Diode laser – A cure for obstinate oral lichen planus: A case series and review of the literature

Oral lichen planus (OLP) is a chronic T-cell mediated inflammatory disease of unknown etiology. Hence, no gold standard treatment modalities are available. Due to therapeutic challenges offered by conventional therapy, there is a need for effective alternate treatment with minimal side effects. The development of lasers has brought light to the treatment of obstinate OLP. Three cases of male patients in the age group 30–40 years complaining of a burning sensation in the mouth have been mentioned. Clinical and histopathological investigations showed typical findings of OLP. The treatment was started with conventional therapy of corticosteroids. The symptoms were assessed on the visual analog scale (VAS) and showed marked reduction but without complete alleviation. Hence, ablation of the lesion using a 980 nm soft-tissue diode laser was planned. The outcome of the treatment was successful, VAS 0 and no recurrence occurred in 11 months follow-up. The results of a 980 nm diode laser for the treatment of OLP are satisfactory and should be considered as a treatment alternative to conventional remedies

Treatment of Trans-Sphincteric Fistula-In-Ano with Combined Therapy of Laser and Kshara Sutra

Fistula-in-ano is most infectious disease among all the ano-rectal disorders since ancient times. Over the past few decades, various techniques are being evaluated in terms to prevent its recurrence and complications; it is still a challenging surgical disease. The sign and symptoms of fistula in ano resembles with Bhagandar described in Ayurvedic classics. Kshara sutra therapy (medicated thread) practiced in Ayurveda Since ancient time for the management of Naadi Vrana and Bhagandar. Kshara sutra therapy has revolutionized the treatment of fistula-in-ano, as it treat the main culprit of fistula that is cryptoglandular origin but the drawback of Kshara sutra therapy are as it takes more number of hospital visit, long anxiety period and discomfort. In present time LASER therapy is used in various medical surgery and also in proctology like in fistula as FILAC, DLPL etc. Diode LASER 980nm (Radial Fibre) burns unhealthy granulation tissues in 360° manner with less or minimal pain, LASER act as photo evaporation effect and leads to the shrinkage of the fistula tract. But if we do LASER in internal opening of fistula it provides a bare area for microbes and creates a chance to re-infects the crypts and anal glands, which further leads recurrent fistula formation. Therefore a novel technique for sphincter preserving surgery proposed as combined therapy of Kshara sutra ligation for main culprit that is cryptoglandular infection as SMAK (Sub Mucosal Application of Kshara Sutra) and LASER, shrink the remaining fistula tract instantly

Diode laser vaporization of prostate versus transurethral resesction of prostate in treating benign prostatic hyperplasia: a Meta-analysis / 中国内镜杂志

Objective To systematically review and evaluate the perioperative indicators and surgical curative effect of 980 nm diode laser vaporization of prostate and transurethral resesction of prostate (TURP) in treating benign prostatic hyperplasia (BPH). Methods Retrieved published comparative studies 980 nm diode laser vaporization of prostate versus transurethral resesction of prostate in treating benign prostatic hyperplasia, and pooled the data from eligible studies. The statistical analysis was performed using Revman 5.3 software. Results Six trials including 839 patients were eligible to the criteria (450 in 980 nm diode laser group and 389 in TURP group). The baseline of patients characteristics were comparable in all the studies. Meta analysis showed that: the operative time was not significantly different between the 980 nm diode laser group and TURP group [SMD = 0.11, 95 ~ CI (-0.52,0.74), P > 0.05]; Compared with TURP group, 980 nm diode laser group has shorter hospital stays [SMD = -1.95, 95%CI (-3.42, -0.48), P 0.05], QOL [SMD = 0.00, 95%CI (-0.57, 0.57), P > 0.05] and Qmax [SMD = 0.06, 95%CI (-0.26, 0.37), P > 0.05]. Conclusion 980 nm diode laser vaporization of prostate is safe and effective in treating benign prostatic hyperplasia, and compared with TURP, it has advantages in shorter hospital stays and shorter catheterization time.

Efficacy of a 980-nm laser percutaneously delivered through an optical fiber for the treatment of 167 cases of vascular malformation: a clinical observation / 中华皮肤科杂志

Objective To evaluate the efficacy and safety of endoscopy-assisted percutaneous interventional procedure with a 980-nm laser for the treatment of venous malformations.Methods A total of 167 patients with venous malformation were enrolled,including 102 females and 65 males,whose age ranged from 0.5 to 60 years.Skin lesions occurred on the limbs in 66 patients,on the head and face in 48,on the chest and abdomen in 24,on the back in 13,on the neck in 10,as well as on the scrotum in 6.A 980-nm laser operated at pulse width of 0 ms-2.5 s and pulse energy of 0-20 W with a 400 μm-diameter optical fiber.Puncture was performed after circular infiltration anesthesia around skin lesions,and then the optical fiber was inserted at the same puncture point to directly or indirectly destruct the vascular wall by photothermal effects and thermal coagulation.For deep lesions around important anatomical structures,the interventional therapy was performed with the assistance of endoscopy or ultrasound.According to the size and shape of tumors,these tumors were irradiated back and forth with speeds of 2 cm/s-4 cm/s.The optical fiber was also inserted in different directions in a fan-shaped pattern for 3-5 sessions until tumors were shrunken or even disappeared.The time interval between two treatments was 3 months,and all the patients were followed up for 4 months on average.Results Of the 167 patients,148 (88.6％)were cured,11 (6.6％) markedly improved,4(2.4％) improved,and 4(2.4％) unimproved.The response rate was 97.6％.Totally,159 patients were satisfied with the therapeutic effects after 1 session of treatment,and 8 were improved after 2 sessions of treatment with a time interval of 3 months.In addition,mild postoperative pigmentation occurred in 6 (3.6％) cases,and skin burns in 3 (1.8％) cases.After 3 months,the above symptoms were improved significantly.Two (1.2％) patients had vascular recanalization and residual lesions,but they were improved after reoperation.No adverse reactions were observed,such as bleeding,scar,tendon and nerve injuries,and dysfunction.Conclusion A 980-nm laser percutaneously delivered through an optical fiber is safe and effective for the treatment of venous malformation.

The efficiency of root canal disinfection using a diode laser: In vitro study.

Aims: The aim of this study is to verify the disinfection of diode laser, following chemo-mechanical procedures against Enterococcus fecalis. Materials and Methods: Crowns of 30 extracted premolar teeth were sectioned at the cemento- enamel junction. The canals were shaped using step-back technique to K-file #40. The teeth were randomly assigned to three groups and placed into nutrient broth containing bacterial suspension of Enterococcus fecalis. Group A received no laser radiation. Specimens of group B and C were treated with diode laser (Sirona) with energy set at 1.5 and 3 W, respectively. After laser irradiation, the teeth were placed in vials, which contained 2 mL of the nutrient broth. The vials were incubated at 37°C for 24 h. Grown colonies were identified by standard methods. Statistical Analysis Used: Statistical analysis used was the nonparametric Kruskal-Wallis test, with comparison using the Bonferroni methods of means. Results: Higher mean CFU/mL is recorded in Group A (without laser disinfection) followed by Group B (with 1.5 W laser disinfection) and Group C (with 3 W laser disinfection), respectively. The difference in CFU/mL between the three groups is found to be statistically significant ( P < 0.001). Conclusions: The results of this research show that the 980 nm diode laser can eliminate bacteria that has immigrated into dentin, thus being able to increase the success rate in endodontic therapy.

Transcanalicular diode laser-assisted dacryocystorhinostomy.

Objective: We present a prospective, non-comparative case series study of 126 consecutive diode laser-assisted transcanalicular dacryocystorhinostomy (TCL-DCR) procedures on 122 patients. We analyzed success rate, procedure time and amount of laser energy needed for a 5 mm osteotomy. Materials and Methods: One hundred and twenty-two patients with nasolacrimal duct obstruction were included in the study. The procedure was performed under general anesthesia, and the nasal mucosa was anesthetized. An endoscope was used for examination of the lacrimal pathways. The site of osteotomy was determined with transillumination of the lateral nasal wall. We achieved osteotomy by applying laser energy via an optic fiber. We used a 980 nm diode laser with power of 10 Watts. We inserted a bicanalicular silicone stent as the last step. Success of procedure was absence of epiphora (subjective), or patency of the lacrimal drainage system on irrigation (objective). Results: We performed 126 successive endoscopic laser (EL-DCR) with bicanalicular intubation in 122 patients. The average procedure time was 12 min, and on average 245 Joules of laser energy was needed. The silicone stents were removed three to eight months after surgery. We observed absence of epiphora and a patent nasolacrimal duct on irrigation in 105 out of 126 treated eyes. Eighteen patients had epiphora despite a patent nasolacrimal duct on irrigation. This yields a success rate of 83.3%, with an average follow-up period of 12 months. Conclusions: The 980 nm EL-DCR with bicanalicular intubation is a new contribution to the field of lacrimal surgery. It is a minimally invasive quick procedure yielding a high success rate.