1
|
Kulkarni S, Walsh LJ, Bhurani Y, George R. Assessment of the onset of analgesia and length of analgesia following the use of PBM with different wavelengths: a clinical study. Lasers Med Sci 2024; 39:236. [PMID: 39297993 DOI: 10.1007/s10103-024-04184-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Accepted: 09/04/2024] [Indexed: 09/21/2024]
Abstract
This clinical study assessed photobiomodulation (PBM) induced analgesic effects of diode lasers and an LED light source on the dental pulp. Baseline responses to electric pulp testing (EPT) were recorded in 93 healthy unrestored premolar teeth in 26 adults (age range 22-63 years) attending a private dental practice. The teeth were irradiated on buccal and lingual aspects of the crown, by placing the tips on the middle third of the crown of the teeth, on separate days for each of 4 different light sources (660, 808, or 904 nm diode lasers, or a novel multi-wavelength LED light source (700-1100 nm)) using comparable parameters (100 mW, 30 s, 6 J). EPT scores were measured after a further 1-, 2-, 5- and 20-min. Discomfort caused by PBM therapy was recorded using the Wong-Baker scale. EPT changes were tracked over time using repeated measures analysis of variance. Baseline EPT scores were very consistent between different days (linear regression r2 0.9422-0.9648). All PBM devices caused a significant elevation in EPT at 5 min, with an earlier onset at 2 mins for 904 nm and LED. The LED was the only light source that elevated scores at 20 min. Across 2-20 min, when ranked by effectiveness, the greatest EPT elevations were seen for LED, followed by 904 nm, then 660 nm and finally 808 nm. Discomfort during PBM was most common with 904 nm, followed by 808 nm. No discomfort occurred from the LED. Among the light sources utilized, the LED multi-wavelength system demonstrated the largest increase in EPT readings, suggesting its potential as a non-pharmacological alternative for achieving dental analgesia compared to diode lasers.
Collapse
Affiliation(s)
- Sachin Kulkarni
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Laurence J Walsh
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Yash Bhurani
- School of Dentistry, University of Adelaide, Adelaide, South Australia, Australia
| | - Roy George
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia.
| |
Collapse
|
2
|
Belcheva A, Veneva E, Hanna R. Effect of Various Protocols of Pre-Emptive Pulpal Laser Analgesia on Enamel Surface Morphology Using Scanning Electron Microscopy: An Ex Vivo Study. Biomedicines 2023; 11:biomedicines11041077. [PMID: 37189695 DOI: 10.3390/biomedicines11041077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 03/23/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
Achieving local anaesthesia for various clinical dental applications is a challenge that we encounter in our daily practice. Pre-emptive pulpal laser analgesia (PPLA) treatment strategy could be a promising non-pharmacological modality. Hence, our ex vivo laboratory study is aimed at evaluating the changes in enamel surface morphology when irradiated with various published PPLA protocols using scanning electron microscopy (SEM). To do so, 24 extracted healthy human permanent premolar teeth were collected, and each tooth was divided into equal halves randomised into six groups. The following laser parameter protocols based on published protocols of clinical Er:YAG laser-induced PPLA were randomly assigned for each group: 0.2 W/10 Hz/3 J/cm2 (Group A—100% water spray; Group B—no water); 0.6 W/15 Hz/10 J/cm2 (Group C—100% water spray; Group D—no water); 0.75 W/15 Hz/12 J/cm2 (Group E—100% water spray; Group F—no water); 1 W/20 Hz/17 J/cm2 (Group G—100% water spray; Group H—no water). Each sample was irradiated at an angle of 90° to the dental pulp, with a sweeping speed of 2 mm/s for a 30 s exposure time. Our results have shown, for the first time, no alteration to the mineralised tooth structure when irradiated with the following protocols: 0.2 W/10 Hz/3 J/cm2 with 100% water spray or without water spray with an irradiated area fixed at a 10 mm tip-to-tissue distance, sweeping motion with 2 mm/s speed of movement; average power output of 0.6 W/15 Hz/10 J/cm2, maximum water cooling of 100%, tip-to-tooth distance fixed at 10 mm, 30 s exposure time, sweeping motion with 2 mm/s speed of movement. The authors concluded that the current available proposed PPLA protocols in the literature might cause an alteration to the enamel surface. Hence, future clinical studies are warranted to validate our study’s PPLA protocols.
Collapse
Affiliation(s)
- Ani Belcheva
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Medical University-Plovdiv, 3 Hristo Botev Blvd, 4000 Plovdiv, Bulgaria
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy
| | - Elitsa Veneva
- Department of Pediatric Dentistry, Faculty of Dental Medicine, Medical University-Plovdiv, 3 Hristo Botev Blvd, 4000 Plovdiv, Bulgaria
| | - Reem Hanna
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy
- Department of Oral Surgery, King’s College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK
- Department of Restorative Dental Sciences, UCL-Eastman Dental Institute, Faculty of Medical Sciences, Rockefeller Building, London WC1E 6DE, UK
| |
Collapse
|
3
|
Does luminosity and smear layer influence 810 nm laser energy transmission through human dentine? Photodiagnosis Photodyn Ther 2023; 42:103311. [PMID: 36731731 DOI: 10.1016/j.pdpdt.2023.103311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/27/2023] [Accepted: 01/27/2023] [Indexed: 02/01/2023]
Abstract
PURPOSE The aim of this study was to evaluate the influence of luminosity values and smear layer on transmission characteristics of 810 nm near infrared laser energy through dentine, using extracted human teeth. METHODS A total of 200 teeth treated with endodontic medicaments to cause discolouration (Ledermix, Doxypaste or Odontopaste) were selected, to give a range of values for tooth shade (luminosity values). Sectioned teeth had smear layer created or removed. Near-infrared laser energy transmission was assessed using an 810 nm diode laser (90 mW, CW mode) with the tip placed at 2 mm and 4 mm from the external root surface, and a laser power metre. RESULTS Both tooth shade and smear layer had independent attenuating effects. Transmission of laser energy was significantly lower in teeth with darker shades. There was a strong positive correlation between relative luminosity (lighter tooth colour) and transmitted laser power (r = 0.9271 for the Spearman rank correlation, P = 0.0022). When a smear layer was present, this significantly reduced the transmission of laser energy through the sample, compared to when no smear layer was present. CONCLUSION The results of this laboratory study highlight the attenuating influence of a darker tooth shade and the presence of smear layer on the transmission of 810 nm light when directed onto the surface of human dentine. Such effects may be relevant to photo biomodulation, Photodynamic Therapy and other dental laser treatments.
Collapse
|
4
|
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.
Collapse
|
5
|
Hu SN, Yuan LT, Wang MQ, Wang YG, Zhou YS. Clinical Evaluation of 532-nm Green Laser on Dentin Hypersensitivity: A Randomized Double-Blind Clinical Trial. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:705-710. [PMID: 34762532 DOI: 10.1089/photob.2021.0046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: The aim of this study was to evaluate the therapies of low-level green laser and chemical desensitizer in the treatment of dentin hypersensitivity (DH). Methods: Forty-eight patients with 96 sensitive teeth were invited to participate in this clinical trial and were randomly divided into three groups. One group was treated with low-level green laser, the second group was treated with desensitizer [sodium fluoride (NaF)], and the third group acted as the placebo group and was treated with distilled water and placebo laser. The wavelength of green laser was 532 nm and the irradiance was 15 J/cm2 per treatment site. Hypersensitivity was assessed by visual analogue scale (VAS) according to cold test and probing at baseline. Immediately, 2 weeks, and 3 months after the application of green laser, NaF, and placebo, the participants' sensitivity level was accessed by new VAS analysis. Results: Forty-five patients with 90 teeth (n = 15 patients/group; 30 teeth/group) were followed up for 2 weeks and 3 months after treatment. There were significant differences in VAS scores between the placebo group and intervention group (green laser group and NaF group; analysis of variance, p < 0.05) at all three time points. The mean pain scores in DH reduced significantly immediately after treatment in the green laser group and NaF group when stimulated by cold and probing, whereas no significant difference was observed with these two therapies after 2 weeks (p > 0.05). After 3 months, mean VAS scores of the NaF group were higher than those of the green laser group (p < 0.01). Conclusions: Therefore, the green laser displayed similar effectiveness as NaF in treatment of DH and could be a promising new therapy to reduce DH.
Collapse
Affiliation(s)
- Su-Ning Hu
- Department of Prosthodontics, Peking University School, Hospital of Stomatology, Beijing, China.,Dental Clinic, Peking University International Hospital, Beijing, China
| | - Lin-Tian Yuan
- Department of Prosthodontics, Peking University School, Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Meng-Qi Wang
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China.,School of Nursing, Peking University, Beijing, China
| | - Yu-Guang Wang
- Department of Prosthodontics, Peking University School, Hospital of Stomatology, Beijing, China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yong-Sheng Zhou
- Department of Prosthodontics, Peking University School, Hospital of Stomatology, Beijing, China
| |
Collapse
|
6
|
A New Combined Protocol to Treat the Dentin Hypersensitivity Associated with Non-Carious Cervical Lesions: A Randomized Controlled Trial. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app11010187] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The goal of this research is to assess the desensitizing effect of a diode laser on non-carious cervical lesions (NCCLs) responsible for dentin hypersensitivity (DH) in two separate output forces implemented both independently and in sequential combination modalities. A randomized controlled trial for this study was applied. Sixty-nine NCCLs responsible for DH pain with severity between 6 and 9 on the VAS scale were considered. Three study groups were developed using just one lesion from three different quadrants of the oral cavity of each patient. All treatment procedures were conducted using a laser diode (810 nm, 5 W) with varying power outputs used separately or in combination. The pain by DH was evaluated at baseline, at treatment completion, and at 15 days and 3 months after each laser procedure. Data analysis was performed using a Wilcoxon test for paired samples, a one-way ANOVA test, and an unpaired t-test. The significant reduction of the mean VAS score was estimated in each study group immediately and at 15 days and 3 months after the end of treatment and compared with the baseline mean VAS score (p-value < 0.0001). The best result concerning the improvement of DH symptomatology was assessed when a combined protocol of two different output powers of the diode laser was used. The authors conclude that the diode laser (810 nm) therapy procedure combining two separate output forces (low and high power) can improve the painful symptoms of DH from NCCLs.
Collapse
|
7
|
Eyüboğlu GB, Naiboğlu P. Clinical Efficacy of Different Dentin Desensitizers. Oper Dent 2020; 45:E317-E333. [PMID: 32516395 DOI: 10.2341/19-258-c] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2020] [Indexed: 11/23/2022]
Abstract
CLINICAL RELEVANCE Teethmate Desensitizer, Clinpro White Varnish, Shield Force Plus, and Gluma could be recommended for treating dentin hypersensitivity in terms of clinical efficacy. SUMMARY Objective: The aim of this study was to evaluate the clinical efficacy of widely used dentindesensitizing agents (DDAs) (Teethmate Desensitizer, Clinpro White Varnish, Shield Force Plus, and Gluma) in the treatment of dentin hypersensitivity (DH) according to different evaluation parameters over a four-week follow-up period.Methods and Materials: This study was a randomized, single-center, controlled, parallel group study involving 144 teeth in 40 subjects. The baseline DH levels of the subjects were determined using different evaluation parameters. Daily life hypersensitivity and evaporative air stimulus hypersensitivity scores were recorded using a visual analog scale (VAS), and tactile hypersensitivity scores were recorded using a Yeaple probe and measured in grams and on the VAS. Subjects who experienced evaporative air stimulus DH (30-80 mm on the VAS) and tactile hypersensitivity (10-50 g with the Yeaple probe) were included in the study. After application of the DDAs, these evaluation parameters were recorded throughout the follow-up period (immediately after application and at one day and two and four weeks post-application).Results: All four DDAs demonstrated clinical dentin-desensitizing effects throughout the follow-up period according to evaporative air hypersensitivity, tactile sensitivity (g-VAS), and daily life hypersensitivity scores (p<0.05). Only Clinpro White Varnish had tactile sensitivity (g) scores that were similar at baseline and the one-day follow-up (p>0.05). A comparison of DH-reducing effects among the DDAs revealed that they yielded different results immediately after application and at the one-day follow-up time point, depending on which evaluation parameter was used. However, all DDAs showed similar DH-reducing effects at the two- and four-week follow-up time points.Conclusions: Teethmate Desensitizer, Clinpro White Varnish, Shield Force Plus, and Gluma DH showed clinical efficacy for four weeks. DDAs may produce inconsistent clinical evaluation scores not only across different evaluation parameters but also between early and later follow-up time points.
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Mehdipour M, Mortazavi H, Bahramian A, Haghighi Enayat N, Azari-Marhabi S. The Viewpoints of Last-Year Dentistry Students of Shahid Beheshti University on the Application of Lasers as an Independent Credit in the Education of General Dentistry. J Lasers Med Sci 2020; 11:193-196. [PMID: 32273962 DOI: 10.34172/jlms.2020.32] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: Enhancing students' pragmatic skills as an enabling means brings about changes in their curriculum, which should be reconciled with the students' educational needs. Thus, this study seeks to examine the viewpoints of last-year dentistry students on the need for the instruction of laser application as an independent credit in the general dentistry curriculum. The findings of this study can help determine the educational priorities of students while providing and compiling their curriculum. Methods: This descriptive study was done on 91 last-year dentistry students of Shahid Beheshti University in a full census manner. The data collection tool was a fieldwork questionnaire, the validity and reliability of which were evaluated. To report the findings, frequency distribution, frequency percentage, and average tableaux were utilized. Results: Amongst the 91 participants, regarding the average figures of value assignment from 1 to 10 to respond to questions, the highest value was assigned to learning the side effects of lasers (7.99 ± 0.01) and the lowest value was assigned to learning about the history of lasers and light physics (4.53 ± 0.47). Conclusion: The findings indicate that students have a positive attitude toward the incorporation of an independent laser credit in their curriculum and thus the necessity of incorporating this credit in their curriculum can be posed.
Collapse
Affiliation(s)
| | - Hamed Mortazavi
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Saranaz Azari-Marhabi
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
10
|
Network meta-analysis of the desensitizing effects of lasers in patients with dentine hypersensitivity. Clin Oral Investig 2019; 24:1917-1928. [DOI: 10.1007/s00784-019-03051-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 08/05/2019] [Indexed: 01/08/2023]
|
11
|
Comparison of Er,Cr:YSGG and diode laser effects on dentin hypersensitivity: a split-mouth randomized clinical trial. Clin Oral Investig 2019; 23:4051-4058. [DOI: 10.1007/s00784-019-02841-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 02/07/2019] [Indexed: 10/27/2022]
|
12
|
João-Souza SH, Machado AC, Lopes RM, Zezell DM, Scaramucci T, Aranha ACC. Effectiveness and acid/tooth brushing resistance of in-office desensitizing treatments—A hydraulic conductance study. Arch Oral Biol 2018; 96:130-136. [DOI: 10.1016/j.archoralbio.2018.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/13/2018] [Accepted: 09/09/2018] [Indexed: 11/26/2022]
|
13
|
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).
Collapse
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
| |
Collapse
|
14
|
Tabibzadeh Z, Fekrazad R, Esmaeelnejad A, Shadkar MM, Khalili Sadrabad Z, Ghojazadeh M. Effect of combined application of high- and low-intensity lasers on dentin hypersensitivity: A randomized clinical trial. J Dent Res Dent Clin Dent Prospects 2018; 12:49-55. [PMID: 29732021 PMCID: PMC5928474 DOI: 10.15171/joddd.2018.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 01/06/2018] [Indexed: 12/02/2022] Open
Abstract
Background. Diode lasers (DLs) have demonstrated equal or better desensitizing effects than fluoride varnish, 10% potas-sium nitrate (NK) gel and Gluma. The current study evaluated the desensitizing effect of combined application of DLs with two different output powers and compared it with single DL therapy. Methods. Sixty-two hypersensitive teeth were allocated randomly into two groups: the single group was treated with 3-W DL beam once and in the combined group, the teeth were irradiated three times (the first time with 0.2-W and then with 3-W and the second and third times, 48 and 96 hours after the baseline visit, with 0.2-W DL beams). The amount of dentin hyper-sensitivity (DH) was evaluated, immediately before and after each visit, and 1 week and 1 and 3 months after the first visit. Data analysis was performed using chi-squared test, repeated measurement of ANOVA and Mann-Whitney U test. P<0.05 was considered statistically significant. Results. Statistically significant changes were observed in the means of VAS indices between all the measurement intervals and pretreatment measures, in both experimental groups (P<0.001). The difference in VAS reduction among the groups was not significant when the hypersensitive teeth were stimulated by a periodontal probe and a jet of air (P=0.63 and P=0.12). Conclusion. The results of the present study showed that using both high-intensity and combined DL beams gives rise to significant reductions in DH. There was no significant difference between combined and single laser therapies in the treatment of tooth hypersensitivity.
Collapse
Affiliation(s)
- Zohreh Tabibzadeh
- Department of Periodontics, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Fekrazad
- Department of periodontology, Dental Faculty-Laser research center in medical sciences, AJA university of medical sciences, Tehran, Iran
- International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Azadeh Esmaeelnejad
- Department of Periodontics, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Zahra Khalili Sadrabad
- Department of Pedodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Ghojazadeh
- Research Center for Evidence Based Medicine (RCEBM), Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
15
|
Abstract
Pediatric dentistry provides primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, together with special health care needs. This specialty encompasses a variety of skills, disciplines, procedures and techniques that share a common origin with other dental specialties however these have been modified and reformed to the distinctive requirements of infants, children, adolescents and special health care needs. Disciplines comprise of behavior guidance, care of the medically and developmentally compromised and disabled patient, supervision of orofacial growth and development, caries prevention, sedation, pharmacological management, and hospital dentistry including other traditional fields of dentistry. The skills apply to the ever-changing stages of dental, physical, and psychosocial development for treating conditions and diseases distinctive to growing individuals. Hence with the changing scope of practice it is imperative that the clinician stays updated with the current evidence based trends in practice, collaborates with other disciplines and Imparts quality oral health care tailored to the specific needs of every child.
Collapse
|
16
|
Poli R, Parker S. Achieving Dental Analgesia with the Erbium Chromium Yttrium Scandium Gallium Garnet Laser (2780 nm): A Protocol for Painless Conservative Treatment. Photomed Laser Surg 2016; 33:364-71. [PMID: 26154724 DOI: 10.1089/pho.2015.3928] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this research is to evaluate those techniques and optimal parameters of Erbium Chromium Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) laser use in delivering predictable painless (or with very limited discomfort) restorative cavity preparation without the aid of injected local anesthesia. MATERIAL AND METHODS This study was conducted on 30 patients (26 adults and 4 youth 9-16 years old; average age, 37) treated in a private practice. For each patient, a single cavity was prepared using the Er,Cr:YSGG laser (2780 nm). An Electric Pulp Tester (EPT) was used to monitor the changes in pulp sensibility threshold. The patient experience was tested before and after the treatment using a modified Visual Analogue Scale (VAS) and Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) to evaluate pain and anxiety. RESULTS Pain analysis indicated that 80% of patients (24 out of 30) felt no pain and no discomfort, or only a very slight sensation. None of the 30 patients requested anesthesia. EPT was found to be unreliable in evaluating pulpal pain threshold levels. A tendency was noted wherein greater discomfort was felt by anxious patients. On average, the older the patient, the less discomfort was felt. The factors that have a greater tendency to promote discomfort were: posterior teeth, greater caries depth, greater use of higher power levels and ablation time. CONCLUSIONS Using the Er,Cr:YSGG laser, it was possible to avoid local anesthesia during cavity preparation with a bur. The treatment was effective in a high number of cases (80%), leading to reduction in the anxiety frequently associated with dental care.
Collapse
Affiliation(s)
- Riccardo Poli
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa , Genoa, Italy
| | - Steven Parker
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa , Genoa, Italy
| |
Collapse
|
17
|
Pulpal response following photo-biomodulation with a 904-nm diode laser: a double-blind clinical study. Lasers Med Sci 2016; 31:1811-1817. [DOI: 10.1007/s10103-016-2055-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Accepted: 08/12/2016] [Indexed: 10/21/2022]
|
18
|
Lamba AK, Aggarwal K, Faraz F, Tandon S, Chawla K. Er, Cr:YSGG laser for the treatment of ankyloglossia. Indian J Dent 2015; 6:149-52. [PMID: 26392733 PMCID: PMC4558751 DOI: 10.4103/0975-962x.163049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Ankyloglossia or tongue-tie is the result of a short and tight lingual frenum causing difficulty in speech, feeding problems in infants due to the limitation of tongue movement. This report presents a case of a 22-year-old female with tongue-tie who complained of difficulty in speech following which she underwent frenectomy procedure with erbium, chromium: yattrium-scandium-gallium-garnet laser without any complications. She was referred to the speech therapist after the procedure.
Collapse
Affiliation(s)
- Arundeep K Lamba
- Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Kamal Aggarwal
- Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Farrukh Faraz
- Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Shruti Tandon
- Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Kirti Chawla
- Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India
| |
Collapse
|
19
|
Chan A, Punnia-Moorthy A, Armati P. Low-power pulsed Nd:YAG laser irradiation for pre-emptive anaesthesia: A morphological and histological study. Laser Ther 2015; 23:255-62. [PMID: 25705081 DOI: 10.5978/islsm.14-or-19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 10/10/2014] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIMS To determine if tooth structure or dental pulp of normal healthy human premolar teeth to be extracted for orthodontic reasons exhibit morphological or histological changes following dental anaesthesia by pulsed Nd:YAG laser and subsequent cavity preparation (CP). Materials (Subjects) and Methods: 54 bilateral paired of human, healthy premolar teeth identified for inclusion in a clinical trial of Nd:YAG-induced anaesthesia and subsequently extracted for orthodontic reasons, were randomly divided into 4 treatment groups: Group 1 - teeth (n=44) were irradiated with 150 µs pulsed Nd:YAG laser-1064 nm (American Dental Laser, dLase300, Sunrise Technologies Inc., Folsom, CA, USA; Average power: 1.1 ± 0.2 W, power density: 39+ 0.7 W/cm(2), area 0.28 cm(2), 15 Hz; energy density:0. 260+ 0.047 J/cm(2)) +Sham EMLA (cream without active component) followed by cavity preparation (CP); Group 2 - Teeth (n=44) - were treated with EMLA + Sham Laser (1 mW 632.8-nm He:Ne laser aiming beam only) with CP; Group 3 Teeth (n=10) - were irradiated with pulsed Nd:YAG laser as above but minus CP; Group 4 (n=10)- was a Control group with teeth untreated (no Laser, EMLA or CP). Clinical anaesthesia was assessed by electric pulp testing (EPT) and CP. Teeth in each of the 4 groups were processed for examination by i) scanning electron microscopy (SEM); ii) longitudinal undecalcified ground sectioning (LUGS); iii) light microscopy of pulpal tissues or iv) dye penetration. RESULTS Both Laser and EMLA groups demonstrated no alteration to mineralized tooth structure and dentinal permeability. Mild superficial pulpal changes were found in both groups (3/18 teeth) and of no statistical difference (p>0.99, the McNemar test). Neither Laser nor the Control groups minus CP, showed pulpal changes. CONCLUSIONS Low-power pulsed Nd:YAG laser dose, as used in the clinical trial to induce anaesthesia, does not cause morphological damage to the mineralized tooth structure. Both Laser and EMLA groups showed minor superficial pulpal change following cavity preparation which was not statistically significant. Laser and Control groups minus preparation had no pulpal changes.
Collapse
Affiliation(s)
- Ambrose Chan
- Brain & Mind Research Institute, The University of Sydney, Sydney, Australia
| | | | - Patricia Armati
- Brain & Mind Research Institute, The University of Sydney, Sydney, Australia
| |
Collapse
|
20
|
Chan A, Armati P, Moorthy AP. Pulsed Nd: YAG laser induces pulpal analgesia: a randomized clinical trial. J Dent Res 2012; 91:79S-84S. [PMID: 22699673 DOI: 10.1177/0022034512447947] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This double-blind, randomized, clinical trial investigated the effectiveness and underlying mechanism of neural inhibition of pulsed Nd:YAG laser induction of pulpal analgesia compared with 5% EMLA anesthetic cream. Forty-four paired premolars from 44 orthodontic patients requiring bilateral premolar extraction from either dental arch were randomly assigned to the 'Laser plus Sham-EMLA' or 'EMLA plus Sham-Laser' treatment group. Analgesia was tested by an Electric Pulp Tester (EPT) and the cutting of a standardized cavity, which was terminated when participants reported sensitivity, and Visual Analogue Scale (VAS) and numbness were recorded. Statistical analyses were done by paired t test, McNemar's test, and a chi-squared test (p < 0.05). Sixty-eight percent of laser- and 59% of EMLA-treated teeth had completed cavities with statistically significant EPT increases above baseline. No significant within-patient differences were found for either group. No laser-treated participants reported numbness. The trial confirmed that the pulsed Nd:YAG laser effectively induced pulpal analgesia, by suppression of intradental nerve responses to electrical and mechanical stimuli. Such a laser provides an alternative for dental pain management (ANZ-Clinical Trial Registry: N12611001099910).
Collapse
Affiliation(s)
- A Chan
- Brain & Mind Research Institute, Nerve Research Foundation, Level 7, Building F, Brain and Mind Research Institute, the University of Sydney, 94 Mallett Street, Camperdown, NSW 2050, Australia.
| | | | | |
Collapse
|
21
|
|
22
|
Al-Saud LMS, Al-Nahedh HNA. Occluding Effect of Nd:YAG Laser and Different Dentin Desensitizing Agents on Human Dentinal Tubules In Vitro: A Scanning Electron Microscopy Investigation. Oper Dent 2012; 37:340-55. [DOI: 10.2341/10-188-l] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives
This in vitro study aimed to microscopically evaluate and compare the occluding effect of the Nd:YAG laser and different dentin desensitizing agents on human dentinal tubules.
Materials and Methods
The Nd:YAG laser (SunLase™ 800) and four commercially available and professionally applied dentin desensitizers (Gluma® desensitizer, Tenure Quick®, Quell™ desensitizer, and VivaSens®) were investigated in this study. Sixty-four extracted intact human molars were used. Each dentin surface was divided by shallow indentation into two halves, one of which was used for treatment and the other of which served as a control. The dentin surfaces were etched to remove any smear plugs and to mimic the open dentinal tubules of sensitive dentin using 0.5 M ethylenediaminetetraacetic acid (pH 7.4) for two minutes (applied with a microbrush) and then rinsed with an air-water syringe for 30 seconds. The laser samples (n=16) were randomly divided into four groups of four samples each. These groups were the step-up technique group, the 14-day group, the one-minute group, and the two-minute group. Forty-eight samples were treated with the four tested desensitizing agents and were randomly divided into four groups (n=12/group). Each group was further subdivided into three subgroups (n=4). Samples of the first subgroup were treated for 14 days, while those of the second subgroup were treated once. Samples of the last subgroup were fractured longitudinally after a single treatment. All of the samples were then examined under a scanning electron microscope.
Results
The Nd:YAG laser–irradiated dentin showed reduction or complete obliteration of the dentinal tubule lumen; thus, the treatment modified the original dentinal structure. The lased dentin surface in the two-minute group showed bubble-like changes in the area of the dentinal tubules' orifices. Statistically, the two-minute group was found to have a significantly higher percentage of partially or fully occluded tubules than did the one-minute group. All of the studied desensitizing agents produced occlusion of the dentinal tubules; however, the appearance of the precipitates, the level of coverage, and the degree of dentinal occlusion varied among the tested products.
Conclusion
Throughout the specified period of this study, occlusion and/or narrowing of the open dentinal tubules have been successfully achieved with both treatment approaches.
Collapse
|
23
|
Gholami GA, Fekrazad R, Esmaiel-Nejad A, Kalhori KA. An Evaluation of the Occluding Effects of Er;Cr:YSGG, Nd:YAG, CO2and Diode Lasers on Dentinal Tubules: A Scanning Electron MicroscopeIn VitroStudy. Photomed Laser Surg 2011; 29:115-21. [DOI: 10.1089/pho.2009.2628] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Gholam Ali Gholami
- Dental Faculty of Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Fekrazad
- Dental Faculty of Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | |
Collapse
|
24
|
HE S, WANG Y, LI X, HU D. Effectiveness of laser therapy and topical desensitising agents in treating dentine hypersensitivity: a systematic review. J Oral Rehabil 2011; 38:348-58. [DOI: 10.1111/j.1365-2842.2010.02193.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
25
|
|
26
|
Beldüz N, Yilmaz Y, Özbek E, Kalkan Y, Demirci T. The Effect of Neodymium-Doped Yttrium Aluminum Garnet Laser Irradiation on Rabbit Dental Pulp Tissue. Photomed Laser Surg 2010; 28:747-50. [DOI: 10.1089/pho.2009.2702] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Nihal Beldüz
- Department of Pedodontics, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Yücel Yilmaz
- Department of Pedodontics, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Elvan Özbek
- Department of Histology and Embryology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Yıldıray Kalkan
- Department of Histology and Embryology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Tuba Demirci
- Department of Histology and Embryology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| |
Collapse
|
27
|
Slot DE, Kranendonk AA, Paraskevas S, Van der Weijden F. The effect of a pulsed Nd:YAG laser in non-surgical periodontal therapy. J Periodontol 2009; 80:1041-56. [PMID: 19563283 DOI: 10.1902/jop.2009.080571] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Laser treatment may serve as an alternative or adjunctive treatment to conventional mechanical therapy in periodontics. The neodymium-doped:yttrium, aluminum, and garnet (Nd:YAG) laser has been used in periodontics. Systematic reviews aid in clinical decision-making. The aim of this study was to evaluate, in a systematic manner and after a comprehensive search of the literature, the (additional) therapeutic effects of using a pulsed Nd:YAG laser in the initial treatment of patients with periodontitis. METHODS The focused question for this systematic review was, "What is the efficacy of a pulsed Nd:YAG laser in the initial treatment of patients with periodontitis, either as monotherapy or as an adjunct to non-surgical periodontal treatment?" The efficacy of this technique was compared to conventional therapy (ultrasonics and/or hand instrumentation) in removing plaque, as well as in improving clinical parameters, such as periodontal inflammation and probing depth. Articles published before May 2008 in the databases of MEDLINE/PubMed and the Cochrane Central Register of Controlled Trials were searched to identify appropriate studies. Clinical parameters of periodontal inflammation, namely, plaque, bleeding, gingivitis, probing depth, clinical attachment level, and gingival recession, were selected as outcome variables. RESULTS Independent screening of the titles and abstracts of 285 PubMed and 38 Cochrane articles resulted in eight publications that met the eligibility criteria. Means +/- SDs were collected by data extraction; only descriptive analysis was possible. CONCLUSIONS The majority of the studies analyzed showed no beneficial effect of a pulsed Nd:YAG laser compared to conventional therapy (ultrasonics and/or hand instrumentation) in the initial treatment of patients with periodontitis. The pulsed Nd:YAG laser was assessed as monotherapy and as an adjunct to non-surgical periodontal treatment; efficacy was determined by the extent of plaque removal and the reduction of periodontal inflammation. This literature review suggests that there is no evidence to support the superiority of the Nd:YAG laser over traditional modalities of periodontal therapy.
Collapse
Affiliation(s)
- Dagmar E Slot
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands.
| | | | | | | |
Collapse
|
28
|
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.
Collapse
Affiliation(s)
- Shinichi Kogure
- Department of Bioinformatics, Faculty of Engineering, Soka University, 1-236 Tangi-cho, Hachioji, Tokyo 192-8577, Japan.
| | | | | | | | | |
Collapse
|
29
|
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]
|
30
|
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]
|
31
|
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.
Collapse
|
32
|
Miyata H, Genma T, Ohshima M, Yamaguchi Y, Hayashi M, Takeichi O, Ogiso B, Otsuka K. Mitogen-activated protein kinase/extracellular signal-regulated protein kinase activation of cultured human dental pulp cells by low-power gallium-aluminium-arsenic laser irradiation. Int Endod J 2006; 39:238-44. [PMID: 16507078 DOI: 10.1111/j.1365-2591.2006.01080.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
AIM To examine whether low-power laser irradiation (LPLI) promotes cellular proliferation of human dental pulp-derived fibroblast-like cells (dental pulp cells). METHODOLOGY Dental pulp cells were obtained by primary culture of human dental pulp tissues from extracted third molar teeth. The phosphorylation of the mitogen-activated protein kinase (MAPK) family after LPLI of these cells was investigated by Western blotting. By using a specific MAPK/ERK kinase (MEK) inhibitor (PD098059), the specific effect of LPLI on the MAPK pathway was also investigated by Western blotting as described above. The incorporation of [3H]thymidine into the cells after LPLI was determined, and statistical analysis was performed by Wilcoxon signed-ranks test. RESULTS Extracellular signal-regulated protein kinase (ERK) 1/2 was phosphorylated between 5 and 30 min after LPLI. Moreover, PD098059 inhibited LPLI-mediated ERK1/2 activation. LPLI did not affect p38 MAPK or c-Jun N-terminal kinase (JNK) phosphorylation. But LPLI did not stimulate [3H]thymidine incorporation into these cells. CONCLUSIONS These results indicated that LPLI activated MAPK/ERK, a signal for proliferation, differentiation and survival, but did not activate the stress signals p38 MAPK and JNK in human dental pulp cells.
Collapse
Affiliation(s)
- H Miyata
- Department of Endodontics, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | | | | | | | | | | | | | | |
Collapse
|
33
|
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.
Collapse
Affiliation(s)
- Yoshiki Matsuda
- Department of Bioengineering, Faculty of Engineering, Soka University, Hachioji, Tokyo, 192-8577, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
34
|
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.
Collapse
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.
| | | | | |
Collapse
|
35
|
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.
Collapse
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.
| | | | | |
Collapse
|
36
|
Orchardson R, Peacock JM, Whitters CJ. Effect of pulsed Nd:YAG laser radiation on action potential conduction in isolated mammalian spinal nerves. Lasers Surg Med 2000; 21:142-8. [PMID: 9261791 DOI: 10.1002/(sici)1096-9101(1997)21:2<142::aid-lsm5>3.0.co;2-q] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Dental lasers are claimed to produce analgesia, but the mechanisms and extent of any effects are uncertain. This study investigated the effects of lasing on nerve conduction in isolated nerves. STUDY DESIGN/MATERIALS AND METHODS Pulsed Nd:YAG laser energy was applied to spinal nerves in vitro and effects were measured as attenuation of the compound action potential (CAP) evoked by electrical stimulation. RESULTS Lasing for 1 minute at 0.3-3.0 W caused a dose-dependent attenuation of all components of the CAP (P < 0.03). With 0.3-1.0 W power, the CAP recovered to > 95% of the control levels 7 minutes after lasing; recovery was incomplete after lasing at > 2.0 W. CONCLUSION Isolated nerves were remarkably tolerant of lasing. The degree of nerve conduction block increased with laser power. The data indicate that lasing could diminish sensations, including pain, mediated by peripheral nerves in soft tissues.
Collapse
Affiliation(s)
- R Orchardson
- Institute of Biomedical and Life Sciences, University of Glasgow, Scotland, United Kingdom.
| | | | | |
Collapse
|
37
|
Abstract
BACKGROUND AND OBJECTIVE The purpose of the present study was to evaluate physiologically pulpal nerve responses and to elucidate histopathologically the pulp tissue reactions to "spot irradiation" with a pulsed Nd:YAG laser. STUDY DESIGN/MATERIALS AND METHODS Antidromic compound action potentials and the pulpal blood flow (PBF) were recorded from the canine tooth of a sodium pentobarbitone-anesthetized cat. The laser irradiation-induced pulp tissue changes were histologically investigated. RESULTS The coronal antidromic compound action potentials disappeared in all the teeth tested during lasing, and the time needed to erase them was significantly shortened with increases in lasing power (P < 0.05). The radicular PBF increased when spot irradiation was performed, and the coronal PBF also temporarily increased with low-powered lasing. Histologic investigation revealed that spot irradiation with the laser produced severe damage in the pulp tissue in a dose-dependent manner. CONCLUSION The present study suggests that spot irradiation with a pulsed Nd:YAG laser risks producing nerve injury and irreversible tissue damage in the pulp with lasing for the purpose of desensitizing hypersensitive dentin.
Collapse
Affiliation(s)
- Y Tokita
- Pulp Biology and Endodontics, Graduate School, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo 113-8549, Japan
| | | | | |
Collapse
|
38
|
Abstract
Since the development of the ruby laser by Maiman in 1960 and the application of the laser for endodontics by Weichman in 1971, a variety of papers on potential applications for lasers in endodontics have been published. The purpose of this paper is to summarize laser applications in endodontics, including their use in pulp diagnosis, dentinal hypersensitivity, pulp capping and pulpotomy, sterilization of root canals, root canal shaping and obturation and apicectomy. The effects of laser on root canal walls and periodontal tissues are also reviewed. The essential question is whether a laser can provide equal or improved treatment over conventional care. Secondary issues include treatment duration and cost/benefit ratio. This article reviews the role of lasers in endodontics since the early 1970s, summarizes many research reports from the last decade, and surmises what the future may hold for lasers in endodontics. With the potential availability of many new laser wavelengths and modes, much interest is developing in this promising field.
Collapse
Affiliation(s)
- Y Kimura
- Department of Endodontics, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan.
| | | | | |
Collapse
|
39
|
Yamaguchi H, Kobayashi K, Sato Y, Osada R, Sakuraba E, Nomura T, Arai T, Nakamura J, Cox CF. Nd:YAG laser irradiation of the human dental pulp: implications as a predictor of pulp hemodynamics. Lasers Surg Med 2000; 26:270-6. [PMID: 10738289 DOI: 10.1002/(sici)1096-9101(2000)26:3<270::aid-lsm4>3.0.co;2-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim of study this was to evaluate in vivo the pulpal blood flow rate, pulpal responsiveness, systemic blood pressure, and pulse rate during Nd:YAG laser irradiation of an isolated tooth. STUDY DESIGN/MATERIALS AND METHODS Thirteen volunteers from the Tsurumi Dental University faculty participated in this study after giving their consent to the Nd:YAG laser irradiation test protocol. Gingivobuccal areas adjacent to mandibular canines were used for clinical evaluation. Each area was coated with India ink and treated with a Nd:YAG laser for 30 sec at 120-mJ pulses at 10 pulses/sec. Pulpal blood flow was measured by a laser Doppler flowmeter during Nd:YAG laser irradiation of the tooth. All pulp responses were measured by an electric pulp tester before and after Nd:YAG laser irradiation. In addition, the systemic blood pressure and pulse rate were monitored throughout the laser irradiation procedure. RESULTS For all subjects involved in this study, the pulpal blood flow rate increased during laser irradiation. Threshold values of the electric pulp tests increased in six cases and decreased in six cases. One case showed no change. After 1 month, the threshold values for each subject had returned to previously recorded values. Neither systemic blood pressure nor pulse rate was affected during Nd:YAG laser irradiation. Pulpal blood flow was strongly influenced immediately after Nd:YAG laser irradiation, seen as an increase in the flow rate. CONCLUSION The results of this study suggest that effects of the Nd:YAG laser irradiation are similar to those of low power laser for the improvement of local blood flow.
Collapse
Affiliation(s)
- H Yamaguchi
- Department of Periodontics and Endodontics, Tsurumi University, School of Dental Medicine, Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|
40
|
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.
Collapse
Affiliation(s)
- R Orchardson
- Division of Neuroscience, Institute of Biomedical and Life Sciences, University of Glasgow, Glasgow, Scotland, United Kingdom.
| | | |
Collapse
|
41
|
Yamaguchi H, Kobayashi K, Sato Y, Osada R, Sakuraba E, Nomura T, Arai T, Nakamura J, Cox CF. Nd:YAG laser irradiation of the human dental pulp: Implications as a predictor of pulp hemodynamics. Lasers Surg Med 2000. [DOI: 10.1002/(sici)1096-9101(2000)26:3%3c270::aid-lsm4%3e3.0.co;2-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
42
|
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.
Collapse
Affiliation(s)
- K Yonaga
- Department of Endodontics, Showa University School of Dentistry, Tokyo, Japan.
| | | | | |
Collapse
|
43
|
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.
Collapse
Affiliation(s)
- R Orchardson
- Institute of Biomedical and Life Sciences, University of Glasgow, UK.
| | | | | |
Collapse
|