, we investigated and compared the effects of 808-nm diode laser (CW) with a new flat-top handpiece. To this purpose, we tested the photobiomodulation effects of 1 and 3 J/cm2 fluence, both generated by 100 mW or 1 W of laser power and of 64 J/cm2 of fluence generated by 100 mW, 1 W, 1.5 W or 2 W, as expressed through oxygen consumption and ATP synthesis of Paramecium. Data collected indicates the incremental consumption of oxygen through irradiation with 3 J/cm2-100 mW or 64 J/cm2-1 W correlates with an increase in Paramecium ATP synthesis. The Paramecium respiration was inhibited by fluences 64 J/cm2-100 mW or 64 J/cm2-2 W and was followed by a decrease in the endogenous ATP concentration. The 1 J/cm2-100 mW or 1 W and 3 J/cm2-1 W did not affect mitochondrial activity. The results show that the fluence of 64 J/cm2-1 W more than the 3 J/cm2-100 mW causes greater efficiency in Paramecium mitochondria respiratory chain activity. Our results suggest that thanks to flat-top handpiece we used, high fluences by high-powered laser have to be reconsidered as an effective and non-invasive therapy. Possible associated benefits of deeper tissue penetration would increase treatment effectiveness and reduced irradiation time.

Keywords
High fluence, Laser irradiation, Laser phototherapy, Low-level laser therapy, Mitochondria, Photobiostimulation

Pubmed Abstracts

Influence of lasing parameters on the cleaning efficacy of…

Meire MA, Havelaerts S, De Moor RJ
Lasers Med Sci. 2016 May,31(4):653-8. doi: 10.1007/s10103-016-1892-0. Epub 2016
PMID: 26861988

Abstract

Laser-activated irrigation (LAI) using erbium lasers is an irrigant agitation technique with great potential for improved cleaning of the root canal system, as shown in many in vitro studies. However, lasing parameters for LAI vary considerably and their influence remains unclear. Therefore, this study sought to investigate the influence of pulse energy, pulse frequency, pulse length, irradiation time and fibre tip shape, position and diameter on the cleaning efficacy of LAI. Transparent resin blocks containing standardized root canals (apical diameter of 0.4 mm, 6 % taper, 15 mm long, with a coronal reservoir) were used as the test model. A standardized groove in the apical part of each canal wall was packed with stained dentin debris. The canals were filled with irrigant, which was activated by an erbium: yttrium aluminium garnet (Er:YAG) laser (2940 nm, AT Fidelis, Fotona, Ljubljana, Slovenia). In each experiment, one laser parameter was varied, while the others remained constant. In this way, the influence of pulse energy (10-40 mJ), pulse length (50-1000 mus), frequency (5-30 Hz), irradiation time (5-40 s) and fibre tip shape (flat or conical), position (pulp chamber, canal entrance, next to groove) and diameter (300-600 mum) was determined by treating 20 canals per parameter. The amount of debris remaining in the groove after each LAI procedure was scored and compared among the different treatments. The parameters significantly (P < 0.05, Kruskal-Wallis) affecting debris removal from the groove were fibre tip position, pulse length, pulse energy, irradiation time and frequency. Fibre tip shape and diameter had no significant influence on the cleaning efficacy.

Keywords
Erbium laser, Fibre tip shape, Laser-activated irrigation, Pulse energy, Pulse length, Root canal irrigation

Pubmed Abstracts

Minimally invasive, non-ablative Er:YAG laser treatment of stress urinary…

Fistonic N, Fistonic I, Gustek SF, Turina IS, Marton I, Vizintin Z, Kazic M, Hreljac I, Perhavec T, Lukac M
Lasers Med Sci. 2016 May,31(4):635-43. doi: 10.1007/s10103-016-1884-0. Epub 2016
PMID: 26861984

Abstract

The study presents an assessment of mechanism of action and a pilot clinical study of efficacy and safety of the Er:YAG laser for the treatment of stress urinary incontinence (SUI). The subject of this study is a treatment of SUI with a 2940 nm Er:YAG laser, operating in a special SMOOTH mode designed to increase temperature of the vaginal mucosa up to maximally 60-65 degrees C without ablating the epidermis. Numerical modelling of the temperature distribution within mucosa tissue following an irradiation with the SMOOTH mode Er:YAG laser was performed in order to determine the appropriate range of laser parameters. The laser treatment parameters were further confirmed by measuring in vivo temperatures of the vaginal mucosa using a thermal camera. To investigate the clinical efficacy and safety of the SMOOTH mode Er:YAG laser SUI treatment, a pilot clinical study was performed. The study recruited 31 female patients suffering from SUI. Follow-ups were scheduled at 1, 2, and 6 months post treatment. ICIQ-UI questionnaires were collected as a primary trial endpoint. Secondary endpoints included perineometry and residual urine volume measurements at baseline and all follow-ups. Thermal camera measurements have shown the optimal increase in temperature of the vaginal mucosa following treatment of SUI with a SMOOTH mode Er:YAG laser. Primary endpoint, the change in ICIQ-UI score, showed clinically relevant and statistically significant improvement after all follow-ups compared to baseline scores. There was also improvement in the secondary endpoints. Only mild and transient adverse events and no serious adverse events were reported. The results indicate that non-ablative Er:YAG laser therapy is a promising minimally invasive non-surgical option for treating women with SUI symptoms.

Keywords
Er:YAG laser, Minimally invasive SUI therapy, Stress urinary incontinence

Pubmed Abstracts

Immediate versus delayed loading: comparison of primary stability loss…

Migliorati M, Drago S, Gallo F, Amorfini L, Dalessandri D, Calzolari C, Benedicenti S, Silvestrini-Biavati A
Eur J Orthod. 2016 Jan 4. pii: cjv095.
PMID: 26728036

Abstract

INTRODUCTION: The aim of this randomized clinical trial was to compare torque recordings at insertion time and 1 week post-placement between immediately loaded orthodontic miniscrews and an unloaded control group.
TRIAL DESIGN: This RCT was designed as parallel with an allocation ratio of 1:1.
METHODS: Eligibility criteria to enroll patients were: needs of fixed orthodontic treatment, no systemic disease, absence of using drugs altering bone metabolism. All patients were consecutively treated in a private practice and the miniscrews were placed by the same author. Patients received ORTHOImplant (3M Unitek) miniscrews and they were blindly divided in two groups: group 1 screws were unloaded between T0 and T1, group 2 received immediately loaded screws with NiTi coil. For each patient, maximum insertion torque (MIT) was evaluated at T0. After 1 week, without loading, the screw torque was measured again (T1) and at the end of the treatment maximal removal torque was evaluated (T2). Torque variation in the first week was considered as the primary outcome. RANDOMIZATION: A randomization list was created for the group assignment, with an allocation ratio of 1:1.
BLINDING: The study was single blinded in regard of the statistical analysis.
RESULTS: Patients enrolled in the clinical trial were 51 for a total of 81 miniscrews. The recruitment started in November 2012 and the observation period ended in August 2014. Twenty-six and twenty-five patients were analysed in group 1 and 2, respectively. The MIT mean in each placement time was 18.25 Ncm (SD = 3.00), 11.41 Ncm (SD = 3.51) and 10.52 Ncm (SD = 5.14) at T0, T1, and T2 time, respectively. In group 1, the torque decrease between T1 and T0 was statistically higher compared to group 2 (P value = 0.003). Statistically significant effects of the placement times on MIT were found (P value <0.0001). No serious harm was observed.
LIMITATIONS: This study was performed using only direct force on the miniscrew and not using the miniscrew as an indirect anchorage. It was not possible to obtain quantitative data on bone quality or root proximity to miniscrews.
CONCLUSIONS: A significant stability loss was observed in the first week in both groups, Group 1 showed a statistically higher torque loss in the first week when compared to the immediately loaded group. There were statistically significant effects of the measurement times on MIT and of the miniscrew location on MIT. The overall failure rate was 7.4%.
TRIAL REGISTRATION: This trial was not registered.
PROTOCOL: The protocol was not published before trial commencement. European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Keywords

Pubmed Abstracts

Microtensile strength of resin cement bond to indirect composite…

Garshasbzadeh NZ, Mirzaie M, Yassini E, Shahabi S, Benedicenti S, Angiero F, Chiniforush N
Microsc Res Tech. 2016 Apr,79(4):328-33. doi: 10.1002/jemt.22634. Epub 2016 Feb
PMID: 26873266

Abstract

The study aimed to evaluate the effect of different output powers of Er:YAG laser on microtensile bonding strength of indirect composite to resin cements.36 indirect composite blocks (GC Gradia DA2, Japan) size 15 x 10 x 10 mm(3) were constructed, and divided into 12 groups, as follows:G1: control group (no treatment), Groups G2 to G6: treated with Er:YAG laser (2,940 nm) in noncontact mode, frequency 20 Hz, pulse duration 470 micros, with output power ranging from 2W to 6W, Groups G7 sandblasting, Groups 8 to G12: as Groups G2 to G 6 with preparatory sandblasting. One specimen from each group was analyzed by SEM, each specimen was fixed to a specialized metal jig using cyanoacrylate (Mitreapel, Beta Kimya San. Ve TIC, Iran) and debonded under tension with a universal testing machine (Zwick, Germany) at a crosshead speed of 0.5 mm min(-1) . Sandblasting and laser can improve bond strength above an energy level of 150 mJ. SEM evaluation of laser-treated specimens showed irregularities and deep undercuts. T test analysis showed no significant difference between sandblasted and non-sandblasted group, with laser output power of 0, 100, or 150 mJ (P = 0.666, P = 0.875, and P = 0.069), in the specimens irradiated with energy output of 200, 250, or 300 mJ, sandblasted specimens showed higher bond strength than non-sandblasted ones. The results demonstrate that, in composite resin irradiated with laser at energy output of 200-300 mJ, sandblasting might be a suitable procedure to enhance bond strength of resin cement. Microsc. Res. Tech. 79:328-333, 2016. (c) 2016 Wiley Periodicals, Inc.

Keywords
Er:YAG laser, indirect composite, microtensile strength

Pubmed Abstracts

Accuracy of a flapless protocol for computer-guided zygomatic implant…

Schiroli G, Angiero F, Zangerl A, Benedicenti S, Ferrante F, Widmann G
Int J Med Robot. 2016 Mar,12(1):102-8. doi: 10.1002/rcs.1646. Epub 2015 Jan 27.
PMID: 25625236

Abstract

BACKGROUND: This work evaluated the accuracy and safety of a protocol for minimally-invasive flapless zygomatic implant placement that uses computer-guided stereolithographic mucosa-supported surgical templates.
METHODS: A total of six zygomatic implants were placed in three formalin-fixed human cadaver heads, with edentulous and severely atrophic posterior maxillae. CT scans of each cadaver head were performed after zygomatic implant placement, to evaluate the lateral error (LE) at implant tip and base, and the angular error (AE) of the implant body.
RESULTS: Excluding the implant placed outside the drilling channel, the LE at the implant base was less than 1 mm in all cases. The average LE at the tip was 3.86 mm, and the AE was less than 6 degrees in all cases, with an average of 4.5 degrees .
CONCLUSION: Computer-guided minimally-invasive flapless zygomatic implant surgery remains challenging. Careful planning and perfect stability of the surgical guide are essential. Copyright (c) 2015 John Wiley & Sons, Ltd.

Keywords
flapless protocol, zygomatic implant