Analyzing global research trends and focal points in the utilization of laser techniques for the treatment of urolithiasis from 1978 to 2022: visualization and bibliometric analysis

Laser lithotripsy is gaining global prominence and is a dynamically progressing field marked by a continual influx of new and comprehensive research each year. Recently, there has been a noticeable shift toward the adoption of various kinds of lasers, such as holmium: yttrium-aluminum-garnet (Ho:YAG) and thulium fiber (TFL) lasers. Consequently, we aim to conduct a bibliometric analysis to analyze key areas of research activity within scientific publications that center on the utilization of laser techniques in urolithiasis. A search of the literature spanning from 1978 to 2022 was carried out on 25 December 2023 using the Scopus database to explore research related to the application of laser techniques for urolithiasis treatment. Visualization analysis was performed using VOSviewer software (version 1.6.20). We examined 962 publications that met the specified criteria, 791 (82.22%) of which were original articles. The analysis of the retrieved publications indicated a consistent increase in research output from 1978 to 2022; a particularly noteworthy surge occurred after 2003. In particular, the U.S. claimed the leading position as the most productive country, contributing 211 articles (21.93%). However, India had the highest research productivity according to the adjustment index of 19.08. In the European region, 324 publications (33.68% of the total) originated from 25 countries. The Journal of Endourology contributed the most between 1978 and 2022 (n = 96, 9.98%). The most cited paper examined the effectiveness of holmium: yttrium-aluminum-garnet (Ho:YAG) lasers, while a subsequent study focused on the use of a thulium fiber laser (TFL), an emerging laser technology that has gained increased recognition. Co-occurrence analysis revealed three distinct clusters focusing on the types of laser technology, minimally invasive approaches, and success rate/postoperative complications. This comprehensive investigation delves into the global landscape of laser use for the treatment of urolithiasis. This review supports the emerging clinical concept of using various types of laser technology for urolithiasis treatment. Moreover, the hot issues that researchers should focus on based on the findings of this study are the use of different types of laser lithotripsy in view of the surgical approach, success rate and complications.

[Treatment of early capsular blockage syndrome with Nd:YAG laser anterior capsulotomy containing neodymium-doped yttrium aluminum garnet in a case]

A 62-year-old female patient presented with no improvement in vision 10 days after undergoing cataract extraction in the right eye. The unaided visual acuity in the right eye was 0.1, and examination with a slit lamp revealed the presence of the intraocular lens with an increased gap between the intraocular lens and the posterior capsule. Anterior segment optical coherence tomography showed a distance of 3.236 mm between the posterior capsule and the posterior surface of the intraocular lens. Based on the medical history, ocular examination, and auxiliary examinations, a diagnosis of right eye capsular blockage syndrome was made. Nd:YAG laser capsulotomy was performed at the anterior capsule outside the optical zone of the intraocular lens. One week later, the posterior capsule adhered to the posterior surface of the intraocular lens, and there was a significant improvement in vision compared to before the procedure.

Strength-limiting damage and defects of dental CAD/CAM full-contour zirconia ceramics

OBJECTIVE

This study aimed to compare the four-point flexural strength of CAM-milled and sintered (as-sintered, AS) specimens with those of high-polished (HP) specimens using chairside polishing systems to simulate clinical surface conditions.

METHODS

Seven full-contour zirconia CAM/CAM blanks with various yttria contents (3, 4, 5 mol%) including three high-translucent groups (5Y) were selected to prepare flexural specimens. The bend bar specimens (2.0 × 4.0 × 25.0 mm3) were fabricated by using STL file and dental CAM machine with the respective zirconia blanks (98 mm ϕ and 10-14 mm in height). Twelve bar specimens were machined from one zirconia puck and a total of 24 specimens were prepared from each group. The pre-sintered bar specimens were sintered by using a dental zirconia furnace at 1530-1550 °C for 2 h according to the instructions. All sintered specimens were divided into two groups: as-sintered (AS) group and high-polished (HP) groups (n = 12). HP groups were subjected to polishing one surface of specimens using a three-step polishing system and finally finished with diamond polishing. After cleaning and drying, the flexural strength of all specimens was determined by a fully articulating four-point flexure fixture consisting of a 1/4-point test configuration with an inner/outer span of 10/20 mm. Statistical differences between AS and HP groups were conducted with Weibull analysis. The fractured surfaces of zirconia specimens were observed using a field emission SEM and EDS to detect failure origins.

RESULTS

The mean AS flexural strength values were significantly lower than those of HP counterparts. However, Weibull moduli expressing the reliability of HP groups were generally decreased although not significantly in comparison to their AS. The fracture of the AS specimens mostly originated from extrinsic CAM-milling defects, while the HP specimens were fractured from intrinsic subsurface or volume defects including pores, large grain clusters, inclusions, and corner-located critical flaws. Two high-translucent (5Y) zirconia groups were not affected in their strength and reliability after polishing, whereas one 5Y zirconia significantly increased its strength but significantly lowered its reliability.

SIGNIFICANCE

The extrinsic and intrinsic strength-limiting defects should be considered in evaluating the flexural strength and reliability of dental CAD/CAM zirconia ceramics for full-contour restorations. For the materials tested in this study, more optimized processing of blanks and milling protocols of pre-sintered zirconia blanks should be developed including post-sintering surface finishing to reduce the flaw population regulating strength and reliability which will affect the survivability of dental zirconia prostheses.

Fabrication of translucent graded dental crown using zirconia-yttrium multi-slurry tape casting 3D printer

This paper aims to fabricate functionally graded dental crown using a multi-slurry tape casting additive manufacturing technology. The different luminescence of the dental crown was obtained with different composition of zirconia and yttria. Zirconia with tunable mechanical properties and translucency are obtained by adding 3, 3.5, 4, 4.5, and 5 mol% of yttrium oxide to zirconia powder. After obtaining the printable slurry with maximum solid loading, the green bodies are prepared using the in-house built high-speed multi-ceramic tape casting technology. They are later sintered with two-stage sintering method. After the successful fabrication, the mechanical properties and translucency of the specimens were evaluated with Vickers hardness, three-point bending and translucency parameter tests. Finally, an FGM tooth crown with five photocurable slurries is proposed to demonstrate the translucent gradient effect of sintered part. The solid loading of 80% zirconia and 20% resin delivered samples without any surface cracks. The shrinkage ratio analysis showed that the sintered sample dimension was reduced by 20%, 20%, and 23% along X, Y, and Z directions. The samples fabricated with 3% yttrium oxide to zirconia delivered excellent hardness (1687 HV) and flexural strength (650.6 MPa). However, the relative luminescence increased with increasing the yttrium oxide for 3-5 mol%. With the optimized process parameters, the proposed dental crown is fabricated and analyzed for their shrinkage ratio, mechanical, and translucency properties. The study proposes the potential of fabricating customized dental crown with gradient translucent appearance.

Comparison of subcritical growth parameters of a Y-TZP obtained via cyclic or dynamic fatigue tests

OBJECTIVE

The objective of this study was to 1) compare the stress corrosion coefficient (n) of a Y-TZP obtained by two fatigue tests: cyclic and dynamic and 2) evaluate the effect of frequency in the characteristic lifetime and the existence of interaction between the cyclic fatigue and slow crack growth.

METHODS

A total of 145 Y-TZP specimens were produced in accordance with the manufacturer's instructions. These specimens, measuring 4.0 × 3.0 × 25.0 mm, were used for dynamic (n = 70) and cyclic fatigue tests (n = 75). The specimens were obtained from CAD/CAM blocks, sectioned, and sintered in a furnace at 1530 °C with a heating rate of 25 °C/min. They were tested in their "as-sintered" form without any additional surface treatment. The fatigue tests were conducted using a four-point bending to obtain the slow crack growth parameters (n). The cyclic fatigue test was also conducted in two frequencies (2 and 10 Hz), using stress levels between 350 and 600 MPa. Data from these tests were analyzed using ASTM C 1368-00 formulas and Weibull statistics. Scanning electron microscope (SEM) was used for fracture surface analysis to identify the origin of the fracture. Critical defect size was measured and used, along with flexural strength values, to estimate fracture toughness. Dynamic fatigue test data were used to obtain subcritical crack growth (SCG) parameters and perform Weibull statistical analysis. The cyclic fatigue data were used in the General Log-linear Model equation using the ALTA PRO software. Data were analyzed using one-way ANOVA followed by Tukey post-hoc tests and Student's t-test at a significance level of p ≤ 0.05.

RESULTS

In the dynamic fatigue test, the values obtained for σfo and n were 667 and 54, respectively. This parameter indicates how the strength of the material diminishes over time due to internal cracks. The Weibull parameters obtained from the same test results were m = 7.9, σ0 = 968, 9 and σ5% = 767, which indicates the reliability of the material. The Weibull parameters obtained by cyclic fatigue were statistically similar for the two frequencies used, the m* was 0.17 (2 Hz) and 0.21 (10 Hz); characteristic lifetimes (η) were 1.93 × 106 and 40,768, respectively. The n values obtained by cyclic fatigue were 48 and 40 at frequencies of 2 and 10 Hz, respectively. There was no effect of the frequency, the stress level or the interaction of the two in the Y-TZP lifetime, when analysed by General Log Linear Model.

SIGNIFICANCE

the n values obtained by cyclic and dynamic fatigue tests showed no statistically significant difference and the effect of frequency in the characteristic lifetime and the existence of interaction between the cyclic fatigue and subcritical growth were not observed in the tested specimens.

An energy efficiency assessment of Yttrium-aluminum-garnet laser in vitro

To study the effect range of the Nd:YAG laser through various levels of cloudy medium for targets with varying grayscale values in vitro. The coated paper cards with grayscale values of 0, 50, 100, and 150 were used as the laser's targets, which were struck straightly with varying energies using three burst modes (single pulse, double pulse, and triple pulse). Six filters (transmittances of 40, 50, 60, 70, 80, and 90) were applied to simulate various levels of cloudy refractive medium. Image J software was used to measure the diameters and regions of the laser spots. The ranges of the Nd:YAG laser spots increased with energy in the same burst mode (P < 0.05). Under the same amount of energy, the ranges of the Nd:YAG laser spot increased with the grayscale value of the targets (P < 0.05). The greater the transmittance of the filters employed, the larger the range of the Nd: YAG laser spots produced. Assuming that the total pulse energy is identical, the effect ranges of multi-pulse burst modes were significantly larger than those of single-pulse burst mode (P < 0.05). The effect range of a Nd:YAG laser grows with increasing energy and the target's grayscale value. A cloudy refractive medium has a negative impact on the effect range of the Nd: YAG laser. The single pulse mode has the narrowest and safest efficiency range.

Choroidal Effusion with Exudative Retinal Detachment following Non Perforating YAG-Laser Peripheral Iridotomy: A Case Report

AIM

To report a case of choroidal effusion and exudative retinal detachment following a non perforating Yttrium-Aluminium-Garnett (YAG)-laser iridotomy.

DESIGN

Case report.

METHODS

A 53-year-old woman complains of sudden onset of blurred vision in her left eye 15 days after the attempt of YAG-laser peripheral iridotomy. Clinical examination revealed 3+ flare and 1+ cells in the anterior chamber, 2+ vitreous cells, swollen optic nerve, ciliochoroidal effusion, and exudative retinal detachment involving macular area in the left eye. After starting treatment with prednisone 25 mg once daily, choroidal effusion and retinal detachment were managed successfully without any surgical approach.

CONCLUSION

Serous choroidal and exudative retinal detachments are rare complications following YAG-laser procedure. In our case, this clinical presentation occurs after a non perforating iridotomy. In medical practice, exudative retinal detachment should be always considered after YAG-laser iridotomy.

Effect of low-temperature degradation and sintering protocols on the color of monolithic zirconia crowns with different yttria contents

This study investigated the effects of low-temperature degradation (LTD) on the L*, a*, and b* values of highly translucent zirconia crowns. Four types of zirconia disks with different yttria contents (IPS e.max ZirCAD LT, IPS e.max ZirCAD MT, IPS e.max ZirCAD MT Multi, IPS e.max ZirCAD Prime, Ivoclar) and two shades (A2 and BL) were used. A crown was manufactured using four types of zirconia and LTD treated. Color measurements were performed, and the color difference (ΔE00) before and after LTD was calculated. The microstructure was determined through X-ray fluorescence and X-ray diffractometry. Highly translucent zirconia crowns showed greater changes in the a* and b* values than in the L* value after LTD, regardless of the shade. The Multi2 crowns exhibited a discernible color change due to the LTD treatment. The X-ray fluorescence results did not reveal any apparent change in the microstructure between sintering programs for all zirconia specimens.

Determination of lutetium density in LYSO crystals: methodology and PET detector applications

Objective. Lutetium yttrium oxyorthosilicate (LYSO) scintillation crystals are used in positron emission tomography (PET) due to their high gamma attenuation, fair energy resolution, and fast scintillation decay time. The enduring presence of the176Lu isotope, characterized by a half-life of 37.9 billion years, imparts a consistent radiation background (BG) profile that depends on the geometry and composition attributes of the LYSO crystals.Approach. In this work, we proposed a methodology for estimating the composition of LYSO crystals in cases where the exact Lutetium composition remains unknown. The connection between BG spectrum intensity and intrinsic radioactivity enables precise estimation of Lutetium density in LYSO crystal samples. This methodology was initially applied to a well-characterized LYSO crystal sample, yielding results closely aligned with the known composition. The composition estimation approach was extended to several samples of undisclosed LYSO crystals, encompassing single crystal and crystal array configurations. Furthermore, we model the background spectrum observed in the LYSO-based detector and validate the observed spectra via simulations.Main results. The estimated Lutetium composition exhibited adequate consistency across different samples of the same LYSO material, with variations of less than 1%. The result of the proposed approach coupled with the simulation successfully models the background radiation spectra in various LYSO-based detector geometries.Significance. The implications of this work extend to the predictive assessment of system behaviors and the autonomous configuration parameters governing LYSO-based detectors.

What are exposure biomarkers of rare earth elements for the ionic rare earth occupational population?

Rare earth elements (REEs) are widely utilized in industries. However, The specific exposure features of REEs and potential biomarkers of exposure in occupational populations remain unclear. In this study, we evaluated the external and internal REEs exposure levels among the participants working in the ionic rare earth smelting plant. For the external exposure, the concentrations of 14 REEs and total rare earth elements (ΣREEs) in airborne particles were significantly elevated in the REEs-exposed versus non-exposed group (P < 0.05). Meanwhile, the levels of Yttrium (Y), Gadolinium (Gd), Terbium (Tb), Dysprosium (Dy), Holmium (Ho), Thulium (Tm), Ytterbium (Yb), and ΣREEs in urine were higher in the REEs-exposed group compared to the non-exposed group (P < 0.05). Notably, a significant positive correlation was observed between Y in both the airborne particles and urine samples as well as Gd, and the Spearman correlation coefficient was 0.53 and 0.39 respectively, both P < 0.05. Conversely, no statistically significant differences were found in the levels of 15 REEs or ΣREEs in the blood samples between the REEs-exposed group and non-exposed group. Moreover, the concentrations of ΣREEs and 9 REEs in nail samples of the exposed group were significantly higher than those of the non-exposed group (P < 0.05), and the composition ratios of REEs in the nail samples closely resembled those found in individual airborne particles. Therefore, nail and urine samples were proposed to reflect long-term and short-term exposure to ionic rare earth respectively. Exposure biomarkers confirmed by external and internal exposure characteristics accurately provide the situation of human exposure to REEs environment, and have profound significance for monitoring and evaluating the level of REEs pollution in human body. It also provides a vital basis to find out the effect biomarkers, susceptible biomarkers and the health effects of rare earth environment for the future research.

Translucency of recent zirconia materials and material-related variables affecting their translucency: a systematic review and meta-analysis

BACKGROUND

Recent forms of translucent zirconia material have been developed, offering a wide range of options and varieties for enhancing aesthetics, making it a preferred choice in the field of prosthetic dentistry. However, there is insufficient understanding regarding the recent types of zirconia materials and their optical behavior. Understanding the variables that influence the translucency of zirconia and identifying strategies to enhance its esthetics are crucial.

PURPOSE

The current systemic review highlights a comprehensive understanding of different zirconia generations in relation to their optical characteristics and evaluates material-related variables affecting their translucency.

METHODS

The present review studied in-vitro studies that evaluated the optical characteristics of different yttria content of yttria stabilized materials. The topics explored were: (1) the different zirconia material generations and their optical behavior; (2) material-related factors that affect their translucency. The research was restricted to online publication in the English language from July 1, 2010, to July 31, 2023, using PubMed, Scopus, and Science Direct resources. The search key terms and their combinations were "zirconia," "translucent zirconia," "cubic zirconia," "highly translucent zirconia," "yttria partially stabilized zirconia," "monolithic zirconia," "translucency," "optical properties," and "light transmission."

RESULTS

The data obtained from fifty-three studies addressed the optical characteristics of various zirconia generations. They reported that changing yttria content had a significant impact on translucency. Different kinds of zirconia ceramics of the same generation have varying translucencies. Achieving optimum aesthetics with monolithic zirconia is challenging due to factors related to material aspects such as the presence of additives, point defects, microstructure, thickness, phase distribution, and sintering conditions.

CONCLUSIONS

Newly developed monolithic dental zirconia ceramics have improved aesthetics and translucency. However, additional research is necessary to evaluate their performance and long-term durability.

TRIAL REGISTRATION

This systematic review was registered in PROSPERO, under number CRD42023474482.

Identification of yttrium oxide-specific peptides for future recycling of rare earth elements from electronic scrap

Yttrium is a heavy rare earth element (REE) that acquires remarkable characteristics when it is in oxide form and doped with other REEs. Owing to these characteristics Y2 O3 can be used in the manufacture of several products. However, a supply deficit of this mineral is expected in the coming years, contributing to its price fluctuation. Thus, developing an efficient, cost-effective, and eco-friendly process to recover Y2 O3 from secondary sources has become necessary. In this study, we used phage surface display to screen peptides with high specificity for Y2 O3 particles. After three rounds of enrichment, a phage expressing the peptide TRTGCHVPRCNTLS (DM39) from the random pVIII phage peptide library Cys4 was found to bind specifically to Y2 O3 , being 531.6-fold more efficient than the wild-type phage. The phage DM39 contains two arginines in the polar side chains, which may have contributed to the interaction between the mineral targets. Immunofluorescence assays identified that the peptide's affinity was strong for Y2 O3 and negligible to LaPO4 :Ce3+ ,Tb3+ . The identification of a peptide with high specificity and affinity for Y2 O3 provides a potentially new strategic approach to recycle this type of material from secondary sources, especially from electronic scrap.

Comparative Treatment of Mucocutaneous Lesions in Hereditary Haemorrhagic Telangiectasia Patients With Dual Sequential Pulsed Dye Laser and Neodymium: Yttrium-Aluminium-Garnet Versus Neodymium: Yttrium-Aluminium-Garnet Laser Alone: A Double-Blind Randomized Controlled Study With Quality-of-Life Evaluation

BACKGROUND

Hereditary haemorrhagic telangiectasia (HHT) is characterized by the presence of telangiectases and larger arteriovenous malformations in different organs. Mucocutaneous telangiectases can bleed and become an aesthetic concern, impairing quality of life (QoL). However, the best treatment approach has not been defined yet.

OBJECTIVE

To evaluate the efficacy and safety of dual wavelength sequential 595/1064nm laser (DWSL) compared to 1064nm laser (Nd:YAG) alone. Secondarily, to evaluate QoL impairment in HHT patients, and its improvement with laser therapy.

METHODS

A comparative randomized split-body double-blinded prospective study (DWSL vs Nd:YAG). Demographic, clinical and treatment characteristics were recorded. The severity and degree of improvement were evaluated by three blinded examiners who scored pre-treatment and post-treatment pictures on a 5-point scale. Patients fulfilled Skindex-29 and FACE-Q® tests and assessed procedure-associated pain and patient satisfaction.

RESULTS

111 treatment areas (55 treated with DWSL and 56 with Nd:YAG) from 26 patients were analyzed. The median number of laser sessions was 2 (interquartile range [IQR] 2-4; mean 2.90 vs 2.88, respectively). The median improvement score, irrespective of location, was significantly higher for Nd:YAG compared to DWSL: 3 (IQR 2-3; mean 2.61) vs 2 (IQR 2-3; mean 2.32), p=0.031. Both FACE-Q index and Skindex-29 test results improved significantly (p<0.001), and 92.4% patients reported a high degree of satisfaction (≥8). No severe adverse events were reported.

CONCLUSIONS

DWSL and Nd:YAG laser are convenient, safe and effective treatment options for mucocutaneous telangiectases in HHT patients. However, Nd:YAG delivered better results with better tolerability. QoL was significantly improved by both treatments.

Comparative analysis of flexural strength of 3D printed and milled 4Y-TZP and 3Y-TZP zirconia

STATEMENT OF PROBLEM

The mechanical properties of 3 dimensionally (3D) printed zirconia have been reported to be comparable with those of milled zirconia, except for the flexural strength. However, most previous studies tested 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP), making it necessary to study 3D printed zirconia with 4 mol% yttria content (4Y-TZP).

PURPOSE

The purpose of this in vitro study was to compare the flexural strength of 3D printed 4Y-TZP with 3Y-TZP materials and milled 4Y-TZP.

MATERIAL AND METHODS

A total of 80 disk specimens (Ø15×1.5 mm) were fabricated and divided into 4 groups (n=20) using the fabrication method and yttria content: milled 3Y-TZP (Katana HT; Kuraray Noritake), 3D printed 3Y-TZP (TZ-3Y-E; Tosoh), milled 4Y-TZP (Katana STML; Kuraray Noritake), and 3D printed 4Y-TZP (3DMAT; Genoss). The biaxial flexural strength was determined with a piston-on-3-ball test (n=15). The flexural strength of each specimen was measured, and the Weibull modulus (m) and characteristic strength (σ0) were estimated from the fracture load distribution. Two intact and fractured specimens were examined with scanning electron microscopy (SEM). The crystalline phase of the specimens in each group was identified through X-ray diffraction (XRD) analysis (n=5). A 1-way ANOVA was used to compare the flexural strength among different groups. Subsequently, pairwise comparisons were conducted with the Tukey post hoc method (α=.05).

RESULTS

The flexural strength of 3D printed 4Y-TZP was significantly higher than that of milled 4Y-TZP (P<.001). In contrast, the flexural strength of 3D printed 3Y-TZP was significantly lower than that of milled 3Y-TZP (P<.001). X-ray diffraction (XRD) analysis revealed that the tetragonal phase was the dominant phase in all groups, with the identification of some cubic phase peaks.

CONCLUSIONS

Three dimensionally printed 4Y-TZP showed significantly higher flexural strength than milled 4Y-TZP and exhibited a clinically acceptable flexural strength exceeding 800 MPa.

Comparative Treatment of Mucocutaneous Lesions in Hereditary Haemorrhagic Telangiectasia Patients With Dual Sequential Pulsed Dye Laser and Neodymium: Yttrium-Aluminium-Garnet Versus Neodymium: Yttrium-Aluminium-Garnet Laser Alone: A Double-Blind Randomized Controlled Study With Quality-of-Life Evaluation

BACKGROUND

Hereditary haemorrhagic telangiectasia (HHT) is characterized by the presence of telangiectases and larger arteriovenous malformations in different organs. Mucocutaneous telangiectases can bleed and become an aesthetic concern, impairing quality of life (QoL). However, the best treatment approach has not been defined yet.

OBJECTIVE

To evaluate the efficacy and safety of dual wavelength sequential 595/1064nm laser (DWSL) compared to 1064nm laser (Nd:YAG) alone. Secondarily, to evaluate QoL impairment in HHT patients, and its improvement with laser therapy.

METHODS

A comparative randomized split-body double-blinded prospective study (DWSL vs Nd:YAG). Demographic, clinical and treatment characteristics were recorded. The severity and degree of improvement were evaluated by three blinded examiners who scored pre-treatment and post-treatment pictures on a 5-point scale. Patients fulfilled Skindex-29 and FACE-Q® tests and assessed procedure-associated pain and patient satisfaction.

RESULTS

111 treatment areas (55 treated with DWSL and 56 with Nd:YAG) from 26 patients were analyzed. The median number of laser sessions was 2 (interquartile range [IQR] 2-4; mean 2.90 vs 2.88, respectively). The median improvement score, irrespective of location, was significantly higher for Nd:YAG compared to DWSL: 3 (IQR 2-3; mean 2.61) vs 2 (IQR 2-3; mean 2.32), p=0.031. Both FACE-Q index and Skindex-29 test results improved significantly (p<0.001), and 92.4% patients reported a high degree of satisfaction (≥8). No severe adverse events were reported.

CONCLUSIONS

DWSL and Nd:YAG laser are convenient, safe and effective treatment options for mucocutaneous telangiectases in HHT patients. However, Nd:YAG delivered better results with better tolerability. QoL was significantly improved by both treatments.

Angle-closure glaucoma associated with vitreous prolapse after neodymium-doped yttrium-aluminum-garnet laser posterior capsulotomy

Capsulotomy with neodymium-doped yttrium--aluminum-garnet (Nd:YAG) laser is an effective treatment for posterior capsule opacification following cataract surgery. A wide opening of the posterior capsule associated with the ruptured anterior hyaloid can cause anterior chamber vitreous prolapse. Two patients who developed angle-closure glaucoma associated with vitreous prolapse following Nd:YAG laser posterior capsulotomy were successfully treated with antiglaucoma medication and peripheral iridotomies. Patient identification for potential risk factors and a careful postoperative follow-up are essential to avoid these serious complications.

Effects of Various Laser Treatments on Surface Characterization and Repair Bond Strength of Zirconia-Reinforced Lithium Silicate Ceramics

PURPOSE

To evaluate the effects of two different lasers and their use in combination with hydrofluoric acid (HF) etching on the surface roughness of zirconia-reinforced lithium silicate (ZLS) ceramics and their shear bond strength (SBS) to composite resin.

MATERIALS AND METHODS

The five study groups were as follows: (1) Group H = HF etching; (2) Group N = Nd:YAG (neodymium: yttrium-aluminum-garnet) laser; (3) Group NH = Nd:YAG laser + HF gel; (4) Group E = Er:YAG (erbium: yttrium-aluminum-garnet) laser; and (5) Group EH = Er:YAG laser + HF gel. Surface roughness was assessed using a noncontact profilometer, and SBS tests were conducted with a universal testing machine.

RESULTS

The mean SBS values were 16.23 ± 1.77 MPa for Group H, 17.1 ± 1.65 MPa for Group N, 16.65 ± 1.11 MPa for Group NH, 8.08 ± 1.12 MPa for Group E, and 11.58 ± 0.82 MPa for Group EH. There were significant differences between groups E and EH (P < .001) but no significant differences (P > .05) among the other groups.

CONCLUSIONS

Clinicians may prefer Nd:YAG laser or the combination of Nd:YAG and HF to intraorally repair fractured areas.

Mechanical Properties of Zirconia Materials with Different Translucency: An In Vitro Study

PURPOSE

To investigate the biaxial flexural strength of zirconia materials with different translucency before and after aging procedures and to evaluate the effects of aging on hardness and surface characteristics.

MATERIALS AND METHODS

A total of 90 disc-shaped specimens (n = 30 each) were prepared from translucent (Upcera-ST, Upcera Dental), high translucent (Katana HT, Kuraray Noritake), and ultra high translucent (Katana UTML, Kuraray Noritake) zirconia materials to a ø.16 ±1.2 mm thickness. The different translucency discs were then divided into three subgroups; one group was subjected to aging in a chewing simulator (n = 10), one group was aged with thermocycling (n = 10), and one was a control group (n = 10). Biaxial flexural strength, Vickers hardness, and surface characteristics were examined for all discs. The data were analyzed using the Shapiro-Wilk (P = .05), Mann-Whitney U, and Kruskal-Wallis H tests. Fracture strength was determined using biaxial bending strength tests, and Weibull analysis was used to analyze the resulting data.

RESULTS

A statistically significant difference was found among zirconia materials with different translucency in terms of fracture strength. On average, fracture strength was highest in the Upcera ST group (1,932.87 MPa) and lowest in the Katana UTML group (1,073.6 MPa; P = .001). The results of Weibull analysis showed a statistically similar distribution for all groups.

CONCLUSIONS

Aging procedures did not cause significant differences in fracture strength and hardness. The fracture strength of the zirconia materials with different translucency was considered acceptable for intraoral use.

Experts' recommendations in laser use for the treatment of bladder cancer: a comprehensive guide by the European Section of Uro-Technology (ESUT) and Training and Research in Urological Surgery and Technology (TRUST)-Group

PURPOSE

To identify laser settings and limits applied by experts during laser vaporization (vapBT) and laser en-bloc resection of bladder tumors (ERBT) and to identify preventive measures to reduce complications.

METHODS

After a focused literature search to identify relevant questions, we conducted a survey (57 questions) which was sent to laser experts. The expert selection was based on clinical experience and scientific contribution. Participants were asked for used laser types, typical laser settings during specific scenarios, and preventive measures applied during surgery. Settings for a maximum of 2 different lasers for each scenario were possible. Responses and settings were compared among the reported laser types.

RESULTS

Twenty-three of 29 (79.3%) invited experts completed the survey. Thulium fiber laser (TFL) is the most common laser (57%), followed by Holmium:Yttrium-Aluminium-Garnet (Ho:YAG) (48%), continuous wave (cw) Thulium:Yttrium-Aluminium-Garnet (Tm:YAG) (26%), and pulsed Tm:YAG (13%). Experts prefer ERBT (91.3%) to vapBT (8.7%); however, relevant limitations such as tumor size, number, and anatomical tumor location exist. Laser settings were generally comparable; however, we could find significant differences between the laser sources for lateral wall ERBT (p = 0.028) and standard ERBT (p = 0.033), with cwTm:YAG and pulsed Tm:YAG being operated in higher power modes when compared to TFL and Ho:YAG. Experts prefer long pulse modes for Ho:YAG and short pulse modes for TFL lasers.

CONCLUSION

TFL seems to have replaced Ho:YAG and Tm:YAG. Most laser settings do not differ significantly among laser sources. For experts, continuous flow irrigation is the most commonly applied measure to reduce complications.

Two-Photon-Excited FLIM of NAD(P)H and FAD-Metabolic Activity of Fibroblasts for the Diagnostics of Osteoimplant Survival

Bioinert materials such as the zirconium dioxide and aluminum oxide are widely used in surgery and dentistry due to the absence of cytotoxicity of the materials in relation to the surrounding cells of the body. However, little attention has been paid to the study of metabolic processes occurring at the implant-cell interface. The metabolic activity of mouse 3T3 fibroblasts incubated on yttrium-stabilized zirconium ceramics cured with aluminum oxide (ATZ) and stabilized zirconium ceramics (Y-TZP) was analyzed based on the ratio of the free/bound forms of cofactors NAD(P)H and FAD obtained using two-photon microscopy. The results show that fibroblasts incubated on ceramics demonstrate a shift towards the free form of NAD(P)H, which is observed during the glycolysis process, which, according to our assumptions, is related to the porosity of the surface of ceramic structures. Consequently, despite the high viability and good proliferation of fibroblasts assessed using an MTT test and a scanning electron microscope, the cells are in a state of hypoxia during incubation on ceramic structures. The FLIM results obtained in this work can be used as additional information for scientists who are interested in manufacturing osteoimplants.

The effect of phase contents on the properties of yttria stabilized zirconia dental materials fabricated by stereolithography-based additive manufacturing

The aim is to investigate the impact of phase contents on mechanical properties, translucency, and aging stability of additively manufactured yttria partially stabilized zirconia ceramics. For that purpose, we evaluated two PSZ materials. The first type was prepared utilizing commercially available 5 mol% yttria-stabilized zirconia(5Y-PSZ), while the second type, denoted as 3Y+8Y-PSZ ceramics, was fabricated by blending 3 mol% and 8 mol% yttria-stabilized zirconia powders. Compared to 5Y-PSZ (39.90 wt% tetragonal phases and c/a2 = 1.0141), 3Y+8Y-PSZ is characterized by a greater abundance of tetragonal phases (47.68 wt%), which display higher tetragonality (c/a2 = 1.0165) and lower yttrium oxide content (2.25mol%). As a result, the 3Y+8Y-PSZ demonstrates elevated strength (816.52 MPa) and toughness (4.32 MPa m1/2), accompanied by reduced translucency(CR:0.47) and it exhibits greater susceptibility to aging. The phase contents, yttrium oxide content, and lattice parameters in the tetragonal phase play a crucial role in determining the mechanical properties, translucency, and aging stability of PSZ ceramics.

Wear of lithium disilicate opposed by various ceramic materials

OBJECTIVES

To compare volumetric wear of lithium disilicate against different ceramic (3 mol% yttria-stabilized (3Y) zirconia, 5 mol% yttria-stabilized (5Y) zirconia, lithium disilicate, porcelain and enamel antagonists).

MATERIALS AND METHODS

Forty lithium disilicate (e.max CAD) specimens (n = 8/antagonist) were wet sanded to 1200grit SiC and mounted into a UAB wear device. Antagonist spheres (diameter = 4.75 mm) were made from polished 3Y zirconia, 5Y zirconia, lithium disilicate, porcelain and human enamel. A two-body wear test was performed with 20 N load and 1.5 mm slide for 400,000 cycles at 1 Hz. 33% glycerin was used as a lubricant. Wear facets were measured with optical profilometry. Wear scar areas of antagonists were measured with digital microscopy. Scanning electron microscopy was performed on wear facets and scars. Vicker's microhardness was measured of all antagonist materials. All data were compared with 1-way ANOVA and Tukey post-hoc analysis.

RESULTS

Significant differences in lithium disilicate volumetric wear (mm3 ) occurred with various antagonist materials: 0.38 ± 0.01a (3Y zirconia), 0.33 ± 0.01b, (5Y zirconia), 0.16 ± 0.01c (lithium disilicate), 0.11 ± 0.03d, (enamel), and 0.07 ± 0.01e (porcelain). The lithium disilicate antagonist demonstrated a larger wear scar than other materials. Zirconia was the hardest material and enamel the least hard.

CONCLUSIONS

Zirconia causes significant wear on lithium disilicate and lithium disilicate causes significant wear against itself.

CLINICAL SIGNIFICANCE

When selecting a material to oppose an existing lithium disilicate crown, a porcelain or lithium disilicate surface would cause significantly less wear to the existing crown. If an existing zirconia crown exists opposed to a prepared tooth, lithium disilicate may not be an ideal material selection to restore the tooth.

Effect of printing layer orientation and polishing on the fatigue strength of 3D-printed dental zirconia

OBJECTIVE

The aim of the study was to evaluate the influence of surface polishing and printing layer orientation on the fatigue behaviour of 3 mol% yttria-stabilized zirconia (3Y-TZP) by stereolithography (SLA) in comparison with subtractive manufacturing.

MATERIALS AND METHODS

60 experimental zirconia bar-shaped specimens were 3D-printed (P) via SLA, and 30 specimens were milled (M) from commercial zirconia block (Lava™ Frame, 3 M ESPE AG). All specimens had the same dimensions (1 mm × 1 mm x 12 mm) after sintering. The 3D-printed specimens were randomly divided according to printing orientations: parallel or perpendicular to the tensile surface in the fatigue test. The specimens were subsequently submitted to two surface finishing protocols (n = 15/gr): unpolished or polished. Their phase compositions were analysed by X-ray diffraction. The fatigue behaviour was evaluated by a stepwise approach.

RESULTS

The milled and both 3D-printed groups showed similar phase compositions for the as-sintered condition. Considerable amounts of rhombohedral phase were detected after polishing. Milled unpolished samples presented significantly higher fatigue strength than 3D-printed unpolished samples. Polishing did not improve the fatigue strength for milled zirconia but was advantageous for the 3D-printed specimens. 3D-printed specimens with parallel printing-layer orientation were significantly stronger than specimens with perpendicular layers regardless of surface finishing.

CONCLUSION

The manufacturing techniques had a significant influence on the fatigue strength of 3Y-TZP, but not on the phase compositions of the surface. The polishing protocol showed different effects on 3Y-TZP fatigue strength and induced phase transition of the 3Y-TZP from Tetragonal to Rhombohedral. The best fatigue strength was achieved through milling using an unpolished surface and SLA-printed layers that were parallel to the tensile surface, followed by polishing.

Oncological Outcomes of Thulium-Yttrium-Aluminum-Garnet (Tm:YAG) Laser Ablation for Penile Cancer

OBJECTIVE

To report oncological outcomes after thulium-yttrium-aluminum-garnet (Tm:YAG) laser ablation for penile cancer patients.

MATERIALS AND METHODS

We retrospectively analyzed 71 patients with ≤cT1 penile cancer (2013-2022). All patients underwent Tm:YAG ablation with a RevoLix 200W continuous-wave laser. First, Kaplan-Meier plots and multivariable Cox regression models tested local tumor recurrence rates. Second, Kaplan-Meier plots tested progression-free survival (≥T3 and/or N1-3 and/or M1).

RESULTS

Median (interquartile range) follow-up time was 38 (22-58) months. Overall, 33 (50.5%) patients experienced local tumor recurrence. Specifically, 19 (29%) vs 9 (14%) vs 5 (7.5%) patients had 1 vs 2 vs 3 recurrences over time. In multivariable Cox regression models, a trend for higher recurrence rates was observed for G3 tumors (hazard ratio:6.1; P = .05), relative to G1. During follow-up, 12 (18.5%) vs 4 (6.0%) vs 2 (3.0%) men were retreated with 1 vs 2 vs 3 Tm:YAG laser ablations. Moreover, 11 (17.0%) and 3 (4.5%) patients underwent glansectomy and partial/total penile amputation. Last, 5 (7.5%) patients experienced disease progression. Specifically, TNM stage at the time of disease progression was: (1) pT3N0; (2) pT2N2; (3) pTxN3; (4) pT1N1 and (5) pT3N3, respectively.

CONCLUSION

Tm:YAG laser ablation provides similar oncological results as those observed by other penile-sparing surgery procedures. In consequence, Tm:YAG laser ablation should be considered a valid alternative for treating selected penile cancer patients.

Er:YAG laser debonding of zirconia and lithium disilicate restorations

STATEMENT OF PROBLEM

Yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) restorations of different formulations are being used increasingly in monolithic form for a range of clinical applications. Using rotary instruments to remove such restorations for any purpose is challenging, but they can be removed conservatively with erbium lasers. However, studies on how a laser penetrates different zirconias to break the cement bond between the tooth surface and the zirconia are lacking.

PURPOSE

The purpose of this in vitro study was to evaluate and compare the time required for an erbium-doped yttrium-aluminum-garnet (Er:YAG) laser to remove different types of zirconia and lithium disilicate crowns.

MATERIAL AND METHODS

Forty extracted premolar teeth were prepared, scanned, designed, and milled to fabricate 40 computer-aided design and computer-aided manufacturing (CAD-CAM) crowns, which were assigned to 4 groups (n=10): 3 mol% Y-TZP, 4 mol% Y-TZP, 5 mol% Y-TZP, and lithium disilicate as a control. All crowns were bonded to the teeth with a self-adhesive resin cement (Panavia SA Cement Universal). Each specimen was irradiated with an Er:YAG laser with the following parameters: 300 mJ, 15 Hz, 5.0 W, and a 50-microsecond pulse duration (supershort pulse mode). The irradiation time required for crowns to be retrieved successfully was recorded for each specimen. Data were statistically analyzed using analysis of variance and the Tukey honestly significant difference post hoc test (α=.05). The intaglio surfaces of the restorations were analyzed using scanning electron microscopy (SEM).

RESULTS

The mean ±standard deviation times in minutes needed for crown debonding were 12.46 ±4.17 for the 3 mol% Y-TZP group, 10.30 ±3.33 for the 4 mol% Y-TZP group, 4.03 ±1.62 for the 5 mol% Y-TZP group, and 2.08 ±0.92 for the lithium disilicate group. A statistically significant difference (P<.05) in the debonding time was found for all investigated groups, expect between the 3 mol% and 4 mol% Y-TZP groups and between the 5 mol% Y-TZP and lithium disilicate groups. SEM analysis of the ceramic surfaces showed no visual damage associated with Er:YAG laser irradiation.

CONCLUSIONS

Zirconia crown retrieval time with the Er:YAG laser was influenced by the yttria content of the zirconia, with decreasing retrieval time with increasing yttria content. Er:YAG laser debonding of zirconia crowns is a noninvasive, efficient, and rapid approach to the removal of crowns and could be applied in clinical practice.

[90Y]Yttria Alumino Silicate Glass Microspheres: A Biosimilar Formulation to "TheraSphere" for Cost-Effective Treatment of Liver Cancer

Background: Selective internal radiation therapy (SIRT) using a suitable β--emitting radionuclide is a promising treatment modality for unresectable liver carcinoma. Yttrium-90 (90Y) [T1/2 = 64.2 h, Eβ(max) = 2.28 MeV, no detectable γ-photon] is the most preferred radioisotope for SIRT owing to its favorable decay characteristics. Objective: The present study describes indigenous development and evaluation of intrinsically radiolabeled [90Y]yttria alumino silicate ([90Y]YAS) glass microsphere, a formulation biosimilar to "TheraSphere" (commercially available, U.S. FDA-approved formulation), for SIRT of unresectable liver carcinoma in human patients. Methods: YAS glass microspheres of composition 40Y2O3-20Al2O3-40SiO2 (w/w) and diameter ranging between 20 and 36 μm were synthesized with almost 100% conversion efficiency and >99% sphericity. Intrinsically labeled [90Y]YAS glass microspheres were produced by thermal neutron irradiation of cold YAS glass microspheres in a research reactor. Subsequent to in vitro evaluations and in vivo studies in healthy Wistar rats, customized doses of [90Y]YAS glass microspheres were administered in human patients. Results: [90Y]YAS glass microspheres were produced with 137.7 ± 8.6 MBq/mg YAS glass (∼6800 Bq per microsphere) specific activity and 99.94% ± 0.02% radionuclidic purity at the end of irradiation. The formulation exhibited excellent in vitro stability in human serum and showed >97% retention in the liver up to 7 d post-administration when biodistribution studies were carried out in healthy Wistar rats. Yttrium-90 positron emission tomography scans recorded at different time points post-administration of customized dose of [90Y]YAS glass microspheres in human patients showed near-quantitative retention of the formulation in the injected lobe. Conclusions: The study confirmed the suitability of indigenously prepared [90Y]YAS glass microspheres for clinical use in the treatment of unresectable hepatocellular carcinoma.

Experts' recommendations in laser use for the treatment of urolithiasis: a comprehensive guide by the European Section of Uro-Technology (ESUT) and Training-Research in Urological Surgery and Technology (T.R.U.S.T.)-Group

PURPOSE

To identify laser lithotripsy settings used by experts for specific clinical scenarios and to identify preventive measures to reduce complications.

METHODS

After literature research to identify relevant questions, a survey was conducted and sent to laser experts. Participants were asked for preferred laser settings during specific clinical lithotripsy scenarios. Different settings were compared for the reported laser types, and common settings and preventive measures were identified.

RESULTS

Twenty-six laser experts fully returned the survey. Holmium-yttrium-aluminum-garnet (Ho:YAG) was the primary laser used (88%), followed by thulium fiber laser (TFL) (42%) and pulsed thulium-yttrium-aluminum-garnet (Tm:YAG) (23%). For most scenarios, we could not identify relevant differences among laser settings. However, the laser power was significantly different for middle-ureteral (p = 0.027), pelvic (p = 0.047), and lower pole stone (p = 0.018) lithotripsy. Fragmentation or a combined fragmentation with dusting was more common for Ho:YAG and pulsed Tm:YAG lasers, whereas dusting or a combination of dusting and fragmentation was more common for TFL lasers. Experts prefer long pulse modes for Ho:YAG lasers to short pulse modes for TFL lasers. Thermal injury due to temperature development during lithotripsy is seriously considered by experts, with preventive measures applied routinely.

CONCLUSIONS

Laser settings do not vary significantly between commonly used lasers for lithotripsy. Lithotripsy techniques and settings mainly depend on the generated laser pulse's and generator settings' physical characteristics. Preventive measures such as maximum power limits, intermittent laser activation, and ureteral access sheaths are commonly used by experts to decrease thermal injury-caused complications.

Treatment of periorbital hyperpigmentation using light devices

The treatment of dark circles is one of the most common request from the patients attending to the esthetics clinic. A tired, sad or aged appearance is perceived by our patients. Moreover, it is a multifactorial problem and we could treat it with a wide range of treatments. With this systematic review, we want to check the best available evidence regarding the treatment of periorbital hyperpigmentation using light devices. We have reviewed 208 papers, including 14 of them for full consideration. Several light sources have demonstrated to be effective treating pigmented dark circles. The best results have been reported using intense pulsed light and rubi laser together with depigmenting substances. If we want to treat periocular hyperpigmentation, soft wrinkles, rhytides and skin density we should use carbo dioxide laser or Erbium:Yttrium Scandium Gallium Garnet. The Neodymium-Doped Yttrium Aluminium Garnet, alexandrite and diode lasers were the ones giving the worst outcome regarding pigmentation treatment. The concomitant use of depigmenting treatment may help getting better results and reducing the rate of post inflammatory hyperpigmentation. A better standardization and measuring of the obtained results is needed regarding pigmentation changes. We must keep on investigating on this topic with new clinical trials measuring objective results and combining different light devices for a multifactorial treatment of the dark circles.

Yttrium-Iron Garnet Film Magnetometer for Registration of Magnetic Nano- and Submicron Particles: In Vitro and In Vivo Studies

In the current article, we present a new kind of magnetometer for quantitative detection of magnetic objects (magnetic nano- and submicron particles) in biological fluids and tissues. The sensor is based on yttrium-iron garnet film with optical signal registration system. Inheriting the working principle of a fluxgate magnetometers, the sensor works at a room-temperature, its wide dynamic range allows the measurements in an unshielded environment. A small size of sensitive element combined with a short recovery time after the excitation coils are off provide us with a potentially high spatial and temporal resolution of measurements. We show the feasibility of the developed devices by sensing the remanent magnetization of magnetic nanoparticles (MNPs) both in vitro (test tubes, dry MNPs) and in vivo (local injection of the MNPs into mice).

Zirconia restoration types, properties, tooth preparation design, and bonding. A narrative review

OBJECTIVE

The purpose of this review was to provide dental professionals with information regarding the various types of zirconia restorations, their mechanical and optical properties, tooth preparation design, and bonding protocol in an effort to enhance the longevity and durability of zirconia restorations.

OVERVIEW

The yttria content of zirconia ceramics determines their classification. The mechanical and optical properties of each type are discussed, with an emphasis on the effect of yttria concentration on the properties of zirconia. The processing and sintering methods are also discussed as they have a direct impact on the properties of zirconia. The design of tooth preparation, specifically occlusal reduction, varies depending on the type of zirconia used in each case. Finally, a protocol for zirconia restoration bonding is described to ensure optimal bonding to the tooth structure.

CONCLUSION

Not all zirconia restorations are the same. The selection of zirconia type based on yttria concentration, processing and sintering methods, tooth preparation design, and adherence to the bonding protocol are all critical to the success and longevity of zirconia restorations.

CLINICAL SIGNIFICANCE

Zirconia restorations are the most commonly used indirect restorative material. The selection of the most appropriate zirconia type based on its yttria content, which determines its strength and translucency, is critical to the success and the longevity of the restoration. Tooth preparation design also influences the strength and translucency of the zirconia. Air-borne particle abrasion, followed by a ceramic primer and resin cement, can ensure a durable bond to the tooth structure.

NaYF4:Yb/Ho upconversion nanoprobe incorporated gold nanoparticle (AuNP) based FRET immunosensor for the "turn-on" detection of cardiac troponin I

Cardiac troponin I (cTnI) is a significant biomarker for acute heart attack. Hence, fast, economical, easy and real time monitoring of cardiac troponin I (cTnI) is of great importance in diagnosis and prognosis of heart failure in the healthcare domain. In this work, an immunoassay based on NaYF4:Yb/Ho based photon-upconversion nanoparticle (UCNP) with narrow emission peaks at 540 nm and 655 nm respectively, is synthesized. Then, it is encapsulated with amino functionalized silica using 3-aminopropyltriethoxysilane (APTES) to form APTES@SiO2-NaYF4:Yb/Ho UCNPs. When AuNPs is added to this system, the fluorescence is quenched by the electrostatic interaction with APTES@SiO2-NaYF4:Yb/Ho UCNPs, thereby exhibiting a FRET-based biosensor. When the cTnI antigen is introduced into the developed probe, an antibody-antigen complex is formed on the surface of the UCNPs resulting in fluorescence recovery. The developed sensor shows a linear response towards cTnI in the range from 0.1693 ng mL-1 to 1.9 ng mL-1 with a low limit of detection (LOD) of 5.5 × 10-2 ng mL-1. The probe exhibits adequate selectivity and sensitivity when compared with coexisting cardiac biomarkers, biomolecules and in real human serum samples.

Biosorption of rare earth elements from luminophores by G. sulphuraria (Cyanidiophytina, Rhodophyta)

Lanthanides are indispensable constituents of modern technologies and are often challenging to acquire from natural resources. The demand for REEs is so high that there is a clear need to develop efficient and eco-friendly recycling methods. In the present study, freeze-dried biomass of the polyextremophile Galdieria sulphuraria was employed to recover REEs from spent fluorescent lamps (FL) luminophores by pretreating the freeze-dried biomass with an acid solution to favour ion exchange and enhance the binding sites on the cell surface available for the metal ions. Lanthanides were extracted from the luminophores using sulfuric acid solutions according to standardised procedures, and the effect of biosorbent dosage (0.5-5 mg/ml) and biosorption time (5-60 min) were evaluated. The content of individual REEs in the luminophores and the resulting algal biomass were determined using inductively coupled plasma mass spectrometry (ICP-MS). The most abundant REE in the luminophores was yttrium (287.42 mg/g dm, 91.60% of all REEs), followed by europium (20.98 mg/g, 6.69%); cerium, gadolinium, terbium and lanthanum was in trace. The best biosorption performances were achieved after 5 min and at the lowest biosorbent dosage (0.5 mg/mL). The highest total metal amount corresponded to 41.61 mg/g dried mass, and yttrium was the most adsorbed metal (34.59 mg/g dm, 82.88%), followed by cerium (4.01 mg/g); all other metals were less than 2 mg/g. The rapidity of the biosorption process and the low biosorbent dosage required confirmed this microalga as a promising material for creating an eco-sustainable protocol for recycling REEs.

Alleviation of calcium hydroxide nanoparticles induced genotoxicity and gastritis by coadministration of calcium titanate and yttrium oxide nanoparticles in mice

Diverse applications of nanoparticles due to their unique properties has rapidly increased human exposure to numerous nanoparticles such as calcium hydroxide (Ca(OH)2), calcium titanate (CaTiO3), and yttrium oxide (Y2O3) nanoparticles almost in all aspect of daily life. However, very limited data are available on the effect of these nanoparticles on genomic DNA integrity and inflammation induction in the gastric tissues. Hence, this study estimated the effect of Ca(OH)2, CaTiO3, or/and Y2O3 nanoparticles multiple oral administration on the genomic DNA damage and inflammation induction in the mice gastric tissues. A suspension containing 50 mg/kg b.w of Ca(OH)2, CaTiO3, or Y2O3 nanoparticles were given orally to male mice separately or together simultaneously three times a week for two consecutive weeks. Multiple oral administration of Ca(OH)2 nanoparticles led to significant elevations in DNA damage induction and ROS generation, in contrast to the non-significant changes observed in the level of induced DNA damage and generated ROS after administration of CaTiO3 or Y2O3 nanoparticles separately or in combination with Ca(OH)2 nanoparticles. Oral administration of Ca(OH)2 nanoparticles alone also highly upregulated INOS and COX-2 genes expression and extremely decreased eNOS gene expression. However, high elevations in eNOS gene expression were detected after multiple administration of CaTiO3 and Y2O3 nanoparticles separately or together simultaneously with Ca(OH)2 nanoparticles. Meanwhile, non-remarkable changes were noticed in the expression level of INOS and COX-2 genes after administration of CaTiO3 and Y2O3 nanoparticles separately or simultaneously together with Ca(OH)2 nanoparticles. In conclusion: genomic DNA damage and inflammation induced by administration of Ca(OH)2 nanoparticles alone at a dose of 50 mg/kg were mitigated by about 100% when CaTiO3 and Y2O3 nanoparticles were coadministered with Ca(OH)2 nanoparticles until they reached the negative control level through altering the expression level of eNOS, INOS and COX-2 genes and scavenging gastric ROS. Therefore, further studies are recommended to investigate the toxicological properties of Ca(OH)2, CaTiO3 and Y2O3 nanoparticles and possibility of using CaTiO3 and Y2O3 nanoparticles to mitigate genotoxicity and inflammation induction by Ca(OH)2 nanoparticles.

Enhancing fluoride removal from wastewater using Al/Y amended sludge biochar

This study explored the potential of utilizing aluminum and yttrium amended (Al/Y amended) sewage sludge biochar (Al/Y-CSBC) for efficient fluoride removal from wastewater. The adsorption kinetics of fluoride on bimetallic modified Al/Y-CSBC followed the pseudo-second-order model, while the adsorption isotherm conformed to the Freundlich equation. Remarkably, the material exhibited excellent fluoride removal performance over a wide pH range, achieving a maximum adsorption capacity of 62.44 mg·g-1. Moreover, Al/Y-CSBC demonstrated exceptional reusability, maintaining 95% removal efficiency even after six regeneration cycles. The fluoride adsorption mechanism involved ion exchange, surface complexation, and electrostatic adsorption interactions. The activation and modification processes significantly increased the specific surface area of Al/Y-CSBC, leading to a high isoelectric point (pHpzc = 9.14). The incorporation of aluminum and yttrium metals exhibited a novel approach, enhancing the adsorption capacity for fluoride ions due to their strong affinity. Furthermore, the dispersing effect of biochar played a crucial role in improving defluoridation efficiency by enhancing accessibility to active sites. These findings substantiate the significant potential of Al/Y-CSBC for enhanced fluoride removal from wastewater.

Rare earth elements in sands collected from Southern California sea beaches

Rare earth elements (REEs) are considered the limiting resources for advancing clean technologies and electronics. Because global REEs reserve is limited, non-conventional and secondary sources are being investigated for recovery. Here, we investigated wet and dry sand from seven Southern California beaches for sixteen REEs. These include five light REEs, two medium REEs, and nine heavy REEs, separated by their atomic weight. The mass of the magnetically separated compounds ranged from 15.19 to 129.91 g per kg of dry sand in the studied sea beaches in Southern California. The total REEs concentration ranged from 1168.1 to 6816.7 μg per kg of wet sand (dry sand basis) and 1474.7-7483.8 μg per kg of dry sand. Cerium (Ce) and Yttrium (Y) were the most prevalent REEs in these beaches ranging from 387.4 to 2241.1 μg kg-1 and 104.5-2302.3 μg kg-1 of sand respectively. This study found light REEs concentration accounted for 70-80% of total rare earth elements in the studied beaches. The concentrations of the analyzed REEs were significantly different (p < 0.05) from each other in the studied beaches. Additionally, Pearson correlation showed that the REEs were strongly correlated (r ≥ 0.83) with each other in the reported sea beaches, indicating a similar origin of the REEs. The dominant heavy metals in the studied samples were Vanadium (V), Chromium (Cr), Cobalt (Co), Nickel (Ni), Copper (Cu), Zinc (Zn), and Strontium (Sr). Dominant minerals identified in sands were quartz, anorthite, ilmenite, and xenotime. All the beaches are lowly enriched with REEs, and any of the REEs caused no ecological risk or pollution. Similarly, no pollution/ecological risk was observed for the analyzed heavy metals. This study identified beach sand as a potential REEs source and demonstrated an easy separation of REEs containing magnetic compounds from sand.

Investigation of mechanical properties and low-temperature degradation of dental 3Y-TZP ceramics fabricated by stereolithography in combination with microwave sintering

The purpose of this study was to obtain dental ceramic materials with excellent mechanical properties and high resistance to low temperature degradation (LTD) via stereolithography (SLA) in combination with microwave sintering (MWS). The results have shown that the unaged MWS-1425 °C 3Y-TZP ceramics with uniform microstructure have high density up to 99.04% and excellent mechanical properties (Vickers hardness 14.07 GPa, fracture toughness 4.32 MPa m1/2, flexural strength 947.87 MPa). After 50 h of LTD, the m-phase content of MWS 3Y-TZP ceramics accounts for only 10.3%. In addition, the surface roughness increases by only 1.3 nm, the degraded depth is less than 5 μm, and the flexural strength exceeds 900 MPa. This exhibits the high resistance to LTD and excellent mechanical properties of dental 3Y-TZP ceramics can be obtained.

СOMPARATIVE SPECTROPHOTOMETRY ANALYSIS OF ZIRCONIUM DIOXIDE WITH THE CUBIC AND TETRAGONAL PHASE AFTER ARTIFICIAL AGING

Aim - to evaluate optical features of the 3, 4 and 5Y-TZP zirconium dioxide with the spectrophotometry analysis under artificial aging procedure. For all experiments, identical standardized specimens of different types of zirconia with a diameter of 10 mm and a height of 1 mm were used. These types included Katana (Kuraray Noritake Dental, Tokyo, Japan) HTML (control) UTML, STML and ZirCAD Prime (Ivoclar Vivadent). Artificial aging (low-temperature degradation) was performed using the following autoclaving regime: 134 degrees Celsius, 2 atmospheres, 5 hours. A Shimadzu UV-3600 spectrophotometer was used to study the spectral characteristics of the provided samples. Since the samples have low bandwidth, it was decided to investigate the reflectance spectra. For this purpose, a Shimadzu SR-1503 integrating sphere was installed on the spectrophotometer. Results: All samples of Prime manufacturer show an increase in the reflected signal intensity in the range of 650-820 nm. This range corresponds to red and orange colors, which means that as a result of autoclaving the beige tint of the materials will become more pronounced. The intensity of scattered light of the sample UTML-glaze and STML-glaze has lower values in the whole visible wavelength range. However, the intensity decrease in this case is not uniform. In the range above 500nm the intensity decrease is more pronounced, which means that as a result of artificial aging the beige tint of the materials will become somewhat less pronounced. Zirconia restorations with a predominantly tetragonal phase with polished and glazed surfaces will not change reflectance during artificial aging.

Effect of sintering time on microstructure and optical properties of yttria-partially stabilized monolithic zirconia

OBJECTIVES

To evaluate the impact of speed sintering on the microstructure and optical properties of 3 and 5 mol% yttria-partially stabilized monolithic zirconias.

METHODS

120 plate-shaped zirconia specimens (10x10x 0.4 mm) were prepared from three commercial 5 mol% yttria-partially stabilized zirconia blocks (5Y-PSZs); Katana UTML (Kuraray Noritake), Cercon xtML (Dentsply Sirona), and Zolid FX white (Amann Girrbach), and two commercial 3 mol% yttria-partially stabilized zirconia blocks (3Y-PSZs); Lava Plus (3 M ESPE) and InCoris (Sirona, GmbH). Specimens were either conventional sintered (CS) using a 7-hour program or speed sintered (SS) using a quick 90-minute program. The microstructure was inspected with a scanning electron microscope (SEM), and phase fractions were detected using x-ray diffraction analysis (XRD). Translucency (TP00), and contrast ratio (CR) were obtained using a spectrophotometer (VITA Easyshade V). Color difference (ΔE00) between both sintering processes was calculated with the CIEDE2000 formula. ΔE00 up to 1.8 was set as the acceptability threshold. Data were analyzed using two-way ANOVA, Krusakll-Wallis, and Mann-Whitney U tests. (n = 12, α = .05).

RESULTS

Grain size was significantly decreased after SS for all tested materials (P < .0001). The average grain sizes of 5Y-PSZs were significantly larger than those of 3Y-PSZs. The atomic structure, microstructure, and transparency of CS and SS were all affected by the amount of yttria, the size of the crystals, and tetragonality. SS significantly reduced TP00 (F = 7135.95, P < 0.0001) and increased CR (F = 453.21, P < 0.0001). The CS Katana presented the highest TP00 and lowest CR value. ΔE00 between the CS and SS groups were clinically acceptable except for Lava, which had values above the set threshold (1.89).

SIGNIFICANCE

SS altered the grain size and internal structure of the tested materials, which was reflected in translucency.

Clinical, Bacterial, and Prosthodontic Parameters After Implant Abutment Disinfection Using Nd:YAG, Er,Cr:YSGG, Chlorhexidine, and Conventional Steam Before Prosthesis Delivery

Objective: This 1-year prospective clinical trial was designed to assess the microbial, clinical, radiographic, and prosthetic parameters after disinfection of the implant abutment connection using Er,Cr:YSGG (erbium, chromium-doped: yttrium, scandium, gallium, and garnet) and Nd:YAG (neodymium-doped yttrium, aluminum, garnet). Materials and methods: All the patients were divided into four groups; Group I: Nd:YAG laser, Group II: Er,Cr:YSGG laser, Group III: 0.2% chlorhexidine (CHx), and Group IV: steam disinfection. Peri-implant parameters assessed included peri-implant bleeding scores (PIBS), peri-implant plaque scores (PIPS), peri-implant pocket depth (PIPD), and crestal bone loss (CBL). The peri-implant plaque samples were acquired to perform microbiological analysis to assess Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, respectively. All measurements were completed at baseline, 6 months, and 12 months postsurgery. Multiple groups were compared with the help of the Bonferroni post-hoc adjustment test (p < 0.01). Logistic regression models were utilized to assess the association between age, oral hygiene practices (brushing and flossing), and duration of implant function. Results: At the baseline level, there were no discernible differences in the peri-implant parameters between the study groups (p > 0.05). At the 6-month (p < 0.01) and 12-month (p < 0.001) follow-ups, all four study groups demonstrated a significant improvement in PIPS and PIBS, with no significant differences between the groups at baseline (p > 0.05). Based on an intergroup comparison, Group I (Nd:YAG) showed a significant decrease in PIBS when compared with the other groups. Group II showed a considerable decrease in PIPD and enhancements in CBL when compared with Groups I, III, and IV (p < 0.01). At the 6- and 12-month follow-up periods, P. gingivalis and T. denticola reduction were found to be statistically higher in Group II, whereas P. gingivalis and T. forsythia mean log CFU/mL were found to be statistically higher in Group I. Conclusions: Nd:YAG and Er,Cr:YSGG lasers both outperformed CHx and steam disinfection in terms of clinical, peri-implant, and prosthetic results when used to clean implant abutments.

The effect of low-temperature degradation and building directions on the mechanical properties of additive-manufactured zirconia

This study aimed to investigate the effect of low-temperature degradation (LTD) on the mechanical properties of additive-manufactured zirconia. In addition, the mechanical properties of additive-manufactured were compared with those before aging under similar experimental conditions. This study prepared stereolithography apparatus fabricated zirconia specimens with flexural strength, modulus of elasticity, Vickers hardness, and fracture toughness. The specimen position data were set as parallel (0°), diagonal (45°), and perpendicular (90°) to the direction of the building. The LTD condition was 5 h under 134ºC and 0.2 MPa in an autoclave. It was found that the 0° direction differed significantly from all other conditions before and after aging, and the highest flexural strength was obtained when the additive specimen was manufactured perpendicular to the building direction. However, the results indicate that there is a negligible effect of aging on the mechanical properties of additive-manufactured zirconia.

Yttrium-modified drinking water treatment residue for efficient phosphorus removal: efficacy, mechanism, and reproducibility

The excessive presence of phosphate can cause eutrophication in water bodies. Yttrium has an extremely high affinity for phosphorus and is capable of forming stable complexes at low concentrations. Moreover, limitations in the resourcefulness of drinking water treatment residues were observed. In this study, a highly efficient phosphorus removal adsorbent (RJDWTR@Y) was prepared by calcination-alkali leaching-yttrium-loaded composite modification employing domestic drinking water treatment residue as raw material. And the effects of multiple factors on phosphate adsorption by RJDWTR@Y were examined. The results illustrated that the maximum adsorption capacity of the RJDWTR@Y for phosphate was 319.76 mg/g, with the chemical reaction of the multilayer as the predominant adsorption process. The adsorption mechanism is electrostatic gravitational force and the inner sphere complexation effect. RJDWTR@Y was effective against interference even at high concentrations of the coexisting anion. After five cycles, the desorption efficiency of phosphate was 75.11%. Filling the fixed bed with the material can efficiently remove phosphorus from the flowing liquid. The synthesis of RJDWTR@Y and the results of the study indicated that it has good application prospects. In addition to efficiently removing phosphorus, it can also recycle waste and achieve sustainability.

Biomonitoring of rare earth elements in Southern Norway: Distribution, fractionation, and accumulation patterns in the marine bivalves Mytilus spp. and Tapes spp

Growing extraction and usage of rare earth elements and yttrium (REY) for medical and industrial applications has resulted in increased discharges into the marine environment. Using Mytilus spp. Mussels and Tapes spp. clams as bioindicator organisms, we analyzed 15 REY in soft tissues of specimens collected at two potentially polluted sites in Southern Norway: in the vicinity of an industry producing gadolinium-based MRI contrast agents (GBCAs) (Lindesnes) and in an industrially-affected fjord (Porsgrunn). The spatial distribution of REY and shale-normalized fractionation patterns were determined to assess the potential anthropogenic contribution of REY at the sites. At both sites, the REY fractionation pattern in soft tissue was characterized by enrichment of light rare earth elements (LREE) over heavy rare earth elements (HREE), while also displaying negative cerium and small positive gadolinium (Gd) anomalies. LREEs contributed to over 80% of the total REY concentrations, with increasing relative enrichment following higher total REY. Gd anomalies remained conserved in most sites despite significant differences in total REY; however, a high Gd anomaly (Gd/Gd* = 4.4) was found downstream of the GBCA industry spillwater outlet, indicating biotic uptake of excess anthropogenic Gd at this site. Total REY concentrations in clams in Porsgrunn were one order of magnitude higher than in mussels in Lindesnes. This may be attributable to freshwater influences in Porsgrunn, where clams collected closer to the river mouth had significantly higher total REY concentrations. This study constitutes the first assessment of REY concentrations in marine bivalves in Norway and can provide useful information for future biomonitoring studies on REY contamination.

A systematic review on removal of osseointegrated implants: un update

BACKGROUND

Today dental implants represent an effective therapy in case of partial or total edentulism, with an excellent success rate. Despite the results obtained, there may be biological or mechanical complications during the therapy, which lead to the loss of the implant. This systematic review aims to evaluate the current state of the art in the literature on techniques used for the removal of dental implants. Various aspects will be analyzed, such as the success of the technique, any complications, and the advantages and disadvantages of their use.

METHODS

Two reviewers conducted a literature analysis (PubMed, Embase, Web of Science) of the last 20 years (2003-2023). The main criterion analyzed was the success of the technique, while secondary outcomes such as complications and risks of the technique were also analyzed. 258 articles were identified in the various search databases. 42 eligible articles were subsequently identified after an article screening. Only 18 full texts were subsequently included in the review.

RESULTS

A total of 18 articles were selected and 1142 implants and 595 patients were included. The main techniques used were the Counter-Torque Ratchet Technique (CTRT), Piezoelectric bone surgery (PBS), trephine drills, carbide burs, Erbium, Chromium, Yttrium, Scandium, Gallium, Garnett (Er:Cr:YSGG) laser and carbon dioxide (CO2) laser. Combined uses of techniques have been identified such as: PBS and trephine burs or carbide burs, trephine burs with the use of a 3d-printed guide, CTRT and trephine burs. The technique with the highest success rate, less morbidity for the patient, and less removal of bone appears to be the CTRT.

CONCLUSIONS

The use of conservative techniques, especially CTRT, in bone removal is useful to allow for immediate implant placement in the removal area. However, further studies with a high sample size are needed to be performed on all techniques, particularly new randomized controlled trials (RCTs) that allow for the analysis of the success of alternative techniques such as Laser and Piezosurgery, which appear to be very promising.

Speed-sintering and the mechanical properties of 3-5 mol% Y2O3-stabilized zirconias

Ever faster workflows for the fabrication of all-ceramic restorations are of high economic interest. For that purpose, sintering protocols have been optimized for use in modern sintering furnaces, the so-called speed-sintering. However, conventional furnaces are still the most widely used equipment to sinter zirconia restorations. In this in-vitro study, we evaluated the feasibility of a speed-sintering protocol using a conventional sintering furnace to sinter different dental zirconias (stabilized with 3 mol% up to 5.4 mol% Y2O3) in comparison to a conventional sintering program. The properties evaluated were Young's modulus, Poisson's ratio, density, biaxial flexural strength, and fracture toughness. We show here that despite differences being dependent on material, the physical and mechanical properties of speed-sintered zirconia are comparable to those obtained by the conventional sintering.

Synthesis, Solid State Structure, and Cytotoxic Activity of a Complex Dimer of Yttrium with Anthranilic Acid against Cancer Cells

This paper presents the synthesis and isolation of a new binuclear complex of yttrium with anthranilic acid (HA). The complex [Y2(HA)6(H2O)4] Cl6.2C2H5OH (C1) was obtained as single crystals that its X-ray analysis revealed its triclinic P-1 space group in addition to anti-prismatic geometry around each of the yttrium ions. In the complex, the anthranilic acid ligands are bidentate, zwitter ionic and neutral, and the yttrium ions' charge is only compensated by six chloride ions. The cytotoxicity of this complex against human breast cancer MDA-MB-231 cells, prostate cancer PC-3 cells, and bladder cancer T-24 cells was evaluated. This yttrium complex displayed more cytotoxic activity against the bladder cancer cells with an IC50 value of 307.7 μg/ml (223 μM). On the other hand, the activities of complex C1 against the MDA-MB-231 and PC-3 cells were less significant respectively with IC50 values of 1097 μg/ml (796 μM) and 921 μg/ml (669 μM).

Evaluation of Er:YAG laser energy transmitted through novel dental zirconia ceramics

Erbium:yttrium-aluminum-garnet (Er:YAG) laser debonding is a promising removal method in prosthodontics. This study aimed to assess Er:YAG laser energy transmission through novel zirconia ceramics. Five types of ceramic samples: lithium disilicate ceramic (LDC), self-glazed zirconia (SGZ), 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP), 4Y-TZP and 5Y-TZP with 5 thicknesses (0.5, 1.0, 1.5, 2.0, 2.5 mm) and 2 shades (A1, A3), 50 specimens total, were made. Fourier transformation infrared absorption spectra were obtained for each ceramic type, and Er:YAG laser energy transmission tests were conducted for each specimen. The novel zirconia ceramic (SGZ, 4Y-TZP, 5Y-TZP) transmission ranged from 40%-60%. The transmitted laser energy decreased with increasing ceramic thickness, and the differences between different shades were significant (p<0.05). The novel zirconias had a higher translucency than 3Y-TZP at any given thickness and shade, and when the thickness was >1.5 mm, the novel zirconias had a higher translucency than LDC.