Chairman:Assoc. Prof. Georgi Tomov – President of BDLS
Honorary Chairmen:Prof. Stefan Kostianev – Rector of Medical University of Plovdiv
Prof. Georgi Todorov – Dean of Faculty of Dental Medicine, MUP
Team MembersProf. Ani Belcheva (Plovdiv)
Prof. Vladimir Panov (Varna)
Assoc. Prof. Vesela Stefanova (Plovdiv)
Assoc. Prof. Assya Krasteva (Sofia)
Assoc. Prof. Maria Dencheva (Sofia)
Assoc. Prof. Miglena Balcheva (Varna)
Dr. Janet Dumanova (Plovdiv)
Dr. Blagovesta Yaneva (Plovdiv)
Dr. Maria Mutafchieva (Plovdiv)
Dr. Elitsa Veneva (Plovdiv)
Dr. Nikolay Nikolov (Plovdiv)
Dr. Mihail Tanev (Plovdiv)
Dr. Evgenii Mironov (Sofia)
Dr. Rada Kazakova (Plovdiv)
DGL Organizing TeamProf. Norbert Gutknecht
Dr. Detlef Klotz
Prof. Dr. Siegfried Janicke
Dr. Stefan Grumer
Prof. Dr. Anton Sculean
Prof. Dr. Baun
Dr. Gabriele Schindler-Hultzsch
Dr. Thorsten Kleinert
Dr. Ralf Borchers
Dr. Iris Brader
Dr. Birgit Fitsch
Dr. Thorsten Kuypers
Olaf Oberhofer
Eva Speck
SCIENTIFIC COMMITTEE
Chairman:Prof. Norbert Gutknecht
Prof. Adam Stabholz
Prof. Aslihan Usumez
Prof. Andreas Braun
Assoc. Prof. Rene Franzen
Prof. Kosmas Tolidis
Prof. Ani Belcheva
Prof. Marcia Marques
Prof. Carlo Fornaini
Assoc. Prof. Assya Krasteva
Assoc. Prof. Dr. Jorg Meister
Dr. Sharonit Sahar-Helft
Assoc. Prof. Georgi Tomov
Assoc. Prof. Maria Dencheva
Assoc. Prof. Vesela Stefanova
Prof. Jean-Paul Rocca
Prof. Vladimir Panov
Prof. Angelina Kisselova-Yaneva
Prof. Zaharii Krastev
Prof. Ayala Stabholz
Prof. Roeland De Moor
Prof. David Vincent Dilouya
Dr. Youssef Sedky
Assoc. Prof. Sirin Guner Onur
INTERNATIONAL CO-ORGANIZING COMMITTEE
Chairmen: Dr. Dimitris Strakas, Leon Vanweersch
Dr. Miguel Martins (Portugal)
Dr. Avi Reyhanian (Israel)
Dr. Alireza Fallah (Iran)
Dr. Peter Fahlstedt (Sweden)
Radu Pop (Romania)
Dr. Ilay Maden (UK)
Assoc. Prof. Sirin Guner Onur (Turkey)
Dr. Anna Maria Yannikou (Cyprus)
Dr. Pilar Martin (Spain)
Dr. Jaana Sippus (Finland)
Dr. Leena El-Sheerawy (Bahrain)
Dr. Martiniano Francischetti (Argentina)
Rita Hage (Lebanon)
Dr. Joharia Saadat (Pakistan)
Dr. Mohammed Ben Aziz (Morocco)
Dr. Ana Catarina Da Silva (Portugal)
Dr. Gottfried Gisler (Switzerland)
Prof. Roly Kornblit (Italy)
Prof. Kosmas Tolidis (Greece)
Dr. Adriana Barylyak (Ukraine)
Dr. Kenneth Luk (Hong Kong)
Dr. How Kim Chuan (Malaysia)
Dr. Salam Alakash (Jordan)
Dr. David Vincent Dilouya (France)
Dr. Daniela Stojceva (North Macedonia)
Dr. Piotr Roszkiewicz (Poland)
Dr. Merita Bardoshi (Albania)
Dr. Mountaha Al Hage (Algeria)
Dr. Michal Nawrocki (Poland)
Dr. Carolina Benítez (Uruguay)
Dr. Alireza Mirsaei (Iran)
Prof. Tosun Tosun (Turkey)
The Organisers of the 17th Laser Dentistry World Congress would like to thank the
Sponsors for their contribution and support to make this Congress a success
LIGHT INSTRUMENTSRISE ABOVE TECHNOLOGIES
Platinum Sponsor
Gold Sponsor
Silver Sponsor
Basic Sponsor
ÉCLAIRAGES MÉDICAUX MULTIMÉDIA
Събитието се организира със съдействието на Фонд „Научни изследвания“, договор № КП – 06 – МНФ/12, за съфинансиране на международен научен форум на тема
„10–та Международна лазерна дентална академия“
The event is organized in association with the Scientific Research Fund, contract № КП-06-МНФ/12, for co-fi-nancing an international scientific forum on the “10th International Dental Laser Academy”.
17th Congress of ISLD
54 JUNE 6-8, 2019, PLOVDIV, BULGARIA
17th Congress of ISLD
76 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Welcome Messages
Assoc. Prof. Georgi Tomov
Organizing Committee Chairman
Prof. Norbert Gutknecht
Scientific Committee Chairman
Prof. Stefan Kostianev
Rector of the Medical University
of Plovdiv Leon Vanweersch
Dear colleagues,
It is a great responsibility and pleasure to take part in the organi-
zation of the most important event in the field of Laser Den-
tistry. Since 2009 Bulgarian Dental Laser Society together with
the Medical University of Plovdiv organise Annual Dental Laser
Academia and gathers leading practitioners and researchers. In
2019 this tradition will continue with the 17th World Congress of
International Society for Laser Dentistry (ISLD).
The Congress integrates five significant events: 17th World
Congress of ISLD, 28th DGL Annual Meeting, 10th Anniversary
Congress of Bulgarian Dental Laser Society (BDLS), 7th Interna-
tional WALED Congress and the 2nd National Meeting of Bulgarian
Association Oral Medicine.
The theme of the congress “Laser Technologies and Translation
to Clinical Practice” was chosen to address two major challenges
in the field of laser dentistry i.e. the fast progress in new tech-
nologies and the barriers to evidence-based application of new
discoveries in day to day clinical practice. Within the Congress
program, round table debates, workshops and short oral presen-
tation sessions will address cutting edge topics. Several prom-
ising new technologies are on the horizon in laser dentistry and
this Congress will provide an ideal forum to exchange knowledge
related to these innovations in order to advance the field. Educa-
tional sessions and practical courses will be offered on pragmatic
topics that are of immediate relevance from research and clinical
practice perspective to clinicians.
I want to declare my sincere thanks to our lecturers, colleagues,
students, alumni and staff who have contributed to organise this
event and who are all instrumental in helping our University and
Society maintain their international stature as centres of excel-
lence in laser education and research.
In addition, as a city of art and history, Plovdiv offers many
wonderful social and tourist activities. Stroll round the old town,
explore the Roman amphitheatre and the medieval basilicas,
enjoy the museums and galleries, and sample the local wines and
specialties – all these experiences and many more are within a
few minutes’ walk of the conference venue.
Reminding the motto of the Bulgarian Dental Laser Society
“Lucem sequamur” (“Let us follow the Light”), we wish you more
lights in your life and we are looking forward to seeing you in
Plovdiv.
Sincerely yours,
Assoc. Prof. Georgi TOMOV, DMD, PhD
Chairman of Local Organising Committee
Dear Friends and Colleagues,
It is a great honour and pleasure for me to cordially welcome you
to our ISLD Congress in Plovdiv, for an unforgettable experience
where technology and culture go hand in hand and join to create
an outstanding event. Throughout history we can see that the
greatest architectural, technological and scientific achievements
were made where human culture has advanced. Plovdiv, the
oldest city in Europe, established 4000 years ago, celebrates this
year its selection as European Capital of Culture. There are many
attractive events all year around where people from all over Eu-
rope and other parts of the world are coming to Plovdiv to enjoy
magnificent events and artwork of hundreds of artists.
Therefore, it was only natural that Plovdiv, the European Capital
of Culture for 2019, was unanimously selected as the site for the
17th World Laser Congress of ISLD. The International Society for
Laser Dentistry (ISLD) was established in Japan in 1988. In 2018,
thirty years later, the ISLD celebrated its Pearl Anniversary during
the Laser Dentistry World Congress held in Aachen Germany. The
Congress was a great success and more then 540 participants
from 43 countries enjoyed a high level of scientific presentations,
warm hospitality and a friendly atmosphere. It was indeed an
unforgivable event and an ideal time where the stage was set for
the revitalisation of our prestigious Dental Laser Society.
I and many other colleagues representing numerous national den-
tal laser societies were determined to place ISLD as an outstand-
ing scientific organisation in laser dentistry. We are encouraged
to see more and more new membership applications. The number
of colleagues from all over the world, happy to join ISLD, as well
as a number of national laser societies that choose to be part of
our organization, is constantly growing. I believe that all of us,
dental laser users worldwide, can see a bright future for Laser
Dentistry.
Your participation in this Congress of the ISLD, the leading World
Laser Dentistry Organization in beautiful Plovdiv, the European
Capital of Culture for 2019 is strengthening ISLD, which is striving
to enrich the knowledge of its members and to promote profes-
sional excellence in the use of lasers through science research
and education. I look forward to seeing you join us in a great
celebration of science and art.
Prof. Norbert Gutknecht
ISLD President
Dear guests and participants,
I warmly welcome you to the Medical University of Plovdiv, one of
the largest and innovative universities in Bulgaria.
Plovdiv has a history that 99.9% of the cities in the world can only
dream of. It is not only the oldest, but also the most vibrant, aris-
tocratic and bohemian city in Bulgaria – a city with unique brain
power. For this reason it was elected to be the European Capital
of Culture in 2019.
Using the language of “Star Wars” movie there will be a “power
surge” in Plovdiv on 6th – 8th of June 2019. The Medical Univer-
sity of Plovdiv will host the 17th World Congress of ISLD. This is a
great recognition of the achievements of the Academic body of
the Medical University of Plovdiv.
As a modern place of science, MU - Plovdiv bundles top-quality
researches on an international level in several core fields including
Laser Dentistry. A decade of cooperation with partner institutions
from Europe and the world have not only led to the establish-
ment of a Laser Centre at our Faculty of Dental Medicine, but also
ensures that the University consistently develops its educational
responsibilities.
Nowadays few comparisons could be made with the progress
in Dentistry. Laser treatment is used not only in physiotherapy,
stones in the urinary tract, gastro-intestinal surgery but also in
oral medicine and dentistry.
Today, the globalization of knowledge is not only a trend, but a
priority for international institutions and research centres, making
technology available to all professionals. With the initiation of
interdisciplinary partnerships in Laser Dentistry, the Medical Uni-
versity of Plovdiv is now linked with the Universities in Aachen,
Jerusalem, Nice, Geneva, Taipei and many other.
We thank our invited lecturers, partners and guests from all over
the world who kindly accepted to come to Bulgaria and share
their experience and expertise!
It is a great pleasure to welcome all of you to Plovdiv!
Corr.mem. Prof. Dr. STEFAN KOSTIANEV, DMSc
Rector of the Medical University of Plovdiv
Dear friends, dear participants, especially dear WALED family,
I am happy to welcome you again to the 17th Congress of ISLD
and the 7th WALED Congress; this time in the wonderful historical
town of Plovdiv, Bulgaria from 6-8 June.
This year, the WALED congress part will focus on innovative
clinical presentations by mostly newly graduated MS-s and Mas-
tership graduates. The ISLD congress features many exceptional
keynote lectures and oral presentations, that will be executed
throughout the 2-days ISLD event on 7 and 8 June. The exhibition
space is again so designed that we can visit the exhibition during
the breaks, while „learning and informing by enjoying food and
drinks“.
Beside the learning effects, the social gathering is very import-
ant, and we continue the WALED tradition with our Get-Together
event on Thursday evening on 6th of June after the congress day.
The same counts for the ISLD open air welcome cocktail event,
with the chance for each and every one of you to meet, network
and enjoy at the end of the first ISLD congress day. The ISLD
gala dinner event will be as always one of the social highlights of
these congress days.
Looking forward to welcome you all,
With best regards,
Leon Vanweersch
Vice-Director and Organizing Chairman - WALED
ISLD Board Member – Organization Board
17th Congress of ISLD
98 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Exhibitors Floor Plan
Congress Area / Auditorium Complex
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ÉCLAIRAGES MÉDICAUX MULTIMÉDIA
REGISTRATION DESK
Floor 1 Hall 1
Hall 2
Floor 2 Hall 4
Hall 5
Hall 6
Floor 3 Hall 9
17th Congress of ISLD
1110 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Congress Program
Thursday 06 June 201908:00 - 17:00 7th WALED Annual Meeting (AUDITORIUM COMPLEX - HALL 2)
09:00 – 09:20 Welcome words by Prof. Norbert Gutknecht (Scientific Chairman) Leon Vanweersch (Organizing Chairman)
Morning Session Chairpersons: Prof. Norbert Gutknecht and Dr. Dimitris Strakas, PhD
09:20 – 10:20 Dr. Maria Pilar Martin Santiago Contributions of the fractional handpiece to orofacial photobiocosmetics
10:20 – 10:50 Dr. Alshaimaa Alanaggar Blow (blue) out the smile
10:50 – 11:20 Dr. Arghavan Farrokhian Comparing the antifungals effect of a 940nm diode laser with different powers on Candida albicans
11:20 – 11:50 COFFEE BREAK
11:50 – 12:20 Dr. Marwa Taha Laser in the daily pediatric dentistry practice
12:20 – 13: 00 Dr. Sara Hassan El-Toukhy Laser stability in one year follow up, with dermal fillers myomodulation In gummy smile treatment
13:00 – 14:00 LUNCH BREAK
Afternoon Session Chairpersons: Assoc. Prof. Rene Franzen and Dr. Miguel Martins, PhD
14:00 – 14:45 Prof. Norbert Gutknecht All you need to know about the different CO2 wavelengths
14:45 – 15:30 Assoc. Prof. Rene Franzen Physics quiz: check, control and update your knowledge, and stay ahead of all other laser dentists
15:30 - 16:00 Dr. Ibrahim Samir A novel clinical approach of Diode Laser 980nm in gingival contouring
16:00 – 16:30 Dr. Alina Rotar Digital Science and Diode Laser Therapy : enhancing the quantification of oral inflammation reduction for periodontal patients.
16:30 – 17:00 Dr. Monika Masilionyte Laser assisted endodontics and restorations: save more teeth
20:00 - 00:00 WALED GET-TOGETHER PARTY
10:00 - 15:00 Pre-Congress clinical course (LASER CENTER - FDM)
Chairpersons: Assoc. Prof. Vesela Stefanova and Dr. Stanimir Kisselov
14:30 - 15:00 PLENARY LECTURE Dr. Sapan Mistry Clinical applications of Solea, a 9.3 µm CO2 all-tissue laser
15:00 - 16:00 ORAL PRESENTATIONS Ana Catarina Nogueira da Silva Adhesion on dentin surfaces prepared with Er,Cr:YSGG laser: is the key in the grape?
Ahmed Ibrahim Youssef Efficiency of Er,Cr:YSGG laser in veneers debonding on two types of ceramic materials and cements: pilot study
17th Congress of ISLD
1312 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Congress Program
16:00 - 16:30 COFFEE BREAK
NEW WAVELENGHTS
Chairpersons: Prof. Norbert Gutknecht and Dr. Sharonit Sahar-Helft
16:30 - 17:00 INTRODUCTORY Patricia Buttler LECTURE Overview of laser scanning microscopy and other optical laboratory techniques for investigations of 9.6 µm CO
2
laser irradiated hard tissue samples
17:00 - 18:30 ORAL PRESENTATIONS Nora Gutknecht-Schreiber New findings regarding 9.6 CO2 laser bone surgery - a temperature study
Jancee Anton Vetter Application of CO2 Laser with a wavelength of 9.6µm on pork tubular bone – a pilot study
Patrick Jansen Potential of caries prevention by sealing with a new CO2 9.6 µm-laser system – a pilot study
Enno Brackebusch General ablation characteristics in bovine enamel using a newly developed CO2 laser system at 9600 nm – a pilot study
18:30 - 21:00 WELCOME COCKTAIL
Friday 07 June 201908:00 - 18:00 CONGRESS REGISTRATION DESK (AUDITORIUM COMPLEX – FLOOR 1)
ISLD International Society for Laser Dentistry
HALL 4 – FLOOR 2
09:00 – 11:00 OPENING CEREMONY AND WELCOME MESSAGES ( HALL 1 – FLOOR 1)
11:00 - 11:30 COFFEE BREAK
ORAL SURGERY
Chairpersons: Prof. Tosun Tosun and Dr. Ilay Maden
11:30 - 12:00 PLENARY LECTURE Dr. Evgeniy Mironov Specific treatments in Implantology using Light Touch Еr:YAG laser
12:00 - 12:30 PLENARY LECTURE Dr. Avi Reyhanian The use of the Erbium Yttrium Aluminium Garnet (2940 nm) in a laser-assisted implant therapy
12:30 - 13:00 PLENARY LECTURE Dr. Michal Nawrocki Treatment of periimplantitis - a challenge in nowadays implantology
Chairpersons: Prof. Ani Belcheva and Dr. Mihail Tanev
14:30 - 15:00 PLENARY LECTURE Prof. Marcia Marques Therapies based on low intensity laser irradiation: photobiomodulation and aPDT
15:00 - 15:30 PLENARY LECTURE Prof. Andreas Braun Lasers in periodontal therapy – not just a gimmick!
15:30 - 16:00 ORAL PRESENTATIONS Maria Mutafchieva Histological improvement in oral lichen planus following LLLT
Ahmed Ibrahim Khalaf Evaluation of Post-Endodontic Pain Control using Low- Level Laser Therapy in Comparison to Intra-canal Cryotherapy: A Randomized Placebo-controlled Clinical Trial
16:00 - 16:30 COFFEE BREAK
17th Congress of ISLD
1514 JUNE 6-8, 2019, PLOVDIV, BULGARIA
AESTHETIC DENTISTRY
Chairpersons: Prof. Roly Kornblit and Dr. Ana Catarina da Silva
16:30 - 17:00 PLENARY LECTURE Dr. Dimitris Strakas Light and white. Utilizing lasers in dental aesthetics
17:00 - 18:30 ORAL PRESENTATIONS Mohamed Bahgat, Inas El Zayat, Ahmed Tarek Farouk The effect of a novel bleaching protocol on the color change of non-vital anterior teeth: in vitro and in vivo study.
Mohamed Bahgat, Inas El Zayat, Ahmed Tarek Farouk The effect of diode laser internal bleaching protocol on thermal changes color outcomes using different parameters: An in vitro study.
Rada Kazakova Histological evaluation of gingival tissue after conventional and laser gingivectomy
Mihail Tanev Local aPDT in the complex treatment of drug-induced gingival hyperplasia
18:30 - 21:00 WELCOME COCKTAIL
Friday 07 June 201908:00 - 18:00 CONGRESS REGISTRATION DESK (AUDITORIUM COMPLEX – FLOOR 1)
New diagnostic and treatment modalities in oral medicine Lasers in oral medicineChairpersons: Assoc. Prof. Miglena Balcheva and Assoc. Prof. Maria Dencheva
14:30 - 15:00 PLENARY LECTURE Prof. Angelina Kisselova-Yaneva Practical application of probiotic BioGaia ProDentis in dental medicine
15:00 - 15:30 PLENARY LECTURE Assoc. Prof. Assya Krasteva Hand, foot, and mouth disease – what to expect
15:30 - 16:00 PLENARY LECTURE Dr. Vesselina Bozalieva Nogier frequencies and their use in LLLT
16:00 - 16:30 COFFEE BREAK
Congress Program
17th Congress of ISLD
1716 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Congress Program
ORAL PRESENTATIONS
Chairperson: Assoc. Prof. Assya Krasteva and Assoc. Prof. Maria Dencheva
16:30 – 18:30 Lilia Kavlakova Topical therapy with tacrolimus 0,1% ointment for the treatment of gingival erosive lichen planus
Atanas Chonin Assessment of the role of increased corrosion potential and sensitization to metals in patients with burning sensation in the oral cavity
Christiana Madjova Clinical and paraclinical indicators of saliva in the establishment of oral disease
Daniel Markov Leukoplakia. Evolution in carcinoma-treatment
Svetoslav Slavkov Clinical case of gigantic pleomorphic adenoma of the parotid gland. Challenge in diagnosis and surgical treatment
Evgeni Stanev Clinical case: Oral lesions in a patient with iron deficiency anemia
Simeon Chokanov The effect on oral health in drug abuse
Maria Mutafchieva Molecular disturbances in oral lichen planus – a new viewpoint on the pathogenesis of the disease
Yanitza Istatkova Management of leukokeratosis – clinical cases
Yanitza Istatkova Erythroplakia a flag for oral cancer – difficulty in treatment
Evgeni Stanev Difference in male and female thermoregulation after prick test
Aleksandar Georgiev Implant treatment in patients with underlying diseases
18:30 - 21:00 WELCOME COCKTAIL
Friday 07 June 201908:00 - 18:00 CONGRESS REGISTRATION DESK (AUDITORIUM COMPLEX – FLOOR 1)
10:00 - 11:00 ORAL PRESENTATIONS Lotfi Lazrak Gummy smile, what performance can bring the SLS: smilelogy laser surgery?
Thachaini Balakumar Er:YAG laser debonding of zirconia brackets. SEM evaluation
Vasilis Panayiotou Laser-assisted treatment of a child with hereditary gingival fibromatosis - 2 years follow up
11:00 - 11:30 COFFEE BREAK
LASERS-ASSISTED MINIMALY INVASIVE DENTISTRY
Chairpersons: Assoc. Prof. Vesela Stefanova and Dr. Nadia Bibova
11:30 - 12:00 PLENARY LECTURE Prof. Roly Kornblit Minimal invasive aesthetic dentistry by Er:YAG laser
12:00 - 13:00 ORAL PRESENTATIONS Maria Shindova Parents` attitudes towards alternative methods of dental treatment in children
Mohamed Abdalmoniem Introducing daily usage of laser dentistry in aesthetics
Mohamed Mahmoud The effect of photobiomodulation and laser therapy in management of alveolar osteitis after tooth extraction
13:00 - 14:00 LUNCH BREAK
PEDIATRIC DENTISTRY
Chairpersons: Prof. Roly Kornblit and Dr. Youssef Sedky
14:00 - 14:30 PLENARY LECTURE Prof. Ani Belcheva Laser irradiation used as a method of preventing the enamel demineralization
14:30 - 15:00 PLENARY LECTURE Assoc. Prof. Sirin Guner Onur Lasers in pediatric dentistry
15:00 - 15:30 PLENARY LECTURE Assoc. Prof. Konstantinos Arapostathis Use of technology to reduce dental fear and avoidance for children and adults
15:30 - 16:00 PLENARY LECTURE Dr. Gabriele Schindler-Hultzsch New technology and predictable pathways in pediatric oral surgery – minimally invasive laser-assisted pediatric surgery in combination of high-resolution digital volume tomography
16:00 - 16:30 COFFEE BREAK
PHYSICS OF LASER AND BASIC SCIENCE
Chairpersons: Prof. Marcia Marques and Assoc. Prof. Konstantinos Arapostathis
16:30 - 17:00 PLENARY LECTURE Assoc. Prof. Vesela Stefanova Invisioning the future of lasers in operative dentistry and endodontics
17:00 - 18:20 ORAL PRESENTATIONS Maite Moreno State of the art and future for gingivae stem cell applications
Ibrahim Samir Abdelmoamen Sayed Temperature change of neighboring alveolar bone during diode laser gingival recontouring: a preliminary in vitro study
Rahimy Soorosh Regrowth of own teeth - the role of laser in stem-cell therapy
Arghavan Farrokhian Comparing antifungal effect of 940 nm diode laser with different powers on Candida albicans
20:30 - 00:00 GALA DINNER EVENT
CLOSING CEREMONY - AWARDS - PRESENTATION OF NEXT CONGRESS 2020
17th Congress of ISLD
2120 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Congress Program
Saturday 08 June 2019
ISLD International Society for Laser Dentistry
HALL 6 – FLOOR 2ORAL SURGERY AND IMPLANTOLOGY
Chairpersons: Prof. Jean-Paul Rocca and Dr. Bogdan Krastev
09:00 – 11:00 ORAL PRESENTATIONS Alejandro Steinman Shorten your rehabilitation times with the ultimate protocol of laser assisted implants
Alireza Cyrus Raie The influence of initiation of the tip on the concentration and transmission of the diode laser (940nm) energy at the end of the tip: non-initiated versus pre-initiated tips!
Daniel Abousaid Laser-аssisted intervention in soft tissue management around dental implant - clinical case
Krikor Giragosyan Application of Er-YAG laser in the preparation of bone for autogenous targeted tissue regeneration
Darya Alhaidary First investigation of dual wavelength lasers (2780 nm Er,Cr:YSGG and 940nm diode) on implants in a simulating peri-implantitis situation regarding surface morphologies in an in vitro pocket model
Ingmar Ingenegeren Full laser sinus lift and simultaneously implantation ten years evaluation
11:00 - 11:30 COFFEE BREAK
E-Poster Sessions (P01-P10)Examination Commitee: Prof. Adam Stabholz and Prof. Ani Belcheva
11:30 - 13:00 E-POSTERS Bogdan Krastev Er:YAG laser-assisted apicectomy of endodonticaly compromised central incisor
Christina Karanasiou Crown lengthening utilizing different wavelengths for restorative challenges
Marcia Marques Long-term follow-up of medication-related osteonecrosis of the jaws lesions prevented or treated with aPDT and photobiomodulation
Evgeniya Popova Thermographic and morphological studies of the effects of diode laser (810 nm) irradiation on root canal walls
Maite Moreno Separation process of stem cells (trophoblasts) from gingiva assisted with 904 nm low laser wavelength
Maria Pilar Martin Santiago Optimization in a case of orofacial rehabilitation after trauma: improvement of oral and facial volumes
Melania Cojocaru LLLT treatment for impaired wound healing in periodontal regeneration and grafting procedures
Nevin Kırbıyık Er,Cr:YSGG laser-assisted crown lengthening: a case report
13:00 - 14:00 LUNCH BREAK
VARIAChairpersons: Prof. Siegfried Jänicke and Dr. Sharonit Sahar-Helft
14:00 - 16:00 ORAL PRESENTATIONS Radka Cholakova Assessing the effect of supernumerary teeth on pulpal perfusion of adjacent teeth using laser-doppler flowmetry
Evgeniya Popova Influence of diode laser radiation on the apical leakage of endodonticaly treated teeth
Tomaz Ivanusic Laser – the tool for all dentists
Eslam Aboubakr Ali Mohamed Effect of different Er,Cr:YSGG laser parameters on surface conditioning of glass ceramics
Imneet Madan Dual wavelengths in pediatric dentistry: a success story of compromised primary teeth
Maria Pilar Martin Santiago The contribution of laser to orofacial photobiocosmetics
16:00 - 16:30 COFFEE BREAK
VARIAChairpersons: Prof. Carlo Fornaini and Dr. Imneet Madan
16:30 – 18:00 ORAL PRESENTATIONS Piotr Roszkiewicz Hard- and soft-tissue management around broken teeth
Alshaimaa Alanaggar Blow (blue) out the smile
Yuliya Kozlova Application of fluorescent method for evaluation of the hygienic condition of the oral cavity.
Stefan Schreiber Temperature development during explantation comparing conventional trephine system with innovative laser technique
Marwa Taha Laser applications in pediatric dentistry: is it a myth or a magical treatment?
20:30 - 00:00 GALA DINNER EVENT
CLOSING CEREMONY - AWARDS - PRESENTATION OF NEXT CONGRESS 2020
17th Congress of ISLD
2322 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Congress Program
Saturday 08 June 2019
ISLD International Society for Laser Dentistry
HALL 4 – FLOOR 2
IMPLANTOLOGY - 1
Chairpersons: Dr. Ilay Maden and Dr. Stefan Grumer
09:00 - 09:30 PLENARY LECTURE Prof. Jean-Paul Rocca Advanced peri-implantitis: Proposal for a multi wavelength approach
09:30 – 09:50 PLENARY LECTURE Dr. Adriana Barylyak Treatment of periimplantitis with using Er:YAG laser in combination with Photodynamic therapy
09:50 - 10:20 PLENARY LECTURE Dr. David Vincent Diloya Benefits of laser therapeutics in periodontics and implantology an evolution towards new less invasive surgical procedures
10:20 – 11:00 ORAL PRESENTATIONS Roman Itelman Peri-implantitis therapy by Er:YAG Laser
Codruta Ciurescu Periimplantitis – A different therapeutic approach
11:00 - 11:30 COFFEE BREAK
ENDODONTICS - 2
Chairpersons: Assoc. Prof. Georgi Tomov and Dr. Jancee Anton Vetter
11:30 - 12:00 PLENARY LECTURE Dr. Sharonit Sahar-Helft Influence of periapical lesions on dental implants
12:00 - 12:30 PLENARY LECTURE Dr. Miguel Martins Preserve your patients’ teeth... The powerful and amazing world of endodontic laser practice!
12:30 - 13:10 ORAL PRESENTATIONS Riman Nasher Microscopic investigation of the effectiveness of dual wavelength Er,Cr:YSGG and diode 940 nm laser and the XP-Endofinisher in removing the endodontic sealer from dilacerated root canals
Carolina Isabel Benitez Arevalo Laser in endodontics
13:00 - 14:00 LUNCH BREAK
CARIOLOGY
Chairpersons: Dr. Miguel Martins and Dr. Dimitris Strakas
14:00 - 14:30 PLENARY LECTURE Prof. Carlo Fornaini Er:YAG in conservative dentistry: burr or no burr? That is the question!
14:30 - 16:00 ORAL PRESENTATIONS Basant El Asaly The effect of diode laser 940nm on deep cavities and on S. mutans. Pilot study
Mohamed Bahgat Abdelhamid, Ola Mohamed Ibrahim Fahmy Microbiological assessment of diode laser with different parameters in comparison to chemical disinfection in the management of deep carious lesions
Sergiu Calancea The use of Er:YAG Laser for Minimal Invasive ablation of dental hard tissues
Elitsa Veneva Laser analgesia: Efficacy of a modified protocol for achieving pre-emptive dental analgesia with Er:YAG
16:00 - 16:30 COFFEE BREAK
IMPLANTOLOGY AND PERIODONTOLOGY
Chairpersons: Prof. Ayala Stabholz and Dr. Evgeniy Mironov
16:30 - 17:00 PLENARY LECTURE Dr. Ilay Maden Laser treatment of peri-implantitis vs periodontitis; what we see and what we know
17:00 - 17:30 PLENARY LECTURE Dr. Daniela Cvetanovska Stojcheva Er:YAG laser-assisted prevention of peri-implantits in patients with periodontitis
17:30 - 18:00 PLENARY LECTURE Dr. Blagovesta Yaneva Er:YAG laser assisted periodontal treatment – reasons for success
18:00 – 18:30 ORAL PRESENTATIONS Carolina Isabel Benitez Arevalo Comparative study on Endodontic treatment with and without laser with microbiological control
Violeta Dogandzhiyska Influence of diode laser radiation on the apical leakage of endodonticaly treated teeth
20:30 - 00:00 GALA DINNER EVENT
CLOSING CEREMONY - AWARDS - PRESENTATION OF NEXT CONGRESS 2020
17th Congress of ISLD
2524 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Tuesday 6 June
Hall 9 15:00
LIGHT INSTRUMENTS WORKSHOP
Title: YAG Laser in Endodontics: A New, Side Firing, Spiral Endo Tip
Lecturer:
Prof. Adam Stabholz
HANDPIECE
360° SWIVEL
360°
APPLICATOR 120° ROTATION
120°
APPLICATOR
FLEXIBLE CORD
LASER- IN-HANDPIECE
PLATINUM SPONSOR
Workshop:
Er:YAG Laser in Endodontics: A New, Side Firing, Spiral Endo Tip
Is there a way to completely disinfect the endodontic space during root canal treatment? Can we get rid of the smear layer after chemo-mechanical preparations?
Is it possible to increase success rate of root canal treatments?
Prof. Adam Stabholz, former Dean and Head of the Endodontic Department at the Hebrew University - Hadassah School of Dental Medicine, will answer these questions and more during the workshop
Auditorium complex, 3rd floor, Hall 9, Medical University of Plovdiv, Bulgaria
ISLD Pre-Conference, Thursday, June 6th at 15:00 When:
Where:
For more information contact at +359 35 932 26
17th Congress of ISLD
2726 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Patients’ and dentists’ love of Solea® keeps on growing. As the #1-selling, all-tissue laser, Solea delivers reliably anesthesia-free, blood-free, suture-free, and pain-free procedures. It helps eliminate three major fears patients have when going to the dentist – noise, needle, and numbness. Patients love the experience and so will you because Solea is changing what it means to go to the dentist.
Norbert GutknechtWhat makes the significant difference between a 10.6µm, a 9.6µm CO
2 lasers and the
Erbium laser wavelengths 2.79µm and 2.94µm on human hard tissue
Adam Stabholz
Er:YAG Laser Supported Endodontic Treatment, Endodontic Retreatment and Endodontic Surgery
Adriana Barylyak
Treatment of periimplantitis with using Er: YAG laser in combination with Photodynamic therapy
Adam Stabholz
Adriana Barylyak
Ani Belcheva
Ayala Stabholz
Assya Krasteva
David Dilouya
Dimitris Strakas
Ilay Maden
Evgeniy Mironov
Zaharii Krastev
Marcia Marques
Maria Dencheva
Jean-Paul Rocca
Miglena Balcheva
Miguel Martins
Daniela Stojcheva
Roeland De Moor
Roly Kornblit
Sharonit Sahar-Helft
Sirin Guner Onur
Carlo Fornaini
Tosun Tosun
Vesela Stefanova
Blagovesta Yaneva
Youssef Sedky
Avi Reyhanian
Michal Nawrocki
Gabriele Schindler-Hultzsch
Sapan Mistry
Vesselina Bozalieva
Konstantinos Arapostathis
Justin Kolnick
Angelina Kisselova-Yaneva
Andreas Braun
Mechanical trauma, extreme high temperature and bleedings occur in many surgical procedures when cutting, removing or modelling soft tissue, bone, dentin or enamel.
For many years there have been discussions about the use of different lasers in this areas, gaining different results.
In 1964 the 10.6µm carbon dioxide (CO2)
laser was introduced by Patel.
It was approved by the FDA in 1984 and afterwards mainly used as an incision tool in different medical fields, as well as in dentistry. The Er:YAG laser wavelength was introduced in dentistry in 1988 and the Er,Cr:YSGG laser in 1995 and approved by the FDA in 1997 and 1998.
Since different CO2 laser wavelengths
exist, most of them have different tissue absorptions. The 9.3 µm and 9.6 µm are highly absorbed in hydroxyapatite followed by water with a lower absorption, while the 10.6µm is highly absorbed in water and has a lower absorption in hydroxyapatite. Similarities are found in the absorptions of the both Mid infrared lasers Er:YAG and Er.Cr:YSGG even though the mode of operation, the active medium and the pumping mechanism are totally different.
Never before in the history of CO2 lasers
in dentistry a CO2 laser with a wavelength
of 9.6µm has been build exclusively for dentistry. This new wavelength in the field of dentistry will maintain known CO
2 treatments, but will also open new
indications and treatments on hard tissue as well as on soft tissue.
First investigations on the different tissue surfaces have shown, why this is no longer a hypothesis and why the same naming is not automatically generating same tissue interactions and results.
Laser technology is being developed very quickly; through the years, more experience and knowledge was gained and new laser applications in dentistry were introduced.
Our studies using SEM analysis following debridement and removal of pulp tissue, as well as old gutta percha root canal fillings, could demonstrate heavy smear layers on the wall surfaces of the root canals as well as remnants of the old filling materials in cases of endodontic retreatments. The use of Er:YAG laser irradiation in the root canal system enabled a thorough cleansing of the root canal. SEM photographs showed clean root canal walls with open dentinal tubules.
The walls of root canals lased with the Er:YAG laser after biomechanical preparation with NiTi rotary files were cleaner in comparison to root canals that were similarly prepared but not lased.
Also the presence of biofilm in the contaminated root canal system calls for effective means to enable its removal. It will be shown that the laser irradiation could play a paramount role in the fulfilment of this objective. The advantage of the Er:YAG laser to sterilize the bony walls of the crypt following the surgical removal of a periapical lesion will be also discussed.
Clinical cases of endodontic treatment, endodontic retreatment and endodontic surgery with follow-ups, using the Er:YAG laser will be presented and discussed. Cervical Invasive Root Resorptin (CIRR) is a clinical entity presenting a considerable challenge to the clinician. A new treatment approach using Er:YAG laser in the reatment of CIRR will also be presented.
Presence of bacteria on the implant surface may lead to inflammation of the mucous membrane around the implant. For the treatment of periimplantitis it is important to remove bacterial plaque and inflammatory tissues, to protect the surface of the implant. Er: YAG laser is able to remove infected soft and hard tissue around the surfaces of implants. Since this wavelength is poorly absorbed by the titanium surface of the implant, the temperature around the implant during irradiation does not significantly increase, therefore, does not lead to pyrolytic effects.
Aim: to evaluate the effectiveness of the use of Er: YAG laser in the treatment of peri-implants in combination with photodynamic therapy.
Materials and methods: 25 patients with 42 implants were included. All patients have been diagnosed with peri-implants and were divided into two groups. First group: 10 patients (15 implants) were treated with Er: YAG laser (160 mJ, 10 Hz). Second group: 15 patients (27 implants) were treated with Er: YAG laser in combination with photodynamic therapy (7.3 W, 690-905, 60, in combination with toluidine blue). PDT was used immediately after laser purification and removal of granulation tissue. After that, bone plastics were made on the surface of the implant.
Results and discussion: In both groups, the treatment results were positive: decreased pocket depth, gum attachment and no bleeding during the sensation. In the first group, in 80% of the patients, a complete positive result was evaluated in 5-6 months.
17th Congress of ISLD
3130 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Ani Belcheva
Laser irradiation used as a method of preventing the enamel demineralization
Ayala Stabholz
Enlightening the future of laser handling in periodontal and peri-implant disease treatment
David Dilouya
Benefits of laser therapeutics in periodontics and implantology an evolution towards new less invasive surgical procedures
Dimitris Strakas
Light and White. Utilizing lasers in Dental Aesthetics
Assya Krasteva
Hand, foot, and mouth disease – what to expect
Laser irradiation can greatly improve the acid resistance of sound enamel and prevent surface demineralization. Many studies over the last 20 years have tracked the mechanism of inhibiting demineralization. Thermal laser treatment converts carbonate hydroxyapatite to tooth enamel into less soluble fluorapatite minerals. Chemical inhibitors act by a general ion effect on the surface of the enamel.
It is of great importance to determine the wavelengths that would lead to increasing the acid resistance of the enamel.
Thermal analysis studies show that there is significant loss of carbonate and water at temperatures between 100 and 400°C. This loss is sufficient to alter the crystal structure of the inherent mineral and to form a cleaner phase, acid-stable form of hydroxyapatite.
The aim of the lecture is to provide evidence on increasing enamel resistance and to evaluate the different lasers in order to check the potential for prevention.
Periodontlogy is a field of dentistry that focuses on treating pathologies of the tissues around natural teeth as well as around implants. Both, periodontitis and peri-implantitis involve infection and inflammation and lead to bone loss around teeth and implants. The primary etiology of these diseases is believed to be the microbial biofilm which accumulates on the tooth and implant surfaces. Therefore, it is natural that the elementary treatment of these pathologies is aimed at eliminating this biofilm. Non-surgical and surgical methods as well as chemical therapy have been developed during the years with different rates of success. Though, the search for new minimally invasive methods that could serve as an alternative or supplement to conventional treatments, continues. Laser technology has gained much interest among clinicians and patients as a new tool for periodontal treatment and this field is growing fast and gains popularity. However, there are still several limitations, weaknesses and queries that need to be addressed and recognized in order to enable optimal treatment outcomes. Adjustments of several laser variables which could optimize treatment sequelae will be discussed.
The purpose of this presentation is to describe the benefits of laser therapy in implantology and periodontics.
In Implantology in the treatment of implant complications and especially periimplantitis; in Periodontics in the treatment of aggressive complex periodontitis, offering new perspectives to the smoker; by using new less invasive surgical procedures, laser therapeutics are thus much more than a therapeutic alternative, but the therapeutic choice of first intention, the gold standard, constituting a true innovation and therapeutic evolution.
A century ago Abbott proposed the combination of hydrogen peroxide and externally applied heat for discolored teeth bleaching. In present day as clinicians we are amidst an increased need of patients for minor or major aesthetic interventions and a great variety of means to achieve this. Lasers, utilize a light of special properties compared to non-coherent natural light, is one of the most modern tools in our inventory. Since lasers have been introduced in the field of teeth bleaching, the process has been reported as safer and more efficient. The Erbium family of lasers only recently was utilized for this purpose. In this presentation we will review the use of laser light in this field of aesthetic procedures. We will analyze the extensive research we have done, regarding the introduction of Er,Cr:YSGG in teeth laser-assisted bleaching. Different protocols will be presented and answer the questions of safety and efficiency of the procedure. A variety of material and methods has been used and this will be highlighted with background analysis, statistical data and photographic documentation. The aim is to comprehend the biophysical background and the essential steps, for a successful laser-assisted aesthetic treatment.
Hand, foot, and mouth disease is a common viral illness that usually affects infants and children younger than 5 years old. However, it can sometimes occur in older children and adults. The cause of hand, foot and mouth disease is coxsackievirus A type 16 in most cases, but the infection can also be caused by many other strains of coxsackievirus, fever, mouth sores, and a skin rash.
Hand, foot, and mouth disease is characterized by a brief febrile illness, typical vesicular rashes on the palms, soles, or buttocks, and oropharyngeal ulcers. In rare cases, patients may also develop neurological complications, such as encephalomyelitis, aseptic meningitis, and acute flaccid paralysis.
Hand, foot, and mouth disease is a mild clinical syndrome and will resolve within 7 to 10 days. Treatment is primarily supportive. Pain and fever can be managed with NSAIDs and acetaminophen.
Ribavirin, quinacrine, and amantadine have all been used off-label to treat severe cases of enterovirus 71 induced hand, foot, and mouth disease.
A.Krasteva, A.Kisselova
Plenary Speakers
Ilay Maden
Laser treatment of peri-implantitis vs periodontitis; what we see and what we know
Near and mid-infrared lasers have been used to control periodontitis and peri-implantitis in various ways: in combination with conventional treatment, as a single wavelength, in combination between different wavelengths or applications like photodynamic therapy, with non-surgical and surgical approaches. There are many advantages of using lasers, but we still face challenges and limitations, which seem to be getting less and less. The lecture will discuss these topics with comparison and contrast between periodontitis and peri-implantitis and their treatment.
17th Congress of ISLD
3332 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Evgeniy Mironov
Specific treatments inImplantology using Light Touch er:YAG laser
Maria Dencheva
Contemporary approach to corrosion potential in the oral cavity
Zaharii Krastev
Drugs and Oral medicine
Marcia Marques
Therapies based on low intensity laser irradiation: photobiomodulation and aPDT
Implant dental prosthetic rehabilitation requires accurate approach and thorough evaluation of the bone and soft tissue in the target area. Inadequate quality and volumes may lead to failures or alternative treatment plans, both with unsatisfactory results for the patient.
Lasers can help in correction or recovering the hard and soft tissue damages due to wrong planning or implantation, also can be a tool for optimising the operation site prior to implantation and assist the operation itself.
Cases with implant complications treated by Er:YAG lasers are presented in the lecture, showing possibilities to treat soft and hard tissues with similar settings, only changing the pulse-length. Laser cavitation efects used for cleaning titanium, bone and gingiva surfaces show high clinical potential in minimally invasive manner. Even the simple, but risky procedure like cleaning the internal implant chamber in case of loosen abutment screw is done in seconds without touching the walls and damaging the tread.
The biggest advantage of the Er:YAG wavelength - surface cleaning and underlying collagen stimulation is the basis of different type of grafting procedures prior to implantation - guaranteeing predictable and long lasting result.
The measurement of corrosion potential in the oral cavity is part of the diagnostic algorithm of complex focal diagnostics. It demonstrates the presence of pathogonalism.
All metallic objects in the oral cavity - obturations, onlays, inlays, edges of metal-ceramic constructions, dentures, metal occlusal stops, metal rings, etc. are subject to measurement.
Under the influence of saliva, which is an electrolyte, regardless of its precious nature, the base metal alloys are slowly or rapidly corroded. The process of electrochemical corrosion is associated with electron transfer and the release of corrosion products.
The influence of pathogonalism in this case is seen in two directions - the magnitude of the electricity and the sensitization of the organism to the separated cortisone products - haptens, which lead to the appearance of various oral lesions and/or the manifestation of allergic conditions.
The presence of pathogonalism is a valid reason for replacement of dental restorations in the oral cavity, but the question is with what?
Introduction: Treatment of Medication-Related Osteonecrosis of the Jaws (MRONJ) is complex and varied with no effective therapeutic protocol.
Aim: To evaluate a protocol for treating and/or preventing MRONJ lesions based on antimicrobial photodynamic therapy (aPDT) and photobiomodulation therapy (PBMT).
Methods: Patients in use or with history of antiresorptive drugs usage were followed-up between 2015-2019. MRONJ treatment included preoperative aPDT sessions, as follows: 0.01% methylene blue solution applied inside surgical wound just after necrotic bone removal and after 5 minutes the lesion was irradiated with a AsGaAl diode laser (660nm, 0.028cm2, 0.1W, 3.57W/cm2, 90s per point, 321J/cm2, 9J per point, 3 points and total energy of 27J per session). For MRONJ prevention, immediately after tooth extraction the aPDT was applied inside dental socket and repeated weekly until tissue repair. Antibiotics were administered pre or postoperatively for no longer than 7 days. PBMT (808nm, 0.1W, 0.028 cm2, 3.57 W/cm2, 30 s, 107J.cm2, 3J per point in 4 points and total energy of 12J) was applied postoperatively to control inflammation and stimulate repair.
Results: Thirty-four patients (71 years average age; 87% women), mostly in use of oral bisphosphonates for osteoporosis, were evaluated. Sixteen showed total regression of lesions after a mean of two postoperative aPDT sessions. None patients on the preventive protocol (18 patients) presented signs of MRONJ at least until 6 months.
Conclusion: The aPDT and PBMT protocols were effective therapeutic approaches to prevent the development of MRONJ lesions after tooth extraction or to heal existing MRONJ lesions.
Adverse effects of systemic drugs on the oral cavity. The most common clinical presentations of oral mucosal reactions to medications are xerostomia, lichenoid reactions, ulcers, bullous disorders, pigmentation, fibrovascular hyperplasia, white lesions, dysesthesia, osteonecrosis, infection, angioedema, and malignancy.
Optimal drug treatment for oral diseases. Different drugs are used to control plaque and gingivitis, to treat periodontal disease, to prevent tooth decay and dry mouth. Critical factor in periodontal therapy is gingival fluid antibiotic concentration.
Direct absorption of drugs through the oral mucosa. Oral mucosal drug delivery is applicable for immediate and controlled release action by preventing first pass metabolism and enzymatic degradation due to GI microbial flora.
Oral microbiota. Oral bacteria occupy the ecological niche provided by the dental surface and gingival epithelium and prevent bacterial invasion of tissues. There is an opportunity to keep the normal oral flora in cases of oral and general diseases.
Jean-Paul Rocca
Advanced peri-implantitis: Proposal for multi wavelength approach
Miglena Balcheva
Contemporary options for pain control in BMS
Peri-implantitis is today – we could say alas - a common complication due to numerous parameters we will not discuss here.
Research on this topic is very active because of possible health complications and, also, economic difficulties. But the problem is not solved today. Treatment protocols are often sophisticated and may combine medication, surgery, flaps, bone grafts, membranes, etc. But among a lot of protocol proposals no one represents a 100% key for success.
Combining different wavelengths could be of help and specifically:
- LLLT before surgical flap could help the soft tissues to heal in acceptable conditions;
- Once the flap has been realized Er-YAG laser irradiation the implant surface (100mJ, 20 to 30 Hz, Fluence:XXXX) decontaminate breaking the cell walls of the bacterial biofilm without damages on the implant surface (SEM observations). Moreover Er-YAG laser may serve for decontamination of the inner surface of the flap (peeling technique) aiming to break the cell walls of intra cellular bacteria (ex: Porphyromonas gingivalis).
- Considering that the bacterial decontamination could be not complete, bacterial charge reduction is assumed by PDT.
- LLLT used at the end of surgery, once sutures have been realized, contributes to the healing process as well as a strict post-surgical maintenance.
This proposal has to be completed by numerous clinical observations including follow-up.
Introduction: Burning mouth syndrome is an intraoral burning sensation which develops in the absence of mucosal changes. It is a chronic condition and in most of the cases it is idiopathic – no cause or mechanism can be identified, and no effective treatment can be prescribed. This leads to anxiety, altered pain perception, and as a consequence reduced quality of life of the affected patients.
Aim: The aim of this study is to present different options for pain control in patients with burning mouth syndrome.
Materials and methods: Different approaches for pain control are the object of our study – pharmacological treatment and low-level laser therapy. We present a review on the topical agents applied in such cases – capsaicin, alpha-lipoic acid, clonazepam, olive oil, etc., and reveal the potential of diode laser to reduce the unpleasant burning sensation.
We also apply laser therapy on patients with primary burning mouth syndrome. The affected sites on the oral mucosa in the selected cases are various (tongue, lower lip, upper lip, palate, cheeks). They are irradiated 10 times (two or three times a week) with infrared laser (λ=904nm). The probe is kept in contact with the tissue, and the mucosal surface is scanned during the irradiation. Burning intensity is evaluated through visual analog scale before and after the treatment.
Results: Topical agents induce short-term relief of burning sensation. Low-level lasers decrease statistically, and for a longer period the burning sensation.
Conclusions: LLLT is a valuable alternative for BMS treatment, and could be combined with other treatment methods.
Plenary Speakers
17th Congress of ISLD
3534 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Miguel Rodrigues Martins
Preserve your patients’ teeth... The powerful and amazing world of Endodontic Laser Practice!
Daniela Stojcheva
Er-YAG laser assisted pevention of peri-implantits in patients with periodontitis
Roeland De Moor
The evolution of the bubble: does it matter?
Roly Kornblit
Minimal Invasive Aesthetic Dentistry by Er:YAG Laser
For years lasers have been overlooked as powerful alternatives to assist endodontics due to several economical and technical constraints.
However, the combination of wavelengths and the technological development of Endodontic Tips and techniques have completely changed such paradigm.
As preservation of natural teeth is nowadays Dentistry ultimate goal, this presentation aims to present how Lasers in Endodontics have completely revolutionized prognosis and outcomes.
Lasers, Disinfection, Cleansing, Drainage, Cost-Effectivness, Painless and Healing... you will aknowledge that technology and biology are indeed a powerfull combination!
Patients with history of periodontitis have higher risk for biological complications after getting dental implants, then patients who lost their teeth for another reason.
In order to thoroughly treat the periodontal disease prior to dental implants, we have used Er-YAG laser assisted protocols, checked the periopathogens with PCR analysis before and after the Er-YAG laser assisted periodontal treatment and safely placed dental implants.
The 5-years follow up of patients with dental implants and history of periodontal disease showed implants survival rate similar to the one of the patients without periodontal diseases, which makes the Er-YAG laser, in a specific protocol, very important tool for preventing peri-implantitis in those patients.
It was only some 10 years ago that activation of irrigation solutions with Erbium lasers was introduced. This was the beginning of the era of “laser activated irrigation” (LAI), with a fibre in an irrigation solution and inducing fluid streaming based on the creation of cavitation bubbles. During this decade the technology evolved rapidly. At present two approaches are possible i.e. (1) conventional LAI (with the fibre still in the root canal lumen) and (2) the PIPS/SWEEPS approach with the fibre in the pulp chamber activating the irrigation solution in the root canal. Thanks to the development of shorter pulse durations, and different cavitation bubble dynamics (single- versus double-pulse regime) enhanced fluid dynamics lead to a better 3D root canal cleaning efficacy. Moreover, laser activated irrigation has now objectively proven its superiority over ultrasonic activation of irrigation solutions, and overcomes the problems of spatial hindrance encountered with instruments and tips vibrating within the confines of the root canal system.
Nowadays, as the esthetic parameters of the smile have become an important issue, aesthetic plays a significant role in modern dentistry. Several features as color, shape, position and teeth length must be considered when it comes to assessing whether a smile is harmonious. Not only the teeth play a role in an aesthetic harmonious smile, but also the gums have an important role. The gums color, the smile line and the amount of gum exposure are some of the gums features to be taken in consideration.
The Er:YAG laser, that can be applied on hard and soft tissues, is used for the treatment of the teeth and the gums with aesthetic upgrade results, thus, used for the improvement of the smile.
The bio stimulation effect, the tissue selective ablation, the low penetration deep, the small ablation surfaces and the antibacterial property are only some of the Er:YAG laser properties that guarantees optimal results of the hard and soft tissue Er:YAG laser Minimal Invasive high technology aesthetic treatments.
The presentation will include the different clinical applications of Er:Yag Laser in aesthetic dentistry and the scientific evidences that makes it the adapted High-Tech tool for treating hard and soft oral tissues in Aesthetic Dentistry.
Sharonit Sahar-Helft
Influence of Periapical Lesions on Dental Implants
Sirin Guner Onur
Lasers in Pediatric Dentistry
Retrograde peri-implantitis (RPI) is termed as a symptomatic periapical lesion, developed after implant placement, while the coronal portion of the implant remains fully osseointegrated. It was initially described in 1992 by McAllister et al. They described two cases of RPI caused by bacteria remained in the extraction socket.
Etiological factors of RPI are divided to those which occur at the time of implant placement and those due to a preexisting disease. Moreover, infection was described as an etiological factor for RPI.
Enterococcus faecalis is the most commonly recovered species from root canals after failed root canal therapy. Complete eradication of bacterial colonization from the complex root canal system is difficult even when state of the art technologies are used nowadays. E. faecalis has the ability to adhere to osseous collagen polymer chains and to remain in a vegetative state. It can be encapsulated in edentulous areas, up to 1 year after the extraction. Therefore, retrograde peri-implantitis can be developed around implants in sites where teeth that were previously endodontically treated were extracted. Er:YAG laser (2.94 micron wave length), has been shown to be very effective due to its real cavitation effect. It has an advantage in disinfecting bacteria which remained in teeth extracted sites where periapical lesions were developed.
The rapid evolution of laser technology offers the possibility of completing several clinical procedures in pediatric dentistry including restorative procedures in primary and permanent teeth, pulpal treatments and soft tissue applications. Laser therapy in pediatric dentistry is a choise of treatment which offers a viable alternative to low and high-speed handpieces and surgical procedures. Laser technology can be used for many clinical applications in pediatric dentistry with its many clinical advantages including minimizing discomfort to the patient as well as analgesic, biostimulating and anti-inflammatory effects. It is also very important to make dental experience as comfortable as possible during dental treatment of children. Treating a pediatric patient with dental laser for oral and dental procedure increases patient acceptance and cooperation thus enhancing treatment outcomes. Therefore having a dental experience through the use of a modern laser technology is an efficient preventive and therapeutic approach for the pediatric patients who are the first in the line to receive dental laser treatment. In this presentation we will briefly discuss the use of dental lasers and their various applications in the different fields of pediatric dentistry.
Plenary Speakers
17th Congress of ISLD
3736 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Tosun Tosun
Er:YAG in surgical orthodontic treatments
Vesela Stefanova
Invisioning the Future of Lasers in Operative Dentistry and Endodontics
Carlo Fornaini
Er:YAG in conservative dentistry: burr or no burr? That is the question!
In the scientific literature the erbium laser (Er:YAG) wavelenght (2940nm) is proven to be a safe in bone ablation. Er:YAG is a choise of preference as a treatment tool in corticotomies being precise in removal of hard tissues, being atraumatic and not increasing edema, swelling and pain postoperatevily. In orthodontic treatment plans where corticotomies are needed to avoid the resistance of cortical bone and to accelerate treatment sequences, Er:YAG laser is a suitable surgical device. In this presentation ‘surgically assisted rapid maxillary expansion’; ‘zygomatic anchorage’, ‘supracrestal fiberotomy’ and ‘corticision’ methods made by use of Er:YAG would be presented
With technological development, some alternatives to rotary cutting instruments have been introduced for caries removal and cavity preparation. High power lasers are now widely used following their introduction for use in dental hard tissues in 1964. Wavelengths close to 3000 nm, such as those emitted by the erbium lasers, are close to the main absorption peak of water and hydroxyapatite, and therefore they have been demonstrated to be effective for cutting soft and hard (enamel, dentin, and alveolar bone) tissues.
A femtosecond laser is a laser which emits optical pulses with a duration well below 1 ps (àultrashort pulses), i.e., in the domain of femtoseconds (1fs = 10−15 s). It thus also belongs to the category of ultrafast lasers or ultra short lasers. The generation of such short pulses is nearly always achieved with the technique of passive mode locking.
Femtosecond lasers can be used for applications requiring either very high time resolution, or very high peak intensity. Because of their very short pulse duration they can be used as a “flash” to capture and resolve very fast processes such as molecular vibrations. The short pulse duration and low duty cycle also means that the energy in each pulse is contained in a very short timescale so that the peak power is extremely high.
In the 3 µm to 6 µm wavelength window, now covered by interband cascade lasers, many industrially relevant trace gases have their strongest absorption bands. They show absorption strengths that are several orders of magnitude higher than those in other infrared (IR) areas. This concerns prevalent molecules such as carbon dioxide (CO
2), nitric oxide
(NO) or water (H2O). Most hydrocarbons,
e. g. methane, equally locate their topmost absorbing features at these ICL wavelengths.
Using the strongest absorption band of the detected trace gas contributes to accelerate the sensing speed, reduce the noise and miniaturize the sensor. These lasers are considered for various progressive applications in industry and research. In the oil and gas sector, they enable accurate process control and support higher energy efficiency and pollutant reduction.
Different laser technologies have been investigated in recent years to access the 3 µm to 6 µm wavelength range. Besides interband cascade lasers, GaSb-based type I interband diodes and intersubband quantum cascade lasers (QCL) have been a major focus of research.
More investigations are needed in the field of dental medicine for the application of these new lasers.
Background: The use of laser technology in conservative dentistry was proposed in 1990 by Hibst and Keller who described the possibility to employ Er:YAG laser as an alternative to conventional rotating instruments. In fact, thanks to the affinity of this wavelength (2940 nm) to water (absorption peak = 3000 nm) and hydroxyapatite (absorption peak = 2800 nm), Er:YAG laser can ablate hard dental tissues without the risk of micro- and macro-fractures, often observed with the use of conventional rotating instruments and the dentin surface treated by this laser appears clean, without smear-layer and with the tubules open and clear. The aim of this clinical study was to demonstrate, by the description of different clinical cases, the possibilities and advantages of the use of Er:YAG lasers in conservative dentistry and also to show that better results may be achieved in terms of stronger adhesion, less invasiveness, reduced pain as well as greater comfort and satisfaction of patients. Methods: The advantages of the use of Er:YAG laser in adhesive dentistry is demonstrated by the description of a great number of cases in different clinical situations, with different parameters and techniques, and with follow-up observations. Results: All the cases reported showed good functional and aesthetic results with great satisfaction of the patients. In most cases, anaesthetic injection was avoided without pain and discomfort, also due to the thermal elevation in the pulp, recorded during Er:YAG laser irradiation, lower than that recorded by using a turbine and micro-motor with the same conditions of air/water spray. This wavelength also produces an antimicrobial decontamination effect on the treated tissue, which destroys both aerobic and anaerobic bacteria. Discussion: The most interesting aspects of this new technology may be related to the goals of modern conservative dentistry: i.e. minimally invasive treatment and adhesive dentistry. In fact, Er:YAG lasers can reach spot dimensions smaller than 1 mm, thus enabling a selective ablation of the affected dentin with the preservation of the surrounding sound tissues. Moreover, several in vitro studies have demonstrated that the preparation of enamel and dentine by Er:YAG laser, followed by orthophosphoric acid-etching, enhance the effectiveness in terms of reduced micro-leakage and increased bond strength. For this reason the role of the Er:YAG laser in modern conservative dentistry is of greater and greater importance: it is able to make a very small cavity and, by realizing a rough surface, to increase the adhesion of the composite resin. If this is desirable in the whole of conservative dentistry, it becomes strictly necessary in particular clinical situations where a minimal volume of ablation and/or greater adhesion is required, i.e. pits and fissures sealing, fluorosis or enamel defects, spots and crown fractures of frontal teeth. The follow-up observation of the described cases confirmed the long-term stability of the results, both in terms of functionality and aesthetics. Conclusion: Er:YAG laser has demonstrated to be a good device in conservative dentistry; it may replace the conventional rotating instruments with several advantages in terms of patient comfort, results, and longevity.
Blagovesta Yaneva
Er:YAG laser assisted periodontal treatment – reasons for success
Youssef Sedky
Laser failitated orthodontics
Avi Reyhanian
THE USE OF THE ERBIUM YTTRIUM ALUMINIUM GARNET (2940 NM) - IN A LASER ASSISTED IMPLANT THERAPY Thou Shalt and Shalt Not Do!
Periodontitis is the most common dental disease together with the caries. Its connection with a lot of systemic diseases requires proper diagnostic, treatment and prophylaxis. There are many instruments and therapy options proposed for periodontal treatment. However, all of them have some disadvantages.
The Er:YAG laser promises to be applicable in periodontitis treatment because of its wavelength of 2940 nm which is absorbed equally well in soft and hard tissues – both components of periodontal complex.
The presentation aims to demonstrate the characteristics of the Er:YAG laser, its potential for periodontal application and the advantages of this wavelength over conventional periodontal treatment.
Own and other laboratory and clinical studies will be presented to prove the ability and advantages of the Er:YAG laser alone or as an additional tool in periodontal treatment. The lecture will give a contemporary insight into the latest studies in the field of Er:YAG laser periodontology.
Orthodontics is a discipline dealing with dentofacial aesthetics and function; reaching optimal treatment results and patients satisfaction is the primary goal. Introducing new treatment modalities utilizing top notch technologies became a mandatory demand to reach such goals. Dental laser is a state-of the-art adjunctive tool that can be used to optimize different treatment procedures. Diverse dental laser wavelengths provide a wide applicability in different orthodontic clinical applications. Laser can be used from the first step of orthodontic brackets bonding, re-bonding to the final step of debonding brackets. Throughout the treatment course, laser can be applied for soft tissue managements associated with orthodontics as in cases of canine impactions, gingival overgrowth, and high frenal attachments. Accelerating the rate of orthodontic tooth movement is a marked application for diode laser; its biological effect on molecular messengers biostmulating bone remodeling have been proved clinically and in the literature adding a cornerstone application for laser in orthodontics. Different applications, with cases presentation and literature review and criticism will be presented to critically evaluate Laser Facilited Orthodontics.
The array of available clinical applications for laser assisted dentistry is growing rapidly, with the greater number of applications being for oral surgery.
Er: YAG laser wavelength is considered to be extremely safe, and is the dominant wavelength in dentistry today. Er:YAG is one of the most suitable wavelengths for bone applications.
The presentation will demonstrate the use of the Er:YAG laser in the world of implantology, and the advantages vs conventional treatment methods.
Today we can observe an inordinate lack of clarity concerning the clinical uses of the laser in the field of implantology, and with many doctors in the field reality does, indeed, mix with fantasy. The purpose in my presentation is to put some order into the chaotic information surrounding the subject and to provide some answers to the most common and frequent questions we often meet: How far can we go with this technology? Is it just a marketing tool or proven therapy? Where is the line between reality and fantasy? Does this technology completely replace the conventional methods and if not, at which point do we lay the laser’s hand piece down and re-employ the “old” tools and conventional ways?
The presentation will exhibit, beyond any doubts, that Er:YAG laser, is a very valuable tool and shows promise and safety as an effective new technical modality for implant therapy.
Plenary Speakers
17th Congress of ISLD
3938 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Michal Nawrocki
Treatment of periimplantitis - a challenge in nowadays implantology
Sapan Mistry
Clinical applications of Solea, a 9.3 µm CO
2 all-
tissue laser
Konstantinos Arapostathis
Use of technology to reduce dental fear and avoidance for children and adults
Dental implants are the most recommended method for replacement of missing teeth. Increasing interest in this method of treatment is reflected in the growing number of implants inserted in the subsequent years.
Although the method is safe and predictable some complications like peri implant inflammation can appear. There are a lot of different risk factors, which can influence for prevalence of those inflammation. When only soft tissue is affected - it is defined as mucositis, when there is bone defect - then we diagnose peri-implantitis. Different methods of treatment for tissue inflammation around the implant are used, depending on inflammation extent, method availability, type of defect, skills and experience of the dental surgeon.
In recent years, with a view to improving effectiveness and minimizing the invasiveness of peri-implant tissue treatment there is more and more attention given to the possibility of using lasers with different wavelengths.
During the lecture the comparison between the two methods of peri-implantitis treatment with the use Nd:YAG and Er:YAG lasers will be presented. The first method - surgical one was performed with opening mucoperiosteal flap to obtain the proper access to the defect. In the second method laser therapy was performed through the pocket, without creating mucoperiosteal flap. The key issue in periimplantitis treatment is conducting the effective decontamination of infected implant surface and eradication of the surrounding inflammation in order to obtain stable condition.
Until now no uniform protocol of procedure has been defined which could be considered the best and the most effective one.
Solea, a 9.3 µm CO2 all-tissue laser,
enables anesthesia-free hard tissue procedures and virtually bloodless soft tissue performance. Its precision in both hard and soft tissue leads to improved clinical outcomes and allows for most procedures to be completed in a minimally invasive manner. A 9.3 µm CO
2
all-tissue laser can be successfully used in the field of cariology and in various oral surgeries involving soft tissue and bone ablation. It eliminates the need for anesthesia and enables clean surgical site during soft tissue procedures, improves post-operative comfort and healing.
Learning Objectives:
Discover the science behind a 9.3 µm CO2
laser and how this unique wavelength enables fast and precise cutting of dentin, enamel, gingiva, and bone.
Uncover how a 9.3 µm CO2 laser can
benefit you and your patients when used for cavity preps and surgical procedures.
Review clinical cases of hard and soft tissue procedures performed with a 9.3 µm CO
2 laser.
Prevalence of dental fear is significant among children, adolescents and adults and it can lead to serious behavioral problems and avoidance of dental treatment. The understanding of dental fear’s mechanism is essential for its early diagnosis and finally the acceptance of dental treatment. Over the last decades, the rapid evolution of technology in dental science has to present new devices and techniques with the aim, among others, to achieve friendly and lightweight dentistry dealing with ensuring or improving the quality of dental care. We will discuss the effect of the new, friendly, alternative devices or techniques for administering anesthesia, cavity preparation, oral surgery and other modalities in dental fear, behavioral management and finally acceptance and cooperation.
Justin Kolnick
Managing Refractory Endodontic Disease with Radial Apical Cleansing, a Laser-Assisted Endodontic Protocol
Angelina Kisselova-Yaneva
Practical aspects of biogaia prodentis applications in dental practice
Andreas Braun
Lasers in periodontal therapy – not just a gimmick!
One of the defining attributes of an astute endodontist is the ability to successfully treat refractory endodontic disease. Refractory disease is defined as disease that is recalcitrant, unresponsive, stubborn, unmanageable or resistant to treatment or cure. While the pathogenesis of refractory endodontic disease is not clearly comprehended, it is highly likely that microbiological and host immune influences play an important role. Unsuccessful endodontic outcomes are often attributed to persistent infection perpetuated by entombed bacteria or by reinfection of a previously disinfected root canal system, commonly via coronal leakage or tooth fracture.
Aim: To present a laser-assisted clinical protocol for the successful management of refractory endodontic disease.
Methods: A treatment protocol, Radial Apical Cleansing, (RAC) is presented for non-surgical management of refractory endodontic disease. The protocol relies primarily on a synergistic effect between Er,Cr:YSGG laser irradiation, deep dentin disinfection with 940nm diode and subsequent apical negative pressure irrigation with 6% sodium hypochlorite solution.
Results: The protocol efficacy will be presented via clinical case reports of refractory endodontic disease successfully managed with RAC.
Conclusion: While several studies have focused on identifying root canal microflora in recalcitrant cases in an attempt to explain the pathogenesis of refractory disease, it is the contention of this author that RAC is a valuable tool capable of successfully treating the infectious bioburden, irrespective of the makeup of the biofilm itself.
Gum diseases sre a major health problem as 60–80% of the population in industrialized countries suffer from gingivitis (bleeding gums) and 10–20% suffers from periodontitis (tooth loss). The oral cavity contains around 800 different species of bacteria and there are more than one billion bacteria on each tooth. Under normal conditions, these are in balance and protect you from illnesses, but when the balance among oral bacteria is disrupted due to inadequate oral hygiene, stress and poor diet plaque forming bacteria can gain the upper hand, causing gum problems.
During the past few years have been developed special probiotic products to maintain balanced oral flora, not only affecting the plaque index and breath odor but also reducing the local inflammation and risk of caries. BioGaia ProDentis tablets proved to have beneficial effects in gingivitis, periodontitis and some other inflammation conditions both in children and adults.
The removal of periopathogenic biofilm is a fundamental aspect of systematic periodontal therapy. Adjunctive antimicrobial procedures such as laser applications and antimicrobial photodynamic therapy (aPDT) procedures are suggested to improve the therapeutic outcome.
Locally delivered and systemic antibiotics are used to improve periodontal treatment regimens. However, with respect to the possible development of bacterial resistance to antibiotics, the use of these agents should be restricted to specific groups of patients, for example, those with highly active disease or a specific microbiological profile. Lasers and aPDT procedures could be an adjunctive antimicrobial approach for preventive and therapeutic treatment regimens without the disadvantages of antibiotic agents. Development of bacterial resistance has not yet been shown and could not be generated in an experimental study protocol. Conventional laser treatment comprises heat generation and subsequent heat-induced cell death of pathogenic microorganisms. Photodynamic therapy utilizes a photosensitizing agent, which is irradiated with a light source tuned to a wavelength that matches the absorption spectrum of the agent. The subsequent photochemical reaction results in oxygen-mediated destruction of pathogenic bacteria. Sustained exposure of the treated tissue results in breakdown of cellular microstructures and cell death. Several photosensitizers have been shown to be effective against target microorganisms without inducing damage to the host tissues.
In general, the adjunctive use of lasers and aPDT procedures was reported to have a positive effect on treatment outcomes. Thus, it might be possible to improve conventional treatment regimens to enhance the prognosis for clinical long-term success.
Plenary Speakers
17th Congress of ISLD
4140 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Gabriele Schindler-HultzschNew technology and predictable pathways in pediatric oral surgery – Minimally invasive laser-assisted pediatric surgery in combination of high-resolution digital volume tomography
Vesselina Bozalieva
Nogier frequencies and their use in LLLT
Introduction: In pediatric dentistry surgical procedures are difficult to deal with dependent on the age of the child, the compliance and the complexity of the clinical situation. Because of the fear of the pediatric patients and difficult behavioral management during surgery, many kinds of treatment are carried out under general anesthesia.
Aim: Considering the circumstances of general anesthesia for the child, the parents and dentists, an atraumatic approach of an in-office surgical procedures can open new pathways in pediatric therapy. Especially a combined technique with precise diagnostic and gentle, minimally invasive surgical laser treatment make a big step forward in pediatric treatment options.
Methods: Different surgical indications of 10 pediatric patients were examined and planned with the help of digital volume tomography. The indications ranged from mesiodens, multiple odontoms, tooth anomalia, supernumerary incisors, uncovering of retained teeth of children aged between 5,5 and 12 years who were examined and treated under local anesthesia and Er,Cr:YSGG laser (2780nm) with 2,25 -2,75 W, 60 µs, 50 Hz, air 20%, water 40%.
Results and conclusion: All pediatric patients could be treated properly, fast, without pain and good behavioral outcome. Patients described no or only slight postoperative pain. Patients and parent comfort and satisfaction was high. Considering the circumstances of surgical procedures and general anesthesia, the new combination of high-resolution 3D-diagnostic, digital planning and minimally invasive laser treatment opens new predictable treatment options in the future for clinical practice in pediatric dentistry which were untreatable conventionally before. More studies have to underline the implication of this procedure.
The cell is the basic constituent of living tissue and it reacts well to the external stimuli of laser light. Laser light acts on the cell’s metabolism and environment. The electromagnetic field induced by coherent emission of the photons composing the laser beam appears to have an action on the membrane polarity of the cells. This facilitates intercellular exchanges, which promotes repolarization and the return of sick or injured cells to cellular homeostasis. In addition to providing light energy, the cell is also submitted to laser irradiation with repetition frequencies. The work conducted by Dr Paul Nogier showed that some frequencies present undeniable effects both for diagnosis and treatment. These frequencies are called “Nogier frequencies” and their use in LLLT will be discussed in this lecture.
Plenary Speakers
09 Юни гр. Пловдив Практически курс с лектори: д-р Илай Маден, д-р Дмитрий Малев, д-р Томаш Иванушич
07 Септември гр. София Приложението на Er:Yag и Nd:Yag лазери в стоматологията
03-06 Октомври гр. София Sofia Dental Meeting
05-06 Октомври гр. София Global Aesthetics AcademyМеждународна академия за естетика, гинекология и стоматология
09-10 Ноември Словения Практически курс с лазерна система Fotona Light Walker
17th Congress of ISLD
4342 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Oral Presentations
Ana Catarina Nogueira da Silva
Adhesion on dentin surfaces prepared with Er,Cr:YSGG laser: is the key in the Grape?
The proanthocyanidin (PA)-rich grape seed extract (GSE) is a collagen cross-linking agent that can perform a chemical bond with the dentin’s collagen. The objective of this study was to evaluate the influence on shear bond strength (SBS) of the pre-conditioning of GSE, on human dentin surfaces conditioned with Er,Cr:YSGG laser. The sample consisted of 64 non-carious human teeth, divided into eight groups, four groups conditioned with Er,Cr:YSGG laser (4.5W, 50 Hz, 50 µs, 70%air, 90%water) and four prepared with conventional methods (control). In both groups, a GSE solution was applied before using the two adhesives tested: Clearfil™SE Bond (CSE) and Scotchbond™ Universal (SU). Subsequently, a SBS test, a scanning electron microscopy, and a statistical analysis, were performed. In the laser groups, the best SBS mean (20.08 ± 4.01 MPa) was achieved in the group treated with GSE and CSE. The control group with the application of CSE showed the highest SBS mean (24.27 ± 10.28 MPa), and the group treated with laser and SU showed the lowest SBS mean (12.94 ± 6.51 MPa). Between these two groups there was a statistically significant difference (p =0.05). However, this was not observed among the laser or control groups. The type of dentin surface preparation can influence the SBS. The CSE showed better SBS in laser and control groups. The presence of GSE did not improve the adhesion on surfaces conditioned with laser, but more studies should be carried out in the future to confirm this conclusion.
Ana C. Silva, Paulo Melo, João Ferreira, Sofia Oliveira, Norbert Gutknecht
Ahmed Ibrahim Youssef
Efficiency of Er,Cr:YSGG laser in veneers debonding on two types of ceramic materials and cements: pilot study
In the last decade, the patients seeking smile makeover had drastically increased, thus, ceramic veneers have become more popular due to their superior aesthetic appearance. The porcelain veneers usually adhesively cemented, which makes their removal a challenging process. There are certain risks associated with conventional methods, as harming the underlying tooth structure due to lack of color contrast, making removal and remake a more frustrating process. To overcome these limitations, the laser technology was introduced as a more comfortable and conservative technique, showing favorable results. Thus, the current study might be of value.
The purpose: to evaluate the debonding efficiency of Er,Cr:YSGG (using turbo hand piece) through bonded feldspathic and lithium disilicate discs by two different adhesive cements, light and dual cured cement for rebonding.
Materials and Methods: (40) Freshly extracted central incisor were used in the study and divided into two groups according to material of choice and types of adhesive cement into Group (A) lithium disilicate and Group (B) feldspathic porcelain and each group will be subdivided into two subgroups according to cement used Subgroup (i) light cured resin cement and Subgroup (ii) dual cured resin cement and Er,Cr:YSGG (turbo handpiece) was used on all subgroups. Scanning electron microscope was used to evaluate the surface tomography. Data was analyzed statistically.
Patricia Buttler
Overview of laser scanning microscopy and other optical laboratory techniques for investigations of 9.6 µm CO2 laser irradiated hard tissue samples
Different techniques exist in a scientific laboratory regarding the evaluation of laser irradiated surfaces. The aim of a particular study determines which kind of evaluation is chosen for any given group of specimens.
In our CO2 laser research group at RWTH Aachen University the needed investigations are decided by the doctorate candidates involved in the research projects. Common approaches involve teeth and bone specimens that are cut by a diamond band saw and irradiated under experiment-specific conditions. Usually after irradiation the sample is divided into three parts. One part is embedded in resin. Subsequently it is cut and polished for histological evaluation. The second part is prepared for electron microscopy. The third part is investigated by different optical means.
Here, we use optical microscopy and laser scanning microscopy in order to assess the nature of the irradiated surfaces. In this presentation, beside the well-known microscopy, we focus on the function of the laser scanning microscope and its advantages in higher accuracy, sharper images, simple specimen preparation and lower costs. A big advantage is the possibility of viewing the samples after irradiation without further processing.
Patricia Buttler, Jancee Anton Vetter, Enno Brackebusch, Nora Gutknecht-Schreiber, Patrick Jansen, Sareh Michael, Rene Franzen, Norbert Gutknecht
Nora Gutknecht-Schreiber
New findings regarding 9.6 CO2 laser bone surgery - a temperature study
Alina Rotar
Digital Science and Diode Laser Therapy: enhancing the quantification of oral inflammation reduction for periodontal patients
Introduction and aim: Providing a virtual environment upon high quality impressions (facility of intra-oral scanners), we become able to compile data regarding dental arches and soft tissues. Removing microbial biofilm, calculus deposits, maintaining a biologically compatible surface represent main objectives of periodontal therapy. Digital reproducibility might support translation and quantification of periodontal inflammation reduction, after diode laser therapy.
Methods: Devices used for non-surgical periodontal treatment approach comprise: SIROLaser Blue - 970nm Diode laser (class IV) - preset: Power 1.5 W, Frequency 10Hz, Duty Cycle 75%, Fiber Tip 320um; 3 Shape Trios – dental intraoral scanner (IOS). First session: digital impression (IOS), periodontal charting (Florida Probe System), removing supra gingival calculus, professional cleaning, instructing the patient for improving oral hygiene. Second session: digital impression (IOS) then deploying the 970nm diode to reduce germs inside periodontal pockets, afterwards performing subgingival ultrasonic debridement. Third session: another digital impression and perio-germ reduction - 970nm Diode (same settings). Fourth session : reevaluation phase using periodontal charting and digital impression.
Results: during non-surgical treatment and diode laser irradiation the use of digital impression, virtual models allows immediate measurements, evaluation of the soft periodontal tissues.
Conclusions: capturing high quality impression might be sufficient to superimposed different oral scans, in order to evaluate the extent of inflammation deviation/reduction after diode laser therapy. Driving innovation requires more scientifically proven protocols, well designed step-by-step process, several specific kinds of software.
Introduction: Nowadays, the usage of Lasers in different medical areas is very popular. It is commonly used in ophthalmology or dermatology and even in other surgical operating fields. Due to its hemostatic and aseptic properties as well as precise cutting, Lasers have gained more and more attention. But a Laser does not equal a Laser. There are many different products, each working with different wavelengths on the market. The aim of working with a Laser should be to know the correct wavelength for the right indication. Due to diffrent disadvantages, like thermal damage, it is most important to choose a Laser with a suitable wavelength for medical purposes.
In the following study a new innovative prototype laser system from Dentaray was tested regarding the thermal behavior applied on a human femur. The prototype is a CO
2 Laser with a wavelength of
9600nm.
Material und Methods: Our research was performed by choosing ten diffrent areas on a human femur bone in which the temperature during the cutting process was measured. Each area was prepared in the same way. Three small canals where drilled with a distance of 0.5 mm, next to the planned laser cut, to place the thermo couples for temperature measurement. Those thermo couples have been covered by a thermo paste and sealed by wax. An additional thermo couple was placed in the water bath to control the water temperature at a constant temperature of 37.0 degrees. The recording of the
temperature was done by a computer program in the form of a temperature diagram.
All laser cuts were performed free handed while the femur was fixed inside the water bath. The laser applications were made with the following parameters: Pulse energy: 91mJ; Pulse duration: 100micro seconds; Frequency: 100Hz.
The laser hand piece was used free handed in a distance range approximately 1cm towards the bone surface. In addition, water spray was used.
Results: All measurements done during the laser cutting on the femur showed a significant decrease of temperature in the bone structure. The temperature decrease was given in a range of 26 degree Celsius.
Conclusion: On analyzing the results of our study it was found, that no temperature raise in the bone during the laser cutting process of the femur bone with the 9.6 CO
2 laser was found.
The temperature of the bone tissue even decreased due to the specific ablation mechanism of the 9.6 CO
2 laser in hard
tissue. So it can be clearly stated, that even when using the highest output power possible in this device all our records showed clearly, that there was no thermal damage to the surrounding tissue found.
Nóra Gutknecht-Schreiber, Stefan Schreiber, Jancee Anton Vetter, Enno Brackebusch, Patrick Jansen, Patricia Buttler-Bücher, Rene Franzen, Andreas Prescher, Norbert Gutknecht
17th Congress of ISLD
4544 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Oral Presentations
Enno Brackebusch
General ablation characteristics in bovine enamel using a newly developed CO
2 laser system at
9600 nm – a pilot study
CO2 lasers theoretically have a great potential in both hard and soft tissue, due to their high absorption in both water and hydroxyapatite. Acting in accordance to this principle, Israeli company Dentaray designed a new CO
2 laser system to
establish it as an “all-tissue-CO2-laser” by
introduction of a wavelength of 9600 nm.
This pilot study aimed to investigate the system’s general ablation characteristics in bovine enamel at certain settings.
20 bovine incisivi were selected, cut and ground plane (n=10). Two groups with different displayed parameter values were formed. The waterspray-cooled samples were continuously passed through the laser beam in a pendulum motion at a fixed speed by a computer-controlled scanning stage at 10 mm distance to the laser. Samples were then examined by stereomicroscope and laser scanning microscope.
Resulting cavities showed mainly consistent depths. Depending on the settings, slight or no surface discolouration was found. Preparation depth was found to be the greatest next to the margins while being the lowest at the cavities’ centers, forming an arch-like shape.
Power measurements performed after each sample irradiation showed discrepancies between indicated power and actually emitted power as well as a continuous loss of power over time.
Therefore, although preliminary results appear promising, further testing is necessary to assess applicability, effects and performance on dental hard tissues after the system’s performance and stability have been improved during further development.
Molecular disturbances in oral lichen planus –a new viewpoint on the pathogenesis of the disease
Introduction: OLP is a chronic inflammatory disease the etiology and pathogenesis of which remain uncertain. It is considered that T-lymphocytes induce apoptosis of basal keratinocytes. However, recent reports demonstrated that epithelial cells in OLP do not preferentially develop apoptosis but rather cycle arrest and show an increased proliferation rate.
Aim: The aim of this study is to evaluate the expression of pro-apoptotic, anti-apoptotic and proliferation markers in OLP lesions in order to highlight their potential role in the pathogenesis of the disease.
Material and methods: The immunohistochemical method was used to detect p53, p63, bcl-2 and Ki-67 in biopsies taken from 20 patients with OLP and 10 healthy volunteers. The reaction intensity was measured using a semi-quantitative scale. Correlations among immunohistochemical parameters were tested by Spearman correlation test.
Results: The expression of p63 was significantly reduced in OLP lesions as compared with the healthy epithelium. 55% of OLP specimens were p53 negative and there was no significant difference in the levels of this marker with that in the control group. OLP lesions demonstrated lower staining for bcl-2 and Ki-67 in comparison with the healthy controls. Significant associations were found between expressions of p63 and Ki-67 and between p53 and p63.
Discussion: P63-deficiency is likely to be an important molecular mechanism in the pathogenesis of OLP, resulting in cell proliferation inhibition and presumably inducing cycle arrest. There was no evidence of p53-mediated apoptosis. The observed decreased levels of p63, bcl-2 and Ki-67 suggested thinning of the epithelium and erosions.
Maria Mutafchieva, Milena Draganova-Filipova, Plamen Zagorchev, Georgi Tomov
Ahmed Ibrahim Khalaf
Evaluation of Post-Endodontic Pain Control using Low- Level Laser Therapy in Comparison to Intra-canal Cryotherapy: A Randomized Placebo-controlled Clinical Trial
Introduction: One of the most important aspects of endodontic treatment is pain management. Postoperative pain after endodontic treatment is a frequent complication. According to a systematic review, the frequency of endodontic postoperative pain is between 3% and 58% of patients.
Aim: In this clinical trial, we are evaluating the effect of low-level laser therapy (LLLT) and intra canal cryotherapy on postoperative pain in molar teeth with symptomatic apical periodontitis.
Methods: Ninety five patients were included in the study according to the inclusion and exclusion criteria.The patients were randomly distributed into 5 groups using a Web program as follows: control (no intervention), placebo (mock laser therapy), LLLT, cryotherapy and a combination of both. Postoperative pain levels after 6 hrs, 12 hrs, on 2nd day and 5th day were assessed and postoperative percussion pain levels on the visual analog scale wererecorded.
Ahmed Ibrahim Khalaf, Ahmed Mustafa Ghobashy, Yousef Wael
Maria Mutafchieva
Histological improvement in oral lichen planus following LLLT
Introduction: OLP is a chronic inflammatory disease in which T-lymphocytes destroy the basal keratinocytes. This immune aggression results in the occurrence of hyperkeratotic plaque, painful atrophic and erosive fields or blisters. LLLT is considered a justified treatment modality in this patients since it provides analgesic and anti-inflammatory effects.
Aim: The aim of this study was to evaluate clinical, morphological and molecular effects of LLLT when applied in patients with OLP.
Materials and Methods: Twenty patients with OLP underwent LLLT with diode laser (810nm), (0,50W, 30s, 1,2J/cm2), 3 times weekly for a month. The clinical scores of the lesions and pain level were recorded before and after therapy, using Thongprasom sign scoring and VAS respectively.
Biopsies were taken before and after therapy to obtain histological diagnosis and to reveal tissue changes following laser irradiation. The levels of pro-inflammatory cytokines in unstimulated whole saliva from all patients were measured before and after LLLT by ELISA.
Results: The pain level and clinical scores of the lesions decreased significantly. Corrections of the pathological processes in tunica epithelialis were characterized by repair of the epidermal-dermal attachment, increased proliferation in the atrophic-erosive forms and partial reduction of the hyperplastic processes in the keratotic forms. Additionally, reduction up to complete resolution of the inflammatory infiltrate, was revealed after treatment. This anti-inflammatory effect was confirmed by the reduction of the increased levels of pro-inflammatory cytokines before therapy.
Conclusions: The observed clinical improvement, confirmed at morphological and molecular level determines LLLT as a useful and harmless treatment modality in OLP patients.
Maria Mutafchieva1, Svitlana Bachurska2, Milena Draganova-Filipova3, Plamen Zagorchev4, Georgi Tomov1
Jancee Anton Vetter
Application of CO2 Laser with a wavelength of 9.6µm on pork tubular bone – a pilot study
The application of lasers on bone can have hemostatic and aseptic advantages. Precise and clean cuts can also be achieved compared to conventional surgical and dental instruments.
For this application a suitable laser without causing thermal side effects is necessary. In the following pilot study a new laser system with a wavelength of 9.6 µm (Dentaray) was tested regarding the applicability for cutting tubular bone.
Twelve pork ribs specimen (n=4) were used in this study. To test the effect on bone surface the specimens were irradiated with two laser parameters with different energy levels (display values). The samples and the handpiece were mounted on a computer-controlled motorized x-y-table with a distance of 10mm to each other (table speed: 3mm/s; water cooling was applied; 4 repetitions in a line with a length of 3mm).
With an additional parameter a specimen was cut into 2 parts to analyze the cross-sectional areas. This was done free handed. The samples were then analyzed with a stereo, laser scanning microscope and SEM.
The images show a sharply limited cut, which varies in depth according to the different parameters. No carbonizations were observed. SEM images showed areas with coating of molten and re-solidified material. Based on the results of the preliminary tests, it can be stated that the new laser system has great potential for bone cutting. However, further studies are necessary to test the clinical applicability.
Jancee Anton Vetter1, Enno Brackebusch1, Nora Gutknecht-Schreiber1, Patrick Jansen1, Sareh Michael1, Patricia Buttler1, Rene Franzen1,2, Norbert Gutknecht1
Patric Jansen
Potential of caries prevention by sealing with a new CO
2 9.6 µm-
laser system – a pilot study
Prevention, e.g. through fissure or pit sealing, is an important procedure to protect dental hard tissues. A new CO2 laser system (I=9.6 µm; prototype stadium) will soon be available on the market (Dentaray). The aim of the present pilot study was to check if there are suitable parameters of the new laser system for preventive applications.
Ten ground polished bovine teeth were used (n=10). The irradiations were performed using two parameters with different energies on the polished, buccal enamel surfaces (display values): P7 and P14. With the scanner system of the laser, water cooling, a distance of 10mm, without any motion of the handpiece and 5s exposure circa 5-7 nearly round spots (diameter: circa 3mm each) per tooth were possible. Of one exemplary sample per parameter stereomicroscopic and laserscanning microscopic images, including surface roughness measurements, were taken. Irradiated enamel was scraped off the blocks and pulverised to grain size of ≤45µm. The obtained powders were subjected to XRD analysis (2θ-range: 5-70°, CuKα, 40kV, 40mA, step size: 0.01°, counting time: 96s, Bragg-Brentano).
The images showed a glassy surface without carbonizations and an increased surface roughness (P7: Ra=3.85µm; P14: Ra=3.06µm). The XRD analysis showed beginning phase changes which can be contributed to alpha-Tricalciumphosphate.
In conclusion we can say that the tested parameters could be potential sealing parameters but further studies are necessary to check their suitability.
The effect of Diode laser internal bleaching protocol on thermal changes color outcomes using different parameters: An in vitro study.
Abstract: the aim of the study is to evaluate the effect of application of lasers in internal bleaching on thermal changes and color outcomes of non-vital anterior teeth using different parameters.
Materials and methods: 60 freshly extracted maxillary incisors were stained artificially using black tea. Teeth were then divided randomly into 6 groups (n=10). Group 1: application of 35% H
2O
2 internally
followed by laser activation with an output power of 2 watt then immediate color change assessment, Group 2: application of 35% H2O2 internally followed by laser activation with an output power of 3 watt then immediate color change assessment, Group 3: application of 35% H
2O
2 internally followed by laser activation
with an output power of 4 watt then immediate color change assessment, Group 4; application of 35% H
2O
2
internally and externally followed by laser activation with an output power of 2 watt then immediate color change assessment, Group 5: application of 35% H
2O
2
internally and externally followed by laser activation with an output power of 3 watt then immediate color change assessment, and Group 6: application of 35% H
2O
2
internally and externally followed by laser activation with an output power of 4 watt then immediate color change assessment. Color assessment: the color of all teeth will be measured after staining as a baseline and after different treatments using a digital spectrophotometer (Easyshade Advance 4.0), thermocouples will be used to measure temperature changes during laser irradiation, and the collected data will be analyzed statistically.
Rada Kazakova
Histological evaluation of gingival tissue after conventional and laser gingivectomy
Background: Various instruments can be used for the purpose of gingivectomy – a commonly performed procedure in everyday clinical practice.
Aim: To evaluate and compare histologically the gingival cut surface after gingivectomy with 6 different surgical instruments – a surgical scalpel, an Er:YAG laser, a CO
2 laser, a ceramic bur, an
electrocautery device, and a diode laser.
Materials and methods: Gingivectomy using the above listed instruments was performed on 18 patients. The histological samples excised with a surgical scalpel were assigned as a control group and the other five types – as test groups. The following histological parameters were measured: coagulation layer thickness (in µm); presence or absence of a microscopic rupture and presence or absence of hemostasis in-depth.
Results: The best instrument of the above listed ones which demonstrated excellent results is the CO
2 laser. The Er:YAG laser
leads to a thin coagulation layer and lack of hemostasis in-depth. The diode laser samples have the widest coagulation layer, which is an advantage from a clinical point of view. Electrocautery proved to be as effective as the diode laser, but it should not be used around metal restorations. The ceramic bur causes less pronounced hemostasis in-depth.
Conclusions: Contemporary dentistry offers a wide variety of gingivectomy methods that can be successfully applied in the everyday practice. Thorough knowledge of different means, their advantages and disadvantages are essential to obtaining the optimal result depending on the clinical case.
Mihail Tanev
Local aPDT in the complex treatment of drug-induced gingival hyperplasia
Drug-induced gingival hyperplasia manifests as abnormal growth of the gingiva due to an adverse drug reaction (ADR) in patients treated with anticonvulsants, immunosuppressants, or calcium channel blockers. The presented clinical case is focused on the complex treatment plan employing the benefits of different laser modalities. The treatment plan included Er:YAG laser-assisted gingivectomy and gingivoplasty followed by adjunctive local aPDT. In this case, Indocyanine green was selected for its proven efficacy against Gram (-) anaerobic flora (predominant in periodontal pockets). As the dye’s highest absorption peak ranges between 750 - 850 nm, an 810nm diode laser was selected as light source for the photodynamic reaction. The positive outcome confirmed the effectiveness of combined laser-assisted treatment of drug-induced gingival hyperplasia.
Jyuhn H. Ke1, Mihail Tanev2, Georgi Tomov2
Lilia Kavlakova
Topical therapy with tacrolimus 0,1% ointment for the treatment of gingival erosive lichen planus
Introduction: Management of gingival lesions of oral lichen planus is one of the main challenges of oral medicine, primarily because of their chronic nature. Treatment options are numerous, including both topical and systemic agents. Although topical corticosteroids are first-line therapies, they often lead to local and systemic adverse effects. Recent studies have shown that tacrolimus ointment 0.1% is an efficacious and well-tolerated topical therapy for gingival erosive lichen planus that causes few local side effects.
Aim: The aim of this poster is to evaluate the clinical efficiency of topical therapy with tacrolimus 0,1% ointment in patients with gingival erosive lichen planus.
Methods and materials: A 39 year old female with complaints of soreness and burning sensation in the gums. Preliminary impressions were taken for making individual custom trays. The patient was instructed to coat all internal surfaces with 0,1% tacrolimus ointment (Protopic) and to insert the trays twice daily, 20 minutes each time. Treatment period was two weeks.
Results: Physical examination demonstrated a reduction in lesion surface area and patient had no complaints.
Conclusion: Topical therapy with tacrolimus 0,1% ointment is a safe and very effective treatment approach for gingival erosive lichen planus and deserves further investigations.
Lilia Kavlakova*, Georgi Tomov
Inas El Zayat
The effect of a novel bleaching protocol on the color change of non-vital anterior teeth: in vitro and in vivo study.
Abstract: the aim of the study is to evaluate the effect of application of lasers in bleaching on the color change of non-vital anterior teeth in comparison to carbamide peroxide.
Materials and methods: 40 freshly extracted maxillary incisors were stained artificially using black tea. Teeth were then divided randomly into 4 groups (n=10). Group 1: application of carbamide peroxide and sealed with temporary restoration for 7 days as a control group, Group 2: application of 35% H
2O
2
internally followed by laser activation then sealed with a temporary restoration for 7 days, Group 3: application of 35% H
2O
2 internally followed by laser
activation then immediate color change assessment, Group 4; application of 35% H2O2 internally and externally followed by laser activation then immediate color change assessment. Color assessment: the color of all teeth will be measured after staining as a baseline and after different treatments using a digital spectrophotometer (Easyshade Advance 4.0) and the collected data will be analyzed statistically. The same protocols will be applied clinically to assess the clinical efficiency of the proposed protocols.
Inas El Zayat a, Mohamed Bahgat A/Hamid b, Ahmed Tarek Farouk
Mohamed Bahgat Abdelhamid
Microbiological Assessment of Diode Laser with different parameters in comparison to Chemical Disinfection in the management of Deep Carious Lesions
Management of carious lesions has been changing significantly because of improved understanding of the caries process. Different new conservative approaches have been introduced in the management of deep carious lesions. Diode laser has shown promising results in cavity disinfection and biomodulation of odontoblastic like cells. Thus, the current study might be of value.
Purpose: to evaluate the antimicrobial effect of Diode laser with different parameters in comparison to chemical disinfection in the management of deep carious lesions.
Materials and methods: 40 dentinal samples were collected from deep carious lesions and divided according to dentinal sample disinfection protocol into 4 equal groups (n= 10). Group 1: Diode laser disinfection of dentinal sample with an output power of 0.1 watt, Group 2: Diode laser disinfection of dentinal sample with an output power of 0.5 watt, Group 3: Diode laser disinfection of dentinal sample with an output power of 1 watt and Group 4: chemical disinfection of dentinal sample using 2% chlorhexidine. Microbiological Assessment of dentinal samples was performed before and after disinfection by inoculation of the samples on blood agar for total viable count, on the mitis salivurias agar, a selective medium for Streptococcus mutans, and Rogosa agar medium for Lactobacilli. Colony forming units were counted using a colony counter. Data was analyzed statistically.
Ola Mohamed Ibrahim Fahmya, Mohamed Bahgat Abdelhamidb
17th Congress of ISLD
4948 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Oral Presentations
Daniel Markov
Leukoplakia. Evolution in carcinoma- treatment
Oral leukoplakia is a white lesion usually not associated with other condition. It can’t be scraped, cause no pain. This premalignant lesion has a malignant transformation rate of 0.13% to 34 % depending on which site of the mouth is found. Most leukoplakia patches are noncancerous (benign), though some show early signs of cancer. Although the cause of leukoplakia is unknown, chronic irritation, such as from tobacco use, including smoking and chewing, appears to be responsible for most cases. Often, regular users of smokeless tobacco products eventually develop leukoplakia where they hold the tobacco against their cheeks. Other causes may include chronic irritation from: jagged, broken or sharp teeth rubbing on tongue surfaces, broken or ill-fitting dentures, long-term alcohol use. After a biopsy is performed lesion without dysplasia may be followed up in time, others are excised.
Svetoslav Slavkov
Clinical case of gigantic pleomorphic adenoma of the parotid gland. Challenge in diagnosis and surgical treatment
Maxillo facial region may be affected by inflammatory, traumatic, oncological and other processes. The main section of the specialty is maxillofacial oncology. One of its features is the development of tumors characteristic of the maxillo-facial area only. These are the tumors of the salivary glands. Engaging an anatomical area usually leads to disturbances in the boundary areas. On the other hand, surgical interventions in oncology surgery should be radical and ablative. Observing this basic rule in conducting surgical treatment in patients with salivary gland tumors, especially their malignant variants, often there are severe functional, aesthetic and, last but not least, psychosocial problems.
We present to you a difficult case of parotid gland tumor developed for more than 20 ears, challenging is as a diagnosis and surgical treatment.
Simeon Chokanov
The effect on oral health in drug abuse
Introduction: Drug abuse is rising worldwide and its effect on oral health is long term. Increasingly various medical specialists are engaged in preventive and therapeutic activities related to patients dependent on substances. The professional training and awareness of individual doctors is at a different level. This necessitates a summary of the problem and the associated oral and general-pathological pathology.
Aim: The main aim of this work is to study the most frequent drug abuse effects on oral health and how to manage with patients in those conditions.
Methods: A critical analysis of available scientific literature was made for the last 10 years. We analyzed and compared the results of articles, published in Pubmed, Google Scholar, PubMed Central and Science Direct.
Results and Discussion: Despite the fact that oral health is important, it is very often neglected. The oral pathology that occurs in drug abusers depends on the type of drug, the drug dose and individual patient differences. Some conditions like: poor oral hygiene, xerostomia, caries, dental erosion, periodontal diseases, gingival hyperplasia could be linked to drug abusers. Very often this patients have dental phobia and don’t think that oral health is their priority.
Conclusion: Drug abusers are patients who have more dental problems. Dentists can help to prevent problems to become irreversible. In treatment of those patients should be used a multidisciplinary approach.
Simeon Chokanov, Christiana Madjova
Yanitsa Istatkova
Erythroplakia a flag for oral cancer – difficulty in treatment
Premalignant squamous lesions of the oral cavity are areas of altered epithelium that are at an increased risk for progression to squamous cell carcinoma. The most common of these lesions is squamous dysplasia in association with leukoplakia and erythroplakia.
An erythroplakia is a fiery red patch that cannot be classified as another entity. Far less common than leukoplakia, erythroplakia has a much greater probability (91%) of showing signs of dysplasia or malignancy at the time of diagnosis. Such lesions have a flat, macular, velvety appearance and may be speckled with white spots representing foci of keratosis.
Management of oral erythroplakia focuses on the prevention of malignant transformation and early detection of occult malignancy. In view of the high malignant potential of these lesions the recommended treatment is surgical excision, including laser. However, even after surgical excision, the recurrences and development of malignancy at the same site are high.
Y. Istatkova, D. Markov, A. Krasteva
Atanas Chonin
Assessment of the role of increased corrosion potential and sensitization to metals in patients with burning sensation in the oral cavity
Introduction: Oral burning is a symptom with many different etiological factors. Among the reasons for such condition can be sensitization to the components in dental alloys. The local toxic effect of the released ions resulting from the corrosion of metal objects is another etiological factor.
Aim: To assess the role of increased corrosion potential and sensitization to dental alloys in oral burning.
Materials and Methods: 43 patients who had complaints of burning in the oral cavity were included in the study. After history taking, clinical examination, skin allergy testing, corrosion potentials were measured. Allergy testing was done with a “Dental Screening Series” of haptens in the composition of dental alloys. The corrosion potential was measured using a “Dentotest six” apparatus, observing the requirements for the patients not to have eaten and conducted oral hygiene.
Results: The surveyed were 81.4% women and 18.6% men. The average age of the study group was 59.5 ± 13.9 years. Six (13.9%) of the patients were sensitized to dental alloy components. Increased corrosion potential values were measured in 39 (90.7%) patients.
Conclusion: The obtained results show the influence of increased corrosion potential as a factor in the aetiology of burning sensation in the mouth.
Iliana Stoeva1, Atanas Chonin2
Christiana Madjova
Clinical and paraclinical indicators of saliva in the establishment of oral disease
Introduction: Saliva is a biological fluid formed in the oral cavity. For medical purposes, it is obtained in a non-invasive way, making it the preferred material for research. It constantly “swaps” the oral cavity and strives to cope with the ever-changing oral environment.
Aim: Our goal is to use saliva as a diagnostic fluid that offers different advantages over blood samples. Saliva is also ideal for screening large populations, because it provides a cost-effective approach.
Methods: Through critical analysis of available literature and our research we show that saliva is an easily accessible biomaterial. It offers a number of diagnostic advantages - it can easily be assembled, no special device is needed, and contains components from the serum. A number of biological parameters can be examined through saliva.
Results and Discussion: Saliva has a unique composition and includes a large number of inorganic and organic compounds. It performs multilateral functions, but in addition to its role in controlling and/or modifying the oxidative damage in the oral cavity, it plays a first line of defense, including oxidative stress.
For its part, the oral cavity, in which saliva is secreted, is a very complex and unique biosystem, thanks to its dual function. Studies indicate it as the only place in the human body where the mineralized tissue is exposed to the external environment, and complex interactions between the different surfaces occur: on the one hand, the soft and hard tissues of the individual, and on the other - food, air and microorganisms.
Christiana Madjova, Simeon Chokanov
17th Congress of ISLD
5150 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Oral Presentations
Evgeni Stanev
Clinical case: Oral lesions in a patient with iron deficiency anemia
Introduction: The iron deficiency anemia is caused by lack of iron in the body. The symptoms are pallor, fatigue, weakness and oral lesions. Laboratory tests show: decreased levels of ferritin, haemoglobin, MCV, MCH; and increased levels of: transferrin, RDW-CV (Red blood cell distribution width). We present a patient with burning sensation and ulcers in the mouth due to iron deficiency.
Case: The patient is 77-years old male from Sofia, with pale skin. He looks tired and his motions are slow. Status extraoralis: cheilitis angularis on the both corners of the mouth. Anamnesis: The patient has a burning sensation, changed taste, and problems with eating. Status intraoralis: White exophytic grouped lesions on the oral mucosa and the front 1/3 of the tongue with regular borders. There is surrounding erythema. Laboratory tests: iron – 11.2 µmol (10.6 – 28.2); HGB – 87 g/l (140-180); RBC – 3.28 g/l (4.40-5.90); HCT - 0.286 L/L (0.40-0.54); MCV – 87.2 fL (82.00-95.00); MCH – 26.5 pg (27.00-33.00); RDW-CV – 18.9 % (11.5-14.5). Treatment plan: Maltofer tabl. 100mg/0.35mg 3 tablets per day. Results: After one week there is no burning sensation and the patient eats normally. The lesions are still on the oral mucosa, but smaller and not so inflamed.
Discusion: The income of iron has reduced the symptoms of the anemia. The patient status is better compared to the time before the treatment. The lesions are still visible in the mouth but we expect them to disappear. We prescribed new laboratory blood tests after one month.
Conclution: In some cases the symptoms of Iron deficiency anemia which force patients to seek help are the oral lesions and the pain in the oral cavity. The laboratory blood tests are obligatory for the clarification of the diagnosis. The treatment with Iron-containing drugs reduces the symptoms after one week and prevents from exacerbation of the condition.
E. Stanev, A. Krasteva
Aleksandar Georgiev
Implant treatment in patients with underlying diseases
Dental implant surgery has developed to a widely used procedure for dental rehabilitation and it is a secure and predictable procedure. Local and systemic risk factors can result in higher failure rates. Diabetes mellitus is and cardio-vascular diseases are chronic diseases that cause multifarious side effects. Diabetes as a relative contraindication for implant surgery is controversially discussed. Because of the increasing number of patients suffering from diabetes, there are more diabetic patients demanding implant procedures. The intake of antiplatelet drugs and anticoagulants is a relative contraindication for surgical procedures. We aimed to answer the question “Do diabetic patients with dental implants have a higher complication rate in comparison to healthy controls?” and “Do we have to replace or stop the anticoagulant therapy before dental implant treatment?”. We conclude that patients with poorly controlled diabetes suffer from impaired osseointegration, elevated risk of peri-implantitis, and higher level of implant failure. The influence of duration of the disease is not fully clear. The supportive administration of antibiotics and chlorhexidine seems to improve implant success. When diabetes is under good control, implant procedures are safe and predictable with a complication rate similar to that of healthy patients. We conclude that patients on anticoagulant therapy with INR up to 3 do not have to stop or replace medications for minor dental implant procedures.
Aleksandar Georgiev, Miglena Balcheva
Lotfi Lazrak
Gummy smile, what performance can bring the SLS: smilelogy laser surgery?
Introduction: The exacerbated contraction of the elevator muscle of upper lip and wing of nose can uncover excessively the teeth and gums giving way to an unsightly smile, says “Gummy smile”.
Aim: Orthodontists by ingressing anterior teeth; periodontists by performing a gingivectomy/gingivoplasty; maxillofacial surgeons by impacting the maxilla in order to reduce the anterior maxillary height, all try to remedy this uncomfortable situation according to the fields of activity of each.
Currently the dentist has skills advantages, which will allow him to achieve new approaches in the management of gingival smile, including the SLS.
Methods: After aesthetic study, a virtual and anaesthesia simulation are achieved to the patient to get his approbation about the project. Then, a reverse vestibuloplasty is performed with a diode laser or Er, Cr: YSGG laser. An alveolar mucosa strip is removed without bleeding in a minimally invasive way.
Results end: Pulling down the upper bank, the upper lips will be repositioned down. As a result, the exposed gingiva will be correctly covered and the patient will benefit of a radiant smile. LLLT Biostimultion sessions are also programed. At the end, fast recovery will be obtained.
Conclusions: We are convinced that modern dentistry must open up to the new techniques like laser! We will be able to optimize the integration of the patient into a society that cares more about the beauty of everyone. After all, Aristotle said: “Beauty is the best introduction in society”
Thachaini Balakumar
Er:YAG Laser Debonding of Zirconia Brackets. SEM evaluation
Introduction: Removal of orthodontic brackets with conventional debonding pliers may result in enamel cracks. To avoid damage to the enamel surface and effectively remove zirconia brackets, Er:YAG laser has been introduced for debonding. Er:YAG laser (wavelength 2940 nm) has a high absorbance coefficient in water. Energy transfers into heat within the monomer of the bonding agent, it is vapored, and the brackets are separated from the enamel surface.
The aim of this study is to evaluate the enamel surface after bracket removal using Er:Yag laser.
Materials and methods: A total of 20 brackets were bonded to 20 caries-free premolars extracted for orthodontic indications. Brackets were irradiated with Er:YAG laser (Lite touch, Light instruments, ) with a wavelength of 2940 nm at a power of 5W, energy 200 mJ, frequency 20Hz, tip diameter 1.3 mm, water cooling 20 mL/s, and time of irradiation 10 sec. Debonding was made by scanning the four edges of each bracket consecutively. The irradiation was at a distance of 1 mm from the bracket with a constant movement. The damage in tooth enamel surface was evaluated and analyzed using scanning electron microscope Philips515.
Results: SEM analysis revealed no cracks, craters or melting on the enamel surface after laser-assisted debonding
Conclusions: Er:YAG laser-assisted debonding is an effective approach for brackets removal. It is a safe method and helps to protect the enamel surface.
Thachaini Balakumar, Ani Belcheva, Georgi Tomov, Kristina Mihailova
Evgeni Stanev
Difference in male and female thermoregulation after prick test
Introduction: Thermoregulation is the ability of an organism to keep its body temperature within certain boundaries. The internal thermoregulation is one of the aspects of homeostasis. During Prick test we have inflammation which increases the temperature of the skin. With thermovision we can analyze these temperature changes in the areas where it is performed.
Methods and materials: A group of 100 patients – 50 male (50%) and 50 female (50%) were included. All were examined for hypersensitivity to the local anaesthetic Mepivastesin, together with a positive and negative control. Temperature changes of the skin were examined with FLIR A320 thermocamera and theFLIR Reporter Professional software 2013 – application used to process the thermocamera images and data. There were performed two thermal pictures of the skin – before and 20 minutes after the test.
Results: The T-test statistic method shows that there is no significant difference between male and female temperature of the skin before the test is performed: in the area of the tested allergen (P=0.074), the negative control (P=0.265) and the positive control (P=0.635). The same statistic test shows significant difference between male and female in the tested allergen (P<0.001), the negative control (P<0.001) and the positive control (P=0.006).
Conclusions: The thermoregulation processes in reactions with increase of the temperature are different in male and female. This is true for temperature rise due to small inflammations (negative control, negative reactions to allergen) and due to stronger inflammations (positive control).
Evgeni Stanev, Maria Dencheva
Yanitsa Istatkova
Management of leukokeratosis – clinical cases
Oral leukoplakia is the most common potentially malignant lesion that cannot be characterized as any other definable lesion; some oral leukoplakia will transform into cancer”.
Leukoplakia is often associated with tobacco smoking or chewing, although idiopathic forms are not rare.
The role of alcohol, viruses and systemic conditions needs further investigation.
Preventing this is critical because rates of oral cancer survival longer than five years after diagnosis are low.
Surgical interventions, including laser therapy and cryotherapy are methods of choice. The included trials tested and a range of medical and complementary treatments, in particular, vitamin A and retin oids; beta carotene or carotenoids; non-steroidal anti-inflammatory drugs, specifically ketorolac and celecoxib; herbal extracts, including tea components, and Chinese herbal mixture and freeze-dried black raspberry gel; bleomycin; and Bowman-Birk inhibitor.
We want to share our failures and successes in the treatment of leukokeratosis
17th Congress of ISLD
5352 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Oral Presentations
Mohamed Abdalmoniem
Introducing daily usage of laser dentistry in aesthetics
Different dental laser wavelenghts have impacted our daily dental procedures becoming day to day routine.Enhancing the spectrum of differential services in respect to patients‘ high aesthetic demands nowadays ; ranging from simple gingival trouphing , teeth shade whitening , gummy smile correction and even adjunct treatments as frenectomies and elemination of gingival hyper trophoies with orthodontic treatment, or crown lengthening for prosthodontic work and smile design. A case presentaion using Er, Cr:YSGG (2780nm) and Diode (940 nm), with followups after procedures.
Mohamed Mahmoud
The effect of photobiomodulation and laser therapy in the management of alveolar osteitis after tooth extraction
Abstract: Introduction: This scoping review evaluate the effect of photobiomodulation and laser therapy in the treatment of alveolar osteitis (dry socket) after tooth extraction.
Material and methods: The search strategy was carried out only on MEDLINE/PubMed database, up to June 2017, were adapted according to the database with five different searches.
Results: The result was three prospective randomized clinical studies, it was conducted on systemically healthy adult humans, photobiomodulation and laser therapy was used on 105 patients from a total of 224 patients, age varied in range of approximately 30 years, patients were both males and females. The type of laser used in three studied has varied wavelengths from 660nm to 2780nm.the most common used was diode laser with 808nm and 810nm wavelength. The laser power used vary from 0.1W to 1W. All laser treated groups showed positive effect compared to other groups and there was no adverse or negative effect reported.
Conclusion: Within the limitation of this review, PBMT and laser therapy showed significant and faster decreasing in pain, swelling and increasing in healing process in treatment of Alveolar osteitis (AO) after tooth extraction. Irrigation to remove the debris from dry socket plays an important role in treatment of AO in any type of treatment chosen. Further clinical studies should be made not only to come with a PBMT and laser therapy protocol for treatment of AO but also for its prevention after tooth extraction and promote healing of extraction socket after any tooth extraction.
Maite Moreno
STATE of the art and future for Gingivae Stem cell applications
Introduction: Stem cell regenerative medicine and dentistry are in conjunction within the universe of personalized treatments for different health problems. There is less morbidity to obtain gingival tissue and process it in vitro to separate trophoblasts (pluripotent stem cells).
Aim: Compare a faster separation process of trophoblasts from gingiva assisted with low laser irradiation of 904nm from studies done elsewhere.
Methods: Three tissue samples of gingiva were obtained with a tissue punch of 2.5 mm. after subjected to irradiation with 904 nm wavelenght, for 30 seconds, at 4000 Hz, .5 Watts (Laserthec Mod. KVT 106 UP, Mexico.) to biostimulate and disinfect tissues with a distance of 1.5 cm, at .6 Jules/sq cm. In biochemistry laboratory were immediately placed in a 6 cm round cell well, 45 minutes previously coated. The tissue was covered with Dubelco’s Modified Eagle Medium (DMEM) and supplemented with 10% fetal bovine serum (FBS) and antibiotics 50 units/ml penicillin. The samples were incubated at 37˚C and 5% de CO2. Medium was changed every third day. Only one of the samples was irradiated, once in vitro with 904 nm wavelenght, for 15 seconds, at 2000 Hz, .5 Watts with .3 Jules/ for 15 sec.
Results: Immunochemistry analysis showed MGSC and NCSC, or trophoblasts separated faster than controls for 3 days difference.
Conclusion: Irradiated Pluripotent stem cells from gingivae, faster and less morbid source of cells, for tissue engineering.
Ibrahim Samir Abdelmoamen Sayed
Temperature change of neighboring alveolar bone during diode laser gingival recontouring: A preliminary In Vitro study
Studies have showed that temperature around 56⁰ C is a critical temperature level where alkaline phosphatase undergoes denaturation. Studies also showed that bone necrosis may result even if the denaturation temperature of alkaline phosphatase is not exceeded. Eriksson and Albrektsson found that 47⁰C is the border temperature for the occurrence of morphologically evident bone tissue damage.
Aim: This study aims to evaluate the safety of diode laser usage on alveolar bone during neighboring soft tissue recontouring.
Material and methods: sectioned mandibles from freshly sacrificed sheep kept in saline are the samples. The samples were randomly divided into six groups I - VI. Diode lasers are utilized to do soft tissue recontouring in the labial soft tissue of the mandibular teeth, while thermocouples are attached to the alveolar bone crest to measure temperature change during laser irradiation. 980 nm diode laser is used in groups I, II, III and 940 nm diode laser is used in groups IV, V, VI. Groups I, IV parameters are 2w peak power, continuous wave (CW), 300 µm initiated tip in contact mode. Groups II, V parameters are 2w peak power, chopped mode, 50% duty cycle, 300 µm initiated tip in contact mode. Groups III, VI parameters are 2w peak power, CW, 300 µm non-initiated tip in contact mode.
Ibrahim Samir, Youssef Sedky, Amir Ezzat
Vasilis Panaiotou
Laser-assisted treatment of a child with hereditary gingival fibromatosis – 2 years follow-up
Introduction: Gingival fibromatosis is a rare group of disorders that develop as slowly progressive, local or diffuse enlargements within marginal and attached gingiva or interdental papilla. In severe cases, the excess tissue may cover the crowns of the teeth, causing functional, esthetic, and periodontal problems. Hereditary gingival fibromatosis can occur as an isolated condition or as part of a genetic syndrome. The diagnosis is mainly made on the basis of the patient’s history and clinical features, and on histopathological evaluation of affected gingiva. The pathologic manifestation of gingival fibromatosis comprises excessive accumulation of extracellular matrix proteins, in which interactions between gingival cells and the extracellular matrix are weakened as epithelial cells transdifferentiate into fibrogenic fibroblast-like cells.
Case report: This clinical case represents a 15 years old boy who came at the Laser center for treatment of his teeth and gums. He complained he cannot brush his teeth because of the bleeding and presence of primary teeth and missing permanent teeth. After thorough history taken from his grandfather and clinical examination the boy was diagnosed with hereditary fibromatosis. The excisional biopsy by Er:Yag laser confirmed the diagnosis. Treatment plan included uncover of the impacted permanent teeth with the laser, extraction of the primary teeth, oral hygiene motivation and orthodontic treatment for establishment of occlusion. Two years of treatment and regular follow-ups bring the successful outcome of this difficult and complicated case.
Conclusions: Er:Yag laser removal of the overgrowing gingival tissue in combination with orthodontic treatment seems an effective decision for treatment of a child with hereditary gingival fibromatosis.
Vasilis Panaiotou, Georgi Tomov, Ani Belcheva
Maria Shindova
Parents` attitudes towards alternative methods of dental treatment in children
Introduction: As the applications of dental lasers in pediatric dentistry expand, parents` worries regarding the safety and effectiveness of this method compared to conventional rotary treatment increase. Parents` attitudes towards the new alternative methods for caries removal are essential for the choice of treatment technology and dental team for the dental care of their children.
Aim: To investigate the attitudes of parents towards lasers as an alternative method of dental treatment in children and the influence of education and socioeconomic status on parental acceptability of it.
Material and methods: The study was conducted among 88 parents, randomly selected during treatment visit of their children at the Department of Pediatric Dentistry, Plovdiv. An interview was performed to gather information about their education, socioeconomic status and desire to be present/absent in the dentist’s office.
Results: Most parents (78.88%) preferred to stay with their child in the dentist’s office when laser was the therapy of choice for treatment. When conventional treatment was used, the proportions of parents who wanted to be present with their child for care (51. 54%) and be absent (48.46%) are equal. The analysis indicated direct relationship between parents’ high educational level and high family socioeconomic status and their desire to be present in the dentist’s office.
Conclusion: Although the expanding use of lasers for the treatment of pediatric patients, for parents this alternative method remains unknown. Therefore, providing additional information by dentists, health organizations and promotion programs would be valuable for parents’ oral health literacy.
Shindova Maria, Belcheva Ani
17th Congress of ISLD
5554 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Oral Presentations
Alejandro Steinman
Shorten your rehabilitation times with the ultimate protocol of LASER ASSISTED IMPLANTS”.New Tailormade Protocol of Placing Dental Implants Laser Assisted
Our research was focus to find best method of Implant placement.
We made the ostectomy to place the implants with laser technology, mixing laser and drilling tegnology or by standard drilling in more than 20 cases of older adults with edentolous lower jaw. In all the clínical cases the ostectomy in 43 was made with ERBIUM CROME YSGG LASER in 42 a mix protocol and in 33 with traditional drilling tecnique. 60 days later we mesure the three identical implants with OSSTELL and find very similar results between 43 a 42 better than 33. We decided to deepen the investigation and describe a new Tailormade protocol combining the best of LASER and drilling tegnology in implant placement with excelient clínical results by speeding up the recovery of soft and hard tissue.
Conclusions: Using this protocol standart titanium Implants were suitable for loading in just 8 weeks or less.
Alireza Cyrus Raie
The influence of initiation of the tip on the concentration and transmission of the Diode laser (940nm) energy at the end of the tip: Non-initiated versus pre-initiated tips!
Introduction: The diode lasers are used in different fields of dentistry, especially surgery. To create an effective cut with less side effects, the laser energy must be concentrated on the end of the laser tip. This can be achieved by initiating the tip.
Aim: The aim of this study is to show the amount of the diode laser (940nm) energy that is concentrated at the end of the pre initiated and manually initiated tips.
Methods: two groups of non-initiated (E3-7mm, E4-4mm and E4-7mm (two)) and pre-initiated (epi3-4mm (two) and epi4-4mm) tips for Epic-X were tested on a power meter with the settings of 1W (0.74W real power), before and after initiation and after cutting a tissue with 3W (continuous mode).
Results: On the power meter, non-initiated tips (E3-7mm, E4-4mm and E4-7(two)) showed the device setting respectively, and after initiation, 0.3W, 0.14W, 0.46 and 0.41W, and after cutting the tissue (in vitro), 0.56W, 0.40W, 0.68W and 0.53W. Pre-initiated tips (epi3-4mm (two) and epi4-4mm) showed 0.4W, 0.37W and 0.32W before and 0.43W, 0.37W and 0.37W after cutting (in vitro).
Conclusion: The initiation of the tips concentrates the energy, but not totally, a percentage is transmitted. Non-initiated tips showed in average 39.5% and 66.7% and pre-initiated tips showed in average 49% and 52.6% transmission of energy before and after cutting.
Daniel Abousaid
Laser-аssisted intervention in soft tissue management around dental implant - Clinical Case
Introduction: The width and thickness of the attached gingiva is essential for the function of peri-implant tissues, adequate maintenance and aesthetic effect. Many surgical methods have been developed to increase the attached gingiva and the biological width. Some of the contemporaly concepts include the use of lasers, bilaminar grafts, PRF and flap repositioning.
Aim: The clinical case demonstrates a method of dental implant treatment in an area of high aesthetic value and soft tissue insufficiency.
Material and methods: A bilaminar technique was used to increase the width of the attached gingiva and the biological width by a coronally positioned flap in partial thickness by the Zucchelli method from vestibular and palatal by Raezke. We used a palatal soft tissue graft partially deepithelized with Er:YAG laser (5.40W; 18Hz; 300mJ). An autogenous PRF membrane is placed over the cover screw and the donor area.
Results: Four weeks after surgery, the implant was uncovered with a CO2 laser (implant second surgery 3W). Three weeks later the gingival former was removed, an adequate biological width in the vestibular zone was established and the marginal edge was on horizontal level with that of the adjacent teeth. After placing the supra-construction the dental defect was restored with high aesthetics.
Conclusions: The soft tissue management in implantological treatment is important for shaping the optimal biological and physiological values of the implant interface. It helps not only with the aesthetics but also increases the surviving of the implant and decreases the risk of peri-implant diseases.
Abousaid D. Asenov R. Hristozov D., Nachkov I., Stamenov N., Vasilev C.
Nikolay Kanazirski
Application of Er-YAG laser in the preparation of bone for autogenous targeted tissue regeneration
Introduction: Over the course of recent years Er-YAG Lasers are used progressively in the fields of oral surgery and implantology. Many recent studies accentuate their advantages such as better visualization of the surgical field, by reducing the bleeding, which often results in decrease in the duration of a certain procedure. Furthermore, improved wound debridement and stimulation of osteoblast proliferation can be observed.
Purpose: Presentation of clinical cases in which we utilized the advantages of Er-YAG lasers for the purposes of guided tissue regeneration. Demineralized dentin matrix was derived from patients own teeth with the use of Auto-Tooth Bone Graft System.
Materials and methods: Patients with jaw lesions originating from chronic inflammatory and cystic processes as well as peri-implantitis. Subsequent to the removal of the pathological processes, curettage of the bone is performed with the use of Er-YAG laser. Henceforth the bone defects are filled with demineralized dentin matrix and the graft is coated with PRF membrane.
Results: Acceleration and stimulation of bone healing can be observed. The grafting material volume loss is within the range of 10%.
Conclusion: Er-YAG laser insures excellent bone debridement properties and stimulation of osteoblastic activity which leads to rapid bone growth with satisfying density characteristics.
Regrowth of own teeth - the role of Laser in Stem-cell therapy
Introduction: Even with good oral hygiene, it is not always possible to prevent tooth decay and periodontal disease, and teeth may sometimes need to be extracted. Scientists are already working on the idea that patients no longer have to adapt to fillings, implants, crowns or prostheses, but naturally regrow completely new teeth by using Laser in Stem-cell therapy.
Materials and methods: PubMed search of articles containing the terms: Laser, Stem cells, re¬growth, teeth were performed.
Results: In a study performed by the University of Cambridge (USA), dentists drilled holes in the molars of rats and the pulp was irradiated with a low-energy, pulsed laser. The Laser-light pulses stimulate the stem cells for the production of dentin. The laser light causes the formation of oxygen molecules in the dentin, activating a growth stimulator (TGF-beta-1) which excites the stem cells to form new dentin material.
In another study performed by researchers from Columbia University in New York stem cells were used for the renewal of different dental materials. Lost teeth were used to form a model of degradable polymers based on an impression of the old tooth. This model was implanted and stimulated with Laser-light and growth factors. These stem cells were able to grow into the polymer structure which resulted in firmly functional new teeth.
Conclusions: After comparing these two articles, Laser-stem-cell therapy in mice and humans shows a lot of potential, but the results could only be achieved under certain conditions in the laboratory. More studies are needed.
Soroosh RAHIMY, Nikoo WERNER, Malwin WERNER
Arghavan Farrokhian
Comparing antifungal effect of 940 nm diode laser with different powers on Candida albicans
Introduction: Oral candidiasis is the most common disease in people who use dentures. Laser therapy has shown positive results in the treatment of this disorder. The aim of this study was to evaluate the effectiveness of 940 nm diode laser on the reduction of Candida albicans colonies as the most common cause of oral candidiasis.
Objectives: Determining anti-fungal effects of laser radiation of 940 nm diode with different powers on Candida albicans colony with colony count and gene expression and comparing laser groups with each other and with negative control group and positive control group (Fluconazole group).
Materials and methods: In this laboratory study, after the preparation of Candida albicans colonies and preparation of standard suspensions, with the use of a micropipette, 200 µl samples were prepared Intervention groups included fluconazole solution, diode laser with 2,3 and 4 watts, and no radiation (negative control) (2µg / ml for each sample). After 48 hours, samples were evaluated for colony count and gene expression (by real-time PCR method). Data were analyzed by SPSS17 software and one way ANOVA test. Findings with P <0.05 were considered as significant.
Results: Colony count in negative control group, the 2,3,4 watt laser and the fluconazole group were 8.1 ± 0.1, 5.5 ± 0.2 , 4.4 ± 0.2 , 4.0 ± 1.1 and 2.4 ± 0.3 CFU/ml. The difference in the colony count between all groups was significant (p=0.000). Considering the expression of the gene in the negative control group was 1, the ratio of gene expression in the 2, 3, 4 watt laser group and the fluconazole group compared with the negative control group was, 0.9 ± 0.0, 0.6 ± 0.1, 0.4 ± 0.1, 0.2 ± 0.1, respectively. The difference in gene expression was significant in all groups (p=0.000).
Conclusion: The findings of this study showed, 940-nm diode laser with the power of 2,3,4 watts has significantly reduced the Candida albicans colony, although it didn’t have a better effect than fluconazole.
Dr. Med. Dent. Msc Arghavan Farrokhian Professor Dr. Med. Dent. Norbert Gutknecht
17th Congress of ISLD
5756 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Oral Presentations
Radka Cholakova
Assessing the effect of supernumerary teeth on pulpal perfusion of adjacent teeth using laser-doppler flowmetry
Supernumerary teeth (ST) exceed the regular number of teeth in the dentition and may alter the pulpal blood perfusion of adjacent teeth, thereby pulp vitality. Laser-Doppler flowmetry (LDF) is а current non-invasive method for studying the pulpal blood-flow.
Aim of this study is investigating the effect ST have on pulpal perfusion of adjacent teeth using LDF.
Materials and methods: Thirty-three patients with radiographical evidence of ST received LDF to the normal teeth located mesially and distally of the supernumerary tooth – 66 teeth. In cases of mesiodens we deemed the left central incisor as laterally localized, and the right central incisor as mesially localized. Root development of teeth of interest was assessed radiographically in accordance with Demirjan’s method.
Results: Average LDF-value for the studied teeth was 11.49±1.23PU. Average LDF-value for mesially positioned teeth was 11.86±1.72PU and for distally positioned teeth was 11.12±1.77PU. No statistical significance was found in pulpal perfusion scores of tested adjacent normal teeth localized mesially and distally to the ST (p>.05). 56.06% of all teeth had full root development. A statistically significant difference was found in pulpal perfusion depending on the stage of root development of adjacent to ST teeth (p<.05). Average LDF-value was 11.38±1.78PU in mature and 13.11±1.81PU in immature teeth. Perfusion was reduced in 42.1% of the mesially-localized mature teeth and in 44.44% of the distally-localized mature teeth, however no statistically significant difference was identified relative to the stage of root development. Only 42.85% mesially-localized and 33.33% distally-localized immature teeth showed reduced perfusion.
Conclusion: ST impede the pulpal blood-flow of adjacent teeth, whereas perfusion reduction is more notable in teeth with full root development.
Influence of diode laser radiation on the apical leakage of endodonticaly treated teeth
Introduction: The outcome of root canal treatment is based on efficient disinfection of the root canal system and prevention of reinfection. Current chemomechanical cleaning methods do not always achieve these goals, and insufficient root canal disinfection is the main reason for endodontic failure.
Aim: The aim of our in vitro study was to evaluate the effect of diode laser irradiation (λ=660 nm; λ=970 nm) on the intracanal dentin and their interference in the apical seal of filled root canals.
Methods: 48 human single rooted teeth were randomly assigned into 4 groups. Root canal preparation was done using ProTaper Universal rotary system up to F3. 2 % Sodium hypochlorite, 17 % EDTA and distilled water were used as irrigants. The laser irradiation was performed at the end of the traditional endodontic preparation and teeth were filled with gutta-percha and AH- plus. The apical leakage was report on mm.
Results: Statistical analysis showed that the laser-treated groups had significantly less leakage in apical third than the control group.
Conclusions: Certain lasers can help in removing the smear layer and debris and can modify the morphology of the root canal wall for better root canal sealing.
Violeta Dogandzhiyska, Evgeniya Popova
Tomaz Ivanusic
Laser – the tool for all dentists
In my presentation I will address few common problems in dentistry like tooth hypersensitivity, ceramic debonding and efficient irrigation in endodontics.
Tooth hypersensitivity affects more than one third of the population. Conventional techniques for treating this condition have low success rate and don’t have long-term results.
Laser treatment has proved to be fast, effective, minimally invasive and has better long-term results.
Aesthetics is very important in dentistry. A lot of patients ask for ceramic brackets in orthodontics and veneers in anterior region. Composite adhesives are hard to remove and Er:YAG laser is a most effective and conservative tool for this indication.
Success in endodontics is mostly dependent on our ability to eliminate microorganisms in the root canal system. Mechanical instrumentation is not enough to clean all parts of root canals. Different irrigation methods are utilized to increase penetration of irrigation solutions in noninstrumented parts of complex root canal system.
SWEEPS® technique of irrigation is very effective and lowers the need for overshaping and enlarging the root canals. This allows us to be minimally invasive, faster and have less iatrogenic complications.
Eslam Aboubakr Ali Mohamed
Effect of different Er,Cr:YSGG laser parameters on surface conditioning of glass ceramics
All ceramic restorations are nowadays being increasingly used for oral rehabilitation due to their exceptional physical properties and their ability to adhesively bond to tooth structure. Glass ceramics’ adhesive bond includes multiple clinical and laboratory steps that have a critical role in the clinical success of glass ceramic restorations. Lasers nowadays are being practically used for different surface treatments including surface conditioning of dental ceramics. The effective use of Er,Cr:YSGG lasers can be a safe alternate for the conditioning of lithium disilicate ceramics.
Purpose: to evaluate the Effect of different Er,Cr:YSGG laser parameters on surface conditioning of Lithium disilicate glass ceramics in comparison with conventional methods.
Materials and methods: 20 glass ceramic specimens were constructed and divided into 4 equal groups (n=5) according to the surface treatment protocol (conventional method, Er,Cr:YSGG with 3 different parameters). Surface topography for each group was analysed before and after treatment. For each group, microtubules were bonded to the disc specimens (n=20). Adhesive resin was then loaded and bonded according to manufacturer’s instructions. Microshear bond strength was performed at the disc/cement interface. Data was analyzed statistically.
Eslam Aboubakr, Ingy Farag, Hanaa Hassan Zaghloul
Darya Alhaidary
First Investigation of dual wavelength lasers (2780 nm Er,Cr:YSGG and 940nm diode) on Implants in a simulating peri-implantitis situation regarding surface Morphologies in an in-vitro pocket model
Introduction: The most common long- term complication associated with dental implant treatment is periimplantitis. It is defined as an inflammatory process affecting both soft and hard tissue surrounding the dental implant. In recent years, lasers have been demonstrating positive results in the treatment of periimplantitis. However, one of the most important points to be considered is implant surface roughness alterations after laser application. Because implant topography plays a significant role in achieving re-osseointegration. Aim: This study aimed to investigate the implant surface roughness parameters (Rp in µm), questioning the safe laser settings and protocols for laser-assisted peri-implantitis treatment. Methods: Four Types of Implants (Neoss, Dentegris, Camlog, and Zirconia) Implants were randomized into two groups according to the laser irradiation parameters (1W/ 50Hz and 1.5W/ 50Hz). The surface profile of each Implant was analyzed before and after laser irradiation using laser-scanning microscopy. Result: preliminary results showed a reduced mean and peak surface roughness values after laser irradiation. Although, no signs of thermal defects were observed. Conclusion: based on the conditions of this preliminary study, it can be concluded that the use of the dual wavelength protocol is a safe tool for Implant surface decontamination.
D. Alhaidary, R. Hilgers, N. Gutknecht
Ingmar Ingenegeren
Full Laser Sinus Lift And Simultaneously Implantation Ten Years Evaluation
Purpose: To show an alternative way of performing a sinus lift and simultaneously implantation without the use of scalpel and bur and its long-term evaluation.
Materials and Methods: Under local anesthesia on a 70-year old female, the surgery was done with an ErCr;YSGG laser with wavelength 2870 nm 300 mJ and 20 Hz, in the left maxilla. Wound was closed with stitches. After six months healing the supra construction was made.
Results: Rather fast wound healing and no swelling was observed and patient had no pain. At the sinus floor an eminent amount of bone had grown. Evaluation up to ten years showed no alteration of the situation with stable gingival conditions.
Discussion: The surgical intervention with only laser seems, although it takes evidently more time, a secure alternative to conventional methods.
17th Congress of ISLD
5958 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Oral Presentations
Piotr Roszkiewicz
Hard- and Soft-Tissue Management Around Broken Teeth
Fractured walls or even whole tooth crowns are quite common in cases of root canal treated teeth with large fillings. Rebuilding supragingival fracture is not a problem, but fractures located subgingivally or below bone level often means that we qualify the tooth for extraction. In the elderly, any extraction is still reasonably well accepted. While in younger patients (20 - 30 years) extraction often is not acceptable. A similar situation exists with deep subgingival decay descending to the bone level, in which it’s impossible make proper conservative restoration and/or root canal treatment due to the lack of dryness or isolation.
The use of a laser as an alternative to extraction has not encountered negative feedback from the patient. As a minimally traumatic tool for shaping gums and bone, the laser is an ideal tool for younger patients - when extraction will cause loss of alveolar bone or will be associated with expensive regenerative treatments and implantation. Also implantation over a longer period of time is associated with the risk of bone loss around the implant, with mucositis and periimplantitis. Controlled “loss” of bones and gums with the laser use is always safer than uncontrolled bone loss, even with minimally traumatic extraction. The doctor’s workload is relatively small and the risk associated with possible complications is practically zero in comparison to the socket preservation and implantation. This involves compromise and a dilemma. How mucosa and bones can be or should be removed? Will it still be possible to make a proper restoration after this surgery? How to reduce the size of the tooth to achieve longevity? How long will the tooth remain?
Yulia Kozlova
Application of fluorescent method for evaluation of the hygienic condition of the oral cavity
Alshaimaa Alanaggar
blow (blue) out the smile
Laser in dental clinics became a necessary tool, which helped and fastered many cases that traditional dentistry could not treat with.
Presentation will show many cases that laser enhanced their smiles, the laser which is used in this presentation is sirolase blue with multiple wavelengths (445nm, 970nm, 660nm), it will show from gingival treatment (970nm, 660nm), depigmentation (445nm), frenectomy (445nm) to gingival recontouring case (445nm) which is guided by digital smile design.
Laser definitely can blow out and release a beautiful confidant smile.
Imneet Madan
Dual Wavelengths in Pediatric Dentistry: A success story of compromised primary teeth
Introduction: Primary molars last in the mouth until the age of ten to twelve years. Sometimes, deep caries can lead to periapical infections, making their status compromised. Use of Erbium and Diode lasers together helps to restore primary teeth, thereby helping us avoid pre mature extractions.
Aim: Aim of this presentation is to introduce and highlight the “Pediatric Laser assisted Endodontics PLAE Concept”, which aims at achieving successful sterilization of the infected root canals in primary teeth.
Methods: This concept utilizes Erbium laser assisted root canal access, followed by sterilization of the canals both with Erbium 2780 nm and Diode 940 nm lasers. This step is followed by obturation with Zinc Oxide Eugenol and composite filling. The success of treatment is reevaluated in three months and crowns are placed.
Results: PLAE protocol worked well with all the teeth under evaluation. These teeth had variable diagnosis ranging from periapical abscess, fistula to mucogingival swellings or facial plane swellings. Erbium lasers, Er,Cr:YSGG 2780 nm help in removing the smear layer from the root canals, whereas Diode 940 nm, targets with its bactericidal effect in the lateral canals, periapical areas and beyond. As the symbiotic broad spectrum approach, PLAE exhibits positive results.
Conclusion: Primary teeth are the best natural space maintainers, and thus, should be treated rather than considering the option of pre mature extractions in young children. Laser assisted endodontics certainly plays a major role in this success.
Maria Pilar Martin Santiago
The contribution of laser to orofacial photobiocosmetcs
Introduction: We present 10 clinical cases where we applied the orofacial protocol to improve the cosmetic appearance of our smile design and the mucosa-skin appearance of the lips at the same time. We make a control of before and after, using pictures, radiographic studies in front and lateral view, hydration status and ultrasound study of the skin and mucosa before and after.
Aim: Our aim in this presentation is to prove, whether laser improves our cosmetic treatments in a minimally invasive way, with a higher precision and improving the properties of the soft tissues of the face.
Methods: We used, clinical explorations including a Wood’s Lamp and a Skin Microscope. Radiographic, diagnostic ultrasound, hydration and photographic studies of before and after were recorded. Treatments were performed with diode and erbium Laser systems and a fractional handpiece.
Results: We obtained very good aesthetic results in our patients with laser, with better quality of tissues and better hydration and they presented quickly and better postoperative periods.
Conclusions: The use of laser systems allow us to improve our aesthetic results, improving the quality of tissues and to control parameters in a more exact way, thanks to its technology.
The urgent task of modern medicine is the creation of non-invasive diagnostic methods that can reduce the traumatic effect on the body, simplify the procedure, increase the efficiency of diagnosis and make a diagnosis with high accuracy1.
Currently, there are many different indexes used to assess the hygienic condition of the oral cavity. A noticeable negative side of these indexes is that only teeth are stained, which makes it impossible to comprehensively evaluate the hygienic condition of the oral cavity. As is known, the hygienic state is determined mainly by the microflora, and in various biotopes of the microflora it is different (Biotope of saliva, hard palate, soft palate, tongue, teeth, cheeks, gums and lips). That is why in order to give an accurate integral assessment of the hygienic condition of the oral cavity, it is necessary to take into account the hygienic state of all the above biotopes. Based on the conceptual position presented, it was proposed by Prof. Alexander M.T., the purpose of our research was the development of medical technology for an objective, rapid assessment of the hygienic condition of a cavity based on the use of a digitized fluorescent technique.
Material and methods: The measurement was performed using the InSpectr M hardware-software complex with a probe radiation wavelength of 532 nm (fluorescence diagnostics device). Prior to the study itself, the analytical sensitivity of the method was evaluated, in particular, the method of serial dilutions determined the intensity of fluorescence given from Staphylococcus aureus microbes in a concentration of CFU / ml 5 * 10 ^ 1. The group of volunteers was formed by the following criteria: age, absence of any prostheses, absence of any inflammatory diseases of gum or periodontal diseases in acute stage, extracted teeth not more than 2.
Measurements were made on: lips biotope, gum biotope, tongue biotope, palate biotope, cheeks biotope, teeth biotope, saliva biotope.
In both groups, the average values of each of the biotopes were calculated, and then the calculation was made according to the formulas, in which the integral index of the hygienic condition of the oral cavity
was calculated. Thus, the following results were obtained: lips biotope – 0,53%, gum biotope – 23,81%, tongue biotope – 2.58%, palate biotope – 8,65%, cheeks biotope – 15,90%, teeth biotope – 56.73%, saliva biotope – 45,97%.
Statistically processing the average values of each of the biotopes, we found an index for the hygienic condition of the oral cavity as a whole, using the formula for the integral assessment of the hygienic condition of the oral cavity based on normalized indicators of the fluorescence intensity. Index of hygiene for all 40 volunteers was 20.72%. The results of the 1st group without pronounced background pathologies of the oral cavity showed differences in the integral indices by no more than 5-19%, and the results in the 2nd group differed by 51-90%. In this regard, we have proposed the following method for assessing the hygienic condition of the oral cavity.
With an index value of up to 19%, the hygienic condition of the patient was considered functionally adequate to good, from 20% to 49% satisfactory to good hygiene, from 50% and further considered unsatisfactory. The biotope of the oral cavity, in which the indices of violation of its hygienic state are the greatest, as compared to similar indicators of other biotopes, is considered the main source of impairment of the hygienic condition of the oral cavity as a whole, with differences of more than 5-10%.
Conclusion: The digitized fluorescent indices of the hygienic condition of the mouth obtained in the present study are objective and universal, since they allow the doctor to objectively substantiate the hygienic status and thereby develop an individual approach for further treatment.
In addition, the proposed express method allows a comprehensive assessment of the hygienic condition of the mouth in patients under normal and pathological conditions (caries, periodontitis, stomatitis, etc.) and objectively select and clinically implement an individual approach for each of them during treatment.
Microscopic investigation of the effectiveness of dual wavelength Er,Cr:YSGG and diode 940 nm laser and the XP-Endofinisher in removing the endodontic sealer from dilacerated root canals
Introduction: Endodontic retreatment can be one of the most complicated procedures with varied prognosis. Moreover, curvatures in root canals can pose additional obstacles during retreatment procedures.
Aim: to validate the ability of the dual wavelength laser Er,Cr:YSGG and diode 940 nm laser in removing the debris and sealer remnants from endodontically retreated canals.
Methods: 24 curved root canals were prepared using the reciproc system, and then filled with AH-sealer and reciproc Gutta percha cones. The samples were stored in thymol solution for six weeks to allow the filling to bind with the canal walls and dentinal tubules. The fillings were then removed and the teeth were randomly divided into 3 groups:
Group A, Negative control: irrigated with normal saline
Group B: XP-Endofinisher with EDTA 17%
Group C: Er,Cr:YSGG and diode 940 nm laser 2W, 20 Hz, 50 µs
Magnified images of the samples (1000x) were taken using the laser scanning microscope, they were scored by three blinded dentists using the Hülsmann scoring system.
Results and conclusion: Preliminary results show overall clean canals and open dentinal tubules in the cervical and middle thirds in both groups B and C. The apical region exhibited varied results in both groups. Statistical analysis of the results will be presented.
Riman Nasher, Norbert Gutknecht
Basant El Asaly
The Effect of Diode LASER 940nm on deep cavities and on S. mutans
Introduction: A pilot study was held on twenty teeth. Ten sound and ten carious.
Holes were prepared to allow the entrance of thermocouple.
S.mutans were lased with the same parameters and counted.
Aim of the study: To preserve the pulp in deep cavities. As a partial caries removal technique
Methods: The study was divided into four groups. Two groups of carious teeth and two groups’ sound teeth lased with 0.5 and 1 Watts. Same parameters were applied for lasing S.mutans in comparison with chlorhexidine.
Results: Sound Teeth 0.5W: 3 teeth: 1 degree temperature rise;
Sound teeth 1W: 4 teeth: 1 degree temperature rise;
Carious teeth 0.5W: No temperature rise;
Carious teeth 1W: 3 teeth with no temperature rise;
S.mutans count 0.5W: 98X1000;
S.mutans count 1W: 70X1000;
Conclusion: The diode LASER showed a decrease in the bacterial count without affecting the pulpal temperature.
Basant El Asaly, Prof. Norbert Gutknecht
Marwa Taha
Laser Applications In Pediatric Dentistry. Is It A Myth Or A Magical Treatment
Laser, as a technology, is booming in dental practice, where a new era of laser treatments is proposed with various applications in all branches of dentistry. Yet, its use in pediatric dentistry is quite challenging. In this presentation, we will know the challenges together and know what to expect from the treatment outcome and what not to expect from the laser regarding the pediatric dentistry field. Various clinical cases will be presented showing different laser treatment options and management. By the end of this presentation, we will know where laser stands in pediatric dentistry, if it is a myth, a magical treatment or somewhere in between...
Roman Itelman
Peri-implantitis therapy by Er:YAG Laser
Peri-implant diseases have received much attention in the last years. It has been described as progressive crestal bone loss around a dental implant. Microorganisms living on the implant surface are considered to be the initial cause of peri-implantitis. Those bacteria form a biofilm which establishes harmful inflammatory response in the host and inhibits bone cells reattachment to the implant surface. The first step of the therapy is the implant surface decontamination.
Several approaches for implant decontamination like mechanical debridement or disinfection with chemotherapeutic agents and smoothing implant surface have been suggested but the efficacy of mechanical or chemical modalities seems to be limited due to resistant bacterial strains. Moreover, mechanical strategies may develop a roughened implant surface, which itself increases bacterial colonization and biofilm formation.
The antibiotic therapy has pharmacologic limitations like in site drug dosage or insufficient antibacterial effect. Also, the limited access to the inflamed area is to be taken into consideration. Up-to-day there was not a valid treatment for bacterial peri-implantitis.
In the last years the peri-implantitis therapy by Er:YAG have received a lot of attention and reliable documentation. The therapy can be carried out without any damage to the implant surface, as the laser energy is totally reflected by titanium and without any heat rise of the implant and of the surrounding tissues, as spray air/water is used.
The presentation will include the protocol of the peri-implantitis therapy by Er:YAG Laser , advantages and disadvantages of the Er:YAG Laser therapy and well documented different clinical cases of peri-implantitis treatments by Er:YAG Laser.
Codruta Ciurescu
Periimplantitis – A different therapeutic approach
The use of dental implants in dentistry is increasing exponentially, because they appear to be a successful treatment for partially and fully edentulous patients. But even the implants with successful osteointegration can develop inflammatory complications at later stages.
Nowadays, most of the dentists face late implant complications as mucositis and periimplantitis. Ever since 1994, when Mombelli named these implant complications “Periimplantitis”, several treatment protocols have been proposed for these diseases. But no standard protocol has been announced so far, even though there are numerous studies related to this topic that compare one treatment protocol to another in the attempt to singularize the best one of them.
Due to their special characteristics, lasers appear to be the next great actors on stage, each one with its special laser-tissues interaction, but more than that, the combination of wavelengths in treatment protocols will open a new perspective in the treatment of this group of peculiar, but widely spread diseases.
Our research work on this topic is focused on evaluating the contribution of 2 wavelengths: 940 nm and 2780 nm into the same treatment protocol. Apparently, it stands in obtaining a better, promising result in the treatment of mucositis and incipient periimplantitis.
Codruta Ciurescu, Anca Gheorghiu
Stefan Schreiber
Temperature development during explantation comparing conventional trephine system with innovative laser technique
Introduction: The aim of this study was to evaluate the temperature changes in a human mandible jaw during explantation of dental implants with laser versus Trephine bur.
Materials and Methods: The conventional trephine bur method and a new method with the Er,CR:YSGG-Laser, were compared. Our research was performed on 5 mandible jaws from human cadavers, prepared to place 10 dental implants. After placing the implants, 4 small canals were drilled with a distance of 3mm next to the implant, to place the thermocouples for temperature measurement. An additional thermocouple was placed in the water bath to control the water temperature, at a constant temperature of 37°C. All Implants were removed while the jaws where fixed inside the water bath. On each Jaw one implant was removed by using the laser with a setting of 8W, 20Hz, 80% Water, 40% air and MZ8 tip. The opposing implant was removed with the Trephine bur.
Result: All measurements done during the implant removal with laser and trephine bur showed a significant decrease of temperature in the jaw bone. The temperature decrease was found in a range from 37°C to 26°C. No significant difference was found between the Laser group and the trephine bur group.
Conclusion: It was clearly demonstrated, that the removal of implants from the human jaw bone with an Er,Cr:YSGG Laser was not only possible, but also safe for the surrounding tissue. The temperatures recorded during the removal of the implants, showed no significant difference in both groups.
17th Congress of ISLD
6362 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Oral Presentations
Elitsa Veneva
Laser analgesia: Efficacy of a modified protocol for achieving pre-emptive dental analgesia with Er:YAG
Introduction: A current non-pharmacological means for attaining painless conservative treatment is presented by laser analgesia (LA), considered as photomodulation of pulp reactivity aiming reduction of nociceptive impulse formation. Currently no consensus has been reached regarding a detailed protocol with laser parameter settings for pre-emptive laser analgesia.
Aim of this study is determining the efficacy of Er:YAG laser in achieving pulpal analgesia and quantifying duration and extent of any effects assessed.
Methods: This is a double-blind placebo-controlled randomized split-mouth clinical trial with two-way repeated measures design. Eligible patients of age 10 - 12 years undergo two single-visit treatments, randomized to receive either LA or placebo analgesia (PA) prior to caries ablation in the first visit. Primary outcome measure is pain felt during treatment, reported by patient on visual-analogue scale. Secondary outcomes: changes in pulpal sensibility to electrical and cold-stimuli, patient experience during LA/PA; pain-related behavior during caries ablation according to Faces, Legs, Activity, Cry, Consolabilty scale; heart-rate. Trial registration: ClinicalTrials.gov (Registration number: NCT03412721).
Results: This study is currently recruiting patients. Pre-test on 20 subjects resulted in n=41 patients needing to be recruited. Data will be analyzed with intention-to-treat concept by Student T-test for paired samples, P<.05. Results will be presented at the congress.
Conclusion: Pulp sensibility testing, along with assessment of subjective and objective pain sensation during caries ablation should help estimate the clinical adequacy of laser analgesia protocol.
Elitsa Veneva, Ani Belcheva, Ralitsa Raycheva
Carolina Isabel Benitez Arevalo
Comparative study on Endodontic treatment with and without laser with microbiological control
Introduction: We present 5 cases of endodontic treatment, with microbiological control before and after laser treatment and with microbiological control but without any laser application. The evolution is also reviewed with radiographic studies of 3 (months) before and after.
Aim: Our aim in this presentation is to prove whether laser improves endodontic treatment, using a microbiological control.
Materials & Methods: Microbiological study, periapical and panoramic radiographs before and after. We used laser ErCr YSGG of 2780nm, diode lasers of 940nm and 660nm (high and low power) endodontic treatment (Rotary endodontic, apex locator, isolation).
Results: Patients treated with laser, presented better postoperative period and better microbiological results.
Conclusions: The microbiological control improves notably with laser and the radiographic evolution is very positive.
Violeta Dogandziyska
Influence of diode laser radiation on the apical leakage of endodonticaly treated teeth
Introduction: The outcome of root canal treatment is based on efficient disinfection of the root canal system and prevention of reinfection. Current chemomechanical cleaning methods do not always achieve these goals, and insufficient root canal disinfection is the main reason for endodontic failure.
Aim: The aim of our in vitro study was to evaluate the effect of diode laser irradiation (λ=660 nm; λ=970 nm) on the intracanal dentin and their interference in the apical seal of filled root canals.
Methods: 48 human single rooted teeth were randomly assigned into 4 groups. Root canal preparation was done using ProTaper Universal rotary system up to F3. 2% Sodium hypochlorite, 17% EDTA and distilled water were used as irrigants. The laser irradiation was performed at the end of the traditional endodontic preparation
Calancea Sergiu
The use of Er:YAG Laser for Minimal Invasive ablation of dental hard tissues
Introduction: The Er:YAG laser is used today in dentistry, mainly for the ablation of hard tissues (enamel, dentine and bone), but also for the treatment of soft tissues.
Many papers have reported that Er:YAG laser ablation of enamel and dentine is effective and efficient without any heat damage to the pulp, and without carbonization or cracks of the irradiated enamel and dentine surface.
Aim: To demonstrate the scientific and clinical evidence which makes the Er-Yag Laser the most adapted tool for treating oral hard tissues following the requirements of Minimal Invasive Dentistry.
Methods: Scientific evidences and clinical cases.
Results and conclusions: The Er:YAG laser treatment possesses the requirements of Minimal Invasive Dentistry: the possibility to ablate small area of infected layer guarantees maximum conservation of the tooth structure; the antibacterial property of the Er:YAG laser can guarantees the decontamination of the affected layer that retains its remineralisation potential; the lack of smear layer after laser vaporization assures a better retention of the composite resin to the dentine.
Moreover, the bio stimulation effect, the tissue selective ablation, the low penetration deep are other Er:YAG laser properties that guarantees better results in Laser dental hard tissues treatment
and teeth were filled with gutta-percha and AH- plus. The apical leakage was report on mm.
Results: Statistical analysis showed that the laser-treated groups had significantly less leakage in apical third than the control group.
Conclusions: Certain lasers can help in removing the smear layer and debris and can modify the morphology of the root canal wall for better root canal sealing.
All teeth had the root canals biomechanically instrumented using the ProTaper system (Dentsply, Maillefer, Ballaigues, Switzerland) and Crown-down.
All teeth had the root canals biomechanically instrumented using the ProTaper system (Dentsply, Maillefer, Ballaigues, Switzerland) and Crown-down.
Violeta Dogandzhiyska, Evgeniya Popova
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17th Congress of ISLD
6564 JUNE 6-8, 2019, PLOVDIV, BULGARIA
E-Poster Presentations Abstracts
P01Antimicrobal activity of probiotic species against P. gingivalis
Dermendzhieva Y., Yaneva B., Michaylova M., Yungareva T., Urshev Z., Dobrev I.
Chronic periodontitis is one of the most common diseases in the oral cavity. Its presence is associated with certain viru-lent bacterial species, one of the most pathogenic isolated is P. gingivalis. In recent years, the possibility of a potential beneficial effect of probiotic lacti acid bacteria (LAB) in addition to the conventional treatment of periodontitis has been widely discussed.
The aim of this work is an in vitro study of antimicrobial activity of Lactobacillus spp. and strains of Streptococ-cus thermophilus against Porhyromonas gingivalis DSM 20709.
MATERIAL AND METHOD:
The antimicrobial activity of L. bulgaricus LBB.B1054 and Str. thermophilus 187/4 were tested against chronic periodontitis pathogen by the agar-well diffusion method. P. gingivalis DSM 20709 inocula were prepared in WC broth and than were plated onto WC agar plates. The 6 mm diam-eter wells were filled with 50 µL of the antimicrobial agent. The inoculated agar plates were incubated at 37°C under anaerobic conditions for 4-5 days. The diameters of the in-hibitory zones were measured in millimetres. As a positive result for a bactericidal/bac-teriostatic effect, an inhibition zone of at least 2.0 mm in diameter is considered.
RESULTS:
The results showed inhibition zones of 3.0 mm for L. bulgar-icus LBB.B1054 and 2.0 mm for Str. thermophilus 187/4. Growth of lactic acid bacteria colonies out of wells on WC agar was observed.
CONCLUSIONS:
The results obtained are promising for the clinical application of Lb. bulgaricus LBB.B1054 and Str. thermo-philus 187/4 as adjunctive therapy to the treatment of chronic periodontitis due to a pronounced bacteriostatic effect against one of the most active parodontopatogens - P. gingivalis.
P02Er:YAG Laser-Assisted Apicectomy of Endodonticaly Compromised Central Incisor
Tomov G., Syuleyman M., Beltcheva A., Ke Jyuhn, Krastev B.
Fracture of root canal instruments is one of the most troublesome incidents in endodontic therapy. It is reported that the prevalence of broken instruments ranges from 0.5% to 5%1. Endodontic instruments rarely separate beyond the apical foramen. The fractured segment is a foreign object and might cause inflammation. Moreover, patients often regard the frac-tured segment as “a broken needle” and suffer psycholog-ically. Therefore, an attempt to remove the segment from such cases with a surgical approach is often necessary. The purpose of this article is to present the Er:YAG laser-as-sisted surgical removal of a broken endodontic instrument from the periapical region of the maxillary central incisor.
P03CROWN LENGTHENING UTILIZING DIFFERENT WAVELENGTHS FOR RESTORATIVE CHALLENGES
Karanasiou C., Sfeikos T., Strakas D, Dionysopoulos D., Tolidis K.
Crown lengthening is a surgi-cal procedure used to increase the extent of supragingival tooth structure for restor-ative or esthetic purposes. There are two types of crown lengthening: the soft tissue that involves excising a small amount of soft gingival tissue and the osseous that involves excising both gingival tissue and alveolar bone. Crown lengthening can be done by scalpel, electrosurgery and la-ser. However, the use of lasers provides many advantages compared to other methods. The advantages of laser over scalpel surgical procedures include greater precision, a relatively bloodless surgical and postsurgical course, ster-ilization of the surgical area, minimal swelling and scarring, coagulation, vaporization, cut-ting, minimal or no suturing, and less or no postsurgical pain.
The present poster de-scribes case series of crown lengthening using diode (940,980nm) and Er,Cr:YSGG laser (2780nm). The usage of laser provides an alternative, effective method that produc-es good results with patient satisfaction. In all cases, the surgical procedure is aimed at re-establishing the biological width apically, while exposing more tooth structure.
Lasers can be applied in aes-thetic procedures, such as the recontouring or reshaping of gingiva and in crown length-ening. Using lasers, the depth and amount of soft tissue ablation is more precisely con-trolled than with mechanical instruments.
P04Thermographic and morphological studies of the effects of diode laser (810 nm) irradiation on root canal walls
Popova E., Radeva E., Grozdanova R., Uzunov T.
INTRIDUCTRION:
The use of diode lasers in end-odontic treatment has been increasing in recent years. We investigated a new method for laser coagulation at the apical part of the root canal after vi-tal extirpation. This is a proper method of prevention of com-plications such as bleeding, pain, remaining vital pulp.
AIM:
The aim of the present in vitro study is to register the ther-mal changes and the morpho-logical changes after diode laser irradiation (810 nm) of dentinal root canals walls.
METHODS:
30 extracted teeth have been prepared and wiped dry. Samples were irradiated at diode laser (DenLase, 810 nm) 1 W and pulse interval 1 ms within 8 seconds with slow circular motion. Тemperature changes of the surface of the hard dental tissues have been recorded with infrared camera FLIR T330 and software prod-uct Flir Reporter Pro 9. The morphological changes were assayed by scanning electron microscopy (SEM, ZEISS EVO LS25) at the coronal, middle and apical part of the root.
RESULTS:
The registered temperature changes in the apex and the outer root surface were within 8°C, at 5 teeth deviations
ranged from 2°C to 4°C. The SEM images revealed melting and fusing especially at the apical regions.
CONCLUSION:
The results suggest that the diode laser can be used for endodontic purposes and show that the method is bio-compatible at the investigated parameters.
P05Separation process of stem cells (trophoblasts) from gingiva assisted with 904 nm low laser wavelength
Moreno M.
INTRODUCTION:
Stem cell regenerative med-icine and dentistry are in conjunction in the universe of personalized treatments for different health problems.
AIM:
Faster Separation process of Trophoblasts from gingiva as-sisted with low laser irradiation of 904nm. Method
Three gum tissue samples were obtained with a tissue punch of 2.5 mm. after subject-ed to irradiation with 904 nm wavelenght, for 30 seconds, at 4000 Hz, .5 Watts (Laserthec Mod. KVT 106 UP, Mexico.) to biostimulate and disinfect tissues with a distance of 1.5 cm, at 8 Jules/sq cm. In biochemistry laboratory were immediately placed in a in a 6 cm round cell well, 45 minutes previously coated with trypsin SM (at 0.025%). The tissues were covered with Dubel-co’s Modified Eagle Medium (DMEM) and supplemented with 10% fetal bovine serum (FBS) and antibiotics 50 units/ml penicillin. The samples were incubated at 37˚C and 5% de CO2. Medium was changed ev-ery third day. Only one of the samples was irradiated once in vitro with 904 nm wavelenght, for 15 seconds, at 2000 Hz, .5 Watts with .3 Jules/ 15 sec.
RESULTS:
Immunochemistry analysis showed MGSC and NCSC, or trophoblasts separated faster than controls for 3 days differ-ence.
CONCLUSION:
Mesenchymal and Neural crest stem cells (trophoblasts) sepa-rate 3 days faster from giginval tissues when irradiated with 904nm wavelength laser in vivo and in vitro, compared to other studies done elsewhere.
P06Long-term follow-up of medication-related osteonecrosis of the jaws lesions prevented or treated with aPDT and Photobiomodulation
Deboni M., Tartaroti N., Lucio L., Naclério-Homem M., Martins Marques M.
INTRODUCTION:
Treatment of Medication-Re-lated Osteonecrosis of the Jaws (MRONJ) is complex and varied with no effective therapeutic protocol.
AIM:
To evaluate a protocol for treating and/or preventing MRONJ lesions based on antimicrobial photodynamic therapy (aPDT) and photobio-modulation therapy (PBMT).
METHODS:
Patients in use or with history of antiresorptive drugs usage were followed-up between 2015-2019. MRONJ treatment included preoperative aPDT sessions, as follows: 0.01% methylene blue solution applied inside surgical wound just after necrotic bone removal and after 5 minutes the lesion was irradiated with a AsGaAl diode laser (660nm, 0.028cm2, 0.1W, 3.57W/cm2, 90s per point, 321J/cm2, 9J per point, 3 points and total energy of 27J per session). For MRONJ prevention, imme-diately after tooth extraction the aPDT was applied inside dental socket and repeated weekly until tissue repair. Antibiotics were administered pre or postoperatively for no longer than 7 days. PBMT (808nm, 0.1W, 0.028 cm², 3.57 W/cm², 30 s, 107J.cm², 3J per point in 4 points and total energy of 12J) was applied postoperatively to control inflammation and stimulate repair.
RESULTS:
Thirty-four patients (71 years average age; 87% women), mostly in use of oral bisphos-phonates for osteoporosis, were evaluated. Sixteen showed total regression of lesions after a mean of two postoperative aPDT sessions. None patients on the preven-tive protocol (18 patients) presented signs of MRONJ at least until 6 months.
CONCLUSION:
The aPDT and PBMT protocols were effective therapeutic approaches to prevent the de-
velopment of MRONJ lesions after tooth extraction or to heal existing MRONJ lesions.
P07“Optimization in a case of Orofacial Rehabilitation after Trauma: Improvement of oral and facial volumes”
Santiago M.
INTRODUCTION:
We present the case of a 50-year-old female patient, who visited us days after fall-ing frontally, causing an oro-facial trauma and immediate avulsion of the upper central incisors. She was treated in the Emergency Department where they did not perform cosmetic treatment of the cut in her lip or approach the cutting line with cosmetic sutures or treatment of the dental alveoli to avoid contamination.
AIM:
Our aim in this presentation is to show how we perform a comprehensive orofacial diag-nosis and clinical treatment to improve the situation of the intraoral and extraoral tissues.
METHODS:
We used an Erbium laser (2780 nm), and diodes (940 nm and 660 nm) for decon-taminating alveoli and also biomodulation therapy, to improve osseointegration and regeneration of tissues. The YSGG with C3 tip and Frac-tional Handpiece was used for the skin and lip profile.
We used monitoring and diag-nostic imaging with X-rays and CT-Scan and other studies for the implant surgery (Premium Implants 3.3 x 11.5 mm, synthet-ic bone and plasma), which was also, supported with laser and intraoral and digital scan sys-tems for the three-dimensional impressions and design of the rehabilitation.
RESULTS:
The results are highly posi-tive, with great control of the orofacial tissues, in a minimally invasive way, more predictable and less uncomfortable for the patient, achieving a restoration of more than 90% of the orofa-cial aesthetics.
CONCLUSIONS:The combination of laser treatment and implants, with the contributions of imaging and scanning systems, allowed us to optimize orofacial results in these complex cases where oral and facial structures are involved.
P08LLLT treatment for impaired wound healing in periodontal regeneration and grafting procedures
Cojocaru M., Popesco S., Dragichi E., Cojocaru R.
INTRODUCTION:
In recent years it has been shown that wound healing in patients with periodontal regeneration, grafting proce-dures and reconstruction of the alveolar ridge, generally place a significant burden the patient. Local irradiation of the surgical site by LLLT at a suitable wavelength has been discussed as the method of choice to reduce this bur-den and to promote wound healing.
MATERIAL AND METHODS/CLINICAL PROCEDURE:
Selection criteria
9 Patients with surgical treat-ment of soft-tissue defects, mucosal grafts, subepithelial connective-tissue grafts, GBR, implant placement with GBR; they reveal a thin gingival biotype and inadequate mo-bilization of the soft tissues in order to achieve complete tension-free coverage of the bone or conective tissue graft. If a suture is dehiscent or in the flap occurs partial or a complete necrosis during the wound-healing process,there is an intense inflammatory reaction and no revasculariza-tion will take place. We estab-lish the index of inflamation for each wound, and decide the LLLT treatment in two directions: direct wound irra-diation and application of the lymphatic drainage technique with LLLT.
RESULTS:
Many studies have confirmed the stimulatory effect of PBM on osteocytes and bone mar-row cells, even in guided bone regeneration and placement of different bone substitutes. We achived a complete wound healing in 3-4 weeks, with pain and oedema diso-lution for different types of wounds.
CONCLUSION:
It is important to diagnose wound dehiscence early and to control their extent and progression by an appropriate therapy. LLLT used in differ-ent settings offer beneficial solution of management for impaired wound healing.
P09Er,Cr:YSGG Laser-assisted Crown Lengthening: A Case Report
Nevin Kırbıyık, Ece Açıkgöz, Gizem Duygu Ateş, Sevgi Ersay, Bülend İnanç, Şirin Güner Onur
INTRODUCTION:
Dental lasers have a number of advantages over convention-al surgery as they reduce the amount of local analgesia re-quired and the need for sutures is eliminated. Laser therapy improves wound healing, which occurs faster and with less scar-ring and pain than the conven-tional treatments. Er,Cr:YSGG laser is being used in both hard and soft tissue applications due to its wide-spectrum biological action and high therapeutic effectiveness.
AIM:The aim of this case report is to present minimally invasive flapless crown lengthening per-formed with Er,Cr:YSGG laser for orthodontic reasons.
CASE REPORT:
Crown lengthening procedure was performed to a 22 year-old male patient using 2780 nm Er,Cr:YSGG laser for orthodontic band placement. Before crown lengthening procedure sulcus depth and crestal bone position of the upper first molars were verified using Williams peri-odontal probe. 6-mm-long MZ5 tip was used for gingival recontouring. The existing gingival margin was vapor-ized and properly contoured. Following gingivectomy bone sounding was performed to de-termine the position of osseous crest relative to newly formed gingival margin. Using MC3 Chisel tip osseous recontouring was performed. After crown lengthening procedure ortho-dontic bands were placed and the patient was followed up postoperatively.
RESULTS AND CONCLUSION:
Postoperative follow up indi-cated satisfying results of the periodontal health parameters; including the position of the gingival margin and health of the attachment apparatus. It can be concluded that laser assisted crown lenghtening can be a safe and effective alternative approach due to its advantages such as producing less pain, rea-sonable bleeding and acceler-ated healing term compared to the conventional methods.
KEYWORDS: crown lengthening, dental laser
17th Congress of ISLD
6766 JUNE 6-8, 2019, PLOVDIV, BULGARIA
Welcome Coctail
Gala Dinner
Where: at the Auditorium complex at Medical University, Plovdiv
When: 07 June 2019 – 18:30 – 21:00
Where: Ball room, Imperial hotel – Plovdiv
When: 08 June 20:30 – 00:00
Social Events Program
People have been living here since the sixth-millennium BC, making Plovdiv one of
Europe’s oldest cities. It stood at a vital Roman crossroads in classical times, when it
was known as Philippopolis. Plovdiv has a delightful old town topped by the atmo-
spheric ruined fortress Nebet Tepe and a Roman-era stadium (still used for opera and
rock concerts). Plovdiv has been ramping up its cultural and events tourism creden-
tials in the lead-up to stepping out as 2019 European Capital of Culture (plovdiv2019.
eu). This year will see the city come alive with art installations, culinary events, con-
temporary arts and dance programs, and a host of music and arts festivals. Kick back
in the recently revived and renovated bohemian quarter Kapana, with its tangle of
artisans’ workshops, bars, craft-beer outlets and hipster cafes. Most of its streets have
been pedestrianised, and there is a perennially buzzing atmosphere.
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