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Albar NH. Efficacy of GLUMA for the Treatment of Dentin Hypersensitivity Compared to Lasers: A Systematic Review. J Contemp Dent Pract 2022; 23:1057-1065. [PMID: 37073920 DOI: 10.5005/jp-journals-10024-3420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
OBJECTIVE Dentin hypersensitivity (DH) is characterized by a short, sharp pain in response to a thermal or tactile stimulus. The application of desensitizing agents such as GLUMA and laser is a non-invasive and safe approach to decrease sensitivity. The evidence for the efficacy of GLUMA desensitizer compared to laser desensitization in patients with DH was evaluated for 6 months. DESIGN In March 2022, an electronic search of PubMed, Scopus, and Web of Science databases was conducted. Articles published in English that compared GLUMA and laser in the treatment of DH with a follow-up of 6 months or more were included. Randomized, non-randomized controlled trials, and clinical trials were included. Risk of bias assessment tools developed by the Cochrane collaboration ROB 2 and ROBINS-I were used to assess the quality of studies. The GRADE assessment method was used to assess the certainty of evidence. RESULTS About 36 studies were identified in the search results. After applying the predefined eligibility criteria, eight studies with 205 participants and 894 sites were included in this review. Of the eight studies, four were judged to be at high risk of bias, three had some concerns, and one had a serious risk of bias. The certainty of the evidence was graded as low. CONCLUSION Based on limited evidence, GLUMA and laser appear to be equally effective in providing relief from DH. GLUMA showed an immediate effect and provided pain relief. Over the course of a week, laser showed long-term stable results. GLUMA is effective in providing immediate relief.
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Affiliation(s)
- Nassreen H Albar
- Department of Restorative Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia, Phone: +966 505745812, e-mail:
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2
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The 1064-nm Nd: YAG Photobiomodulation vs. 20% Benzocaine Topical Gel in Inducing Mucosal Anesthetic Effect: A Double-Blind Randomized Clinical Trial. PHOTONICS 2022. [DOI: 10.3390/photonics9080519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The periapical local anesthetic injection may be associated with fear of needles and pain administration. Dental topical anesthetic agents can help to reduce pain perception; however, adverse events can occur. To investigate the efficacy of 1064-nm photobiomodualtion (PBM) in inducing mucosal anesthesia delivered with a flat-top hand-piece compared to 20% Benzocaine topical anesthetic gel, sixty healthy patients were randomly allocated (1:1) to either 20% benzocaine topical gel + placebo laser (T group) or PBM + placebo gel (L group). The 1064-nm Nd:YAG laser was employed and is associated with a novel flat-top hand piece. The applied operational parameters were 0.5 W, 10 Hz, 100 µs pulse width, and 30 J/cm2 for one-minute single application time. The enrolled subjects were asked to assess pain intensity at the time of anesthetic injection with a Visual Analog Scale. Taking into consideration taste, undesirable numbness, and overall satisfaction, the patients were asked to rate their experiences according to a verbal rating scale. Statistical analysis showed no statistically significant difference between the T and L Groups for pain ratings (p = 0.0596). The L Group displayed significantly higher ratings than T Group for taste, undesirable numbness, and overall satisfaction (p < 0.001). The 1064-nm PBM delivered by flat-top hand piece is effective in inducing mucosal anesthesia, eliminating the adverse side-effects of the conventional topical anesthetic gel.
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Poli R, Parker S, Anagnostaki E, Mylona V, Lynch E, Grootveld M. Laser Analgesia Associated with Restorative Dental Care: A Systematic Review of the Rationale, Techniques, and Energy Dose Considerations. Dent J (Basel) 2020; 8:dj8040128. [PMID: 33198128 PMCID: PMC7712922 DOI: 10.3390/dj8040128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/30/2020] [Accepted: 11/10/2020] [Indexed: 12/17/2022] Open
Abstract
It is a common experience amongst laser dentists and patients that mid-IR wavelength application in cavity preparation may be achieved without causing any associated pain. The erbium family of lasers (Er,Cr:YSGG 2780 nm and Er:YAG 2940 nm) are frequently used without employing injectable local anesthesia as an adjunct: the phenomenon arising from the application of these devices is known as laser analgesia. This review seeks to apply a systematic approach to the examination of appropriate published studies but also to highlight the need for much more structured clinical investigations that consolidate photonic dose and methodology. A search of published data using PRISMA criteria was carried out to examine clinical trials into laser analgesia in conjunction with restorative dentistry, applying inclusion and exclusion criteria. From this, 10 published articles were selected for analysis. Suitability assessment was carried out, using a modified Cochrane risk of bias methodology. In 8/10 of the included studies, laser-induced analgesia is claimed to be better and effective, while in 2/10 of the studies, no difference was exhibited compared to the control group. Statistical analysis of three split mouth studies concluded that only one of these investigations reviewed demonstrated a significant analgesic effect for laser treatment while the other two did not support this observation. From this data, it is inconclusive to assess the predictability of laser analgesia in cavity preparation. A possible rationale and laser operating parametry has been discussed. Successful implementation of this treatment modality remains technique sensitive and subject to further investigation.
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Affiliation(s)
- Riccardo Poli
- Leicester School of Pharmacy, De Montfort University, Gateway House, Leicester LE1 9BH, UK; (S.P.); (E.A.); (V.M.); (E.L.); (M.G.)
- Correspondence:
| | - Steven Parker
- Leicester School of Pharmacy, De Montfort University, Gateway House, Leicester LE1 9BH, UK; (S.P.); (E.A.); (V.M.); (E.L.); (M.G.)
| | - Eugenia Anagnostaki
- Leicester School of Pharmacy, De Montfort University, Gateway House, Leicester LE1 9BH, UK; (S.P.); (E.A.); (V.M.); (E.L.); (M.G.)
| | - Valina Mylona
- Leicester School of Pharmacy, De Montfort University, Gateway House, Leicester LE1 9BH, UK; (S.P.); (E.A.); (V.M.); (E.L.); (M.G.)
| | - Edward Lynch
- Leicester School of Pharmacy, De Montfort University, Gateway House, Leicester LE1 9BH, UK; (S.P.); (E.A.); (V.M.); (E.L.); (M.G.)
- School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
| | - Martin Grootveld
- Leicester School of Pharmacy, De Montfort University, Gateway House, Leicester LE1 9BH, UK; (S.P.); (E.A.); (V.M.); (E.L.); (M.G.)
- School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, NV 89154, USA
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Marto CM, Baptista Paula A, Nunes T, Pimenta M, Abrantes AM, Pires AS, Laranjo M, Coelho A, Donato H, Botelho MF, Marques Ferreira M, Carrilho E. Evaluation of the efficacy of dentin hypersensitivity treatments—A systematic review and follow‐up analysis. J Oral Rehabil 2019; 46:952-990. [DOI: 10.1111/joor.12842] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/20/2019] [Accepted: 06/09/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Carlos Miguel Marto
- Institute of Integrated Clinical Practice, Faculty of Medicine University of Coimbra Coimbra Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
- Experimental Pathology Institute, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Anabela Baptista Paula
- Institute of Integrated Clinical Practice, Faculty of Medicine University of Coimbra Coimbra Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
| | - Tiago Nunes
- Institute of Integrated Clinical Practice, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Miguel Pimenta
- Institute of Integrated Clinical Practice, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Ana Margarida Abrantes
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
- Biophysics Institute, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Ana Salomé Pires
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
- Biophysics Institute, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Mafalda Laranjo
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
- Biophysics Institute, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Ana Coelho
- Institute of Integrated Clinical Practice, Faculty of Medicine University of Coimbra Coimbra Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
| | - Helena Donato
- Documentation Department Coimbra Hospital University Centre Coimbra Portugal
| | - Maria Filomena Botelho
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
- Biophysics Institute, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Manuel Marques Ferreira
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
- Institute of Endodontics, Faculty of Medicine University of Coimbra Coimbra Portugal
| | - Eunice Carrilho
- Institute of Integrated Clinical Practice, Faculty of Medicine University of Coimbra Coimbra Portugal
- Institute for Clinical and Biomedical Research (iCBR), Area of Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine University of Coimbra Coimbra Portugal
- CNC.IBILI University of Coimbra Coimbra Portugal
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Machado AC, Maximiano V, Eduardo CDP, Azevedo LH, de Freitas PM, Aranha AC. Associative Protocol for Dentin Hypersensitivity Using Nd:YAG Laser and Desensitizing Agent in Teeth with Molar-Incisor Hypomineralization. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:262-266. [PMID: 31050957 DOI: 10.1089/photob.2018.4575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: The aim of this article was to describe and discuss a clinical case in which the Nd:YAG laser and a desensitizing agent were associated in a protocol for dentin hypersensitivity (DH) in teeth with molar-incisor hypomineralization (MIH). Background data: DH is a common condition among the population, being one of the main reasons for patients to seek for a dental treatment. MIH can be considered a condition that induces DH. Methods: The patient was referred for evaluation, complaining of hypersensitivity during eating or drinking cold foods. Clinical evaluation revealed the presence of MIH on the first lower molars. Aiming to treat DH, two strategies for dentin desensitization were associated: the use of a high-power laser (Nd:YAG laser, 1.064 nm; Lares Research), with a 300 μm quartz optical fiber, 1 W of power, 100 mJ of energy, 10 Hz of repetition rate, and 85 J/cm2 of energy density, followed by the application of two layers of a desensitizing agent (Gluma Desensitizer). Results: DH was evaluated immediately, after 1 week and after 1 month of the treatment. Clinical outcomes were satisfactory, confirming the efficacy and considerable durability of the protocol used for the reduction of DH originated from MIH. Conclusions: The association of Nd:YAG laser and a desensitizing agent for controlling DH was effective, showing to be an interesting protocol.
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Affiliation(s)
- Alana Cristina Machado
- 1 Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Vinícius Maximiano
- 1 Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,2 Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Carlos de Paula Eduardo
- 1 Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,2 Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Luciane Hiramatsu Azevedo
- 2 Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Patricia Moreira de Freitas
- 1 Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,2 Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ana Cecilia Aranha
- 1 Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,2 Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Veneva E, Raycheva R, Belcheva A. Efficacy of erbium-doped yttrium aluminium garnet for achieving pre-emptive dental laser analgesia in children: A study protocol for a randomized clinical trial. Medicine (Baltimore) 2018; 97:e13601. [PMID: 30572467 PMCID: PMC6320132 DOI: 10.1097/md.0000000000013601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION A current non-pharmacological mean for attaining painless conservative treatment is presented by laser analgesia (LA), considered as bio-photomodulation of pulp reactivity aiming reduction of nociceptive impulse formation. Currently no consensus is reached regarding a detailed protocol with laser parameter settings for pre-emptive LA. The purpose of this study is determining the efficacy of erbium-doped yttrium aluminium garnet (Er:YAG) laser in achieving pulpal analgesia and quantifying duration and extent of any effects assessed. METHODS AND ANALYSIS The proposed study is a double-blind placebo-controlled randomized split-mouth clinical trial with 2-way repeated measures design. Eligible patients of age 10 to 12 years undergo 2 single-visit treatments, receiving LA or placebo analgesia (PA) prior to caries ablation, randomized via computer-generated, permuted-block sequence. Primary outcome measure is pain felt during treatment, reported by patient on visual-analogue scale. SECONDARY OUTCOMES changes in pulpal sensibility to electrical and cold-stimuli; patient experience during LA/PA; pain-related behavior according to Faces, Legs, Activity, Cry, Consolabilty (FLACC) scale; heart-rate dynamics. Data will be analyzed with intention-to-treat concept by Student t test for paired samples, P < .05. Pre-test on 20 subjects resulted in n = 41 patients needing to be recruited. ETHICS AND DISSEMINATION This study protocol has been approved by the Committee for Scientific Research Ethics, Medical University - Plovdiv, Bulgaria (Reference number P-8604, Protocol of approval N:6/23.11.2017) and registered on a publically accessible database. This research received institutional funding from the Medical University - Plovdiv, Bulgaria under project SPD-03/2017. Findings will be reported in scientific publications and at research conferences, and in project summary papers for participants. TRIAL REGISTRATION ClinicalTrials.gov (Registration number: NCT03412721).
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Affiliation(s)
- Elitsa Veneva
- Department of Pediatric Dentistry, Faculty of Dental Medicine
| | - Ralitsa Raycheva
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University – Plovdiv, Bulgaria
| | - Ani Belcheva
- Department of Pediatric Dentistry, Faculty of Dental Medicine
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7
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Nd:YAG laser and calcium sodium phosphosilicate prophylaxis paste in the treatment of dentin hypersensitivity: a double-blind randomized clinical study. Clin Oral Investig 2018; 23:3331-3338. [DOI: 10.1007/s00784-018-2759-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 11/22/2018] [Indexed: 10/27/2022]
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8
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Kurt S, Kırtıloğlu T, Yılmaz NA, Ertaş E, Oruçoğlu H. Evaluation of the effects of Er:YAG laser, Nd:YAG laser, and two different desensitizers on dentin permeability: in vitro study. Lasers Med Sci 2018; 33:1883-1890. [PMID: 29850962 DOI: 10.1007/s10103-018-2546-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 05/18/2018] [Indexed: 11/25/2022]
Abstract
The purpose of this in vitro study was to evaluate and compare the efficacy of erbium-doped yttrium aluminum garnet (Er:YAG) laser, neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, PrevDent nano-hydroxyapatite toothpaste plus Repairing Serum Kit (PNH), and NUPRO Sensodyne Prophylaxis Paste with NovaMin (NPP) on dentin permeability reduction. Forty dentin discs obtained from bovine incisors were divided into four study groups: Er:YAG laser-treated (2940 nm; 0.2 W, 80 mJ/pulse, 3 Hz); Nd:YAG laser-treated (1064 nm; 1 W, 10 Hz); PNH-treated; and NPP-treated groups. The quantitative changes in permeability of each dentin disc were measured using a computerized fluid filtration method (CFFM) before and after desensitizer treatments. The data were analyzed using the Wilcoxon, paired-samples t, Kruskal-Wallis, and Mann-Whitney U tests. The dentin surfaces and tubules were also morphologically detected by scanning electron microscopy (SEM). In all groups, dentin permeability was significantly reduced after the desensitizer and laser treatments (p < 0.05). Among the groups, we detected a significant difference in only when comparing the Er:YAG laser- and NPP-treated groups (p = 0.034). SEM analysis revealed physical changes in the dentin surface in all groups. This in vitro study shows that all tested desensitizers and laser treatments reduced dentin permeability. Also, surface changes, such as complete or partial occlusion or shrinkage of dentin tubules, were observed in all groups. Although the laser groups performed best, the PNH protocol can be considered as an alternative therapeutic product. In addition, clinical and laboratory studies should be performed for this product, and their efficacy should be assessed by combined therapy with lasers.
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Affiliation(s)
- Sevda Kurt
- Department of Periodontology, Faculty of Dentistry, Recep Tayyip Erdogan University, Rize, Turkey.
| | - Tuğrul Kırtıloğlu
- Department of Periodontology, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey
| | - Nasibe Aycan Yılmaz
- Department of Restorative Dentistry, Faculty of Dentistry, Adnan Menderes University, Aydın, Turkey
| | - Ertan Ertaş
- Department of Restorative Dentistry, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey
| | - Hasan Oruçoğlu
- Department of Endodontics, Faculty of Dentistry, Abant Izzet Baysal University, Bolu, Turkey
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9
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Chow RT, Armati PJ. Photobiomodulation: Implications for Anesthesia and Pain Relief. Photomed Laser Surg 2016; 34:599-609. [DOI: 10.1089/pho.2015.4048] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Roberta T. Chow
- Honorary Research Associate, Brain & Mind Centre, The University of Sydney, Camperdown, New South Wales
| | - Patricia J. Armati
- Neuroinflammation Group, Brain & Mind Centre, The University of Sydney, Camperdown, New South Wales, Australia
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Xiao S, Liang K, Liu H, Zhang M, Yang H, Guo S, Ding Y. Effect of Water-Cooled Nd:YAG Laser on Dentinal Tubule Occlusion In Vitro. Photomed Laser Surg 2016; 35:98-104. [PMID: 27827556 DOI: 10.1089/pho.2016.4169] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE The objective of this study was to investigate the effect of a new water-cooled Nd:YAG laser on dentinal tubule occlusion. BACKGROUND DATA The effect of water-cooled Nd:YAG laser on dentinal tubule occlusion has not been reported. METHODS Acid-etched dentin samples were randomly divided into three groups: (1) dentin control, (2) dentin treated by Nd:YAG laser, (3) dentin treated by water-cooled Nd:YAG laser. After laser irradiation, half of the samples were immersed in a 6 wt% citric acid (pH 1.5) solution for 1 min to evaluate the acid resistance. The morphologies of dentin surfaces were characterized by scanning electron microscopy. The number and diameters of the open dentinal tubules were analyzed by one-way and two-way analyses of variance. RESULTS Both the Nd:YAG laser and water-cooled Nd:YAG laser melted the superficial layer of dentin, which caused dentinal tubule occlusion in most areas and diameter reduction of the rest open tubules. Microcracks on the dentin surface were only observed in the Nd:YAG laser group. The tubule occlusion induced by the two lasers showed a good acid resistance. CONCLUSIONS The effect of water-cooled Nd:YAG laser on dentinal tubule occlusion is similar to that of the Nd:YAG laser. The dentinal tubule occlusion induced by the two lasers could resist acid challenge to some extent.
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Affiliation(s)
- Shimeng Xiao
- 1 State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University , Chengdu, China .,2 Department of Periodontology, West China Hospital of Stomatology, Sichuan University , Chengdu, China
| | - Kunneng Liang
- 1 State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University , Chengdu, China
| | - Hongling Liu
- 1 State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University , Chengdu, China
| | - Manling Zhang
- 1 State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University , Chengdu, China .,2 Department of Periodontology, West China Hospital of Stomatology, Sichuan University , Chengdu, China
| | - Heng Yang
- 1 State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University , Chengdu, China .,2 Department of Periodontology, West China Hospital of Stomatology, Sichuan University , Chengdu, China
| | - Shujuan Guo
- 1 State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University , Chengdu, China .,2 Department of Periodontology, West China Hospital of Stomatology, Sichuan University , Chengdu, China
| | - Yi Ding
- 1 State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University , Chengdu, China .,2 Department of Periodontology, West China Hospital of Stomatology, Sichuan University , Chengdu, China
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11
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Mou ZX, Hou WS, Zheng XL, Yao JP, Shang GB, Yin ZQ. Pulsed near infrared laser stimulates the rat visual cortex in vivo. Biocybern Biomed Eng 2015. [DOI: 10.1016/j.bbe.2015.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Mehari F, Rohde M, Knipfer C, Kanawade R, Klämpfl F, Adler W, Stelzle F, Schmidt M. Laser induced breakdown spectroscopy for bone and cartilage differentiation - ex vivo study as a prospect for a laser surgery feedback mechanism. BIOMEDICAL OPTICS EXPRESS 2014; 5:4013-23. [PMID: 25426327 PMCID: PMC4242035 DOI: 10.1364/boe.5.004013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 10/16/2014] [Accepted: 10/16/2014] [Indexed: 05/04/2023]
Abstract
Laser surgery enables for very accurate, fast and clean modeling of tissue. The specific and controlled cutting and ablation of tissue, however, remains a central challenge in the field of clinical laser applications. The lack of information on what kind of tissue is being ablated at the bottom of the cut may lead to iatrogenic damage of structures that were meant to be preserved. One such example is the shaping or removal of diseased cartilaginous and bone tissue in the temporomandibular joint (TMJ). Diseases of the TMJ can induce deformation and perforation of the cartilaginous discus articularis, as well as alterations to the cartilaginous surface of the condyle or even the bone itself. This may result in restrictions of movement and pain. The aim of a surgical intervention ranges from specific ablation and shaping of diseased cartilage, bone or synovial tissues to extensive removal of TMJ structures. One approach to differentiate between these tissues is to use Laser Induced Breakdown Spectroscopy (LIBS). The ultimate goal is a LIBS guided feedback control system for surgical laser systems that enables real-time tissue identification for tissue specific ablation. In the presented study, the authors focused on the LIBS based differentiation between cartilage tissue and cortical bone tissue using an ex-vivo pig model.
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Affiliation(s)
- Fanuel Mehari
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Strasse 6, 91052 Erlangen,
Germany
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Konrad-Zuse-Straße 3/5, 91052 Erlangen,
Germany
| | - Maximilian Rohde
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstrasse 11, 91054 Erlangen,
Germany
| | - Christian Knipfer
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstrasse 11, 91054 Erlangen,
Germany
| | - Rajesh Kanawade
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Strasse 6, 91052 Erlangen,
Germany
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Konrad-Zuse-Straße 3/5, 91052 Erlangen,
Germany
| | - Florian Klämpfl
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Strasse 6, 91052 Erlangen,
Germany
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Konrad-Zuse-Straße 3/5, 91052 Erlangen,
Germany
| | - Werner Adler
- Chair of Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstraße 6, 91054 Erlangen,
Germany
| | - Florian Stelzle
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Strasse 6, 91052 Erlangen,
Germany
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstrasse 11, 91054 Erlangen,
Germany
| | - Michael Schmidt
- Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Strasse 6, 91052 Erlangen,
Germany
- Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Konrad-Zuse-Straße 3/5, 91052 Erlangen,
Germany
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13
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Abstract
Methods to control neural activity by light have been introduced to the field of neuroscience. During the last decade, several techniques have been established, including optogenetics, thermogenetics, and infrared neural stimulation. The techniques allow investigators to turn-on or turn-off neural activity. This review is an attempt to show the importance of the techniques for the auditory field and provide insight in the similarities, overlap, and differences of the techniques. Discussing the mechanism of each of the techniques will shed light on the abilities and challenges for each of the techniques. The field has been grown tremendously and a review cannot be complete. However, efforts are made to summarize the important points and to refer the reader to excellent papers and reviews to specific topics. This article is part of a Special Issue entitled .
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Affiliation(s)
- Claus-Peter Richter
- Northwestern University Feinberg School of Medicine, Department of Otolaryngology, 303 E. Chicago Ave, Searle 12-561, Chicago, IL 60611, USA; Dept. of Biomedical Engineering, Northwestern University, 2145 Sheridan Road, Tech E310, Evanston, IL 60208, USA; The Hugh Knowles Center, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL 60208, USA.
| | - Xiaodong Tan
- Northwestern University Feinberg School of Medicine, Department of Otolaryngology, 303 E. Chicago Ave, Searle 12-561, Chicago, IL 60611, USA
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Ko Y, Park J, Kim C, Park J, Baek S, Kook Y. Treatment of dentin hypersensitivity with a low-level laser-emitting toothbrush: double-blind randomised clinical trial of efficacy and safety. J Oral Rehabil 2014; 41:523-31. [DOI: 10.1111/joor.12170] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Y. Ko
- Department of Periodontics; Seoul St. Mary's Hospital; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - J. Park
- Department of Periodontics; Seoul St. Mary's Hospital; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - C. Kim
- Department of Oral and Maxillofacial Surgery; Seoul St. Mary's Hospital; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - J. Park
- Department of Oral and Maxillofacial Surgery; Seoul St. Mary's Hospital; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - S.H. Baek
- Department of Orthodontics; School of Dentistry; Seoul National University; Seoul Korea
| | - Y.A. Kook
- Department of Orthodontics; Seoul St. Mary's Hospital; College of Medicine; The Catholic University of Korea; Seoul Korea
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Sgolastra F, Petrucci A, Severino M, Gatto R, Monaco A. Lasers for the Treatment of Dentin Hypersensitivity. J Dent Res 2013; 92:492-499. [DOI: 10.1177/0022034513487212] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
This systematic review and meta-analysis assessed the efficacy of lasers in reducing dentin hypersensitivity (DH) as compared with placebo or no treatment. Seven electronic databases and a manual search resulted in 2,538 unique publications. After selection, 13 studies were included in the meta-analysis. A CONSORT-based quality assessment revealed that 3 and 10 studies were at low and high risk of bias, respectively. A random-effects model with the generic inverse variance standardized mean difference (SMD) was used because of expected heterogeneity. Meta-analyses of the baseline-end of follow-up changes in pain revealed no differences for Er,Cr:YSSG vs. placebo (SMD = 2.49; 95% CI, -0.25 to 5.22; p = .07) but did reveal differences in favor of lasers for Er:YAG vs. placebo (SMD, 2.65; 95% CI, 1.25 to 4.05; p = .0002), Nd:YAG vs. placebo (SMD, 3.59; 95% CI, 0.49 to 6.69; p = .02), and GaAlAs vs. placebo (SMD, 3.40; 95% CI, 1.93 to 4.87; p < .00001). High and significant heterogeneity was found for all comparisons. In conclusion, Er:YAG, Nd:YAG, and GaAlAs lasers appear to be efficacious in reducing DH. However, given the high heterogeneity of the included studies, future randomized controlled clinical trials are needed to confirm these results.
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Affiliation(s)
- F. Sgolastra
- Department of Life, Health, and Environmental Sciences, School of Dentistry, University of L’Aquila, Italy
| | - A. Petrucci
- Department of Life, Health, and Environmental Sciences, School of Dentistry, University of L’Aquila, Italy
| | - M. Severino
- Department of Life, Health, and Environmental Sciences, School of Dentistry, University of L’Aquila, Italy
| | - R. Gatto
- Department of Life, Health, and Environmental Sciences, School of Dentistry, University of L’Aquila, Italy
| | - A. Monaco
- Department of Life, Health, and Environmental Sciences, School of Dentistry, University of L’Aquila, Italy
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Wu XY, Mou ZX, Hou WS, Zheng XL, Yao JP, Shang GB, Yin ZQ. Irradiation of 850-nm laser light changes the neural activities in rat primary visual cortex. Lasers Med Sci 2012; 28:791-8. [PMID: 22814897 DOI: 10.1007/s10103-012-1160-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 07/05/2012] [Indexed: 12/11/2022]
Abstract
Although infrared laser was proven to be an alternative approach for neural stimulation, there is very little known about the neural response to infrared laser irradiation in visual cortex. This study is to investigate the effect of near-infrared laser irradiation on neural activities at the cortex level. A 850-nm pigtailed diode laser was applied to stimulate the rat primary visual cortex while the horizontal black and white stripe pattern was used as standard visual stimulation to evoke visual-evoked potential (VEP). Both amplitude and latency of VEP P100 was measured with or without infrared pulse stimulation applied in rat primary visual cortex. Paired t test and one-way analysis of variance were used to evaluate the impact of infrared irradiation and its pulse width on the amplitudes and latencies of P100, respectively. The results from our preliminary study revealed that, the pulsed near-infrared laser depressed the VEP amplitude and shortened the latency of P100; with the increment of pulse width of infrared irradiation, further decline of VEP amplitude and much shortened latency of P100 were observed. The present work suggests that near-infrared laser irradiation can alter the neural activities in primary visual cortex transiently, and could provide a novel contactless artificial neural stimulus to brain cortex with high spatial selectivity.
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Affiliation(s)
- Xiao Y Wu
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, Bioengineering College, Chongqing University, Chongqing, 400044, China
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Stelzle F, Terwey I, Knipfer C, Adler W, Tangermann-Gerk K, Nkenke E, Schmidt M. The impact of laser ablation on optical soft tissue differentiation for tissue specific laser surgery-an experimental ex vivo study. J Transl Med 2012; 10:123. [PMID: 22704127 PMCID: PMC3546422 DOI: 10.1186/1479-5876-10-123] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 05/16/2012] [Indexed: 11/10/2022] Open
Abstract
Background Optical diffuse reflectance can remotely differentiate various bio tissues. To implement this technique in an optical feedback system to guide laser surgery in a tissue-specific way, the alteration of optical tissue properties by laser ablation has to be taken into account. It was the aim of this study to evaluate the general feasibility of optical soft tissue differentiation by diffuse reflectance spectroscopy under the influence of laser ablation, comparing the tissue differentiation results before and after laser intervention. Methods A total of 70 ex vivo tissue samples (5 tissue types) were taken from 14 bisected pig heads. Diffuse reflectance spectra were recorded before and after Er:YAG-laser ablation. The spectra were analyzed and differentiated using principal component analysis (PCA), followed by linear discriminant analysis (LDA). To assess the potential of tissue differentiation, area under the curve (AUC), sensitivity and specificity was computed for each pair of tissue types before and after laser ablation, and compared to each other. Results Optical tissue differentiation showed good results before laser exposure (total classification error 13.51%). However, the tissue pair nerve and fat yielded lower AUC results of only 0.75. After laser ablation slightly reduced differentiation results were found with a total classification error of 16.83%. The tissue pair nerve and fat showed enhanced differentiation (AUC: 0.85). Laser ablation reduced the sensitivity in 50% and specificity in 80% of the cases of tissue pair comparison. The sensitivity of nerve–fat differentiation was enhanced by 35%. Conclusions The observed results show the general feasibility of tissue differentiation by diffuse reflectance spectroscopy even under conditions of tissue alteration by laser ablation. The contrast enhancement for the differentiation between nerve and fat tissue after ablation is assumed to be due to laser removal of the surrounding lipid-rich nerve sheath. The results create the basis for a guidance system to control laser ablation in a tissue-specific way.
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Affiliation(s)
- Florian Stelzle
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University of Erlangen-Nuremberg, Glückstrasse 11, 91054, Erlangen, Germany.
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Sgolastra F, Petrucci A, Gatto R, Monaco A. Effectiveness of Laser in Dentinal Hypersensitivity Treatment: A Systematic Review. J Endod 2011; 37:297-303. [DOI: 10.1016/j.joen.2010.11.034] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 11/26/2010] [Accepted: 11/30/2010] [Indexed: 11/29/2022]
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Richter CP, Matic AI, Wells JD, Jansen ED, Walsh JT. Neural stimulation with optical radiation. LASER & PHOTONICS REVIEWS 2011; 5:68-80. [PMID: 23082105 PMCID: PMC3472451 DOI: 10.1002/lpor.200900044] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 04/08/2010] [Indexed: 05/18/2023]
Abstract
This paper reviews the existing research on infrared neural stimulation, a means of artificially stimulating neurons that has been proposed as an alternative to electrical stimulation. Infrared neural stimulation (INS) is defined as the direct induction of an evoked potential in response to a transient targeted deposition of optical energy. The foremost advantage of using optical radiation for neural stimulation is its spatial resolution. Exogenously applied or trans-genetically synthesized fluorophores are not used to achieve stimulation. Here, current work on INS is presented for motor nerves, sensory nerves, central nervous system, and in vitro preparations. A discussion follows addressing the mechanism of INS and its potential use in neuroprostheses. A brief review of neural depolarization involving other optical methods is also presented. Topics covered include optical stimulation concurrent with electrical stimulation, optical stimulation using exogenous fluorophores, and optical stimulation by transgenic induction of light-gated ion channels.
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Affiliation(s)
- Claus-Peter Richter
- Department of Otolaryngology, Feinberg Medical School, Northwestern University, Searle Building 12-470, 303 E. Chicago Avenue, Chicago, IL 60611-3008, USA
- The Hugh Knowles Center, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
| | - Agnella Izzo Matic
- Department of Otolaryngology, Feinberg Medical School, Northwestern University, Searle Building 12-470, 303 E. Chicago Avenue, Chicago, IL 60611-3008, USA
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | | | - E. Duco Jansen
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Joseph T. Walsh
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
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Stelzle F, Tangermann-Gerk K, Adler W, Zam A, Schmidt M, Douplik A, Nkenke E. Diffuse reflectance spectroscopy for optical soft tissue differentiation as remote feedback control for tissue-specific laser surgery. Lasers Surg Med 2010; 42:319-25. [PMID: 20432281 DOI: 10.1002/lsm.20909] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Laser surgery does not provide haptic feedback for operating layer-by-layer and thereby preserving vulnerable anatomical structures like nerve tissue or blood vessels. Diffuse reflectance spectra can facilitate remote optical tissue differentiation. It is the aim of the study to use this technique on soft tissue samples, to set a technological basis for a remote optical feedback system for tissue-specific laser surgery. MATERIALS AND METHODS Diffuse reflectance spectra (wavelength range: 350-650 nm) of ex vivo types of soft tissue (a total of 10,800 spectra) of the midfacial region of domestic pigs were remotely measured under reduced environmental light conditions and analyzed in order to differentiate between skin, mucosa, muscle, subcutaneous fat, and nerve tissue. We performed a principal components (PC) analysis (PCA) to reduce the number of variables. Linear discriminant analysis (LDA) was utilized for classification. For the tissue differentiation, we calculated the specificity and sensitivity by receiver operating characteristic (ROC) analysis and the area under curve (AUC). RESULTS Six PCs were found to be adequate for tissue differentiation with diffuse reflectance spectra using LDA. All of the types of soft tissue could be differentiated with high specificity and sensitivity. Only the tissue pairs nervous tissue/fatty tissue and nervous tissue/mucosa showed a decline of differentiation due to bio-structural similarity. However, both of these tissue pairs could still be differentiated with a specificity and sensitivity of more than 90%. CONCLUSIONS Analyzing diffuse reflectance spectroscopy with PCA and LDA allows for remote differentiation of biological tissue. Considering the limitations of the ex vivo conditions, the obtained results are promising and set a basis for the further development of a feedback system for tissue-specific laser surgery.
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Affiliation(s)
- Florian Stelzle
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Erlangen, Germany.
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Kogure S, Takahashi S, Saito N, Kozuka K, Matsuda Y. Effects of low-power laser irradiation on the threshold of electrically induced paroxysmal discharge in rabbit hippocampus CA1. Lasers Med Sci 2009; 25:79-86. [PMID: 19462168 DOI: 10.1007/s10103-009-0681-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2008] [Accepted: 05/03/2009] [Indexed: 11/30/2022]
Abstract
In acute experiments using adult rabbits, we measured the paroxysmal discharge threshold (PADT) elicited by stimulation to the apical dendritic layer of the hippocampal CA1 region before and after low-power laser irradiation. Nd:YVO(4) laser irradiation (wavelength: 532 nm) was introduced into the same region as the stimulation site. The average PADT was 247 +/- 13 microA (n = 18) before laser irradiation, while after 5-min laser irradiation with 50, 75, and 100 mW, PADT was 333 +/- 40 (n = 4), 353 +/- 33 (n = 4) and 367 +/- 27 microA (n = 6), respectively. The latter two increments were statistically significant compared to the control (p < 0.05 and p < 0.01). After 10-min laser irradiation with 75 and 100 mW, PADT was 340 +/- 47 (n = 9) and 480 +/- 60 microA (n = 11; p < 0.01), respectively. Laser irradiation with a specific wavelength and average power offers the potential to suppress the generation of paroxysmal discharges in rabbit hippocampus CA1. Correlation analyses suggest that PADT increments are based on photochemical as well as photothermal effects of laser irradiation.
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Affiliation(s)
- Shinichi Kogure
- Department of Bioinformatics, Faculty of Engineering, Soka University, 1-236 Tangi-cho, Hachioji, Tokyo 192-8577, Japan.
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Komatsu M, Kubo T, Kogure S, Matsuda Y, Watanabe K. Effects of 808 nm low-power laser irradiation on the muscle contraction of frog gastrocnemius. Lasers Surg Med 2008; 40:576-83. [DOI: 10.1002/lsm.20665] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Zand N, Ataie-Fashtami L, Djavid GE, Fateh M, Alinaghizadeh MR, Fatemi SM, Arbabi-Kalati F. Relieving pain in minor aphthous stomatitis by a single session of non-thermal carbon dioxide laser irradiation. Lasers Med Sci 2008; 24:515-20. [DOI: 10.1007/s10103-008-0555-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2007] [Accepted: 02/21/2008] [Indexed: 11/30/2022]
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Abstract
The cutting of dental hard tissue during restorative procedures presents considerable demands on the ability to selectively remove diseased carious tissue, obtain outline and retention form and maintain the integrity of supporting tooth tissue without structural weakening. In addition, the requirement to preserve healthy tissue and prevent further breakdown of the restoration places the choice of instrumentation and clinical technique as prime factors for the dental surgeon. The quest for an alternative treatment modality to the conventional dental turbine has been, essentially, patient-driven and has led to the development of various mechanical and chemical devices. The review of the literature has endorsed the beneficial effects of current laser machines. However utopian, there is additional evidence to support the development of ultra-short (nano- and femto-second) pulsed lasers that are stable in use and commercially viable, to deliver more efficient hard tissue ablation with less risk of collateral thermal damage. This paper explores the interaction of laser energy with dental hard tissues and bone and the integration of current laser wavelengths into restorative and surgical dentistry.
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Abstract
BACKGROUND The objective of this review is to inform practitioners about dentin hypersensitivity (DH) and its management. This clinical information is described in the context of the underlying biology. TYPES OF STUDIES REVIEWED The authors used MEDLINE to find relevant English-language literature published in the period 1999 to 2005. They used combinations of the search terms "dentin*," "tooth," "teeth," "hypersensit*," "desensiti*" and "desensitiz*." They read abstracts and then full articles to identify studies describing etiology, prevalence, clinical features, controlled clinical trials of treatments and relevant laboratory research on mechanisms of action. RESULTS The prevalence of DH varies widely, depending on the mode of investigation. Potassium-containing toothpastes are the most widely used at-home treatments. Most in-office treatments employ some form of "barrier," either a topical solution or gel or an adhesive restorative material. The reported efficacy of these treatments varies, with some having no better efficacy than the control treatments. Possible reasons for this variability are discussed. A flowchart summarizes the various treatment strategies. CLINICAL IMPLICATIONS DH is diagnosed after elimination of other possible causes of the pain. Desensitizing treatment should be delivered systematically, beginning with prevention and at-home treatments. The latter may be supplemented with in-office modalities.
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Matsuda Y, Niwa M, Iwai H, Kogure S, Honjoe N, Komatsu M, Ishii Y, Watanabe K. Effects of argon laser irradiation on polar excitations in frog sciatic nerve. Lasers Surg Med 2006; 38:608-14. [PMID: 16634074 DOI: 10.1002/lsm.20343] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVES Since the mechanisms underlying the effects of low-power laser irradiation on the nervous system remain unclear, we examined whether such irradiation can influence ionic channels of the nerve membrane using the law of polar excitation in isolated frog sciatic nerve. STUDY DESIGN/MATERIALS AND METHODS Using 43 frogs (Xenopus laevis), nerve preparations were stimulated at 0.5/second using a 10-millisecond pulse at supramaximal intensity. Ar+ laser irradiation (457, 488, 514 nm; 50, 75, 100 mW) was applied for 30 minutes to the portion between the anode and cathode stimulating electrodes. RESULTS AND CONCLUSIONS Ar+ laser irradiations (457, 488 nm; 50 mW) blocked the generation of anode-break-excitation, rather than cathode-make-excitation. Such a selective effect occurred when applying a blocker of hyperpolarization-activated cation current (Ih) channel, ZD7288. Ar+ laser irradiation may influence Na+ channels in addition to Ih channels.
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Affiliation(s)
- Yoshiki Matsuda
- Department of Bioengineering, Faculty of Engineering, Soka University, Hachioji, Tokyo, 192-8577, Japan.
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Abstract
With the rapid development of laser technology, new lasers with a wide range of characteristics are now available and being used in various fields of dentistry. In the past two decades, much experience and knowledge has been gained. This article provides an overview of the current and possible future clinical applications of lasers in endodontics, including their use in alleviating dentinal hypersensitivity, modification of the dentin structure, pulp diagnosis, pulp capping and pulpotomy, cleaning and shaping of the root canal system, and endodontic surgery. Endodontic procedures for which conventional treatments cannot provide comparable results or are less effective are emphasized.
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Affiliation(s)
- Adam Stabholz
- Izador I Cabakoff Center for Advanced and Continuing Education in Dentistry, The Hebrew University-Hadassah School of Dental Medicine, P.O. Box 12272, Jerusalem 91120, Israel.
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Toida M, Watanabe F, Goto K, Shibata T. Usefulness of low-level laser for control of painful stomatitis in patients with hand-foot-and-mouth disease. ACTA ACUST UNITED AC 2004; 21:363-7. [PMID: 14709221 DOI: 10.1089/104454703322650176] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the usefulness of low-level laser therapy (LLLT) for the control of painful stomatitis in patients with hand-foot-and-mouth disease (HFMD). BACKGROUND DATA LLLT has been successfully applied to various painful oral mucosal diseases, although there have been few reports on LLLT for HFMD patients. MATERIALS AND METHODS Through a randomized double-blind placebo controlled trial, the painful period of HFMD stomatitis was compared between the LLLT group (n=11) and the placebo LLLT one (n=9), which had similar clinical backgrounds. The LLLT parameters supplied were as follows: wavelength of 830 nm, power of 30 mW, frequency of 30 Hz, and energy output of 1.1 J/cm2. Acceptability and safety of the treatment were also evaluated. RESULTS The painful period was shorter in the LLLT group (4.0 +/- 1.3 days) than in the placebo LLLT one (6.7 +/- 1.6 days) with a statistically significant difference (p<0.005). The treatment was judged acceptable for 90.0% (18 of 20) of patients. No adverse events were observed in any cases. CONCLUSION LLLT is a useful method to control HFMD stomatitis by shortening the painful period, with its high acceptability and lack of adverse events.
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Affiliation(s)
- Makoto Toida
- Department of Oral and Maxillofacial Sciences, Gifu University School of Medicine, Gifu, Japan.
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Sunakawa M, Tokita Y, Suda H. Pulsed Nd:YAG laser irradiation of the tooth pulp in the cat: II. Effect of scanning lasing. Lasers Surg Med 2000; 26:477-84. [PMID: 10861703 DOI: 10.1002/1096-9101(2000)26:5<477::aid-lsm7>3.0.co;2-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND OBJECTIVE The purpose of the present study was to assess whether "scan irradiation" with a pulsed Nd:YAG laser could produce changes in intrapulpal nerve activities and pulpal blood flow and to investigate whether it would cause tissue damage in the pulp. STUDY DESIGN/MATERIALS AND METHODS The pulsed Nd:YAG laser was used to irradiate, in a scanning manner, the canine tooth pulp in sodium pentobarbitone anesthetized cats. The compound action potentials and spike response in the functional single afferent nerve fibers were recorded while responding to various external stimuli applied to the exposed dentin. Histologic observation was performed to detect lasing-induced tissue changes. RESULTS Pulpal compound action potentials evoked by various external stimuli were significantly reduced (P < 0.05) and unit firings were observed in both functional single A delta- and C-fibers during irradiation. Unit responses to external mechanical stimulation of the dentin completely disappeared after "scan irradiation" with the pulsed Nd:YAG laser. Histologic observation revealed that irradiation with the laser produced tissue damage in the pulp. CONCLUSION "Scan irradiation" with the pulsed Nd:YAG laser of cat's teeth produced alterations in the intrapulpal nerve activities, as well as caused tissue damage in the pulp.
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Affiliation(s)
- M Sunakawa
- Pulp Biology and Endodontics, Graduate School, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo 113-8549, Japan.
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Orchardson R, Whitters CJ. Effect of HeNe and pulsed Nd:YAG laser irradiation on intradental nerve responses to mechanical stimulation of dentine. Lasers Surg Med 2000; 26:241-9. [PMID: 10738286 DOI: 10.1002/(sici)1096-9101(2000)26:3<241::aid-lsm1>3.0.co;2-i] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE Our study aimed to determine how lasing affected intradental nerve responses to dentine stimulation. Study Design/Materials and Methods Intradental nerve activity was recorded from canine teeth of anaesthetised ferrets. Dentine exposed at the tip of the tooth was stimulated with a glass probe. After determining baseline responses to mechanical stimulation, dentine was lased using a pulsed Nd:YAG laser at 60-150mJ/pulse and 10-30 pulses/sec (total power = 0.3-3.0 W). RESULTS The HeNe aiming beam alone and Nd:YAG laser at 0.3 W (+ HeNe) had no effect on intradental nerve responses to dentine stimulation. Lasing at 0.6-1. 5 W could either enhance or suppress intradental nerve responses. Lasing at more than or equal to 2.0 W or repeated lasing at lower intensities depressed intradental nerve responses. Lasing often induced intradental nerve firing. CONCLUSION HeNe lasing had no effect on intradental nerve excitability. The Nd:YAG laser could depress intradental nerve responses to dentine stimulation.
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Affiliation(s)
- R Orchardson
- Division of Neuroscience, Institute of Biomedical and Life Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom.
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Yonaga K, Kimura Y, Matsumoto K. Treatment of cervical dentin hypersensitivity by various methods using pulsed Nd:YAG laser. JOURNAL OF CLINICAL LASER MEDICINE & SURGERY 1999; 17:205-10. [PMID: 11199824 DOI: 10.1089/clm.1999.17.205] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the results of two irradiated regions, the cervical and apical, for cervical dentin hypersensitivity treatment using pulsed a Nd:YAG laser with or without black ink. SUMMARY BACKGROUND DATA There has been no reports on the irradiated area(s) except the cervical region for dentin hypersensitivity treatment using pulsed Nd:YAG laser. METHODS A total of 180 teeth diagnosed with cervical dentin hypersensitivity in 54 (39 females, 15 males, aged 21 to 73) healthy adult patients were included in this study, and teeth were randomly divided into four groups of 45 each. Sensitivity was rated using a blast from a fully depressed air syringe on a four-grade scale both before and up to 2 months after laser treatment. The effectiveness was evaluated on the change in the degree of hypersensitivity after laser treatment. The tooth surfaces in groups 1 and 2 were observed by the replica model method using scanning electron microscopy (SEM). RESULTS The methods of irradiation at the cervical regions were better than those at the apical regions except for the period 2 months later. The laser effect was enhanced by black ink at both areas. The effective (excellent and good) rate was decreased depending on the time in every group. SEM observation at the tooth surfaces from group 2 showed that dentinal tubules were occluded or narrowed after laser irradiation. CONCLUSIONS These results show that the method of irradiation by a pulsed Nd:YAG laser at cervical regions with black ink is the most effective for cervical dentin treatment of hypersensitivity and recurrence by this method is less than in other methods.
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Affiliation(s)
- K Yonaga
- Department of Endodontics, Showa University School of Dentistry, Tokyo, Japan.
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Orchardson R, Peacock JM, Whitters CJ. Effects of pulsed Nd:YAG laser radiation on action potential conduction in nerve fibres inside teeth in vitro. J Dent 1998; 26:421-6. [PMID: 9699432 DOI: 10.1016/s0300-5712(97)00037-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed to simulate the effects of lasing dentine on pulpal nerve function. METHODS Rat spinal nerve roots were threaded through the prepared pulp canal of a 10 mm long tooth root segment which was mounted in a perspex bath. The protruding ends of the nerve were placed on platinum wire electrodes used to elicit and to record compound nerve action potentials (CAPs). Laser energy (average power = 0.3-3.0 W) was applied to the surface of the root segment using a pulsed Nd:YAG dental laser (dLase 300). RESULTS With the laser probe tip placed in static contact with the tooth surface, the nerve CAP was irreversibly abolished within 60 s of lasing at 1.0-3.0 W power. When the laser tip was moved to and fro over the root surface in a scanning mode, similar levels of radiation produced less marked effects. In the latter mode, CAP attenuation increased with increasing power and duration of lasing. After 60 s lasing at 0.3 W, the CAP size was 95% (+/- 5, S.D.) of the prelasing controls value; with 2.0 W the CAP was reduced to 54% (+/- 33). The CAP recovered to 90% of control levels after lasing at powers up to 1.5 W, but reached only 72% of control values after lasing at 2.0 W power. CONCLUSIONS Laser radiation applied to dentine caused a dose-dependent block of action potential conduction in nerve fibres in the underlying pulp chamber.
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Affiliation(s)
- R Orchardson
- Institute of Biomedical and Life Sciences, University of Glasgow, UK.
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