Laser safety is much more than wearing safety goggles, and posting a sign on the treatment room door. Compliance audits from facilities in a number of different countries, have revealed misconceptions, lack of education and training, areas of non-compliance with standards, and potentially unsafe practices that could result in staff and patient injuries. Far too often, laser safety is underappreciated and poorly implemented. A laser is as safe or as hazardous as the user. The knowledge and skill of the user and members of the surgical team, and the level of administrative support allocated to laser program management, will determine how well and safely a clinical practice operates. Healthcare lasers have the same risks and hazards, regardless of where they are used. Therefore, standards and guidelines for safety should be the same for all practice settings, including hospitals, clinics, or private office facilities. Of all hazards, complacency is the most dangerous. Too often, what begins as a commitment to safety fades over time. The best way to combat apathy, and maintain a level of compliance and attention to safe practice, is to establish a laser program on a foundation of risk management principles and evidence based standards. Proper safety management requires a fourfold approach including: initial and ongoing education and training, identification of hazards and risks, consistent use of appropriate control measures, and sustainable program audit and management.
Background and aims: Eradication failures are increasing with the increasing antibiotic resistance of Helicobacter pylori. We examined the basic effect of methylene blue (MB) with sodium bicarbonate (NaHCO3) on H. pylori eradication using antimicrobial chemotherapy activated by light. Material and methods: When NaHCO3 was added to MB, the pH became basic. We smeared H. pylori on a medium with basic MB and irradiated it using a red light-emitting diode with a wavelength of 660 nm. The applied energy fluencies were 10 J/cm2 and 15 J/cm2. After 4 days of culture, the effect of this intervention was determined according to the bacterial growth area. Results: The basic effect of MB appeared between a pH of 8.6 and 9.0. The NaHCO3 concentration was between 4% and 6%. The basic effect at 15 J/cm2 was greater than that at 10 J/cm2. Conclusions: We concluded that antimicrobial chemotherapy activated by light with basic MB was effective in H. pylori eradication.
Objective: We report relationship between complications and predictive factors of occurrence with multivariate analysis for cases of laser treatment under general anesthesia. Study Design: Pediatric patients (330 cases, aged 1 to 15 years old) who underwent laser treatment under inpatient general anesthesia against body surface hemangiomas or melanocytosis were examined for the complications. Methods: Retrospective study from medical and anesthesia records, statistical assessment was carried out using multivariate analysis by univariate and logistic regression analysis, and p value less than 0.05 was considered to be significant difference. Results: Complications were confirmed in 25%, mostly due to emergence agitation from anesthesia, and no severe complications were recognized. Multivariate analysis of factors causing complications revealed a significant difference in the limbs, the Q-switched Nd: YAG laser, and the anesthesia time of 60 minutes or longer. Conclusion: While the length of anesthesia time was reported as a factor of complication occurrence in the past, there has been no report on the extremity and the Q-switched Nd: YAG laser as significant complication factors.
Background and aims: Photodynamic therapy (PDT) is a potential strategy to eliminate infection in the specific tissue. It uses lower-power laser to activate a photosensitizing agent. Studies have shown the benefit of PDT in the periodontal treatment. The aim of this study was to evaluate the periodontal changes after applying PDT as an adjunct to one visit full-mouth SRP (scaling and root planing) with subgingival piezoelectric ultrasonic scaler compared with full-mouth SRP alone. Methods: A split-mouth randomized clinical trial was designed. Twenty patients with moderate to severe chronic periodontitis were treated with subgingival piezoelectric ultrasonic device alone in control group and adjunct treated with PDT in the test group. Probing pocket depth (PD), clinical attachment level (CAL), plaque index (PI), gingival bleeding index (GBI) and gingival inflammation index (GI) were evaluated at baseline, 1 month, 3 and 6 months after treatment. Only sites with PD ≥ 4 mm at baseline were calculated. Results: All periodontal parameters were significantly improved in both groups at 1 month, 3 and 6 months after treatment. All parameters in test group were better than that control group, with statistically significant differences of GBI and GI (P < 0.05) at 3 and 6 months after treatment but no statistically significant differences of PD, CAL and PI. Conclusions: One visit full-mouth ultrasonic SRP seems to have good enough effort for the periodontal status till 6 months. The adjunct treatment of PDT provided positive effect in term of GBI and GI.
Background and Aim: Fractional CO2 lasers have been shown to provide improvement of vulvovaginal atrophy (VVA). The aim of the current study was to assess the early effect of a fractional CO2 laser system in treating postmenopausal women with clinical symptoms of VVA. Methods: 28 healthy post-menopausal women (mean age 60.1 ± 5.55 years) with VVA-related symptoms were treated with fractional CO2 laser 3 times, in 4-week intervals. At each study visit, VHIS score and VVA symptom severity were recorded. Sexual function was assessed with the Female Sexual Function Index (FSFI). Results: One month following the first laser treatment, the mean VHIS score was significantly improved (13.89 ± 4.25 vs. baseline 11.93 ± 3.82; p ‹ 0.05), and improved further at 3 and 6 months following all three laser treatments (16.43 ± 4.20 and 17.46 ± 4.07, respectively). Almost all VVA symptoms were significantly improved at one month following the first treatment. A further significant improvement in VVA symptoms was noted at 3 and 6 months following the third laser treatment. Following treatments, the FSFI score increased significantly (22.36 ± 10.40 vs. baseline 13.78 ± 7.70; p ‹ 0.05), and remained significantly higher than baseline at the 3- and 6-month follow-up visits. Conclusion: CO2 laser therapy for post-menopausal women can be considered an effective therapeutic option providing relief of symptoms already noted after one laser treatment.
Background and aims: The purpose of this study is to determine the effect of CO2 laser irradiation in comparison with sandblasting (Sb), hydrofluoric acid (Hf) and silane coupling agent (Si) on shear bond strength (SBS) of resin cement to CAD/CAM ceramics bonded to dentin. Material and Methods: Forty-eight (CAD/CAM) ceramic discs were prepared and grouped by material, i.e. lithium disilicate (Emax CAD) and zirconia ceramic (Emax ZirCAD), distributed into four different groups: group A, lithium disilicate (Li) CO2/HF/Si; group B, Li: HF/Si; group C, zirconia (Zr) CO2/Sb/Si; group D, Zr: Sb/Si. Results: It was shown significant difference between irradiated and non-irradiated groups in terms of shear bond strength for zirconia ceramics (p value = 0.039). Conclusion: CO2 laser irradiation increases shear bond strength for both CAD/CAM ceramics bonded to dentin.
Background and Aims: Peripheral nerve injury is one of the frequent complaints which is seen in the outpatient clinic of our medical institute. In previous studies we have reported on the benefits of low level laser therapy (LLLT) for central nerve system disorders, namely cerebrovascular accidents and cerebral palsy. The present study is a report on our experience of the effects of LLLT for peripheral nerve palsy Materials and Methods: Over the past 5 years, 13 subjects visited the out-patient clinic with the chief complaint of radial nerve palsy caused by compression of the nerve through with abnormal positioning, and sleeping posture at night. The patients were treated with LLLT. A 1000 mW semi-conductor laser device was used, delivering 830 nm in continuous wave at a dose of 20.1 J/cm2 /point, and five points were treated per session (i.e., 1 treatment) twice a week for 3 months (total 24 treatments). In 6 patients LLLT was combined with brace therapy. Results: Modified Daniels' manual muscle testing was used to determine the effects of LLLT for the muscle power of the extensor carpi radialis, and on completing the treatment regimen excellent improvement was observed in 9 cases out of 13. Combination treatment (laser therapy with bracing) resulted in 4 excellent cases out of 6 cases. Discussions with the patients clarified that it was important for them to learn how to avoid the particular posture that could cause them radial nerve palsy in daily life in order to have continuous benefits from the treatment. Conclusion: The present study demonstrated that LLLT was an effective form of treatment for radial nerve palsy. In addition, patients were advised to avoid any incorrect posture which might induce radial nerve palsy.
Background and aims: It is generally thought that bleeding from a hemangioma is difficult to stop. With development of the long pulse dye laser (LPDL), it has become possible to treat hemangioma with a large blood vessel diameter. Thus, it is effective in treating infantile hemangioma and pyogenic granuloma. Materials and methods: Five patients who visited our hospital from July 2015 to July 2017 due to hemorrhagic hemangioma were treated using a flash lamp excitation pulse dye laser with parameters of 7 mm spot size, 3 msec pulse width, fluence 12-14J/cm2, DCD 30 msec, and delay 30 msec. Results: The bleeding not only stopped, but the raised lesion was flattened in all cases. Conclusion: LPDL is effective for both infantile hemangioma and pyogenic granuloma. It not only stops bleeding, but also treats the vascular lesions.