effectiveness of fractional CO[2] LASER in treatment of striae rubra and striae alba: a comparative study

Background: Striae distensae are a well-recognized, common skin condition that rarely causes any significant medical problems but are often a significant source of distress to those affected. The natural evolution of striae is from red or purple, raised wavy lesions [striae rubra] to white atrophic lesions with wrinkly surface [striae alba]

Aim of the Work: was to compare the efficacy of the fractional CO2 laser in the treatment of striae rubra versus striae alba

Patients and Methods: The present study included 20 patients above the age of 18 of both sexes; 10 patients had striae rubra and 10 patients had striae alba. They were recruited from Dermatology outpatient clinic in Ain Shams University Hospital from June 2017 to January 2018. 4 sessions of Fractional CO2 Laser for each patient were performed one month apart. The treated striae were randomly selected from each patient [Striae rubra and alba] and were assessed before starting treatment, at the beginning of every session and one month after the last session as regards length, width, texture, color of striae and any complications encountered

Results: No significant difference was found on comparing the clinical response [improvement of color P= 0.653], [improvement of atrophy P= 0.606], side effects [Hyperpigmentation P= 0.531], [Pain P=0.606], [Hypopigmentation P=0.305], [Erythema P= 0.060], of both striae alba and rubra to the laser treatment

Conclusion: The present study showed significant clinical improvement in both types of striae distensae treated by Fractional CO2 Laser with non-significant difference between the 2 groups except the development of erythema in striae rubra group. Furthermore, the histological improvement was significant for both groups with low incidence of the side effects

Recommendations: Larger scale studies with longer follow up period are recommended to further clarify the role of fractional CO2 laser in treatment of striae distensae

Does the CO2 laser reduce bond strength in different types of ceramic brackets?

ABSTRACT OBJECTIVE: The aim of this study was to assess in vitro the influence of the CO2 laser and of the type of ceramic bracket on the shear bond strength (SBS) to enamel. METHODS: A total of 60 enamel test surfaces were obtained from bovine incisors and randomly assigned to two groups, according to the ceramic bracket used: Allure (A); Transcend (T). Each group was divided into 2 subgroups (n = 15): L, laser (10W, 3s); C, no laser, or control. Twenty-four hours after the bonding protocol using Transbond XT, SBS was tested at a crosshead speed of 0.5 mm/min in a universal testing machine. After debonding, the Adhesive Remnant Index (ARI) was evaluated at 10 x magnification and compared among the groups. Data were analyzed by one-way ANOVA, Tukey’s, Mann-Whitney’s and Kruskal-Wallis tests (α = 0.05). RESULTS: Mean SBS in MPa were: AL = 0.88 ± 0.84; AC = 12.22 ± 3.45; TL = 12.10 ± 5.11; TC = 17.71 ± 6.16. ARI analysis showed that 73% of the specimens presented the entire adhesive remaining on the tooth surfaces (score 3). TC group presented significantly higher SBS than the other groups. The lased specimens showed significantly lower bond strength than the non-lased groups for both tested brackets. CONCLUSION: CO2 laser irradiation decreased SBS values of the polycrystalline ceramic brackets, mainly Allure.

RESUMO OBJETIVO: o objetivo deste estudo foi avaliar in vitro a influência do laser de CO2 sobre a resistência ao cisalhamento da colagem (RCC) no esmalte dentário, usando diferentes tipos de braquetes cerâmicos. MÉTODOS: no total, 60 superfícies de esmalte de incisivos bovinos foram obtidas e aleatoriamente divididas em dois grupos, de acordo com o braquete cerâmico utilizado: Allure (A) e Transcend (T). Cada grupo foi dividido em dois subgrupos (n = 15): L, laser (10W, 3s); C, sem laser, ou controle. Vinte e quatro horas após a colagem dos braquetes com o sistema Transbond XT, foi realizado o teste de resistência ao cisalhamento, com velocidade de 0,5 mm/min, em máquina universal de ensaios mecânicos. Após a descolagem, o Índice de Remanescente de Adesivo (IRA) foi avaliado com aumento de 10X e comparado entre os grupos. Os dados foram analisados pelo ANOVA one-way, testes de Tukey’s, Mann-Whitney’s e Kruskal-Wallis (α = 0,05). RESULTADOS: as médias da RCC em MPa foram: AL = 0,88 ± 0,84; AC = 12,22 ± 3,45; TL = 12,10 ± 5,11; TC = 17,71 ± 6,16. A análise do IRA mostrou que 73% dos corpos de prova apresentaram todo o compósito remanescente aderido à superfície do esmalte (escore 3). O grupo TC apresentou valor significativamente maior de RCC do que os outros grupos. Os corpos de prova dos grupos com laser obtiveram valores adesivos significativamente menores do que os corpos de prova dos grupos sem laser, com ambos os tipos de braquetes. CONCLUSÃO: a irradiação com laser de CO2 diminuiu os valores de RCC dos braquetes policristalinos testados, principalmente do Allure.

Bartholin's gland cysts: management with carbon-dioxide laser vaporization / Cistos da glândula de Bartholin: tratamento com vaporização laser com CO2

PURPOSE: To evaluate the effectiveness, recurrence rate, and complications of carbon-dioxide laser vaporization in the treatment of Bartholin's gland cysts. METHODS: A retrospective study including 127 patients with symptomatic Bartholin' gland cysts submitted to carbon-dioxide laser vaporization at our institution from January 2005 to June 2011. Patients with Bartholin's gland abscesses and those suspected of having neoplasia were excluded. All procedures were performed in an outpatient setting under local anaesthesia. Clinical records were reviewed for demographic characteristics, anatomic parameters, intraoperative and postoperative complications, and follow-up data. Data were stored and analyzed in Microsoft Excel® 2007 software. A descriptive statistical analysis was performed, and its results were expressed as frequency (percentage) or mean±standard deviation. Complication, recurrence, and cure rates were calculated. RESULTS: The mean age of the patients was 37.3±9.5 years-old (range from 18 to 61 years-old). Seventy percent (n=85) of them were multiparous. The most common symptom was pain and 47.2% (n=60) of patients had a history of previous medical and/or surgical treatment for Bartholin's gland abscesses. Mean cyst size was 2.7±0.9 cm. There were three (2.4%) cases of minor intraoperative bleeding. Overall, there were 17 (13.4%) recurrences within a mean of 14.6 months (range from 1 to 56 months): ten Bartholin's gland abscesses and seven recurrent cysts requiring reintervention. The cure rate after single laser treatment was 86.6%. Among the five patients with recurrent disease that had a second laser procedure, the cure rate was 100%. CONCLUSIONS: At this institution, carbon-dioxide laser vaporization seems to be a safe and effective procedure for the treatment of Bartholin's gland cysts.

OBJETIVO: Avaliar a eficácia, a taxa de recorrência e as complicações da vaporização laser com CO2 no tratamento dos cistos da glândula de Bartholin. MÉTODOS: Estudo retrospectivo com 127 pacientes que apresentavam cistos sintomáticos da glândula de Bartholin submetidas à vaporização laser CO2 na nossa instituição de janeiro de 2005 a junho de 2011. Foram excluídas todas as pacientes com abcessos da glândula de Bartholin ou com suspeita de câncer. Todos os procedimentos foram realizados em regime ambulatorial, sob anestesia local. A coleta dos dados foi feita com base na consulta do processo clínico, tendo-se procedido à análise das características demográficas, dos parâmetros anatômicos, das complicações intra e pós-operatórias e dos dados de acompanhamento. Os dados foram armazenados e analisados no software Microsoft Excel® 2007, e os resultados foram apresentados como frequência (porcentagem) ou média±desvio padrão. As taxas de complicações, recorrência e cura foram calculadas. RESULTADOS: A idade média das pacientes foi de 37,3±9,5 anos (variando entre 18 e 61 anos). Setenta por cento (n=85) delas eram multíparas. A queixa mais frequente foi dor e 47,2% (n=60) das pacientes tinham antecedentes de tratamento médico e/ou cirúrgico por abcesso da glândula de Bartholin. A dimensão média dos cistos foi de 2,7±0,9 cm. Foram verificados três (2,4%) casos de hemorragia intraoperatória ligeira e 17 (13,4%) recorrências durante um período médio de 14,6 meses (variando entre 1 e 56 meses): dez abscessos da glândula de Bartholin e sete cistos recorrentes, que precisavam de uma nova intervenção cirúrgica. A taxa de cura após um único tratamento à laser foi de 86,6%. Dentre as cinco pacientes com doença recorrente que foram submetidas a um segundo procedimento com laser, a taxa de cura foi de 100%. CONCLUSÕES: Na presente instituição, a vaporização laser com CO2 parece ser uma opção terapêutica segura e eficaz no tratamento dos cistos da glândula de Bartholin.

Morphological alterations of the surfaces of enamel and dentin of deciduous teeth irradiated with Nd: YAG, C0(2)and diode lasers / Alteraciones morfológicas de las superficies de esmalte y dentina de dientes deciduos irradiados con láseres de Nd: YAG, C0(2) y diodo

In this work, we studied the effects of C0(2), Nd:YAG and diode lasers on the enamel and dentin of deciduous human teeth. After the irradiations, the samples were duly prepared and set up on metallic bases, covered with gold and examined in the scanning electron microscope. The results showed that the irradiation with the C0(2) mode locked laser with 1.0 W power caused melting and irregularities with small cavities on the surface of the enamel. The irradiated area on the dentin surface appeared circular and well delimited, containing blocks of dentin and cracks. By using the pulsed Nd:YAG laser with 1.0 W mean power and 10 Hz frequency, the enamel surface presented granules of molten enamel, with a typical melting look. The irradiated dentin surface presented a cavity with a margin elevated with granules and holes, and its bottom presented dentinary tubules with globules of melted dentin. Irradiation with the mode locked of diode laser with 1.0 W mean power, showed the formation of a melted and evenly resolidified enamel surface, and the dentin surface presented a block of melted dentin with adjacent regions of normal dentin, evidently with a relatively smooth surface.

El estudio presenta algunos resultados del efecto del láser de C0(2), Nd:YAG y Diodo sobre el esmalte y dentina de dientes deciduos humanos. Después de las irradiaciones, se prepararon las muestras y se montaron sobre bases metálicas, cubiertas con oro y examinadas en el microscopio electrónico de barrido. Los resultados mostraron que la irradiación con el láser C0(2) en modo conmutado con 1,0 W de potencia, provoca fusión e irregularidades con pequeños cráteres en la superficie del esmalte. En la superficie de la dentina, el área irradiada se mostró circular y bien definido, con bloques de dentina y grietas. Con el uso del láser Nd: YAG en el modo pulsado con 1,0 W de potencia media y frecuencia de 10Hz, la superficie del esmalte presentó granulos de esmalte fundido, dándole el aspecto de "melting" (derretido). La superficie de dentina irradiada presentó un cráter con borde elevado con gránulos y agujeros, y su fondo presentó túbulos dentinarios con glóbulos de dentina derretida. La irradiación del láser de Diodo en el modo conmutado con potencia media de 1,0 W, provocó la formación de una superficie de esmalte fusionada y resolidificada uniforme y la superficie de la dentina presentó un bloque de dentina fundida en la regiones adyacentes de dentina normal, mostrando una superficie bastante lisa.

O uso do laser de CO2 no tratamento de coristoma sebáceo na cavidade oral: relato de caso / Treatment of sebaceous choristoma of the oral cavity with CO2 laser: a case report

O objetivo deste estudo foi relatar nossa experiência com a aplicação oral de laser CO2 na excisão de lesão em tecido mole. O coristoma é o termo que define uma massa de células normais que se assemelham a um tumor ou um tecido que se desenvolve em local atípico. Os aspectos clínico e histológico do coristoma oral pode variar: há relatos de coristomas sebáceos, cartilaginosos, ósseos e gástricos. O coristoma sebáceo, também denominado grânulo de Fordyce, é uma característica comum da mucosa oral que normalmente não requer biópsia ou excisão e cujo diagnóstico é essencialmente clínico. Neste relato descrevemos um caso de coristoma sebáceo do arco palatal, removido devido ao desconforto causado ao paciente. Após obter a autorização do paciente, foi realizado o tratamento cirúrgico, que consistiu de uma sessão de laser CO2 (Opus 20, Lumenis, EUA). potência 2W e feixe de luz 2 mm, modo pulsado. O paciente relatou um mínimo edema pós-cirúrgico, ausência de dor e completa reepitelização após duas semanas. Concluímos que o laser CO2 ainda é um comprimento de onda útil, na prática da cirurgia oral, devido à alta absorção pela água e hemoglobina, bem como sua atuação favorável no processo de cicatrização.

The aim of this study was to report our experience on the oral application of CO2 laser for the excision of soft tissues lesions. Choristoma is the term indicating a tumor-like mass of normal cells or tissue that develops in an abnormal location. The clinical and histological aspect of the oral choristoma can vary: there are reported cases of sebaceous, cartilaginous, osseous and gastric choristoma. Sebaceous choristoma, also defined as Fordyce's spot or granule, is a common feature of oral mucosa for which biopsy or excision is normally not required and diagnosis is essentially clinical. In this report we describe a case of sebaceous choristoma of the palatal arch removed because of the patient discomfort. We used for the surgical treatment, after informed consent informed was obtained, a C02 laser (Opus 20, Lumenis - USA) using an output power of 2 Watts with a spot size of 2 mm in surgery pulsed mode in one session. The patient reported a minimal post-surgical oedema without pain and the complete reepithelization was obtained 2 weeks later. C02 laser is still a useful wavelength in the oral surgery practice due to its high absorption in water and haemoglobin (bloodless field) as well as its healing process ability.