Clinical parameters in soft tissue adjunctive periodontal procedures for orthodontic patients: surgical laser vs scalpel -: A systematic review

ABSTRACT Objectives To systematically review existing literature regarding clinical parameters comparing surgical laser and conventional surgery with scalpel for soft tissue adjunctive periodontal procedures in orthodontic patients. Methods and Materials MEDLINE, Scopus, Web of Science, The Cochrane Library, LILACS, Bibliografia Brasileira de Odontologia (Brazilian Dental Literature - BBO), Embase, Open Grey, Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Coordination for the Improvement of Higher Education Personnel - CAPES), and Google Scholar were searched up to December 2020 without language restriction. Clinical trials comparing clinical parameters from surgical laser and conventional surgery with scalpel for soft tissue adjunctive periodontal procedures in orthodontic patients were selected. Risk of bias (RoB) assessments were performed using the Cochrane RoB2 tool. Narrative syntheses were performed, and the certainty of evidence was determined using the GRADE tool. Results Five randomized clinical trials were included. One study was rated as low RoB, whereas others presented some concerns or high RoB. The studies were highly heterogeneous in relation to the procedure performed, laser protocol, outcomes evaluated, and follow-up periods. In general, regardless of the procedure and laser protocol used, the studies did not show significant differences between laser and scalpel for the outcomes of probing pocket depth, clinical crown length, gingival index, and relapse rate. Pain and bleeding were significantly lower with the use of laser compared with the scalpel. The certainty of evidence ranged from moderate to very low. Conclusions The existing literature on the subject is scarce and very heterogeneous and has methodological limitations. Based on the available evidence, it is not possible to draw definitive conclusions about the beneficial effect of laser use in orthodontic patients.

The use of protective red light filter glasses as a m ethod of preventing the development and progression of retinopathy of prematurity, based on the phenomenon of preconditioning photostimulation

Purpose. To study the possible effect of protective red light filter glasses as a method of preventing retinopathy of prematurity, based on the phenomenon of preconditioning photostimulation. Material and methods. For this study, we selected 20 children (40 eyes) from 26.5 to 36 weeks of gestational age and a birth weight of 650 to 2650 grams. All children were divided into 2 groups – the main and control groups of 10 children (20 eyes) each. Results. In the main group of the study, with the use of protective red light filter glasses, the best indicators of the electroretinogram were noted. Conclusions. The use of glasses with red protective light filters-as a method based on the phenomenon of preconditioning photostimulation, is a simple and affordable method of preventing retinopathy of prematurity, which reduces the need for surgical laser treatment and the number of adverse outcomes of this disease. Key words: retinopathy of prematurity, methods of prevention of retinopathy of prematurity.

Efficacy of Surgical Laser Diode Therapy in the Management of Labial and Lingual Frenectomy

A frenum, a triangle-shaped fold of tissue connects the lip, tongue and buccal musculature to the alveolar bone in the oral cavity. Any abnormalities in the size and location of the frenum can cause functional and esthetic problems which require surgical excision. Frenectomy can be accomplished either by the routine scalpel technique, or by using lasers such diode laser. The 1st case is an 8-year-old healthy boy with the chief complaint of spacing between his upper front teeth and a palatoversion of the left central incisor. Intraoral clinical examination revealed the presence of midline diastema (1 mm) with high, fibrous labial frenal attachment. The 2nd case is a 6-year-old boy consulted with the complaint of difficulty in speech associated to the limitations of the lingual movements. Intraoral examination revealed partial ankyloglossia. The 2 cases, the frenectomy was then made with 980 nm diode laser.

Multiple Inflammatory Fibrous Hyperplasia in Upper Lip: A Case Report

Aims: This study aimed to report a case of multiple inflammatory fibrous hyperplasia in the upper lip, resulting from the association of lip sucking habit and the use of orthodontic appliance, treated with high-powered laser. Presentation of Case: A 42 years-old male patient, anxious, presented with five lesions in upper lip in close contact with dental appliance. Also, he had a habit of sucking his lip. After the removal of the appliance, it was performed a surgery using a diode laser (Thera Lase Surgery λ=808 nm, P=2.5 W). Discussion: The removal of the traumatic etiological agent is essential for the treatment of proliferative lesions, such as hyperplasias. After removal, if there is no complete regression of a small hyperplasia, surgical removal will be necessary. Diode surgical laser is a good alternative, due its advantages. Conclusion: It is very important to advise patients with harmful habits, as lip sucking, that with the persistence of the habit, new lesions will arise again. Monitoring psychological factors is also essential.

Laser uses in endodontic therapy. Literature Review

Lately, the use of laser in endodontics has gained acceptance, being considered as a complement to endodontic therapy, which aims to carry out an effective shaping, cleaning and disinfection of the root canal system (RCS), allowing an effective elimination of microorganisms present, and thus prevent reinfection of the canal. Different laser application methods have been adopted to improve the disinfection of the RCS, which could be effective in reducing the microbial population present inside the canals, by activating the irrigant used. The use of laser could also be useful in surgical endodontic procedures which aim to maintain the tooth and its roots when conventional treatment has failed, the positive effects of laser would focus on reducing inflammation and increasing volume, in addition of the reduction in the filtration of orthograde seal materials in apicoectomized teeth. Another use of laser in this area is related to post-endodontic therapy pain management, which has shown promise. Two types of lasers are defined; low-power, which produces a biostimulant, analgesic and anti-inflammatory action of biological tissues, also used in RCS decontamination processes, and high-power or surgical laser, with which incisions, excision, performing cutting functions and coagulation.

Evaluating the utility of a CO2 surgical laser for piglet castration to reduce pain and improve wound healing: a pilot study

CO2 surgical lasers are widely used for procedures in veterinary and human medicine. There is evidence to suggest surgery using a CO2 laser reduces pain and swelling and improves healing time compared with surgery with a scalpel. Millions of piglets in North America are surgically castrated each year using a scalpel. Therefore, piglet welfare may be improved by making refinements to the surgical procedure. The objectives of this preliminary study were to determine the ability of a CO2 surgical laser to (1) reduce pain and (2) improve wound healing of piglets undergoing surgical castration. Two-day-old male Yorkshire × Landrace piglets were used and randomly assigned to 1 of 3 treatments (n = 10 piglets/treatment group): surgical castration with the CO2 laser, surgical castration with a scalpel, or sham (uncastrated control). Piglets were video recorded in their pens for 1 hr preprocedure and from 0 to 2, 6 to 8, and at 24 hr postprocedure for behavior scoring. Surgical site images were collected at baseline, 0, 8, 24, 48, 72, 96, 120, 144, and 168 hr postcastration for wound healing assessment. Infrared thermography images of the surgical site were also taken at baseline, 0, 0.5, 8, and 24 hr postprocedure to assess inflammation. Finally, blood was collected from each piglet at baseline and 0.5 hr postcastration to assess cortisol levels, prostaglandin E metabolite and pig-major acute phase protein concentration. Laser-castrated piglets displayed more pain behaviors across the observation period than scalpel-castrated piglets (P = 0.05). Laser-castrated piglets also displayed significantly more agonistic behavior than both scalpel-castrated piglets (P = 0.005) and sham piglets (P = 0.036); yet, laser-castrated piglets had significantly lower temperatures at the site of incision compared with scalpel-castrated piglets (P = 0.0211). There was no significant difference in wound healing or any of the blood parameters assessed between laser-castrated and scalpel-castrated piglets. There was evidence of thermal tissue damage on the scrotum of piglets that were castrated using the CO2 laser. This may have resulted in the unremarkable healing time and the increased pain behavior observed in this study. The surgical laser technique should be refined before conclusions can be made regarding the utility of a CO2 laser for piglet castration.