Enhanced Postablative Laser Skin Healing with a Regenerative Skincare Formulation: a Comparative Randomized Evaluator-Blinded Clinical Study.

To assess and compare children's anxiety level and pain perception during cavity preparation using an erbium-doped yttrium aluminum garnet (Er:YAG) laser vs traditional rotational treatment. A randomized, controlled, split-mouth clinical trial was carried out in 35 healthy children with 70 carious primary molars. Teeth were divided equally into two groups according to the method of treatment. A bur was used to prepare the cavity in one quadrant, while an Er:YAG laser was used to prepare the cavity in the other quadrant. Anxiety was assessed using Venham's dental anxiety scale and a fingertip pulse oximeter. The pain was assessed using the Wong-Baker Face Pain Rating Scale, and the number of local anesthesia (LA) needed during both procedures was also considered. The mean age was 9.4 ± 1.29. Males accounted for 51.4% of the participants. There were no statistically significant variations in pulse rate at the baseline between Er:YAG laser and the conventional treatments. The mean pulse rate was higher during the conventional intervention than during the laser intervention; this difference was statistically significant vs the baseline pulse rate. The mean pulse rate with the conventional method was significantly higher during and after cavity formation than with the laser method. The Er:YAG laser and the conventional groups showed statistically significant differences in the Venham's and Wong-Baker scores. The scores of both scales were much higher in the conventional group. The number of participants who requested LA during the conventional technique was significantly higher than during the laser procedure. Using Er:YAG lasers to remove caries produces minimal pain and anxiety and reduces the requirement for LA. During cavity preparation, the Er:YAG laser helps children stay calm. Abdrabuh RE, El Meligy OAES, Felemban OM, et al. Evaluation of the Erbium-doped Yttrium Aluminum Garnet Laser and the Conventional Method on Pain Perception and Anxiety Level in Children during Caries Removal: A Randomized Split-mouth Study. Int J Clin Pediatr Dent 2023;16(S-1):S39-S44.

To evaluate efficacy and safety of the FotonaSmooth device in treatment of SUI (stress urinary incontinence) patients after treating them with Er: YAG laser using both objective and patient-reported outcomes. Stress urinary incontinence (SUI) is a leakage of urine during moments of physical activity that increases abdominal pressure, such as coughing, sneezing, laughing, or exercise. It is most common seen health problem among women of certain age and it is most common type of urinary incontinence in women. Here, SUI is treated using intravaginal laser therapy by using non ablative Er: YAG (erbium-doped yttrium aluminium garnet) laser with SMOOTH mode technology.: The 96 parous women with SUI were treated according to IncontiLaseclinical treatmentprotocol by using non-ablative Er: YAG (erbium-doped yttrium aluminium garnet) laser with SMOOTH mode technology at Vcare laser centre state of art centre for cosmetic gynaecology, Indore, Madhya Pradesh. At baseline, at 2 months and at 9 months after treatment patients were clinically examined, answered questionnaires for SUI severity and sexual function assessment. King‘s Health Questionnaire (KHQ); UDI-6 (Urogenital Distress Inventory, Short Form) Questionnaire; 3D Voiding Diary ;Satisfaction Questionnaire (0-3) which was used for assessment of relief of symptoms (complaints) and satisfaction. Patients were monitored for side-effects and discomfort during treatment period and follow-up period.A total of 96 patients suffering from mild-to-moderate stress urinary incontinence underwent treatment with an Er:YAG (2940 nm) laser in non-ablative fractional mode, which requires 2-3 sessions with one month interval (Out of 96 patients- 96 patients completed the first session; 72 patients completed two sessions and 30 patients completed three sessions). Out of which 75% patients were very satisfied with the treatment and outcome. The Enrolment of study participants was started in September 2017 and completed in April 2019.The non-ablative Er: YAG laser therapy improves the impact of SUI symptoms in parous women significantly better than placebo by improving the quality of life and sexual function; it also provides a promising minimally invasive safe treatment for stress urinary incontinence (SUI) confirmed by the preliminary results.

To determine how Erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiation affects the proliferation and transcriptional programs of MLO-Y4 osteocyte-like cells. Although Er:YAG lasers are widely used in periodontal hard tissue therapy, how they affect osteocytes remain elusive. MLO-Y4 cells were seeded before 72 h Er:YAG laser irradiation at energy fluences of 3.1, 6.0, and 8.9 J/cm2. Cell surface temperature and Hspa1a expression were measured to evaluate thermal effects. Cell proliferation and cytotoxicity were assessed by the Cell Counting Kit-8 (CCK-8) and lactate dehydrogenase (LDH) assays. RNA sequencing (RNA-seq) was performed 6 h after 6.0 J/cm2 laser irradiation versus nonirradiated controls. According to surface temperature and Hspa1a expression, no major thermal effects were observed at 6.0 J/cm2. The CCK-8 assay revealed significantly increased proliferative activity, although LDH levels were slightly but significantly increased at 6.0 J/cm2 laser irradiation. RNA-seq identified 337 differentially expressed genes (DEGs). Expression of mechanical stimulation-associated genes, including Epha2, Itga5, and Tcf7, was highly upregulated in the laser-irradiated cells. Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed upregulation of the PI3K-Akt signaling pathway in the laser-irradiated cells. Upregulated DEGs belonged to the "euchromatin" cellular component Gene Ontology term in the laser-irradiated cells. Gene set enrichment analysis showed enrichment of the Transforming Growth Factor Beta (TGF-β) signaling gene set and downregulation of mechanistic target of rapamycin (mTORC1) signaling gene set in the laser-irradiated cells. Er:YAG laser irradiation at 6.0 J/cm2 promotes MLO-Y4 osteocyte-like cell proliferation via altering gene expression, possibly by activating PI3K-Akt and TGF-β signaling while suppressing mTORC1 signaling.

In recent years, fractional ablative lasers at low density have proven to be the centerpiece in a multimodality approach to treating hypertrophic burn scars. To determine the safety and efficacy of fractional ablative erbium-doped yttrium aluminium garnet (Er:YAG) laser in the treatment of hypertrophic burn scars. Eleven patients received 3 fractional ablative Er:YAG laser to hypertrophic burn scars at 400 to 800 μm, density 11%, no coagulation, and single pass at 4-week intervals. Overall, average improvement was noted to be 2.27 of 3 as determined by blinded observers. A significant improvement was noted in all measured parameters including dyschromia, atrophy hypertrophy, vascularity, and texture. This is a pilot study showing the safety and efficacy of fractional ablative Er:YAG laser treatment is a safe and effective treatment modality in the treatment of hypertrophic scars.

In this study, shear bond strength (SBS) of metal orthodontic brackets to porcelain following conditioning by Er:YAG (erbium-doped yttrium aluminum garnet) and Nd:YAG (neodymium-doped yttrium aluminum garnet) laser in comparison to conventional methods was evaluated. One hundred glazed porcelain discs with an upper central shape were prepared and randomly assigned to five equal groups of 20. In the first group, samples were only deglazed and roughened by diamond burs. In the second group, after roughening and deglazing of porcelain samples, the samples were etched by 9.6% hydrofluoric acid for 4 min. Groups, 3, 4, and 5 were prepared by 0.8-W Nd:YAG laser, 2-W Er:YAG laser, 3-W Er:YAG laser for 10 s, respectively. Then, metal, mesh-based brackets were bonded to porcelain samples, and after being stored in distilled water for 24 h, debonding was carried out by a Zwick testing machine. ANOVA and Tukey tests were used to compare SBS in five groups. Mean SBS in groups 1 to 5 were 3.3 ± 1.6, 7.0 ± 2.1, 6.9 ± 2.7, 2.3 ± 1.1, and 3.7 ± 2.3 MPa, respectively. ANOVA test revealed a significant difference between five groups (p < 0.05). Although Tukey's test showed SBS in groups 2 and 3 were significantly higher than the other groups, they did not differ with each other significantly (p > 0.05). The results revealed that SBS of 9.6% hydroflouric acid and Nd:YAG Laser was in an acceptable range for orthodontic treatment. Nd:YAG laser was shown to be an acceptable substitute for hydrofluoric acid while Er:YAG laser with the mentioned power and duration was not a suitable option.

ObjectivesNd:YAG and Er:YAG lasers have been previously used as an adjunct in periodontal therapy. The aim of this single-blinded randomized controlled clinical trial was to evaluate the efficacy of a combined application of Nd:YAG and Er:YAG laser irradiation in periodontal treatment.Materials and methodsTwenty-two patients with at least one site of ≥ 6 mm periodontal probing depth (PPD) after mechanical debridement with curettes and sonic instruments at periodontal reevaluation were included in the study. Patients were randomly allocated at a 1:1 ratio to either a combined Nd:YAG/Er:YAG laser therapy (test group) or a “turned off” laser therapy (control group). The Nd:YAG laser was used for periodontal pocket deepithelialization and to stabilize the resulting blood clot. The Er:YAG laser was primarily used for root surface modification. PPD (mm), clinical attachment level (CAL, mm), and bleeding on probing (BOP, +/−) at the site of laser treatment were evaluated at baseline and 2 months after treatment.ResultsThe mean improvements from baseline to 2-month follow-up for PPD were significantly better in the laser group (2.05 ± 0.82 mm) compared to the control group (0.64 ± 0.90 mm; p = 0.001). Likewise, the gain in CAL was significantly better in the laser group (1.50 ± 1.10 mm) than in the control group (0.55 ± 1.01mm; p = 0.046).ConclusionsThe combined application of Nd:YAG and Er:YAG laser irradiation as an adjunct to conventional non-surgical therapy showed a significant beneficial effect on periodontal treatment results.Clinical relevanceCombined Nd:YAG and Er:YAG laser irradiation could be a useful procedure additionally to conventional non-surgical periodontal therapy to improve periodontal treatment results.Clinical trial registrationISRCTN registry #ISRCTN32132076

Objective: The purpose of this review is to systematically assess the existing literature and summarize the evidence regarding the effect of erbium-doped yttrium aluminum garnet (Er:YAG) laser on enamel surface roughness and pulp health compared with the conventional orthodontic debonding techniques. Materials and methods: Following the preferred reporting items for systematic reviews (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement, the electronic database, PubMed, Scopus, Web of Science, Google scholar, and Saudi Digital Library were searched for relevant published records. Data were collected following specific keywords: "debonding" "Er:YAG laser" etc. In vitro studies, and clinical randomized- and nonrandomized-controlled studies limited to the English language and published in peer-reviewed journals were included. Results: A total of 564 articles were identified as relevant to the topic. Duplicates were excluded resulting in 382 articles, out of which 374 articles were discarded upon screening titles and abstracts. The remaining eight articles were read to their entirety and included in the current qualitative review after fulfilling the eligibility criteria. In all the included studies, a total of 480 sound posterior teeth were used to evaluate the effect of Er:YAG laser on debonding of orthodontic brackets from the enamel surface. Conclusions: Er:YAG laser debonding has demonstrated a reduced risk of enamel damage (fracture or cracks) but resulted in increased enamel surface roughness and was time-consuming for adhesive removal procedures compared with the conventional debonding methods. Further, within the applied laser settings, Er:YAG lasers have found to exhibit low thermal exhaustion in relation to the pulp. The laser source with a wavelength of 2940 nm has been used with different setting ranges (power of 2.5-5 W, energy 125-600 mJ, frequency 4-30 Hz, and pulse duration 50-350 μsec) for debonding of orthodontic brackets.

Objective:This study aimed to assess the efficacy of erbium-doped yttrium aluminum garnet (Er:YAG) laser, pastes containing casein phosphopeptide amorphous calcium phosphate (CPP-ACP) with and without fluoride and their combination for prevention of white spot lesions in the enamel.Materials and Methods:This in vitro experimental study was conducted on 90 extracted sound premolars. The teeth were then randomly divided into six groups of 15: (1) Control, (2) laser, (3) CPP-ACP with fluoride (GC MI Paste, Recaldent™ 900 ppm as NaF), (4) CPP-ACP without fluoride (GC Tooth Mousse Recaldent™), (5) laser + CPP-ACP with fluoride, and (6) laser + CPP-ACP without fluoride. In each group, enamel surface was exposed to the remineralizing agent. The teeth were then subjected to pH cycling for 14 days. The teeth were then sectioned, polished, and underwent cross-sectional microhardness testing at 20–160 μ depth quantitatively. Using the Simpson's rule, the amount of mineral loss was calculated in each group. Statistical Analysis Used: ANOVA was used for the comparisons, and Tukey's test was applied for pairwise comparisons.Results:The highest mean volume percentage of microhardness at 20–60 μ depth belonged to the group laser + CPP-ACP with fluoride and the lowest belonged to the control group (P = 0.001). The differences were not significant at 80-120 μ depth (P > 0.05). These finding are confirmed according to △Z (mineral loss).Conclusion:Based on these results, Er: YAG laser was able to decrease demineralization and was a potential alternative to preventive dentistry and was more effective when combined with CPP-ACP products.

This study aimed to identify the optimal technological parameters for rebonding zirconia brackets treated using an erbium-doped yttrium aluminum garnet (Er:YAG) laser. Er:YAG lasers with varying energies were compared with the flaming and sandblasting treatment methods. Detached zirconia brackets were treated and evaluated for shear rebond strength, bracket bottom-plate morphology, position, and depth of microleakage. They were then treated for rebonding using flaming, sandblasting, or an Er:YAG laser set at 250-mJ, 300-mJ, 350-mJ energy. Their shear rebond strength were measured using microforce tester. The topography of the treated bottom plates were observed using scanning electron microscopy. A confocal laser scanning microscope was used to measure the depth of the joint and gingival-side microleakage at the bracket-adhesive (B-A) and enamel-adhesive interfaces. With 300 mJ Er:YAG laser treatment, the detached zirconia brackets can obtain good rebonding strength and minimize the shape change of bracket bottom plates; the adhesion of the B-A interface is better than other methods.

The purpose of this study was to investigate the effects of carbon dioxide (CO2) and Erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiations on the shear bond strength (SBS) of differently sintered zirconia ceramics to resin cement. Eighty zirconia specimens were prepared, sintered in two different periods (short = Ss, long = Ls), and divided into four treatment groups (n = 10 each). These groups were (a) untreated (control), (b) Er:YAG laser irradiated with 6 W power for 5 sec, (c) CO2 laser with 2 W power for 10 sec, (d) CO2 laser with 4 W power for 10 sec. Scanning electron microscope (SEM) images were recorded for each of the eight groups. Eighty composite resin discs (3 × 3 mm) were fabricated and cemented with an adhesive resin cement to ceramic specimens. The SBS test was performed after specimens were stored in water for 24 h by an universal testing machine at a crosshead speed of 1 mm/min. Data were statistically analyzed with two way analysis of variance (ANOVA) and Tukey honest significant difference (HSD) test (α = 0.05). According to the ANOVA, the sintering time, surface treatments and their interaction were statistically significant (p < 0.05). Although each of the laser-irradiated groups were significantly higher than the control groups, there was no statistically significant difference among them (p > 0.05). Variation in sintering time from 2.5 to 5.0 h may have influenced the SBS of Yttrium-stabilized tetragonal zirconia polycrystalline (Y-TZP) ceramics. Although CO2 and Er:YAG laser irradiation techniques may increase the SBS values of both tested zirconia ceramics, they are recommended for clinicians as an alternative pretreatment method.

The erbium-doped yttrium aluminum garnet (Er:YAG) laser is used to treat periodontal disease; however, its effectiveness at killing oral bacteria is not well known. Furthermore, the compounding effect of the combination of a laser treatment and irrigation methods with antimicrobials on bacterial viability is yet to be determined. The purpose of this in vitro study was to evaluate the effect of the Er:YAG laser with irrigation using chlorhexidine (CHX), hydrogen peroxide (H2O2), or sodium hypochlorite (NaOCl) on the viability of oral bacteria. Three bacterial species were used in our study: Streptococcus gordonii, Fusobacterium nucleatum, and Porphyromonas gingivalis. Bacteria were grown in an anaerobic chamber in brain heart infusion broth and incubated at 37 °C. Bacterial samples with an OD of 0.5 were irradiated with the Er:YAG laser at 2940 nm using a 400-µm Varian tip. The experiment was repeated four times using these parameters: 40 mJ, 40 Hz, and 1.6 W for 20 seconds with the 300 µs short pulse duration in contact mode. Treatment groups consisted of the following: (1) no treatment, (2) 0.5% H2O2 alone, (3) 0.5% NaOCl alone, (4) 0.03% CHX alone, (5) Er:YAG irradiation alone, (6) Er:YAG irradiation with 0.5% H2O2, (7) Er:YAG irradiation with 0.5% NaOCl, and (8) Er:YAG irradiation with 0.03% CHX. Microbial viability was determined through plating and colony counts and calculated into CFU/ml. Statistical analysis was done using a two-tailed paired t-test. The use of the Er:YAG laser alone failed to show statistically significant antibacterial activity against any of bacteria. The most effective mono-treatment with irrigation solutions for all three bacteria were 0.5% H2O2 and 0.5% NaOCl (p < 0.001 for each solution). Irrigation with 0.03% CHX was most effective against F. nucleatum (p < 0.01) and less against P. gingivalis and S. gordonii and showed the least antibacterial action alone but improved significantly in combination therapy (p < 0.05). The combined treatment with the Er:YAG showed the greatest and most significant improvement in the reduction of bacterial viability compared to any other treatment group (p < 0.05 for each combined treatment). Irradiation with the Er:YAG laser with the addition of 0.5% H2O2, 0.5% NaOCl, or 0.03% CHX under a short working time (20 s) resulted in a significant reduction of bacterial viability for all three bacterial species compared with any single treatment option. The combination of irradiation with the Er:YAG laser with the addition of 0.5% H2O2, 0.5% NaOCl, or 0.03% CHX resulted in a larger reduction of bacterial survival when compared to monotherapies with antimicrobial solutions or laser. The combination of the Er:YAG laser with a low concentration irrigant solution of 0.5% H2O2, 0.5% NaOCl, or 0.03% CHX could be an effective treatment protocol for the reduction of periodontal pathogens and thus suitable treatment for non-surgical periodontal therapy.

The aim of this study was to investigate the effect of different surface pretreatment methods on the bond strength of veneering resin to polyetheretherketone (PEEK) based aesthetic frameworks. Five hundred and forty PEEK disks were fabricated and divided into 6 pretreatment groups (n = 90); (C) untreated control group, (B) airborne-particle abrasion, (S) silica coating, (L) etching with Er:YAG (erbium-doped yttrium aluminium garnet) laser, (LB) etching with Er:YAG laser and airborne-particle abrasion and (LS) etching with Er:YAG laser and silica coating. After topographical surface examinations, specimens were conditioned with adhesive and veneering resin was polymerized onto the PEEK specimens. Twenty-four hours after veneering, specimens were subjected to thermal aging. Afterwards, shear bond strength (SBS) tests were performed and the obtained data were analyzed with one-way ANOVA and Tukey test at a significance level of α = .05. Group B (1.58 ± 0.15 μm), Group L (1.79 ± 0.29 μm), Group LB (2.20 ± 0.23 μm) and Group LS (2.31 ± 0.52 μm) demonstrated significantly higher surface roughness (SR) values compared to Group C (1.03 ± 0.11 μm). Group B (10.97 ± 2.88 MPa), Group S (12.07 ± 2.82 MPa), Group LB (12.09 ± 2.08 MPa) and Group LS (13.14 ± 1.45 MPa) demonstrated significantly higher SBS values compared to Group C (6.35 ± 1.21 MPa). Airborne-particle abrasion, silica coating or their combined use with Er:YAG laser system establish durable bond between PEEK and resin; however, only Er:YAG laser treatment has no positive effect on resin-PEEK bond.

Introduction: Repair of old composite restorations is a conservative approach. This study sought to compare the effects of two adhesive systems on the bond strength of repaired composites prepared by three different surface treatments: erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiation, air-abrasion, and bur preparation. Methods: Eight microhybrid (Polofil Supra, VOCO, Germany) composite resin blocks were fabricated. The blocks were aged and assigned to four groups as stated by the surface treatment: (I) air-abrasion (50 µ aluminum oxide particles), (II) diamond bur (fine grit), (III) Er:YAG laser (3 W output power, 300 mJ energy) and (IV) control. After surface treatment, the blocks were acid-etched and salinized. Each group was divided two subgroups, and the Clearfil SE Bond or All-Bond Universal was applied on their surface. Composite resin was bonded to the aged composites. The blocks were cut into eight samples, and the microtensile bond strength (MTBS) was measured. Results: The maximum MTBS was noted in the air-abrasion (25.1+6 MPa) group, followed by the Er:YAG laser (21.2+4.7 MPa). The mean MTBS in laser and air-abrasion groups was significantly higher than that in other groups (P<0.05). The mean MTBS was not significantly different between the laser and air-abrasion groups (P>0.05). Composite resin conditioning by All-Bond Universal in laser and air-abrasion groups yielded significantly higher MTBS than the Clearfil SE Bond (P<0.05). Conclusion: All surface treatments created acceptable bond strength. The surface treatment of the aged composite by the Er:YAG laser or air-abrasion along with the application of silane and All-Bond Universal provide high bond strength.

Objectives: This study assessed the effects of two remineralizing agents namely MI Paste Plus containing casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACFP) and Remin Pro containing hydroxyapatite, fluoride and xylitol (HFX) with/without erbium-doped yttrium aluminium garnet (Er:YAG) and CO2 laser irradiation on demineralized enamel microhardness. Materials and Methods: In this in vitro study, 70 sound human premolars were mesiodistally sectioned, demineralized at a pH of 4.6 for 8 hours, and randomly divided into 7 remineralization groups (n=10): of (I) MI Paste Plus (CPP-ACFP), (II) Remin Pro (HFX), (III) MI Paste Plus+CO2 laser (0.7 W power, 50 Hz), (IV) Remin Pro+CO2 laser, (V) MI Paste Plus+Er:YAG laser (1 W power, 10 Hz), (VI) Remin Pro+Er:YAG laser, and (VII) negative control. The Vickers hardness number of specimens was then measured. The groups were compared by one-way ANOVA and Tukey's test (α=0.05). Results: The mean microhardness was 319.8±49.9, 325.3±44.6, 359.4±35.7, 296.4±33.7, 319.9±58.1, 358.9±28.4, and 240.0±41.6 kg/mm2 in groups 1 to 7, respectively. The difference in microhardness was significant among the groups (P<0.0001). Pairwise comparisons revealed significant differences in microhardness between all groups (P≤0.03) except between groups 1 and 2, 1 and 5, 2 and 5, and 3 and 6 (P>0.05). Conclusion: Both Remin Pro (containing HFX) and MI Paste Plus (containing CPP-ACFP) can cause enamel remineralization. MI Paste Plus+CO2 laser irradiation and Remin Pro+Er:YAG laser irradiation were significantly more effective than the application of each remineralizing agent alone.

Introduction: Surface pretreatment of posts is expected to increase the chemical and mechanical bond between the luting composite resin and the post by exposing the surface glass fibers and allowing the silane-coupling agent to directly react with the silicate group of the glass fibers allowing a stronger bond to form between the post and the resin cement. The best method to do this has not been definitively determined. Aim: To analyze the surface changes on glass fiber posts after pretreatment with erbium-doped yttrium aluminium garnet (Er: YAG) laser at different settings. Materials and Methods: Twenty glass fiber posts (ReforPost, Angelus, Londrina, Brazil) were divided into four groups. Group I: No surface pretreatment was performed Group II: Surface pretreatment of posts with Er: YAG laser at 1 W Group III: Surface pretreatments of posts with Er: YAG laser at 1.5 W Group IV: Surface pretreatment of posts with Er: YAG laser at 2 W. Results and Conclusion: Er: YAG laser does not damage the glass fibers at 1.5 W and at the same time clears the epoxy resin coating over the surface of the posts potentially allowing silane coupling agent to chemically interact with exposed glass fibers.