Original Article

Influence of Laser Irradiation Low Intensity on Reparative Osteogenesis and Angiogenesis under Transosseous Osteosynthesis

Yuri Mikhailovich Iryanov

Journal of Lasers in Medical Sciences, Vol. 7 No. 3 (2016), 17 July 2016, Page 134-138

Introduction: The use of non-medicinal facilities of correcting processes for various pathological conditions is one of the most urgent problems of modern medicine. The purpose of the work is to study the efficiency of low-intensive of infrared laser irradiation in promoting reparative osteogenesis and angiogenesis during fracture treatment under transosseous osteosynthesis with a qualitative and quantitative morphological analysis.

Methods: A tibial fracture was modeled experimentally in rats from control and experimental groups, then repositioning and fixation of fragments performed. The fracture zone of the experimental group animals was exposed to pulsed infrared laser irradiation of low intensity. The animals from control group underwent irradiation simulation. The operated bones were investigated using x-ray, light and electron microscopy, x-ray electron probe microanalysis.

Results: The sessions of laser irradiation decreased inflammatory process severity, activated fibrillogenesis and angiogenesis, accelerated the compactization of newly formed bone tissue, and enhanced its maturity degree while primary healing occurred in the fracture.

Conclusion: Laser therapy of fracture zone ensures the formation of regenerated bone and fragment union within earlier periods.

Efficacy of Antimicrobial Photodynamic Therapy as an Adjunctive to Mechanical Debridement in the Treatment of Peri-Implant Diseases: A Randomized Controlled Clinical Trial

Mohammad Reza Karimi, Ali Hasani, Salva Khosroshahian

Journal of Lasers in Medical Sciences, Vol. 7 No. 3 (2016), 17 July 2016, Page 139-145

Introduction: The purpose of the present study was to assess the clinical effects of anti-microbial photodynamic therapy (PDT) after closed surface scaling in the treatment of peri-implant diseases.

Methods: Ten patients with a total of 15 pairs of dental implants, showing clinical and radiographic signs of peri-implant diseases, were included in this study. In each patient, one implant randomly served as control implant and the other served as test implant. The control implants were treated with closed surface scaling only and the test implants received additionally PDT, using light with a wavelength of 630 nm and intensity of 2000 mw/cm2 for 120 seconds after application of photosensitizer in peri-implant sulcus. Clinical parameters were evaluated before and 1.5 and 3 months after treatment.

Results: Statistical analysis showed significant differences in probing pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and gingival index (GI) at each time point between the two groups. There were no statistically significant changes with respect to any of the parameters in the control group. Complete resolution of BOP at 3 months was achieved in 100% of test implants. At 1.5 and 3 months, there were significant differences in the mean probing depth and CAL gain measurements at implants in the test group.

Conclusion: The present study revealed that adjunctive use of PDT following closed surface scaling could lead to clinical improvement of peri-implant diseases. Further studies are necessary to confirm our results

Low-Level Laser Action on Orthodontically Induced Root Resorption: Histological and Histomorphometric Evaluation

Eliziane Cossetin Vasconcelos, Jose Fernando Castanha Henriques, Marinês Vieira Silva Sousa, Rodrigo Cardoso de Oliveira, Alberto Consolaro, Arnaldo Pinzan, Fernanda Pinelli Henriques, Caroline Nemetz Bronfman

Journal of Lasers in Medical Sciences, Vol. 7 No. 3 (2016), 17 July 2016, Page 146-151

Introduction: Studies have been conducted to develop a means of preventing, controlling or reducing orthodontically induced root resorption. Phototherapy has demonstrated effectiveness as an anti-inlammatory and, considering the inlammatory origin of this pathology, this study evaluated the effects of laser on root resorption.

Methods: The research was conducted among 54 80-day-old male Wistar rats, with weights of 280 ± 40 g. Phototherapy consisted of a diode laser (Ga-Al-As), calibrated with a wavelength of 808 nm, an output power of 100 mW, 2.1 J or 96 J of energy and area of 0.0028 cm2. The application was continuous, punctual and with contact. The left irst maxillary molar was moved by a super-elastic closed spring with a pre-calibrated and constant force of 25 g. The specimens were irradiated every 48 hours, totaling three or six times, depending on the group to which they belonged. Euthanasia was made in the 7th or 10th day after the onset of movement. The histological and histomorphometric examination was performed with sections of 6 μm stained with hematoxylin and eosin (H&E).

Results: Considering the dosimetry studied, when compared the subgroups with the same time of movement, 7 or 10 days, the low-level laser (LLL) has no statistically signiicant effect on the root resorption. As expected, differences were found between groups with different time of movement.

Conclusion: Based on the result, this dosimetry does not seem to be clinically recommended to avoid or reduce inlammatory root resorption, but it also does not induce any root surface alteration.

Microshear Bond Strength of OptiBond All-In-One Self-adhesive Agent to Er:YAG Laser Treated Enamel After Thermocycling and Water Storage

Shahin Kasraei, Ebrahim Yarmohammadi, Mohammad Vahid Ghazizadeh

Journal of Lasers in Medical Sciences, Vol. 7 No. 3 (2016), 17 July 2016, Page 152-158

Introduction: This study aimed to compare the microshear bond strength of composite to enamel treated with Erbium-Doped Yttrium Aluminum Garnet (Er:YAG) laser using a self-etch one step bonding agent.

Methods: Seventy-six enamel surfaces were prepared from 38 sound human third molar teeth. Specimens were randomly divided into four groups of 18. The enamel surface in half the specimens was irradiated with Er:YAG laser. One extra specimen from each group was evaluated under a scanning electron microscope (SEM). Composite micro-cylinders were bonded to the specimen surfaces using OptiBond All-In-One (OB) adhesive agent and stored in distilled water for 24 hours. Half the specimens were thermocycled (2000 cycles) and stored in distilled water at 37°C for three months (TW). The microshear bond strength of composite to enamel was measured using a universal testing machine at a crosshead speed of 1 mm/min. The fractured surfaces were evaluated under a stereomicroscope at ×40 magnification to determine the mode of failure. Data were analyzed using repeated measures analysis of variance (ANOVA) and t test.

Results: The mean values (±standard deviation) were 17.96 ± 2.92 MPa in OB group, 22.29 ± 4.25 MPa in laser + OB group, 18.11 ± 3.52 MPa in laser + OB + TW group and 9.42 ± 2.47 MPa in OB + TW group. Repeated measures ANOVA showed that laser irradiation increased the microshear bond strength (P < 0.001). Bond strength decreased when the samples were thermocycled and stored for three months (P < 0.001). The interaction effect of water storage and laser treatment on bond strength was significant (P < 0.05).

Conclusion: Enamel surface preparation with Er:YAG laser is recommended to enhance the durability of the bond of self-etch bonding systems to enamel.

Evaluation of Effective Transmission of Light Through Alveolar Bone: A Preliminary Study

Monalisa Jacob Guiselini, Alessandro Melo Deana, Marcelo Betti Mascaro, Raquel Agnelli Mesquita-Ferrari, Ana Carolina Costa Mota, Sandra Kalil Bussadori, Cristiane Miranda França, Kristianne Porta Santos Fernandes

Journal of Lasers in Medical Sciences, Vol. 7 No. 3 (2016), 17 July 2016, Page 159-162

Introduction: The aim of the present study was to determine the effective transmission of 660 and 780 nm lasers through mandibular and maxillary alveolar bones in the buccal-lingual/ palatal direction.

Methods: The laser probe was positioned in direct contact with the surface of the anterior, middle and posterior regions of each bone (5 dried maxillae and 5 mandibles) and the power meter was positioned on the bone wall opposite to the radiated wall for the measure of the remaining energy passing through the bone tissue. Ten measurements were performed with each laser at each irradiated point.

Results: Transmitted power was significantly higher in bones irradiated with 780 nm laser. Tendencies toward greater average power transmitted in the anterior region of both bones at both wavelengths were also observed.

Conclusion: Dosimetry and the choice of light source may be adjusted according to the anatomic region of the alveolar bone to be treated.

Algorithm for Analyzing Thermal Images of Laser Irradiated Human Skin

Johnny Toumi, Fawaz Saiof, Wesam Bachir

Journal of Lasers in Medical Sciences, Vol. 7 No. 3 (2016), 17 July 2016, Page 163-166

Introduction: Tracking temporal changes of temperature during laser skin treatment plays an important role in improving the process of laser skin treatment itself. There are a number of methods to analyze temperature’s temporal dependency during laser skin treatment; some of those methods depend on imaging the skin with thermal cameras. However, the use of thermal cameras exhibits specific problems, including the ability to track laser-skin interaction spot. This paper is dedicated to solve that problem using digital image processing program coded with Matlab.

Methods: The measurements were taken for 15 native Syrian subjects of different sex, age and skin tones, the treated ailment was port wine stain. The clinical work (laser exposure) was performed in Damascus University, hospital of dermatology. The treatment was observed by thermal camera and analyzed using the proposed Matlab coded tracking system.

Results: For all the subjects, the treatment laser spot was tracked and the curves of skin temperature change with time where calculated by the use of the proposed algorithm, then the active time was calculated for each subject. The algorithm proved practical and robust.

Conclusion: The proposed algorithm proved to be efficient and can be used to support future researchers with capability to measure the temperature with high frame rate

An In Vitro Comparison of the Bond Strength of Composite to Superficial and Deep Dentin, Treated With Er:YAG Laser Irradiation or Acid-Etching

Homayoon Alaghehmand, Fatemeh Nezhad Nasrollah, Hanieh Nokhbatolfoghahaei, Reza Fekrazad

Journal of Lasers in Medical Sciences, Vol. 7 No. 3 (2016), 17 July 2016, Page 167-171

Introduction: The aim of this study was to compare the micro-shear bond strength of composite resin on superficial and deep dentin after conditioning with phosphoric acid and Erbium-Doped Yttrium Aluminum Garnet (Er:YAG) laser.

Methods: Thirty human molars were selected, roots were removed and crowns were bisected to provide a total of 60 half-crowns. Specimens were ground to expose superficial and deep dentin. Samples were assigned to six groups: (1) AS (acid etching of superficial dentin); (2) AD (acid etching of deep dentin); (3) LS (Er:YAG laser irradiation on superficial dentin); (4) LD (Er:YAG laser irradiation on deep dentin); (5) LAS (Er:YAG laser irradiation on superficial dentin followed by acid etching); (6) LAD (Er:YAG laser irradiation on deep dentin followed by acid etching) The adhesive protocol was performed. Samples were thermocycled and micro-shear bond strength was tested to failure. The data were submitted to statistical analysis with one-way analysis of variance (ANOVA) and Tukey post hoc test.

Results: The AS group, demonstrated the greatest amount of micro-shear bond strength. Statistical analysis showed a decrease in bond strength in laser-treated groups which was more significant for deep dentin.

Conclusion: Preparation of dentin with laser did not improve bonding to superficial and deep dentin.

Introduction: Marginal seal integrity is important for a successful adhesive dental restoration. Alterations caused by laser irradiation in the enamel and dentin surface can affect the marginal integrity of adhesive restorations. The aim of this study was to evaluate the microleakage of a composite resin restoration in primary teeth following laser irradiation of enamel and dentin.

Methods: Forty freshly extracted sound human primary maxillary and mandibular anterior teeth were used in this study. The teeth were randomly divided into two groups (I and II), with 20 teeth in each. In group I, proximal cavities (Class III) were prepared using an airotor hand –piece and diamond bur. The cavities were etched for 15 seconds with 35% phosphoric acid gel, rinsed with water for 15 seconds, air dried and a bonding agent was applied onto the cavity surfaces and light cured for 20 seconds. The cavities were restored with composite resin and light cured for 40 seconds. In group II, proximal (Class III) cavities were prepared using Erbium, Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) (Er,Cr:YSGG) (Biolaseiplus, wave length 2.78 μm). The cavity was then rinsed, air dried and without etching, a bonding agent was applied and light cured for 20 seconds. The cavities were restored in the same manner as that of group I. The treated teeth were mounted on acrylic resin blocks and were subjected to a thermocycling regimen. Following, the teeth were immersed in 2% methylene blue for 24 hours. The teeth were sectioned longitudinally in a bucco-lingual direction using a diamond disc at slow speed. The sections of all the groups were examined under a stereomicroscope for micro-leakage.

Results: The mean scores for microleakage in group I was 1.95 ± 1.31 and in group II it was 1.4 ± 1.27. There was no significant difference between the two groups (P = 0.882). Conclusion: No significant difference in microleakage was noticed between the composite resin bonded to lased enamel and dentin and the teeth preparedwith conventional method.

The Effect of Low Level Laser Therapy on Direct Pulp Capping in Dogs

Maryam Bidar, Siavash Moushekhian, Maryam Gharechahi, Ali Talati, Farzaneh Ahrari, Maryam Boujarpour

Journal of Lasers in Medical Sciences, Vol. 7 No. 3 (2016), 17 July 2016, Page 177-183

Introduction: The aim of this study was to determine the histologic effect of low level laser therapy (LLLT) with or without the use of mineral trioxide aggregate (MTA) on exposed pulp tissues of dogs.

Methods: Twenty-five premolar teeth in three healthy mature dogs were randomly divided into five groups. In group 1, the pulp tissue was capped with MTA. In groups 2 and 3, before capping with MTA, the exposure site was irradiated by low power lasers at 630 nm (20 mW, 150 seconds, 7.5 J/cm2) and 810 nm (peak power 80 W, average power 50 mW, 1500 Hz, 50 seconds, 6.25 J/cm2) wavelengths, respectively. In groups 4 and 5, the exposure site was irradiated similar to that described in groups 2 and 3, but the pulp tissue was covered by gold foil instead of MTA. After 2 months, the animals were sacrificed and the samples were prepared for histologic evaluation.

Results: There were differences in pulpal response and dentinal barrier formation among the study groups. The morphology of pulpal tissue and the integrity of dentinal barrier and formation of odontoblastic layer were more favorable in the first three groups. The occurrence of extensive and intense inflammation and necrosis was more frequent in groups 4 and 5.

Conclusion: Under the conditions used in this study, the presence of MTA as a pulp capping material was more important than laser therapy in the success of direct pulp capping (DPC) treatment. MTA proved to be an effective material either alone or in combination with laser irradiation in vital pulp therapy.

Comparison of the Amount of Temperature Rise in the Pulp Chamber of Teeth Treated with QTH, Second and Third Generation LED Light Curing Units: An In Vitro Study

Rajesh Harivadanbhai Mahant, Shraddha Chokshi, Rupal Vaidya, Pruthvi Patel, Asima Vora, Priyanka Mahant

Journal of Lasers in Medical Sciences, Vol. 7 No. 3 (2016), 17 July 2016, Page 184-191

Introduction: This in vitro study was designed to measure and compare the amount of temperature rise in the pulp chamber of the teeth exposed to different light curing units (LCU), which are being used for curing composite restorations.

Methods: The study was performed in two settings; first, an in vitro and second was mimicking an in vivo situation. In the first setup of the study, three groups were formed according to the respective three light curing sources. i.e. Quartz-Tungsten-Halogen (QTH) unit and two light-emitting diode (LED) units (second and third generations). In the in vitro setting, direct thermal emission from three light sources at 3 mm and 6 mm distances, was measured with a k-type thermocouple, and connected to a digital thermometer. For a simulation of an in vivo situation, 30 premolar teeth were used. Class I Occlusal cavity of all the teeth [RM1] were prepared and they were restored with incremental curing of composite, after bonding agent application. While curing the bonding agent and composite in layers, the intrapulpal temperature rise was simultaneously measured with a k-type thermocouple.

Results: The first setting of the study showed that the heat produced by irradiation with LCU was significantly less at 6 mm distance when compared to 3 mm distance. The second setting of the study showed that the rise of intrapulpal temperature was significantly less with third generation LED light cure units than with second generation LED and QTH light cure units.

Conclusion: As the distance from the light source increases, less irradiation heat is produced. Third generation LED lights cause the least temperature change in the pulp chamber of single rooted teeth.


Prevention of Enamel Adjacent to Bracket Demineralization Following Carbon Dioxide Laser Radiation and Titanium Tetra Fluoride Solution Treatment: An In Vitro Study

Amir Hossein Mirhashemi, Sina Hakimi, Mohammad Sadegh Ahmad Akhoundi, Nasim Chiniforush

Journal of Lasers in Medical Sciences, Vol. 7 No. 3 (2016), 17 July 2016, Page 192-196

 Introduction: The aim of this study was to assess the caries-preventive potential of carbon dioxide (CO2) laser application in conjunction with the use of titanium tetra fluoride solution on the enamel adjacent to bracket.

Methods: Seventy-five freshly extracted bovine incisors were used. In order to attach the brackets, the area of examination was covered with adhesive tape to limit acid etching of the entire enamel surface. Metal orthodontic brackets for upper central were bonded to all the teeth following the manufacturer’s instruction. Then all the teeth were painted with 2 layers of acid-resistant nail varnish on all surfaces except the boxes area cervical to the brackets. The teeth were then randomly divided into five groups (n = 15): control group (C); laser group (L); titanium group (T); laser-titanium group (LT) and titanium-laser group (TL). The laser-titanium group was first irradiated with CO2 laser (same as the L group) then TiF4 solution was applied on the enamel (same as the T group). Samples in the TL group were first treated with TiF4 solution (same as the T group) and then irradiated with CO2 laser on the surface (same as the L group). Then, the teeth were immersed in pH-cycling solutions. After that, the amount of calcium released into the two solutions (de- and re-mineralization) was measured with an atomic absorption spectroscopy. The data were analyzed by one-way Analysis of var-iance (ANOVA) and Tukey test.

Results: Calcium loss in LT, TL and T groups were significantly lower than those in the L and C groups (P < 0.05).

Conclusion: The application of Titanium tetra fluoride 4% solution on enamel can inhibit as much as 87% of subsequent caries like lesion progression.

A Comparative Study of Enamel Surface Roughness after Bleaching with Diode Laser and Nd: YAG Laser

Mansoreh Mirzaie, Esmaiel Yassini, Saber Ganji, Zohreh Moradi, Nasim Chiniforush

Journal of Lasers in Medical Sciences, Vol. 7 No. 3 (2016), 17 July 2016, Page 197-200

Introduction: Bleaching process can affect surface roughness of enamel, which is a vital factor in esthetic and resistance of tooth. The aim of this study was to compare surface roughness of enamel in teeth bleached using Diode and Neodymium-Doped Yttrium Aluminium Garnet (Nd: YAG) lasers with those bleached using conventional method.

Methods: In this study, 75 anterior human teeth from upper and lower jaws were randomly divided into 5 groups. Group 1: Laser white gel (Biolase, USA) with 45% hydrogen peroxide concentration and GaAlAs Diode laser (CHEESETM, GIGAA, China), group 2: Heydent gel (JW, Germany) with 30% Hydrogen peroxide concentration and Diode laser, group 3: Laser white gel and Nd:YAG laser (FIDELISTM, Fotona, Slovenia), group 4: Heydent gel and Nd:YAG laser and group 5: The Iranian gel Kimia (Iran) with 35% hydrogen peroxide concentration were used. Surface roughness of the samples was measured using the Surface Roughness Tester system (TR 200 Time Group, Germany) before and after bleaching. In each group, one sample was randomly selected for SEM analysis.

Results: The results showed that the mean surface roughness of the teeth before and after bleaching had a significant difference in all the study groups. It was indicated that after bleaching, the mean surface roughness had increased in all the study groups. The highest surface roughness was seen in the conventional bleaching group and the lowest surface roughness was reported in group 3 (laser white gel + diode laser), in which the average surface roughness increased by only 0.1 μm.

Conclusion: It was concluded that using the Laser white gel and the diode laser for bleaching resulted in the least surface roughness compared to conventional method.

Comparison of Carbon Dioxide Laser With Surgical Blade for Removal of Epulis Fissuratum. A Randomized Clinical Trial

Abbas karimi, Farhad Sobouti, Sara Torabi, Ali Bakhshandehfard, Armaghan Amirian, Mahsa Shariati, Ehsan Morshedi, Maryam Barati

Journal of Lasers in Medical Sciences, Vol. 7 No. 3 (2016), 17 July 2016, Page 201-204

Introduction: Epulis fissuratum is often formed as a result of a poor fitting denture. The conventional treatment for this fibrous hyperplastic tissue is to excise it using a scalpel and to close the wound by a continuous or an interrupted suture. The increased utilization of lasers in dentistry also includes the utilization of carbon dioxide (CO2) lasers in place of surgical scalpels in soft tissue surgeries. The objective of this study is to assess the feasibility of utilizing CO2 laser in place of scalpel in surgical treatment of epulis fissuratum.

Methods:In this clinical trial research (IRCT code: IRCT2016071124969N2), 19 patients were selected with nearly symmetrical epulis fissuratums in the anterior part of the jaws. The hyperplastic tissue was evenly divided into two sections in each patient. One section was randomly selected and cut by CO2 laser and the other section by a surgical scalpel. The wound created by the scalpel was closed by appropriate number of interrupted sutures. Surgery duration and bleeding as well as vestibular depth, re-epithelialization and edema in both sections were noted and recorded after 7 and 14 days postoperatively.

Results:The time of surgery and the amount of bleeding during surgery in the laser section was less and the vestibular depth was more than surgical scalpel section (P < 0.05). Surgical scalpel wound at day seventh healed significantly better than the section treated by the CO2 laser (P< 0.05). Wound in both sections healed similarly on day 14 and no statistical difference was observed. Edema presence was also equal in both sides after 7th and 14th following the surgery.

Conclusion:According to the results it could be concluded that the use of CO2 laser may result in less surgery time, less bleeding during surgery, more vestibular depth, better re-epithelialization of the wound and less need for suturing. CO2 laser may be a clinically preferred method for surgical treatment of epulis fissuratum.

Case Report

The Versatility of 980 nm Diode Laser in Dentistry: A Case Series

Nahid Derikvand, Zahra Chinipardaz, Sara Ghasemi, Nasim Chiniforush

Journal of Lasers in Medical Sciences, Vol. 7 No. 3 (2016), 17 July 2016, Page 205-208

Introduction: Laser surgery has been considered a popular alternative over conventional modalities in dentistry during the last few years. Among different types of lasers, diode lasers have gained special attention in oral soft tissue surgery.

Case Reports: Five patients were referred to a private office. After careful evaluation of medical history and oral examination, oral diagnosis and treatment plan of each patient was established as follows: (1) A 21-year-old female with ankyloglossia (tongue-tie); (2) A 65-year-old female with a poor denture fit needing vestibuloplasty and frenectomy; (3) A 10-year-old male patient with pigmented gingiva in mandible and maxilla; (4) A 14-year-old female needing exposure of maxillary right canine for bracket bonding; and (5) A 25-year-old female patient who has a gingival maxillary frenum with a nodule. The treatment plan for all the patients was laser surgery with diode laser at 980 nm, in continuous mode.

Results: All the patients experienced normal healing process with no postoperative complications. Favorable outcomes of laser surgery were observed on follow-up sessions.

Conclusion: Considering the versatility of the 980 nm diode laser in oral soft tissue surgeries and the advantages of laser surgery, this study suggests the use of 980 nm diode laser in this regard.