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Immediate effect of Nd:YAG laser monotherapy on subgingival periodontal pathogens: a pilot clinical study

  • McCawley, Thomas K.;McCawley, Mark N.;Rams, Thomas E.
    • Journal of Periodontal and Implant Science
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    • v.52 no.1
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    • pp.77-87
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    • 2022
  • Purpose: This pilot study assessed the immediate in vivo effect of high peak pulse power neodymium-doped yttrium aluminum garnet (Nd:YAG) laser monotherapy on selected red/orange complex periodontal pathogens in deep human periodontal pockets. Methods: Twelve adults with severe periodontitis were treated with the Laser-Assisted New Attachment Procedure (LANAP®) surgical protocol, wherein a free-running, digitally pulsed, Nd:YAG dental laser was used as the initial therapeutic step before mechanical root debridement. Using a flexible optical fiber in a handpiece, Nd:YAG laser energy, at a density of 196 J/cm2 and a high peak pulse power of 1,333 W/pulse, was directed parallel to untreated tooth root surfaces in sequential coronal-apical passes to clinical periodontal probing depths, for a total applied energy dose of approximately 8-12 joules per millimeter of periodontal probing depth at each periodontal site. Subgingival biofilm specimens were collected from each patient before and immediately after Nd:YAG laser monotherapy from periodontal pockets exhibiting ≥6 mm probing depths and bleeding on probing. Selected red/orange complex periodontal pathogens (Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia/nigrescens, Fusobacterium nucleatum, Parvimonas micra, and Campylobacter species) were quantified in the subgingival samples using established anaerobic culture techniques. Results: All immediate post-treatment subgingival biofilm specimens continued to yield microbial growth after Nd:YAG laser monotherapy. The mean levels of total cultivable red/orange complex periodontal pathogens per patient significantly decreased from 12.0% pretreatment to 4.9% (a 59.2% decrease) immediately after Nd:YAG laser monotherapy, with 3 (25%) patients rendered culture-negative for all evaluated red/orange complex periodontal pathogens. Conclusions: High peak pulse power Nd:YAG laser monotherapy, used as the initial step in the LANAP® surgical protocol on mature subgingival biofilms, immediately induced significant reductions of nearly 60% in the mean total cultivable red/orange complex periodontal pathogen proportions per patient prior to mechanical root instrumentation and the rest of the LANAP® surgical protocol.

SHEAR BOND STRENGTH OF COMPOSITE RESIN TO ENAMEL FOLLOWING ENAMEL MICROABRASION (Enamel Microabrasion을 시행한 법랑질과 복합레진의 전단결합강도)

  • Hong, Kee-Sang;Lee, Sang-Dae;Lee, Sang-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.1
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    • pp.45-53
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    • 2000
  • Enamel microabrasion is a means by which superficial enamel discoloration is removed using hydrochloric acid and fine pumice. As enamel microabrasion alone may not be sufficient in cases of deeper discoloration, composite resin restoration is recommended in areas where there is remaining discoloration. The purpose of this study was to investigate the effects of different methods and number of applications of enamel microabrasion on the shear bond strength of composite resin to enamel. Untreated control was designated as group 1. 5-second applications of a mixture of 18% HCl and fine pumice were performed 5 and 10 times on groups 2 and 3, respectively. A commercially available mixture of 10% HCl and abrasives(PREMA) was applied using a 10 : 1 gear reduction handpiece 5 and 10 times on groups 4 and 5, respectively, with each application lasting 20 seconds. After etching with 37% phosphoric acid, composite resin was bonded. Thermocycling was performed and shear bond strength was measured. The following results were obtained : 1. Group 2 showed the highest bond strength$(24.36{\pm}3.34)$, while group 3 showed the lowest$(19.35{\pm}3.43)$, Shear bond strength decreased in the following order: 2>4>5>1>3. 2. Group 2 showed bond strength significantly higher compared to groups 1 and 3(p<0.05). 3. There were no significant differences between groups 2 and 3, which had been microabraded using HCl and pumice, and groups 4 and 5, to which PREMA had been applied, when bond strengths were compared(p>0.05). 4. When modes of fracture were examined, adhesive failure was observed in groups 3 and 4, while cohesive failure was observed in groups 1, 2, 3 and 4. Only mixed failures were found group 5. 5. When viewed using a SEM, groups 2 and 3, which had been microabraded using HCl and pumice, showed surface appearances similar to that of enamel etched with phosphoric acid. Groups 4 and 5, treated with PREMA, exhibited a smooth surface similar to that of group 1. All oops showed similar, typical surface characteristics following phosphoric acid etching.

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ANALYSIS OF ER:YAG LASER IRRADIATION ON CUTTING EFFICACY AND TEMPERATURE CHANGES OF DENTIN (Er:YAG 레이저의 상아질 삭제효과 및 이에 따른 온도변화)

  • Im, Kwang-Ho;Lee, Chang-Seop;Lee, Sang-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.1
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    • pp.32-44
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    • 2001
  • The purpose of this study was to investigate the effects of Er : YAG laser on cutting efficacy and temperature changes of dentin. We used the dentin specimens of human premolars and molars which contain the physiologic saline and maintain the pulpal pressure in dentinal tubules. Each specimen was exposed to Er : YAG laser with non-contact handpiece type delivery system under different treatment condition of irradiation energy, pulse repetition rate, and exposure time. Two procedures were conducted by the presence of water flow during lasing. The specimens were grouped by thickness of dentin. We investigated the cavity pattern, volume, and temperature change of dentin specimen to determine the cutting efficacy and temperature rise of Er : YAG laser, and obtained following results. 1. Cutting volume of dentin was increased by increasing the irradiation energy, pulse repetition rate, and exposure time(P<0.05). 2. Margins of abulated cavities were sharp and clean and floors of cavities were conical in shape and showing smooth surfaces. Upper diameter of abulated cavities were increasing as laser parameter of irradiation energy, pulse repetition rate, and exposure time were increased. A few cracks were observed on abulated surfaces under treatment condition of laser parameter with 150mJ, 5Hz, and 5sec. 3. Temperature was increased as laser parameter of irradiation energy, pulse repetition rate, and exposure time were increased, and temperature rise was decreased as dentin thickness was increased(P<0.05). 4. Temperature rise was decreased under water flow compared with no water flow during laser exposure(P<0.05). From these results, we think that the method of using a Er:YAG laser would be effective and safe in cutting dentin for clinical application.

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Comparison of screw-in effect of three NiTi file systems used by undergraduates (학생들이 사용한 세 종류 NiTi file systems의 screw-in effect 비교)

  • Oh, Seung-Hei;Park, Jeong-Kil;Hur, Bock;Kim, Hyeon-Cheol
    • Restorative Dentistry and Endodontics
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    • v.31 no.6
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    • pp.477-484
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    • 2006
  • The purposes of this study were to compare the apical terminus width of simulated curved root canal prepared with three NiTi file systems used by undergraduates for evaluation the effects of flute angle and pitch or radial land on reducing screw-in effect and to determine more safe NiTi file system for inexperienced operators. Fifty inexperienced undergraduate students prepared 150 simulated curved root canals in resin blocks with three NiTi file systems ; ProFile$^{(R)}$, Hero Shaper$^{(R)}$, K3$^{TM}$. The electric motor set at a speed of 300 rpm and torque of 30 in a 16 : 1 reduction handpiece was used. The simulated root canal was prepared to ISO #25 sizes with each file system. The scanned images of pre- and post-instrumented canal of resin block were superimposed. To evaluate the screw-in effect of three NiTi file systems, apical terminus width of root canal was measured from superimposed images and statistical analysis was performed. There were significant differences in three NiTi flle systems. ProFile$^{(R)}$ had significantly smaller width than Hero Shaper$^{(R)}$ and K3$^{TM}$"" (P < 0.05), but no significant difference was observed between K3$^{TM}$ and Hero Shaper$^{(R)}$. Under the condition of this study, active file system (Hero SHaper$^{(R)}$, K3$^{TM}$) with variable pitch and helical angle had more screw-in effect than passive file system (ProFile$^{(R)}$) with constant pitch and helical angle. It seems that the radial lands play more important role in reducing screw-in effect.

The Evaluation of RPM Change in X-Smart According to Power Source: Endodontic Wireless Electronic Motor (근관치료용 무선전기모터인 X-Smart의 전원의 종류에 따른 RPM 변화의 평가)

  • Park, Se-Hee;Jeong, Dong-Bin;Cho, Kyung-Mo;Kim, Jin-Woo
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.1
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    • pp.91-97
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    • 2011
  • The purpose of this study was to evaluate RPM maintenance in X-Smart according to the power supplied by the AC adapter and rechargeable battery. Five new X-Smart were used in this study. A handpiece with rubber disk which has reflective tape was mounted on the vice. To measure the RPM, a non-contact type digital tachometer was used. RPM measurements were recorded every 5 minutes to 180 minutes and repeated 3 times per motor from each power source. To evaluate a difference of the RPM changes, two-way repeated measures were performed using $SPSS^{TM}$ 14.0. All tests were conducted at the 95 percent confidence level. There was no significant difference in the RPM change between the power sources. Continuous use of X-Smart with a rechargeable battery for up to 180 minutes could be safely used as an endodontic wireless motor with a reliable RPM maintenance.

A STUDY ON THE MICROBIAL CONTAMINATION OF DENTAL UNIT AND ULTRASONIC SCALER (덴탈유니트의 핸드피스 및 초음파 치석 제거기의 미생물 오염에 관한 연구)

  • Lee, Byung-Moon;Kim, Chang-Whe;Kim, Young-Soo
    • The Journal of Korean Academy of Prosthodontics
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    • v.36 no.1
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    • pp.64-80
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    • 1998
  • The risk of cross-contamination in dental clinic is very high. Those who are engaged in dental clinic are exposed to various microorganisms in saliva and blood of patient. Potential possibility of cross-contamination of patient to patient, patient to dentist, dentist to laboratory technician always exist, which is important in the view of public health. It is well known that microorganisms may cause cross-contamination by suck-back of microorganisms into the water supply line or air supply line of dental unit and sprayed back into the next patient's oral cavity. The majority of microorganisms coming from dental unit are water microorganisms from the main water supply which have colonized the tube within the units and multiplied in the relatively warm and stagnant conditions. The purpose of this study is to measure the extent of microbial contamination of dental unit and ultrasonic scaler, to evaluate that dental unit water supply is suitable for drinking water, and to assess the effect of flushing on reduction of microbial contamination of dental unit and ultrasonic scaler. In the first experiment, water samples(50ml) from 20 dental units and 10 ultrasonic scalers in Seoul National Univ. Hosp. were tested for the presence of coliform. The samples were filtered by membrane filtration technique.(Microfil system, Millipore Co. U. S. A.) The filter was then placed onto MacConkey agar plate and the plates with filter on it were incubated aerobically at $37^{\circ}C$ for 5 days. The colors and shapes of colonies were examined if those were coliform. To verify the presence of coliform, the colonies were inoculated into phenol red lactose broth and incubated aerobically at $37^{\circ}C$ for 2 days. The fomation of gas was observed. In the second experiment, water samples from 20 handpieces, 10 ultrasonic scalers and 30 A/W syringes after 0, 2, 4, 6 min. flushing respectively were taken. $200{\mu}l$ water samples were spreaded on Brain Heart Infusion agar plate and the plates were incubated aerobically at $37^{\circ}C$ for 5 days. The number of colony was counted. The results obtained were summarized as follows 1. The water from dental unit and ultrasonic scaler was not suitable for drinking water. 2. No coliform was founded in dental unit and ultrasonic scaler water supply. 3. The number of colony of dental unit and ultrasonic scaler was highest in the group of o min. flushing(p<0.05). 4. There was no statistically significant difference in the extent of microbial contamination among handpiece, ultrasonic scaler and A/W syringe (p>0.05). 5. The number of colony was lowest in the group of 4 min. flushing, but there was no statistically significant difference among 2, 4, 6 min. flushing groups.(p>0.05) 6. It is recommended to flush dental unit water line for 4 min. after use on each patient.

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SHADE ANALYSIS OF ANTERIOR TEETH USING DIGITAL SHADE ANALYSIS SYSTEM (Digital Shade Analysis System을 이용한 전치부의 색조 특성에 관한 연구)

  • Kim Hee-Eun;Cho In-Ho;Lim Ju-Hwan;Lim Hun-Song
    • The Journal of Korean Academy of Prosthodontics
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    • v.41 no.5
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    • pp.565-581
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    • 2003
  • Statement of problem : A scientific examination and understanding of overall aspects of the natural dentition is the first step involved in making a satisfactory selection in the shade of an aesthetic prosthesis. Proper natural shade selection of the prosthetic restoration that is in harmony with the remaining dentition is as important aesthetically, as harmony of form and function in the anterior dentition. Clinically, the most commonly applied method of shade selection has been visual, but because of the subjective nature inherent to this method, shade selection results are variable and can be influenced by such factors as the technician, the type of shade guide used, and the type and intensity of the lighting. Purpose : The purpose of this study was to develop a more objective and scientific approach to examining and understanding the shade of teeth, which has in turn lead to the development of a number of shade analysis devices that present a more objective method of shade analysis. Material and Method : In this study, the shades of healthy anterior teeth were examined and analyzed using the recently developed digital shade analysis of the $ShadeScan^{TM}$ System. The study examined 80 individuals in their twenties, 40 males and 40 females, presenting 6 healthy, unrestored maxillary anterior teeth. Tooth brushing and oral prophylaxis were performed prior to evaluation. The ShadeScan handpiece was used to acquire images of the 6 maxillary anterior teeth. These images were analyzed using the Vita/Classical mode of the $ShadeScan^{TM}$ Software, and shade maps of each tooth were acquired and divided into cervical, middle, and incisal thirds. The shade distribution of each third, left and right symmetry, and gender differences were investigated and analyzed. Results : The results of the study are as follows : 1. An overwhelming majority of the examined teeth were found to possess shades belong to Group A, with the greatest variations occurring at the middle and cervical thirds of the maxillary central and lateral incisors, in both male and female subjects. 2. Canines of both male and female subjects showed left and right symmetry with uniform shade distribution of A4 and C4, while the lateral and central incisors showed left-right symmetry of the incisal 1/3 with a uniform shade distribution of A2 and A3 shades 3. No significant differences in shade distribution were seen between genders in maxillary canines, whereas maxillary central and lateral incisors showed differences at the middle and cervical thirds between male and female subjects The results of this study show that with the exception of maxillary canines, maxillary anterior teeth display a diverse shade distribution as well as gender differences. Conclusion : Clinically, when making a shade selection using the existing shade guide, one must consider the fact that even a single tooth consists of a variety of shades. The results of this study show that when selecting a shade from a number of groups is difficult, shades from A group are the most consistent with the natural shade or maxillary anterior teeth.

Effects of the root conditioning treatments after Nd:YAG laser irradiation on in vitro human gingival fibroblast attachment to root surfaces (Nd:YAG 레이저조사 후 치근의 처치방법들이 치근면 치은섬유아세포부착에 미치는 영향에 관한 연구)

  • Moon, Hye-Seong;Lim, Kee-Jung;Kim, Byung-Ock;Han, Kyung-Yoon
    • Journal of Periodontal and Implant Science
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    • v.26 no.3
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    • pp.701-713
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    • 1996
  • The purpose of this study was to evaluate the biocompatibility of the Nd:YAG lased root surface followed by root planing and/or tetracyline-HCI(T.C.-HCI) conditioning. $30,4mm{\times}4mm$ root segments were obtained from unerupted third molars and 21, periodontally involved root segments. The treatment groups were as follows : (1) healthy root cementum surface groups : 1) control(non-treated group), 2) lased only, 3) lased/root planed, and 4) lased/T.C.-HCI. (2) diseased root cementum surface groups : 1) control(root planed only), 2) lased/root planed, and 3) lased/root planed/T.C.-HCI. The specimens were treated with a Nd:YAG laser using a $320{\mu}m$ noncontact optic fiber handpiece with an energy setting of 1.5W($114.6J/cm^2$), 2.0W($152.9J/cm^2$), 5.0W($382J/cm^2$) for one minute. The fiber was held perpendicular to the petri dish(NUNC) 2cm apart in an attempt to expose the entire root segments equally. Human gingival fibroblasts were cultured from explants of normal interdental gingival tissue obtained during third morlar extraction. The attachment assay was performed with third-generation fibroblasts. The numbers of gingival fibroblasts attached to the root surface were counted on each specimen under the light microscope, and were statistically analyzed by the oneway ANOVA followed by Tukey's test in SPSS/PC+programs. The results were as follows : 1) In healthy root cementum surfaces, lased/root planed groups exhibited a significantly increased fibroblast attachment compared to controls, lased only, and lased/T.C.-HCI groups(p<0.05), 2) In diseased root cementum surfaces, laser treatment followed by root planing and/or T.C.HCl groups exhibited a increased tendency of fibroblast attachment compared to root planed only group. The results suggest that laser treatment followed by root planing and/or T.C.-HCl would appear necessary so as to render the root surface biocompatible.

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A RADIOGRAPHIC STUDY OF THE EXPERIMENTAL LESIONS IN THE MAXILLARY SINUS (상악동의 실험병소에 관한 X선학적 연구)

  • Lee Joo Hyun;Hwang Eui Hwan;Lee Sang Rae
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.24 no.1
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    • pp.115-124
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    • 1994
  • The purpose of this study was to examine the differences in representation of a globular radiopaque mass on the pantomograms and Waters' views and to compare the efficacy of periapical radiograms, pantomograms and Waters' views in detection of defects on the internal walls of the maxillary sinus. This study was performed with dried human skull. For the study of difference of radiopaque mass shadow in the two views, rubber ball with a diameter of 10㎜ was used as the experimental lesion. It was placed successively on the internal wall of the anterior, posterior, medial, lateral walls and floor of the maxillary sinus. To examine the detectability of defects for radiographic techniques, defects were formed in the anterior, posterior, medial, lateral walls, and floor of the maxillary sinus. They were formed with 0.5㎜, 0.75㎜, 1.0㎜, 2.0㎜ and 3.0㎜ sized steel round burs with a slow speed dental handpiece. By subsequently plugging the holes with zinc oxide eugenol paste, radiopaque defects were produced. After that the periapical radiograms, the pantomograms and the Waters' views were taken each and every defect. The obtained results were as follows: 1. Rubber balls placed on each internal wall of the maxillary sinus were correctly depicted on the posterior wall and the floor in case of the pantomogram, and on the anterior wall and the medial wall in case of the Waters' view. 2. On the detectability of defects for each radiographic technique, radiolucent defects were detected in different places for each technique. Periapical radiogram could detect 1.0㎜ defect on the floor of the maxillary sinus, pantomogram could detect 2.0㎜ defect on every internal wall of the maxillary sinus, and Waters' view could detect 3.0㎜ defect on the anterior wall of the maxillary sinus. 3. On the detectability of defects for each radiographic technique, radiopaque defects were detected in different places for each technique. Periapical radiogram could clearly detect 0.5㎜ defect on the floor of the maxillary sinus, pantomogram could detect 0.5㎜ defect on every internal wall of the maxillary sinus, and finally Waters' view could detect 0.5㎜defect on the anterior wall of the maxillary sinus but 0.75㎜ defect on the anterior wall, lateral wall and floor of the maxillary sinus. As the result, the periapical radiogram is the most simple and satisfactory method for investigating in the maxillary sinus. The pantomogram is suitable method for screening of changes in the maxillary sinus. And the Waters' view is available for detect of lesion in the anterior wall of the maxillary sinus. For the purpose of accurate diagnosis and evaluation of lesion in the maxillary sinus, these techniques supplement each other.

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The Study on Organization, Infection Controller, Patient Infection Control of Dental Clinic in Certain Areas (일부지역 치과의 기관, 감염관리자, 환자의 감염관리에 관한 연구)

  • Choi, Du-Ri;Kim, Seol-Hee
    • Journal of dental hygiene science
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    • v.15 no.4
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    • pp.399-406
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    • 2015
  • The purpose of this study was to investigate the performance of dental infection control. This survey was performed on 158 of the dental hygienist in certain areas. The research was performed using a self-reported questionnaire and interview method from June to July, 2014. The collected data was analyzed by PASW Statistics ver. 18.0. Guideline of infection management, infection controller, regular infection control training, Sterilization of the handpiece/per head resulted 57~74% for dental hospital. It was higher than 13~20% for dental clinics (p<0.05). Infection control guidelines and vaccination recognition of dental were more performed in dental hospital. Patient's hand hygiene performed, tooth brushing before treatment, cross infection educational experience was less than 20%, research cooperation of medical history was over 90% (p<0.05). Performing rate of the dental hospital workers were investigated higher in protective personal devices, infection control of treatment room. A correlation analysis about institutional support, infection control of dental hygienists, patients with infection control cooperation showed a positive correlation statistically significant. Infection control can be enhanced when the medical staff, the patient, the organization combined cognitive and practice. Dental hygienist is required to recognize and practice the infection control guidelines through continuing education.