Journal of Lasers in Medical Sciences
Volume:9 Issue: 1, Winter 2018

The usage of laser in medicine is not recent, and its history in urology goes back to 40 years ago. For the last 2 decades, common uses of laser have been treatments of subjects with urolithiasis, bladder tumors, benign prostatic enlargement, lesions of the genitalia and urinary tract strictures.
To evaluate laser application in urology in Iran, we reviewed all of the Iranian literature on the topic. This study was designed to retrieve all studies on laser application in urology in Iran, regardless of publication status or language, covering years 1990–2017. Twenty-six articles were identified: 12 about urolithiasis, 8 about benign prostatic hyperplasia (BPH), 2 case reports, 1 paper about prostate cancer, 1 on female urethral stricture, 1 review and 1 basic sciences study. We conclude that the use of this technology has not yet found its position in Iran, especially in the field of urology. The main causes for it are the difficult accessibility and disturb of laser devices and its accessories, as well as the lack of adequate knowledge of the medical community about this modality.

Hypothyroidism is caused by inadequate production and storage of thyroid hormones. Hypothyroidism is associated with delayed wound healing. Laser therapy may stimulate wound regeneration. The aim of this study was to determine the combined effects of levothyroxine and low level laser therapy during the wound healing process on skin of hypothyroidism male rat model.
Thirty male Wistar rats were randomly divided into 5 groups: control group, hypothyroidism group, hypothyroidism group treated by laser, hypothyroidism group treated by levothyroxine, and hypothyroidism group treated by laser and levothyroxine. To induce hypothyroidism, methimazole was given at a dose of 4 mg/100 mL in their drinking water. After hypothyroidism was proven through immunoassay commercial kit, rats were generally anesthetized with ketamine and xylazine, then, an incisional skin wound was created in a length of 1.2 cm on the back of the ribcage. The surgical day is considered as the zero day. The third and fifth groups were treated with a pulse laser, 810 nm wavelength 80 Hz frequency and 0.2 J/cm2 energy densities for 200 seconds. Levothyroxine was injected to the fourth and fifth groups intraperitoneally. On the 14th day, a normal sample of each healing skin wound was harvested for biomechanical examination. The obtained data were analyzed by the SPSS software 21 and reported as a mean ± standard error of mean (SEM). P The results showed that the mean maximum force and the accomplished work (energy) made a significant difference in the group receiving both laser and levothyroxine synchronously rather than the other groups (P ≤ 0.05). The elasticity of the wound healing in the groups that received laser and levothyroxine synchronously was significantly higher in comparison with the control and hypothyroidism groups but the difference was not significant in comparison with the laser or levothyroxine groups.
The results of our study showed that the application of laser and levothyroxine synchronously improves the biomechanical parameters of wound during healing in comparison to the use of laser and levothyroxine solely

Achieving appropriate anesthesia in patients with symptomatic irreversible pulpitis in mandibular molars during endodontic treatment is always one of the most challenging aspects. Photobiomodulation (PBM) has been used in dentistry due to its anti-inflammatory properties and regenerative effects. This study evaluates the effects of PBM in the depth of anesthesia in inferior alveolar nerve block.
In this randomized clinical trial, 44 patients requiring endodontic treatment in lower molar, left or right were selected, half of them were randomly treated with PBM therapy. Laser irradiation by 980 nm diode laser with a single dose (15 J/cm2, for 20 seconds) before anesthesia was performed at the buccal aspect. Inferior alveolar nerve block was performed once. Success was defined as no or mild pain (no need for any supplemental injection), based on the visual analogue scale during access cavity preparation. Results were evaluated using SPSS software.
The results of this study showed that the necessity for supplemental injection was lower in the group receiving laser than in the group without laser (P = 0.033). The mean pain intensity during dentin cutting was lower in the group receiving laser than in the group without laser (P = 0.031). Also, the mean pain intensity during pulp dropping was lower in the group receiving laser, than the group without laser (P = 0.021).
Based on the results of this study, it seems that the application of PBM before anesthesia is effective on increasing depth of anesthesia.

In recent years, the positive effect of fractional CO2 laser on increasing collagen fibers, and consequently its effect on treating striae has been suggested. The present study aims to assess the effectiveness of CO2 fractional laser 10600-nm in the treatment of striae alba.
In this prospective clinical trial, 2 treatment sessions of fractional CO2 laser with 4-week interval was given to 30 patients with striae alba. Cutaneous resonance running time (CRRT) was measured at baseline and at week 4 and 3 months after the last session of laser therapy. The level of improvement was assessed by 2 independent dermatologists and patients after 3 months of follow up.
16.7% of patients had moderate improvement, 63.3% had minimal improvement, and 20% had no improvement. A statistical significant difference was found in median CRRT during the study (P Striae alba remain a challenging condition to treat. The treatment of striae alba with CO2 fractional laser results in minimal improvement with mild side effects.

Pulsed dye laser (PDL) for treatment of port wine stain (PWS) usually causes some acute adverse effects, including pain, erythema, scabbing and swelling. This study aimed to determine whether topical halometasone can be used to reduce these acute adverse effects for post-PDL care of patients.
A total of 40 PWS subjects were enrolled in this study and randomly assigned into two regimens: PDL alone and PDL halometasone. All subjects were given a single treatment of PDL with wavelength of 595 nm, fluence of 8.0~13.5 J/cm2, pulse duration of 0.45~20 ms (We mainly used purpuric pulse duration for PWS) and spot size of 7 mm. Subjects in the PDL halometasone group received topical application of halometasone daily for 3 days. Subjects were followed-up on days 3, 7 and one month post-PDL to evaluate the reduction of adverse effects.
Subjects in the PDL halometasone group had significantly improved erythema and scab scores and had less erythema duration days as compared to those in the PDL alone group. Topical halometasone also showed a decrease in pain index among subjects, but was statistically insignificant. Topical halometasone did not affect the ultimate efficacy of PDL treatment for PWS.
Topical halometasone can significantly reduce acute adverse effects induced by PDL for treatment of PWS birthmarks, thus providing a safe and efficacious solution for post-PDL care of PWS patients.

Infrared photocoagulation (IRC) was introduced as a mainstay procedure for treatment of hemorrhoids. The present study aimed to compare the clinical efficacy of IRC compared to closed hemorrhoidectomy.
Forty patients suffering grade-3 hemorrhoid that referred to the surgery clinic at Imam Hossein hospital in Tehran in 2013 were randomly assigned to groups treated with the IRC modality or Ferguson’s closed hemorrhoidectomy method. The patients in the 2 groups were followed-up for the first 24 hours after surgery and 8 weeks later. Postoperative pain was assessed using visual analogue scale (VAS) at three time points of 24 hours, 2 weeks and 8 weeks after operation.
Regarding bleeding, its overall prevalence was 5.0% in the IRC group and 30.0% in the hemorrhoidectomy group, which was significantly less prevalent in the IRC group. Notably, the IRC group had a lower mean postoperative pain score compared to the hemorrhoidectomy group. Time of return to work was significantly shorter in the IRC group; no difference was found in the mean duration of hospital stay, and recurrence rate across 2 groups.
IRC procedure is safer than closed hemorrhoidectomy with lower postoperative pain severity, less secondary bleeding, and leads to earlier return to work in patients with hemorrhoid.

The demand for esthetic dental treatments is increasing in recent years mainly due to improved oral hygiene and better maintenance of oral health and teeth in older individuals. Bleaching of discolored anterior teeth is the most popular among esthetic dental treatments. Even individuals with sound teeth and adequate esthetics seek to have whiter teeth in the anterior region. The aim of this study was to evaluate tooth color changes following conventional in-office bleaching techniques compared to light-activated methods using different light sources.
Seventy sound anterior teeth (devoided of caries and/or fracture), extracted for periodontal and orthodontic reasons were selected and allocated to 7 groups: (A) control, (B) conventional bleaching (C) LED-activated bleaching, (D) KTP laser-activated bleaching, (E) diode laser-activated bleaching, (F) Nd:YAG laser-activated bleaching and (G) CO2 laser-activated bleaching. Colorimetric evaluation was carried out before and after treatment using a spectrophotoradiometer. Data were analyzed by one- and two-way analysis of variance (ANOVA) as well as multiple comparison methods.
The results showed that all bleaching procedures were effective in reducing the yellowness index. However, the KTP laser-activated bleaching was significantly more effective than the other techniques in 95% confidence level. It was also seen that CO2 laser activated method has outperformed groups E, F and G and the conventional bleaching without light activation was not effective at all and represented similar results with the control group. Furthermore, the groups E and G had almost the same results in decreasing the yellowness index.
The results showed that all bleaching techniques were effective however, the KTP laser-activated bleaching was significantly more efficient, closely followed by the CO2 laser-activated bleaching technique.

Non-ablative fractional erbium-doped glass 1540 nm and fractional ablative 10600 nm carbon dioxide lasers are regarded as effective modalities for treating acne atrophic scars. In this study, we aimed to compare the effectiveness of fractional CO2 laser and fractional non-ablative 1540 nm erbium doped glass laser in treating post acne atrophic scars in Egyptian patients.
Fifty-eight patients complaining of moderate and severe acne atrophic scars were randomly divided into 2 groups of 29 patients each. Both groups were subjected to 4 treatment sessions with 3 weeks interval and were followed up for 3 months. In group A, enrolled patients received CO2 laser, while in group B, patients were treated with 1540 nm erbium glass fractional laser.
Clinical assessment revealed that the mean grades of progress and improvement were higher with fractional 10600 nm CO2 laser but with non-significant difference between both treatments (P = 0.1). The overall patients’ satisfaction with both lasers were not significantly different (P = 0.44).
Both fractional ablative CO2 and fractional non-ablative erbium glass lasers are good modalities for treating acne scars with a high efficacy and safety profile and good patient satisfaction. The fractional ablative laser showed higher efficacy while non-ablative laser offered less pain and shorter downtime.

This study aimed to determine the bond strength of fiber post to composite core following surface treatment with Er,Cr:YSGG laser at different powers and sandblasting with and without thermocycling.
In this experimental study, 30 fiber posts (Glassix, Nordin, Switzerland) were randomly divided into 5 groups of sandblasting, no treatment and laser irradiation at 1, 1.5 and 2 W powers. Following composite filling and mounting, 1-mm thick sections were made for push-out bond strength testing. Half of the samples in each group were subjected to thermocycling (n=15). Two-way analysis of variance (ANOVA) was used to analyze the bond strength values. Pairwise comparisons were made using Tukey test (P Effect of treatment method on push-out bond strength of fiber post to composite core was significant (P = 0.017), while thermocycling had no significant effect on bond strength (P = 0.964). Pairwise comparison of surface treatment methods revealed no significant difference in groups with and without thermocycling (P > 0.05), but Er,Cr:YSGG laser irradiation with 1 W power yielded significantly higher bond strength than the control group (P =0.01).
Irradiation of Er,Cr:YSGG laser at 1 W power increased the bond strength of fiber post to composite core. Thermocycling slightly decreased the bond strength at the fiber post-core interface.

Orthodontic treatment has many advantages such as esthetic improvement and self-esteem enhancement; yet it has some disadvantages such as increasing the risk of formation of white spot lesions, because it makes oral hygiene more difficult. It is rational to implement procedures to prevent these lesions. The present study was aimed to assess the effect of CO2 laser and fluoride varnish on the surface of the enamel surface microhardness around the orthodontic braces.
Eighty extracted premolar teeth were selected, scaled, polished with nonfluoridated pumic and metal brackets were bonded to them. Then, they were randomly allocated to 5 groups: control (neither fluoride nor laser is used on enamel surfaces), fluoride (4 minutes fluoride varnish treatment of the enamel surfaces), CO2 laser (10.6 μm CO2 laser irradiation of the teeth), laser-fluoride (fluoride application after laser irradiation) and fluoride-laser (fluoride was applied and then teeth were irradiated with laser). After surface treatment around brackets on enamel, the samples were stored in 0.1% thymol for less than 5 days and then they were exposed to a 10-day microbiological caries model. Microhardness values of enamel were evaluated with Vickers test. One sample of each group (5 teeth from 80 samples) was prepared for SEM (scanning electron microscopy) and the data from 75 remaining teeth were analyzed with analysis of variance (ANOVA) and chi-square tests (α = 0.05).
Microhardness mean values from high to low were as follow: fluoride-laser, laser-fluoride, laser, fluoride and control. Microhardness in fluoride-laser group was significantly higher compared with that of the control group. Distribution adhesive remnant index (ARI) scores were significantly different between groups and most of bond failures occurred at the enamel-adhesive interface in groups 2 to 5 and at the adhesive-bracket interface in the control group.
Combination of fluoride varnish and CO2 laser irradiation can reduce enamel demineralization around orthodontic brackets.

Near-infrared (NIR) optical imaging is a non-ionizing modality that is emerging as a diagnostic/prognostic tool for breast cancer according to NIR differentiation of hemoglobin (Hb)concentration.
The transmission values of LED-sourced light at 625 nm were measured by power meter to evaluate the optical properties of Hb in breast phantom containing major and minor vessels. For the simulation of blood variations in cancerous breast condition, we prepared 2 concentrations of pre-menopausal Hb and 4 concentrations of post-menopausal Hb and, for comparison with normal tissue, one concentration of Hb injected inside the phantom’s vessels. Imaging procedure on the phantom was also conducted by LED source and CCD camera. The images from the experiments were compared with the results obtained from the images analyzed by MATLAB software. Finally, mammography of phantom including various concentration of Hb was prepared.
The transmitting intensities of NIR in blood containing 1, 2 and 4 concentrations of Hb in the major vessels were 52.83 ± 2.85, 43.00 ± 3.11 and 31.17 ± 2.27 μW, respectively, and in minor vessels containing similar Hb concentrations were 73.50 ± 2.43, 60.08 ± 5.09 and 42.42 ± 4.86 μW, respectively. The gray-scale levels on the major vessel were about 96, 124, 162 and on the minor vessel about 72, 100, 130 measured for 1, 2 and 4 Hb concentrations, respectively. The sensitivity and specificity of NIR imaging differentiation were 97.4% and 91.3%, respectively.
Significant differences in transmitting intensity, optical imaging as well as software analysis of images were observed for 1, 2 and 4 concentrations of Hb in major and minor breast phantom vessels. Differentiation capability of minor vessels was higher than major vessels for Hb concentrations. Despite a good detection for location of vessels by mammography, it could not show differences between vessels with various concentrations. However, NIR optical imaging demonstrated a good image contrast for showing vessels in terms of concentration. This study recommends NIR optical imaging for prescreening breast cancer due to its potential for early diagnosis.

The aim of this study was to assess the effect of surface treatment with erbium: yttrium-aluminum-garnet (Er:YAG) and erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers on shear bond strength of composite resin to recently bleached dentin.
In this study, 40 extracted human premolars were selected. The teeth were cut 4 mm apical to the cusp tip and were randomly divided into four groups (n = 10 in each group) for shear bond strength testing. For bleaching, 35% hydrogen peroxide (H2o2) gel (Opalescence Endo, Ultradent, South Jordan, UT, USA) was applied to dentin surfaces of all specimens for 10 days. Before etching and bonding, in Er,Cr:YSGG and Er:YAG laser groups, dentin surfaces were irradiated with Er,Cr:YSGG and Er:YAG lasers, respectively. In Er,Cr:YSGG group, Er:YAG group and control group, composite restoration was performed immediately after bleaching while in common procedure group, composite restoration was performed after seven days. The teeth were then subjected to shear bond strength testing machine. The data were statistically analyzed using analysis of variance (ANOVA) and Tukey test.
The mean and standard deviation (SD) of shear bond strength was 4.3 ± 1.4 MPa for control group, 6.7 ± 2.0 Mpa for Er,Cr:YSGG group, 14.4 ± 3.7 Mpa for Er:YAG group and 19.4 ± 2.6 Mpa for common procedure group.
The shear strength of composite to Er:YAG laser-treated bleached dentin was significantly higher than control group while significantly lower than common procedure.

Trigeminal neuralgia (TN) is the most common neuralgia in the head and neck region and a common cause of orofacial pain. It is routinely treated with carbamazepine. Laser, acupuncture and radiofrequency are among other treatment modalities for this condition. This study sought to assess the efficacy of laser therapy in conjunction with carbamazepine for treatment of TN.
A total of 30 patients who met the inclusion criteria were divided into 2 groups of cases and controls (n = 15) by double blind randomized controlled clinical trial. All patients received 100 mg carbamazepine at baseline and another 100 mg after 2 days for pain control. In the case group, low level laser therapy (LLLT) was also performed in addition to pharmaceutical therapy. Sham laser was used in the control group instead of LLLT. Treatment was continued for 9 sessions (3 days a week). The intensity of pain was measured and compared in the 2 groups using visual analog scale (VAS) in 3 period. The qualitative variables among the groups were compared using the repeated measures analysis of variance (ANOVA).
The severity of pain was lower at the end of treatment in the case compared to the control group so this difference was statistically significant (P = 0.003). The severity of pain decreased in both groups over time. Significant difference was noted in this regard between the 2 groups either (P = 0.003). At the end of treatment pain intensity dropped in the intervention group from 6/8 to 1/2 and control group from 6/6 to 2/7.
Laser therapy did add to the value of pharmaceutical therapy for treatment of TN. Both groups experienced significant improvement over time. So it is better to used laser complementary therapy to reduce side effects and the medicine dosage.

Presently, different holmium: yttrium aluminum garnet (Ho:YAG) laser calibers are used for endoscopic stone treatment, which include 200, 365, 500 and 1000 Mm fibers. Currently, there are not enough studies to compare the performance of these fibers. In this retrospective investigation, we compared the outcome of 200, 365 and 500 Mm fibers of Ho:YAG laser in transurethral lithotripsy of ureteral stone.
From January 2016 to June 2017, 74 subjects with mean age of 35.3 ± 5.6 were randomly allocated to 3 groups according to the caliber of laser, 200, 365 and 500 Mm for transurethral lithotripsy. The main purpose of this investigation was to evaluate mean operation time (MOT), stone free rate (SFR) and complications.
MOT and SFR were significantly different in 500 Mm laser caliber (P = 0.046, P = 0.029, respectively). There was no remarkable difference between the 3 groups in this regard.
Based upon our data, the clinical potency of the Ho: YAG laser was great in all 3 fiber calibers. The most important results of this comparison were the significantly higher SFR with increased laser caliber.

Necrotizing ulcerative gingivitis (NUG) is a microbial disease of the gingiva in the context of an impaired host response. This form of gingivitis is relatively rare. NUG is an infection characterized by gingival necrosis presenting as “punched-out” papillae, spontaneous bleeding, pain, oral malodor, and pseudomembrane formation. The primary predisposing factors are bacterial plaque and an inadequate diet, but smoking and psychological stress may also affect the disease severity. NUG is associated with a characteristic bacterial flora, which includes fusiform bacteria, spirochetes, and Prevotella intermedia. Conventional treatment includes control of both the bacterial plaque and the secondary factors, as well as topical or systemic treatment biostimulative effect on wound healing, pain control, and inflammatory processes. Patients with NUG were treated using adjunct use of a diode laser (980 nm) for the control of pain and to accelerate the wound healing at day 2. 3. 5. 9, energy density was 9 J/cm2. After treatment, the patients’ quality of life improved faster than with conventional treatment. These results suggest that low-level laser therapy (LLLT) is an effective treatment for the reduction of pain levels and healing times. As a result, our case report shows that LLTT has a positive effect in relieving the symptoms of NUG.