A Clinical Trial of Photobiomodulation Effect on Orthodontic Microscrews Stability Using a 635 nm Red Laser Light.

Background: One of the procedures enhancing implants stability can be photobiomodulation. Objective: To assess the effect of a 635 nm wavelength on orthodontic microscrews stability, survival rate, and an individual patient's pain score. Materials and methods: The study was done with 15 subjects, 30 orthodontic microscrews with a length of 10 mm and diameter 1.4 mm. Implants inserted on the right and left side of the maxilla. The implants in the test group (G1) were irradiated with the laser at palatal and buccal part of peri-implant area (two points). The diode laser (SmartM PRO; Lasotronix, Warsaw, Poland) was used with the following settings: power: 100 mW, spot size: 0.5 cm2, mean power density (irradiance): 200 mW/cm2, in continuous wave (CW) mode, energy per point: 4 J, radiant exposure: 8 J/cm2, time per point: 40 sec, the total energy dose (radiant energy) per session: 8 J in contact mode, handpiece diameter: 8 mm. Laser sessions: day of surgery and 3, 6, 9, 12, 15, 30 days later. Cumulative radiant energy was 59 J. Periotest appliance was used to assess the microscrews stability at day of surgery and 3, 6, 9, 12, 15, 30, 60 days later. Each patient received a survey for individual pain assessment (NRS-11) promptly after the implantation. Results: The analysis after 60 days revealed significantly higher secondary stability for the laser-irradiated microscrews group in comparison with control implants (G2 group) (p = 0.0037). We observed significantly higher stability in the experimental group compared with the control after 30 days (p = 0.0218). Moreover, we noted significantly higher microimplants stability for the control group in comparison with the test group, 9 days after implantation (p = 0.0374). Laser application had no effect on pain reduction noted in the first day in comparison with the control sites (p = 0.6690). No microscrews were lost in the study. Conclusions: Application of a 635 nm laser on peri-implant soft tissue increased the microscrews stability after 30 and 60 days.

Effect of 808 nm Semiconductor Laser on the Stability of Orthodontic Micro-Implants: A Split-Mouth Study.

BACKGROUND: To evaluate the effect of photobiomodulation (PBM) on orthodontic micro-implants (n = 44; 14 women, 8 men). METHODS: PBM with 808 nm diode laser was applied immediately, 3, 6, 9, 12, 15, and 30 days post the implantation. Results were assessed within same time frames and additionally after 60 days to check for implants stability using the Periotest device. Patients pain experiences following the first day post-treatment and potential loss of micro-implants after 60 days were recorded. The procedure involved insertion of mini-implants in the maxilla for the laser group (L, n = 22) and negative control group (C, n = 22). Irradiation was carried buccally and palatally with respect to the maxillary ridge (2 points). The energy per point was 4 J (8 J/cm2), total dose was 56 J. RESULTS: Patients did not report significant differences in terms of pain experiences comparing the L and C groups (p = 0.499). At 30 days post-treatment, higher secondary stability of implants was observed in the laser group (Periotest Test Value, PTV 6.32 ± 3.62), in contrast to the controls (PTV 11.34 ± 5.76) (p = 0.004). At 60 days post-treatment, significantly higher stability was recorded in the laser group (PTV 6.55 ± 4.66) compared with the controls, PTV (10.95 ± 4.77) (p = 0.009). Conclusions: Application of the 808 nm diode laser increased secondary micro-implant stability.

Effect of ozone and diode laser (635 nm) in reducing orthodontic pain in the maxillary arch-a randomized clinical controlled trial.

The effect of ozone, diode laser irradiation, and presence of teeth crowding/spacing on pain perception in orthodontic patient was tested. Overall, 76 patients [55 women and 21 men; age 35.1(6.4) years] who met the inclusion criteria participated in the study. Immediately after fixed orthodontic appliance placement, the patients were exposed to a pain relief treatment (one single session) using either 635-nm diode laser (SmartM, Lasotronix, Warsaw, Poland) or ozone therapy (OzoneDTA, Apoza, New Taipei City, Taiwan) by placing the handpieces in the area of each teeth apex and interdental papillae, from the maxillary right first molar to the maxillary left first molar. Subjects were divided into three groups: control group (G1, n = 26), ozone (G2, n = 26, exposed to ozone therapy, generator probe type 3, working time per point 5 s, 23 points, application time 1 min and 55 s), and laser group (G3, n = 25, exposed to continuous mode diode laser, 400 mW, handpiece diameter 8 mm, spot area 0.5024 cm2, power density per second 1.59 W/cm2, dose 2 J per point, time: 5 s per point, 23 points, total energy per session 46 J, application time 1 min and 55 s). The level of teeth crowding was assessed using the Lundstrom indicator. The patients received a questionnaire for pain assessment (the Numeric Rating Scale, NRS-11, grade level 0-10) and recorded at 7 time points (1 h, 6 h, and 1, 2, 3, 4, and 5 days ) after the fixed orthodontic appliance placement. The mean pain values for the diode laser, ozone, and control group were 3.6 (1.31) (95% CI, 2.95-4.25), 5.25 (3.37) (95% CI, 3.52-6.98), and 5.75 (2.40) (95% CI, 4.69-6.81), respectively. We observed lower pain values in the diode laser group compared to the control group (p = 0.0237). The use of ozone in this study did not result in significant pain reduction in comparison to control (p = 0.8040) and laser groups (p = 0.1029). There were no differences in pain perception between patients with crowded teeth and non-crowded teeth in each group (G1, p = 0.66, G2, p = 0.86, G3, p = 0.24). The use of 635-nm diode laser led to decreased pain perception; however, ozone and presence of teeth crowding/spacing did not affect the pain perception in orthodontic patients during the first 5 days after the fixed orthodontic appliance placement.

Bilateral Bone Ridge Splitting in Maxilla with Immediate Implant Placement in a Patient with Osteoporosis: A Clinical Report with 2-Year Follow-up.

Every year, a higher percentage of bisphosphonates is prescribed for osteoporosis treatment which can lead to bone osteonecrosis after several surgical procedures in the oral cavity. This report describes an approach to restore two missing teeth, employing bilateral bone ridge splitting in the maxilla with immediate placement of implants in a patient using bisphosphonates in the management of osteoporosis. Two titanium implants with a width of 3.45 mm and a length of 10 mm were placed in the maxillary ridge with a diameter of 4.4 mm and 3.0 mm in positions 15 and 24 according to the classification of the World Dental Federation. The implants were placed immediately by bone splitting, using a piezosurgery device and guided bone regeneration with an alloplastic material and a collagen membrane. Five months later, the implants were uncovered and the final porcelain crowns were cemented. 24 months later, the control through clinical and radiographical examinations showed no bone loss in the collar part of the implants and the proper status of the peri-implant soft tissue without any signs of inflammation. Piezosurgery is a useful and safe method of ridge splitting in a very thin ridge (4.5 and 3.0 mm).

Low-Level Laser Therapy with a 635 nm Diode Laser Affects Orthodontic Mini-Implants Stability: A Randomized Clinical Split-Mouth Trial.

BACKGROUND: The study aimed to clinically estimate an influence of a 635 nm diode laser on the stability of orthodontic mini-implants, to assess mini-implants loss, and to evaluate a pain level after the treatment. MATERIALS AND METHODS: The randomized clinical split-mouth trial included 20 subjects (13 women and 7 men; age: 32.5 ± 6.1 years), 40 implants (RMO, West Colfax Ave., Denver, CO, USA) with a diameter 1.4 mm and length of 10 mm. Mini-implants were placed in the area of the attached gingiva between the second premolar and first molar teeth, 2 mm below the mucogingival junction of both sides of the maxilla. Each implant on the right side (G1, n = 20) of the maxilla was irradiated with a diode laser, and the implants on the opposite side (left, G2, n = 20) were a control group (without laser irradiation). The 635-nm laser parameters; dose: 10 J per point (20 J/cm2), time: 100 s per point, two points (irradiation on a buccal, and a palatal side of the alveolus/implant), the total energy per session 20 J. Laser application protocol: immediately and 3, 6, 9, 12, 15, and 30 days after surgery. The total energy after all therapeutic sessions was 140 J. The implants' stability was measured employing a Periotest device (Periotest Test Value-PTV) immediately and 3, 6, 9, 12, 15, 30, and 60 days after the insertion of the mini-implants. RESULTS: We found significantly higher secondary stability, lower mean PTV (6.18 ± 5.30) and (1.51 ± 2.25), for self-drilling mini-implants (G1, test group) in contrast to the control, G2 group (9.17 ± 8.25) and (5.00 ± 3.24), after 30 (p = 0.0003) and 60 days (p = 0.0000). Moreover, the analysis of the mini-implants stability after 635-nm diode laser application revealed significant higher stability in comparison with none irradiated implants (G2 group) after 3 days. (p = 0.0000) There was no significant difference in pain level measured on the NRS-11 scale on both sides of the maxilla. (p = 0.3665) An important finding was that all inserted mini-implants survived during a two-month observation period. CONCLUSIONS: 635-nm diode laser at laser irradiation increases the secondary stability of orthodontic mini-implants.

The best time for orthodontic treatment for Polish children based on skeletal age analysis in accordance to refund policy of the Polish National Health Fund (NFZ).

BACKGROUND: The ability to estimate the growth potential correctly is an important factor in taking effective actions with respect to orthodontic diagnosis, suitable treatment protocol and optimal timing of commencing the therapy. OBJECTIVES: The aim of this study was to compare skeletal maturity between the groups depending on the malocclusion as well as to define the optimal timing for particular orthodontic treatment procedures in children with miscellaneous types of malocclusion and compare it with the duration of treatment proposed by the National Health Fund (NFZ). MATERIAL AND METHODS: The delivery of the objectives of this study has been divided into 4 stages: the selection of the lateral head films (n = 180) of patients with malocclusion without congenital defect - diagnosing an orthodontic defect using Angle's classification, noting the chronological age (7-16 years) at the moment of taking the radiograph; the evaluation of the patients' skeletal maturation stages determined by the cervical vertebrae; comparison of the skeletal maturity between the groups considering the calendar age and the type of malocclusion and analysis of 45 cephalometric RTG projections of patients with different malocclusions. RESULTS: The average age for children with malocclusion was significantly higher for class III as compared to class II or I in pubertal peak group (CS3 and CS4), and for class III as compared to class I or II after the puberty peak (CS5 and CS6). Our findings of the average age according to Angle's classification revealed significant differences between class II and class III at CS2, CS3, CS4, CS5, between class I and class III at CS3 and CS5, between class I and class II at CS4, between class III and I at CS5, and between all classes at CS6 maturity stage. CONCLUSIONS: Based on our research, it is concluded that the time of the refund of orthodontic treatment in Poland should be extended to 13.6 years of age for class II malocclusion and to 14.7 years of age for class III defects.

Er:YAG laser, piezosurgery, and surgical drill for bone decortication during orthodontic mini-implant insertion: primary stability analysis-an animal study.

It is important to identify factors that affect primary stability of orthodontic mini-implants because it determines the success of treatment. We assessed mini-implant primary stability (initial mechanical engagement with the bone) placed in pig jaws. We also assessed mini-implant insertion failure rate (mini-implant fracture, mini-implants to root contact). A total of 80 taper-shaped mini-implants (Absoanchor® Model SH1312-6; Dentos Inc., Daegu, Korea) 6 mm long with a diameter of 1.1 mm were used. Bone decortication was made before mini-implant insertion by means of three different methods: Group G1: Er:YAG laser (LiteTouch®, Light Instruments, Yokneam, Israel) at energy of 300 mJ, frequency 25 Hz, fluence 38.2 J/cm2, cooling 14 ml/min, tip 1.0 × 17 mm, distance 1 mm, time of irradiation 6 s; Group G2: drill (Hager & Meisinger GmbH, Hansemannstr, Germany); Group G3: piezosurgery (Piezotom Solo, Acteon, NJ, USA). In G4 group (control), mini-implants were driven by a self-drilling method. The primary stability of mini-implants was assessed by measuring damping characteristics between the implant and the tapping head of Periotest device (Gulden-Medizinteknik, Eschenweg, Modautal, Germany). The results in range between - 8 to + 9 allowed immediate loading. Significantly lower Periotest value was found in the control group (mean 0.59 ± 1.57, 95% CI 0.7, 2.4) as compared with Er:YAG laser (mean 4.44 ± 1.64, 95% CI 3.6, 5.3), piezosurgery (mean 17.92 ± 2.73, 95% CI 16.5, 19.3), and a drill (mean 5.91 ± 1.52, 95% CI 5.2, 6.6) (p < 0.05). The highest failure rate (33.3%) during mini-implant insertion was noted for self-drilling method (G4) as compared with G1, G2, and G3 groups (p < 0.05). The small diameter decortication by Er:YAG laser appeared to provide better primary stability as compared to drill and piezosurgery. Decortication of the cortical bone before mini-implant insertion resulted in reduced risk of implant fracture or injury of adjacent teeth. The high initial stability with a smaller diameter of the mini-implant resulted in increased risk of fracture, especially for a self-drilling method.

Assessment of the primary stability of root analog zirconia implants designed using cone beam computed tomography software by means of the Periotest® device: An ex vivo study. A preliminary report.

BACKGROUND: The implant primary stability is a fundamental prerequisite for a success of osseointegration process which determines the prosthetic reconstruction time. OBJECTIVES: The aim of the present study was to assess the quality and precision of modern conical bone computer tomography (CBCT) software in preparing root analog zirconia implants (RAZIs) by measuring its primary stability by means of the Periotest device. MATERIAL AND METHODS: Thirteen pig jaws with proper erupted first premolar (P1) teeth were used in the study. The CBCT examination was conducted in the area of the P1 tooth in each mandible. The 3-dimensional (3D) view of each tooth was designed from CBCT scan. The created 3D images were used to prepare root analog zirconia implants milled from a medical-grade zirconia block by means of laboratory milling. The RAZIs and titanium implants were placed into an alveolar socket after the tooth had been removed. The primary stability of the teeth before their extraction (G1), RAZIs (G2) and titanium implants (G3) were checked by Periotest devices. RESULTS: The mean results in PTV were: 15.9, 3.35, 12.7 for G1, G2 and G3 group, respectively. RAZIs during immediate loading achieved a significantly higher primary stability (lower Periotest value) as compared to the teeth and implants. CONCLUSIONS: The modern CBCT device allows us to design a precise image of an extracted tooth for the purpose of manufacturing a root analog implant. The additional feature of the surgical protocol using RAZI is the possibility of avoiding the augmentation procedure, which reduces the whole cost of the treatment.

Effect of diode lasers with wavelength of 445 and 980 nm on a temperature rise when uncovering implants for second stage surgery: An ex-vivo study in pigs.

BACKGROUND: Many surgical procedures in soft tissue are performed using diode lasers. Recently, a novel diode laser operating at 445 nm wavelength was introduced in dentistry. OBJECTIVES: The aim of our study was to evaluate the time of surgery and an increase in temperature of titanium implants during its uncovering using 445 and 980 nm wavelengths. MATERIAL AND METHODS: The research included 45 pig mandibles (n = 45). The specimens were randomly divided into 3 groups (n = 15) according to the laser irradiation mode and wavelength; G1 - 445 nm laser, power: 3 W, continuous wave (CW), distance: 2 mm, power density: 7460 W/cm2, fiber: 320 µm, noncontact mode; G2 - 445 nm laser (power: 2 W, CW, power density: 4970 W/cm2, fiber: 320 µm, contact mode; G3 (control) - 980 nm laser, power: 2.5 W, CW, power density: 15920 W/cm2, fiber: 200 µm, contact mode. The temperature was measured with a 2 K-type thermocouples (a P1 at collar and a P2 at mid height of the implant). RESULTS: The mean temperature rises measured by the P1 thermocouple were 16.9°C, 36.1°C and 21.6°C in the G1, G2 and G3 group, respectively. Significant differences in temperature rise were found between the G1 and G2 group (p = 0.0007) and the G2 and G3 group (p = 0.01). The mean temperature rises measured by the P2 thermocouple were 1.8°C, 1.4°C and 5.6°C in the G1, G2 and G3 group, respectively. Significant differences in temperature rise were found between the G1 and the G2 or G3 group (p = 0.0001). The significant differences among the study groups in average time necessary for uncovering the implants amounted to 69.7, 54.4 and 83.6 s, respectively (p < 0.05). CONCLUSIONS: The application of the 445 nm diode laser in non-contact mode reduced the temperature rise of the implants. The additional pulse intervals during laser irradiation with wavelength of 445 nm when operating in contact mode are needed.

Assessment of Temperature Rise and Time of Alveolar Ridge Splitting by Means of Er:YAG Laser, Piezosurgery, and Surgical Saw: An Ex Vivo Study.

The most common adverse effect after bone cutting is a thermal damage. The aim of our study was to evaluate the bone temperature rise during an alveolar ridge splitting, rating the time needed to perform this procedure and the time to raise the temperature of a bone by 10°C, as well as to evaluate the bone carbonization occurrence. The research included 60 mandibles (n = 60) of adult pigs, divided into 4 groups (n = 15). Two vertical and one horizontal cut have been done in an alveolar ridge using Er:YAG laser with set power of 200 mJ (G1), 400 mJ (G2), piezosurgery unit (G3), and a saw (G4). The temperature was measured by K-type thermocouple. The highest temperature gradient was noted for piezosurgery on the buccal and lingual side of mandible. The temperature rises on the bone surface along with the increase of laser power. The lower time needed to perform ridge splitting was measured for a saw, piezosurgery, and Er:YAG laser with power of 400 mJ and 200 mJ, respectively. The temperature rise measured on the bone over 10°C and bone carbonization occurrence was not reported in all study groups. Piezosurgery, Er:YAG laser (200 mJ and 400 mJ), and surgical saw are useful and safe tools in ridge splitting surgery.

Analysis of skeletal maturity of children with cleft palate in terms of healthy children by the CVM method.

BACKGROUND: For many years, the analysis of bone age X-rays have been used for the hand and wrist, which were assessed on the basis of changes in the various centers of ossification. These images, however, do not constitute a diagnostic element of cleft defects, leading to additional exposure of the patient to X-rays. The problem was solved by using lateral head films, which enabled the interpretation of the morphological changes in the cervical spine to evaluate skeletal development stages. OBJECTIVES: The objective of this work is to define the differences between the skeletal age and chronological age of children with malocclusion and congenital craniofacial disorders - primary and secondary palate cleft. MATERIAL AND METHODS: The study material comprised 90 lateral cephalometric radiographs of patients at the age of 7 to 16 (45 lateral head radiographs of patients with various occlusion disorders and 45 lateral head radiographs of patients with various types of primary and secondary palate cleft). Then, all the lateral cephalometric radiographs were analysed in terms of the shape of the 2nd, 3rd and 4th cervical vertebra in line with the Cervical Stage method (CS), developed by Baccetti et al. in 2005. RESULTS: Patients with malocclusions without malformations achieved various stages of bone development at an earlier chronological age compared with patients with primary and secondary palate. An exception was the phase CS 3 (early growth spurt) development disorders, in which patients with different types of cleft had lower chronological age compared with patients with malocclusion. CONCLUSIONS: The method that allows for an assessment of the development of skeletal maturity is the analysis of the shape of the cervical vertebrae in lateral head film.

Comparison of bone and chronological age in different types of primary and secondary palate clefts.

BACKGROUND: The ability to correctly assess the patient's bone age is an important element that allows correct diagnosis and proper planning of the start of orthodontic treatment. OBJECTIVE: The objective of this study was to estimate bone age in children with congenital craniofacial defects - primary and secondary palate cleft. MATERIAL AND METHODS: The analysis covered lateral head images of 45 patients 8 to 15 years old with different types of cleft (primary and secondary palate cleft, bilateral, right or left unilateral). The patients' bone age was assessed by means of the Cervical Stage method (CS). The correlation between the bone age and chronological age was defined with the division into male and female patients. RESULTS: The results showed the relationship between the skeletal age and chronological age by gender and cleft type (the differences between the types of clefts by gender were presented). The correlation rate between the values of variables was defined. CONCLUSIONS: The chronological age of children with developmental craniofacial defects (primary and secondary palate cleft) in relation to the stages of skeletal development, indicates a difference of about one year in plus and that fact should be taken into account when choosing orthodontic treatment.

[Tumor markers used in the diagnosis, monitoring, treatment, and prognosis head and neck cancer]. / Markery nowotworowe stosowane w diagnostyce, monitorowaniu leczenia i prognozowaniu nowotworów glowy i szyi.

UNLABELLED: Cancer is currently the second to heart disease and vascular cause of death and observed tends to increase the number of cases. The cause of high mortality from cancer it is too late malignant diagnosis. In the case of head and neck cancers at diagnosis in about 40% of patients found to have metastatic lymph nodes within. Therefore, an important issue for modem oncology is the early diagnosis of the disease cancer. Currently high hopes for the early detection and diagnosis of treatmen cancer is put in simple, accessible and low-cost testing to determine the biochemical tumor markers. THE AIM OF THE STUDY was to examine the latest reports on biochemical markers useful in cancer diagnosis, disease staging, prognosis and monitoring the treatment of the most common cancers of the head and neck. MATERIALS AND METHODS: The material consisted of references of the last 17 years. Criterion search accounted for password: biochemical tumor markers, diagnostics, monitoring treatment of cancer. 10 of 90 works were selected to examine. CONCLUSIONS: Usefulness of biochemical tumor markers in monitoring course of the disease and evaluation of treatment effectiveness was demonstrated. In combination with other diagnostic methods as they apply to screening, as well as in the detection of cancer in the study population.

Changes in the masticatory organ in patients with Recklinghausen's disease - a case report.

In the report the authors present changes in the masticatory organ in the case of a 9-year-old girl affected with Recklinghausen's disease. The characteristics included neurofibromatosis of the face, salivary gland and external ear in the form of an extensive tumour. The disease also resulted in acute right hemifacial hypertrophy. The computer-assisted tomography examination identified acute atrophy of the zygomatic bone, maxilla, mandible alveolar ridge and right base of the skull. The clinical intraoral examination of the patient revealed right buccal occlusion and lingual occlusion on the opposite side. The patient underwent functional orthodontic treatment of the co-existing malocclusion with an orthodontic appliance for the upper and lower jaw which was to prevent further mandible movement towards the right. According to researchers, neoplasia is an inherent characteristic of a phenotype seen in patients suffering from Recklinghausen's disease. Therefore, it is the main factor influencing the selection of a therapy. Although there are certain single attempts of pharmacological treatment of ganglioneurofibromas at their early development stage, it is agreed that, in fact, no preventive actions are possible. Hence, in the case of neurofibromatosis type 1, reconstruction and aesthetic procedures are widely applied in treating the disease.