Gengivectomia convencional e gengivectomia a laser ­ uma revisão crítica / Conventional gingivectomy and laser gingivectomy ­ a critical review

Objetivo: realizar uma avaliação crítica da literatura em relação à melhor técnica cirúrgica, convencional ou a laser, bem como suas indicações. Material e métodos: para síntese deste trabalho, foi realizada uma busca bibliográfica na base PubMed e incluídos estudos relevantes relacionados ao tema. Resultados: foram selecionados, por dois revisores, dez artigos para serem incluídos nessa revisão da literatura: um ensaio clínico, um estudo experimental e oito relatos de casos. Conclusão: a gengivectomia convencional continua sendo uma técnica de grande escolha, e a gengivectomia a laser é uma opção que traz resultados satisfatórios com tempo cirúrgico menor, hemostasia, conforto para o paciente e cicatrização mais rápida. Entretanto, é necessária a realização de ensaios clínicos controlados randomizados para afi rmar se esta tecnologia poderá tornar-se padrão-ouro na prática diária.

Objective: to perform a critical literature review regarding the best surgical technique (conventional or laser) and its indications. Material and methods: an electronic search was made at the PubMed and relevant studies were included. Results: 10 articles were selected by two reviewers to be included as follows: 1 clinical trial, 1 experimental study, and 8 case reports. Conclusion: conventional gengivectomy continues to be the chosen technique, and laser gengivectomy is an option with satisfactory results with less surgical time, hemostasis, more patient comfort, and a fast healing. However, more randomized controlled clinical trials are needed to verify whether this technology will be the gold-standard in our daily practice.

Uso de ultrassom e laser na descontaminação do sistema de canais radiculares: revisão de literatura / Use of ultrasound and laser in root canal decontamination: literature review

O maior obstáculo para o sucesso do tratamento endodôntico é a eliminação da microbiota instalada. A instrumentação mecânica, bem como as substâncias químicas auxiliares, é utilizada para eliminação dessa microbiota. Além das soluções irrigantes, outras técnicas complementares, como a agitação ultrassônica passiva (PUI) e o laser, estão sendo utilizadas para otimizar a eliminação dos microrganismos. Desse modo, o presente estudo objetivou o levantamento bibliográfico de diferentes tipos de agitação dos irrigantes no tratamento endodôntico. A PUI tem sido sugerida como um meio para melhorar o desbridamento do canal. Já o laser tem sido utilizado por apresentar vantagens terapêuticas ao tratamento. Todas as técnicas citadas para melhorar a limpeza dos canais radiculares mostraram alguma melhora. A técnica mais empregada ainda é a agitação ultrassônica, por apresentar eficiência e praticidade no procedimento. Pôde-se concluir que a diminuição da microbiota é mais eficiente quando se utiliza uma maior concentração da solução irrigadora, independentemente da agitação final de escolha.

O uso do laser e seus princípios em endodontia: revisão de literatura / The use of laser and its principles in endodontics: review of literature

INTRODUÇÃO: com advento e criação do aparelho laser em 1960 por Theodore Harold Maiman e a utilização do laser na Endodontia em 1971 com Weichman várias aplicações potenciais foram criadas para a utilização dos lasers. Este estudo permite ao clínico um melhor entendimento da utilização do laser dentro da odontologia mais especificamente na área endodôntica. OBJETIVO: evidenciar o uso do equipamento laser na área endodôntica nas modalidades em: Auxílio no diagnóstico pulpar, capeamento pulpar, pulpotomia, preparo e Limpeza do canal radicular, esterilização dos canais radiculares e terapia fotodinâmica (PDT), irrigação dos canais radiculares, remoção de smear layer e cirurgia parendodontica. MÉTODO: trata-se de uma revisão de literatura estruturada. CONCLUSÃO: este estudo fornece evidências de que o equipamento laser pode ser pensado e usado como um instrumento alternativo o qual pode complementar ou substituir alguns dos tratamentos endodônticos convencionais. (AU)

Introduction: with advent and creation of the laser apparatus in 1960 by Theodore Harold Maiman and posterior use in Endodontics in 1971 with Weichman, several potential applications were created for the use of lasers. This study allows the clinician a better understanding of the use of the laser in dentistry more specifically in the endodontic area. Objective: the objective of this study is to show the use of laser equipment in the endodontic area in the following modalities: Pulp diagnosis, pulp capping, pulpotomy, preparation and root canal cleaning, sterilization of root canals and photodynamic therapy (PDT), root canal irrigation, Smear layer removal and parendodontic surgery. Method: a critical literature review. Conclusion: this study provides evidence that laser equipment can be considered and used as an alternative instrument that can complement or replace some of the conventional endodontic treatments. (AU)

Cirugía de catarata asistida con láser de femtosegundo / Femtosecond laser-assisted cataract surgery

Se realizó una búsqueda en la plataforma Infomed, específicamente en la Biblioteca Virtual de Salud, con el objetivo de conocer las técnicas más avanzadas en la cirugía de córnea y de catarata. La última incorporación de estas tecnologías es el láser de femtosegundo. La aplicación del femtoláser en la cirugía de catarata podría ser una de las más grandes revoluciones ocurridas en el campo del tratamiento quirúrgico ocular en los últimos años. Actualmente se dispone en el mercado de varias plataformas de láseres de femtosegundos aprobadas para cirugía de córnea y de catarata. Hoy en día se espera una agudeza visual posquirúrgica perfecta después de la cirugía de catarata con una excelente calidad visual, e independencia de los espejuelos respecto a la visión cercana y de lejos(AU)

A search was made in Infomed platform, particularly in the Virtual Library of Health, to find out the most advanced techniques in cornea and cataract surgery. The most recent one is the femtosecond laser that may become one of the greatest revolutions in the field of ocular surgical treatment in the last few years. Several femtosecond laser platforms are now available at the market, all of them approved to be used in cornea and cataract surgery. It is expected to attain a perfect visual acuity after the cataract surgery with excellent visual quality and to free the patient from using glasses regarding the near-sight and far-sight vision(AU)

Photodynamic Therapy: A Shining Light in Periodontics.

Photodynamic therapy (PDT) uses a photoactive dye (photosensitizer [PS])that activates by exposure to light of a specific wavelength in the presence of oxygen. The energy transfer from the activated PS to available oxygen leads to the formation of reactive oxygen species, such as singlet oxygen and free radicals. These chemical species are extremely reactive and can damage proteins, lipids, nucleic acids, and other components of the bacterial cell wall. Bacterial biofilms are widely implicated in their role in the causation of gingivitis and periodontitis. Prophylactic and therapeutic regimens for dental plaque related diseases include the usage of various chemotherapeutic agents. Since it is difficult to maintain therapeutic concentrations of these agents in the oral cavity and they run the risk of being rendered ineffective by bacterial resistance mechanisms, the need for an alternative antimicrobial approach in the treatment and prevention of dental plaque related diseases was felt. Many studies have reported the killing of bacteria via lethal photosensitization including both Gram-positive and Gram-negative bacteria. Photosensitization leads to bacterial elimination, with minimal chances of microbial resistance and with no adverse effects on host tissues and resident microflora. In dentistry, PDT has found use in the treatment of oral cancers, bacterial and fungal infections, and also in the detection of malignancies. PDT is free from genotoxic and mutagenic effects; another important factor for long-term safety. The ease of accessibility of the oral cavity to illumination makes it a suitable target for PDT.

Helium Neon laser therapy for post mastectomy lymphedema and shoulder mobility

The aim of this work was to evaluate the efficacy of Helium Neon [He-Ne] laser therapy on post mastectomy lymphedema and shoulder mobility. Thirty female patients with axillary lymph node dissection [ALND], with or without radiotherapy had been participated in this study. The patients were randomly divided into two groups of equal numbers. Group A received He-Ne laser therapy and decongestive lymphatic therapy. Group B received placebo laser therapy in addition to decongestive lymphatic therapy. Measurements of limb volume and shoulder mobility [by tape measurement and standard goniometer] were collected before treatment and after six months of treatment. The mean values of limb volume and Shoulder mobility after 6 months of treatment showed a significant improvement [p < 0.05] for the two groups of the study with a greater improvement for patients in group A. Helium Neon laser therapy has a positive effect in reducing post mastectomy lymphedema and increasing range of motion of shoulder joint

Endovenous laser therapy for great saphenous vein reflux and its preliminary results

This study was conducted to describe the feasibility and short-term outcome of patients with varicose great saphenous vein [GSV] using Endovenous laser therapy [EVLA]. Between June 2010 and April 2011 EVLT is performed to 25 patients treated for varicose veins with saphenous reflux who were admitted in King Abdul Aziz university hospital consisting of 6 women and 19 men with an age ranging from 21 to 54 years [median 36 years]. In total, 31 great saphenous veins were treated by Endovenous laser therapy. Tumescent anesthesia was given before the ablation procedure. All patients were advised to return for the first follow-up after 3 weeks and to be visited earlier in the clinic if complications ensued. Patients were followed up with Doppler ultrasonography and clinic assessment at the first to third week and the first to third month after operation. All patients attended for post procedural duplex examination and clinical follow-ups. Twenty three patients [29 limbs] returned for 3-weeks follow-up. The GSV was occluded in 27 [93.1%] limbs at 3 weeks, at 3 months, 17 [19 limbs] patients continued the DUS follow-up. The recurrence of varicose GSV was not seen in 18 [94.7%] limbs. EVLA appears to be a very effective and safe option in the treatment of varicose GSV. It can be performed under local anesthesia, after EVLA treatment, patients can immediately return to their daily life activities with the improved aesthetic outcome, especially among women

Cataract and Refractive Surgery in ; a Survey of KSCRS Members From 1995~2006

PURPOSE: This purpose of this report was to study trends in cataract and refractive surgeries conducted during the past twelve years and to compare results to previous reports from the ASCRS and New Zealand (NZ) in order to forecast future medical services. METHODS: We surveyed members of the Korean Society of Cataract and Refractive Surgery (KSCRS) every year from 1995 to 2006, and studied changes in cataract and refractive surgeries (RS). RESULTS: The duration of hospitalization has been gradually decreasing to the point that a one day hospitalization following surgery has become common. The rate of topical anesthesia use has significantly increased since 1998. Sutureless incision methods are now commonly practiced. The use of acryl IOL as an optic material has been gradually increasing for cataract surgeries. KSCRS members showed an interest in the special intraocular lenses as multifocal IOL. While Excimer laser PRK was the most popular refractive surgery during the first stage, KSCRS members increasingly prefer LASIK to the Excimer laser PRK. Regression of the corrected visual acuity, dry eye, night halo, and flashes were the most common complications following refractive surgeries. Medical disputes related to PRK and LASIK have been gradually increasing throughout the study period. CONCLUSIONS: We confirm that the KSCRS practice styles for cataract and RS are similar to those of the ASCRS and NZ. We infer a world-wide trend from the comparison of these three societies.

Laser bronchoscopy: experience at Siriraj Hospital.

Laser bronchoscopy is a major procedure employed in intervention bronchoscopy. From August 1998 to August 2000, 20 patients with endobronchial lesions were treated by this procedure in the Respiratory and Tuberculosis Division of the Department of Internal Medicine, Siriraj Hospital. Of 16 malignant lesion, a good response was obtained in 78 per cent (7 out of 9) of lesions in the proximal right main bronchus with failure to open any of the 3 completely obstructed lesions at the left distal bronchus. The results of treatment of malignant lesions in the trachea and carina were acceptable. Good results were obtained from all 4 benign endobronchial obstructions. No complications arose in this study. This small series demonstrates the benefit of laser bronchoscopy in patients with high risk endobronchial obstructive lesions.

use of carbon dioxide laser to remoe small submandibular sialoliths

Six cases of small submandibular duct sialoliths were treated using carbon dioxide laser as a surgical dissector. When the laser beam encountered the small submandibular sialolith [3 mm or less], a light scattering effect [flash or burst] was observed thus enabling an almost immediate localization of the stone in the salivary duct or in the surrounding tissue. Stone extirpation is more rapid, with less surgical trauma, using this technique

Laser assisted surgery: the San Pablo experience

Two thousand plus (2,000+) assisted laser surgical procedures were performed between July 1986 and November 1993. Multiwavelength specialties: Argon, CO2 and NdYAG usage include: general surgery, thoracic surgery, neurosurgery, ophthalmology, and gynecology. 65 of the patients were female whose ages range from 6 to 105 years. Endoscopic vs. handheld procedures ratios 1:1. In 95 of the cases attended, the procedures were performed for benign conditions. The office hospital usage distribution was 60-40. The office morbidity was 0.8 (16 out of 2,000 cases) and a mortality of 0.15 (3 out of 2,000 cases). A reported 100 safety compliance was seen. Laser assisted surgery is a safe, effective and reliable option available to the surgeon's armamentarium. It appears that in some procedures it will allow shorter hospital stays and an earlier return of the patient to his/her normal routine

effect of different techniques on the results of argon laser trabeculoplasty

Patients with uncontrolled open-angle glaucoma on maximal tolerable treatment were treated with argon laser to the trabecular meshwork. Forty eyes [30 patients - 10 patients had bilateral open angle glaucoma]. These patients were divided into 4 groups. The technique of argon laser therapy is different in each group of eyes. Follow up of intraocular pressure and field changes for 6 months for each group was performed to compare between various techniques