Effect of Low-Level Er: YAG (2940 nm) laser irradiation on the photobiomodulation of mitogen-activated protein kinase cellular signaling pathway of rodent cementoblasts.

BACKGROUNDS: Dental avulsion due to trauma, especially in young patients, is a worldwide problem, requiring tooth replacement. Delayed replantation could cause tooth loss when the cementum is severely damaged. A small number of studies has reported that photobiomodulation (PBM) therapy using Er: YAG laser irradiation activates cellular signaling responses in different cell types, resulting in a variety of favorable biological effects. The aim of this in vitro study was to evaluate the potential biostimulatory effect of low-level Er: YAG laser irradiation on the biological responses of cultured mouse cementoblasts (OCCM-30), including the mitogen-activated protein kinases (MAPKs). METHODS: OCCM-30 cells were exposed to 2940 nm Er: YAG laser irradiation for 15 s at 0.34 W (pulse duration of 100 or 1000 µs, 17 mJ/pulse) at energy densities of 1 or 2 J/cm2. Irradiated and non-irradiated OCCM-30 cells were tested for migration (Scratch assay), proliferation (MTS assay) and functional differentiation (Alizarin Red S assay). Lumican (Lum) and Fibromodulin (Fmod) gene expression, and activation of MAPKs, were assessed by RT-PCR and Western blotting, respectively. RESULTS: Low-level Er: YAG laser irradiation at 2 J/cm2 and pulse duration of 1000 µs resulted in the highest migration rate and proliferation. Moreover, the pulse duration irradiation of 100 µs increased Lum expression. Fmod expression was increased after 1000 µs pulse duration laser stimulation. Low-level Er: YAG laser irradiation increased the mineralization of OCCM-30 cells after 7 days and activated ERK1/2, P38 and JNK signaling. CONCLUSIONS: Low-level Er: YAG laser irradiation induces OCCM-30 cell migration, proliferation and differentiation, and activates the MAPK signaling pathway.

980nm diode laser for treatment of vascular lesions in oral district: a 5 years follow-up trial.

INTRODUCTION: Mulliken and Glowacki introduced a simple classification in 1982 that was based on the clinical, hystochemical and cellular criteria to distinguish between the various vascular anomalies. They described two distinct entities - hemangiomas and vascular malformations. Numerous methods of treatment have been used such as cryotherapy, embolization, sclerotisation, cold scalpel and laser. MATERIALS AND METHODS: This study comprised 60 patients treated for vascular lesions of the oral region. The research protocol was performed in two groups. In the first group 30 patients were treated with 980nm diode laser and the second group, the control group 30 patients treated with cold scalpel. Treatments were conducted from May 2007 to May 2012 at the Department of Oral Surgery in Tirana. RESULTS: The follow-up periods were one month, six months and one year. In this study according the protocol research the results from two groups of populations were compared. The parameters evaluated were: bleeding, swelling, scarring, recurrence, functional disturbance based on treatment protocol. Clinical applications of 980 nm diode laser for the management of vascular lesion of lip is of beneficial effects due to the good absorption in hemoglobin. Laser treatment is short in time and well-accepted by all age group. CONCLUSIONS: Surgical laser wounds were healed in time, without scar formation and functional disturbance.

Laterally closed tunnel technique with and without adjunctive photobiomodulation therapy for the management of isolated gingival recession-a randomized controlled assessor-blinded clinical trial.

The objective of this prospective randomized controlled single-center clinical trial was to prove the efficacy of adjunctive photobiomodulation in improving selected outcomes following the use of laterally closed tunnel technique for the management of isolated gingival recession. Nineteen participants (with isolated gingival recession) each treated by laterally closed tunnel technique were randomized to either add on treatment with control (sham laser application) or test group (photobiomodulation with 660 nm diode, 3.5 J/cm2 per point of application). The primary outcome variable was change in recession depth and secondary variables included recession width, width of keratinized gingiva, periodontal biotype, and VAS score for pain assessment and EHS index for early wound healing assessment. Analysis was performed using a linear mixed effects model. There were no significant differences in the gingival recession depth (p = 0.8324) and recession width (p-0.969) at 3-month follow-up. The VAS scores were significantly lower for the test (laterally closed tunnel technique + photobiomodulation) group as compared to control (laterally closed tunnel technique + sham laser) over time (p = < 0.0001) as well as per site (p = 0.0006) The Early Wound Healing Index scores were significantly higher in the test (laterally closed tunnel technique + photobiomodulation) group as compared to control (laterally closed tunnel technique + sham laser) group (p < 0.0001). The adjunctive use of photobiomodulation did not show a better outcome concerning recession depth but appears to provide faster healing of the surgical wounds and better patient comfort. The result needs further evaluation in particular with respect to long-term effect and due to limitation in sample size. Clinical Trial Registry of India: CTRI/2019/11/022012.

The Photobiomodulation Effect of 940nm Laser Irradiation on Enterococcus faecalis in Human Root Dentin Slices of Varying Thicknesses.

Introduction: An increase in dentine thickness could result in an inadequate depth of laser energy penetration. This study aimed to evaluate the effect of a 940 nm laser on Enterococcus faecalis through varying thicknesses of human root dentin slices. Methods: Thirty-five dentin slices of root dentin with thicknesses ranging between 500 and 3000 µm were produced. Six experimental groups (500, 1000, 1500, 2000, 2500, and 3000 µm (n=5 each) were lased and the seventh, non-lased group served as the positive control with a dentine thickness of 2000 µm. The slices were inoculated with 2 µL of E. faecalis suspension of 1.5 × 108 E. faecalis cells/mL. All the lased slices were lased from the opposing side of the inoculation. A non-initiated 200 µm bare end fibre at the power of 1 W, in a continuous wave was used. Four doses of laser irradiation of 5 seconds with a side to side movement with the tip held at a 5º angle to the dentine slice were performed. The colony-forming units of E. faecalis were determined and the bacterial photobiomodulation effect analysed using one-way ANOVA with a Bonferroni and Holm post hoc test at a significance level of P > 0.05. Results: There were statistical differences between the dentin slices of 500, 1000, and 1500 µm treated with the laser compared to the positive control (P < 0.01). However, there were no statistical differences between the lased 2000 and 2500 µm slices compared to the positive control. There was significantly more photobiomodulation of the E. faecalis for the dentine slices of 3000 µm than the positive control (P < 0.01). Conclusion: Laser treatment through dentine slices of 2000 µm and thinner significantly reduced bacterial growth. The photobiomodulation effects started to occur in dentine slices thicker than 2500 µm compared to the positive control.

Two-year outcomes following the adjunctive use of InGaAsP and Er,Cr:YSGG lasers in nonsurgical periodontal therapy in patients with stages III and IV periodontitis.

OBJECTIVE: To evaluate the clinical outcomes 2 years after the adjunctive use of an InGaAsP diode and Er,Cr:YSGG laser for nonsurgical treatment of severe periodontitis. METHOD AND MATERIALS: Forty-two patients (45.31 ± 9.78 years old, n = 22 females, n = 23 smokers) with stage III or IV grade B periodontitis were randomly treated either with laser (InGaAsP + Er,Cr:YSGG) adjunctive to subgingival debridement (test group, n = 21) or with subgingival debridement alone (control group, n = 21). Subjects in the test group received a second laser treatment in residual sites 2 months after the initial laser therapy. At baseline, and at 12 and 24 months after therapy, periodontal clinical parameters were evaluated. The primary outcome variable was the number of residual deep sites at 12 months (probing depth [PD] ≥ 6 mm). RESULTS: One and two years after nonsurgical periodontal treatment, both groups yielded statistically significant clinical improvements. The adjunctive use of InGaAsP and Er,Cr:YSGG laser to mechanical debridement resulted in statistically significantly higher clinical (PD, clinical attachment level, bleeding on probing, number of sites with PD ≥ 5 mm, PD ≥ 6 mm, PD ≥ 7 mm) improvements (P < .05) compared to subgingival debridement alone both at 12 and 24 months after therapy. CONCLUSION: In patients with stage III or IV grade B periodontitis, InGaAsP and Er,Cr:YSGG used adjunctively to subgingival debridement may additionally improve the clinical outcomes compared to mechanical debridement alone over a period of 24 months.

Preventing Enamel Caries Using Carbon Dioxide Laser and Silver Diamine Fluoride.

Objective: This study was intended to investigate the caries prevention potential of carbon dioxide (CO2) laser (λ = 10,600 nm) irradiation followed by application of silver diamine fluoride (SDF) to enamel. Materials and methods: Human enamel specimens were randomly allocated to four groups (n = 10 per group). Group 1 specimens were treated with SDF; Group 2 specimens were treated with a CO2 laser; Group 3 specimens were irradiated with a CO2 laser then treated with SDF, and Group 4 specimens received no treatment. All specimens were subjected to pH cycling for cariogenic challenge. Lesion depth, microhardness, surface morphology, and elemental analysis were assessed. Results: The lesion depths for Groups 1-4 were 33 ± 16, 80 ± 9, 18 ± 15, and 102 ± 9 µm, respectively (p < 0.001; Group 3 < Group 1 < Group 2 < Group 4). Knoop hardness values for Groups 1-4 were 61 ± 19, 68 ± 20, 78 ± 27, and 36 ± 8, respectively (p = 0.002; Group 4 < Groups 1, 2, and 3). The enamel in Group 4 but not in the other groups showed a roughened surface resembling an acid-etched pattern. Calcium-to-phosphorus molar ratios of Groups 1-4 were 1.68 ± 60.09, 1.61 ± 0.06, 1.69 ± 0.10, and 1.49 ± 0.10, respectively (p < 0.001; Group 4 < Groups 1, 2, and 3). Conclusions: Using the CO2 laser or SDF separately enhanced the resistance of enamel to cariogenic challenge. Moreover, there was an additional effect of the combined use of the CO2 laser and SDF for preventing enamel demineralization.

Patologías del área oral en los recién nacidos e infantes: frenillos y las aportaciones de los sistemas láser / Pathologies of the oral area in newborns and infants: frenula and contributions of laser systems

El propósito de este artículo es mejorar nuestro conocimiento sobre las estructuras y función de los diferentes elementos presentes en la boca del recién nacido, ya que en ocasiones los odontólogos no recuerdan la importancia de la boca en el desarrollo general del lactante y la necesidad de una intervención temprana con láseres para ayudarles a obtener un buen estado de su sistema oral. Realizamos una exploración clínica integral del paciente con el fin de realizar un diagnóstico más preciso. Cuando la cirugía sea necesaria, recomendamos utilizar láseres de Erbio siempre que sea posible (láser de 2780nm Er, Cr: YSGG o un Er: YAG de 2940nm), ya que es una opción rápida y eficaz para tratar estas lesiones orales, especialmente los frenillos labiales o linguales que pueden poner en riesgo el acto de amamantar; Asimismo podemos utilizar láseres de diodo (810nm, 940nm, 980 nm o un láser Nd: YAG de 1064nm o de CO2 10.600- 9600 nm) con sus gafas de seguridad específicas. Estos sistemas láser utilizados por un profesional certificado, en colaboración con un personal debidamente entrenado, son un factor muy importante durante la cirugía. Al tener un conocimiento adecuado de las estructuras orales y sus patologías, podemos diagnosticar si esos trastornos deben tratarse quirúrgicamente y, de ser así, cómo proceder con los sistemas láser, ya que son procedimientos mínimamente invasivos; o si debiésemos recomendar a los padres que visiten a un terapeuta miofuncional para ayudar a recuperar la función normal. La comprensión de las estructuras orales de los recién nacidos es muy importante para promover el desarrollo del crecimiento craneofacial y para brindar un servicio importante a las madres, dándoles a sus bebés un buen comienzo en la vida desde una etapa muy temprana. Necesitamos mejorar la colaboración entre profesionales de diferentes disciplinas con el fin de mejorar nuestro conocimiento.

The purpose of this article is to improve our knowledge about the structures and function of the different elements present in the mouth of newborns since dentists sometimes do not remember the importance of the mouth in the general development of infants and the need for an early intervention with lasers to help them obtain a good state of their Oral System. We performed a comprehensive clinical exploration of the patient in order to make a more accurate diagnosis. When surgery is necessary, we recommend to use erbium lasers when possible (2780nm Er, Cr: YSGG laser or a 2940nm Er: YAG), as they are a quick and effective option to treat these oral lesions, especially lip or tongue ties which can risk the act of breastfeeding; moreover, we can also use diode lasers (810nm, 940nm, 980nm or a 1064nm Nd:YAG laser or CO2 10.600-9600 nm.) al lof them with their specifical safety goggles. These laser systems used by a certified professional, in collaboration with a properly trained staff, are a very important factor during the surgery.By having proper knowledge of the oral structures and their pathologies, we are able to diagnose whether those disorders should be surgically treated and if so, how to proceed with laser systems as they are minimally invasive procedures; or if we should recommend parents to visit a myofunctional therapist in order to help recover the normal function.The understanding of oral structures of newborns is very important in order to improve the development of craniofacial growth and provide an important service to mothers by giving their babies a right start in life from a very early stage. We need to improve collaboration between professionals from different disciplines in order to enhance our knowledge.

Caries Prevention Effects of Silver Diamine Fluoride with 10,600 nm Carbon Dioxide Laser Irradiation on Dentin.

Objective: To investigate the caries prevention effect of silver diamine fluoride (SDF) with a carbon dioxide (CO2) laser (λ = 10,600 nm) on dentin. Method: Human dentin slices (n = 10) were prepared and allocated to the following treatments: Group 1 (SDF)-slices received an SDF application. Group 2 (laser)-slices were irradiated with a CO2 laser. Group 3 (laser + SDF)-slices were irradiated with a CO2 laser, followed by an SDF application. Group 4 (negative control)-slices had no treatment. All of the slices were subjected to pH cycling for cariogenic challenge. Lesion depth, nanohardness, and chemical and morphological changes were assessed by microcomputed tomography (micro-CT), nanoindentation, and scanning electron microscopy (SEM) with energy dispersive X-ray spectroscopy (EDS), respectively. Results: micro-CT determined lesion depths for groups 1-4 were 27 ± 6, 138 ± 32, 17 ± 5, and 182 ± 49 µm, respectively (p < 0.001; group 3 < group 1 < groups 2 and 4). The nanohardness values for groups 1-4 were 456 ± 109, 288 ± 5, 444 ± 142, and 258 ± 76 MPa, respectively (p = 0.003; groups 2 and 4 < groups 1 and 3). EDS determined that the calcium-to-phosphorus molar ratio for groups 1-4 were 1.26 ± 0.12, 1.07 ± 0.19, 1.37 ± 0.08, and 0.80 ± 0.17, respectively (p < 0.001; group 4 < group 2 < groups 1 and 3). SEM evidenced no ablation or cracking on the lased dentin surfaces. The treated dentin showed a relatively more intact and smoother surface morphology compared with the untreated dentin. Conclusions: SDF can reduce dentin demineralization against cariogenic challenge, and the caries preventive effect of SDF is further enhanced through CO2 laser irradiation.

Comparative Evaluation of the Effects of CO2 and Er:YAG Lasers on Smear Layer Removal and Blood Cell Attachment to Tooth Root Surfaces.

Introduction: The tooth root surfaces are modified by different agents for better removal of the smear layer, the formation of fibrin clots, and the attachment of blood cells. This in vitro study compared the removal of the smear layer, the formation of fibrin clots and the attachment of blood cells after exposing periodontally compromised root surfaces to ER:YAG and CO2 laser beams. Methods: Eighteen dentin block samples were prepared from freshly extracted periodontally compromised teeth that were deemed hopeless, and they were divided into 3 groups: exposed to Er:YAG laser beams, exposed to CO2 laser beams, and the control group. The samples were evaluated using scanning electron microscopy and micrographs were taken. Smear layer removal and blood cell attachment were scored. Data were analyzed using Kruskal-Wallis and MannWhitney tests. Results: In the Er:YAG laser group, the smear layer was removed completely. In the specimens exposed to blood, better fibrin clot formation and blood cell attachment were observed in the Er:YAG laser group. In the CO2 laser group, the smear layer was also removed; however, there were no significant differences between the CO2 laser and control groups in fibrin clot formation and blood cell attachment. Conclusion: The application of the Er:YAG laser to the root dentin appears to result in the formation of a suitable surface for fibrin clot formation and blood cell attachment. Further clinical studies are necessary to support these results.

Debris and Smear Layer Removal in Curved Root Canals Using the Dual Wavelength Er,Cr:YSGG/Diode 940 nm Laser and the XP-Endoshaper and Finisher Technique.

Objective: To validate the capability of the dual wavelength laser (Er,Cr:YSGG and diode 940 nm) and the XP-Endoshaper and finisher in removing the smear layer from curved canals. Methods: Forty curved root canals were prepared using the R25 file of the Reciproc® system. The teeth were randomly divided into five groups: G1: negative control irrigated with distilled water, G2: positive control irrigated with EDTA 17% and a final rinse of NaOCl 3%, G3: XP-Endoshaper and finisher with EDTA 17%, G4: dual wavelength Er,Cr:YSGG (1.25 W, 50 Hz, 50 µs) and diode 940 nm (2 W, 50% DC), and G5: dual wavelength Er,Cr:YSGG (2 W, 20 Hz, 50 µs) and diode 940 nm (2 W, 50% DC). Laser scanning microscope images (1000 × ) were scored with the Hülsmann scoring system. Results: Superior smear layer removal was observed in G5 in comparison with G4, especially in the apical third of the canal. Furthermore, the XP-Endoshaper and finisher exhibited positive results in all parts of the canal. Conclusions: The higher power output of the Er,Cr:YSGG in the dual wavelength laser may be a suitable approach to remove the smear layer from the apical third of curved canals. Moreover, the XP-Endoshaper and finisher with EDTA could expose the dentinal tubules, however, the negative side effects of applying EDTA 17% for longer periods must be taken into consideration. This work is clinically significant as it addresses the main aim of endodontic treatment and provides a suitable method to remove the debris, smear layer, and bacterial remnants from the clinically challenging curved root canals.

Effects of 10,600 nm Carbon Dioxide Laser on Remineralizing Caries: A Literature Review.

Objective: To study the effects of carbon dioxide (CO2) lasers (λ = 10,600 nm) on remineralizing dental caries. Methods: This study involved performing a systematic search of English articles archived in the PubMed, Scopus, and Web of Science databases. The keywords used to identify the relevant articles were ((CO2 laser) OR (carbon dioxide laser)) AND ((dental caries) OR (tooth remineralization)). Publications before 2019 were selected. The titles and abstracts of the initially identified articles were screened. Duplicate records, reviews, and irrelevant studies were removed. Full texts were retrieved for publications that studied the effects of CO2 lasers on remineralizing dental caries. Results: The search identified 543 potentially relevant publications. A total of 285 duplicate records were removed. Sixteen articles were included in this review. Four studies reported that CO2 lasers inhibited bacterial growth. The growth of cariogenic bacteria, mainly Streptococcus mutans, on an irradiated tooth surface was slower compared with nonirradiated ones. Four studies investigated the reduction of the demineralization of enamel with cariogenic challenge. They found that CO2 lasers reduced the carbonate content of mineralized tissues and increased the microhardness of enamel. Nine studies used CO2 lasers associated with topical fluorides in remineralizing dental caries. The results of the synergistic effect of laser irradiation and fluoride application with regard to the inhibition of caries progression varied among these studies, whereas laser irradiation could enhance fluoride uptake to demineralized mineral tissues. Conclusions: CO2 laser irradiation increased acid resistance and facilitated the fluoride uptake of caries-like lesions. In addition, it reduced the growth of cariogenic bacteria.

First Investigation of Dual-Wavelength Lasers (2780 nm Er,Cr:YSGG and 940 nm Diode) on Implants in a Simulating Peri-Implantitis Situation Regarding Temperature Changes in an In Vitro Pocket Model.

Objective: This study aimed to investigate the temperature changes and question the safe laser settings and protocols for laser-assisted peri-implantitis treatment in an in vitro environment. Materials and methods: Three types of implants (Neoss, Dentegris, and Camlog) were implanted in an artificial bone model (n = 15). The model was placed into a 37°C water bath to simulate the in vivo oral condition. Throughout the laser irradiation, K-type thermocouples were used to record the real-time temperature measurements at different anatomically important locations in the artificial bone. Results: In all of the temperature measurements, no temperature rise above the critical safe limit, that is, >47°C, was observed. Conclusions: Within the limitations of this in vitro study, the use of the dual-wavelength protocol [Er,Cr:YSGG (1 and 1.5 W, 25, 50, 75 Hz)] and the 940 nm diode (peak power 2 W, duty cycle 50%) can be considered a safe method in the treatment of peri-implantitis, regarding its thermal safety.

Adjunctive use of InGaAsP and Er,Cr:YSGG lasers in nonsurgical periodontal therapy: a randomized controlled clinical study.

OBJECTIVE: To evaluate clinically and microbiologically the outcomes following the combined application of InGaAsP diode laser and Er,Cr:YSGG laser for nonsurgical treatment of chronic periodontitis (ChP). METHOD AND MATERIALS: Forty-two patients (age 45.31 ± 9.78 years, 22 female, 23 smokers) with ChP were randomly treated with subgingival debridement (SD) by means of ultrasonic and hand instruments (control group, n = 21) or with InGaAsP followed 1 week later by InGaAsP + SD + Er,Cr:YSGG (test group, n = 21). In the test group, a second laser treatment was performed for all residual sites (bleeding sites with probing depth [PD] ≥ 4 mm) 2 months after the first laser therapy. At baseline and 6 months after therapy, periodontal clinical and microbiologic parameters were evaluated. RESULTS: Six months after therapy, statistically significant clinical and microbiologic improvements (PD reduction, clinical attachment level [CAL] gain, quantitative reduction of periopathogens) were observed in both groups compared to baseline. However, the use of InGaAsP followed by SD and the adjunctive use of an Er,Cr:YSGG laser, yielded statistically significantly higher clinical (PD, CAL, bleeding on probing, number of sites with PD ≥ 5 mm, PD ≥ 6 mm, PD ≥ 7 mm) and microbiologic (Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, Prevotella intermedia, Peptostreptococcus micros, Fusobacterium nucleatum) improvements (P < .05) compared to SD alone. CONCLUSIONS: In patients with ChP, the adjunctive use of InGaAsP and Er,Cr:YSGG to SD may additionally improve the clinical and microbiologic parameters obtained with SD alone, thus representing a valuable approach in nonsurgical periodontal therapy.

Calculus Removal and Root Surface Roughness When Using the Er:YAG or Er,Cr:YSGG Laser Compared with Conventional Instrumentation Method: A Literature Review.

Objective: The purpose of this literature review was to evaluate the effectiveness of using Er:YAG (erbium-doped yttrium/aluminum/garnet) laser or Er,Cr:YSGG (erbium, chromium-doped yttrium/scandium/gallium/garnet) laser on calculus removal and their effect on the topography and roughness of root surface in comparison with the conventional instruments in the nonsurgical periodontal therapy. Background data: One of the most challenging problems in treatment of periodontal disease is the elimination of plaque and calculus, leaving a clean and smooth root surface to decrease plaque and calculus retention, and for good gingival reattachment. Materials and methods: PubMed and Google Scholar were searched for available literature. The electronic search was limited to articles published in the period between January 2007 and April 2017, in the English language. Results: A total of 47 publications fulfilled the inclusion criteria of this systematic review and screened according to the research questions. Calculus removal using the ultrasonic instrument showed remaining calculus compared with the hand instrument, whereas, on the contrary, erbium lasers revealed no remaining calculus or smaller amounts compared with the conventional instruments when used in appropriate settings. The results of this review showed that ultrasonic instrumentation produced effects on the root surface almost similar to that of hand instrumentation. Er:YAG laser and Er,Cr:YSGG laser clarify a little more surface roughness when compared with conventional instruments. Conclusions: The present systematic review indicates that a combination of scaling and root planing (SRP) using the erbium lasers as an adjunctive therapy at certain parameters can be appropriate to remove residual debris from the root surface and at the same time have little or no negative thermal effect on the root surface. The Er:YAG laser also seems to be the most suitable for nonsurgical periodontal therapy. Additional new good-designed studies are needed to evaluate the effectiveness of erbium lasers with SRP in nonsurgical periodontal therapy.

Influence of grape seed extract in adhesion on dentin surfaces conditioned with Er,Cr:YSGG laser.

The proanthocyanidin (PA)-rich grape seed extract (GSE) is a collagen cross-linking agent that can perform a chemical bond with the dentin's collagen. The objective of this study was to evaluate the influence on shear bond strength (SBS) of the pre-conditioning of GSE, on human dentin surfaces conditioned with Er,Cr:YSGG laser. The sample consisted of 64 non-carious human teeth, divided into eight groups, four groups conditioned with Er,Cr:YSGG laser (4.5 W, 50 Hz, 50 µs, 70% air, 90% water) and four prepared with conventional methods (control). In both groups, a GSE solution was applied before using the two adhesives tested: Clearfil™ SE Bond (CSE) and Scotchbond™ Universal (SU). Subsequently, a SBS test, a scanning electron microscopy, and a statistical analysis were performed. In the laser groups, the best SBS mean (20.08 ± 4.01 MPa) was achieved in the group treated with GSE and CSE. The control group with the application of CSE showed the highest SBS mean (24.27 ± 10.28 MPa), and the group treated with laser and SU showed the lowest SBS mean (12.94 ± 6.51 MPa). Between these two groups there was a statistically significant difference (p = 0.05). However, this was not observed among the laser or control groups. The type of dentin surface preparation can influence the SBS. The CSE showed better SBS in laser and control groups. The presence of GSE did not improve the adhesion on surfaces conditioned with laser, but more studies should be carried out in the future to confirm this conclusion.

The effect of low-level laser radiation on improving inferior alveolar nerve damage after sagittal split osteotomy: a systematic review.

Inferior alveolar nerve (IAN) damage is a common complication occurring after sagittal split osteotomy (SSO) and results in sensory disorders of the jaw region. In recent years, published experimental and clinical evidence suggests that low-level laser (LLL) radiation is effective in nerve recovery. Therefore, the aim of the present study was to review clinical trial studies investigating the effect of LLL radiation on improving the sensory defects of IAN after SSO. The keywords associated with SSO and LLL were searched in PubMed, Medline (via Ovid), Web of Science (WOS), Scopus, and Cochrane Library databases. Then, controlled clinical trial studies published before November 2017 regarding LLL radiation conducted on patients with IAN neuropathy due to SSO were investigated. The articles fulfilling the study criteria were further scrutinized and the necessary information was extracted from them. A total of seven papers were included in the study. The diode laser used had a wavelength range of 760-930 nm, radiation power of 20-200 mw, and radiation energy of 10.2-95 J (per point of radiation). In the mentioned studies, the patients underwent 3-20 sessions of laser irradiation and were monitored for an additional 0-23 months after completion of the laser intervention. The tests performed in the mentioned studies dealt with examining the perceptions of superficial touch and pressure, two-point discrimination, stimulus movement on skin, temperature, and pain. Furthermore, the patients' general awareness regarding sensory perception in the mandibular region was gauged. In six studies, laser irradiation caused relative improvement in the IAN sensory disorder for a subjective test as well as for one or more objective tests. In the reviewed clinical trial studies, LLL was generally found to be effective in improving the IAN sensory disturbance resulting from SSO, though there was no placebo effect.

Adhesion in Dentin Prepared with Er,Cr:YSGG Laser: Systematic Review.

BACKGROUND: In dentistry, cavities prepared with Erbium lasers present more advantages, compared to traditional methods, but there is still a lack of investigation about the adhesion in dentin surfaces prepared with Erbium lasers, especially with Erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser. AIM: The purpose of this systematic review was to find out which might be "The most adequate adhesive and laser parameters for adhesion in dentin prepared with Er,Cr:YSGG laser." METHODS: An electronic search was performed in the PubMed database. The search was limited to studies between 2009 and 2016. RESULTS: Ten articles were selected to the systematic review according to TRANSPARENT REPORTING of Systematic Reviews and Meta-ANALYSES checklist. CONCLUSIONS: The adhesive that showed the best bond strength results in dentin prepared with Er,Cr:YSGG laser was the self-adhesive Clearfil™ SE (Kuraray), with preconditioning with 40% phosphoric acid. The settings 2 W, 75% water, 60% air, 140 µs pulse duration, and 20 Hz showed the best adhesion outcome.

Extrusion of Irrigant in Open Apex Teeth with Periapical Lesions Following Laser-Activated Irrigation and Passive Ultrasonic Irrigation.

INTRODUCTION: Sodium hypochlorite (NaOCl) irrigation is critical for the success of endodontic treatment and several agitation techniques have been developed to improve the efficacy of this irrigation. Using a combination of contrast medium and radiographic examination, this study evaluated NaOCl extrusion during agitation of irrigant. Development of pressure, which may result in apical extrusion of the irrigant, has been described during laser-activated irrigation (LAI) and passive ultrasonic irrigation (PUI). METHODS AND MATERIALS: We examined 40 single root canals categorized as having open apices with apical lesions in 40 patients. For the final irrigation, the teeth were irrigated with a mixture of radiopaque contrast medium and 2.5% NaOCl in solution. The solution was activated for 60 sec in both groups [the Er, Cr: YSGG laser group (n=20) and the ultrasonic group (n=20)]. The teeth were imaged subsequently using radiography for the evaluation of contrast extrusion. RESULTS: Radiopaque contrast medium was absent from the periapical tissues in all cases. CONCLUSION: Use of LAI or PUI appears to be safe as used currently in endodontic treatment.

Comparison of gingival depigmentation with Er,Cr:YSGG laser and surgical stripping, a 12-month follow-up.

Gingival melanin hyperpigmentation is an esthetic concern for many individuals. In this study, we compared the standard surgical removal method with two different Er,Cr:YSGG laser settings in order to find the best treatment method. In 33 dental arches, the following three treatment groups were comparatively evaluated: (1) surgical stripping, (2) removal with laser setting 1 (4.5 W, 50 Hz, 100% water, 80% air, 60 µs, 800 µm Tip; MZ8), and (3) laser setting 2 (2.5 W, 50 Hz, 20% water, 40% air, 700 µs, 800 µm Tip; MZ8). We comparatively evaluated pain, patient satisfaction and wound healing, treatment time, and the amount of bleeding. Re-pigmentation was evaluated after 1 and 12 months by Hedin and Dummet pigmentation scores. Laser setting 1 had the best results regarding pain and patient satisfaction, although not statistically significant (P > 0.05). Wound healing results were better using lasers compared to surgical stripping (P < 0.05). Laser setting 1 was a faster procedure with mild amounts of bleeding. The least amount of bleeding was seen with laser setting 2. After 1 month, only two cases of the laser setting 2-treated areas showed an isolated pigmented area in the papilla; at 12 months, the mean Hedin indexes were still less than 2 and mean Dummett index less than 1 in all treatment techniques, with the lowest scores seen in the laser setting 1 sites. Based on our results, Er,Cr:YSGG laser can be more convenient for gingival depigmentation compared to surgical blade. Although not statistically significant, laser setting 1 with shorter pulse duration and higher water spray showed better overall results. However, laser setting 2, with longer pulse duration and less water spray, resulted in better coagulative effects and can be used to control bleeding wherever necessary in clinical practice.

Evaluation of Effectiveness of Photodynamic Therapy With Low-level Diode Laser in Nonsurgical Treatment of Peri-implantitis.

Introduction: Side effects related to antibiotic therapy for peri-implantitis are rare in laser therapy (LT); therefore, the aim of this study was to evaluate the effectiveness of LT and photodynamic therapy (PDT) on patients with primary peri-implantitis. Methods: In this randomized clinical trial, 40 implants presenting primary peri-implantitis in 20 patients with a mean age of 52.6 years old were included using the simple sampling technique. Periodontal treatment comprising scaling and root planing (SRP) was accomplished for the whole mouth while mechanical debridement with titanium curettes and air polishing with sodium bicarbonate powder was accomplished around the implants. The implants were randomly divided into two groups and treated with LT (control) and PDT (test). The clinical indices were measured at baseline, 6 weeks and 3 months after treatment. Real-time polymerase chain reaction (PCR) was used for analysis of microbial samples at baseline and 3-month follow-up. Data were analyzed with SPSS 20, using repeated-measures analysis of variance (ANOVA) and Friedman's and Mann-Whitney tests (α = 0.05). Results: Both groups showed statistically significant improvements in terms of bleeding on probing (P < 0.001), probing pocket depth (PPD) (P = 0.006) and modified plaque index (P < 0.001), with no significant differences between the 2 groups (P > 0.05). The number of Aggregatibacter actinomycetemcomitans (P = 0.022), Tannerella forsythia (P = 0.038) and Porphyromonas gingivalis (P = 0.05) in the test group and Porphyromonas gingivalis (P = 0.015) in the control group significantly decreased. Conclusion: The results suggested that LT and PDT have significant short-term benefits in the treatment of primary peri-implantitis.