108 research outputs found
Blue diode laser: A new approach in oral surgery?
No full textThe introduction of diode lasers in dentistry had several advantages, principally consisting on the reduced size, reduced cost and possibility to beam delivering by optical fibbers. Up today two diode wavelengths, 810 and 980 nm, were the most utilized in oral surgery but recently a new wavelength emitting in the blue had been proposed. The aim of this ex vivo study was to compare the efficacy of five laser wavelengths (450, 532, 808, 1064 and 1340 nm) for the ablation of soft tissues. Specimens were surgically collected from the dorsal surface of four bovine tongues and irradiated by the five different wavelengths. Thermal increase was measured by two thermocouples, the first at a depth of 0.5 mm, and the second at a depth of 2 mm while initial and final surface temperatures were recorded by IR thermometer. The quality of the incision was histologically evaluated by a pathologist by giving a score from 0 to 5. The time necessary to perform the excision varied between 215 seconds (1340 nm, 5W) and 292 seconds (808 nm, 3W). Surface temperature increase was highest for 1340 nm, 5W and lowest for 405 nm, 4 W. The most significant deep temperature increase was recorded by 1340 nm, 5 W and the lowest by 450 nm, 2 W. The quality of incision was better and the thermal elevation lower in the specimens obtained with shortest laser wavelength (450 nm)
Cyclosporin-induced gingival overgrowth: a clinical-epidemiological evaluation of 121 Italian renal transplant recipients
No full textBackground: Although other immunosuppressive agents have been
recently introduced (e.g., tacrolimus), it has been calculated that in
the next decade about 1 million people will still be taking cyclosporin
(CsA). The association between gingival overgrowth (GO) and the
use of CsA is still not clear. In the present study we evaluated the
prevalence and the degree of GO in a group of Italian renal transplant
patients and the possible relationship between gingival lesions
and demographic, oral, systemic, and pharmacological variables.
Methods: One hundred twenty-one renal transplant recipients
receiving immunosuppressive therapy with CsA were evaluated in
this study. Patients were classified in two groups. In the first (screening
group), we included all those patients referred by the Parma University
Renal Transplant Center for a general oral checkup, with no
specific indications for GO. The second group (non-screening group)
included all those patients who specifically had been referred to
the Oral Pathology and Oral Medicine Unit because of GO. We considered
the following variables: gender, daily CsA dose, duration of
immunosuppressive treatment, CsA plasma concentration, concomitant
use of another immunosuppressive agent (azathioprine),
use of other GO inducers (calcium channel blockers, anti-epileptic
drugs), oral hygiene scores, and other drugs taken at the time of
oral examination.
Results: Fisher’s exact test and chi square test demonstrated that
in the screening group, duration of immunosuppressive treatment
and oral hygiene scores were associated both with the prevalence
and the high GO scores (P1
DIT <0.0001; P2
DIT = 0.0023; P1
hyg = 0.0084;
P2
hyg = 0.0068). In the screening group, concomitant use of CsA and
azathioprine is related to a low development degree of GO (P =
0.0088). In the non-screening group, we found a significant association
between poor oral hygiene and high degree of GO (P = 0.0349).
Conclusion: In addition to a probable genetic predisposition,
duration of immunosuppressive treatment and oral hygiene status
are the most important variables related to development and degree
of GO during the use of CsA in this study
Laser welding and syncristallization techniques comparison: in vitro study.
No full textIntroduction. The aim of this study was to analyse the effects of an Er:YAG laser on enamel and dentine in cases of dental restorations involving fractured teeth, utilizing the dental fragment. Materials and Methods. Seventy-two freshly extracted bovine incisors were fractured at the coronal level by using a hammer applied with a standardized method, and the fragment was reattached by using three different methods: Er:YAG laser, orthophosphoric acid, and laser plus acid. The different groups were evaluated by a test realized with the dynamometer to know the force required to successfully detach the reattached fragment and by a microinfiltration test by using a 0.5% methylene blue solution followed by the optic microscope observation. Results. The compression test showed only a slight difference between the three groups, without any statistical significance. The infiltration test used to evaluate the marginal seal between the fracture fragment and the tooth demonstrated that etching with Er:YAG laser alone or in combination with orthophosphoric acid gives better results than orthophosphoric acid alone, with a highly significant statistical result. Discussion. Reattaching a tooth fragment represents a clinically proven methodology, in terms of achieving resistance to detachment, and the aim of this work was to demonstrate the advantages of Er:YAG laser on this procedure. Conclusion. This "in vitro" study confirms that Er:YAG laser can be employed in dental traumatology to restore frontal teeth after coronal fracture
Er:YAG Laser: A New Technical Approach to Remove Torus Palatinus and Torus Mandibularis.
No full textObjective. The aim of this study was to assess the ability of Er:YAG laser to remove by excision torus mandibularis and to smooth torus palatinus exostosis. Materials and Methods. Torus mandibularis (TM) and torus palatinus (TP) were surgically eliminated via the Er:YAG laser using the following parameters: TM: output power ranging from 500 to 1000 mJ, frequency from 20 to 30 Hz, sapphire tips (diameter 0.8 mm), air-water spray (ratio 5/5), pulse duration 150 μsec, fluence ranging from 99592 J/cm(2) to 199044,586 J/cm(2). TP: a peeling technique was used to eliminate TP, as excision by slicing being impossible here. Results. TM: excision was obtained after 12730 pulses. TP: smoothing technique took more time compared with excision. Once peeling was considered to be accomplished, the use of a surgical rasp was necessary to eliminate bone spicules that could delay the wound to heal in good conditions. Conclusion. Er:YAG excision (TM) or Er:YAG peeling (TP) are safe clinical techniques easy to practice even if the time required for excision or surface smoothing is more than the time required with bony burs and high speed instruments
Thermal increase in the oral mucosa and in the jawbone during Nd:YAG laser applications. Ex vivo study.
No full textOBJECTIVE:
Literature reports bactericidal and biostimulant effects for Nd:YAG laser procedures on bone and oral mucosa but the possible overheating can cause damage to anatomical structures. The aim of the study was to evaluate the is the evaluation of thermal increase in different levels of oral tissues: mucosa, periosteum and bone during defocused application of Nd:YAG laser at different parameters.
STUDY DESIGN:
Superficial thermal evaluation was performed in pig jaws with a thermal camera device; deep thermal evaluation was realized by 4 thermocouples placed at a subperiosteal level and at 1,2 and 4 mm depth in the jaw bone. Laser applications of 1 minute were performed 5 times (with a pause of 1 minute) on a surface of 4 cm2 with a Nd:YAG laser (MSP mode, 320 micrometer fiber, defocused mode) with different parameters. Temperatures were recorded before and after laser applications and after each pause in order to evaluate also the thermal relaxation of tissues.
RESULTS:
At submucosal level, mean thermal increase was between 1.1°C and 13.2°C, at 1 mm depth between 1.1°C and 8.5°C, at 2 mm depth between 1.1°C and 6.8°C, at 4 mm depth between 1.0°C and 5.3°C. Temperature decrease during the rest time period was variable between 0°C and 2.5°C.
CONCLUSIONS:
Temperatures reached during clinical procedures with parameters reported in the literature in biostimulation protocols (1.25-2 Watts) for the five minutes of application are not dangerous for biological structures. The decrease in temperature during the rest time period is less considerable in the bone in comparison to oral mucosa
Odontogenic myxofibroma: a concise review of the literature with emphasis on the surgical approach
No full textPurpose
: The aim of this work is to report a review of the literature concerning epidemiology, clinical and radiographic features as well as treatment of odontogenic myxofibroma (MF).
Methods
: The PubMed database was searched using the following keywords: “odontogenic myxofibroma”, “odontogenic fibromyxoma”, “myxofibroma of the jaw” and “fibromyxoma of the jaw”.
Results
: Fifteen articles reporting the experience with 24 patients were identified. Male/female ratio was 1:1.4
and the average age was 29.5 years. The most frequent location was the mandible. In 66.7% of the cases the radiographic appearance was a multilocular radiolucency. Swelling was observed in 13 patients (92.86%), varying
degrees of pain in 5 (35.71%) and paresthesia in only one patient (7.14%). Six out of 24 patients (26.09%) were
treated with radical surgery and 17 (73.91%) with a conservative approach. In two out of 21 cases (9.52%) a recurrence was reported.
Conclusions
: MF is an extremely rare tumor and no agreement exists on the causes of its development. According to the present review, the choice of treatment should depend on variables such as localization, presence of a
primary or of a recurrent lesion, age, general medical conditions and aesthetic needs of the patien
Intraoral Laser Welding (ILW) in Implant Prosthetic Dentistry: Case Report
No full textThe aim of this clinical study was to describe the possibility of using the Nd:YAG laser device utilized in the dental offices to weld metals intraorally. The authors, before applying this technique “in vivo” on human subjects, tested the “in vitro” metal welding efficacy of dental Nd:YAG device firstly by interferometry, SEM, and EDS and subsequently by thermal camera and thermocouples in order to record temperature changes during the welding process on bovine jaws. Four implants were inserted in the edentulous maxillary arch of a 67 years old male patient. Immediately after that, a bar previously made by the dental technician was intraorally welded to the abutments by Nd:YAG laser (Fidelis Plus III, Fotona, Slovenia) with these parameters: 9.90 mJ, 1 Hz, 15 msec, 0.6 mm spot. Then the prosthesis was connected to the bar with four OT Caps. This clinical study, even if preliminary, suggests that laser welding technique may be intraorally used without side effects
Laser Welded versus Resistance Spot Welded Bone Implants: Analysis of the Thermal Increase and Strength
No full textIntroduction. The first aim of this “ex vivo split mouth” study was to compare the thermal elevation during the welding process of titanium bars to titanium implants inserted in pig jaws by a thermal camera and two thermocouples. The second aim was to compare the strength of the joints by a traction test with a dynamometer. Materials and Methods. Six pigs’ jaws were used and three implants were placed on each side of them for a total of 36 fixtures. Twelve bars were connected to the abutments (each bar on three implants) by using, on one side, laser welding and, on the other, resistance spot welding. Temperature variations were recorded by thermocouples and by thermal camera while the strength of the welded joint was analyzed by a traction test. Results. For increasing temperature, means were 36.83 and 37.06, standard deviations 1.234 and 1.187, and P value 0.5763 (not significant). For traction test, means were 195.5 and 159.4, standard deviations 2.00 and 2.254, and P value 0.0001 (very significant). Conclusion. Laser welding was demonstrated to be able to connect titanium implant abutments without the risk of thermal increase into the bone and with good results in terms of mechanical strength
Medication-Related Osteonecrosis of the Jaw: An Autofluorescence-Guided Surgical Approach Performed with Er:YAG Laser
No full textOBJECTIVE:The aim of this study was to propose an autofluorescence (AF)-guided surgical approach performed with Er:YAG laser and Nd:YAG low-level laser therapy (LLLT).
BACKGROUND DATA:Medication-related osteonecrosis of the jaw (MRONJ) therapy remains an unresolved problem. The proposed conservative and surgical treatment regimens are associated with contradictory success rates. However, the increased experience with MRONJ management suggests that surgical therapy can halt disease progression, and can allow a histology-based diagnosis of osteonecrosis. Surgical approach with Er:YAG laser is associated with significantly better results compared with medical treatment and traditional surgical approaches. One of the difficulties encountered during surgical removal of a MRONJ is the precise individuation of necrotic bone margins.
PATIENT AND METHODS: A case of Stage III maxillary osteonecrosis treated with a new surgical approach is presented.
RESULTS: After 7 months of follow-up, complete mucosal healing was evident, and the patient was free of symptoms. Such a technique allowed a highly accurate and minimally invasive approach through the selective ablation of the non-/hypofluorescent areas.
CONCLUSIONS:Taking into account the advantages of laser therapy and the possible effectiveness of AF in highlighting surgical margins, this approach would probably achieve excellent outcomes
Surgical approach with Er:YAG laser on osteonecrosis of the jaws (ONJ) in patients under bisphosphonate therapy (BPT).
No full textOsteonecrosis of the jaw (ONJ) in patients on long-term bisphosphonate Therapy (BPT) has been reported with increasing frequency in literature over the past 4 years. Therapy for this condition is still a dilemma. Temporary suspension of BPT offers no short-term benefits; hyperbaric oxygen has no proven efficacy and therefore is not recommended. Intermittent or continuous antibiotic therapy with surgical debridement can be beneficial to palliate the symptoms. Er:YAG laser can be used to eliminate necrotic bone portions by partial or total resection as an alternative to conventional rotary devices. In our study, 91 patients affected by ONJ-BP lesion, for a total of 115 ONJ sites were observed between January 2004 and May 2008 (Department of Odontostomatology, University of Parma). Fifty-five ONJ sites were considered for this study in four different groups, retrospectively identified on the basis of treatment performed (G1-G4). G1: 13 ONJ-BP sites were treated with medical therapy (amoxicillin 1gr x 3/die per os with metronidazole 250 mg x 2/die per os) for at least 2 weeks; G2: 17 ONJ-BP sites received medical treatment in association with cycles of low-level laser therapy (LLLT) applications performed using an Nd:YAG laser (1,064 nm) once a week for 2 months; G3: 13 ONJ-BP sites were surgically treated (sequestrectomy of necrotic bone, debridement, corticotomy/surgical removal of alveolar and/or cortical bone); G4: 12 ONJ-BP sites were treated with surgical therapy performed using an Er:YAG laser (2,940 nm) in association with LLLT. Clinical success has been defined for each treatment performed as: (a) complete mucosal healing free from signs and symptoms (classified as stage "0") or (b) transition from a higher to a lower stage (Ruggiero staging) for at least 3 months. All the ONJ-BP sites treated with Er:YAG laser (G4 group) had a clinical improvement (100%) and 87.5% of sites had a complete mucosal healing with a mean follow-up of 13 months. The result obtained in the G4 is extremely significant in comparison with those obtained by medical treatment alone or in a traditional surgical approach. Thanks to the high degree of affinity of this wavelength for water and hydroxyapatite, both soft and bone tissues can be easily treated. This technique can also be used for conservative operations whereby necrotic bone is vaporized until healthy bone is reached. In addition, an additional advantage of the Er:YAG laser is its bactericidal and possible biostimulatory action, accelerating the healing of both soft tissues and bone tissues, in comparison to conventional treatments. In conclusion, from our experience, it is possible to observe that an early conservative surgical approach with Er:YAG laser associated with LLLT, for BP-induced ONJ could be considered as more efficient in comparison with medical therapy or other conventional techniques
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