Search

Purpose: To assess the difference in intraocular pressure before and after Nd-YAG laser posterior capsulotomy. Study Design: Quasi-experimental study. Place and Duration of Study: Layton Rahmatulla Benevolent Trust Eye Hospital, Karachi, from July 2021 to October 2021. Methods: Patients of both gender with posterior capsular opacification (PCO) after cataract surgery, were included. Age ranged between 40 and 60 years. Patients with less than 6 months of surgery were excluded. Patients with posterior segment pathology like glaucoma, uveitis, high myopia, diabetic retinopathy, macular pathology, and hereditary fundus dystrophies were excluded from the study. After detailed history, complete ocular examination was performed. After pupil dilatation, YAG laser capsulotomy was done.IOP was measured with Goldmann Applanation Tonometer after instilling a topical anesthetic agent. Post-YAG, IOP was again measured at 1 hour and on day 1. Data was analyzed using SPSS version 25. Paired T-tests were used to assess the significance of any change in IOP. Results: Ninety eyes of 90 patients were inducted into the study in which 51 (57%) were male and 39 (43%) were female. The age varied from 40 to 60 years (mean 52.3 ± 10.25 years). There was no statistically significant difference between pre-YAG and post-YAG IOP. Similarly, no difference in IOP was found depending upon the age of the patients. No significant change was observed after 1 hour and 1 day in both groups with P > 0.05. Conclusion: This showed no significant change in intraocular pressure at one hour and one day, after Nd-YAG laser posterior capsulotomy. [ABSTRACT FROM AUTHOR]

Background: Treating melasma is a challenge due to suboptimal efficacy and recurrence encountered with most modalities. There is inadequate literature regarding the use of lasers for melasma in Indian skin. We compared three modalities SSR (Super Skin Rejuvenation 540 nm), PQSNDY (pixel Q-switched Nd: YAG 1064 nm), and ablative pixel-Er: YAG (2940 nm) laser in melasma, amongst Indian patients. Materials/Methods: Sixty patients of recalcitrant melasma were enrolled and randomized into three groups with 20 patients each. These were treated with SSR, low fluence PQSNDY, and pixel-Er: YAG, respectively, for five sessions at 3-week intervals. Results were evaluated using Modified melasma area severity index (mMASI) by blinded comparison of digital photographs at baseline, each visit and 6 months (i.e. 2 months after the last session). Results: All groups showed a highly significant reduction in the mMASI score (p <.001). Pixel-Er: YAG maximally reduced mMASI and homogeneity (p <.001), while the other groups showed a more uniform fading. Epidermal melasma had best results with SSR and PQSNDY (p <.001), while recalcitrant cases of dermal and mixed melasma with pixel-Er: YAG laser (p <.001). There was no persistent or rebound pigmentation observed. Conclusions: All three modalities are effective and safe for melasma in Indian patients. Fractional technology, low fluences, adequate recovery time between sessions and a sound maintenance plan ensure efficacy and safety. [ABSTRACT FROM AUTHOR]

This work explores laser assisted removal of uranium-di-oxide and thorium-di-oxide particulates from zircaloy substrate. An electro-optically Q switched Nd-YAG laser operating on three wavelengths of 1064 nm, 532 nm, 355 nm was used as the cleaning tool to compare the efficiency of the decontamination process. Laser assisted surface cleaning that offers the dual advantage of remote operation and minimizing the generation of secondary waste has therefore emerged as the most attractive technique with regard to decontamination of radioactive surface. In case of loose contamination wherein the contaminant particulates are often attached to the substrate surface by short range van-der-wall’s force, the absorption of energy from the incident radiation field by both particulates and substrate can contribute towards generation of cleaning force leading to expulsion of the particulates. It was found that laser parameters like its wavelength, fluence, number of exposures and particulate shape/size play an important role in the cleaning process. A single laser exposure with a fluence of ∼0.3–0.5 J/cm 2 was found to be enough to obtain decontamination efficiency of ∼70–80% while removing the contaminants from zircaloy substrate. Subsequent exposure of laser pulses to the contaminants further increases the efficiency of cleaning. Decontamination efficiency was found to be always higher for uranium-di-oxide particulates than virgin thorium-di-oxide particulates under identical cleaning conditions. However, decontamination efficiency of milled thorium-di-oxide particulates was found to be marginally higher than uranium-di-oxide particulates. [ABSTRACT FROM AUTHOR]

Purpose: Our purpose was to assess the early intraocular pressure (IOP) changes of ultralow fluence laser iridotomy using pattern scanning laser followed by neodymium:yttrium-aluminum-gamet (Nd:YAG) laser.Methods: This is a prospective interventional study. Thirty-three eyes of 33 adult Chinese primary angle-closure suspect subjects were recruited for prophylactic laser peripheral iridotomy. Sequential laser peripheral iridotomy was performed using pattern scanning laser followed by Nd:YAG laser. Visual acuity (VA) and IOP were measured before treatment, at 1 h, 1 day, 1 week, 1 month, 3 months and 6 months after laser. Laser energy used and complications were documented. Corneal endothelial cell count was examined at baseline and 6 months. Patency of the iridotomy was assessed at each follow-up visit.Results: All subjects achieved patent iridotomy in a single session. The mean energy used was 0.335+/−0.088 J for the pattern scanning laser, and 4.767+/−5.780 mJ for the Nd:YAG laser. The total mean energy was 0.339+/−0.089 J. None of the eyes developed a clinically significant IOP spike (≥ 8 mmHg) at 1 h and 1 day after laser use. Only four eyes developed higher IOP at 1 h and all were ≤3 mmHg compared to baseline. The mean IOP was 13.8+/−2.5 mmHg at 1 h and 11.5+/−2.2 mmHg at 1 day, both were significantly lower than baseline (15.8+/−2.1 mmHg) (P < 0.001). Mean VA (logMAR) was similar at 1 h post laser compared to baseline (0.23 vs 0.26). There was also no statistically significant difference in mean VA at other follow-up visits compared to baseline. Peripheral iridotomy closure was encountered in two (6.1%) eyes, one at 1 month and another at 6 months follow-up. There were no complications including hyphema, peripheral anterior synechia formation nor prolonged inflammation throughout the follow-up period. There was no significant loss in corneal endothelial cell counts at 6 months (2255+/−490) compared to baseline (2303+/−386) (P = 0.347).Conclusions: Sequential LPI using an ultralow fluence pattern scanning laser, followed by a Nd:YAG laser, is safe and efficacious, and produces no IOP spike in dark irides of primary angle-closure suspects. Further studies to investigate its role in the treatment of other angle-closure conditions are warranted. [ABSTRACT FROM AUTHOR]

Introduction: A contemporary protocol for managing horizontal alveolar defects adjacent to immediate implants includes placement of a well‐designed provisional restoration to contain graft material and seal the socket. However, immediate provisionalization is not always possible or practical. Case Presentation: A 39‐year‐old male presented with a non‐restorable tooth #29, which was extracted. An immediate implant was placed in the tooth #29 position, and a freeze‐dried bone allograft was placed in the horizontal defect between the implant platform and osseous walls. A neodymium:yttrium‐aluminum‐garnet (Nd:YAG) laser was used to create a stable fibrin clot over the graft material. After 31 months, favorable radiographic bone levels and complete papilla fill were noted. Conclusion: The present case illustrates use of an Nd:YAG laser in the management of an immediate implant horizontal defect in lieu of an immediate provisional restoration. [ABSTRACT FROM AUTHOR]

Background The aim of the present study was to compare the effectiveness of combined Er: YAG and Nd: YAG laser therapy to that of scaling and root planing with hand instruments in non-surgical treatment of chronic periodontitis. Material and Methods Twenty-five systemically healthy patients with chronic periodontitis were selected for this study. The quadrants were randomly allocated in a split-mouth design to either combined Er: YAG (160 mJ/pulse, 10 Hz) and Nd: YAG laser (100 mJ/pulse, 20 Hz) therapy (test group) or scaling and root planing alone (control group). At baseline, 1 month and 3 months after treatment, plaque index, gingival index, probing depth, clinical attachment level and bleeding on probing (%), were recorded and gingival crevicular fluid and subgingival plaque samples were taken. The gingival crevicular fluid levels of interleukin-1β and tumor necrosis factor-α were analyzed by enzyme-linked immunosorbent assay. Quantitative analysis of red complex bacteria was performed using quantitative real-time polymerase chain reaction. Results The clinical parameters had significantly improved for both groups after treatment. There were statistically significant differences in probing depth and clinical attachment level between the test and control groups only for deep pockets (≥7 mm) ( P<.05). No significant differences between the two groups were observed for the biochemical and microbiological parameters at any time points ( P>.05). Conclusions The present study suggests that a combined course of Er: YAG and Nd: YAG laser therapy may be beneficial particularly in inaccessible areas such as deep pockets on a short-term basis. Further, well-designed studies are required to assess the effectiveness of the combination of these lasers. [ABSTRACT FROM AUTHOR]

Port-wine stains (PWSs) usually respond poorly to pulsed dye laser treatment because of the shallow penetration and light absorption of melanin in the epidermis. Multiple laser pulses (MLPs) Nd:YAG laser in conjunction with an optical clearing agent can help to reduce the total laser energy required for blood coagulation. The quantitative optical clearing effect (OCE) of glycerol was investigated by using a tissue-like phantom. Thereafter, an in vitro capillary tube experimental system and an in vivo hamster dorsal skin chamber experiment for the laser treatment of PWSs were established to visually obtain the quantitative relationship between the OCE and the blood coagulation properties under the irradiation of 1064 nm MLPs. Diffuse reflection coefficient decreases by 36.69% and transmission coefficient increases by 38.73% at 1064 nm, after applying 0.5 mL anhydrous glycerol for 10 min on the surface of the tissue-like phantom. The number of laser pulses required for blood coagulation decreases by 25% after the application of 0.5 mL anhydrous glycerol for 4 min, thrombosis appears after 10 min, and the 0.0854 clotting area completely blocks the capillary tubes in 6 pulses. For 10 min, the incident energy can be reduced by 35.09 and 29.82%. When the 0.3-mm vessel's buried depths are 1 and 0.5 mm, the pulse number can be reduced from 11 to 8 and from 6 to 4, respectively. Adding anhydrous glycerol directly on the hamster dorsal skin is an effective way to reduce the number of laser pulses from 4∼5 to 2∼3 for similar capillary tube diameter. Therefore, the MLPs of 1064 nm Nd:YAG demonstrates a substantial curative effect for large capillary tubes. In conjunction with glycerol, this approach may treat deeply buried cutaneous capillary tubes and prevent the unwanted thermal damage of normal dermal tissue. [ABSTRACT FROM AUTHOR]

Background Laser therapy is the treatment of choice in tattoo removal. However, the precise mechanisms of laser-tattoo pigment interactions remain to be evaluated. Methods We evaluated the geometric patterns of laser-tattoo pigment particle interactions using a tattoo pigment-embedded tissue-mimicking ( TM) phantom. Results A Q-switched ( QS) neodymium-doped yttrium aluminum garnet laser was used at settings of 532-, 660-, and 1064-nm wavelengths, single-pulse and quick pulse-to-pulse treatment modes, and spot sizes of 4 and 7 mm. Most of the laser-tattoo interactions in the experimental conditions formed cocoon-shaped or oval photothermal and photoacoustic injury zones, which contained fragmented tattoo particles in various sizes depending on the conditions. In addition, a long-pulsed 755-nm alexandrite laser was used at a spot size of 6 mm and pulse widths of 3, 5, and 10 ms. The finer granular pattern of tattoo destruction was observed in TM phantoms treated with 3- and 5-ms pulse durations compared to those treated with a 10-ms pulse. Conclusion We outlined various patterns of laser-tattoo pigment interactions in a tattoo-embedded TM phantom to predict macroscopic tattoo and surrounding tissue reactions after laser treatment for tattoo removal. [ABSTRACT FROM AUTHOR]

Purpose To determine the rate of retinal tear and retinal detachment (RD) after neodymium:YAG (Nd:YAG) laser capsulotomy for posterior capsule opacification (PCO) after cataract surgery. Setting Province-wide outpatient and hospital settings, Alberta, Canada. Design Database study. Methods Eleven years of billing records data were collected to assess the rate of retinal tear and/or RD after Nd:YAG laser capsulotomy. A period of 90 days from Nd:YAG was considered the at-risk period, although statistics for 10 years of data were included in the study. Risk was calculated as a rate (%) of retinal tear or RD after Nd:YAG laser capsulotomy. Results The study comprised 92 654 discrete billing records yielding 73 586 ocular procedures for the analysis of the rate of retinal tear and/or RD after Nd:YAG laser capsulotomy. There were 67 287 Nd:YAG capsulotomies for PCO performed during the study. The 90-day risk for retinal tear after Nd:YAG was 0.21%; 720 retinal tears occurred in the study population at some point after the procedure. The rate of RD was 0.60%, with 2219 RDs occurring at some point after Nd:YAG capsulotomy. The cumulative risk for retinal tear or detachment at 3, 6, 9, and 12 months was 0.21%, 0.30%, 0.36%, and 0.43% and 0.60%, 0.96%, 1.19%, and 1.39%, respectively. The rates of retinal tear and detachment varied significantly between age categories. Conclusions There was an increased risk for RD in the first 5 months after Nd:YAG, with a return to a baseline plateau thereafter. As such, the rate of retinal tear after Nd:YAG capsulotomy at 5 months was 0.29%, whereas the rate of RD was 0.87%. [ABSTRACT FROM AUTHOR]

Background: Recently dual-pulsed low-fluence 1064-nm Q-switched Nd:YAG (QSNY) laser has been developed for reducing complication during melasma treatment.Objective: Comparison of the efficacy and safety between dual-pulsed mode and single-pulsed mode for the treatment of melasma. Materials and methods: In preclinical study, adult zebrafish were irradiated with dual-pulsed and single-pulsed mode. Changes of melanophore and cell death were assessed. In split-face clinical study, dual-pulsed and single-pulsed mode were irradiated on the left and right side of the face, respectively.L* value, clinical digital photos, modified Melasma Area and Severity Index (MASI) scores, and side effects were measured. Results: As compared to single-pulsed mode and dual-pulsed mode with longer intervals, zebrafish melanophore was cleared quickly at dual-pulsed mode with 80-μsec interval and 0.3 J/cm2fluence. Dual-pulsed mode showed the least regeneration of melanophore at 4 weeks after irradiation and no cell death was observed with 80-μsec interval. Both pulse modes improved melasma significantly but modified MASI score andL* value were not significantly different between each other. Lesser pain and shorter duration of post-laser erythema were observed with dual-pulsed mode.Conclusion: Dual-pulsed mode was as effective as single-pulsed mode for the treatment of melasma and revealed less side effects.ABSTRACT FROM PUBLISHERCopyright of Journal of Cosmetic & Laser Therapy is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. [ABSTRACT FROM AUTHOR]

Introduction: Ablative and nonablative lasers have been used to treat melasma. We aimed to assess and compare the combining Q-switched Nd:YAG laser (QSNYL) and fractional erbium:YAG laser (FEYL) with QSNYL alone in treatment of melasma. Methods: This randomized controlled clinical trial was performed in our Research Center during 2013-2014. Women with melasma and without a history of keloid formation, hypersensitivity to hydroquinone, or pigmentary changes due to laser therapy were randomly allocated to receive four sessions of either QSNYL-FEYL combination or QSNYL alone. All patients received topical treatment with Kligman's formula. Before laser therapy and 4 weeks after the last treatment session, patients' skin was assessed for changes in skin color, melanin content, and erythema intensity of melasma lesions quantitatively. Results: Finally, 21 patients in QSNYL-FEYL and 20 in QSNYL group (mean age, 38.57 [5.60] and 42.60 [8.44] years, respectively) completed study. The skin color had become lighter in both groups (mean [SD] percentage change of 56.95 [40.29] and 29.25 [13.20] in QSNYL-FEYL and QSNYL groups, respectively) with significantly better results in QSNYLFEYL group (P = 0.006). Percentage of decrease of melanin content was significantly higher in QSNYL-FEYL group (22.01 [10.67] vs. 7.69 [4.75]; P < 0.001). After adjustment for baseline values, the post treatment intensity of erythema was significantly lower in QSNYLFEYL group (P < 0.001). The patients reported no adverse events. Conclusion: QSNYL-FEYL was significantly more effective in decreasing melanin content of lesions than QSNYL and led to a lighter skin. [ABSTRACT FROM AUTHOR]

Objective: To compare frequency of rise in Intra Ocular Pressure (IOP) in patients undergoing low energy and high energy Nd: YAG laser posterior capsulotomy. Study Design: Comparative, cross-sectional study. Place and Duration of Study: Armed Forces Institute of Ophthalmology (AFIO), Rawalpindi from January 2013 to August 2013. Material and Methods: One hundred and twenty patients fulfilling the inclusion criteria were enrolled in the study. Base line IOP was measured with the help of Goldman applanation tonometer. After dilating pupil, Nd: YAG laser posterior capsulotomy was performed, using minimum possible pulses of Nd: YAG laser. The total amount of energy used in the procedure was recorded. IOP was measured 4 hours after the procedure. Post laser frequency of change in IOP (5 mm of Hg from baseline) was calculated in low energy and high energy groups. Chi square test was applied to compare the frequency of raised IOP in both groups. Results: Raised IOP was noted in 33 (27.50%) cases and this was more common in high energy group occurring in 22 (46.8 % ) as compared to low energy group 11 (15.1 % ).The p-value was found to be <0.05 and was statistically significant. Conclusion: The results suggested that high energy levels used during Nd: YAG laser posterior capsulotomy had significantly more chances of raised IOP. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate the effects of different fluences of Q-switched 1064 nm Nd:YAG laser on skin repair and barrier, and clarify its mechanisms. Background data: The Q-switched 1064 nm Nd:YAG laser is widely used for rejuvenation, which needs appropriate fluence data to optimize efficacy and minimize side effects, and for elucidation of action mechanism. Materials and methods: The dorsal skin of BABL/c mice was administered 0, 1, 1.5, and 2 J/cm2 energy level laser, twice a week for 4 weeks. Immediately, 7, 14, 21, and 28 days after last treatment, the skin elasticity, moisture content, and transepidermal water loss (TEWL) were measured; 7, 14, 21, and 28 days after last treatment, the hydroxyproline content, mRNA level of procollagen types I and III, protein level of keratin-10 (K-10), filaggrin, transforming growth factor beta receptor II (TGFβRII), Smad2, and p65 were detected. Results: Compared with the unirradiated control, the laser treatments decreased skin elasticity immediately, but increased skin moisture content in the 2 J/cm2 group, and then from day 21 to day 28, the skin elasticity, moisture content, hydroxyproline content, and gene expression of types I and III procollagen increased significantly. The TEWL value of the irradiated group significantly increased after irradiation immediately and 7 days after, K-10 and filaggrin were also decreased at 7 days after. The phosphorylation of TGFβRII (p-TGFβRII) increased at days 7 and 21, and phosphorylation of Smad2 (p-Smad2) was induced at 21 days. Conclusions: Irradiation of 1064 nm Q-switched Nd:YAG laser was able to markedly promote repair of mouse skin within 28 days through stimulation of collagen synthesis, with less skin barrier dysfunction, especially at the 1.5 J/cm2 fluence, and the activation of TGFβ1-signaling pathways seemed to play an important role in repair. [ABSTRACT FROM AUTHOR]

Background: Onychomycosis is a common nail disease, especially in older patients. Various treatment options are currently available for onychomycosis; however, their limitations include high failure rates, time-consuming nature, high cost and high risk of drug interactions. Previous studies on the treatment of dermatophyte onychomycosis with a long-pulsed 1064-nm Nd:YAG laser demonstrated excellent outcomes without severe side effects.Objective: To evaluate the efficacy and side effects of onychomycosis treatment with a long-pulsed 1064-nm Nd:YAG laser.Methods: Sixty-four onychomycotic nails (35 patients) were evaluated. The first treatment cycle involved treatment with a long-pulsed 1064-nm Nd:YAG laser in four sessions at 1-week intervals. A potassium hydroxide examination and fungal culture were performed every week during this treatment course and then at a 1-month follow-up visit. If either test was positive for a pathogenic organism, a second treatment cycle was performed. If the two tests produced negative results, each affected nail was followed up at 3- and 6-month visits after completion of the second treatment protocol. In cases of resistance (positive for a pathogenic organism after completion of the second treatment cycle), the onychomycotic nails were excluded from the study and treated by standard methods.Results: Of all 64 nails evaluated, 59 completed the first cycle of treatment and 24 (40.7%) demonstrated mycological clearance at the 1-month follow up. Thirty-five of the 59 nails (59.3%) were positive for a pathogenic organism and underwent a second treatment cycle. Upon completion of the second treatment cycle, 28 nails remained enrolled in the study, and the mycological test results were negative in nine of these (31.2%). For all nails that completed the first or second treatment cycle, the overall cure rates at the 1-, 3- and 6-month follow-up visits were 63.5, 57.7 and 51.9%, respectively. Side effects were mild and limited to erythema and swelling after the laser procedure.Conclusions: Long-pulsed 1064-nm Nd:YAG laser therapy is safe and effective for the treatment of onychomycosis. However, a larger sample and longer follow-up period are needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Until recently, pharmacologic molecules have been the only available treatments for onychomycosis. Laser treatments were introduced for recurrent or resistant cases or in patients in whom oral treatments are contra-indicated. Some devices were approved by the Food and Drug Administration ( FDA). Neodymium yttrium aluminium garnet (Nd: YAG) is used for onychomycosis as a short-pulse or a long-pulse system. We aim to evaluate the efficacy of the short-pulse Nd: YAG in treating onychomycosis, its side effects, cure rates, and 12-month recurrence rates. Efficacy was evaluated based on a subjective measure of patient satisfaction on a scale from 1 to 10, and an objective measure based on the results of the mycologic cultures. Medical records of 30 patients were reviewed. Ages ranged from 22 to 85, with a mean of 44. Mycologic cure at 12 months was not achieved in 5 patients (16.67%) who had received laser treatment. None of these patients showed any signs of clinical improvement. Twenty patients (66.67%) were completely cured at 12 months, with corroborating negative mycologic cultures. The remaining five patients (16.67%) had discordance between their clinical cure status and their mycologic cultures. Side effects were reported by 7 patients out of 30 (33%): pain within 48 hours of the treatment session, burning sensation in the treated nail bed area. Our primary end point of negative mycologic cultures at 12 months was seen in 24 out of 30 (80%) of our patients. Similar culture cure rates have not been reported before, not even with systemic treatments with oral antifungals. However, few limitations should warrant us (False-negative results in fungal cultures; time limitation; sample size...). Still, we propose that this alternative should be offered for patients in whom antifungals are contraindicated or for patients previously treated, but not cured by oral antifungals, and in elderly and polymedicated patients. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 46-year-old female with posterior sub capsular cataracts (PSCC) who was treated with Nd: YAG laser vitreolysis for floaters treatment earlier. It notes Nd:YAG laser vitreolysis caused cataract formation with posterior capsule defects in the patient. The article discusses side effect of the Nd:YAG laser treatment for cataract including cause retinal holes, vitreous hemorrhage, chorioretinal bleeding and elevated intraocular pressure.

An 83-year-old man presented with a 1-year history of blurry vision in his left eye. Bilateral cataract surgery and ciliary sulcus posterior chamber intraocular lens (IOL) implantation had been performed 11 years earlier. The corrected distance visual acuity (CDVA) was 20/60 in the left eye. Slitlamp examination revealed moderate posterior capsule opacification. Neodymium:YAG laser posterior capsulotomy was performed and complicated by IOL fracture and immediate dislocation of optic fragments into the anterior chamber. An IOL exchange was performed, and the damaged IOL was removed in 7 pieces. A 3-piece acrylic IOL was suture fixated to the posterior iris. Pathologic analysis showed that the damaged IOL was made of glass supported by a polyimide frame. Twelve months after the IOL exchange, the CDVA was 20/60. Financial Disclosure Dr. Ahmed is a consultant to Alcon Laboratories, Inc., Abbott Medical Optics, Inc., and Bausch & Lomb. Dr. Mamalis is a consultant to Anew Optics, Inc., and Medennium, Inc. No other author has a financial or proprietary interest in any material or method mentioned. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to evaluate and compare surgical stripping and neodymium-doped: yttrium, aluminum garnet (Nd:YAG) laser techniques for gingival depigmentation and to evaluate their effect on repigmentation. Background data: Gingival depigmentation is often associated with repigmentation. Recurrence of pigmentation differs according to different treatment modalities. Materials and methods: In this study, 40 maxillary sites from 20 patients presenting bilateral melanin gingival hyperpigmentation were selected. Contralateral quadrants in the maxilla were randomly assigned to receive Nd:YAG laser at 3 W, 30 mJ per pulse, with contact mode, and with a handpiece with a 300 μm diameter optic fiber and surgical stripping. Plaque index, Dummett Oral Pigmentation Index (DOPI), Hedin melanin index, size of pigmented area, time interval and extent of repigmentation, time taken for each of the procedures, assessment of pain, intraoperative bleeding index, and patient preference were compared from baseline to 6 months. Results: Comparison between Nd:YAG laser and surgical stripping group for plaque index, DOPI, Hedin index, size of pigmented area, time interval, and extent of repigmentation, at 6 months was statistically nonsignificant. Intergroup comparison for time taken, pain, and patient preference was statistically significant. Intragroup comparison for Nd:YAG laser and surgical stripping at 6 months for DOPI, Hedin index, and size of pigmented area was statistically significant. Conclusions: From the present study it can be concluded that Nd:YAG laser can be used as an alternative technique for gingival depigmentation. However, surgical stripping continues to remain as a cost-effective procedure. [ABSTRACT FROM AUTHOR]

Objective: The present study was to assess the effect of surface treatments of Er:YAG, Nd:YAG, and Ho:YAG lasers on the tensile bond strength of a silicone-based resilient liner to an acrylic denture in an in vitro setting. Methods: Experimental dumbbell-shaped specimens (75 mm) were produced by combining two acrylate pieces fabricated from heat-polymerized acrylic resin (36 mm) with 3 mm of Molloplast®-B filling between them. The specimens ( n=200) were randomly divided in half for thermocycling, and each 100 specimen set was randomized into five groups ( n=20) with different surface treatments: control (no surface treatment), sandblasting, Er:YAG laser, Nd:YAG laser, and Ho:YAG laser. A tensile bond strength test was performed. The effect of the laser surface treatments was examined with scanning electron microscopy. Results: Only the Er:YAG laser increased the tensile bond strength compared with the other treatments. The other laser groups showed lower bond strengths. The Ho:YAG laser resulted in considerably reduced tensile bond strength. The scanning electron microscopy images showed that applying laser surface treatments modified the surface of the denture base resin. Conclusions: There was not an overall improvement with the use of the studied laser modalities in the adhesion quality of resilient denture liner to acrylic resin, although Er:YAG laser showed a potential to improve their adhesion. These laser modalities need to be subjected to further studies to determine optimal setup for use in prosthodontics. [ABSTRACT FROM AUTHOR]

Background and aim Effect of non-surgical periodontal therapy (NSPT) with and without adjunct neodymium-doped:yttrium, aluminum and garnet (Nd:YAG) laser therapy in the treatment of periodontal inflammation in patients with type 2 diabetes mellitus (T2DM) remains uninvestigated. The aim of the present short-term pilot study was to assess efficacy of NSPT with adjunct Nd:YAG laser therapy in the treatment of periodontal inflammation in patients with and without T2DM. Methods Twenty-two patients with T2DM (Group-1) and 22 controls (Group-2) were included. Teeth on test- and control-sites underwent NSPT with and without Nd:YAG laser therapy, respectively. Periodontal parameters (plaque index [PI], bleeding on probing [BOP] and probing pocket depth ⩾ 4 mm [PPD]) were measured at baseline and after 1 and 3 months. Hemoglobin A1c (HbA1c) levels were measured at baseline and after 3 months. Results In Group-1, PI, BOP and PPD ⩾ 4 mm were higher at the control-sites (6.4% [ P < 0.05], 5.5% [ P < 0.05] and 3.5% [ P < 0.05], respectively) than test-sites (1.5%, 2.1% and 1.1%, respectively) at 1-month follow-up. In Group-2, PI, BOP and PPD ⩾ 4 mm were higher at the control-sites (4.2% [ P < 0.05], 2.2% [ P < 0.05] and 2.2% [ P < 0.05], respectively) than test-sites (1.2%, 1.3% and 1.1%, respectively). At 3-months follow-up, there was no difference in PI, BOP and PPD ⩾ 4 mm among test- and control-sites in both groups. At 3-month follow-up, mean HbA1c levels were comparable among patients in groups 1 and 2 (5 ± 0.2% and 4.6 ± 0.1%, respectively). Conclusion These short-term pilot results support our hypothesis that NSPT + Nd:YAG laser therapy is more effective in reducing periodontal inflammation in patients with and without T2DM than when NSPT is used alone. Further long-term randomized controlled clinical trials are needed in this regard. [ABSTRACT FROM AUTHOR]

Background Low-fluence Q-switched Nd: YAG 1064 nm laser ( LFQS) and intense pulsed light ( IPL) have been shown to be effective in the treatment of melasma. LFQS can target deeper pigment, while IPL can target a wide range of cutaneous structures. However, there is limited information on efficacy and side-effects of the combined treatment. Objective To compare the efficacy and safety of combined LFQS and IPL therapy with LFQS monotherapy in the treatment of melasma. Methods Twenty female patients with mixed-type melasma on both cheeks were treated with LFQS on full face for five sessions at 1-week intervals. One side of the face was randomly assigned to receive additional three sessions of IPL treatments at 2-week intervals. Patients were evaluated 12 weeks after the last treatment. Outcome measures include the assessment by colorimeter and calculated as relative lightness index (R*LI), modified Melasma Area and Severity Index ( mMASI), patient satisfaction and adverse effects. Results Eighteen patients completed the study. Both sides of the face showed significant improvement of R*LI and mMASI. A more rapid improvement of R*LI and mMASI was observed on combined side. At the end of treatment, 55% improvement and 37% improvement of R*LI was observed on combined side and monotherapy side respectively. The overall patients' satisfaction was in favour of the combined side. Recurrence occurred on both sides but there was still a significant decrease compared to baseline. No serious side effect was noted. Conclusion The combination of LFQS and IPL results in faster clearance of melasma and is more effective than LFQS alone for melasma treatment. However, recurrence is still inevitable. [ABSTRACT FROM AUTHOR]

The article focuses on a study to analyze influence of using different shapes and sizes of neodymium and yttrium aluminum-garnet (Nd:YAG) laser capsulotomy on visual acuity and refraction. Topics include retrospective analysis of patients treated with Nd:YAG laser posterior capsulotomy for posterior capsule opacification (PCO), cruciate shape capsulotomy improving visual function with minimal complications, and no changes in intraocular pressure observed after capsulotomy.

Background and objectives: Telangiectasias of the lower extremities are very common. The objective of this study was to investigate whether the visual control of clinical signs for coagulation is needed to obtain an efficient treatment. Study design/Materials and methods: A total of 28 pairs of close-to-identical telangiectasias located on their lower extremities of 14 Caucasian females were included in the study. One of the paired vessels was randomly treated with a theoretically optimized and clinically verified fixed fluence (FF). The fluence on the other vessel was manually adjusted to the lowest level that resulted in visual coagulation or obstruction of blood flow (judged fluence [JF]). One or two treatments were made. Results: By the four-month follow-up the same high degree of clinically evaluated vessel clearance of 2.6 (0-4 scale) was obtained for both the FF- and JF-treated vessels ( P > 0.95, power = 0.60). The JF-treated group showed a significant higher incidence of hyperpigmentation 39.3% versus 28.6% ( P = 0.05). Conclusions: As the vessel clearance was equal in both groups, these results strongly indicate that the use of fixed, clinically proven standard device laser settings lead to fewer side effects and should be recommended as the most safe Nd:YAG laser treatment for leg telangiectasias. [ABSTRACT FROM AUTHOR]

Background: Verruca Vulgaris (VV) is common benign neoplasm. However, it can present a therapeutic challenge. Previous studies have suggested that the Nd-YAG laser may be beneficial in the management of warts. Objective: To determine the effectiveness and safety of a novel 100 microsecond pulsed 1064 nm Nd:YAG laser for the treatment of VV. Method: A total of 25 adult subjects with a total of 63 hand verrucae were enrolled in the clinical trial to receive treatment with a low-energy (200 mjoule) 1064 nm Nd:YAG laser (PinPointe, NuvoLase, Inc.). Each subject was eligible for 3 treatments administered at monthly intervals. All verrucae were measured before each treatment session and at 6 months after the final treatment. Results: A complete response was seen in 19 subjects and in 41 verrucae. A complete response was defined as complete absence of verruca with the presence of normal skin dermatoglyphics. All other lesions showed at least partial response. A partial response was defined as a 50% or greater reduction in verruca size. No adverse events were noted. Conclusion: Low-energy 1064 nm Nd: YAG laser treatment may be a promising, safe, and effective therapeutic modality for the treatment of VV. However, more treatment sessions may be needed for complete clearance and increased efficacy in some subjects. [ABSTRACT FROM AUTHOR]

BACKGROUND Low-fluence Q-switched neodymium-doped yttrium-aluminum-garnet 1,064-nm laser (LFQS) and glycolic acid (GA) peeling have been reported as a treatment option for melasma. However, there are limited data on their efficacy in men. OBJECTIVE To compare the efficacy and safety of LFQS monotherapy with combined LFQS and 30% GA peeling in male patients with melasma. MATERIALS AND METHODS Fifteen males with mixed type melasma were randomized to receive 5 weekly sessions of LFQS on one side of the face and LFQS plus 30% GA peeling on the contralateral side and were followed for 12 weeks. Twelve patients completed the protocol. RESULTS Mean relative lightness index (RL*I) of the combined treatment side was lowered throughout the study period, with the maximal improvement of 52.3% reduction at the fourth week follow-up (p = .023). Patient selfassessment was favorable in the combined treatment. However, the mean RL*I increased at 8 and 12 weeks of follow-up. One subject (8.3%) developed guttate hypopigmentation, which did not resolve by the 12-week follow-up. CONCLUSION Low-fluence Q-switched neodymium-doped yttrium-aluminum-garnet 1,064-nm laser combined with GA peeling temporarily reduced melasma in men, but the incidence of side effects does not justify the short-lived benefits of this procedure. This technique requires further study. [ABSTRACT FROM AUTHOR]

Purpose: Flexible microcoils integrated with ablation catheters can improve the temperature accuracy during local MR-thermometry in Nd:YAG laser interstitial thermal therapies. Here, the authors are concerned with obtaining a preliminary confirmation of the clinical utility of the modified catheter. They investigate whether the thin-film substrate and copper tracks of the printed coil inductor affect the symmetry of the thermal profile, and hence of the lesion produced. Methods: Transmission spectroscopy in the near infrared was performed to test for the attenuation at 1064 nm through the 25 jum thick Kapton substrate of the microcoil. The radial transmission profile of an infrared high-power, light emitting diode with >80% normalized power at 1064 nm was measured through a cross section of the modified applicator to assess the impact of the copper inductor on the optical profile. The measurements were performed in air, as well as with the applicator surrounded by two types of scattering media; crystals of NaCl and a layer of liver-mimicking gel phantom. A numerical model based on Huygens-Fresnel principle and finite element simulations, using a commercially available package (COMSOL Multiphysics), were employed to compare with the optical measurements. The impact of the modified optical profile on the thermal symmetry was assessed by examining the high resolution microcoil derived thermal maps from a Nd:YAG laser ablation performed on a liver-mimicking gel phantom. Results: Less than 30% attenuation through the Kapton film was verified. Shadowing behind the copper tracks was observed in air and the measured radial irradiation correlated well with the diffraction pattern calculated numerically using the Huygens-Fresnel principle. Both optical experiments and simulations, demonstrate that shadowing is mitigated by the scattering properties of a turbid medium. The microcoil derived thermal maps at the end of a Nd:YAG laser ablation performed on a gel phantom in a 3 T scanner confirm that the modified irradiation pattern does not disrupt the thermal symmetry, even though, unlike tissue, the gel is minimally scattering. Conclusions: The results from this initial assessment indicate that microcoils can be safely integrated with ablation catheters and ensure that the complete necrosis of the liver tumor can still be achieved. [ABSTRACT FROM AUTHOR]

Introduction: Dentin hypersensitivity (DH) is characterized by tooth pain arising from exposure of dental roots. In this study the efficiency of neodymium yttrium-aluminum-garnet (Nd:YAG) laser in association with graphite on dentinal surface changes as the alternative to the treatment of DH was evaluated. Methods: Sixteen noncarious human third molars were collected and sectioned into 5 parts from cemento-enamel junction (CEJ) to the furcation area. The prepared samples were randomly assigned into five groups (Gs) of each 16: Control (Gl), treated by Nd:YAG laser at 0.5 W (G2), irradiation of Nd:YAG with a 0.25 W output power(G3), smeared with graphite and then using Nd:YAG laser at output powers of 0.5 W (G4) and 0.25 W (G5). For all groups the parameters were 15 Hz, 60 s, at two stages and with a right angle irradiation. The number and diameter of dentinal tubules (DT) were compared and analyzed by SPSS software, One way ANOVA and Post hoc LSD tests. Results: The number of open dentinal tubules varied significantly between all groups except among Gl with G3 and G2 with G5. Multiple comparison tests also exhibited significant differences regarding the diameter of tubules between the groups two by two except among G2 with G5. Conclusion: Nd:YAG laser used at 0.25 W and 0.5 W with application of graphite smear was able to reduce the number and diameter of dentinal tubules. [ABSTRACT FROM AUTHOR]

Vascular lesions such as hemangiomas can be found in the oral cavity. Some therapeutic modalities can be used in the treatment of these lesions and Nd:YAG 1064 nm long pulse laser shows good results with easy application, fewer complications and satisfactory results. This study describes the technique and outcome of a case of hemangioma located on the tongue treated with Nd:YAG laser. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate changes in anterior chamber depth (ACD) and angle width after neodymiumyttrium- aluminum-garnet (Nd:YAG) laser capsulotomy. DESIGN: Prospective interventional case series. METHODS: In a single institution, 43 eyes of 43 consecutive pseudophakic patients with symptomatic posterior capsule opacification (PCO) underwent Nd:YAG laser capsulotomy. Anterior chamber depth and angle width in pseudophakic eyes with posterior capsule opacification were measured with anterior segment optical coherence tomography (AS-OCT) before and 3 days after Nd:YAG laser capsulotomy. Preoperative and postoperative measurements of anterior chamber depth and angle width included the angle opening distance, measured as the perpendicular distance from the trabecular meshwork at 500 mm and 750 mm anterior to the scleral spur to the anterior iris surface (AOD500 and AOD750, respectively), and anterior chamber angle (ACA) in the nasal and temporal quadrants. Main outcome measures were the changes in ACD and angle width parameters. RESULTS: The mean patient age was 63.4 ± 3.6 years. Before Nd:YAG laser capsulotomy, mean ACD, AOD500, AOD750, and ACA (nasal and temporal) measurements were 3.71 ±0.11 mm, 0.61 ±0.054 mm, 0.67 ± 0.063 mm, and 34.5 ± 1.67 degrees and 34.8 ± 1.55 degrees, respectively. Three days after Nd:YAG laser capsulotomy, mean ACD, AOD500, AOD750, and ACA (nasal and temporal) measurements were 3.77 ± 0.1 mm, 0.69 ± 0.06 mm, 0.73 ± 0.06 mm, and 35.51 ± 1.64 degrees and 36.17 ± 1.51 degrees, respectively (P < .01 for all). CONCLUSIONS: The depth and width of the ACA in pseudophakic eyes with PCO increased significantly after Nd:YAG laser capsulotomy, as shown by AS-OCT, a reliable and noncontact method for measuring anterior ocular structures. Our study shows that the different angle parameters such as ACD, AOD500, AOD750, and ACA measurements seem highly correlated. [ABSTRACT FROM AUTHOR]

Introduction: Pyogenic granuloma (PG) is a common tumor-like growth of the oral cavity, considered to be of non-neoplastic nature, often caused by constant low-grade trauma as well as poor oral hygiene and maybe due to hormonal disturbances. Surgical excision, and removal of underlying cause in some cases, is the preferred method of treatment as it is only a benign lesion. In order to remove this lesion, scalpel, cryosurgery and laser are used. Currently different lasers, with adequate parameters, are used for the surgery of PG, which include C 0 2 (Carbon Dioxide Laser), Nd:YAG (Neodymium-Doped Yttrium Aluminium Garnet), Diode and Er Family amongst others. In this present case, due to the proximity of the lesion with dental hard tissue, Er:YAG (Erbium-Doped Yttrium Aluminum Garnet) laser appears to be the more appropriate laser. The application of Laser is also a newly recommended technique. The aim of this study is to assess the stages of treatment, recovery and recurrence of PG when the Er:YAG laser is used. Furthermore this study aims to also evaluate the friendliness of this method with regards to the surgeon (therapist). Case report: A 24-year-old female was referred to the Laser Research Center of Dentistry of Tehran University of Medical Sciences with a complaint of gingival overgrowth and bleeding. This lesion was in the buccal and palatal side of the 5 and 6 maxillary teeth. Treatment plan included an excisional biopsy of the lesion using Er:YAG laser (3W, 300mJ, 10Hz, Short pulse, with contact headpiece). The bones were then cleaned of soft tissue before being smoothed using a curette. The excised specimen was preserved and sent for histopathological examination. Results: The patient reported no pain after surgery and did not use any systemic antibiotics. The patient was satisfied after the surgery. Chlorhexidine mouthwash was given to the patient. Pathology results confirmed Pyogenic granuloma. After 2 weeks, complete healing was observed. The 9-month follow-up was also carried out in order to check the process of healing as well as the recurrence. Conclusion: Excisional surgery is the preferred treatment method for PG. The application of laser can be considered as an effective and safe technique for excision of this lesion with minimal invasion and many clinical advantages such as less intra-operative bleeding, hemostasis and reduced pain and times of healing. [ABSTRACT FROM AUTHOR]

We describe two cases have unusual features of capsule contraction syndrome who were successfully treated with surgical procedure and Nd-YAG laser capsulotomy. The first case was 65 years old man who developed CCS without any risk factors, after 4 years later followed uncomplicated phacoemulsification surgery. He treated with extraction of intraocular lense (IOL) combined with complete capsulectomy, anterior vitrectomy and anterior chamber IOL implantation. The second case was 8 years old boy had operated for cortical cataract and ectopia lentis. Anterior capsular contraction was detected in patient one year after the surgery, combined with peripheral fibrotic thickenning, reduction of total equatorial diameter of capsular bag, banding of haptics over the optic and banding over each other both ends of capsular tension ring without posterior capsular opacification. The first case, visual acuity (VA) was improved from 20/200 to 20/25 at the end of firsth month without any complication. The second case who treated with Nd-YAG laser anterior capsulotomy, VA was improved from 20/200 to 20/20 after the first day. Surgical procedures and Nd-YAG laser are seen to be effective treatmet modalities for CCS and anterior capsular opacification. [ABSTRACT FROM AUTHOR]

BACKGROUND Melasma is a common disorder of facial hyperpigmentation that is often resistant to treatment. OBJECTIVE To evaluate the efficacy of trichloroacetic acid (TCA) peeling in comparison with double frequency Q-switched neodymium-doped:yttrium aluminum garnet (QS-Nd:YAG) laser in the treatment of melasma. PATIENTS AND METHODS Sixty-five adult Egyptian female patients with melasma were enrolled in this study. Wood light was used for determination of the histological type of melasma. The patients were divided into 4 groups according to treatment modalities: peeling with different concentrations of TCA and double frequency QS-Nd:YAG laser. Trichloroacetic acid peeling was performed every 2 weeks up to 8 sessions, whereas laser treatment was performed every month up to 6 sessions. Melasma area and severity index (MASI) score was used before and after treatment for evaluation. RESULTS Improvement percentage of MASI score was significantly higher among patients treated with TCA 25% (p < .001). Epidermal type of melasma was significantly improved compared with the dermal type (p = .0029). Q-switched neodymium-doped:yttriumaluminum garnet laser showed the highest incidence of postinflammatory hyperpigmentation (53.3%). CONCLUSION Trichloroacetic acid peeling is effective in the treatment of melasma, TCA 25% was the most effective concentration. Q-switched neodymium-doped:yttrium aluminum garnet laser is not recommended in the treatment of melasma because it was associated with the highest incidence of complications. [ABSTRACT FROM AUTHOR]

BACKGROUND Lasers have been proposed as an alternative treatment for axillary osmidrosis. OBJECTIVE This study aimed to investigate the use of a neodymium:yttrium-aluminum-garnet laser with a wavelength of 1,444 nm for treating axillary osmidrosis. MATERIALS AND METHODS Eighteen patients with axillary osmidrosis who underwent an operation with a 1,444-nm wavelength laser were included in this study. Operative parameters were as follows: pulse = 40 Hz and energy = 170 mJ. Total energy was approximately 2,000 to 3,400 J, and the operation time was 45 minutes. RESULTS Statistically significant differences in the degree of malodor evaluated by both the patients (p = .001) and doctors (p = .012) were detected between preoperative and 6-month postoperative assessments. Sweat area was significantly reduced 6 months after the operation compared with preoperative values. Postoperative pain had subsided at day 7 in all but 1 patient. Two patients (11.1%) experienced superficial second-degree burns on the unilateral axilla; these burns were resolved fully. CONCLUSION The laser with a wavelength of 1,444 nm was found to be a reliable method for the treatment of axillary osmidrosis, with advantages such as small wound size, rapidity of the procedure, inconspicuous scars, and speedy recovery and return to normal daily activities. [ABSTRACT FROM AUTHOR]

Permanent makeup is a cosmetic tattoo that is used to enhance one's appearance, and which has become more popular among middle-aged and elderly women. A couple of benefits seem to be associated with permanent tattoos in the elderly: saving time (wake up with makeup); poor eyesight (difficult to apply makeup); and saving money. On the other hand, cosmetic tattoos bear the same risks as other tattoo procedures. We report on fading and unintended hyperpigmentation after tattooing on eyebrows and eyelids, and discuss the scientific and anatomical background behind the possible cause. Dermatochalasis may be a possible risk factor for excessive unwanted discolorations. Q-switched neodymium-doped yttrium aluminum garnet laser is an appropriate and safe therapeutic tool that can manage such adverse effects. Consumer protection warrants better information and education of the risks of cosmetic tattoos - in particular, for elderly women. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to compare degrees of epidermal/dermal tissue damage quantitatively and histologically after laser irradiation, to find ideal treatment conditions with relatively high fluence for skin rejuvenation. Background data: A number of recent studies have evaluated the clinical efficacy and safety of therapeutic lasers under relatively low fluence conditions. Methods: We transmitted the long-pulsed 1064 nm Nd:YAG and 755 nm Alexandrite lasers into pig skin according to different fluences and spot diameters, and estimated epidermal/dermal temperatures. Pig skin specimens were stained with hematoxylin and eosin for histological assessments. The fluence conditions comprised 26, 30, and 36 J/cm2, and the spot diameter conditions were 5, 8, and 10 mm. Pulse duration was 30 ms for all experiments. Results: Both lasers produced reliable thermal damage on the dermis without any serious epidermal injuries, under relatively high fluence conditions. The 1064 nm laser provided more active fibrous formations than the 755 nm laser, while higher risks for tissue damages simultaneously occurred. Conclusions: The ideal treatment conditions for skin rejuvenation were 8 mm diameter with 30 J/cm2 and 10 mm diameter with 26 J/cm2 for the 1064 nm laser, and 8 mm diameter with 36 J/cm2 and 10 mm diameter with 26 J/cm2 for the 755 nm laser. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study is to make a clinical evaluation of vascular malformations in the oral region treated by photocoagulation with an Nd:YAG laser, to determine its effectiveness. Background data: The Nd:YAG laser, with a wavelength of 1064 nm in the near-infrared part of the electromagnetic spectrum, has unique characteristics, such as absorption by oxygenated hemoglobin, negligible absorption by water, and a deep depth of penetration, all of which are ideal for performing the photocoagulation of vascular malformations. Methods: The subjects were 67 patients (69 cases) with vascular malformations in the oral region who visited our hospital from 2004 to 2011, and were treated by photocoagulation using an Nd:YAG laser. They consisted of 23 male patients and 44 female patients, ranging from 7 to 89 years of age. Lesion size was classified for convenience into two groups (<15 mm or ≥15 mm) for clinical analysis and evaluation. The lesions were located at sites including the lip, tongue, buccal mucosa, gingiva, mouth floor, and soft palate, and ranged in size from 3 to 42 mm along the major axis. Fifty patients (74.6%) were treated on an outpatient basis, whereas 17 patients (25.4%) were treated in the hospital. All patients were treated using an Nd:YAG laser at an output of 8-15 W under local anesthesia. Results: No patient developed serious complications from this treatment. However, it was necessary to irradiate the laser beam two or more times in cases of deep-seated lesions. Conclusions: We were able to obtain satisfactory results without clinical complications, using only external irradiation. These results suggest that the Nd:YAG laser is effective for the treatment of vascular malformations in the oral region. [ABSTRACT FROM AUTHOR]

Abstract: We analyzed, designed and fabricated a U-type resonator for intra-cavity frequency doubling of a diode-side-pumped Q-switched Nd:YAG rod laser with high power and high stability for surgery of prostatic tissue. The resonator stability conditions were analyzed graphically in the various configurations for a U-type resonator. We obtained green light at 532nm using a single KTP crystal, with average output power of 151W at 10kHz repetition rate, and with 113ns pulse duration at 810W input pump power. We achieved 1064–532nm conversion efficiency of 75.8%, and pump-to-green optical–optical efficiency of 18.6%. The green power fluctuation was ±1.0% and pointing stability was better than 4μrad. The green laser output was coupled to a side-firing medical fiber to transfer the laser beam to the prostatic tissue. [Copyright &y& Elsevier]

Mesenchymal stem cells (MSCs) from bone marrow are a recent source for tissue engineering. Several studies have shown that low-level laser irradiation has numerous biostimulating effects. The purpose of this trial was to evaluate the effects of Nd:Yag laser irradiation on proliferation and differentiation of MSCs induced into the osteoblastic lineage. MSCs were collected from adult human bone marrow, isolated, and cultured in complete medium (α-MEM). Subsequently, they were treated with osteogenic medium, seeded in three-dimensional collagen scaffolds, and incubated. We used six scaffolds, equally divided into three groups: two of these were irradiated with Nd:Yag laser at different power levels (15 Hz, 100 mJ, 1.5 W, and one with a power level of 15 Hz, 150 mJ, 2.25 W), and one was left untreated (control group). Evaluations with specific staining were performed at 7 and 14 days. After 7 days, proliferation was significantly increased in scaffolds treated with laser, compared with the control scaffold. After 14 days, however, laser irradiation did not appear to have any further effect on cell proliferation. As concerns differentiation, an exponential increase was observed after 14 days of laser irradiation, with respect to the control group. However, this was a pilot study with very limited sample size, we conclude, that low-level laser irradiation might lead to a reduction in healing times and potentially reduces risks of failure. [ABSTRACT FROM AUTHOR]

The neodymium/yttrium-aluminum-garnet (Nd/YAG) laser has been suggested to repair broken prostheses in the mouth. This study investigated the effects of different dentin thicknesses and air cooling on pulpal temperature rise during laser welding. Three intact human maxillary molars were prepared for full-veneer crown. For each tooth, dentin thicknesses in mesiobuccal cusp was 2, 3, or 4 mm. Twenty dies were duplicated from each of the prepared teeth. For metal copings with 0.5-mm thickness, wax patterns were prepared with dip wax technique directly onto each of dies. All patterns were sprued and invested. The castings were made using a nickel-chromium alloy (Nicromed Premium, Neodontics). A hole with 0.5-mm diameter was prepared on the mesiobuccal cusp of each crown. The Nd/YAG laser (9.85 W; 1 Hz repetition rate; fluence, 1.230 J/cm; Fidelis Plus 3, Fotona) was used for welding with or without air cooling ( n = 10). The temperature rise was measured in pulpal chamber with a J-type thermocouple wire that was connected to a data logger. Differences between start and highest temperature reading were taken, and temperature rise values were compared using two-way analysis of variance and Tukey's honestly significant difference tests ( α = .05). Pulpal temperature rise varied significantly depending on the dentin thickness and air cooling ( p < 0.05). The non-air cooling group induced significantly the highest temperature increases. There were no significant differences between 2- and 3-mm dentin thicknesses groups ( p > 0.05); however, pulpal temperature rise was the lowest for 4-mm dentin thickness group ( p < 0.05). The highest values of thermal increase were found in the pulp chamber (6.8°C) when no air cooling was used in 2-mm dentin thickness group. Laser welding on base metal castings with Nd/YAG laser can be applied with air cooling to avoid temperature rises known to adversely affect pulpal health when dentin thickness is 2 or 3 mm. [ABSTRACT FROM AUTHOR]

The effects of Nd:YAG laser irradiations at different power settings on several oral pathogens were evaluated. A total of 252 dentin samples were divided into seven groups consisting of 36 dentin specimens each. In each group, 9 of the 36 specimens were used as controls, thereby including a control in every group. The remaining 27 specimens were divided into three subgroups consisting of nine specimens according to different Nd:YAG laser settings (1.5, 1.8, and 2 W). Each group was inoculated on the nonpulpal side with one of the following microorganisms: Candida glabrata, Candida tropicalis, Candida krusei, Candida sake, Candida lusitaniae, Candida kefyr, and Rhodotorula mucilaginosa. The following irradiation procedure was used: the specimens were irradiated on the bacteria-free side (the side consisting of the pulpal wall) using contact mode under the constant scanning movement of the optical fiber at an angle of 10°. One lasing cycle consisted of four irradiation cycles of 10 s each, with 15-s intervals in between each irradiation cycle. The remainder of the controls and the lased specimens of each group were prepared for the microbiological investigation. After incubation for 24 h at 37 °C, the colonies were counted, and the total number of surviving microorganisms was statistically assessed. Microorganisms irradiated with Nd:YAG laser at power settings 2 W, 15 pps did not survive. Although there was a significant reduction of microorganisms at 1.5 and 1.8 W, when comparing Nd:YAG laser irradiation with the control group, sterilization did not occur. [ABSTRACT FROM AUTHOR]

Up to now, there is no any experience about the application of dental lasers to bond resin composites to metal surfaces in dentistry. The aim of this preliminary study was to evaluate if the laser irradiation of ceramic-covered alloy surface would improve the bond strength of resin to metal, and if different parameters of laser output may influence the strength of this bond. Fifty three cylinders (thickness of 5 mm and diameter of 10 mm) were made up of a commercially available nickel-chromium alloy by lost-wax technique. Forty prepared specimens were divided into four groups. Five specimens in each group were covered by slurry of dental opaque porcelain and irradiated by Nd:YAG laser using different output parameters for each group. Other five specimens in each group were treated using the same laser parameters without porcelain covering. Five sandblasted specimen served as control group. Panavia F2.0 was bonded on the metal surfaces using polyethylene tubes. In ceramic-coated specimens, silane was applied to achieve chemical bond between silica particles and resin cement. All specimens were thermocycled and subjected to shear bond strength (SBS) test (50 kgf at 0.5 mm/min). Two specimens of each ceramic-coated laser-treated groups were studied using scanning electron microscopy and wavelength dispersive X-ray spectroscopy which showed stabilization of silica particles on the metal surface. ANOVA procedure showed that although shear bond strength was significantly higher in porcelain-covered laser treated samples, but the effect of power output of laser irradiation was not significant ( P = 0.917). There were no statistically significant difference between SBS in control samples and laser treated specimens without porcelain covering. It can be concluded that Nd:YAG laser surface treatment may improve the silica coating of alloy surface to achieve better resin-metal bond. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To review the current literature on intracorporeal laser lithotripsy. Methods: We searched PubMed for relevant reports up to January 2012, using the keywords ‘laser’, ‘lithotripsy’ and ‘intracorporeal’. Results: We studied 125 relevant reports of studies with various levels of evidence. Efficient lithotripsy depends on the laser variables (wavelength, pulse duration and pulse energy) and the physical properties of the stones (optical, mechanical and chemical). The most efficient laser for stones in all locations and of all mineral compositions is the holmium yttrium–aluminium–garnet laser (Ho:YAG). The frequency-doubled double-pulse Nd:YAG laser functions through the generation of a plasma bubble. New laser systems, such as the erbium:YAG and the thulium laser, are under evaluation. Laser protection systems have also been developed for the novel digital flexible ureteroscopes. Although complications are rare, a high relevant clinical suspicion is necessary. Conclusions: Laser lithotripsy technology is continuously developing, while the Ho:YAG laser remains the reference standard for intracorporeal lithotripsy. [Copyright &y& Elsevier]

Melasma is an acquired disorder of pigmentation that commonly affects women with phototypes III-V, and it has a negative impact on the quality of life in affected individuals. It presents clinically as symmetric tan or brown patches on the face, most often involving the forehead, cheeks, perioral region, and periorbital region. On histologic examination, there is increased melanin in the epidermis and/or an increased number of melanosomes in the dermis, with a normal number of highly melanized and dendritic melanocytes. The mainstay of treatment is the use of sunscreen along with topical medications that suppress melanogenesis. Clearance is usually incomplete and recurrences or exacerbations are frequent, probably because of the poor efficacy in clearing dermal melanosomes. Treatment with high-energy pigment-specific lasers, ablative resurfacing lasers, and fractional lasers results in an unacceptably high rate of postinflammatory hyper- and hypopigmentation and rebound melasma. Recently, promising results have been achieved with low-fluence Q-switched neodymium-doped yttrium aluminium garnet laser treatment, which can selectively target dermal melanosomes without producing inflammation or epidermal damage, in all skin phototypes. This article reviews the current treatment modalities for melasma, the rationale for using and the clinical results of combination therapy with low-fluence Q-switched neodymium-doped yttrium aluminium garnet lasers. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the long-term effects of a combined periodontal treatment of scaling and root planing (SRP) and Nd:YAG laser (NDL) in chronic periodontitis (CP) patients. This was accomplished by determining the periodontal indices and the interleukin-1beta (IL-1β) and matrix metalloproteinase-8 (MMP-8) levels of the gingival crevicular fluid (GCF). This study was performed according to a random split-mouth-design, controlled clinical trial for sulcular debridement on 40 teeth from 20 patients with generalized moderate chronic periodontitis. The periodontal healing outcomes were compared after periodontal treatment with either SRP + NDL at 1 W (test side) or SRP (control side). Plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded, and samples of gingival crevicular fluid (GCF) were taken at baseline and post-therapy (3 and 9 months after treatment). The GCF samples were analyzed for IL-1β and MMP-8. There was postoperative improvement of all clinical parameters in both groups, but test side GI, PPD, and CAL recovery was higher than that of the control side ( p < 0.05). Although levels of IL-1β and MMP-8 in GCF after treatment were lower in the test side than the control side, there was not a statistically significant difference ( p > 0.05). In the long term, we found that SRP + NDL treatment of periodontal pockets was more effective than SRP alone in reducing PPD, CAL, GI, and GCF values. [ABSTRACT FROM AUTHOR]

The aim of this clinical study was to describe the possibility of using the Nd:YAG laser device utilized in the dental offices to weld metals intraorally. The authors, before applying this technique "in vivo" on human subjects, tested the "in vitro" metal welding efficacy of dental Nd:YAG device firstly by interferometry, SEM, and EDS and subsequently by thermal camera and thermocouples in order to record temperature changes during the welding process on bovine jaws. Four implants were inserted in the edentulous maxillary arch of a 67 years old male patient. Immediately after that, a bar previously made by the dental technician was intraorally welded to the abutments by Nd:YAG laser (Fidelis Plus III, Fotona, Slovenia) with these parameters: 9.90mJ, 1Hz, 15 msec, 0.6mm spot. Then the prosthesis was connected to the bar with four OT Caps. This clinical study, even if preliminary, suggests that laser welding technique may be intraorally used without side effects. [ABSTRACT FROM AUTHOR]

Background. Laser welding was first reported in 1967 and for many years it has been used in dental laboratories with several advantages versus the conventional technique. Authors described, in previous works, the possibility of using also chair-side Nd : YAG laser device (Fotona Fidelis III, λ = 1064 nm) for welding metallic parts of prosthetic appliances directly in the dental office, extra- and also intra-orally. Syncristallisation is a soldering technique based on the creation of an electric arc between two electrodes and used to connect implants to bars intra-orally. Aim. The aim of this study was to compare two different laser welding devices with a soldering machine, all of these used in prosthetic dentistry. Material and Methods. In-lab Nd : YAG laser welding (group A = 12 samples), chair-side Nd : YAG laser welding (group B = 12 samples), and electrowelder (group C = 12 samples) were used. The tests were performed on 36 CrCoMo plates and the analysis consisted in evaluation, by microscopic observation, of the number of fissures in welded areas of groups A and B and in measurement of the welding strength in all the groups. The results were statistically analysed by means of one-way ANOVA and Tukey-Kramer multiple comparison tests. Results. The means and standard deviations for the number of fissures in welded areas were 8.12 ± 2.59 for group A and 5.20 ± 1.38 for group B. The difference was statistical significant (P = 0.0023 at the level 95%). On the other hand, the means and standard deviations for the traction tests were 1185.50±288.56N for group A, 896.41±120.84N for group B, and 283.58±84.98N for group C. The difference was statistical significant (P = 0.01 at the level 95%). Conclusion. The joint obtained by welding devices had a significant higher strength compared with that obtained by the electrowelder, and the comparison between the two laser devices used demonstrated that the chair-side Nd : YAG, even giving a lower strength to the joints, produced the lowest number of fissures in the welded area. [ABSTRACT FROM AUTHOR]

To date no clinic trials have reported on the safety and effectiveness of the use of a frequency-doubled double pulse neodymium YAG (FREDDY) laser with a radiopaque mark under fluoroscopic guidance to treat bile duct stones that are untreatable by conventional endoscopic therapy. We report the cases of 30 patients with impacted or large common bile duct (CBD) stones (> 1.5 cm) treated by endoscopic lithotripsy using FREDDY laser with a radiopaque mark under fluoroscopic guidance. During the procedure, the tip of the laser fiber was packaged with a radiopaque ring mark that was detectable by fluoroscopy. In these patients, complete bile duct clearance was achieved in 27 of the 30 patients (90 %). The majority of patients (18/30) were treated in a single session; the mean number of sessions needed to clear the bile ducts completely was 1.4 ± 0.6. Adverse events were noted in two patients, who both developed acute mild pancreatitis. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 29-year-old female patient with Fitzpatrick skin Type VI, for treatment of its professional black and red tattoo inkings on the neck. The patient then underwent laser removal treatment for her skin tattoos and a 5320nm picosecond laser for her red-colored tattoo inking. The article also discusses the factors for reducing the risk for post-inflammatory hyperpigmentation.

The article presents an overview of the use of lasers in periodontal surgery, noting that they can reduce bacterial exposure, blood loss, and postoperative pain for procedures on hard and soft tissues. Several case reports are presented of periodontic surgeries using carbon dioxide, diode, erbium, and neodymium:yittrium, aluminum, garnet (Nd:YAG) lasers. Also discussed is the use of optical coherence tomogaphy (OCT) in dental imaging and diagnosis.