Foveal structure changes in infants treated with anti-VEGF therapy or laser therapy guided by optical coherence tomography angiography for retinopathy of prematurity

AIM: To evaluate foveal vessel density (VD) and foveal thickness using optical coherence tomography angiography (OCTA) in retinopathy of prematurity (ROP) children treated with laser photocoagulation or anti-vascular endothelial growth factor (VEGF) injection. Additionally, we assessed the relationship between foveal microvascular anomalies and different therapies in ROP children. METHODS: This was a single-center, retrospective study of patients with a diagnosis of type 1 ROP. Twenty-three eyes (14 patients) treated with anti-VEGF injection and twenty-nine eyes (17 patients) treated with laser coagulation were included in this study. The foveal VD, inner thickness and full thickness were measured at the central 0°, 2° to 8°, and 8° of the retina (centered on the fovea) using OCTA and cross-sectional OCT, respectively. RESULTS: Foveal VD, inner thickness and full thickness were significantly smaller within the central 8° of the retina in ROP children treated with anti-VEGF injection than in those treated with laser photocoagulation (P=0.013, 0.009, 0.036, respectively). The full thickness was also smaller in the anti-VEGF group than in the laser group at the central 0° of the retina (P=0.010). The grade of foveal hypoplasia is lower in the anti-VEGF group than in the laser group (P=0.045). Multivariable analysis did not find any risk factors associated with visual acuity in our study. CONCLUSION: In children with type 1 ROP, the better structural development of fovea in those who were treated with anti-VEGF injection compared with laser photocoagulation are identified. However, visual acuity outcomes are similar 70mo after the treatments.

Comparison of Diode Laser and Conventional Method in Treatment of Gingival Melanin Hyperpigmentation

Purpose: The goal of this study is to compare the scalpel and diode laser methods for treating gingival hyperpigmentation in terms of postoperative discomfort and wound healing. Materials & Methods: Sixteen systemically healthy individuals diagnosed with light or moderate gingival hyperpigmentation were enrolled for this study. Patients were randomly assigned to one of two treatment groups: scalpel or laser. Dummett’s oral pigmentation index was recorded at baseline. Early wound healing and post-operative discomfort were evaluated on the 7th day by using the VAS form. Comparisons between the groups were tested using the Mann-Whitney U test and P-value < 0.05 was considered significant. Results: Total epithelization was observed in the laser group, whereas the epithelization was incomplete in the scalpel group at the end of the observation period. The pain perception on the first two days after the surgery was significantly higher in the scalpel group than in the laser group. (p=0,002 and p=0,038, respectively). No significant differences were found between the fourth- and seventh-day when surgical techniques were compared regarding pain perception (p>0,05). Similarly, pain perceptions of female and male individuals showed no significant difference (p>0,05). Conclusion: In the treatment of gingival hyperpigmentation, both surgical techniques were clinically successful. Although the treatment process was long, according to the results of our study, the laser technique is superior to the scalpel method in terms of patient comfort. The choice of the method may vary depending on the available equipment and the clinician’s preference or request of the patient.

MICRO NEEDLING VERSUS CARBON DIOXIDE FRACTIONAL LASER IN MANAGEMENT OF ACNE SCARS

Objective: To compare the effectiveness of carbon dioxide fractional laser with micro needling in acne scarring. Study Design: Quasi experimental study. Place and Duration of Study: Department of Dermatology, Pak Emirates Military Hospital Rawalpindi, from Jun 2019 to Mar 2020. Methodology: Overall 40 patients with acne scars assessed by consultant dermatologist were made part of study. The patients were divided into two treatment groups through lottery method. Group A, was managed by micro needling technique, while Group B was managed by carbon dioxide fractional laser, each to be done monthly for a total of three sessions. The response was measured by the dermatologist and patients in both the groups. The side effects were also compared in both the groups. Results: Out of 40 patients with acne scars included in study, 17 (42.5%) underwent micro-needling while 23 (57.5%) underwent carbon dioxide fractional laser treatment after randomization. Thirty (75%) patients were female while 10 (25%) were male. The patients with acne scars responded better in carbon dioxide fractional laser group as compared to micro needling in opinion of dermatologists (p-value=0.01) and also patients themselves (p-value=0.03). Side effects were significantly higher in carbon dioxide fractional laser group as compared to micro needling (p-value=0.02). Conclusion: Significant number of patients respond well to carbon dioxide fractional laser treatment and the response included both expert opinion and patients own opinion, but adverse effects were seen more in same group. Therefore, better response but at the cost of more adverse effects was noted.

1470 nm/980 nm dual-wavelength laser is safe and efficient for the en-bloc resection of non-muscle invasive bladder cancer: A propensity score-matched analysis

Objective To evaluate the efficacy and safety of a 1470 nm/980 nm dual-wavelength laser system used for the en-bloc resection of non-muscle invasive bladder cancer (NMIBC) compared with transurethral resection of bladder tumour (TURBT). Methods This retrospective study analysed the demographic and clinical data from patients diagnosed with NMIBC that were treated by either dual laser or TURBT. Intraoperative characteristics, postoperative characteristics and outcomes between the two groups were compared. Results This study analysed 64 patients, 32 in each group. No severe complications were identified in either group. After propensity score-matching, there were no significant differences between the two groups in terms of the demographics, clinical and tumour characteristics. There was no significant difference between the two groups in terms of specimen quality. In the laser group, intraoperative blood loss was significantly lower and significantly fewer patients required continuous bladder irrigation after surgery, compared with the TURBT group. No significant differences were observed in the catheterization time, gross haematuria time and hospitalization time. Operation time in the laser group was significantly longer compared with the TURBT group. No significant difference was found in the recurrence and progression rates between the two groups. Conclusions The 1470 nm/980 nm dual-wavelength laser provides a safe and effective surgical treatment option for patients with NMIBC.

Combined application of chondroitinase ABC and photobiomodulation with low-intensity laser on the anal sphincter repair in rabbit

Background Photobiomodulation with low-intensity laser (LIL) and chondroitinase ABC (ChABC) can repair damaged muscle tissue, so the aim of this study was to investigate the effect of co-administration of these two factors on anal sphincter repair in rabbits. Methods Male rabbits were studied in 5 groups (n = 7): Control (intact), sphincterotomy, laser, ChABC and laser + ChABC. 90 days after intervention were evaluated resting and maximum squeeze pressures, number of motor units, collagen amount, markers of muscle regeneration and angiogenesis. Results Resting pressure in the Laser + ChABC group was higher than the sphincterotomy, laser and ChABC groups (p < 0.0001). Maximum squeeze pressure in the all study groups was higher than sphincterotomy group (p < 0.0001). In the laser + ChABC and ChABC groups, motor unit numbers were more than the sphincterotomy group (p < 0.0001). Collagen content was significantly decreased in the laser (p < 0.0001) and laser + ChABC groups. ACTA1 (p = 0.001) and MHC (p < 0.0001) gene expression in the Laser + ChABC group were more than the laser or ChABC alone. VEGFA (p = 0.009) and Ki67 mRNA expression (p = 0.01) in the Laser + ChABC group were more than the laser group, But vimentin mRNA expression (p < 0.0001) was less than the laser group. Conclusion Co-administration of ChABCs and photobiomodulation with LIL appears to improve the tissue structure and function of the anal sphincter in rabbits more than when used alone.

Effect of 970 nm low-level laser therapy on orthodontic tooth movement during Class II intermaxillary elastics treatment: a RCT

This prospective randomized clinical trial aimed to evaluate the effect of low-level laser therapy on tooth movement during Class II intermaxillary elastics treatment. Forty-two patients with Class II malocclusion were included, and their maxillary quadrants were allocated into two groups: treatment with an active diode laser and a placebo group. In each group, the time taken to obtain Class I occlusion after 6 months, rate of movement, total displacement of the maxillary canine to Class I occlusion and pain were recorded. The time to reach Class I occlusion in the active laser group (2.46 ± 2.1 months) was not significantly different from that in the placebo group (2.48 ± 2.0 months) (p = 0.938). Interestingly, the total distance of movement on the active laser side (2.27 ± 1.5 mm) was significantly greater than that on the placebo side (1.64 ± 1.3 mm) (p = 0.009). The pain levels on days 1, 2 and 3 were not significantly different between the laser and placebo sections. The rate of distance change toward Class I occlusion in the laser group (1.1 ± 0.7 mm/month) was significantly higher than that in the placebo group (0.74 ± 0.6 mm/month) (p = 0.037). Low-level laser therapy (970 nm) did not reduce the time needed to obtain Class I occlusion, but a significant acceleration in tooth movement was observed in the irradiated group.Trial registration: NCT02181439. Registered 04 July 2014—https://www.clinicaltrials.gov/ct2/results?term=cinelaser.

Evaluating the Effect of Low Power Diode Laser 806 nm on the Healing of Unilateral Cleft Lip Scar: An Open-Label Comparative Study

Objective To investigate the effect of laser bio-modulation irradiation therapy on the scar after surgical correction of unilateral cleft lip. Design a comparative, open-label study. Setting we conducted the study in a university based tertiary hospital that recruited early wound healers of unilateral cleft lip correction. Patients Eighty patients were divided into two groups: In study's group, patients undergo laser bio-modulation irradiation (n = 60); in the control group, patients were followed-up without intervention (n = 20). Intervention In the study's group, patients underwent low-power diode Laser with wavelength of 806 nm and power of 100 mw. Main outcome The change in the scar of cleft lip patients, which was assessed by clinical examination and ultrasound. Results The median pigmentation score was significantly lower in the laser group (median = 1; IQR = 1–2) than the control group (median 2; IQR 1–3), with p-value of <0.001. Likewise, the median height score was significantly lower in the laser group (median = 1; IQR = 1–1) than the control group (median 1.5; IQR 1.5–2), with p-value of 0.001. The median pliability score was significantly lower in the laser group (median = 1; IQR = 1–1) than the control group (median 2.5; IQR 1–3), with p-value of <0.001. Finally, the median vascularity score was significantly lower in the laser group (median = 1; IQR = 1–1) than the control group (median 1.5; IQR 1–2), with p-value of <0.001. Conclusion laser bio-modulation irradiation therapy demonstrates a potential efficacy in managing the hypertrophic scars after surgical repair of unilateral cleft lip.

COMPARATIVE EVALUATION OF EFFICACY OF SCALING AND ROOT PLANING WITH AND WITHOUT CHLORHEXIDINE CHIP AND DIODE LASER IN CHRONIC PERIODONTITIS PATIENTS

Introduction: The motive of the present study is to comparatively measure the competence and effectiveness of diode laser and chlorhexidine chip as adjuncts to the scaling and root planing procedure, in patients with chronic periodontitis. Aim: To evaluate the efficacy of diode laser and chlorhexidine chip before and after scaling and root planing in the management of chronic periodontitis. The objective is to compare the efficacy of chlorhexidine chip and diode laser before and after scaling and root planning on clinical parameters. Study and design: Randomized clinical trial with split mouth design done in the Department of Periodontics and Implantology. Materials and methods: Twenty chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were selected in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). All subjects received a clinical periodontal examination by single examiner who recorded all the variables by manual procedure. Clinical parameters namely Plaque index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Results were statistically analysed using one-way ANOVA followed by Post Hoc Analysis. Results: The differences in PPD reduction and CAL gain between control group and CHX chip and combination groups were statistically significant (p<0.05) at three months, whereas, the diode laser group did not show any significant difference from the control group. Conclusion: Within the limitations in the present study, the following conclusions were derived, i.e., chlorhexidine local delivery alone or in combination with diode laser decontamination is effective in improving oral hygiene, reducing gingival inflammation, reducing probing pocket depth and improving clinical attachment levels when used as adjuncts to scaling and root planing in non-surgical periodontal therapy of patients with chronic periodontitis. Keywords: Diode laser decontamination, Local drug delivery, Scaling and root planing.

NEUROPHYSIOLOGICAL EFFECT OF LOW LEVEL LASER THERAPY ON ULNAR NERVE

Low level laser therapy is widely used in managing pain and inflammation in musculoskeletal ailments. Its effect on Peripheral nervous system and its function is not yet clearly studied. Objective: To analyze the neurophysiological effect of Low level laser irradiation on ulnar nerve MATERIALS AND METHODS: Sixty healthy subjects with age group between 20-30 years of both genders were recruited in this experimental study design.. The procedure was clearly explained to the subjects and informed consent was obtained. They were assigned randomly to either Ga. As.Laser group or Sham laser group. All the subject’s were positioned in supine lying with the irradiated dominant hand kept at 135 degrees of flexion. Ground electrode was placed over the thenar eminence. The subject's skin (electrode placement area) was degreased for proper transmission of laser. Nerve conduction velocity was recorded Antidromically. A 904nm diode laser was used to irradiate the skin overlying the ulnar nerve behind the medial epicondyle of the humerus for 20 secs. The laser was set to deliver continuous energy at 4.0 J/cm².Antidromically action potential, peak to peak amplitude, onset latency, nerve conduction velocity was recorded before and after irradiation of the ulnar nerve. RESULT: The study revealed that there was a significant difference in onset Latency (P=0.0021) but there was no significant difference in Nerve conduction velocity (P=0.2738) and PPA (P=1.0000) between laser group and sham laser group. CONCLUSIONS: Low level laser irradiation of skin overlying the ulnar nerve resulted in a significant increase in latency in this study. This increase in latency corresponds to a decrease in sensory nerve conduction velocity and could help explain the alleged pain relieving effects of low level laser irradiation.

Evaluation of Surface Change and Roughness in Implants Lost Due to Peri-Implantitis Using Erbium Laser and Various Methods: An In Vitro Study

The aim of our study was to obtain similar surface properties and elemental composition to virgin implants after debridement of contaminated titanium implant surfaces covered with debris. Erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser, erbium, chromium-doped:yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser, curette, and ultrasonic device were applied to contaminated implant surfaces. Scanning electron microscopy (SEM) images were taken, the elemental profile of the surfaces was evaluated with energy dispersive X-ray spectroscopy (EDX), and the surface roughness was analyzed with profilometry. Twenty-eight failed implants and two virgin implants as control were included in the study. The groups were designed accordingly; titanium curette group, ultrasonic scaler with polyetheretherketone (PEEK) tip, Er: YAG very short pulse laser group (100 μs, 120 mJ/pulse 10 Hz), Er: YAG short-pulse laser group (300 μs, 120 mJ/pulse, 10 Hz), Er: YAG long-pulse laser group (600 μs, 120 mJ/pulse, 10 Hz), Er, Cr: YSGG1 laser group (1 W 10 Hz), Er, Cr: YSGG2 laser group (1.5 W, 30 Hz). In each group, four failed implants were debrided for 120 s. When SEM images and EDX findings and profilometry results were evaluated together, Er: YAG long pulse and ultrasonic groups were found to be the most effective for debridement. Furthermore, the two interventions have shown the closest topography of the sandblasted, large grit, acid-etched implant surface (SLA) as seen on virgin implants.