Journal of Lasers in Medical Sciences

In this review collected from the literature on usage of laser in oral minor surgery based on a Medline search in the time period between the years: 2008 and 2013, the most current evidence on laser-assisted oral minor surgery is going to be surveyed.

Used in conjunction with or as a replacement for traditional methods, it is expected that specific laser technologies will become an essential component of contemporary dental practice over the next decade. The current review is designed to focus on the acid resistance of laser application and tries to introduce laser settings capable to achieve this feature for clinical application. Application of laser for its acid resistance might be a valuable adjunct to conventional acid etching for susceptible sites in high caries risk patients such as patients with rampant caries, who cannot follow oral hygiene instructions due to their systematic disabilities, or those under orthodontic treatment with plaque retentive attachment on their teeth. The key words “enamel acid resistance” and “laser” were searched in PubMed. In brief, the current paper involves the results on 5 items: A summary on laser application; Suggested mechanisms of acid resistance; Different types of laser beams used in acid resistance; Comparison of application of different laser types; and Conclusion.

Introduction: Since it is not possible to form an adequate micromechanical bond between resin cement and zirconia ceramics using common surface treatment techniques, laser pretreatment has been suggested for zirconia ceramic surfaces. The aim of this study was to evaluate the effect of Carbon Dioxide (CO₂) Laser treatment on shear bond strength (SBS) of resin cement to zirconia ceramic.

Methods: In this in vitro study thirty discs of zirconia with a diameter of 6 mm and a thickness of 2 mm were randomly divided into two groups of 15. In the test group the zirconia disc surfaces were irradiated by CO₂ laser with an output power of 3 W and energy density of 265.39j/cm2. Composite resin discs were fabricated by plastic molds, measuring 3 mm in diameter and 2 mm in thickness and were cemented on zirconia disk surfaces with Panavia F2.0 resin cement (Kuraray Co. Ltd, Osaka, Japan). Shear bond strength was measured by a universal testing machine at a crosshead speed of 0.5 mm/min. The fracture type was assessed under a stereomicroscope at ×40. Surface morphologies of two specimens of the test group were evaluated under SEM before and after laser pretreatment. Data was analyzed by paired t-test (p value < 0.05).

Results: The mean SBS values of the laser and control groups were 12.12 ± 3.02 and 5.97 ± 1.14 MPa, respectively. Surface treatment with CO₂ laser significantly increased SBS between resin cement and zirconia ceramic (p value = 0.001).

Conclusion: Under the limitations of this study, surface treatment with CO₂ laser increased the SBS between resin cement and the zirconia ceramic.

Introduction: Recurrent corneal erosion occurs when the wounded corneal epithelium failed to adhere to the underlying stroma. Therefore, this work aimed to assess the effect of treatment of corneal injury using Q- switched Nd:YAG laser. 

Method: Twenty one New Zealand male rabbits weighing 2-2.5 kg and 3 months old were classified into three main groups. The control group: did not received any treatment (n=3 rabbits). The rest of the animals (n= 18 rabbits), corneal epithelium was injured by syringe needle and blade 15 and divided into:(A) Normal healing group: which was divided into three subgroups (n=3 rabbits each), and the animals were left for normal healing for1 day, 1 week, and 4 weeks respectively, (B) Laser treated group: divided into three subgroups (n=3 rabbits each) and subjected to anterior stromal puncture using Q-switched Nd: YAG laser on corneal sub-epithelium or superficial stroma, and the animals were left for 1 day, 1 week, and 4 weeks respectively. After the demonstrated periods, the corneas were isolated for estimation of total protein content, sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), total antioxidative capacity (TAC), total oxidative capacity (TOC) and oxidative stress index (OSI).

Results: The present results of corneal total protein showed increment in the percentage change in normal healed groups after 1 day, 1 week and 4 weeks by values of 93%, 68% and 39%. In Q-switched Nd: YAG laser treated group the results showed better improvement in corneal protein than normal healed group with percentage changes of 58%, 29%, and 7.5% respectively. In SDS- PAGE, a protein band at 110 KD appeared in the migrating epithelium for both normal healed group and Q-switched Nd:YAG laser treated group with changes in the peaks intensities at middle and  low molecular weight regions. Moreover, after 4 weeks the peak at 110 KD disappeared in the wounded epithelium treated with Q-switched Nd:YAG. After four weeks, the OSI in laser treated corneas showed pronounced balance between antioxidative capacity and oxidative capacity.

Conclusion: Anterior stromal puncture by Q-switched Nd:YAG laser is an effective, simple, safe and promising procedure to treat recurrent corneal erosion than normal healing.

Introduction: Indirect composites are developed to overcome the shortcomings of direct composites but, the adhesion of resin cements to indirect composites is still difficult.

The purpose of this study was to evaluate the surface morphology of indirect resin composite treated by different powers of Er:YAGlaser using Scanning Electron Microscopy (SEM).

Methods: indirect resin composite blocks (GC Gradia DA2, Japan) with 15× 10 × 10 mm dimensions were made according to manufacturer's instructions (n=7). The bonding surface of these blocks were polished, then the samples were divided to seven groups as follow: Erbium-Doped Yttrium Aluminum Garnet (Er:YAG )laser with output power of 2, 3, 4, 5, 6,7 W (frequency of 20 Hz, very short pulse) and no treatment. Then, the surfaces were evaluated by scanning electron microscope.

Results: The surface treated by Er:YAG laser showed a porous surface. But the amount and pattern of these irregularities differ in each group which may produce micromechanical retention compared to control group with no treatment.

Introduction: With the rapid increase in use of lasers in medical treatments, it is important to understand the mechanisms of heat transfer in biological tissues in order to minimize damage to the tissues resulting from extra heat applied. The aim of this study is to investigate the temperature distribution in living biological tissues when laser irradiation is used in a treatment.

Methods:  In this work a model was suggested to study the impact of several parameters such as (laser power, exposure time, laser spot size) on the temperature distribution within skin tissues when subjected to a laser source. A three-dimensional finite element thermal model of biological tissues was developed using bio-heat equation to describe heat transfer in living tissues.

Results: Temperature distribution within skin tissues subjected to laser heating is calculated in details using the Finite element method and a suggested model; the results are presented in figures and tables showing the effects of Laser spot size, power and exposure time on temperature distribution within treated tissue.

Conclusion: the results presented in this work  are expected to be useful in optimizing Laser spot size, power and exposure time for a variety of laser applications medicine and surgery.    

Introduction:The aim of this study was to evaluate and compare the in vitro effect of the Erbium-Doped Yttrium Aluminum Garnet (Er:YAG) laser with different radiation distances and high-speed rotary treatment on the shear bond strength of flowable composite to enamel of human permanent posterior teeth .

Methods : freshly extracted human molar teeth with no caries or other surface defects were used in this study (n=45). The teeth were randomly divided into 3 groups. Group 1: treated with non-contact Er:YAG Laser and etched with Er:YAG laser, Group 2: treated with contact Er:YAG Laser and etched with Er:YAG laser, Group 3 (control): treated with diamond fissure bur and etched with acid phosphoric 37 % . Then the adhesive was applied on the surafces of the teeth and polymerized using a curing light appliance. Resin cylinders were fabricated from flowable composite. Shear bond strength was tested at a crosshead speed of 0.5 mm/min.

Results: The amount of Shear Bond Strength (SBS) in the 3 treatment groups was not the same (P<0.05).The group in which enamel surfaces were treated with diamond fissure bur and etched with acid (conrtol group) had the highest mean shear bond strength (19.92±4.76) and the group in which the enamel surfaces were treated with contact Er:YAG laser and etched with Er:YAG laser had the lowest mean shear bond strength (10.89±2.89). Mann-whitney test with adjusted P-value detected significant difference in shear bond strength between the control group and the other 2 groups (P < 0.05).

Conclusion: It was concluded that both contact and non-contact Er:YAG laser treatment reduced shear bond strength of flowable resin composite to enamel in comparison with conventional treatment with high speed rotary. Different Er:YAG laser distance irradiations did not influence the shear bond strength of flowable composite to enamel.

Introduction: Halitosis is a common problem that affects a large portion of the population worldwide. The origin of this condition is oral in 90% of cases and systemic in 10% of cases. The foul odor is caused mainly by volatile sulfur compounds produced by Gram-negative bacteria. However, it has recently been found that anaerobic Gram-positive bacteria also produce hydrogen sulfide (H₂S) in the presence of amino acids, such as cysteine. Light with and without the combination of chemical agents has been used to induce therapeutic and antimicrobial effects. In photodynamic therapy, the antimicrobial effect is confined to areas covered by the photosensitizing dye. The aim of the present case series study was to evaluate the antimicrobial effect of photodynamic therapy on halitosis in adolescents through the analysis of volatile sulfur compounds measured using a sulfide meter (Halimeter®).

Methods: Five adolescents aged 14 to 16 years were evaluated using a sulfide meter before and one hour after photodynamic therapy, which involved the use of methylene blue 0.005% on the middle third and posterior thirds of the dorsum of the tongue and nine points of laser irradiation in the red band (660 nm) with an energy dose of 9 J, power output of 100 mW and 90-seconds exposure time.

Results: A 31.8% reduction in the concentration of volatile sulfur compounds was found in the comparison of the initial and final readings. The statistically significant reduction (p = 0.0091) led to an absence of halitosis following treatment (mean: 58.2 ppb).

Conclusion: Photodynamic therapy seems to be effective on reduction the concentration of volatile sulfur compounds.Considering the positive effects of photodynamic therapy in this case series, further studies involving microbiological analyses should be conducted to allow comparisons of the results.