Transurethral plasmakinetic bipolar enucleation of the prostate and diode laser enucleation of the prostate in day surgery patients / 中华泌尿外科杂志

Objective:To compare the clinical safety and the efficacy of the transurethral plasmakinetic bipolar enucleation of the prostate and diode laser enucleation of the prostate in day surgery patients.Methods:The clinical data of 99 patients with benign prostatic hyperplasia (BPH) who underwent day surgery in Zhujiang Hospital of Southern Medical University from August 2019 to August 2021 were retrospectively analyzed. Among them, 47 cases underwent transurethral plasmakinetic bipolar enucleation of the prostate (bipolar group), and 52 cases were treated with diode laser enucleation of the prostate (diode laser group). There were no significant differences in age [57.0(56.0, 61.0)years old vs. 59.0(57.0, 62.0)years old], prostate volume[(60.0±8.2)ml vs. (57.4±9.4)ml], preoperative total prostate-specific antigen (tPSA) [(1.8±0.9) ng/ml and (2.2±0.9) ng/ml], postvoid residual (PVR) [20.0(0, 40.0)ml vs. 20.0(1.3, 41.5)ml], maximum flow rate (Q max) [(9.4±2.6) ml/s vs. (9.6±1.9) ml/s], International Prostate Symptom Score (IPSS) [19.0(16.0, 21.0) vs. 19.0(18.0, 21.0)], quality of life (QOL) [5.0(4.0, 5.0)vs. 5.0(4.0, 5.0)] and International Index of Erectile Function 5 (IIEF-5) [(18.8±1.0) vs. (19.2±0.9)] score between the bipolar group and diode laser group (all P>0.05). The indexes of operation time, postoperative hemoglobin decline, blood sodium decline, bladder irrigation time, catheter indwelling time, Q max, IPSS, QOL, IIEF-5 score and so on were compared between the two groups. Results:All day surgeries were successfully completed without serious complications. The operation time of the bipolar group was less than that of the diode laser group [(57.3 ± 4.2) vs. (64.4 ± 6.3) min, P<0.001], and no statistically significant difference was found in the postoperative hemoglobin decline between the two groups [(9.8 ± 4.3) g/L vs. (8.5 ± 4.3) g/L, P=0.154]. None of the patients received transfusion treatment, and neither group of patients had severe hematuria or needed to be readmitted to hospital. There was no significant difference in the decrease of blood sodium [1.7 (1.3, 2.0) mmol/L vs. 1.7 (1.5, 1.9) mmol/L] and the postoperative bladder irrigation time [(7.7 ± 1.4)h vs. (8.0 ± 1.6)h] between the bipolar and diode laser groups ( P > 0.05). There were 8 patients in the bipolar group and 7 patients in the diode laser group who retained urinary catheter for 48-60 h due to intraoperative inflammatory changes in the prostate, and the remaining patients had their urinary catheter removed within 24 hours. The Q max of the bipolar group and the diode laser group one month after surgery were (20.4 ± 1.8) and (21.1 ± 1.7) ml/s, IPSS scores were 7.0 (7.0, 8.0) and 7.0 (7.0, 8.0), and QOL scores were 3.0 (3.0, 3.0) and 3.0 (2.0, 3.0), respectively. There were no significant differences in Q max, IPSS and QOL between the two groups (all P > 0.05). Conclusions:Transurethral plasmakinetic bipolar enucleation of the prostate is also feasible for day surgery, and the short-term postoperative Q max, IPSS, hemoglobin reduction and other indicators have no significant difference compared with diode laser enucleation of the prostate, and can achieve the same efficacy and safety as diode laser enucleation of prostate.

Experience with 808-nm diode laser in the treatment of 47 cases of oral vascular anomalies

Abstract Treatment of oral vascular anomalies (OVA) has focused on minimally invasive techniques rather than radical surgery. We investigated the efficacy and safety of diode laser using the photocoagulation technique in the management of OVA. Forty-seven subjects with OVA were treated with forced dehydration with induced photocoagulation (FDIP) using diode laser (808 nm/4.5 W). This series consisted mostly of male (63.8%) and non-white (63.8%) patients with a mean age of 57.4 years. Varices (91.5%), venous malformations (6.4%), and hemangiomas (2.1%) with a mean size of 7.1 (±4.9) mm were the conditions treated. OVA presented as a nodular lesion (63.8%) involving mainly the lower lip (46.8%). Pulsed laser mode was used as standard and the number of applications varied from one to four sessions, with the majority requiring only one (83%) FDIP session. Kaplan-Meier analysis revealed that complete clinical healing can occur on the 15th day (n=9/29.5%), followed by the 20th (n=6/45.5%), and 30th (n=7/70.5%) days. Postoperative edema was observed in 31 (66%) patients, and recurrence of the lesion occurred in two (4.2%). Based on the data on complete clinical healing, minimal patient discomfort, and satisfactory esthetic results, we can confirm that FDIP by diode laser is a promising candidate for the safe and efficacious treatment of OVA.

Histological evaluation of the surgical margins of oral soft tissue incisions using a dual-wavelength diode laser and an Er, Cr:YSGG laser; an ex vivo study

Abstract Oral soft tissue lesions require a precise diagnosis by oral biopsy with the ability to recognize these lesions within histopathological levels, so the instrument used for the incisions should be safe and cause little to no harm to the surrounding tissue. Objective This study compared a dual-wavelength diode laser and an Er, Cr:YSGG laser in oral soft tissue incisions to determine the most effective and safest laser system at the histopathological level. Methodology The (810 and 980 nm) dual-wavelength diode laser was used at 1.5 W and 2.5 W (CW) power settings, and the (2780 nm) Er, Cr:YSGG laser was used at 2.5 W and 3.5 W (PW) power settings. Both laser systems were used to incise the tissues of freshly dissected sheep tongue pieces to obtain the following histopathological criteria: epithelial tissue changes, connective tissue changes, and lateral thermal damage extent by optical microscopy. Results The epithelial and connective tissue damage scores were significantly higher in the dual-wavelength diode laser groups than in the Er, Cr:YSGG laser groups (P<0.001), and there was a significant difference between some groups. The extent of lateral thermal damage was also significantly higher in the diode laser groups than in the Er, Cr: YSGG laser groups (P<0.001), and there was a significant difference between groups. Group 2 (2.5 W) of the diode laser was the highest for all three criteria, while group 3 (2.5 W) of the Er, Cr:YSGG laser was the lowest. Conclusion The Er, Cr:YSGG laser with an output power of 2.5 W is, histologically, the most effective and safest laser for oral soft tissue incision. The dual-wavelength diode laser causes more damage than the Er, Cr:YSGG laser, but it can be used with a low output power and 1 mm safety distance in excisional biopsy.

Injectable platelet rich fibrin effect on laser depigmented gingiva: a clinical randomized controlled split mouth trial with histological assessment

Abstract Objective To determine whether intra-mucosal injection of injectable platelet-rich fibrin (i-PRF) can promote healing after Diode Laser Gingival Depigmentation (DLGD). Methodology A total of 20 arch sites of hyperpigmented gingiva of 10 patients underwent DLGD. For each patient, two arch sites were randomly assigned for either intra-mucosal injection of i-PRF (G1-i-PRF) (n=10 sites) or no treatment (G2-Control): (n=10 sites). Wound Healing Score (WHS), patient satisfaction, and Pigmentation Index (DOPI) were measured at 1 week and 1 and 3 months postoperatively. Histological assessment of tissue specimens was performed at baseline and 1 week. Results The percentage change in WHS at 1 week was significantly higher in G1 (58.34±15.43) compared to G2 (37.50±11.79). At day 1, 50% of patients in G1 were pain free compared with 75% in G2, who had mild pain. Mean DOPI decreased significantly at 3 months in both groups (P-value <0.001), without significant differences between groups. G1 specimens showed significantly higher epithelial thickness (P-value <0.001), as well as a higher number of blood vessels and less percentage of inflammatory cells. Conclusions i-PRF demonstrated better clinical and histological healing potential and less patient discomfort compared to sites without treatment after DLGD. Registered at https://clinicaltrials.gov/ as (NCT05283668).

Frenectomia lingual com laser de diodo de alta potência: relato de caso / Lingual frenectomy with high-power diode laser: a case report / Frenectomía lingual con láser de diodo de alta potencia: informe de un caso

Introdução: A laserterapia de alta potência tem estabelecido proporções satisfatórias na odontologia e se tornando a primeira opção de conduta cirúrgica para procedimentos, trazendo qualidade de vida aos pacientes e praticidade aos Cirurgiões. Objetivo: Relatar caso clínico de frenectomia lingual com uso do laser de diodo de alta potência ressaltando os benefícios da conduta. Relato de caso: Paciente sexo feminino, leucoderma, sem alterações sistêmicas, chega à Clínica Escola de Odontologia da Universidade Federal de Campina Grande, com queixa principal de alterações na sua fonologia. No exame intraoral observou-se dificuldade de movimentação lingual e em formato de coração devido a inserção fibrosa do freio, sendo observado a Anquiloglossia. Após explicações da alteração, do tratamento, e assinatura do Termo de Consentimento, foi iniciado a cirurgia: antissepsia, anestesia com vasoconstrictor, e em modo contínuo utilizou-se o laser de diodo de alta potência (TW Surgical- MMO®) configurado em 2W de potência, fibra 600µm, no comprimento de onda infravermelho, de modo que as fibras fossem separadas uniformemente e promovesse mobilidade imediata da língua, por fim realizou-se uma sutura em ponto simples com fio reabsorvível. Para o pós-operatório foi prescrito Dipirona em caso de dor, e estabelecido o acompanhamento. No retorno de 7 dias observou-se cicatrização normal e não ingestão do medicamento, em 30 dias foi visto a completa cicatrização e mobilidade sem desconforto, além de relato da paciente de melhoria na condição de relacionamentos sociais, autoestima e deglutição. Conclusão: O resultado apresentado neste artigo ratifica a benefício da escolha do laser em comparação ao convencional, demonstrando que não há sangramento no trans e pós cirúrgico, além de favorecer o processo de reparação tecidual, da redução do tempo cirúrgico, aumento do conforto, e diminuição de uso de medicamento, desta forma associando o laser cirúrgico a melhoria da qualidade de vida.

Introduction: High-power laser therapy has established satisfactory proportions in dentistry and has become the first choice for surgical procedures, bringing quality of life to patients and convenience to surgeons. Objective: To report a clinical case of lingual frenectomy using high-power diode laser, highlighting the benefits of this approach. Case report: A female patient, leucoderma, without systemic alterations, arrived at the Dental School Clinic of the Federal University of Campina Grande with the main complaint of alterations in her phonology. In the intraoral examination, difficulty in lingual movement and a heart-shaped tongue due to fibrous insertion of the frenum were observed, indicating Ankyloglossia. After explanations of the condition, treatment, and signing of the Informed Consent Form, the surgery was initiated: antisepsis, anesthesia with vasoconstrictor, and continuous mode using a high-power diode laser configured at 2W of power, 600µm fiber, at an infrared wavelength, with the aim of uniformly separating the fibers and promoting immediate tongue mobility. Finally, a simple suture was performed using absorbable thread. For the postoperative period, Dipyrone was prescribed for pain relief, and follow-up was established. At the 7-day follow-up, normal healing was observed, and the patient did not require the medication. At 30 days, complete healing and discomfort-free mobility were observed, along with the patient's testimony of improvement in social relationships, self-esteem, and swallowing. Conclusion: The results presented in this article confirm the benefits of choosing laser therapy over conventional methods, demonstrating the absence of bleeding during and after surgery, promoting tissue repair, reducing surgical time, increasing comfort, and decreasing the use of medication. Therefore, the use of surgical laser is associated with an improvement in quality of life.

Introducción: La terapia láser de alta potencia se ha establecido en proporciones satisfactorias en odontología y se ha convertido en la primera elección para procedimientos quirúrgicos, aportando calidad de vida a los pacientes y practicidad a los cirujanos. Objetivo: Relatar un caso clínico de frenectomía lingual con láser de diodo de alta potencia, destacando los beneficios de este procedimiento. Relato del caso: Paciente del sexo femenino, leucoderma, sin alteraciones sistémicas, llegó a la Clínica de la Facultad de Odontología de la Universidad Federal de Campina Grande con la queja principal de alteraciones en su fonología. El examen intraoral reveló dificultad en el movimiento lingual y lengua en forma de corazón debido a la inserción fibrosa del freno, observándose anquiloglosia. Tras explicar la alteración, el tratamiento y firmar el consentimiento, se inició la cirugía: antisepsia, anestesia con vasoconstrictor y uso continuado de un láser de diodo de alta potencia (TW Surgical- MMO®) configurado a 2W de potencia, fibra de 600µm, a longitud de onda infrarroja, para que las fibras se separaran uniformemente y favorecieran la movilidad inmediata de la lengua, y finalmente una sutura de punto único con hilo reabsorbible. En el postoperatorio, se prescribió dipirona en caso de dolor y se estableció un seguimiento. En el seguimiento a los 7 días, se observó una cicatrización normal y no se tomó medicación. A los 30 días, se observó una cicatrización completa y movilidad sin molestias, así como el informe del paciente de una mejora de las relaciones sociales, la autoestima y la deglución. Conclusión: Los resultados presentados en este artículo confirman el beneficio de la elección del láser frente a la cirugía convencional, demostrando que no hay sangrado durante ni después de la cirugía, además de favorecer el proceso de reparación tisular, reducir el tiempo quirúrgico, aumentar el confort y reducir el uso de medicación, asociando así el láser quirúrgico a una mejor calidad de vida.

Comparative evaluation of efficacy of gluma desensitiser vs diode laser in treating dentinal hypersensitivity: an in vivo study

Background: There are different types of adhesives and resins available today for the treatment of dentinal hypersensitivity. Literature search showed fewer comparative studies using gluma desensitizing agent and diode laser (940nm) in the treatment of dentinal hypersensitivity. Hence, the aim of present study is to compare the efficacy of gluma desensitizing agent and diode laser (940 nm) in the treatment of dentinal hypersensitivity. Methods: Patients were selected using VAS scale and randomly divided into group 1 (gluma) and group 2 (diode laser). Gluma and laser treatment was done for the patients on the contralateral sides. The follow up was done at an interval of 1 month and 3 months. Results: Statistically significant difference was seen in intra group comparison for both gluma and laser treatment but no statistically significant difference was seen in the intergroup comparison of both the groups. Conclusions: Both gluma and diode laser treatment were found to be equally effective for the treatment of dentinal hypersensitivity.

Surgical Treatment of Oral Fibrous Hyperplasia with Diode Laser: An Integrative Review / Tratamiento Quirúrgico de la Hiperplasia Fibrosa Oral con Láser de Diodo: Una Revisión Integradora

This study aimed to carry out an integrative review of the use of diode lasers in the treatment of oral fibrous hyperplasia in order to observe surgical efficacy, healing process, and main microscopic findings. The following databases-PubMed/MEDLINE, Embase, Virtual Health Library, Scopus, Web of Science, and gray literature-were searched without regard to the time of year or language. Diode laser treatment cases described in case reports and case series were included, but those who did not undergo microscopic analysis to confirm the diagnosis or who did not provide postoperative information were excluded. Twelve studies (64 patients) were included. Prevalence was observed for females (68.75 %, n=44). In view of the diagnosis, there was a prevalence of focal fibrous hyperplasia (79.68 %, n=51), followed by inflammatory fibrous hyperplasia (20.31 %, n=13). For surgical removal, a diode laser was used with a wavelength ranging from 808 to 960 nm, in continuous mode, and an average power of 2830 mW. In general, there were no intercurrences in the trans and postoperative periods and wound healing occurred by second intention, with excellent evolution. High-powered diode lasers can be an excellent therapeutic option for oral hyperplastic lesions. Long-term clinical trials should be conducted to determine laser setting parameters in various oral lesions.

El objetivo de este estudio fue realizar una revisión integradora sobre el uso del láser de diodo en el tratamiento de la hiperplasia fibrosa oral, con el fin de visualizar la eficacia quirúrgica, el patrón de cicatrización y el análisis de los principales resultados microscópicos. Se realizó una búsqueda sin restricciones de año e idioma en PubMed/MEDLINE, Embase, Virtual Health Library, Scopus, Web of Science y literatura gris. Se incluyeron reportes de casos y series de casos que brindaron información sobre pacientes diagnosticados con lesiones hiperplásicas orales tratados con láser de diodo, excluyendo aquellos a los que no se les había realizado análisis microscópico para confirmar el diagnóstico, así como aquellos que no brindaron información postoperatoria. Se incluyeron doce estudios (64 pacientes). Se observó prevalencia en el sexo femenino (68,75 %, n=44). Ante el diagnóstico, predominó la hyperplasia fibrosa focal (79,68 %, n=51), seguida de la hiperplasia fibrosa inflamatoria (20,31 %, n=13). Para la remoción quirúrgica se utilizó un láser de diodo con una longitud de onda de 808 a 960 nm, en modo continuo, y una potencia promedio de 2830 mW. En general, no hubo intercurrencias en el trans y postoperatorio y la cicatrización de la herida ocurrió por segunda intención, con excelente evolución. El uso de láseres de diodo de alta potencia puede ser una excelente alternativa terapéutica para las lesiones hiperplásicas orales. Se deben realizar más estudios clínicos a largo plazo para determinar los parámetros de ajuste del láser en diferentes lesiones orales.

Short-term outcomes of micropulse transscleral cyclophotocoagulation as a primary versus additional therapy in eyes with uncontrolled glaucoma

Purpose: To study the safety and efficacy outcomes of Micropulse Transscleral Cyclophotocoagulation (MP?TSCPC) as a primary versus additional therapy in eyes with uncontrolled glaucoma. Methods: This was a prospective, interventional, comparative study. All patients with advanced and refractory glaucoma treated with MP?TSCPC from April 2020 to December 2020 were recruited in this study. Results: A total of 77 eyes of 77 patients were analyzed. Group A (n = 33), included patients with advanced glaucoma at high risk for invasive surgery, who underwent MP?TSCPC as the primary intervention, and group B (n = 44) included patients who had undergone previous surgical intervention and MP?TSCPC was used additionally to control the intraocular pressure (IOP). Mean IOP and mean number of antiglaucoma medications were 34.06 (13.9) mmHg and 3.64 (0.7), respectively, in group A and 35.61 (11.5) mmHg and 3.73 (0.9), respectively, in Group B. Postoperatively, the mean IOP and percentage of IOP reduction were significantly lower at 1, 3, and 6 months, that is, 20.78 (32%), 22.07 (30%), and 19.09 (37%), respectively, in group A and 23.68 (35%), 19.50 (44%), and 19.61 (42%), respectively, in group B, but there was no difference between the groups at all visits. Postoperative need for ocular hypotensive drugs did not differ in group A (P = 0.231); however, it was significantly lower in group B (P = 0.027). Group A had 87%, 77%, and 74% success rates at 1, 3, and 6 months, respectively, whereas group B had 91%, 86%, and 77% success rates at 1, 3, and 6 months, respectively. Postoperative complications and intervention did not reveal any statistical difference between the two groups. Conclusion: MP?TSCPC may be considered as a temporizing measure both as a primary or as an additional intervention to control the IOP in eyes with refractory and advanced glaucoma that have a high risk of vision?threatening complications with invasive surgery.

Clinical application progress on the diode laser in nonsurgical periodontal treatment / 口腔疾病防治

@#Chronic periodontitis is a chronic inflammatory disease caused by plaque microorganisms, and removal of plaque and calculus is the gold standard for nonsurgical periodontal treatment. However, complete debridement is difficult, especially in some complex anatomical sites. Excessive scaling may result in the loss of healthy cementum and lead to dental hypersensitivity. Studies have shown that a diode laser can exhibit the best performance in an environment with blood because its wavelengths (630-1 064 nm) are close to the absorption peaks of heme and melanin and they have broad application prospects in the oral field. In nonsurgical periodontal treatment, diode lasers have three treatment modes: soft diode laser, antimicrobial photodynamic therapy and low-level laser therapy, which can be used alone or in combination. Although diode lasers cannot replace mechanical treatment to remove calculus, they can remove infected periodontal pocket epithelium, change the microcirculation to promote wound healing, reduce bleeding and relieve pain through photothermal effects and biological stimulation. The effect of diode laser treatment depends on the treatment dose. It is necessary to precisely control the output intensity and control the irradiation time to avoid thermal damage to the tissue. In the future, extensive research at the molecular level is needed to reveal the tissue response. At the same time, more high-quality, large-sample randomized controlled trials are needed to standardize the use of lasers for different stages and grades of periodontitis.

Application and research progress of diode laser in the treatment of peri-implant diseases / 口腔医学

@#Laser therapy has become an important means of treating peri-implant diseases, and diode laser shows unique advantages in the adjuvant therapy of peri-implant diseases due to its excellent biological regulation, sterilization effect and biological safety. This article reviews the principle, characteristics, safety, biological effects of and clinical research on diode laser, in order to provide reference for its clinical application in the treatment of peri-implant diseases.

Accommodative Gain in Presbyopic Eye Using a New Procedure of Laser Scleral Softening (LSS): Part-II. Formulas for Volume Efficacy

Purpose: To derive and provide, for the first time, comprehensive analytic formulas for scleral softening volume efficacy (SVE) for accommodative gain (AG) via the increased space between ciliary body and lens (SCL) and mobility of the posterior vitreous zonules (PVZ).Study Design: To increase the AG of presbyopic eye by a new procedure, laser scleral softening (LSS).Place and Duration of Study: New Taipei City, Taiwan, between June 2022 and July 2022.Methodology: The SVE is calculated based on the time and spatial integral of the scleral temperature profiles, T(z,t), solutions of a heat diffusion equation. Analytic formulas for SVE is derived based on the covered area given by a triangle area. The SVE of a 3-D model is governed by the "volume" covered by the laser beam, or its spot size area, the effective penetration depth (z"), which is an increasing function of laser dose, but a decreasing function of the absorption coefficient (A), due to the Beer's law of laser intensity, I(z)=I0exp(-Az). The efficacy depth-range (dZ) and time-ranges (dT) are defined for efficient softening with T(z,t)>T*, where T* is the scleral softening threshold temperature.Results: The accommodative gain is proportional to the 3-D SVE given by: SEV(3D) = SEV(1D) x laser beam spot (2-D area) x total number of spots (N) acting on the sclera, which is proportional to the efficacy ranges dZ and dT, in which dZ is an increasing of laser irradiation time, whereas dT is a decreasing function of depth. Softening of the scleral tissue after a thermal laser leading to the increase of PVZ mobility and SCL. However, the actual relation of SVE and the PVZ and SCL changes require measured data.Conclusion: Safety and efficacy of scleral softening for presbyopia treatment depend upon the laser parameters (intensity, dose, spot size, wavelength) and the effective depths. The SVE is proportional to the efficacy depth-range (dZ) and time-range (dT), in which dZ is an increasing of laser irradiation time and dT is a decreasing function of depth. The AG is proportional to the SVE(in 3-D).

Efficacy Theory and Proposed Protocol for Presbyopia Correction using Scleral Softening by Non-invasive Infrared Diode Lasers

Purpose: To derive and provide analytic formulas and proposed protocol for accommodative gain of presbyopia eyes via laser scleral softening, which causes increased space between ciliary body and lens (SCL) and mobility of the posterior vitreal zonules (PVZ).Study Design: To increase the accommodation of presbyopia by laser scleral heating/softening.Place and Duration of Study: New Taipei City, Taiwan, between April 2022 and June 2022.Purpose: To analyze the safety and efficacy of presbyopia treatment via scleral softening.Methodology: The scleral softening efficacy is calculated based on the rate equation of scleral tissue with a rate coefficient given by an Arrhenius formula, Temperature spatial and temporal profiles are given by the numerical solutions of a heat diffusion equation with a volume heating source. Various effective depths including tissue damage depth, temperature penetration depth and conversion depth, governed by tissue absorption coefficient, light intensity and dose (or irradiation time), and the related threshold values, are introduced in replacing the conventional penetration depth based on a Beer's law.Results: Given the the temperature spatial and temporal profiles, scleral softening efficacy can be calculated. Scleral surface damage can be prevented by cooling window. The suggested protocol for scleral softening treatments include: a diode laser at about 1.45 to 1.5 祄 or about 1.86 to1.9 祄, or about 2.0 to 2.15 祄, wavelength (with absorption coefficient about 20 to 100 cm-1); laser power about 0.2 to 0.8 W per spot, having a total of 4 to 16 spots; and irradiation time of 100 to 600 ms. Results of corneal thermal shrinkage are demonstrated by the topography changes of pig eyes, in which the scleral softening does not affect the corneal shapes. The accommodative gain is proportional to the softening efficacy (Seff) of the scleral tissue after a thermal laser leading to the increase of PVZ mobility and SCL. However, the actual relation of Seff and the PVZ and SCL changes require measured data.Conclusion: Safety and efficacy of scleral softening for presbyopia treatment depend upon the laser parameters (intensity, dose, spot size, wavelength) and the effective depths. By choosing the laser treated areas, a dual function treatment using scleral softening for presbyopia, and cornea stromal shrinkage for hyperopia is proposed and demonstrated by topography of pig eyes.

Efficacy Analysis of Corneal Photo-vitrification (CPV) for Improved Vision of Age-related Macular Degeneration (AMD) Eyes

Purpose: To analyze the safety and efficacy of corneal photovitrification (CPV) for improved visions of age-related macular degeneration (AMD) eyes.Study Design: Using CPV for improved visions of AMD eyes.Place and Duration of Study: New Taipei City, Taiwan, and Austin, TX, USA; between April, 2022 and June, 2022.Methodology: The CPV efficacy is calculated based on the rate equation given by dM/dt=-k(t) M(t), where M(t) is the PCV-treated corneal stroma; and k(t) is the rate coefficient given by an Arrhenius formula, k(t) = A0 exp[?Ea/(RT(t,z)], where t and z are the laser irradiation time and depth of the cornea stroma; Ea is the activation energy and R is the gas constant. The temperature spatial and temporal profiles are given by the numerical solutions of a heat diffusion equation with a volume heating source. Various effective depths including the tissue damage depth, temperature penetration depth and conversion depth, governed by the tissue absorption coefficient, light intensity and dose (or irradiation time), and the related threshold values, are introduced in replacing the conventional penetration depth based on a Beer's law.Results: The suggested protocol for CPV treatments include: a diode laser at about 2 祄 wavelength (with absorption coefficient about 100 cm-1). The laser dose is about 25 J/cm2/spot and irradiation time of 150 ms.Conclusion: The efficacy of CPV may be predicted/calculated by our modeling based on rate equation and the corneal stroma temperature rise due to laser heating. The preferred retinal locus (PRL) movement observed post-CPV is caused mainly by neuroadaptation.

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

High-power laser for periodontal surgery in a patient with glanzmann thrombasthenia / Laser de alta potência para cirurgia periodontal em paciente com trombastenia de glanzmann

Background: Glanzmann thrombasthenia (GT) is a rare autosomal recessive disorder characterized by platelet function impairment. Considering that the oral cavity is highly vascularized and performing some local hemostatic maneuvers may be difficult, GT patients are at high risk for hemorrhage related to invasive oral procedures. This study aimed to present an alternative method for periodontal surgery in a young GT patient. Case Report: A 15-year-old female GT patient with a recent history of excessive bleeding following dental surgeries was referred to a public dental center, presenting gingival hyperplasia. The procedure was performed using a high-power laser (HPL), and except for local anesthesia with epinephrine, no further hemostatic agent was necessary. Conclusion: According to the case, the HPL seems to be an efficient tool for preventing perioperative bleeding in GT patients submitted to minor oral surgeries(AU)

Introdução: A trombastenia de Glanzmann (TG) é uma doença autossômica recessiva rara caracterizada por comprometimento da função plaquetária. Tendo em vista que a cavidade oral é altamente vascularizada e a realização de algumas manobras hemostáticas locais pode ser difícil, pacientes com TG apresentam alto risco de hemorragia relacionada a procedimentos orais invasivos. Este artigo teve como objetivo apresentar uma técnica alternativa para cirurgia periodontal em um paciente jovem com TG. Relato de Caso: Paciente com TG, sexo feminino, 15 anos, com história recente de sangramento excessivo relacionado a cirurgias odontológicas prévias, foi encaminhada a um centro odontológico público apresentando hiperplasia gengival. O procedimento de remoção foi realizado com laser de alta potência e, com exceção da anestesia local com epinefrina, nenhum outro agente hemostático foi necessário. Conclusão: De acordo com o caso, o laser de alta potência parece ser uma ferramenta eficiente na prevenção de sangramento perioperatório em pacientes com TG submetidos a pequenas cirurgias orais(AU)

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

Safety and efficacy of 980nm diode laser in the treatment of scrotal angiokeratoma / 中华泌尿外科杂志

Scrotal angiokeratoma(Fordyce angiokeratoma)is often seen in elderly men presenting nodular hemorrhage. In this study, 8 cases of scrotal angiokeratoma were treated with 980nm diode laser. All the operations were successfully completed under local anesthesia without obvious complications and local symptoms improved. The results showed that 980nm diode laser is an alternative operation for the treatment of scrotal angiokeratoma.

Sodium Fluoride Varnish in Management of Dentin Hypersensitivity Associated with Gingival Recession

ABSTRACT@#Using laser for treatment of dentin hypersensitivity (DH) have recently shown promising results and better immediate reduction in pain scores. However, its efficacy and mechanism of action is controversial. Thus, this study aimed to evaluate the effectiveness of diode laser compared with sodium fluoride varnish in treating DH in patients with gingival recession. Eighteen patients with Miller’s class I and class II gingival recession and hypersensitivity in at least two non-adjacent teeth were included in the study. Test surfaces (n = 25) were treated with diode laser, whilst control surfaces (n = 23) were treated with 5% sodium fluoride varnish. Visual Analogue Scale (VAS) scores were recorded for air and tactile stimulus for both groups at baseline, 15 min, 1 month and 3 months post-treatment. Results showed significant (p < 0.05) reduction in VAS scores at 15 min, 1 month and 3 months compared with baseline in both test and control surfaces, with no significant intergroup differences. However, the percentage reduction in DH was more in laser at all evaluation periods. The use of diode laser and sodium fluoride varnish showed good immediate and prolonged results. Further studies are needed to come up with more effective treatment methods.

Research progress on diagnosis and treatment of gingival pigmentation / 口腔疾病防治

@#Gingival pigmentation(GP) manifests as dark pigmentation spots, such as black or brown spots, in the gums. It is mostly caused by the deposition of melanin particles secreted by melanocytes on the gingival epithelium. The influencing factors may be divided into two categories, exogenous and endogenous. Exogenous factors include heavy metals, tattoos, smoking or drug use, and endogenous factors are related to certain diseases. The clinical grading of GP helps make a reasonable assessment of the necessity of treatment and prognosis. The Dummett-Gupta oral pigmentation index is a commonly used grading method, and the new grading method formed by combining the etiology and clinical manifestations described the patient’s situation more comprehensively. It is necessary to ask for a detailed medical history, complete examination, and correctly differentiate between physiological GP and GP caused by pathological state. Laser treatment is the currenttreatment with a better treatment effect and higher patient acceptance, and it is more comfortable and convenient, including diode laser, Er: YAG laser, and Nd: YAG laser, etc. This article summarizes the formation factors, clinical manifestations and treatment methods of GP to provide ideas for the clinical diagnosis and treatment of GP.

Influence of diode laser and warm air drying on the shear bond strength of Lithium di-silicate to Dentin. An in-vitro study / Influência do laser de diodo e da secagem com ar quente na resistência ao cisalhamento do Di-silicato de Lítio a dentina. Um estudo in-vitro

Objective: The current study aimed to evaluate the effect of diode laser irradiation (980 nm) and warm air drying (50°C) on shear bond strength between Lithium di-silicate (IPS e.max; Ivoclar) and human dentin using both (Etch & Rinse) adhesive, Adper™ Single Bond 2 (3M ESPE) and (Self-etch) adhesive, Single Bond UniversalTM(3M ESPE) before adhesive polymerization. Material and Methods: 54 sound lower molars were sectioned to obtain flat dentinal surfaces. Specimens were divided into 2 equal groups (n=27): Group 1 (ER) and Group 2 (SE) according to bonding approach. Each subgroup was subdivided according to dentin surface treatment into 3 equal subgroups (n=9): Control (Co), Diode laser irradiation (L) and Warm air drying (W). All specimens were adhesively cemented to IPS e.max® CAD discs using RelyX™ Ultimate Clicker™(3M ESPE) resin cement. Samples were then subjected to pre-loading in a thermodynamic manner. All samples were tested for shear bond strength using computer-controlled material testing machine. Data analysis was performed using two-way (ANOVA) (p< 0.05) followed by pair-wise Tukey's post-hoc tests. Results: In (SE) group, the subgroup (W) had the highest shear bond strength values followed by (Co) subgroup and the least was (L) subgroup with statistically significant difference. As for (ER) group, the subgroup (W) had the highest shear bond strength values followed by (Co) subgroup and the least was (L) subgroup with no statistically significant difference. Conclusion: Warm air drying for (SE) bonding approach increased shear bond strength of Lithium di-silicate to human dentin and can be introduced as a new effective protocol.(AU)

Objetivo: o objetivo do estudo atual é avaliar o efeito da radiação do laser de diodo (980nm) e secagem de ar quente (50°C) na resistência ao cisalhamento entre dissilicati de Lítio (IPS e.max; Ivoclar) e a dentina humana usando ambos modelos de adesivos (condicionamento total) Adper™ Single Bond e (auto-condicionante) Single Bond Universal™ (3M ESPE), Single Bond UniversalTM (3M ESPE) antes da fotopolimerização. Material e Métodos: 54 segundos molares inferiores foram selecionados para obter superfícies dentinárias planas. Os espécimes foram divididos em 2 grupos iguais (n=27): grupo 1 (ER) e grupo 2 (SE) de acordo com protocolo de adesividade. Cada grupo foi subdividido de acordo com o tratamento de superfície dentro de 3 subgrupos iguais (n=9): Controle (co), irradiação com laser de diodo (L) e secagem com ar quente (W). Todos os espécimes foram adesivamente cimentados a discos de IPS emax CAD usando RelyX Ultimate Clicker (3M ESPE) cimento resinoso. As amostras foram então submetidas a pré-carregamento de forma termodinâmica. Todas as amostras foram testadas para resistência a cisalhamento usando máquina de teste de materiais controlados por computador. A análise de dados foi realizada usando ANOVA dois fatores (p<0.05) seguindo por testes de Tukey pareado como test post-hoc. Resultados: No grupo (SE), o subgrupo (W) apresentou maiores valores de resistência ao cisalhamento seguindo o subgrupo (Co) é o menor foi o subgrupo (L) com diferença estatisticamente significativa. Já para o grupo (Er), o subgrupo (W) apresentou os maiores valores de resistência ao cisalhamento seguido do grupo (Co) e o menor foi o subgrupo (L) sem diferença estatisticamente significante. Conclusão: a secagem com ar quente para a abordagem de adesividade (Se) aumentou a resistência ao cisalhamento do dissilicato de lítio à dentina humana e poderia ser introduzido como um novo e eficaz protocolo(AU)