Journal of Lasers in Medical Sciences
Volume:6 Issue: 3, Summer 2015

Laser technology has been recently introduced into the dental field with the idea to replace drilling. Having a less painful first dental experience by the use of modern instruments like laser can be an efficient preventive and therapeutic strategy in pediatric dentistry. Pedodontists need to learn the new less invasive technologies and adopt them in their routine practice. This study aimed to review the available types of lasers and their applications in pediatric dentistry.An electronic search was carried out in IranMedex, InterScience, Scopus Science Direct, PubMed,ProQuest, Medline and Google Scholardatabasesto find relevant articles published from 2000 to 2014. Relevant textbooks were reviewed as well.Laser can be used as a suitable alternative to many conventional diagnostic and therapeutic dental procedures.It is especially efficient for caries detection and removal, pulp therapy, lowering the risk of infection, inflammation and swelling and reducing bleeding. On the other hand, due to minimal invasion, laser treatment is well tolerated by children. Improved patient cooperation leads to higher satisfaction of the parents, dentists and the children themselves.

Despite a growing popularity of noninvasive ultrasonic lipolysis procedure, there is a lack of evidence about the efficacy of this method. This study was performed to evaluate the efficacy of focused ultrasonic lipolysis on abdominal cellulite treatment. Twenty-eight consecutive subjects (age: 37.8 ± 8 years) underwent weekly transdermal focused ultrasonic lipolysis (Med Contour, General Project Ltd., Florence, Italy) and vacuum drainage for a maximum of eight sessions. Largest abdominal girth and 2 lines at 4 cm to 7 cm distance above and under it were located as fixed points of measurements. The mean value of the three fixed lines was considered as the abdominal circumference. Subjects were evaluated using measurements of circumference, immediately after and 3 weeks after the final treatment and compared using paired t test. One hundred ninety-four ultrasonic lipolysis procedures were performed on 28 subjects. A statistically significant (P <. 001) average of 1.89 cm (95% CI: 1.63-2.02 cm) decrease of circumference value was observed in each session of ultrasonic lipolysis. The mean pretreatment to posttreatment circumference reduction was 8.21 cm (95% CI: 6.38-10.04, P <. 001) that declined to 7 cm (95% CI: 3.2-10.8, P <. 001) at the 3-month follow-up visit. Focused ultrasonic lipolysis appears to be an effective method for reduction of abdominal cellulite, although some amount of circumference reduction reversal may be observed in long term follow-up visit.

The topical and intradermal photodynamic therapy (PDT) effect of methylene blue (MB) using light-emitting diode (LED) as light source (MB/LED-PDT) in the treatment of lesions of American cutaneous leishmaniasis (ACL) caused by Leishmania braziliensis in hamsters were investigated. Hamsters were infected in the footpad with 4×107 promastigotes of L. braziliensis and divided in 4 groups: Control group was not treated, AmB group was treated with amphotericin B, MB-Id group received intradermal MB at the edge of the lesion and MB-Tp group received MB topic. After treatment with MB, the animals were illuminated using red LEDs at the 655 nm wavelength for 1 hour. The MB/LED-PDT was carried out three times a week for 12 weeks. Animals of MB-Tp group presented lesion healing with significant diminution in extent of the lesion, and reduced parasite burden compared to control group; however, no significant difference was seen compared to the AmB group. MB-Tp group also showed reconstitution of the epithelium, the formation of collagen fibers, organization in the epidermis, a little disorganization and inflammation in the dermis. MB-Id was ineffective in all parameters evaluated, and it was comparable to the control group results. These data show that PDT with the use of MB-Tp and LED may be an alternative for the treatment of ACL. However, additional studies are being conducted to assess the potential of MB/LED-PDT, alone or in combination with conventional therapy, for the treatment of ACL.

The optimum removal of bacteria and their toxins from periodontal pockets is not always obtained by conventional mechanical debridement. Adjunctive therapies may improve tissue healing through detoxification and bactericidal effects. The purpose of the present study was to evaluate the impact of adjunctive laser therapy (LT) and photodynamic therapy (PDT) on patients with chronic periodontitis. Twenty patients with at least three quadrants involved and each of them presenting pockets 4-8 mm deep were included in the study. Periodontal treatment comprising scaling and root planning (SRP) was accomplished for the whole mouth. Applying a split-mouth design, each quadrant was randomly treated with SRP alone (group A), SRP with LT (group B), and SRP with PDT (group C). The clinical indices were measured at baseline 6 weeks and 3 months after treatment. Microbiological samples were taken and evaluated at baseline and 3-month follow-up. All groups showed statistically significant improvements in terms of clinical attachment level (CAL) gain, periodontal pocket depth (PPD) reduction, papilla bleeding index and microbial count compared to baseline (P <. 05). The results showed more significant improvement in the 6-week evaluation in terms of CAL in groups B and C than in group A (P <. 05). Group B also revealed a greater reduction in PPD than the other treatment modalities (P <. 05). The obtained data suggested that adjunctive LT and PDT have significant short-term benefits in the treatment of chronic periodontitis. Furthermore, LT showed minimal additional advantages compared to PDT.

Laser dentistry is a one of the upcoming advanced treatment modality for oral mucosal lesions. Diode laser is a soft tissue laser that has found much acceptance in all branches of dentistry. Available compact size and feasibility has render diode laser an enhanced tool for today’s clinical practice. The aim of this study is to determine the efficacy and safety of diode laser for the management of white lesions such as oral leukoplakia (OL) and oral lichen planus (OLP). The study was conducted by using diode laser 980 nm on 10 patients with white lesions (5 OL and 5 OLP) aged between 35 to 65 years. Of the 10 patients (5 OL and 5 OLP), 3 patients (30%) complained of moderate pain and 7 patients (70%) complained of mild pain, for first 3 days after laser irradiation, and pain disappeared at end of first week. There was no recurrence of the lesion during the 6-month follow up. Diode lasers provide acceptable clinical improvement of potentially malignant lesions with minimal side effects. It can be considered one of the best alternative treatment modality for oral mucosal lesions.

Different modalities have been used to achieve better results in wound healing among which are laser and pharmacological agents. To our knowledge, there is no investigation to compare phenytoin and laser together. In this study, we aimed to evaluate laser and phenytoin efficacy and compare their effect on wound healing. We used 60 rats. The animals were divided into 4 groups, 15 rats in each and each group was subdivided into 3 subgroups for which postoperative evaluation was performed on days 3, 7, and 14. After general anesthesia and back hair shaving of each rat, an excisional wound was made. The wounds in group 2 were treated with 1% phenytoin cream. In group 3, the wounds were irradiated with diode laser. The wounds of group 4 were treated with both phenytoin cream and laser administration. The animals of group 1 served as control. For histopathological evaluation, hematoxylin and eosin staining was used. Polymorphonuclear leucocytes (PMNs), re-epithelization, fibroblasts, new vessels and collagen were evaluated. Faster reduction in polymorphonuclear cells after 7 and 14 days and more collagen fibers on the third day in laser treated group was statistically significant (P <. 05). The result for the phenytoin treated group were not better than control group. When both laser and phenytoin were used samples showed more collagen fibers on the third day, which was statistically significant (P <. 05). It seems that low level laser is effective in skin wound healing and have better results than phenytoin application.

Lasers have made tremendous progress in the field of dentistry and have turned out to be crucial in oral surgery as collateral approach for soft tissue surgery. This rapid progress can be attributed to the fact that lasers allow efficient execution of soft tissue procedures with excellent hemostasis and field visibility. When matched to scalpel, electrocautery or high frequency devices, lasers offer maximum postoperative patient comfort. Four patients agreed to undergo surgical removal of benign lesions of the oral cavity. 810 nm diode lasers were used in continuous wave mode for excisional biopsy. The specimens were sent for histopathological examination and patients were assessed on intraoperative and postoperative complications. Diode laser surgery was rapid, bloodless and well accepted by patients and led to complete resolution of the lesions. The excised specimen proved adequate for histopathological examination. Hemostasis was achieved immediately after the procedure with minimal postoperative problems, discomfort and scarring. We conclude that diode lasers are rapidly becoming the standard of care in contemporary dental practice and can be employed in procedures requiring excisional biopsy of oral soft tissue lesions with minimal problems in histopathological diagnosis.

The role of laser in conservative management of oral disease is well established. Laser procedures are common in the fields of oral surgery, implant dentistry, endodontic, and periodontic therapy.Case: This case series describes the use of diode laser for the excision of oral exophytic lesions. All the patients attended the oral medicine department of Shahid Beheshti University of Medical Sciences, Tehran, Iran. Criteria in patient selection were accessibility to lesions, patient fear from blade surgery, aesthetics, and probability of bleeding. An informed consent was filled by every patient. All of the lesions were completely excised under local anaesthesia by diode laser with 300 μm-fibre tip, 808 nm continuous wavelength and 3-3.5 W power for 3×60 seconds (Dr Smile, Italia). During surgery, the fibre tip was in contact with lesions. No analgesics were prescribed to the patients. The patients were followed for the first, second, and forth week after treatment. The lesions could be excised using the diode laser. This procedure was a quick clinical technique without bleeding.