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OBJECTIVE@#To compare the clinical therapeutic effect between electroacupuncture at "four points of sacral region" and transurethral Erbium laser in treatment of moderate to severe stress urinary incontinence after radical prostatectomy.@*METHODS@#A total of 68 patients of moderate to severe stress urinary incontinence after radical prostatectomy were divided into an electroacupuncture group (34 cases) and an Erbium laser group (34 cases, 3 cases dropped off) according to the settings. In the electroacupuncture group, electroacupuncture was applied at "four points of sacral region", i.e. points of 0.5 cun beside bilateral sacrococcygeal joints and bilateral Huiyang (BL 35), with continuous wave, 2 Hz in frequency, 60 min each time, once every other day, 3 times a week, 12 times as one course of treatment. In the Erbium laser group, transurethral Erbium laser technology was given, once every 4 weeks as one course of treatment. Both groups were treated for 5 courses. The scores of the International Consultation on Incontinence questionnaire-short form (ICI-Q-SF) and the incontinence quality of life questionnaire (I-QOL) were observed before treatment, after each course of treatment and in follow-up after 1 and 2 months of treatment completion, respectively, and the clinical efficacy was evaluated after treatment in the two groups.@*RESULTS@#Compared with those before treatment, the ICI-Q-SF scores were decreased while the I-QOL scores were increased after 5 courses of treatment and in follow-up after 1, 2 months of treatment completion in the two groups (P<0.01). The ICI-Q-SF score in follow-up after 2 months of treatment completion were higher than that after 5 courses of treatment in the Erbium laser group (P<0.05). After 3, 4, 5 courses of treatment and in follow-up after 1 and 2 months of treatment completion, the ICI-Q-SF scores in the electroacupuncture group were lower than those in the Erbium laser group (P<0.05, P<0.01); after 2, 3, 4, 5 courses of treatment and in follow-up after 1 and 2 months of treatment completion, the I-QOL scores in the electroacupuncture group were higher than those in the Erbium laser group (P<0.01). The change ranges of ICI-Q-SF score and I-QOL score between before treatment and after each course of treatment in the electroacupuncture group were lager than those in the Erbium laser group (P<0.01, P<0.05). The total effective rate was 61.8% (21/34) in the electroacupuncture group, which was superior to 19.4 (6/31) in the Erbium laser group (P<0.01).@*CONCLUSION@#Both electroacupuncture at "four points of sacral region" and transurethral Erbium laser can improve the clinical symptoms and the quality of life in patients of moderate to severe stress urinary incontinence after radical prostatectomy. The short-term efficacy and long-term efficacy of electroacupuncture are superior to the Erbium laser technology.
Subject(s)
Male , Humans , Quality of Life , Urinary Incontinence, Stress/therapy , Sacrococcygeal Region , Electroacupuncture , Erbium , Prostatectomy/adverse effectsABSTRACT
Introdução: rugas e flacidez na região periorbital são queixas frequentes. O laser fracionado ablativo (LFA) CO2 10600nm e o Erbium: YAG 2940nm têm a capacidade de induzir a neocolagênese e a contração das fibras de colágeno. Objetivos: o objetivo do nosso estudo foi observar a eficácia de uma única sessão de laser fracionado Erbium: YAG 2940nm dual mode no tratamento de flacidez, rítides e bolsas de gordura das pálpebras superiores e inferiores. Métodos: 17 pacientes com flacidez, rítides e bolsas de gordura das pálpebras superiores e inferiores foram submetidos a uma sessão de laser fracionado ablativo Erbium: YAG 2940nm da plataforma Etherea em modo duplo. Os registros fotográficos foram realizados no mesmo ambiente antes do tratamento e um mês após o término do protocolo. A avaliação foi realizada objetivamente por cinco dermatologistas e cirurgiões plásticos independentes ao estudo. Resultados: as melhorias na avaliação de rítides, linhas de expressão e flacidez foram clínica e estatisticamente significativas, com poucos efeitos adversos, como edema, eritema e descamação. No entanto, as bolsas de gordura não melhoraram significativamente. Conclusão: uma única sessão com o modo duplo LFA Erbium: YAG 2940nm pode contribuir para uma melhoria significativa de rítides, linhas finas e flacidez da área periorbital.
Background: Wrinkles and flaccidity in the periocular region are frequent complaints. Ablative fractional lasers (AFL) CO2 10600nm and Erbium:YAG 2940nm can induce neocollagenesis and contraction of collagen fibers. Objective: Our study aimed to observe the effectiveness of one session of dual mode Erbium:YAG 2940nm fractional laser to treat sagging, rhytids, and fat bags of the upper and lower eyelids. Methods: Seventeen patients with sagging, rhytids, and fat bags of the upper and lower eyelids underwent one session of Ablative fractional laser (AFL) 2940nm from the Etherea platform in dual mode. Photographic records were taken in the same environment before treatment and one month after the end of the protocol, and five dermatologists and plastic surgeons independent of the study assessed them objectively. Results: The improvements in the evaluation of rhytids, fine lines, and flaccidity were clinically and statistically significant with few adverse events such as edema, erythema, and desquamation. However, eyelid bags did not improve significantly. Conclusion: A single session with the dual mode AFL Erbium:YAG tip 2940 can contribute to a significant improvement in rhytids, fine lines, and flaccidity of the periorbital area.
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Aim: To assess the effect of different mechanical surface treatments on flexural strength of repaired denture base. Material and Methods: Sixty bar-shaped specimens of heat-polymerized acrylic resin were fabricated, and divided into six groups (n=10). All specimens, except the positive control group (group PC), were sectioned into halves to create a 1-mm clearance. A negative control group with no surface treatment (group NC) was also considered. Other groups underwent different surface treatments: group Laser; treated with erbium: yttrium-aluminum-garnet (Er:YAG) laser, group APA; airborne-particle abrasion (APA), group APA plus Laser; a combination of laser and APA, and group Bur; bur grinding. After measuring surface roughness (Ra) with a profilometer, all sectioned specimens were repaired by auto-polymerizing acrylic resin, and thermocycled afterward. Three-point bending test was performed by a universal testing machine. Data were statistically analyzed (α=0.05). Results: The mean surface roughness of all experimental groups were significantly higher than that of group NC (p<0.05). The mean flexural strength of all groups was significantly lower than that of group PC (p<0.05). Group B had significantly higher flexural strength than the other surface-treated groups (p<0.05). Group Laser had significantly higher flexural strength than groups APA (p=0.043) and APA plus Laser (p=0.023). No significant difference was found between groups APA and APA plus Laser (p=0.684). Conclusion: All surface treatments increased the surface roughness and flexural strength compared with the untreated group. The highest flexural strength was observed in specimens treated by bur grinding and then laser, however, it was still significantly lower than intact specimens.
Objetivo: Evaluar el efecto de diferentes tratamientos superficiales mecánicos sobre la resistencia a la flexión de la base de la prótesis reparada. Material y Métodos: Se fabricaron sesenta especímenes en forma de barra de resina acrílica termo-polimerizada y se dividieron en seis grupos (n=10). Todas las muestras, excepto el grupo de control positivo (grupo PC), se seccionaron en mitades para crear un espacio libre de 1 mm. También se consideró un grupo de control negativo sin tratamiento superficial (grupo NC). Otros grupos se sometieron a diferentes tratamientos superficiales: grupo Láser; tratados con láser de erbio: itrio-aluminio-granate (Er:YAG), grupo APA; abrasión por partículas en el aire (APA), grupo APA más láser; una combinación de láser y APA, y grupo Bur; molienda de fresas. Después de medir la rugosidad de la superficie (Ra) con un perfilómetro, todas las muestras seccionadas se repararon con resina acrílica de autopolimerización y se sometieron a termociclado. La prueba de flexión de tres puntos se realizó con una máquina de prueba universal. Los datos se analizaron estadísticamente (α=0,05). Resultados: La rugosidad superficial media de todos los grupos experimentales fue significativamente mayor que la del grupo NC (p<0,05). La resistencia media a la flexión de todos los grupos fue significativamente menor que la del grupo PC (p<0,05). El grupo B tenía una resistencia a la flexión significativamente mayor que los otros grupos tratados en la superficie (p<0,05). El grupo Láser tuvo una resistencia a la flexión significativamente mayor que los grupos APA (p=0,043) y APA más Láser (p=0,023). No se encontró diferencia significativa entre los grupos APA y APA más Láser (p=0,684). Conclusión: Todos los tratamientos superficiales aumentan la rugosidad de la superficie y la resistencia a la flexión en comparación con el grupo sin tratar. La resistencia a la flexión más alta se observó en las muestras tratadas con fresado y luego con láser; sin embargo, aún era significativamente más baja que las muestras intactas.
Subject(s)
Humans , Acrylic Resins/chemistry , Denture Repair , Polymethyl Methacrylate/chemistry , Dental Materials/chemistry , Denture Bases , Lasers, Solid-State , Methacrylates/chemistryABSTRACT
Objective:To investigate the efficacy of pixel 2 940 nm erbium laser combined with vitamin B12 in the treatment of acne sunken scar.Methods:From July 2017 to June 2019, 96 patients with acne sunken scar were treated in the Department of Burn and Plastic Surgery of the Second People＇s Hospital of Jiaozuo City, Henan Province. They were randomly divided into two groups with 48 cases in each group. The control group was treated with routine therapy and the observation group was treated with pixel 2 940 nm erbium laser combined with vitamin B12. The therapeutic effects, acne scar weight score (ECCA), skin condition and adverse reactions were compared between the two groups.Results:The total effective rate of the control group was 77.08% (37/48), which was lower than that of the observation group 91.67% (44/48) ( P<0.05); The incidence of adverse reactions, pore and amethyst in ECCA score of the control group were (18.14±9.33), 18.75% (9/48), (32.25±8.41) and (18.24±5.12), which were higher than those of the observation group (26.45±12.60), 4.17% (2/48), (28.24±7.52) and (15.63±4.34) ( P<0.05), respectively. Conclusions:Pixel 2 940 nm erbium laser combined with vitamin B12 is effective in the treatment of acne sunken scar, with less adverse reactions and high safety. It is worthy of clinical application.
ABSTRACT
@#The concept of “minimally invasive dentistry” aims to provide conservative treatment of cavities in which sound dentin is removed. Because the Er: YAG laser can selectively remove caries, the smear layer is removed, dentin tubules are exposed after the preparation of substrate conditioning, and its advantages of precision, safety and painlessness are deeply valued. At the same time, the bonding strength between the prepared dentin surface and the filling material is different due to the different parameters of the Er: YAG laser. In this paper, the principle of dentin bonding, the mechanism of Er: YAG laser action, after treatment of dentin with different parameters (power, energy density, pulse duration, and irradiation distance), whether there is thermal damage to pulp tissue, the ultramicro morphology of dentin surface, the bonding properties of different bonding systems and the filling materials between irradiated hard tissues were reviewed. An appropriate parameter range (power ≤ 10 Hz, energy density ≤ 60 mJ, and pulse duration ≤ 50 μs) combined with water spray cooling will not cause thermal damage to the pulp tissue, while the higher power, energy density and pulse duration of laser treatment for dentin will lead to melting, carbonization, cracks, narrowing of the gap between collagen fibers, etc., which will limit the penetration of adhesives and have a negative impact on bonding. However, whether the adhesive systems based on the smear layer are suitable for dentin after laser treatment needs to be further explored.
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Objective: To compare the effect of three surface treatment protocols and two intermediate agents on repairing aged composite, regarding microtensile bond strength (µTBS) and mode of fracture, at two time intervals. Material and methods: Six-monthaged microhybrid composite blocks, were randomly distributed into three groups, subjected to; Fine, Super Fine grit diamond burs or Erbium- Yag Laser surface treatment. Each block had both One Coat bond SL (Bond) and Brilliant Flow flowable composite (Flow) intermediate agents, alongside. Blocks were incrementally repaired using nanohybrid composite, cut into beams, then randomly subjected either immediately (IM) to µTBS test or after thermocycling (TC) for 5000 cycle. Mode of failure was determined using stereomicroscope. Data were analyzed through three-way ANOVA followed by pairwise comparison with Bonferroni correction. Kruskal Wallis test compared groups for failure mode analysis (α=0.05) Results: Super Fine grit showed the highest mean µTBScompared to control for both intermediate agents, IM and after TC at P<0.05. No difference between Fine grit and Laser application for all groups (P>0.05). IM, Bond showed the highest µTBS compared to TC, Flow for all tested groups. Beams roughened with Fine and Super Fine burs showed significantly lower adhesive failures than those roughened with Laser. Flow suffers significantly higher adhesive failure than those with Bond. For TC tested groups; beams with Super Fine bur and Bond showed significantly lower adhesive failure at P=0.029. Conclusion: Super Fine grit and Bond provide the highest µTBS and the least adhesive failure; moreover TC resulted in significant decrease in µTBS (AU)
Objetivo: Comparar o efeito de três protocolos de tratamento de superfície e dois agentes intermediários no reparo de compósito envelhecido, quanto à resistência à microtração (µTBS) e modo de fratura, em dois intervalos de tempo. Material e métodos: Blocos de compósito microhíbrido envelhecidos por seis meses, foram distribuídos aleatoriamente em três grupos, submetidos a; Pontas diamantadas de granulação Fina, Superfina ou tratamento de superfície com laser de Erbio-Yag. Cada bloco tinha ambos os agentes intermediários One Coat bond SL (Adesivo) ao lado de Brilliant Flow (Resina Fluida). Os blocos foram reparados de forma incremental usando compósito nanohíbrido, cortados em palitose, em seguida, submetidos aleatoriamente imediatamente (IM) ao teste de µTBS ou após termociclagem (TC) por 5000 ciclos. O modo de falha foi determinado usando estereomicroscópio. Os dados foram analisados por meio de ANOVA de três fatores, seguida de comparação pareada com correção de Bonferroni. O teste de Kruskal Wallis comparou os grupos para análise do modo de falha (α = 0,05). Resultados: a granulação Super fina apresentou a maior média de µTBS em comparação com o controle para ambos os agentes intermediários, IM e após TC (P <0,05). Não houve diferença entre granulação fina e aplicação de laser para todos os grupos (P> 0,05). IM, Adesivo apresentou a µTBS mais alta em comparação com TC, Resina Fluida para todos os grupos testados. Os palitos asperizados com pontas de granulações Fina e Superfina apresentaram falhas adesivas significativamente menores do que as asperizadas com Laser. Resina Fluida sofreu falhas adesivas significativamente maiores do que aquelas com Adesivo. Para grupos testados TC; palitos tratados com ponta Superfina e Adesivo apresentaram falha adesiva significativamente menor com P = 0,029. Conclusão: a granulação Superfina e o Adesivo fornecem a maior µTBS e o mínimo de falha adesiva; além disso, o TC resultou em uma diminuição significativa da µTBS. (AU)
Subject(s)
Statistics, Nonparametric , Composite Resins , Resin Cements , LasersABSTRACT
Purpose: De-bonding strength of ceramic veneers by laser use needs to be evaluated in detail. The aim of this study, is to determine the contribution of ceramic thickness and cementing agents to the de-bonding strength of ceramic veneers using Er,Cr:YSGG laser. Methods: A total of 120 maxillary central incisors specimens were randomly divided into twelve groups on the basis of disc thickness, cementing agent, and Er,Cr:YSGG laser use. Under laboratory conditions, 120 IPS Empress II system discs 0.5mm, 1mm, and 2mm in thickness were applied to the tooth surfaces, for laser use. An Er,Cr:YSGG laser system was applied to the central surface of the IPS Empress II discs on specimens in all laser groups (Groups 1,3,5,7,9,11). Then the shear bond strength (SBS) for all specimens were tested with a testing machine at a speed of 0.5mm/min. The SBS values were considered as the de-bonding strength. Results: The mean de-bonding strength values for Groups 9 and 11 (0,5 mm disc thickness + laser application) have the lowest median load (0.000 N), while Group 4 (2mm disc thickness + no laser) has the highest median load (573.885 N). The de-bonding strengths of all the groups without laser application were higher than those of all groups with laser use. When laser is applied, the mean de-bonding strength decreases with decreasing disc thickness, and it reaches zero at 0.5mm thickness of discs cemented by self- or total-etch adhesives. Conclusions: The de-bonding strength decreases with laser use, and decreasing disc thickness. In the absence of laser, the mean de-bonding values of discs cemented by a total etch adhesive system are always higher than those of discs cemented with a self-etch adhesive system. Without any extra load, all 0.5mm thick discs were dislodged from teeth while applying or testing the laser.
Propósito: La resistencia de desunión de las carillas de cerámica mediante el uso del láser debe evaluarse en detalle. El objetivo de este estudio es determinar la contribución del espesor de la cerámica y los agentes de cementación a la resistencia de desunión de las carillas de cerámica utilizando el láser Er, Cr: YSGG. Métodos: Un total de 120 incisivos centrales maxilares se dividieron al azar en doce grupos según el grosor del disco, el agente de cementación y el uso del láser Er, Cr: YSGG. En condiciones de laboratorio, se aplicaron en las superficies de los dientes 120 discos del sistema IPS Empress II de 0,5mm, 1mm y 2mm de grosor, para uso con láser. Se aplicó un sistema láser Er, Cr: YSGG a la superficie central de los discos IPS Empress II en muestras de todos los grupos de láser (Grupos 1,3,5,7,9,11). Luego, la resistencia de la unión al cizallamiento (SBS) para todas las muestras se probó con una máquina de prueba a una velocidad de 0.5mm/min. Los valores de SBS se consideraron como la fuerza de desunión. Resultados: Los valores medios de resistencia de desunión para los Grupos 9 y 11 (espesor de disco de 0,5mm + aplicación de láser) demostró la carga media más baja (0,000 N), mientras que el Grupo 4 (espesor de disco de 2 mm + sin láser) tuvo la carga media más alta (573.885 N). Las fuerzas de desunión de todos los grupos sin aplicación de láser fueron superiores a las de todos los grupos con uso de láser. Cuando se aplica el láser, la fuerza media de desunión disminuye al disminuir el grosor del disco, y llega a cero con el grosor de 0,5mm de los discos cementados, para ambos adhesivos de grabado. Conclusiones: la fuerza de desunión disminuye con el uso del láser y disminuye con el grosor del disco. En ausencia de láser, los valores medios de desunión de los discos cementados con un sistema de adhesivo de grabado total son siempre más altos que los de los discos cementados con un sistema de adhesivo de autograbado. Sin ninguna carga adicional, todos los discos de 0,5mm de grosor se desprendieron de los dientes al aplicar el láser.
Subject(s)
Humans , Ceramics/therapeutic use , Dental Bonding , Shear Strength , Lasers, Solid-State/therapeutic use , Dental Enamel/radiation effects , Dental Materials/chemistry , Dental VeneersABSTRACT
Background: Accurate preparation of recipient area is a critical step in melanocyte-keratinocyte transplantation procedure for vitiligo. It is an important potential step for adaptation in the quest to achieve better results and ablative lasers potentially offer excellent precision over margin and depth control in achieving that. Objective: To compare between the two techniques used for recipient site preparation: Er:YAG laser ablation and mechanical dermabrasion for melanocyte-keratinocyte transplantation procedure in terms of re-pigmentation achieved and adverse effects seen. Methods: A randomized comparative trial was performed among 32 patients of stable vitiligo undergoing melanocyte-keratinocyte transplantation procedure. In Group A (n = 15), recipient site preparation was done with Er:YAG laser, and in Group B (n = 17), it was done with a motorized dermabrader. Patients of both groups were objectively assessed for re-pigmentation at 1, 3 and 6 months. Results: A total of 253.696 cm2 of depigmented surface was operated upon and re-pigmentation of 125.359 cm2 (49.4%) was achieved. On comparison between two groups, no statistical difference was found with respect to total re-pigmentation achieved (Group A: 54.67% vs Group B: 48.841%, P = 0.663) and grades of re-pigmentation achieved (P = 0.796). Occurrence of adverse events was also statistically similar in both the groups. Conclusion: This study did not reveal any statistically different outcome (in terms of re-pigmentation and adverse effects) between the two methods of recipient site preparation – motorized dermabrasion and Er:YAG ablation. Limitations: This study is small and larger studies are needed to ascertain the benefit of Er:YAG for recipient site preparation. Future studies may also ascertain variables such as time taken to prepare the recipient area, nature of bleeding, postoperative healing, difficulties in specific area, cost of the procedure, patient comfort and ease of the surgeon, rather than comparing the re-pigmentation alone.
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Objective Xanthelasma palpebrarum presents a therapeutic and aesthetic challenge because of its high visibility and frequent rate of recurrence with a wide variety of treatments.Many patients were disappointed by an initial unsuccessful treatment and fail to return for further therapy until the problem had become quite conspicuous.So a simple treatment with few side effects and good acceptance remains an important goal.Methods Eleven patients with xanthelasma lesions were treated with the 1540nm erbium:glass laser.We could see erythema and swell around the skin lesion immediately.It needed irradiate again after one month if there was residual lesion.The end point was the lesions completely removed.The therapeutic effect of 1540nm erbium laser,the adverse reaction and the satisfaction of patients were observed.Results All lesions were removed without hyperpigmentation or scarring.Conclusions The 1540 nm erbium:glass laser represents an effective means for treating xanthelasmas with few side effects and good acceptance.
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BACKGROUND: Treatment of congenital melanocytic nevi (CMN) with intense pulsed light (IPL) has recently produced promising results. OBJECTIVE: To evaluate the clinical and histological outcomes of small-to-medium sized CMN treated with IPL alone and in combination with erbium: yttrium-aluminum-garnet (Er: YAG) laser. METHODS: We performed a retrospective chart review of 26 small-to-medium sized CMN treated as described above. The reduction in visible pigmentation, signs of recurrence and any adverse skin changes were evaluated by two independent clinicians. RESULTS: Seventeen patients completed treatment and were followed-up. Nine were not able to complete treatment due to work, change in residence, and treatment related stress. Ten patients received IPL alone (mean: 10.5 sessions) and 7 underwent treatment with IPL (mean: 7.7 sessions) and Er: YAG/IPL combination therapy (mean: 4.7 sessions). The initial treatment outcome was cleared in 5 patients and excellent in 12. Fourteen patients (82.4%) showed CMN recurrence one year after treatment completion. The histological results from a patient with an excellent clinical outcome showed remnant nevus cells nests in the deep dermis. CONCLUSION: IPL treatment alone and in combination with Er: YAG laser are not definitive treatments for CMN and should not be considered as first-line treatment.
Subject(s)
Humans , Dermis , Erbium , Intense Pulsed Light Therapy , Lasers, Solid-State , Nevus , Nevus, Pigmented , Pigmentation , Recurrence , Retrospective Studies , Skin , Treatment OutcomeABSTRACT
BACKGROUND: Treatment of congenital melanocytic nevi (CMN) with intense pulsed light (IPL) has recently produced promising results. OBJECTIVE: To evaluate the clinical and histological outcomes of small-to-medium sized CMN treated with IPL alone and in combination with erbium: yttrium-aluminum-garnet (Er: YAG) laser. METHODS: We performed a retrospective chart review of 26 small-to-medium sized CMN treated as described above. The reduction in visible pigmentation, signs of recurrence and any adverse skin changes were evaluated by two independent clinicians. RESULTS: Seventeen patients completed treatment and were followed-up. Nine were not able to complete treatment due to work, change in residence, and treatment related stress. Ten patients received IPL alone (mean: 10.5 sessions) and 7 underwent treatment with IPL (mean: 7.7 sessions) and Er: YAG/IPL combination therapy (mean: 4.7 sessions). The initial treatment outcome was cleared in 5 patients and excellent in 12. Fourteen patients (82.4%) showed CMN recurrence one year after treatment completion. The histological results from a patient with an excellent clinical outcome showed remnant nevus cells nests in the deep dermis. CONCLUSION: IPL treatment alone and in combination with Er: YAG laser are not definitive treatments for CMN and should not be considered as first-line treatment.
Subject(s)
Humans , Dermis , Erbium , Intense Pulsed Light Therapy , Lasers, Solid-State , Nevus , Nevus, Pigmented , Pigmentation , Recurrence , Retrospective Studies , Skin , Treatment OutcomeABSTRACT
BACKGROUND: Multiple therapies involving ablative and nonablative techniques have been developed for the rejuvenation of photodamaged skin. Radiofrequency (RF) is emerging as a gentler, nonablative skin-tightening device that delivers uniform heat to the dermis at a controlled depth. OBJECTIVE: To compare the efficacy of bipolar radiofrequency (Polaris™) and 1,550-nm fractional erbium-glass laser (Mosaic™) for the treatment of photoaging using a randomized, split-face, patient- and evaluator-blind study. METHODS: We evaluated the clinical effects after the treatment of photoaging. Ten Asian women (Fitzpatrick skin type III to IV) underwent 9 weeks of treatment (3 sessions at 3-week intervals) with monotherapy (Polaris™) on one side of the face and combination therapy with non-ablative bipolar radiofrequency (Polaris™) and 1,550-nm fractional erbium-glass laser (Mosaic™) on the other side. RESULTS: Among 10 patients, 4 were male and 6 were female. Subjective and objective assessments showed that the combination therapy was more effective. As the number of the treatment sessions increased, there was an accompanying increase in the satisfaction level and efficacy. CONCLUSION: This study suggests that bipolar radiofrequency combined with 1,550-nm fractional erbium-glass laser could be effective treatment for photoaging.
Subject(s)
Female , Humans , Male , Asian People , Clothing , Dermis , Hot Temperature , Rejuvenation , SkinABSTRACT
ANTECEDENTES: El síndrome genitourinario de la menopausia (SGM) afecta hasta el 50% de las mujeres posmenopáusicas. Sus síntomas presentan un curso crónico y progresivo, pudiendo alterar significativamente la sexualidad y la calidad de vida. OBJETIVO: Evaluar efectividad a corto plazo y aceptabilidad del láser vaginal de Erbium en cristal de itrio-aluminio-granate (Er:YAG) como una terapia fototérmica no invasiva, no ablativa para el manejo del SGM. MÉTODO: Estudio longitudinal prospectivo, realizado en 28 mujeres posmenopáusicas con SGM. Se aplica láser vaginal Er:YAG en 3 sesiones cada 30 días. En todos los controles, se evalúa sequedad vaginal, dispareunia mediante escala visual analógica, y se registra el "vaginal health index score" (VHIS). Al final del tratamiento se evalúa la aceptabilidad del método. RESULTADOS: Se observa mejoría significativa de los síntomas (sequedad vaginal y dispareunia; p<0,01) durante todo el periodo de estudio y del VHIS (8,2 ± 1,3 previo al tratamiento vs. 19,2 ± 0,4 posterior al tratamiento; p<0,01). El 93,4% de las pacientes calificó el procedimiento como excelente o bueno. CONCLUSIÓN: Nuestro estudio piloto muestra que el tratamiento con láser Er:YAG en mujeres posmenopáusicas con síntomas de SGM es eficaz, factible y seguro en el corto plazo. Se requieren datos a más largo plazo y de mayor tamaño muestral para confirmar nuestros resultados.
BACKGROUND: The genitourinary syndrome of menopause (GSM) affects up to 50% of postmenopausal women. Symptoms are chronic and likely worsen over time. This complains may interfere with sexual function and quality of life. OBJECTIVE: To evaluate the short-term effectiveness and acceptability of Erbium in yttrium aluminum-garnet crystal Laser (Er:YAG) as a non-invasive, non-ablative photothermal therapy for the treatment of GSM. METHODS: Prospective longitudinal study performed in 28 postmenopausal women suffering from GSM. All participants were treated intravaginally with Er:YAG laser in 3 applications performed every 30 days. Symptoms (vaginal dryness and dyspareunia) were evaluated by a visual-analogic scale (VAS) and the vaginal health index score (VHIS). After therapy, the women were asked to evaluate the acceptability of the intervention. RESULTS: Er:YAG laser treatment was effective to improve symptoms (vaginal dryness and dyspareunia; p<0.01) at all the study period, as well the VHIS (8.2 ± 1.3 at baseline vs. 19.2 ± 0.4 after treatment; p<0.01). Satisfaction with the procedure was reported as excellent or good by 93.4% of women. CONCLUSION: Our pilot study shows that the Er:YAG treatment in postmenopausal women with GSM is effective, feasible, and safe. Further larger, long-term and controlled studies are required to confirm this data.
Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Vaginal Diseases/therapy , Menopause , Lasers, Solid-State/therapeutic use , Syndrome , Prospective Studies , Longitudinal Studies , Treatment Outcome , Patient Satisfaction , Dyspareunia/therapy , Erbium , Visual Analog Scale , Hyperthermia, Induced/methodsABSTRACT
Objective To observe the effect of hydrocolloid dressings with instant ice compress on the healing process,postoperative pain and efficacy of patients with acne scar treated by 2940 nm erbium pixel laser.Methods We selected 60 patients with acne scar from November 2012 to June 2014 treated by the erbium pixel laser.They were randomly divided into two groups:hydrocolloid dressings with ice compress after treatment were used in observation group (n=37)and postoperative wound dry were kept in control group (n=23);pain,duration of burning,erythema duration,efficacy,decrustation time,postoperative complications were evaluated and quantitatively analyzed.Results Compared with the control group,the application of hydrocolloid dressings with ice compress group (observation group) received less postoperative paim postoperative VAS pain score was (5.81± 0.64) in observation group and (6.09±0.69) in control group;duration of burning was shorter:(1.86± 0.75) h in observation group and (3.65±0.93) h in control group;duration of erythema was shorter:(2.27±0.73) d in observation group and (3.52 ±0.79) d in control group;decrustation time was shorter:(5.76± 1.06) d in observation group and (8.09±0.95) d in control group;postoperative complications were reduced:(5.4％,2/37) in the observation group and (30.4％,7/23) in the control group,with statistically significant difference (all P＜0.05).The differences were not statistically significant in the intraoperative VAS score and the curative effect.Conclusions The application of hydrocolloid dressing with instant ice compress after erbium pixel laser in the treatment of acne scar can effectively reduce postoperative pain and burning sensation,shorten the duration of erythema and crusting time after operation.It also reduces the incidence of complications.
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Background: Striae distensae or stretch marks are atrophic linear dermal scars with epidermal atrophy. There are many therapeutic options for management, but no consistently effective modality is available yet. Objective: We compared the efficacy of 1064 nm long pulse (LP) Nd: YAG laser and 2940 nm variable square pulse (VSP) erbium: YAG laser in the treatment of striae distensae. Methods: Twenty female volunteers (Fitzpatrick skin types II-V) aged between 20 and 40 years with striae (3 patients with the rubra type and 17 with the alba type) were enrolled in the study. The duration of striae ranged from 4 months to 12 years. Lesions were located on the abdomen in all patients except one patient who had striae on the arms and two patients with striae in the lumbar region. Treatments were randomly allocated to both sides of the body in each patient, one side being treated with VSP erbium: YAG laser and the opposite side with LP Nd: YAG laser. All subjects were treated monthly for a total of three treatments. Two 3-mm punch biopsies were obtained from six subjects, both of the same striae, one before the first treatment and one 4 weeks after the last session. Results: Response was evaluated clinically by photographic comparison and was found to be poor in 17 subjects, both on the LP Nd: YAG laser treated side and VSP erbium YAG laser treated side. All these patients had mature lesions (striae distensae alba). Three subjects had a moderate response on both sides; these patients' striae were immature (striae distensae rubra). Histologically, elastic fibers were slightly increased in post-treatment samples compared with pretreatment skin biopsies. Conclusion: We observed no satisfactory clinical improvement in striae distensae alba lesions although histopathological changes were seen. We suggest that variable square pulse Er: YAG and long pulse Nd: YAG lasers are not useful in the treatment of striae distensae alba.
Subject(s)
Adult , Biopsy , Erythema/etiology , Female , Humans , Lasers, Solid-State/therapeutic use , Skin/pathology , Striae Distensae/pathology , Striae Distensae/surgery , Young AdultABSTRACT
Melasma represents a pigmentary disorder that is difficult to treat. This study aims to broadly review the use of ablative lasers (Er:YAG and CO2) in the treatment of melasma, presenting the level of evidence of studies published to date. A total of 75 patients were enrolled in four case series studies (n=39), one controlled clinical trial (n=6) and one randomized controlled clinical trial (n=30). Studies on the Er:YAG laser showed better results with the use of short square-shaped pulses, which determined low rates of post-inflammatory hyperpigmentation and long-lasting maintenance of results. Likewise, studies on the CO2 laser proved the benefits of short pulse duration along with low-density energy. Post-treatment maintenance with the use of antipigmenting creams was necessary and effective to sustain long-term results. Ablative lasers may represent another useful and effective tool against melasma. Postinflammatory hyperpigmentation and difficulty in sustaining long-term results still represent the main limitations to a broader use of ablative lasers. Based on actual evidence, the use of this technology should be restricted to patients with recalcitrant disease. Further studies will help establish optimal laser parameters and treatment regimens.
O melasma representa desordem pigmentar de difícil tratamento. O presente estudo tem como propósito apresentar ampla revisão da literatura acerca do uso de laser ablativos (Er:YAG e CO2) no tratamento do melasma, estabelecendo o nível de evidência dos estudos publicados até o instante. Um total de 75 pacientes foram envolvidos entre quatro séries de casos (n=39), um ensaio clínico controlado (n=6) e um ensaio clínico controlado e randomizado (n=30). Os estudos acerca do laser de Er:YAG demonstraram melhores resultados com o uso de pulsos de forma quadrada, os quais determinaram menores taxas de hiperpigmentação pós-inflamatória. Ademais, os estudos com laser de CO2 também demonstraram benefício no uso de pulsos curtos com baixa densidade de energia. O uso de cremes despigmentantes no período pós-tratamento se mostrou necessária e efetiva na manutenção de resultados à longo prazo. Os lasers ablativos, por conseguinte, podem representar ferramenta efetiva e de grande utilidade no manejo do melasma. Entretanto, hiperpigmentação pós-inflamatória e dificuldade na manutenção de resultados à longo prazo parecem representar as principais limitações atuais ao seu amplo uso. Por conseguinte, com base nas atuais evidências, o uso de tais tecnologias ainda deve ser restrita à casos de doença recalcitrante. Novos estudos ainda são necessários para o estabelecimento de parâmetros e regimes ideais de tratamento.
Subject(s)
Humans , Facial Dermatoses/surgery , Laser Therapy , Melanosis/surgery , Neurocutaneous Syndromes/surgery , Lasers, Gas/therapeutic use , Lasers, Solid-State/therapeutic use , Treatment OutcomeABSTRACT
Introduction: Laser technology is gaining increasing importance in dental practice and also in the field of Endodontics with its ability to promote disinfection and experimentally in the preparation of root canal. The action of different types of lasers results in changes representing the increase in permeability of dentinal tissue (Er: YAG) or sometimes by a decrease in melting and recrystallization of dentin (Nd: YAG). Objective: this study assessed through apical dye leakage, the influence of irradiation with two types of laser, regarding to the quality of apical sealing of endodontic fillings. Material and methods: Thirty-six single-rooted teeth were used after being prepared with the ProFile system up to size #40 instrument and then divided into four experimental and two control groups. The technique used previously to the filling was as follows: G1 - not irradiated; G2 - irradiated with Er: YAG; G3 - irradiated with Nd: YAG and G4 - irradiated with Er: YAG followed by Nd: YAG. After external waterproofing and dry, the specimens were filled with a cold vertical condensation technique, using AH Plus sealer, and immediately immersed into 0.5% methylene blue solution for subsequent cleavage. The linear values of apical marginal leakage were obtained with the aid of an optical microscope connected to a computer using the Image Lab® software. Results: Data analysis showed the non-existence of statistically significant (p = 0.05) differences between different groups. Conclusion: It was concluded that the laser does not have influence on the apical sealing.
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Introdução: Melasma é hiperpigmentação adquirida que afeta primariamente a face, e acomete mais comumente mulheres de pele escura. Diversas são as terapias utilizadas para seu tratamento; seu manejo clínico a longo prazo, entretanto, permanece um desafio. Objetivos: Avaliar a eficácia do laser de érbio: YAG fracionado, analisar histologicamente as características usuais do melasma e a quantidade de pigmento na epiderme e derme antes e após o tratamento. Métodos: Dez pacientes foram submetidas a três sessões do laser de érbio: YAG fracionado ablativo com intervalo de um mês de uma para outra. As pacientes foram biopsiadas antes e após o tratamento. Foram realizadas avaliações clínicas subjetivas e objetivas, antes, durante e após o tratamento. Resultados: Não foi observada melhora do escore Masi ao longo do tratamento. Histologicamente foram observadas hiperpigmentação da camada basal e deposição de pigmento em derme superficial. Em sete casos observou-se redução no grau de hiperpigmentação da epiderme, sem significância estatística. Conclusões: O tratamento do melasma com o laser de érbio: YAG fracionado ablativo não se mostrou efetivo, apesar de haver tendência a diminuição dos escore Masi e no grau de hiperpigmentação da epiderme, sugerindo que o laser de érbio: YAG pode ser capaz de melhorar tanto clínica quanto histologicamente o grau de hiperpigmentação da pele.
Introduction: Melasma is an acquired hyperpigmentation that affects primarily the face and occurs more frequently in women with darker skin. There are several therapies for treating melasma, however its longterm management remains a challenge. Objectives: To evaluate fractional Erbium:YAG laser's clinical effectiveness in treating refractory melasma through the histological analysis of usual characteristics and the amount of epidermal and dermal pigment before and after treatment. Methods: Ten patients underwent three fractional Erbium:YAG laser sessions at monthly intervals. Biopsies were obtained before and after treatment. Subjective and objective clinical evaluations were carried out before, during, and after treatment. Results: No statistical improvement in Melasma Area Severity Index score was observed during the treatment. Hyperpigmentation of the basal layer and pigment deposition in the dermis was observed histologically. In seven cases, there was a reduction in the degree of hyperpigmentation in the epidermis, which was not statistically significant. Conclusions: The treatment of melasma with fractional Erbium:YAG laser was ineffective. Nonetheless, a decrease in Melasma Area Severity Index scores and in the degree of hyperpigmentation of the epidermis was detected, suggesting that fractional Erbium:YAG laser can clinically and histologically improve the degree of hyperpigmentation of the skin.
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BACKGROUND: Skin injuries, such as lacerations due to trauma, are relatively common, and patients are very concerned about the resulting scars. Recently, the use of ablative and non-ablative lasers based on the fractional approach has been used to treat scars. In this study, the authors demonstrated the efficacy and safety of ablative fractional resurfacing (AFR) for traumatic scars using a 2,940-nm erbium: yttrium-aluminum-garnet (Er:YAG) laser for traumatic scars after primary repair during the early posttraumatic period. METHODS: Twelve patients with fifteen scars were enrolled. All had a history of facial laceration and primary repair by suturing on the day of trauma. Laser therapy was initiated at least 4 weeks after the primary repair. Each patient was treated four times at 1-month intervals with a fractional ablative 2,940-nm Er:YAG laser using the same parameters. Post-treatment evaluations were performed 1 month after the fourth treatment session. RESULTS: All 12 patients completed the study. After ablative fractional laser treatment, all treated portions of the scars showed improvements, as demonstrated by the Vancouver Scar Scale and the overall cosmetic scale as evaluated by 10 independent physicians, 10 independent non-physicians, and the patients themselves. CONCLUSIONS: This study shows that ablative fractional Er:YAG laser treatment of scars reduces scars fairly according to both objective results and patient satisfaction rates. The authors suggest that early scar treatment using AFR can be one adjuvant scar management method for improving the quality of life of patients with traumatic scars.