• Medical Lasers
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• 제10권3호
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• pp.185-188
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• 2021

Onychomycosis is the most common disease of the nail, with a worldwide prevalence of 5.5%. It causes local pain, paresthesia, and cosmetic problems and decreases the patients' quality of life. Conventional treatments include the administration of topical and systemic agents. However, factors such as subungual hyperkeratosis and biofilm formation may affect the efficacy of these treatments. Moreover, side effects associated with systemic agents are a major concern for patients. Therefore, various novel treatments are being developed; among them, photodynamic therapy (PDT) and Nd:YAG laser are promising, and several studies have demonstrated the efficacy and safety of PDT and laser therapy. Here, we report the efficacy and tolerability of PDT combined with 1064-nm Nd:YAG laser therapy and topical efinaconazole for the treatment of three patients with refractory onychomycosis.

• Tuberculosis and Respiratory Diseases
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• 제41권5호
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• pp.494-503
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• 1994

연구배경: 기관 및 기관지결핵으로 인한 반흔성 기도협착으로 호흡곤란을 호소하는 환자들을 대상으로 Nd-YAG 레이저치료를 시행하고 그 효과를 조사하였다. 방법: 기관 및 기관지결핵으로 기도내경이 1~4mm로 심한 반흔성 기도협착이 있는 환자들을 대상으로 하였으며, 기도협착을 내시경소견에 따라 횡경막형, 허탈형 및 복합형으로 분류하고 허탈형의 기도협착은 치료대상에서 제외하고 횡경막형과 복합형의 기도협착이 있는 10명의 환자들을 대상으로 굴곡성기관지경을 통해 Nd- YAG 레이저 치료를 시행하였다. 치료효과는 치료 후 1개월에 주관적인 증상의 호전과 객관적인 검사성적의 호전 유무를 조사하여 평가하였다. 결과: 1) 기도협착의 형태는 횡경막형 1예, 복합형이 9예로 대부분 복합형이었다. 2) 기도협착 부위는 기관 2예, 좌주기관지 6예 등이었고 증상발현 기간은 12.7개월이었다. 3) 레이저치료 횟수는 평균 3.3회였고 총조사량은 평균 865 joule이었다. 4) 기도내경은 치료전 평균 1.8mm에서 치료 후 5.5mm로 유의하게 증가되었다(p<0.05). 5) 10예 가운데 8예에서 측정한 노력성폐활량(FVC)은 치료 전 평균 2.62L에서 치료 후 3.04L로 유의하게 증가되었고, 노력성폐활량 1초치도 평균 1.81L에서 치료 후 2.22L로 유의하게 증가되었다(p<0.05). 6) 10예 가운데 8예는 치료 후 호전되었으나 성대 직하방에서 용골까지 심한 기도협착이 광범위하게 있었던 1예와 기관지의 굴곡변형이 심했던 1예는 호전이 없었다. 7) 출혈 및 천공과 같은 레이저치료에 따르는 합병증은 없었으며 치료 후 호전되었던 8예는 평균 31.9개월 간의 추적기간 동안 이러한 호전이 지속되었다. 결론: 이상의 결과로 기관 및 기관지결핵으로 인한 반흔성 기도협착이 있는 환자에서 기관지경적적 Nd-YAG 레이저치료는 기도협착의 개선에 도움이 되는 것으로 생각된다.

• Journal of Periodontal and Implant Science
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• 제52권1호
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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.

• Tuberculosis and Respiratory Diseases
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• 제47권6호
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• pp.857-862
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• 1999

저자들은 기침, 객혈, 호흡곤란을 호소하는 48세 남자에서 기관 유두종으로 진단 후 부분마취하에 굴곡성 기관지 내시경을 이용하여 Nd-YAG 레이저 치료로써 치료한 후 약 3년동안의 추적 관찰에서 더 이상의 재발이 없어 문헌고찰과 함께 보고하는 바이다.

• Journal of Periodontal and Implant Science
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• 제26권2호
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• pp.522-530
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• 1996

Most dentists are very interested in laser therapy on the intraoral soft tissue lesions because they want to accomplish the analgesic and aseptic surgery with little or no bleeding. In order to determine the difference of pain threshold according to different gingival tissues with or without inflammation, 25 patients with inflammatory periodontal disease and 10 volunteers with good general and oral health were selected as the inflamed group and the normal group, respectively. Interdental papilla, marginal gingiva, attached gingiva, and alveolar mucosa were irradiated by the contact delivery($300{\mu]m$ fiber optic, for 5 seconds) of a pulsed Nd:YAG laser(EN.EL.EN06O, Italy). And the laser power was gradually increased from 0.5W by the increment of 0.1W. The highest laser power was recorded as the first painful power when the painful gesture was recognized at first. The difference of the first painful power of laser according to different gingival tissues with or without inflammation was statistically analyzed by paired t-test in MICROSTAT program. Following results were obtained: 1. In the comparison related with the inflammation, the first painful power was significantly lower in the inflamed group than in the normal group, regardless of interdental papilla and marginal gingiva(p<0.05). 2. In the comparison related with the tissue structure, the first painful. power was significantly lower in alveolar mucosa than in attached gingiva(p<0.05). The results suggest that, for the painless therapy by a pulsed-Nd:YAG laser irradiation, the laser surgery over 2.0W of power should be necessarily accomplished under the local anethesia, and the local anesthesia should be considered according to the degree of inflammation, the tissue structure, and the purpose of laser therapy.

• Journal of Periodontal and Implant Science
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• 제27권4호
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• pp.819-828
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• 1997

The purpose of this study was to evaluate the abrasion-resistance of root surface after NaF iontophoresis, Nd:YAG laser irradiation and combined treatment 50 anterior teeth with flat interproximal root surface that had been extracted due to periodontal destruction were selected. All teeth were treated by the same procedure as conventional periodontal root treatment, such as scaling and root planing, root conditioning with tetracycline HCI(lOOmg/ml, 5min). The pre-treatment weight of each tooth was measured by a dial scale(SHIMADEU Co, LIBROR EB-220HU, capacity 220.000 g, Japan). All teeth were divided into 5 groups as follows: Nd:YAG laser irradiation(group 1, 1 W, 100 mJ, 10Hz, fiberoptic-root surface distance=5mm, $10\;sec.{\times}6times$, EL.EN.EN060, Italy): NaF iontophoresis(group 2, $150{\mu}A$, 4 min}: Nd:YAG laser irradiation following NaF iontophoresis(group 3): NaF iontophoresis following Nd:YAG laser irradiation(group 4): No treatment(control group). Electric toothbrushing (Oral-B, Brown Co, Germany) was conducted during 1 hour($lO\;min.{\times}6\;times$). Subsequently post-treatment weight was remeasured by the same method as pre-treatment weight measurement. The difference of abrasion rate among all groups was statistically analyzed by ANOVA(SAS program). Following results were obtained: 1. The abrasion rate was significantly lower in Nd:YAG laser irradiation group than NaF iontophoresis group(p < 0.001). 2. The abrasion rate was significantly lower in combined groups of Nd:YAG laser irradiation and NaF iontophoresis than either Nd:YAG laser irradiation group or NaF iontophoresis group(p < 0.001). 3. There was no significant difference in abrasion rate according to application order in the combined groups(p > 0.05). 4. The abrasion rate was significantly lower in all experimental groups than control group(p < 0.001). The results suggest that combined treatment of Nd:YAG laser irradiation and NaF iontophoresis on exposed root surface after periodontal therapy can enhance the abrasion-resistance of root surface and may inhibit the root caries development.

• Journal of Oral Medicine and Pain
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• 제25권4호
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• pp.415-425
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• 2000

In order to obtain the basic data concerning the optimal lasing conditions in using Nd:YAG laser as an adjunctive modality of periodontal therapy of root planing without irreversible structural deterioration of cervical cementum, the author selected 36 human teeth having no cervical abrasion and caries (; 12 anteriors, 12 premolars. 12 molars) extracted due to periodontal diseases, and divided them into 4 groups as Group I, II, III and IV (; each group of 3 anteriors, 3 premolars, 3 molars), and prepared a cementum specimen with thickness of $1.0mm{\pm}0.2mm$ sectioned longitudinally at the middle of mesio-distal thickness (; Group I) or horizontally at 1mm-2mm below the cemento-enamel junction (; Group II, III, IV) from each tooth of each group by low speed diamond wheel saw, and treated them with 0.5 M ethylene diamine tetraacetic acid (; EDTA, pH=7.4) for 2 minutes for elimination of remnants during tooth-sectioning. And the author applied the laser energy from a fiberoptic delivered, free running, pulsed Nd:YAG laser (; wavelength 1064nm. pulse duration $120{\mu}sec$, fiber diameter $320{{\mu}m}$) to cementum surfaces in triplicates of one experiment under the following lasing conditions: 1. stationary mode of fiber in contact to cementum surfaces without air-spray (; Group I )/with air-spray (; Group II), 2. unidirectional moving mode of fiber in contact to cementum surfaces under speed of 3mm-4mm/sec without air-spray (; Group III)/with air-spray (; Group IV), 3. energy per pulse (mJ/pulse) [; energy density ($J/cm^{2}$)] in order of 1.0W/10Hz (100J/pulse); $124J/cm^{2}$, 0.5W/10Hz (50mJ/pulse); $62J/cm^{2}$, 0.4W/10Hz (40mJ/pulse); $50J/cm^{2}$, 0.3W/10Hz (30mJ/pulse); $37J/cm^{2}$, 4. exposure time of 1 second. And the author applied the platinum coating on surfaces of cementum specimens, and evaluated the characteristics of ultrastructural change on surfaces of cementum using the scanning electron microscopy. In general the ultrastructural loss of cervical cementum irradiated under the same lasing condition of laser energy density occurred least in specimens of Group IV. And especially, the ultrastructural loss of cervical cementum irradiated under the laser energy density of $37J/cm^{2}$ almost did not occur in specimens of Group IV. Therefore, it is considered that the pulsed Nd:YAG laser should be applied with the lasing conditions of unidirectional moving mode of fiber in contact to cementum surfaces under speed of 3mm-4mm/sec with air-spray and of laser energy density within $37J/cm^{2}$ as an adjunctive modality of periodontal therapy of root planing without irreversible structural deterioration of cervical cementum.

• Journal of Periodontal and Implant Science
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• 제27권2호
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• pp.411-424
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• 1997

The purpose of this study was to evaluate in vitro the effects during subgingival calculus removal using Nd:YAG laser. The study group was consisted of 30 teeth with advanced periodontal disease extracted before the start of periodontal therapy. The specimens were divided into 8 different groups : 1) untreated control 2) scaling and root planing only 3) laser treated using 150mJ/pulse, 1sec, 5sec, contact mode 4) laser treated using 200mJ/pulse, 5sec, contact mode 5) laser treated using 150mJ/pulse, 1sec, non-contact mode 6) laser treated using 200mJ/pulse, 5sec, non-contact mode 7) laser treated using l5OmJ/pulse, 1sec, contact mode with water irrigation 8) laser treated using 200mJ/pulse, 5sec, contact mode with water irrigation. All specimens were prepared for evaluation by scanning electron microscopy(SEM). Specimens from Group 2 exhibited a smear layer of scale like texture with parallel instrument tracks resulting from curet use. Specimens treated by contact mode, Group 3 and 4 featured surface changes not observed· in controls such as charring, randomly distributed pitting and crater formation, and melting down of the tooth material and calculus. Specimens treated by noncontact mode, Group 5 and 6 featured similar surface changes observed in contact mode. However, the differences between contact and non-contact groups not significant. Specimens treated by contact mode with water irrigation, Group 7 and 8 featured slight surface change compared to other groups. The results suggested that Nd: YAG laser did not completely remove the subgingival calculus but was possible the application as adjunctive method.

• Journal of Periodontal and Implant Science
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• 제25권3호
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• pp.614-622
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• 1995

Root caries is very frequently developed on exposed root surface after periodontal surgical treatment. In order to determine the anti-caries effect of Nd : YAG laser irradiation on periodontally exposed root surface, 40 mandibular molar teeth that had been extracted due to excessive periodontal destruction were used as the experimental teeth. All teeth were treated by the same procedure as conventional periodontal root treatment, ie thorough scaling, root planing and root conditioning with tetracycline HCl(100mg/ml, 5min.). Within middle one third of root, mesial half surface(20) or distal half surface(20) was randomly irradiated at various power of 1.0W, 2.0W, 3.0W and 4.0W for 60 seconds by non-contact(5mm) delivery of a pulsed Nd : YAG laser(EN.EL.EN060, Italy). The microhardness was measured by Vikers microhardness tester(Wilson, USA) at 2mm/second of jog speed under 100gm load. The difference of microhardness between irradiated side and non-irradiated side was statistically analyzed ANOVA and Duncan's method. Following results were obtained ; 1. The microhardness(Knoop hardness number) was significantly higher in laser irradiated surface than non-irradiated surface(p<0.05). 2. There was no significant difference in microhardness between experimental groups classified by different laser power(p>0.1). The results suggest that Nd : YAG laser irradiation on exposed root suface after periodontal therapy may inhibit the root caries development by enhancing surface microhardness.

• Journal of Periodontal and Implant Science
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• 제27권3호
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• pp.495-514
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• 1997

The purpose of this study was to evaluate the in vitro effects of Nd:YAG laser irradiation on removal of a root surface smear layer after root planing in comparison with Tetracycline HCl. The 60 extracted human teeth due to severe periodontal disease were vigorously scaled and root planed with Gracey curet. Thirty specimen($5{\times}5{\times}2mm$) were obtained from root planed surface of 30 human teeth and assigned randomly to one of three groups : root planed group(5 specimen), Tetracycline HCI group(5 specimen, burnished for 5 minutes), and Nd:YAG laser group(25 specimen, German Dental Laser, Fotona Twinlight). Nd:YAG laser group was divided into 4 subgroups according to power of 1W, 1.5W, 2W, 3W at frequency to 10Hz. The specimen were then fixed, and examed by Scanning electron microscopic study. 30 of 60 human teeth used to measurement of the intrapulpal temperature rise during laser irradiation. Laser-irradiated surface exhibited various surface texture from relative flat surface to irregular surface with patent dentinal tubules of various shape and size. In some area, the root surface alteration which are carbonization, pit and crater formation and melting and resolidification were observed. The number of exposed dentinal tubules per unit($100_{\mu}m^2$) on tetracycline HCI group was more than that in the laser group below 1.5W of power(150mJ/pulse) and was significantly less than that in laser group above 2W of power(200mJ/pulse)(P<0.OOl). As power increased the intrapulpal temperature rise also increased. The result suggested that the parameter which effectively remove root surface smear layer than tetracycline HCI may cause thermal damage to pulp and root surface alteration result from laser exposure would indicate need for additional instrumentation. Thus, Nd:YAG laser irradiation in these parameter may not be appropriate for clinical use as adjunct to conventional periodontal therapy.