Clinical Approach of High Technology Techniques for Control and Elimination of Endodontic Microbiota

Nasim Chiniforush, Maryam Pourhajibagher, Sima Shahabi, Abbas Bahador

Journal of Lasers in Medical Sciences, Vol. 6 No. 4 (2015), , Page 139-150

The main goal in endodontic treatment is to eradicate or at least reduce intraradicular microbial population to levels that are more compatible with periapical lesions healing process. Since endodontic infections are polymicrobial in nature, intraradicular survival of endodontic microbiota and their pathogenic properties are influenced by a combination of their virulence factors. The purpose of this article is to review the endodontic microbiota and their respective virulence attributes, as well as perform a literature review of the effects of disinfection procedures in the treatment of endodontic infections to gain best practices. Conventional technique for root canal preparation includes mechanical debridement and application of antimicrobial irrigants. Recently, laser irradiation has been used to enhance the results of root canal treatment through its thermal effect. To reduce thermal side effects, laser activated irrigation (LAI) and photon induced photoacoustic streaming (PIPS) were introduced. Antimicrobial photodynamic therapy (aPDT) by photochemical reaction uses light at a specific wavelength to activate a nontoxic photosensitizer (PS) in the presence of oxygen to produce cytotoxic products. Different PSs are used in dentistry including methylene blue (MB), toluidine blue O (TBO), indocyanine green (ICG) and curcumin. Among different options, ICG could be the best choice due to its peak absorption at wavelength of 808 nm, which coincides with the commercial diode laser devices. Also, this wavelength has more penetration depth compared to other wavelengths used in aPDT.

Laser Thermal Ablation of Thyroid Benign Nodules

Mohammad Karim Shahrzad

Journal of Lasers in Medical Sciences, Vol. 6 No. 4 (2015), , Page 151-156



Thermal ablation therapies for benign thyroid nodules have been introduced in recent years to avoid the complications of traditional methods such as surgery. Despite the little complications and the reportedly acceptable efficacy of thermal ablation methods, quite few medical centers have sought the potential benefits of employing them. This paper provides an introduction to the literature, principles and advances of Percutaneous Laser Ablation therapy of thyroid benign nodules, as well as a discussion on its efficacy, complications and future. Several clinical research papers evaluating the thermal effect of laser on the alleviation of thyroid nodules have been reviewed to illuminate the important points. The results of this research can help researchers to advance the approach and medical centers to decide on investing in these novel therapies.

Monochromatic Infrared Photo Energy Versus Low Level Laser Therapy in Chronic Low Back Pain

Tarek Ammar

Journal of Lasers in Medical Sciences, Vol. 6 No. 4 (2015), , Page 157-161

Introduction: Low back pain (LBP) is the most common musculoskeletal disease. Monochromatic infrared photo energy (MIPE) and low level laser therapy (LLLT) are light modalities used to reduce pain and increase blood flow. The aim of this study was to compare the effects of the MIPE and LLLT in reducing functional disability and pain as well as improving lumbar range of motion (ROM) in patients with chronic LBP.

Methods: Seventy participants with LBP completed the program and were randomly assigned into 2 groups. Group 1 (n = 35) received MIPE and therapeutic exercises. Group 2 (n = 35) received LLLT and therapeutic exercises. Both groups received 2 visits per week for 6 weeks. Outcome measures were functional rating index (FRI), visual analogue scale (VAS) and modified-modified Schober test at baseline and after 6 weeks.

Results: There were statistically significant improvements in functional disability, pain and lumbar ROM (P < .05) in each group. However, no significant differences were recorded between the groups (P > .05).

Conclusion: Therefore, MIPE and LLLT may play a role in treating chronic LBP and there are no differences between the two modalities in improving functional disability, pain and lumbar ROM in patients with chronic LBP.

Flexible Ureterorenoscopy Versus Extracorporeal Shock Wave Lithotripsy for the Treatment of Renal Pelvis Stones of 10–20 mm in Obese Patients

Babak Javanmard, Mohammad Reza Razaghi, Anahita Ansari Jafari, Mohammad Mohsen Mazloomfard

Journal of Lasers in Medical Sciences, Vol. 6 No. 4 (2015), , Page 162-166

Introduction: To compare outcomes of retrograde intrarenal surgery (RIRS) with extracorporeal shock wave lithotripsy (ESWL) as treatment of choice.

Methods: A total number of 46 patients with renal pelvic stones 10-20 mm and body mass index (BMI) >30 randomized in two groups underwent RIRS and ESWL from 2011 to 2014 and followed for 3 months.

Results: The patients mean ± SD age was 36.1 ± 13.1 years in ESWL and 33.2 ± 11.4 years in RIRS groups (P = .1) with comparable BMI in both groups (36.2 vs 38.1). In ESWL and RIRS groups, the operation time was 72.2 ± 21 vs 66.5 ± 19 minutes (P = .061), respectively. Stone free rate (SFR) at 3 months was 68% in ESWL group vs 90.4% in RIRS group (P = .019). The complication rate was 20% in ESWL group vs 14.2% in RIRS group (P = .211) but all of them were minor and managed conservatively.

Conclusion: According to our study, RIRS procedure in comparison with ESWL is a safe and successful option of treatment for renal pelvis stone of 10-20 mm in obese people.

Treatment of Acne Vulgaris With Salicylic Acid Chemical Peel and Pulsed Dye Laser: A Split Face, Rater-Blinded, Randomized Controlled Trial

Olga Lekakh, Anne Marie Mahoney, Karlee Novice, Julia Kamalpour, Azeen Sadeghian, Dana Mondo, Cathy Kalnicky, Rong Guo, Anthony Peterson, Rebecca Tung

Journal of Lasers in Medical Sciences, Vol. 6 No. 4 (2015), , Page 167-170

Introduction: Pulsed dye laser (PDL) has been used to treat acne lesions and scar erythema by interrupting superficial vasculature. Salicylic acid chemical peels are employed chiefly due to their lipophilic, comedolytic, and anti-inflammatory properties. Although studies have looked at peels and laser therapy independently in acne management, we examined these treatments in combination. Our primary objective was to evaluate the safety and efficacy of concurrent use of salicylic acid peels with PDL versus salicylic acid peels alone in the treatment of moderate to severe acne vulgaris.

Methods: Adult patients with moderate to severe acne were included. Subjects received a total of 3 treatments at 3-week intervals. Per randomized split-face treatment, at week 0, one half of the subject’s face was treated with PDL (595 nm) followed by whole face application of a 30% salicylic acid peel. At weeks 3 and 6, the treatments were repeated. At 0 and 9 weeks, patients were assessed with the Global Evaluation Acne (GEA) scale and Dermatology Life Quality Index (DLQI) questionnaire.

Results: Nineteen subjects were enrolled, and 18 completed the study. Significant improvement in acne was seen in both the combined (laser and peel) and chemical peel alone treatment arms (P < .0005 and P = .001). Using the GEA scale score, compared to week 0, the mean difference in acne improvement at week 9 was -1.61 in the combination therapy group versus -1.11 in the peel only group. Based on the GEA scale scoring, a statistically significant greater difference in acne improvement was seen, from week 0 to week 9, in the combination treatment group compared with the peel only group (P = .003).

Conclusion: While acne subjects had significant benefit from the salicylic acid peel alone, they experienced greater significant benefit from PDL treatment used in conjunction with salicylic acid peels. The adjunctive utilization of PDL to salicylic acid peel therapy can lead to better outcomes in acne management.

Amalgam Surface Treatment by Different Output Powers of Er:YAG Laser:SEM Evaluation

Mohammad Hashem Hosseini, Mehdi Hassanpour, Ardavan Etemadi, Ladan Ranjbar Omrani, Hojat Darvishpour, Nasim Chiniforush

Journal of Lasers in Medical Sciences, Vol. 6 No. 4 (2015), , Page 171-173

Introduction: The purpose of this study was to evaluate amalgam surfaces treated by different output powers of erbium-doped yttrium aluminum garnet (Er:YAG) laser by scanning electron microscope (SEM).

Methods: Twenty-one amalgam blocks (8 mm × 8 mm, 3 mm thickness) were prepared by condensing silver amalgam (into putty impression material. After keeping them for 24 hours in distilled water, they were divided into 7 groups as follow: G1: Er:YAG laser (1 W, 50 mJ), G2: Er:YAG laser (2 W, 100 mJ), G3: Er:YAG laser (3 W, 150 mJ), G4: Sandblast, G5: Sandblast + Er:YAG laser (1 W, 50 mJ), G6: Sandblast +Er:YAG laser (2 W, 100 mJ) and G7: Sandblast +Er:YAG laser (3 W, 150 mJ). Then after preparation of all samples, they were examined by SEM.

Results: The SEM results of amalgam surfaces treated by different output powers of Er:YAG laser showed some pitting areas with non-homogenous irregularities

Conclusion: It seems that the application of sandblasting accompanied by Er:YAG laser irradiation can provide proper surface for bonding of orthodontic brackets.

Effects of Different Surface Treatment Methods and MDP Monomer on Resin Cementation of Zirconia Ceramics an In Vitro Study

Merve Çakirbay Taniş, Turgut Cihan Akçaboy

Journal of Lasers in Medical Sciences, Vol. 6 No. 4 (2015), , Page 174-181


Introduction: Resin cements are generally preferred for cementation of zirconia ceramics. Resin bonding of zirconia ceramics cannot be done with the same methods of traditional ceramics because zirconia is a silica-free material. In recent years, many methods have been reported in the literature to provide the resin bonding of zirconia ceramics. The purpose of this in vitro study is to evaluate effects of different surface treatments and 10-metacryloxydecyl dihydrogen phosphate (MDP) monomer on shear bond strength between zirconia and resin cement.

Methods: 120 zirconia specimens were treated as follows: Group I: sandblasting, group II: sandblasting + tribochemical silica coating + silane, group III: sandblasting + Nd:YAG (neodymium: yttrium-aluminum-garnet) laser. One specimen from each group was evaluated under scanning electron microscope (SEM). Specimens in each group were bonded either with conventional resin cement Variolink II or with a MDP containing resin cement Panavia F2.0. Subgroups of bonded specimens were stored in distilled water (37°C) for 24 hours or 14 days. Following water storage shear bond strength test was performed at a crosshead speed of 1 mm/min in a universal test machine. Then statistical analyses were performed.

Results: Highest shear bond strength values were observed in group II. No significant difference between group I and III was found when Panavia F2.0 resin cement was used. When Variolink II resin cement was used group III showed significantly higher bond strength than group I. In group I, Panavia F2.0 resin cement showed statistically higher shear bond strength than Variolink II resin cement. In group II no significant difference was found between resin cements. No significant difference was found between specimens stored in 37°C distilled water for 24 hours and 14 days. In group I surface irregularities with sharp edges and grooves were observed. In group II less roughened surface was observed with silica particles. In group III surface microcracks connecting each other were observed.

Conclusion: Tribochemical silica coating is an effective method for achieving an acceptable bond between zirconia and resin cement. Use of a MDP monomer containing resin cement increases the bond strength of sandblasted zirconia.

Removal of an Extra-large Irritation Fibroma With a Combination of Diode Laser and Scalpel

Sedigheh Bakhtiari, Jamileh bigom Taheri, Marziye Sehatpour, Mohammad Asnaashari, Saaedeh Attarbashi Moghadam

Journal of Lasers in Medical Sciences, Vol. 6 No. 4 (2015), , Page 182-184

Introduction: Irritation fibroma is the most common tumor like and sub mucosal reactive lesion in the oral cavity. Usually it is measured less than 1.5 cm in diameter; however in rare case it has more than 3 cm in diameter. Different kind of treatment for soft tissue lesions include scalpel excision, electrical surgery, and laser surgery. The diode laser can be more effective than conventional surgery, electrosurgery and cryosurgery in reduction of bleeding and pain.

Case Report: We reported a very large irritation fibroma in right lingual side of retromolar pad which was less prone to be traumatized under local irritation, in a woman wearing maxillary complete denture and use of both diode laser and scalpel for its excision.