Periosteal releasing incision with diode laser in guided bone regeneration procedure: a case series

Introduction: periosteal releasing incision [PRI] is nearly always essential to advance the flap sufficiently for a tension-free flap closure in bone augmentation procedures. However, hematoma, swelling, and pain are recognized as the main consequences of PRI with scalpel. The aim of this case series was to investigate the effectiveness of laser-assisted PRI in guided bone regeneration [GBR] procedure. In addition, postoperative hematoma, swelling, and pain and implant success were assessed

Methods: seventeen patients needed GBR were included in this study. Diode laser [940 nm, 2 W, pulse interval: 1 ms, pulse length: 1 ms, contact mode, 400-micro m fiber tip] was used in a contact mode to cut the periosteum to create a tension-free flap. Facial hematoma, swelling, pain, and the number of consumed nonsteroidal anti-inflammatory drugs [NSAIDs] were measured for the six postoperative days. Six months after implant loading, implant success was evaluated

Results: minimal bleeding was encountered during the procedure. A tension-free primary closure of the flap was achieved in all cases. The clinical healing of the surgical area was uneventful. None of the patients experienced hematoma, ecchymosis, or intense swelling after surgery. The mean value of maximum pain [visual analogue scale - VAS] was 20.59 +/- 12.10 mm [mild pain]. Patients did not need to use NSAID after four postoperative days. All implants were successful and functional and none of them failed after 6 months of implant loading

Conclusion: this study revealed the effectiveness of laser-assisted PRI in GBR procedure. This technique was accompanied with minimal sequelae at the first postoperative week. All implants were successful and no complication was noted during the course of this study

Oral mucositis prevention and management by therapeutic laser in head and neck cancers

Oral mucositis is considered a severe complication in cancer patients receiving radiotherapy or chemotherapy for head and neck cancer. The aim of this review study was to assess the effect of low level laser therapy for prevention and management of oral mucositis in cancer patients. The electronic databases searched included Pubmed, ISI Web of Knowledge and Google scholar with keywords as "oral mucositis", "low level laser therapy" from 2000 to 2013. The results of most studies showed that photobiomodulation [PBM] reduced the severity of mucositis. Also, it can delay the appearance of severe mucositis. Low level laser therapy is a safe approach for management and prevention of oral mucositis

One visit providing desirable smile by laser application

Providing desirable smile is one of the main concerns in cosmetic dentistry. Hyperpigmentation is one of the esthetic concerns especially in gummy smile patients. Lasers with different wavelength are used for oral surgery including Carbon Dioxide Laser [CO2], Neodymium-Doped Yttrium Aluminium Garnet [Nd:YAG], Erbium family and diode laser. In this case, all esthetic procedures including gingival depigmentation, caries detection and removal were done by laser technology in one session. A 40- year-old male with a chief complaint of black gingiva in upper jaw was referred. The right side of maxillary was anesthetized and depigmentation was done by Erbium, Chromium doped Yttrium Scandium Gallium Garnet [Er-Cr: YSGG] laser. Due to scores obtained from Diagnodent which indicated caries in dentin, the cavities were prepared by Er-Cr:YSGG laser. The cavities were restored by composite resin. The patient was advised to keep oral hygiene instructions and use mouthwash. The patient reported no pain after surgery and did not use any systemic antibiotic. After 4 weeks, complete healing was observed. Considering acceptable clinical outcome, Er-Cr: YSGG laser can be considered as an effective method for combination of soft and hard tissue treatment

effect of antimicrobial photodynamic therapy with radachlorin on staphylococcus aureus and escherichia coli: an in vitro study

The aim of this study is the evaluation of the effect of Antimicrobial Photodynamic Therapy with Radachlorin on Staphylococcus aureus and Escherichia coli. New windows are open in the antimicrobial field so-call Photodynamic therapy that incorporates a nonpoisonous photosensitizer [PS] with innocuous special wavelength photons to excite the PS. Two strains of bacteria used in this study were Methicillin resistant Staphylococcus aureus [ATCC 33591; PTCC 1764] and Escherichia coli [ATCC 25922; PTCC1399]. Concentrations of 0.2 ml of Radachlorin were applied on 0.2 ml of bacterial suspensions and placed in a 48-well microtiter plate. The following groups were used: [I] L- PS- [no laser, no photosensitizer], [II] L-PS+ [treated only with PS], [III] L+ PS- [treated only with laser] and [IV] L+ PS+ [treated with laser and PS: photodynamic therapy group]. Aliquots of bacterial suspensions were sensitized with Radachlorin for 15 minutes in the dark at room temperature and then bacterial suspensions in group III and IV were irradiated with 210 mW [power density] and 12 J/cm2 [energy density] on continuous mode. This study showed that photodynamic therapy reduces 0.14 log 10 in E.Coli [group IV] and there were significant differences for group IV [P<0.01]. Photodynamic therapy in S.Aureus showed 6.28 log 10 colony count reduction [group IV] and there were highly significant differences in Photodynamic therapy group [P<0.0001]. Radachlorin have bactericidal effect on S.aureus [6.28 log 10] and bacteriostatic effect on E.coli [0.14 log 10]

[Effect of 660nm low power laser on pain and healing in palatal donor sites; a randomized controlled clinical trial]

Free gingival graft is one of the most predictable procedures for gingival augmentation, but patient's discomfort and pain during healing period of palatal donor site is a significant concern. The aim of this study was to evaluate the effect of 660nm low power laser on pain and healing in palatal donor sites. The present split mouth randomized controlled clinical trial was performed in 12 patients at the department of periodontics of Tehran University of Medical Sciences. Patients' allocation was done by balanced block randomization [laser group and placebo group]. In laser test group [wave length: 660 nm, power: 200mW, time of irradiation: 32s] was applied immediately post-surgery and in day 1, 2, 4 and 7 after that. In the control group, laser application was done with off power mode. Evaluation of epithelialization and healing was done with H2O2 and photograph. The number of palliative pills and bleeding was recorded. Wilcoxon test was used to analyze healing during the study. Patient's pain during study was analyzed using repeated measure ANOVA. Mc Nemar test was used to analyze bleeding. Level of statistical significance was set at 0.05. Laser group showed better epithelialization [P=0.02] and healing [P=0.01] in day 14 after surgery and showed better epithelialization in day 21[P=0.05]. No statistically differences were observed between laser group and control group in terms of bleeding and medication [P=0.51], [P=1]. According to the results of this study, the low power laser can promote palatal wound healing during the second and third week after free gingival graft procedures

Pyogenic granuloma: surgical treatment with Er:YAG laser

Pyogenic granuloma [PG] is a common tumor-like growth of the oral cavity, considered to be of non-neoplastic nature, often caused by constant low-grade trauma as well as poor oral hygiene and maybe due to hormonal disturbances. Surgical excision, and removal of underlying cause in some cases, is the preferred method of treatment as it is only a benign lesion. In order to remove this lesion, scalpel, cryosurgery and laser are used. Currently different lasers, with adequate parameters, are used for the surgery of PG, which include CO2 [Carbon Dioxide Laser], Nd:YAG [Neodymium-Doped Yttrium Aluminium Garnet], Diode and Er Family amongst others. In this present case, due to the proximity of the lesion with dental hard tissue, Er:YAG [Erbium-Doped Yttrium Aluminum Garnet] laser appears to be the more appropriate laser. The application of Laser is also a newly recommended technique. The aim of this study is to assess the stages of treatment, recovery and recurrence of PG when the Er:YAG laser is used. Furthermore this study aims to also evaluate the friendliness of this method with regards to the surgeon [therapist]. A 24-year-old female was referred to the Laser Research Center of Dentistry of Tehran University of Medical Sciences with a complaint of gingival overgrowth and bleeding. This lesion was in the buccal and palatal side of the 5 and 6 maxillary teeth. Treatment plan included an excisional biopsy of the lesion using Er:YAG laser [3W, 300mJ, 10Hz, Short pulse, with contact headpiece]. The bones were then cleaned of soft tissue before being smoothed using a curette. The excised specimen was preserved and sent for histopathological examination. The patient reported no pain after surgery and did not use any systemic antibiotics. The patient was satisfied after the surgery. Chlorhexidine mouthwash was given to the patient. Pathology results confirmed Pyogenic granuloma. After 2 weeks, complete healing was observed. The 9-month follow-up was also carried out in order to check the process of healing as well as the recurrence. Excisional surgery is the preferred treatment method for PG. The application of laser can be considered as an effective and safe technique for excision of this lesion with minimal invasion and many clinical advantages such as less intra-operative bleeding, hemostasis and reduced pain and times of healing

Defocused irradiation mode of diode laser for conservative treatment of oral hemangioma

Vascular lesions rise from abnormalities in blood vessels or endothelial proliferation. Capillary hemangiomas are formed by small capillaries surrounded by a layer of endothelial cells in a connective tissue stroma. Various treatments are used for these conditions like excisional surgery, sclerotherapy, and recently laser irradiation. In this case study, we report successful treatment of intraoral capillary hemangioma by gallium/aluminum/arsenide [GaAlAs] laser. A 29 year old woman with a red lesion on the upper side of the right maxillary premolar was referred to private dental office. The Diode laser with wavelength of 810 nm was selected for treatment of the lesion in defocused mode by output power of 4 W in continuous mode. No bleeding was observed during surgery which provided better vision for surgeon and resulted in a minimally invasive procedure. According to results, Diode laser can be considered as a conservative modality in treatment of oral capillary hemangioma, especially in the esthetic zone

Comparison of the effect of hand instruments, an ultrasonic scaler, and an erbium-doped yttrium aluminium garnet laser on root surface roughness of teeth with periodontitis: a profilometer study

PURPOSE: The present study aimed to measure root surface roughness in teeth with periodontitis by a profilometer following root planning with ultrasonic and hand instruments with and without erbium-doped yttrium aluminium garnet (Er:YAG) laser irradiation. METHODS: Sixty single-rooted maxillary and mandibular teeth, extracted because of periodontal disease, were collected. The crowns and apices of the roots were cut off using a diamond bur and water coolant. The specimens were mounted in an acrylic resin block such that a plain root surface was accessible. After primary evaluation and setting a baseline, the samples were divided into 4 groups. In group 1, the samples were root planned using a manual curette. The group 2 samples were prepared with an ultrasonic scaler. In group 3, after scaling with hand instrumentation, the roots were treated with a Smart 1240D plus Er:YAG laser and in group 4, the roots were prepared with ultrasonic scaler and subsequently treated with an Er:YAG laser. Root surface roughness was then measured by a profilometer (MahrSurf M300+RD18C system) under controlled laboratory conditions at a temperature of 25degrees C and 41% humidity. The data were analyzed statistically using analysis of variance and a t-test (P<0.05). RESULTS: Significant differences were detected in terms of surface roughness and surface distortion before and after treatment. The average reduction of the surface roughness after treatment in groups 1, 2, 3, and 4 was 1.89, 1.88, 1.40, and 1.52, respectively. These findings revealed no significant differences among the four groups. CONCLUSIONS: An Er:YAG laser as an adjunct to traditional scaling and root planning reduces root surface roughness. However, the surface ultrastructure is more irregular than when using conventional methods.

Effect of hand, ultrasonic scaler and erbium-doped yttrium aluminum garnet [er: yag] laser on the morphology of root surfaces with periodontitis: a comparative in vitro scanning electron microscopy study

The main purpose of the present study was to describe the ultra structural changes which happened after treatment of the root surfaces with ultrasonic and hand devices followed by Erbium-Doped Yttrium Aluminum Garnet [Er:YAG] laser irradiation. Sixty single-rooted maxillary and mandibular teeth which had been extracted due to periodontal problems were collected. Crown and apical parts of the root were cut off using a diamond bur. The specimens were mounted on an acrylic resin in order to make a plain surface of the root accessible. The samples were assigned as following: group1: samples were root planed using conventional hand curette, group2: were prepared by ultrasonic device, group3: roots after scaling by hand instrumentation were treated by Er:YAG laser with 50 mJ/pulse and frequency of 10 Hz, group4: roots were prepared by ultrasonic scaler and consequently were treated by laser. Furthermore, the teeth were dried, sputter-coated with gold, and monitored with scanning electron microscope [SEM]. Photomicrographs from ten samples of root surfaces which were taken at magnifications up to 500X revealed that there were not any severe morphologic changes, such as melting and charring, in any group. However, the samples treated by laser irradiation showed more irregularities and distortions. Er:YAG laser setting at 50mj/pulse, as an adjunctive to traditional scaling and root planning, did not induce severe damages to root surfaces, although root surface irregularities were more pronounced in laser treated groups compare to hand instruments.

Low level laser therapy in management of complications after intra oral surgeries

One of the basic purposes in dental treatment is providing a painless treatment for patients. This purpose may be achieved by the application of laser in dentistry. Low-level laser therapy [LLLT] is an internationally accepted title for biomodulation with low-level lasers which we use to achieve ideal therapeutic effects. Low-level laser therapy is a painless, reproducible, non-invasive, and without need of anesthesia treatment which is used to treat a variety of pain syndromes, injuries, wounds, fractures, neurological conditions and pathologies. Laser therapy works on the principle of inducing a biological response through energy transfer. The parameters that used in laser therapy determine the effective depth of penetration. We can mention anti-inflammatory effects, stimulation of wound healing, stimulation of immune system, increase of blood flow and activation of vasodilatation, increase of cellular metabolism and analgesic effects as advantages of the application of this type of laser. The aim of this review study was to evaluate the effect of low-level laser therapy after oral surgeries

invitro study on the temperature changes of dentin, irradiated by CO2 and Er: Cr;YSGG laser

Aim of this in-vitro study was the evaluation of temperature changes due to irradiation of two different lasers used for the reduction of dentinal hypersensitivity and their effect on the pulp damage. The study was done for two dentin thicknesses. Twenty intact extracted third molars were prepared by longitudinal ground sectioning for 1 and 2 mm dentin thicknesses while a thermocouple was positioned at the inner surface of the dentin disk. Thermal evaluation was assessed by a KJT digital thermometer. During the test, the data produced by the thermometer was transferred and logged into a PC via RS232 serial port. CO2 laser [Ultra pulse, 50W, 100?sec, Spot size: 0.5 mm] and Er,Cr;YSGG laser [Free-running pulse mode,0. 25W, 140?sec, 12.50 milli-joules] irradiations were randomly performed upon the dentin surfaces. The collected data was analyzed by two-way ANOVA test. The mean temperature rise in 1mm dentinal thickness was 8.57°C which was significantly higher than 3.63°C in 2mm dentin thickness [P<0.001] and higher than the threshold temperature for pulp damage; however, no significant difference was noted between the two lasers [P=0.355]. After removing the CO2 laser, the temperature decreased to the initial level faster than the time needed for Er,Cr;YSGG laser [44.47°C versus 62.82°C][P<0.001]. In other words, in both lasers the temperature decrease in 2mm dentinal disc was faster than 1mm dentinal disc. The temperature rise due to both lasers for 1mm of dentinal thickness was in excess of safe limit for the tissue and it would probably result in pulpal damage. In the case of 2mm dentinal thickness, the temperature rise was not higher than the safe limit and it would not damage the pulp in clinical conditions

effect of Er,Cr:YSGG laser irradiation on the apical leakage of retrograde cavity

Controversial results have been reported when organic acids, ultrasonic instruments and laser techniques were used to remove smear layer in endodontic treatments. The aim of this study was to evaluate the effect of removing debris and smear layer by Er,Cr:YSGG laser irradiation on the apical leakage of retrograde cavities. In this ex vivo study, 24 extracted mandibular single-rooted teeth were selected and instrumented up to K-file size #35. Approximately 3 mm of root apices were dissected perpendicular to the root's long axis. Retrograde cavities with 3 mm depth were prepared and the teeth were randomly assigned to two groups. In one group, the retrograde cavities were filled with amalgam and in the other group, the dentinal surface of the retrograde cavities were lased with Er,Cr:YSGG laser [2W, 15 seconds, G4 tip]. The cavities were filled with amalgam; all tooth surfaces except for dissected outsides were covered with blue wax. Then the teeth were immersed in 2% methylene blue dye for 48 hours. The amount of dye penetration into sagittal sections was measured by stereomicroscope at _20 magnification by two independent observers who were blinded to the experiment. Data were statistically analyzed using student t-test. This study demonstrated that dye penetration was 0.8 mm [ +/- 0.53] in the lased and 0.97 mm [ +/- 0.54] in the non-lased group. It showed that, Er,Cr:YSGG laser can remove the debris and smear layer and consequently reduces the amount of dye penetration, although, the difference between the two groups was not statistically significant. This study showed that dye penetration was less in lased group because of the better seal of the dissected surface due to the better removal of the debris and smear layer by laser; further investigations are recommended in this field