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   2015| July-December  | Volume 9 | Issue 2  
    Online since November 26, 2015

 
 
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ORIGINAL ARTICLES
Comparison of labial frenectomy procedure with conventional surgical technique and diode laser
RM Patel, S Varma, G Suragimath, K Abbayya, SA Zope, Vishwajeet Kale
July-December 2015, 9(2):94-99
DOI:10.4103/0976-2868.170565  
Background: An Aberrant frenum encroaches the gingival health when it is attached too closely to the gingival margin, either due to interference in the plaque control or due to a muscle pull. Such condition has to be treated by frenectomy which can be performed by scalpel, electrocautery, or with soft tissue lasers. Hence, the aim of the study is to compare the degree of postoperative pain and healing experienced by patients during frenectomy procedure with surgical scalpel and diode laser technique. Materials and Methods: A total of 20 subjects ranging from 16 to 40 years of age group with papillary or papillary penetrating frenal attachment in the maxillary anterior region were selected. Enrolled subjects were randomly divided into two groups as follows Group A (n = 10): Comprised of 10 subjects selected for conventional scalpel technique. Group B (n = 10): Comprised of 10 subjects selected for diode laser technique. Various parameters such as pain, inflammation, swelling, difficulty of procedure, and wound healing were evaluated at intervals of 1 week, 1 month, and 3rd month. Results: The results indicated patients treated with the diode laser had less postoperative pain (P < 0.0001) and required fewer analgesics (P < 0.001) as compared to patients treated with the conventional scalpel technique. Wound healing at 7th day and after 1 month for both the groups showed statistical significant difference with better outcome in Group A. However, wound healing at the end of 3 months did not show any significant difference between the groups. Conclusion: Based on current findings and clinical outcome, diode lasers provide better patient perception and an efficient and satisfactory option for procedures such as frenectomy.
  7 12,435 1,517
Design and implementation of noninvasive laser imaging system for human teeth carious detection and removal
Yasser H El-Sharkawy
July-December 2015, 9(2):80-88
DOI:10.4103/0976-2868.170563  
Background: Knowledge of heat transfer in biological bodies has many diagnostic and therapeutic applications involving either raising or lowering of temperature, and often requires precise monitoring of the spatial distribution of thermal histories that are produced during a treatment protocol. Aim: This paper, therefore, aims to design and implementation a laser therapeutic and imaging system used for carious tracking and drilling by developing a mathematical algorithm using Hilbert transform for edge detection of photothermal imaging. Photothermal imaging has the ability to penetrate and yield information about an opaque medium well beyond the range of conventional optical imaging. Method: Owing to this ability, Q-switching neodymium-doped yttrium aluminium garnet laser at wavelength 1064 nm has been extensively used in human teeth to study the subsurface deposition of laser radiation. Results: The high absorption coefficient of the carious as compared to the normal region contributes to a greater increase in temperature generating infrared thermal radiation captured by the high resolution thermal camera. Changing the pulse repetition frequency of the laser pulses affects the penetration depth of the laser, which can provide three-dimensional images in arbitrary planes and allow imaging deep within a solid tissue. Conclusions: Photothermal imaging with 2-D Hilbert transform algorithm is a powerful tool for human carious detection
  6 2,983 283
Comparative study of diode laser 940 nm in performing frenectomy in both: Continuous and pulsed modes: An in vivo study
Aws A Al-Khatib, Asmaa S Al-Azzawi
July-December 2015, 9(2):50-68
DOI:10.4103/0976-2868.158461  
The Objectives of this Study: The objective of the study was to evaluate the efficiency of diode laser 940 nm in both, continuous and pulsed modes. Then compare the outcomes of frenectomy procedure, and find the best mode that satisfies the patient's and the surgeon's criteria. Materials and Methods: This study was carried out on 14 patients of which 7 were males and 7 were females with age range from 7 to 46 years. Patients underwent diode laser-assisted frenectomy in continuous wave (CW) mode with power ranging from 1.5–3 W and pulsed mode, which was subdivided into comfort pulse 0 (CP0) with 6–10 W peak power; 1.2–2 W average power and CP2with 2–10 W peak power; 1–5 W average power. Anesthesia method and need, the duration of surgery and intraoperative bleeding events were recorded in all cases. In addition, patient preoperative fear, perception and comments were reported. Ratings of the postoperative pain and the functional complications for each patient in a questionnaire survey were reported using the Wong-Baker FACES Pain Rating Scale at operation day throughout the 1st week postoperatively. All patients were examined at 2, 7, and 21 days after the operation in order to assess the surgical wound healing. Results: In the clinical study, seven patients were operated on without infiltration anesthesia (only spray anesthesia) in the pulsed mode while in CW-mode only one patient operated on with spray anesthesia in low power. Intraoperative bleeding events were bloodless to oozing. There was no preoperative fear; patients' perceptions were comfortable with satisfactory comments except in CW cases and some of the CP0 cases. Severe postoperative complications were absent in all subjects. The reported survey results indicated that the patients treated with the laser had normal day activity on operation day, less postoperative pain and fewer functional complications were noticed in the CP2mode. The surgical wound healing was within normal limits in 7–14 days. Carbonization was the main feature of cases treated with CW-mode while it was mostly absent in the pulsed mode. Conclusion: The use of CW-mode of diode laser can be considered no more suitable for performing oral soft tissues surgery. The pulsed mode was found more practical, effective and easy to carry out incisions, cuttings with less intra and postoperative complications considering its advantages in the clinical cases. The CP2pulsed mode laser treatment offers a safe, effective, acceptable, with impressive outcomes particularly for young patients.
  3 9,572 1,829
The effect of 808 nm diode laser irradiation on shear bond strength of composite bonded to dentin before and after bonding
Mohammadreza Malekipour, Farnoosh Alizadeh, Farzaneh Shirani, Shahram Amini
July-December 2015, 9(2):69-74
DOI:10.4103/0976-2868.158465  
Objectives: As bonding ability to tooth surface is an important factor in durability of composite restorations, the aim of this in vitro study was to evaluate the effect of 808 nm diode laser irradiation with different power outputs on the shear bond strength of composite bonded to the dentin before and after applying the bonding agent. Materials and Methods: A total of 35 healthy third molars were mounted in acrylic resin in a way that each molar had two test sites and divided into seven groups of 10 each. In the control group, the bonding agent was used without laser application. An 808 nm diode laser with different power outputs of 0.5, 1 and 1.5 W for a duration of 20 s was irradiated perpendicularly to the dentin surfaces in three of the experimental groups before and in the other three groups after applying the bonding agent. After composite cylinders had been adhered, they were examined to determine their shear bond strength. Results: According to the least significant difference test, the bond strength mean significantly higher in the control group (P < 0.001) and in all laser power outputs, the mean bond strength was significantly higher in the groups for which laser was irradiated before applying the bonding agent than the groups for which laser was irradiated after applying the adhesive (P < 0.05). Conclusion: Considering the higher bond strength in the control group, it seems that applying laser does not increase the bond strength of composite to the dentin.
  2 3,586 299
A randomized controlled clinical trial on efficacy of photodynamic therapy as an adjunct to nonsurgical treatment of chronic periodontitis
Suryakanth Malgikar, S Harinath Reddy, P Raja Babu, S Vidya Sagar, P Sunil Kumar, G Jagdish Reddy
July-December 2015, 9(2):75-79
DOI:10.4103/0976-2868.170562  
Background and Objectives: In recent years, there has been a growing interest in the use of dental lasers for treatment of periodontal diseases. Recent preclinical and clinical data have suggested a potential benefit of photodynamic therapy (PDT) in the treatment of periodontitis. Aim: The aim of this study was to evaluate the clinical efficacy of PDT as an adjunct to nonsurgical mechanical therapy (SRP) in the treatment of chronic periodontitis. Materials and Methods: In a single-centered randomized and controlled clinical trial, 24 patients with untreated chronic periodontitis were assigned in a split-mouth design into two treatment groups which included: Group I: SRP only (control group), Group II: SRP and PDT (1% methylene blue solution) (test group). Clinical parameters such as plaque index (PI), gingival index (GI), modified sulcular bleeding index (mSBI), probing depth (PD), and clinical attachment level (CAL) were measured at baseline, 1, 3 and 6 months after therapy. Results: Inter-group and intra-group statistical analyses were performed. The improvement in clinical parameters was significantly greater in Group II as compared to Group I. The mean PD (mm) reduction from baseline to 6 months in Group I was 2.50 ± 0.54, Group II was 2.57 ± 0.53. The mean CAL (mm) gain from baseline to 6 month in Group I was 2.63 ± 0.47, Group II was 2.55 ± 0.44. A statistically significant decrease in PI, GI, mSBI scores was seen in Group II at the end of 6 month (P < 0.001). Conclusion: The present study suggests that an additional application of single episode of PDT could be beneficial adjunct to nonsurgical treatment of chronic periodontitis in terms of clinical parameters as compared to scaling and root planing. Direct subgingival delivery of methylene blue in different concentrations should be performed to further investigate the potential antimicrobial effect of soft lasers in the human periodontal disease.
  2 3,398 459
CASE REPORTS
Oral proliferative verrucous leukoplakia with oral submucous fibrosis treated with CO2laser
Reenesh Mechery, Manoj Kumar, Piyush Arora, T Rajkamal, Nithya Dinakar
July-December 2015, 9(2):100-103
DOI:10.4103/0976-2868.158462  
Oral leukoplakia is one of the most common physiologic as well as pathologic white lesion in the oral cavity. Of the many variants, oral proliferative verrucous leukoplakia (OPVL) is a rare clinicopathological entity of unknown etiology. OPLV initially develops as a white hyperkeratotic plaque that eventually becomes a multifocal disease with confluent, exophytic and proliferative features. Published case series with long-term follow-up describes OPVL as a disease with aggressive biological behavior due to its high probability of recurrence and a high rate of malignant transformation. This article describes a rare case report of OPVL associated with oral submucous fibrosis in the light of current information with clinical and histological aspect in a young patient, which was successfully treated with CO2Laser.
  - 6,362 312
Diode laser: An alternative treatment modality for ankyloglossia
Vijayendra Kumar Jain, Gagan R Jaiswal
July-December 2015, 9(2):104-106
DOI:10.4103/0976-2868.158463  
Ankyloglossia or tongue-tie refers to an abnormally short lingual frenulum. Ankyloglossia is a recognized but poorly defined condition and has been reported to cause feeding difficulties, dysarthria, dyspnea, and social or mechanical problems in childhood and adolescence. This article reports a simple, safe, and effective way for management of ankyloglossia associated with restricted movement of the tongue. The treatment involved a diode laser for removal of the lingual frenum, which healed uneventfully. A marked improvement in the movement of the tongue was observed at follow-up visits in the treated case.
  - 2,867 192
Diode laser for treatment of peripheral giant cell granuloma
Jafri Zeba, Nafis Ahmad, Deepika Shukla
July-December 2015, 9(2):107-109
DOI:10.4103/0976-2868.158464  
Peripheral giant cell granuloma (PGCG) is not a true neoplasm but an exophytic benign growth of gingival tissues which has an origin either from periodontal ligament or mucoperiosteum. Clinically, it appears as a solitary nodule which may be sessile or pedunculated, color may vary from pale pink to deep red or purplish blue. The lesion varies widely in size, but usually is between 0.5 to 2 cm in diameter. The treatment is complete surgical excision which can be done either by a scalpel, electrocautery or lasers. This case report presents use of a diode laser aluminum gallium arsenide (denlase 810 nm) in contact mode for the treatment of PGCG. Use of lasers has shown various advantages over the conventional method and is a good treatment option.
  - 2,963 188
Effectiveness of 904 nm gallium arsenide diode laser in treatment of oral lichen planus: Report of two cases
K Patil, PT Bhattacharya, MV Guledgud
July-December 2015, 9(2):110-113
DOI:10.4103/0976-2868.170561  
  - 2,258 169
Diode laser treatment of an oral squamous papilloma of soft palate
PS Rakhewar, Harshal P Patil, Manojkumar Thorat
July-December 2015, 9(2):114-117
DOI:10.4103/0976-2868.170564  
Oral squamous papilloma is one of the most common benign epithelial neoplasm, frequently seen on the tongue, palate, uvula, and gingiva; and found to be associated with human papillomavirus (HPV) 6 and 11. Treatment laser-assisted surgery is common because of several advantages such as successful hemostasis, devoid of sutures, wound sterilization, and minimal postoperative pain and edema. The aim of this report is to present the case of oral squamous papilloma of the soft palate in a 57-year-old male patient and its management with a diode laser.
  - 14,466 417
Application of diode laser for the management of oral verrucous carcinoma mimicking Candidiasis
Kumar Nilesh, Neelima A Malik, Nupura Vibhute, Girish Suragimath
July-December 2015, 9(2):118-121
DOI:10.4103/0976-2868.170566  
Oral verrucous carcinoma (OVC) is a variant of oral squamous cell carcinoma which shows a local invasive pattern without any distant metastases. Accurate diagnosis of OVC depends on a careful association between clinical and histological features of the lesion. This paper reports a case of OVC over mandibular alveolar mucosa, mimicking Candidiasis. Use of diode laser for the management of the lesion is also described.
  - 2,439 195
EDITORIAL
Editor's Message
Naresh Thukral
July-December 2015, 9(2):49-49
DOI:10.4103/0976-2868.170567  
  - 2,425 3,945
ORIGINAL ARTICLES
Evaluation of the effectiveness of low power diode laser with different wavelengths in dental caries prevention
EM Awooda, NA Almuslet
July-December 2015, 9(2):89-93
DOI:10.4103/0976-2868.170568  
Objectives: To investigate the effectiveness of low power diode lasers, with different wavelengths and different irradiation times in caries prevention an ex vivo study. Materials and Methods: True experimental posttest design on 130 extracted human premolar teeth by measuring caries-like lesions examined by polarized light electron microscope after irradiation by four low power diode lasers 532 nm (4 mW), 671 nm (100 mW), 675 nm (30 mW), and 810 nm (20 mW). A fifth group was added as a control (without irradiation). The specimens were prepared by coating the teeth with acid resistance nail varnish leaving uncovered 2 mm × 2 mm of the enamel surface mesially or distally below the contact area. For each wavelength, samples were divided into three groups for three irradiation time as 4, 8, and 12 min; each group consisted of 10 teeth. Irradiated samples and the control were immersed in lactic acid (4.8 pH) and incubated for 21 days under controlled temperature of 37°C and controlled PH of 4.8. After the incubation period, the teeth were sectioned longitudinally by dissecting the 2 × 2 enamel window and the depth of the lesion was measured microscopically. ANOVA test was used to compare between different wavelengths and different irradiation times with level of significant set at P ≤ 0.05. Results: The depth of the caries-like lesions in 810 nm and 675 nm was more than that in control group (180 μm), while statistical significant difference was found (P = 0.002); when the 671 nm and 532 nm lasers wavelengths revealed depth of 70 μm and 112 μm, respectively. Increasing irradiation time decreases the depth of caries-like lesions. Conclusion: Diode laser of wavelengths 532nm and 671 nm showed less depth than control group, indicating caries prevention effect. Increasing irradiation time to a certain value increases resistance to acid dissolution.
  - 2,882 408
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