Photomedicine and laser surgery最新文献

{"title":"Performance of Different Methods for Detection of Incipient Occlusal Caries Lesions: An In Vitro Study.","authors":"Sinem Akgul,&nbsp;Oya Bala,&nbsp;İhsan Yikilgan","doi":"10.1089/pho.2017.4353","DOIUrl":"https://doi.org/10.1089/pho.2017.4353","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this in vitro study was to evaluate the diagnostic performance of visual inspection (VI), laser fluorescence (LF pen), fluorescence camera (FC), and alternating current impedance spectroscopy technique (ACIST) for detection of incipient occlusal caries lesions. Histology was used as the gold standard to determine the interexaminer reliability of the methods, among three examiners with different levels of experiences (Examiner 1: 5 years; examiner 2: 10 years; and examiner 3: 25 years).</p><p><strong>Materials and methods: </strong>One hundred two molar teeth were selected. The occlusal surfaces of teeth were evaluated with VI, LF pen, FC, and ACIST devices independently by three examiners. Diagnostic performances of methods were evaluated with binormal receiver-operating characteristics analysis. Interexaminer agreement of detection methods was assessed using Cohen's kappa coefficient values (p < 0.001).</p><p><strong>Results: </strong>Incipient enamel lesions were determined more successfully with VI by all examiners. All detection methods were presented with statistically acceptable interexaminer agreement (p < 0.001). For D₂ and D₃ thresholds, FC for examiner 1, VI for examiner 2, and both VI and FC for examiner 3 demonstrated statistically high sensitivity and specificity (p < 0.05).</p><p><strong>Conclusions: </strong>It can be concluded that diagnostic performance of the methods was insufficient for detecting incipient occlusal caries lesions by itself. Performance can be improved by using them with VI as a traditional caries detection method.</p>","PeriodicalId":20117,"journal":{"name":"Photomedicine and laser surgery","volume":"36 4","pages":"191-197"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pho.2017.4353","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35673982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrapulpal Temperature Increases Caused by 445-nm Diode Laser-Assisted Debonding of Self-Ligating Ceramic Brackets During Simulated Pulpal Fluid Circulation.","authors":"Steffen Stein,&nbsp;Johannes Wenzler,&nbsp;Andreas Hellak,&nbsp;Michael Schauseil,&nbsp;Heike Korbmacher-Steiner,&nbsp;Andreas Braun","doi":"10.1089/pho.2017.4356","DOIUrl":"https://doi.org/10.1089/pho.2017.4356","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated temperature increases in dental pulp resulting from laser-assisted debonding of ceramic brackets using a 445-nm diode laser.</p><p><strong>Materials and methods: </strong>Eighteen ceramic brackets were bonded in standardized manner to 18 caries-free human third molars. Pulpal fluid circulation was simulated by pumping distilled water at 37°C through the pulp chamber. The brackets were irradiated with a 445-nm diode laser. Temperatures were measured using a thermal camera at points P1 (center of the pulp) and P2 (in the hard dental tissue) at the baseline (T0), at the start and end of laser application (T1 and T2), and the maximum during the sequence (T_max).</p><p><strong>Results: </strong>Significant differences in the temperatures measured at P1 and P2 were observed among T0, T1, T2, and T_max. Significant increases in temperature were noted at points P1 and P2, between T1 and T2, T1 and T_max, and T2 and T_max. The maximum P2 values were significantly higher than at P1. The maximum temperature increase measured in the pulp was 2.23°C, lower than the critical threshold of 5.5°C.</p><p><strong>Conclusions: </strong>On the basis of the laser settings used, there is no risk to the vitality of dental pulp during laser-assisted debonding of ceramic brackets with a 445-nm diode laser.</p>","PeriodicalId":20117,"journal":{"name":"Photomedicine and laser surgery","volume":"36 4","pages":"185-190"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pho.2017.4356","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35706858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Antibacterial Efficiency of Different Root Canal Disinfection Techniques in Primary Teeth.","authors":"Banu Öter,&nbsp;Nursen Topçuog Lu,&nbsp;Mehmet K Tank,&nbsp;Sevi Burçak Çehreli","doi":"10.1089/pho.2017.4324","DOIUrl":"https://doi.org/10.1089/pho.2017.4324","url":null,"abstract":"<p><strong>Background: </strong>A successful primary root canal treatment depends on effective shaping and cleaning the root canal system and finally filling it with a hermetic sealer. Clinically, roots of primary teeth are difficult to shape and the irrigation/disinfection protocol has great importance on prognosis.</p><p><strong>Objective: </strong>The present study evaluated the antibacterial efficiency of Endosafe (Orangedental GmbH & Co. KG), photo-activated disinfection (PAD; Orangedental GmbH & Co. KG), diode laser (Epic 10; Biolase, Inc.), ozone (O₃, Ozonytron; Biozonix, München, Germany), and sodium hypochloride applications in primary root canals that were infected with Enterococcus faecalis after standard mechanical instrumentation.</p><p><strong>Methods: </strong>The study was conducted on roots of 100 human primary molar teeth, which were extracted due to excessive caries. The roots were divided in 5 groups with 15 roots in each root disinfection protocol. In addition, 15 samples and 10 samples served as positive and negative controls, respectively. The Shapiro-Wilk test, the Kruskal-Wallis test and then by post hoc group comparisons with the Bonferroni-adjusted Mann-Whitney U test (unpaired observations) was used.</p><p><strong>Results: </strong>Sodium hypochlorite (NaOCl) exhibited the highest antibacterial effect (0 colony-forming units per mL). Diode laser irradiation was statistically more effective than the ozone, PAD, and Endosafe groups (p < 0.001). Endosafe, PAD, and ozone groups showed similar antibacterial effect (p > 0.05). Although not statistically significant, the Endosafe was more effective in reducing the bacterial count when compared with ozone and PAD.</p><p><strong>Conclusions: </strong>The five tested irrigation systems were shown to be effective in disinfection of the E. faecalis-contaminated primary root canals and best results were obtained with 2.5% NaOCl and diode laser.</p>","PeriodicalId":20117,"journal":{"name":"Photomedicine and laser surgery","volume":" ","pages":"179-184"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pho.2017.4324","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39985101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Different Energy Levels of Er:YAG Laser Regarding Intrapulpal Temperature Change During Safe Ceramic Bracket Removal.","authors":"Didem Nalbantgil,&nbsp;Murat Tozlu,&nbsp;Mehmet Oguz Oztoprak","doi":"10.1089/pho.2017.4397","DOIUrl":"https://doi.org/10.1089/pho.2017.4397","url":null,"abstract":"<p><strong>Objective: </strong>This study was done to compare the intrapulpal temperature change generated by different energy levels of Er:YAG laser used during debonding of ceramic brackets and find the most suitable level for clinical use.</p><p><strong>Material and methods: </strong>Eighty polycrystalline alumina brackets were bonded on bovine incisor teeth, which were randomly divided into 4 groups of 20. One group was assigned as control. In the study groups, after laser exposure with 2, 4, or 6 Watt energy levels, brackets were debonded using an Instron Universal Testing machine. Adhesive remnant index (ARI) scores were recorded to evaluate the site of debonding. To assess intrapulpal thermal increase, 60 human premolar teeth that were prepared in the same way, at the same energy levels, by a thermocouple were used.</p><p><strong>Results: </strong>When the debonding forces, intrapulpal temperature increases, and ARI of the groups were examined, statistically significant difference was observed between the groups. Mean temperature increases of 0.67°C ± 0.12°C, 1.25°C ± 0.16°C, and 2.36°C ± 0.23°C were recorded for the 2, 4, and 6 Watt laser groups. The mean shear bond strength was 21.35 ± 3.43 megapascals (MPa) for the control group, whereas they were 8.79 ± 2.47, 3.28 ± 0.73, and 2.46 ± 0.54 MPa for the 2, 4, and 6 Watt laser groups, respectively.</p><p><strong>Conclusions: </strong>Four watts is the most efficient and safe energy level to be used, utilizing Er:YAG laser with water cooling spray for 6 sec by scanning method during debonding of polycrystalline alumina brackets without any carbonization effects and detrimental temperature changes at debond sites.</p>","PeriodicalId":20117,"journal":{"name":"Photomedicine and laser surgery","volume":"36 4","pages":"209-213"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pho.2017.4397","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35787681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Safety of Needle, EndoActivator, and Laser-Activated Irrigation in Overinstrumented Root Canals.","authors":"Ozgur Genc Sen,&nbsp;Melih Kaya","doi":"10.1089/pho.2017.4380","DOIUrl":"https://doi.org/10.1089/pho.2017.4380","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the safety of sodium hypochlorite (NaOCl) irrigation using three different techniques during the final rinse in overinstrumented root canals.</p><p><strong>Background data: </strong>The effect of irrigant activation on irrigant extrusion from overinstrumented root canals is still unclear.</p><p><strong>Methods: </strong>A total of 30 single-rooted teeth were decoronated. The working lengths were determined and the roots were divided into two groups of 15 teeth each: group 1, instrumentation 0.5 mm short of the apical foramen and group 2, instrumentation 0.5 mm beyond the apical foramen (overinstrumented). Needle irrigation (NI), sonic irrigation with EndoActivator (EAI), and laser-activated irrigation (LAI) were used for the final rinse in each group; each root underwent the three irrigation procedures in a randomized crossover manner. A modified container-foam model was used to collect apically extruded NaOCl. The weight of the extruded NaOCl was calculated by subtracting the initial weights of the containers from their final weights. All data were statistically analyzed.</p><p><strong>Results: </strong>The amount of NaOCl extrusion was similar with all three irrigation systems in group 1. In group 2, the amount of extruded NaOCl was significantly greater with EAI than with NI and LAI. EAI and LAI caused significantly greater extrusion in group 2 than in group 1.</p><p><strong>Conclusions: </strong>EAI, NI, and LAI are equally safe for irrigating canals with intact apices. However, the risk of irrigant extrusion can increase in overinstrumented canals, with EAI associated with a greater risk compared with NI and LAI.</p>","PeriodicalId":20117,"journal":{"name":"Photomedicine and laser surgery","volume":"36 4","pages":"198-202"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pho.2017.4380","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35678100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shear Bond Strength of Composite and Ceromer Superstructures to Direct Laser Sintered and Ni-Cr-Based Infrastructures Treated with KTP, Nd:YAG, and Er:YAG Lasers: An Experimental Study.","authors":"Oguzhan Gorler,&nbsp;Ihsan Hubbezoglu,&nbsp;Melih Ulgey,&nbsp;Recai Zan,&nbsp;Kubra Guner","doi":"10.1089/pho.2017.4394","DOIUrl":"https://doi.org/10.1089/pho.2017.4394","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to examine the shear bond strength (SBS) of ceromer and nanohybrid composite to direct laser sintered (DLS) Cr-Co and Ni-Cr-based metal infrastructures treated with erbium-doped yttrium aluminum garnet (Er:YAG), neodymium-doped yttrium aluminum garnet (Nd:YAG), and potassium titanyl phosphate (KTP) laser modalities in in vitro settings.</p><p><strong>Methods: </strong>Experimental specimens had four sets (n = 32) including two DLS infrastructures with ceromer and nanohybrid composite superstructures and two Ni-Cr-based infrastructures with ceromer and nanohybrid composite superstructures. Of each infrastructure set, the specimens randomized into four treatment modalities (n = 8): no treatment (controls) and Er:YAG, Nd:YAG, and KTP lasers. The infrastructures were prepared in the final dimensions of 7 × 3 mm. Ceromer and nanohybrid composite was applied to the infrastructures after their surface treatments according to randomization. The SBS of specimens was measured to test the efficacy of surface treatments. Representative scanning electron microscopy (SEM) images after laser treatments were obtained.</p><p><strong>Results: </strong>Overall, in current experimental settings, Nd:YAG, KTP, and Er:YAG lasers, in order of efficacy, are effective to improve the bonding of ceromer and nanohybrid composite to the DLS and Ni-Cr-based infrastructures (p < 0.05). Nd:YAG laser is more effective in the DLS/ceromer infrastructures (p < 0.05). KTP laser, as second more effective preparation, is more effective in the DLS/ceromer infrastructures (p < 0.05). SEM findings presented moderate accordance with these findings.</p><p><strong>Conclusions: </strong>The results of this study supported the bonding of ceromer and nanohybrid composite superstructures to the DLS and Ni-Cr-based infrastructures suggesting that laser modalities, in order of success, Nd:YAG, KTP, and Er:YAG, are effective to increase bonding of these structures.</p>","PeriodicalId":20117,"journal":{"name":"Photomedicine and laser surgery","volume":"36 4","pages":"203-208"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pho.2017.4394","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36007348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemolasertherapy: A Novel Procedure for Gingival Papilla Regeneration-Case Report.","authors":"Fatima Zanin,&nbsp;Maria Stella Moreira,&nbsp;Ana Clara Fagundes Pedroni,&nbsp;Mateus Windlin,&nbsp;Ana Paula Brugnera,&nbsp;Aldo Brugnera Júnior,&nbsp;Marcia Martins Marques","doi":"10.1089/pho.2017.4349","DOIUrl":"https://doi.org/10.1089/pho.2017.4349","url":null,"abstract":"<p><strong>Background: </strong>Interdental papilla is of major importance to patients' orofacial aesthetics, especially regarding anterior teeth as part of the smile's harmony. Loss of gingival tissue, which constitutes interdental papilla, forms what in odontology is called black spaces. This loss, besides affecting the smile's aesthetics, also provokes phonetic and functional damage.</p><p><strong>Objective: </strong>The objective of the authors is to present the result of three clinical cases treated with an innovative technique called hemolasertherapy, which stimulates growth of gingival papilla and thus permanently fills in the black spaces.</p><p><strong>Methods: </strong>The photobiomodulation therapy (PBMT) used a 660 nm diode laser (Laser Duo, MMO-São Carlos, SP, Brazil), punctual, contact mode in two steps: before the bleeding (first PBMT) and immediately after bleeding (second PBMT). Parameters used were power output: 100 mW, CW; diameter tip: 5 mm; spot area: 0.19 cm²; irradiation exposure time per point: 20 sec; 14 points per daily session; total of 2 sessions, with a 1-week interval; E: 2 J per point; E: per daily session, 28 J; irradiance per point: 0.52 W/cm²; fluence per point: 10.4 J/cm². Total in two daily sessions: total energy: 56 J; total fluence: 294.75 J/cm, 560 sec total time. An in vitro preliminary study was simultaneously carried out to demonstrate what could happen at cellular level in hemotherapy clinical cases associated with PBMT laser application.</p><p><strong>Results: </strong>This initial study demonstrated that the blood clot originated from the bleeding provoked in the gingival area is rich in mesenchymal stem cells. PBMT enables preservation, viability, and further differentiation, stimulating the return of gingival stem cells, which would support their survival and differentiation in the blood clot, thus favoring interdental papilla regeneration.</p><p><strong>Conclusions: </strong>Follow-up was done for a time span of 4-5 years and considered excellent with regard to papilla preservation.</p>","PeriodicalId":20117,"journal":{"name":"Photomedicine and laser surgery","volume":"36 4","pages":"221-226"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pho.2017.4349","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36007349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Easy Debonding of Ceramic Brackets Bonded with a Light-Cured Orthodontic Adhesive Containing Microcapsules with a CO₂ Laser.","authors":"Shiori Arima,&nbsp;Yasuhiro Namura,&nbsp;Takahiko Tamura,&nbsp;Noriyoshi Shimizu","doi":"10.1089/pho.2017.4346","DOIUrl":"https://doi.org/10.1089/pho.2017.4346","url":null,"abstract":"<p><strong>Objective: </strong>An easy debonding method for ceramic brackets using a light-cured Bis-GMA resin containing heat-expandable microcapsules and CO₂ laser was investigated.</p><p><strong>Background: </strong>Ceramic brackets are used frequently in orthodontic treatment because of their desirable esthetic properties. However, the application of heavy force to ceramic brackets in debonding can fracture the tooth enamel and ceramic brackets, causing tooth pain.</p><p><strong>Materials and methods: </strong>In total, 60 freshly extracted bovine permanent mandibular incisors were divided randomly into 10 groups of 6 specimens each, corresponding to the number of variables tested. Ceramic brackets were bonded to bovine permanent mandibular incisors using an orthodontic bonding agent containing heat-expandable microcapsules at different levels (0-30 wt%) and resin composite paste, and cured by a curing device. The bond strengths were measured before and after CO₂ laser irradiation, and the temperature increase in the pulp chamber in fresh human first premolars was also evaluated.</p><p><strong>Results: </strong>With CO₂ laser irradiation for 5 sec to the bracket, the bond strength in the 25% microcapsule group decreased significantly, to ∼0.17-fold, compared with that of the no-laser group (p < 0.05). The maximum temperature increase in the pulp chamber was 5.3°C with laser irradiation, which was less than the level that induces pulp damage.</p><p><strong>Conclusions: </strong>From these results, it seems likely that the combined use of a light-cured orthodontic bonding agent containing microcapsules and a CO₂ laser is a simple debonding system for ceramic brackets, with less debonding time and enamel damage.</p>","PeriodicalId":20117,"journal":{"name":"Photomedicine and laser surgery","volume":"36 3","pages":"162-168"},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pho.2017.4346","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35282903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxygen-Enriched Photosensitizer Medium with Red Blood Cells to Study Tissue Interaction of Photosensitization Reaction.","authors":"Risa Hamada,&nbsp;Emiyu Ogawa,&nbsp;Tsunenori Arai","doi":"10.1089/pho.2017.4321","DOIUrl":"https://doi.org/10.1089/pho.2017.4321","url":null,"abstract":"<p><strong>Background: </strong>It has been reported that the oxygen pressure of a photosensitizer medium decreases during an irradiation leading to decrease in the efficacy of the photosensitization reaction against the target cell in vitro.</p><p><strong>Objective: </strong>The aim of this study was to obtain solutions with high dissolved oxygen levels in cultivated wells with perceiving oxygen environment and photosensitizer bleaching for photosensitization reaction studies.</p><p><strong>Materials and methods: </strong>We used a 10-mm-wide optical cell cuvette with a 1-mm optical path length as the well. A red blood cell (RBC) suspension with a hematocrit level of 0.625% was employed as the optical sample. The photosensitizer talaporfin sodium was added to a concentration of 30 μg/mL. The optical sample was irradiated by a 663-nm diode laser at 120 mW/cm², for a total radiant exposure of 0-20 J/cm², to induce a photosensitization reaction. Absorption spectra of the samples in the range of 475-700 nm were measured before and after each irradiation condition. Visible spectroscopy was selected to distinguish between the major three hemoglobin (Hb) types: oxygenated Hb, deoxygenated Hb, and met Hb. Also, this wavelength range was selected to investigate photobleaching using the Q band absorption peak. Each Hb concentration was estimated using a multiple regression analysis applied to the obtained absorption spectra.</p><p><strong>Results: </strong>The relationship between oxygen saturation and the absorption peak in the Q band from the talaporfin sodium dynamics with increasing radiant exposure was revealed by our method with approximately twofold oxygen-dissolved solution.</p><p><strong>Conclusions: </strong>We could perceive the oxygen environment and the photosensitization reaction progression simultaneously with increasing dissolved oxygen by adding RBCs to the cell medium and measuring the absorption spectrum of it.</p>","PeriodicalId":20117,"journal":{"name":"Photomedicine and laser surgery","volume":"36 3","pages":"146-150"},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pho.2017.4321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35552690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-Step Irradiance Treatment Can Achieve Excellent Pain Control During Red Light 5-Aminolevulinic Acid Photodynamic Therapy for Actinic Keratoses.","authors":"Gyorgy Paragh,&nbsp;Nathalie C Zeitouni","doi":"10.1089/pho.2017.4351","DOIUrl":"https://doi.org/10.1089/pho.2017.4351","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the ability of two-step irradiance to maintain pain control during red light 5-aminolevulinic acid (ALA) photodynamic therapy (PDT) for actinic keratoses (AK) and assess factors influencing pain.</p><p><strong>Background: </strong>PDT provides excellent clinical and cosmetic results in the treatment AK and early basal cell carcinomas (BCC). Widespread use of PDT is limited, in part, by pain. A two-step irradiance method for PDT has previously been shown to significantly reduce PDT-associated pain during the treatment of BCC, but the ability of this method to limit pain during the treatment of AKs has not been reported.</p><p><strong>Methods: </strong>We performed a retrospective chart review to assess the level of pain during AK treatment by red light PDT (n = 99). Natural density filter was used to reduce the irradiance of the light source and initially 10 J/cm² dose was delivered at 35 mW/cm² and then, 65 J/cm² dose was delivered at 70 mW/cm². Pain level was measured using a 10-point visual analog scale at three points during the procedure.</p><p><strong>Results: </strong>Pain was low to moderate in most patients (mean ± standard error of the mean pain score: 2.35 ± 0.19). Higher pain was seen midprocedure versus at the beginning (p < 0.0001) and at the end (p = 0.003) of PDT. There was no significant difference in pain perception between genders and different treatment areas.</p><p><strong>Conclusions: </strong>Our results provide evidence that red light ALA PDT of AKs is very well tolerated with the two-step irradiance protocol.</p>","PeriodicalId":20117,"journal":{"name":"Photomedicine and laser surgery","volume":"36 3","pages":"174-176"},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1089/pho.2017.4351","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35242747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}