Hasan Guney Yilmaz

Clinical evaluation of Er,Cr:YSGG and GaAlAs laser therapy for treating dentine hypersensitivity: A randomized controlled clinical trial

OBJECTIVE The advent of dental lasers has raised another possible treatment option for dentine hypersensitivity (DH) and has become a research interest in the last decades. The aim of this randomized, controlled, double-blind, split mouth, clinical study was to evaluate and compare the desensitizing effects of erbium, chromium-doped:yttrium, scandium, gallium and garnet (Er,Cr:YSGG) to galium-aluminium-arsenide (GaAlAs) laser on DH. METHODS Fifty-one patients participated in this study for a total of 174 teeth. DH was assessed for all groups with a visual analog scale. For each patient, the teeth were randomized to three groups. In the diode laser group, sensitive teeth were irradiated with the GaAlAs laser at 8.5J/cm(2) energy density. In the Er,Cr:YSGG laser group, sensitive teeth were irradiated with Er,Cr:YSGG laser in the hard tissue mode using a none-contact probe at an energy level of 0.25W and repetition rate of 20Hz, 0% water and 10% air. In the control group no treatment was performed. Treatment time was 60s for GaAlAs laser and 30s for Er,Cr:YSGG laser. RESULTS When compared with the control group and baseline data, in both laser groups, laser irradiation provided a desensitizing effect immediately after treatment and this effect was maintained throughout the study (p<0.05). No significant differences between Er,Cr:YSGG and GaAlAs laser groups were found at any follow-up examination (p>0.05). CONCLUSION Based on these findings, it may be concluded that both Er,Cr:YSGG and GaAlAs lasers were effective in the treatment of DH following a single application.

Effectiveness of Er,Cr:YSGG laser on dentine hypersensitivity: a controlled clinical trial

AIM Attempts have been made to treat dentine hypersensitivity (DH) with lasers. However, there is limited knowledge on the effects of erbium, chromium-doped:yttrium, scandium, gallium and garnet (Er,Cr:YSGG) laser on DH. The aim of this study was to evaluate the efficacy of Er,Cr:YSGG laser on reduction in DH. METHODS Forty-two patients (146 teeth) were included. Teeth were assigned to an experimental group and irradiated with the Er,Cr:YSGG laser. In the control group same clinical instrument was used without laser emission. DH was assessed for both groups utilizing the visual analog scale. Plaque index (PI) scores were recorded immediately following treatment, at 1 week, 1 and 3 months. RESULTS The results showed that Er,Cr:YSGG laser irradiation had a significantly higher desensitizing effect compared with the placebo immediately after treatment (p<0.05). Intra-group comparisons revealed no statistically significant differences within the placebo group (p>0.05). For the test group, the differences between baseline and all time points following treatment were statistically significant (p<0.05). No significant differences were observed in PI between the test and control groups at any follow-up examination (p>0.05). CONCLUSION Within the limits of this study, it appears that Er,Cr:YSGG laser is effective in the treatment of DH compared with the placebo treatment.

Evaluation of Maxillary Incisive Canal Characteristics Related to Dental Implant Treatment With Computerized Tomography: A Clinical Multicenter Study

BACKGROUND A close anatomic relationship between the incisive canal and the roots of the central maxillary incisors should be kept in mind during dental-implant treatment in the anterior maxilla. The aim of the present study is to analyze incisive canal characteristics on computed tomography (CT) sections and to evaluate its relation to bone anterior to the canal with regard to dental implantation. METHODS A total of 933 partially edentulous and/or edentulous patients scheduled for implant insertion in four dental clinics enrolled in the present study. The following were measured and recorded from CT sections for analysis: 1) diameter and length of the incisive canal; 2) width and length of the bone anterior to the canal; 3) palatal bone width and length; and 4) root width and length of the central incisor. RESULTS Mean canal length was 10.86 ± 2.67 mm, and mean diameter was 2.59 ± 0.91 mm. Canal length was shortened in edentulous anterior maxilla compared to dentate maxilla. However, canal diameter did not show any difference between dentate and edentulous groups. Males had a longer and wider incisive canal than females. Canal shape was mostly cylindrical in 40.73% of images. No correlation was found with mean canal length and mean canal diameter according to age. CONCLUSIONS Although variations exist in every patient, the findings from this study suggest that sex and dental status are important factors that can affect incisive canal characteristics and amount of bone anterior to the canal. Clinicians should perform careful planning using CT scans before performing dental implant surgeries in premaxillary region.

Long-Term Effect of Diode Laser Irradiation Compared to Sodium Fluoride Varnish in the Treatment of Dentine Hypersensitivity in Periodontal Maintenance Patients: A Randomized Controlled Clinical Study

OBJECTIVE The aim of this clinical study was to evaluate and compare the desensitizing effects of a gallium?aluminum?arsenide (GaAlAs) laser and sodium fluoride (NaF) varnish on dentine hypersensitivity (DH) in periodontal maintenance patients. BACKGROUND DATA The use of lasers opens a new dimension in the treatment of DH. METHODS Forty-eight patients with 244 teeth affected by DH were included in the trial. To be included in the study, the subjects had to have 4 or more hypersensitive teeth at different quadrants. Selected teeth were randomly assigned to a GaAlAs laser group, placebo laser group, NaF varnish group, or a placebo NaF varnish group. Laser therapy was performed at 8.5?J/cm(2) energy density. In the placebo laser group, the same laser without laser emission was used. In the NaF varnish group, the varnish was painted at the cervical region of the teeth. In the placebo NaF varnish group, the same treatment procedures were performed with a saline solution. DH was assessed with a visual analog scale (VAS); immediately, at 1 week, and at 1, 3, and 6 months after treatments. Intra-group time-dependent data were analyzed by Friedmans test, and Wilcoxons rank sum test was used to evaluate the differences within groups. RESULTS GaAlAs laser and NaF varnish treatments resulted in a significant reduction in the VAS scores immediately after treatments that were maintained throughout the study when compared to the baseline and placebo treatments. In the NaF group, there was a significant increase in the VAS scores at 3 and 6 months compared to at 1 week and 1 month. The placebo treatments showed no significant changes in VAS scores throughout the study period. CONCLUSIONS Within the limits of the study, GaAlAs laser irradiation was effective in the treatment of DH, and it is a more comfortable and faster procedure than traditional DH treatment.

Are Gingival Phenotype, Residual Ridge Height, and Membrane Thickness Critical for the Perforation of Maxillary Sinus?

BACKGROUND Sinus membrane perforation is the most common complication of the sinus-augmentation procedure. Anatomic factors have been implicated in the risk of sinus membrane perforation (SMP) during sinus-lift surgery. However, there are no reports on the relationships among gingival phenotype (GP), residual ridge height (RRH), membrane thickness (MT), and perforation rate of the maxillary sinus. Therefore, the aim of this clinical study is to determine the associations among GP, RRH, MT, and SMP rate. METHODS Forty-four patients (64 sinus-lift procedures) were included in the study. Preoperative computed tomography scanning was performed to radiographically evaluate GP, RRH, and MT. The smallest RRH, highest MT, and gingival thickness values were recorded. These values were classified as follows: RRH, < or >3.5 mm; MT, < or >1 mm; and GP, <1.5 or >2 mm. Sinus-lift surgery was performed with a lateral window approach, and SMPs were detected at 11 sinus sites. Perforation size and locations were recorded, and the perforations were repaired with collagen membrane. One hundred seventy-six implants were placed immediately after augmentation procedure. RESULTS Strong correlations of GP with RRH (r = 0.722, P = 0.001) and MT (r = 0.702, P = 0.001) were noted. Moderate correlations were found between RRH and MT (r = 0.596, P = 0.001) and between MT and SMP (r = 0.417, P = 0.001). Furthermore, mild correlations of SMP with RRH (r = 0.290, P = 0.020) and GP (r = 0.248, P = 0.04) were established. Four implants were lost, but no significant difference was found between implant failure and SMP. CONCLUSION Within the limits of the study, it may be suggested that GP, RRH, and MT may be important factors for sinus perforation.

Use of Mineral Trioxide Aggregate in the Treatment of Invasive Cervical Resorption: A Case Report

INTRODUCTION Guided tissue regeneration (GTR) is a successful treatment procedure of periodontal reconstructive surgery. Adverse effects can be observed after GTR procedure, but external root resorption is rarely reported at clinical studies. Invasive cervical resorption is a clinical term used to describe a relatively uncommon, insidious, and often aggressive form of external root resorption. METHODS The present case demonstrates an invasive cervical resorption that is a potential late complication of GTR in a maxillary canine of a 59-year-old male patient. After the surgical intervention and root canal treatment, the resorption was subsequently sealed with mineral trioxide aggregate. RESULTS The 1-year follow-up demonstrates no pathologic changes on clinical and radiographic examination. CONCLUSIONS This case report presents a treatment strategy that might improve the healing outcomes for patients with invasive cervical resorption.

Evaluation of mandibular lingual foramina related to dental implant treatment with computerized tomography: a multicenter clinical study.

Background:Bleeding can be one of the severe complications during implant placement or other surgeries. Presurgical assessment of the area should be performed precisely. Thus, we examined lingual vascular canals of the mandible using dental computerized tomography (CT); define the anatomical characteristics of canals and the relationship with mandibular bone. Methods:One thousand sixty-one foramina in 639 patients, in 5 dental clinics, were included in this multicenter study. Distance between crest and lingual foramen, tooth apex and lingual foramen, distance from mandibular border, diameter of lingual foramen, canal type, anastomosis, and location of foramen were examined. Results:Foramen was 18.33 ± 5.45 mm below the bony crest and 17.40 ± 7.52 mm from the mandibular border, with men showing larger measurements. The mean diameter of lingual foramina was 0.89 ± 0.40 mm; 76.8% canal type was mono; 51.8% patients presented with median lingual canal-foramen (MLC) and 21.1% with lateral lingual foramen. Diameter of MLC was statistically larger. Conclusions:With a large sample group, results represented that lingual foramina could be visualized with dental CT, providing useful data for mandibular implant surgeries. Findings suggest that vascular canals and several anastomoses exist in the anterior mandible extending through premolar and molar regions as well. It is imperative to consider these vessels with the dental CT before and during the mandibular surgery to prevent threatening hemorrhage.

Low-Level Laser Therapy in the Treatment of Mucous Membrane Pemphigoid: A Promising Procedure

BACKGROUND Mucous membrane pemphigoid is a heterogeneous group of autoimmune, subepithelial, blistering diseases. A combination of topical and systemic steroid treatment is often used when managing patients with mucous membrane pemphigoid. The use of systemic steroids presents an increased risk of adverse side effects. Consequently, effective alternative modalities of therapy should be considered, such as the application of low-level laser therapy (LLLT). METHODS A patient presented with mucous membrane pemphigoid and was successfully treated with the application of local corticosteroids and LLLT using an 810-nm diode laser. The lesions were treated by LLLT over a period of 7 days using a continuous waveform for 40 seconds and an energy density of 5 J/cm(2). RESULTS After treatment, a significant improvement in tissue color and consistency was observed. The patient was followed every month for a period of 12 months, and the lesions healed uneventfully. CONCLUSION The results reported in this case show that the healing of mucous membrane pemphigoid was achieved when LLLT was used as an adjunct to the application of a local corticosteroid.

Treatment of amalgam tattoo with an Er,Cr:YSGG laser

Amalgam tattoos are common, asymptomatic, pigmented oral lesions that clinically exist as isolated, blue, gray, or black macules on the gingival, buccal, and alveolar mucosae, the palate, and/or the tongue. In this case report, the successful use of an erbium, chromium-doped:yttrium, scandium, gallium, and garnet laser for the removal of an amalgam tattoo is explained. A 46-year-old man is presented with a half decade history of an amalgam tattoo on his left maxillary premolar-molar gingiva. Depigmentation procedure was performed under topical anesthesia with the use of an erbium, chromium-doped:yttrium, scandium, gallium, and garnet laser at 2 W in the soft tissue pulsed mode for 10 min. The pigmented tissue was completely removed. The de-epithelialization area healed completely on the 10th day after treatment. The period of healing was uneventful. The amalgam tattoo was completely removed with erbium, chromium-doped:yttrium, scandium, gallium, and garnet laser, and the treated area healed without any adverse effect.

Treatment of recurrent aphthous stomatitis with Er,Cr:YSGG laser irradiation: A randomized controlled split mouth clinical study.

The present randomized controlled split mouth clinical study aimed to investigate the efficacy of Er,Cr:YSGG laser irradiation on pain reduction and healing rate of recurrent aphthous stomatitis. 40 patients with RAS were recruited for this study and RAS ulcerations of each patient were randomly assigned to the control or test group. In the test group, Er,Cr:YSGG laser with non-contact mode was used to irradiate RAS lesions. In the placebo group, RAS lesions were irradiated with the same device without laser emission. Pain was evaluated with visual analog scale (VAS) while a clinician graded healing of RAS (HRAS). In the placebo group at immediate; scores of VAS presented no statistically significance; in the test group, laser application showed significant pain reducing, at 1st day control. In the test group, a significantly healing effect at 1st day control was observed and this effect was maintained throughout the study. In the placebo group, scores of HRAS were statistically significant at controls on 3, 7, 10days. Statistically significant difference between the scores of VAS and HRAS was found for all control days except day 10 according to the intergroup comparisons. Based on these findings, Er,Cr:YSGG laser application at 0.25W without water may be appropriate to reduce pain and also accelerate the healing of RAS.