Lasers in Medical Science最新文献

Xanthelasma palpebrarum (XP), characterized by soft, yellowish plaque primarily on the eyelids, is often associated with lipid metabolism disorders. XP can cause aesthetic concerns that affect social interactions and requires careful treatment evaluations due to potential complications and associations with systemic conditions. We aimed to assess the efficacy of and recurrence rates with erbium:yttrium aluminum garnet (Er:YAG) laser therapy in the treatment of XP. This was a retrospective review involving 214 patients treated with a 2,940 nm Er:YAG laser for XP from January 2021 to June 2023. Treatment efficacy was evaluated using standardized photography and the Vancouver Scar Scale (VSS), with follow-up assessments noting any complications or recurrence. The 214 patients with 457 lesions exhibited a complete removal of lesions post-treatment. Complications were minimal, with hypertrophic scarring occurring in 1.5% of patients and a recurrence rate of 10.5%. Patients with multiple lesions had a higher recurrence rate compared with those with single lesions. Based on VSS evaluation, 66.8% of patients (n = 143) were categorized as having excellent outcomes, while 29.0% (n = 62) were classified as having good outcomes. Er:YAG laser therapy has proven to be an effective and safe treatment modality for XP, accurately and safely removing lesions with minimal recurrence rates. It can achieve complete lesion removal, with recurrence at the treated site being very low. Additionally, Er:YAG laser treatment offers several advantages over surgical methods, making it a promising candidate to become the first-line treatment of choice for XP.

This study aims to investigate and compare the effects of short and long-term application of low-level laser therapy on the mandibular alveolar process of osteoporotic rats. Forty adult male albino rats were included in this study. After animal grouping, the experimental group received dexamethasone (0.1 mg/kg b.wt./day for 60 days) for the induction of osteoporosis, then the rats were treated using LLLT (830 nm, 100 mW, at 60 J/cm²). The lower jaw specimens were collected and processed for histological, molecular, and histomorphometric assessments. The osteoporotic group exhibited alveolar bone resorption, accompanied by significantly upregulated RANKL and downregulated OPG mRNA expression. The short-term application of laser group showed alveolar bone partial improvement with slightly downregulated RANKL and slightly upregulated OPG levels. The long-term application of laser group showed dramatic positive changes in the alveolar bone, with markedly downregulated RANKL and upregulated OPG levels. LLLT shows potential as a low-risk and impactful local management for osteoporosis, with long-term laser application demonstrably improving bone quality, quantity, and organization compared to short-term application.

To assess and compare two techniques of low-level laser application-transgingival (TLLLT) and intrasulcular (ILLLT)-used in photobiomodulation as an adjunct to basic periodontal therapy (BPT) in patients with periodontitis. A randomized, split-mouth, double-blind clinical trial was conducted, selecting three diseased periodontal sites from different quadrants in each patient. These sites were assigned to one of three treatment groups: SRP (control), SRP + TLLLT (test 1), and SRP + ILLLT (test 2). Low-level laser therapy in the test groups was applied at 48 h, 7 days, and 14 days after full-mouth SRP. Clinical parameters such as probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were assessed at baseline (T0), 3 months (T1), and 6 months (T2). Standardized periapical radiographs were used to assess radiographic bone density (RBD) 6 months post-treatment. Statistical analyses included repeated measures ANOVA for continuous variables and chi-square tests for categorical variables, with significance set at p < 0.05 and a 95% confidence interval. Significant reductions in PD (p < 0.001) and CAL (p < 0.001) were observed across all groups at 3 and 6 months, with no significant differences between groups. There were also no significant changes in BOP and RBD between groups at the follow-up intervals. Adjunctive photobiomodulation did not provide additional clinical or radiographic benefits over SRP alone, regardless of the laser application technique employed.

Reusing healing abutments is common practice among clinicians; however, ensuring complete surface decontamination is crucial to avoid further complications. This study aimed to evaluate the cleaning potential of Er: YAG laser at different frequencies, as an adjunctive step prior to autoclave sterilization. Forty contaminated healing abutments were divided into four groups. Positive control group included mechanical wiping and ultrasonic bath, Er: YAG laser (50 mJ/pulse, 100 µsec, water 30%, air 70%) at 20 Hz, 30 Hz, and 40 Hz with the powers of 1 W, 1.5 W, and 2 W respectively. Three unused healing abutments were used as the negative control group. Samples were stained with phloxine B and then photographed using a light microscope. The proportion of stained and contaminated areas on each healing abutment was then quantified using ImageJ. Statistical analysis showed significant differences in the amount of remaining debris among the groups (P < 0.05). The group treated with the Er: YAG laser at 40 Hz demonstrated the most effective decontamination, with the least residual debris observed across all HA surfaces. Higher laser frequencies correlated with reduced contamination, particularly in the body and top areas of the HAs. The Er: YAG laser, particularly at 50 mJ/pulse and 40 Hz, proved to be an effective method for decontaminating used HAs. This laser treatment may offer a reliable protocol for reusing HAs, enhancing the safety and success of implant therapy.

To compare the efficacy and safety of low-power holmium laser enucleation of the prostate (LP-HoLEP) with plasma kinetic resection of prostate (PKRP). Sixty-three patients treated with transurethral LP-HoLEP (observation group) and 68 patients treated with transurethral PKRP (control group) at Beijing Hospital of Traditional Chinese Medicine from November 2019 to November 2022 were retrospectively compared with regard to operation duration, intra-operative blood loss, prostate resection ratio, postoperative bladder irrigation time, postoperative indwelling urinary catheter time, postoperative urinary incontinence incidence, International Prostate Symptom Scale (IPSS), maximum urine flow rate (Qmax), and residual urine volume (RUV). In both groups, postoperative IPSS, Qmax, and RUV were significantly improved compared to preoperative values (P < 0.05). Comparing the observation group to the control group, the intra-operative blood loss were (59.6 ± 18.1) and (173.1 ± 85.3) ml, respectively (t = -10.350, P < 0.01); the prostate resection ratios were (81.2 ± 4.6) % and (56.7 ± 9.7)%, respectively (t = 18.230, P < 0.01); the postoperative bladder irrigation time was (39.1 ± 9.6) h and (49.7 ± 6.0) h, respectively (t = -7.623, P < 0.01); and the postoperative indwelling urinary catheter time was (111.5 ± 19.4) h and (120.4 ± 12.8) h, respectively (t = -3.125, P < 0.01). Comparing the observation group to the control group, the operation duration was (76.2 ± 18.6) and (83.0 ± 32.4) min, respectively, with no statistical difference (t = -1.226, P = 0.208); the postoperative urinary incontinence incidence was 12.7% and 8.8%, respectively and there was no statistical difference (χ² = 0.514, P = 0.473). LP-HoLEP offers excellent surgical efficacy and safety. LP-HoLEP is superior to PKRP in intra-operative blood loss, postoperative bladder irrigation time, and postoperative indwelling urinary catheter time, and can enucleate more hyperplastic glands.

Traumatic scars negatively impact the patient's quality of life. Fractional 1064 nm Nd: YAG picosecond laser improves scars. However, the effect varies among individuals. This study aimed to evaluate the treatment of traumatic scars with fractional 1064 nm Nd: YAG picosecond lasers and the factors associated with its prognostication. We conducted a retrospective study with 161 patients with traumatic scars. All scars were treated using fractional 1064 nm Nd: YAG picosecond lasers. Efficacy was determined based on blinded visual evaluation using the Manchester Scar Scale (MSS) and 5-point Global Assessment Scale (GAS). The mean MSS values before and after treatments was 17.4 ± 2.7 and 13.6 ± 2.6 (P < 0.001), respectively. Color, radiance, contour, and distortion of the traumatic scars improved. (all P < 0.001). The course, location, and height of the scars, and the number of treatments and energy densities, were related to treatment responses (P < 0.05). Fractional 1064 nm Nd: YAG picosecond laser is effective for treating traumatic scars. Clinicians can predict the prognosis using multiple factors.

Purpose: This systematic review and meta-analysis aimed to assess the gingival crevicular fluid (GCF) level of tumor necrosis factor-alpha (TNF-alpha) as a valuable inflammatory cytokine for estimation of the efficacy of adjunctive antimicrobial photodynamic therapy (aPDT) in stage II-IV periodontitis patients.

Methods: This review was conducted in accordance with the PRISMA statements, and registered in PROSPERO (CRD42022321211). An electronic search was conducted for articles comparing the efficacy of aPDT versus scaling and root planing (SRP) published up until June 2023. The mean GCF level of TNF-alpha and clinical attachment loss (CAL) with 95% confidence interval (CI) were pooled and compared between the groups using a random-effect model after 1-2, 4-5, 12-13, and ≥ 24 weeks. The I² test was applied to assess the heterogeneity of the findings, and publication bias was evaluated by visual inspection of the funnel plot symmetry.

Results: Analysis of 11 studies indicated a significant difference in GCF level of TNF-alpha at the 1-2, 12-13 and ≥ 24-week follow-ups in patients treated with aPDT + SRP. However, at the 4-5-week follow-up, the results were significant in favor of the control group (mean difference = -0.17, 95% CI = -1.86-152, P < 0.00001).

Conclusion: Despite the limitations of the included studies, aPDT can decrease the GCF level of TNF-alpha inflammatory biomarker for a longer period of time than SRP alone in grade II-IV periodontitis. However, further investigations are required to assess the efficacy of higher frequency of aPDT applications.

The aim of this study was to investigate the scientific evidence regarding the effectiveness of modified-ILIB (intravascular laser irradiation of blood) in the control of systemic conditions and/or oral changes during dental care. This systematic literature review study aimed to answer the question, "Is modified-ILIB an effective adjuvant therapy in the control of systemic conditions and/or oral changes in children and adults during dental treatment?". The protocol for this systematic review was registered in the PROSPERO database under number CRD42023493800. The search was carried out in the PubMed, Web of Science, LILACS, SCOPUS and EMBASE databases on June 10, 2024. Google Scholar was used as a search source for gray literature. Randomized clinical trials were included, without restrictions on language or year of publication. The RoB 2.0 tool was used to assess the risk of bias and GRADE was used to check the quality of the evidence. A total of 750 articles were retrieved and five studies were selected for this review. All studies were in English and were carried out in Brazil. The outcomes were periodontal parameters and glycemic control in patients with periodontitis and type II diabetes, anxiety control in pediatric dentistry, postoperative pain after third molar extraction and improving taste in post-COVID-19 patients. The majority of studies had a low risk of bias, while only one study was considered to have some concerns. The quality of evidence from the studies was considered very low. The current evidence does not overwhelmingly support the effectiveness of modified-ILIB in controlling oral and/or systemic conditions in dentistry.

Laser-activated irrigation (LAI) of root canal systems depends on the generation of cavitation bubbles in the endodontic irrigant. Physical studies thus far focused on pulse energy, pulse length, frequency, and fiber tip shape, mostly in plain water. This study investigated the effect of endodontically relevant molecules (sodium hypochlorite (NaOCl), 1-hydroxyethylidene-1,1-diphosphonic acid (HEDP), and their combination) in water on physical properties of the resulting solution, and their impact on primary cavitation bubble features. A commercially available 3% NaOCl irrigant was used, as well as an etidronate powder (Dual Rinse HEDP) to be admixed. Physical parameters (density, surface tension, and viscosity) of these solutions were assessed, including HEDP effects in an ascending concentration series of up to 20%. Primary cavitation bubble features (dimensional and temporal) in conjunction with a pulsed erbium-doped yttrium aluminium garnet (Er: YAG) laser equipped with a flat or conical fiber tip were studied in these liquids using a high-speed camera. Solutes increased the solution's density, surface tension, and viscosity, with an almost linear response to HEDP dosage (Pearson correlation coefficient > 0.95). This reduced the speed of the primary cavitation bubble, and increased its size and lifetime. Increased HEDP concentrations had a pronounced effect on the shape of bubbles generated at the flat tip. NaOCl and HEDP alter the physical properties of water, which, in turn, affect its cavitation behavior.