Publications by authors named "Elisabetta Merigo"

76 Publications

Nanosecond pulsed fiber laser irradiation for enhanced zirconia crown adhesion: Morphological, chemical, thermal and mechanical analysis.

J Photochem Photobiol B 2021 Jun 15;219:112189. Epub 2021 Apr 15.

CNR-IMEM Institute, Parco delle Scienze 37a, I-43100 Parma, Italy.

The increasing demand for aesthetics, together with advancements in technology, have contributed to the rise in popularity of all-ceramic restorations. In the last two decades, the continuous progression in ceramic materials science for dental applications has permitted the fabrication of high-strength materials. Amongst these, zirconia-based ceramics have improved in terms of fracture resistance and long-term viability in comparison with other silica-based materials. Unfortunately, while bonding of resin cement-silica ceramics can be strengthened through creation of a porous surface by applying hydrofluoric acid (5%-9.5%) and a subsequent silane coupling agent, the glass-free polycrystalline microstructure of zirconia ceramics does not allow such a reaction. The aim of the present in vitro study was to observe the effect of 1070 nm fiber nanosecond pulse laser irradiation on zirconia samples through morphological analysis (profilometry, SEM), thermal recording with Fiber Bragg Gratings (FBGs), elemental composition analysis (EDX) and bond strength testing (mechanical tests) in order to evaluate the possible advantages of this kind of treatment on zirconia surfaces, as well as to show the potential side effects and changes in chemical composition. Despite laser irradiation with a 1070 nm wavelength fiber laser and correct process parameters demonstrating suitable outcomes in terms of improved surface roughness and minimal thermal damage, comparison between irradiated and unirradiated samples did not exhibit statistically significant differences in terms of bonding strength.
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http://dx.doi.org/10.1016/j.jphotobiol.2021.112189DOI Listing
June 2021

Bactericidal effect of Er,Cr:YSGG laser irradiation on endodontic biofilm: An ex vivo study.

J Photochem Photobiol B 2021 May 31;218:112185. Epub 2021 Mar 31.

University Côte d'Azur, Micoralis Research Laboratory UPR7354, 24 Avenue des Diables bleus, 06357 Nice Cedex 4, France; 2(nd) Hospital, International Department of Stomatology, Shijiazhuang, Hebei Province, China. Electronic address:

Aim: This ex vivo study aimed to evaluate the of Er,Cr:YSGG laser effectiveness in the decontamination of an endodontic biofilm.

Materials And Methods: Seventy-three single rooted human teeth, freshly were chosen. Each tooth was exposed to four associated species in an endodontic biofilm (Enterococcus faecalis, Streptococcus salivarius, Porphyromonas gingivalis, and Prevotella intermedia) and randomly allocated to one of the seven experimental groups. The group 1 (7 teeth) was used to finalize the reliable biofilm-forming technique. The groups 2 and 3 (15 teeth each group) were irradiated with two different Er;Cr:YSGG laser settings (0,75 W - 40 Hz and 4 W - 40 Hz, respectively). The groups 4 and 5 (15 teeth each group) were irrigated with two different solutions and laser irradiated with the same settings (1,5 W - 15 Hz). The group 6 (6 teeth) was the control group treated only with 4 ml 2,5% NaOCl irrigation during 60 s.

Results: The observations of group 2 and 3 specimens showed the ripeness of the biofilm with the presence of Enterococcus faecalis and Streptococcus salivarius in chains but in group 3 thermal edge effects produced by the optic fiber in the canal walls were present. The group 4 specimens observation showed an average cleaning of the root canal walls while on the canal walls of group 5 samples the apical third presented several debris and smear layer and in the centre cracks and melting dentin of the radicular wall were observed.

Conclusion: In those experimental conditions, this study, demonstrated that Er,Cr:YSGG laser has a canals decontamination ability when associated to NaOCl irrigation.
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http://dx.doi.org/10.1016/j.jphotobiol.2021.112185DOI Listing
May 2021

Focal Infection and Periodontitis: A Narrative Report and New Possible Approaches.

Int J Microbiol 2020 29;2020:8875612. Epub 2020 Oct 29.

Shijiazhuang 2 Hospital, Department of Stomatology (South), Gonguong Road 425, Quoxi District, Shijiazhuang, China.

The "focal infection theory" is a historical concept based on the assumption that some infections may cause chronic and acute diseases in different districts of the body. Its great popularity spanned from 1930 to 1950 when, with the aim to remove all the foci of infection, drastic surgical interventions were performed. Periodontitis, a common oral pathology mainly of bacterial origin, is the most evident example of this phenomenon today: in fact, bacteria are able to migrate, develop and cause health problems such as cardiovascular and respiratory diseases, diabetes, and osteoporosis. The aim of this narrative report is to verify the hypothesis of the association between oral infections and systemic diseases by different ways of approach and, at the same time, to propose new kinds of treatment today made possible by technological progress. The analysis of the literature demonstrated a strong relationship between these conditions, which might be explained on the basis of the recent studies on microbiota movement inside the body. Prevention of the oral infections, as well as of the possible systemic implications, may be successfully performed with the help of new technologies, such as probiotics and laser.
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http://dx.doi.org/10.1155/2020/8875612DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7803120PMC
October 2020

[Oral care and the Coronavirus COVID-19 epidemic].

Sante Publique 2020 Mar Apr May Jun;32(2-3):247-251

The COVID-19 Coronavirus epidemic started in December 2019 in China, and progressed very quickly in France. Its consequences were the implementation of national measures such as the containment of the population, but also a disorganization of the healthcare system, in particular concerning oral care. Indeed, dental procedures produce aerosols which can be loaded with viral particles, and as such, constitute a major contamination route by the virus. At the request of the Conference of Deans of the Faculties of Odontology, the National College of University Dentists in Public Health (CNCDUSP) set up a working group in order to issue recommendations for oral care in the context of the COVID-19 epidemic, given the specific risks faced by practitioners. Considering the lack of awareness of the specifics of dentistry in the medical world and among decision-makers, and given the speed with which national measures to fight the epidemic were implemented, the recommendations of the CNCDUSP had to be drawn up rigorously and quickly before being released to the profession. They take into account epidemiological data related to the virus, the specificities of oral care, and thus propose protective measures for dental surgery professionals.The necessary adaptation of the healthcare system during an epidemic will certainly make it possible to learn lessons from this health crisis.
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http://dx.doi.org/10.3917/spub.202.0247DOI Listing
September 2020

[Oral care and the Coronavirus COVID-19 epidemic]

Sante Publique 2020 Mar Apr May Jun;32(2):247-251

The COVID-19 Coronavirus epidemic started in December 2019 in China, and progressed very quickly in France. Its consequences were the implementation of national measures such as the containment of the population, but also a disorganization of the healthcare system, in particular concerning oral care. Indeed, dental procedures produce aerosols which can be loaded with viral particles, and as such, constitute a major contamination route by the virus. At the request of the Conference of Deans of the Faculties of Odontology, the National College of University Dentists in Public Health (CNCDUSP) set up a working group in order to issue recommendations for oral care in the context of the COVID-19 epidemic, given the specific risks faced by practitioners. Considering the lack of awareness of the specifics of dentistry in the medical world and among decision-makers, and given the speed with which national measures to fight the epidemic were implemented, the recommendations of the CNCDUSP had to be drawn up rigorously and quickly before being released to the profession. They take into account epidemiological data related to the virus, the specificities of oral care, and thus propose protective measures for dental surgery professionals.The necessary adaptation of the healthcare system during an epidemic will certainly make it possible to learn lessons from this health crisis.
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http://dx.doi.org/10.3917/spub.202.0247DOI Listing
September 2020

At-Home Photobiomodulation Treatments for Supportive Cancer Care During the COVID-19 Pandemic.

Photobiomodul Photomed Laser Surg 2021 02 8;39(2):81-82. Epub 2020 Sep 8.

Department of Oral Biology & Biomedical Engineering, University of Buffalo, Buffalo, New York, USA.

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http://dx.doi.org/10.1089/photob.2020.4923DOI Listing
February 2021

Laser Multi-Wavelength Approach for the Treatment of Peri-Implantitis: A Case Report.

J Oral Implantol 2020 Dec;46(6):614-618

Micoralis Research Laboratory, UFR Odontologie, University of Nice Côte d'Azur, Nice, France.

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http://dx.doi.org/10.1563/aaid-joi-D-19-00231DOI Listing
December 2020

Auto-Administered Photobiomodulation on Diabetic Leg Ulcers Treatment: A New Way to Manage It?

Case Rep Med 2020 20;2020:7428472. Epub 2020 May 20.

Faculty of Dentistry, University "Côte d'Azur", 5 Avenue du 22ème BCA, 06357 Nice, France.

Background: Peripheral arterial disease is a dramatic consequence of an uncontrolled diabetic condition causing an increase of morbidity and mortality and its treatment is currently medical or surgical, finally requiring, in the 7-20% of cases, major or minor amputation. Photobiomodulation therapy (PBM) is a laser treatment used in medicine, thanks to its ability to stimulate the wound healing, the acceleration of inflammatory process, and the modulation of pain. Recently, the self-administration of the treatment has been suggested for different purposes in medicine and dentistry with a great number of advantages and no side effects.

Methods: A 84-year-old woman affected by diabetes type 2 and positive for diabetes complications had diagnosis for an ulcerative lesion of 1 cm diameter on her right leg and started a treatment of the lesion applying the B-Cure Laser Pro (Erika Carmel, Haifa, Israel) on her own with a fluence per minute of 3.2 J/cm for 2 sessions of 15 minutes by cutaneous application.

Results: After a week of treatment, the ulcer dried and crusted, finally providing complete healing after 30 days of treatment.

Conclusion: With this short case report, we think to add a further contribution by suggesting this kind of treatment for successful management of the leg ulcers in diabetic patients.
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http://dx.doi.org/10.1155/2020/7428472DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260630PMC
May 2020

Er:YAG laser for the aesthetic treatment of developmental enamel defects in frontal teeth: a case report.

Laser Ther 2019 Sep;28(3):199-202

UFR Odontologie, MicOralIS Laboratory EA 7345, Faculty of Dentistry, Université Côte d'Azur, Nice, France.

Background And Aims: Several studies highlighted how the ameloblasts, secretory cells responsible of the tooth enamel formation, are highly sensitive to changes in their environment. Due to enamel maturation, their dysfunctions during a limited period of tooth development may lead to permanent morphological consequences, namely Developmental Enamel Defects (DED). The aim of this study was to show the advantages of Er:YAG laser for DED treatment.

Subjects And Methods: The case report presented describes the treatment, by Er:YAG laser, of some DED lesions present in the upper incisors of a young patient. The settings used were: 1W power, 100mJ energy, 10 Hz frequency corresponding to a Fluence of 0.318 J/cm per pulse or 3, 18 J/cm.

Results: The patient, even in absence of local anesthesia, did not feel any pain or discomfort during and after intervention. Follow-up at 2, 6 and 12 months did not show any problems in an aesthetic point of view as well as regarding hypersensitivity.

Conclusions: The use of Er:YAG laser for the treatment of developmental enamel defects in frontal teeth is a safe, painless and minimally invasive; moreover, it is able to assure a good aesthetic result.
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http://dx.doi.org/10.5978/islsm.28_19-CR-02DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6923348PMC
September 2019

Antimicrobial effect on biofilm by application of different wavelengths and dyes and the synthetic killer decapeptide KP.

Laser Ther 2019 Sep;28(3):180-186

Micoralis Laboratory, Faculty of Dentistry, University of Nice Sophia Antipolis, Nice, France.

The aim of this study was to test the application of different laser wavelengths at a low fluence in combination or not with proper photosensitizing dyes on biofilm with or without a synthetic killer decapeptide (KP). SC5314 was grown on Sabouraud dextrose agar plates at 37°C for 24 h. Cells were suspended in RPMI 1640 buffered with MOPS and cultured directly on the flat bottom of 96-wells plates. The previously described killer decapeptide KP was used in this study. Three different combinations of wavelengths and dyes were applied, laser irradiation has been performed at a fluence of 10 J/cm. The effect on biofilm was evaluated by the XTT assay. Microscopic observations were realized by fluorescence optic microscopy with calcofluor white and propidium iodide. Compared with control, no inhibition of biofilm viability was obtained with application of red, blue and green lasers alone or with any combination of red diode laser, toluidine blue and KP. The combined application of blue diode laser with curcumin and/or KP showed always a very significant inhibition, as curcumin alone and the combination of curcumin and KP did, while combination of blue diode laser and KP gave a less significant inhibition, the same obtained with KP alone. The combined application of green diode laser with erythrosine and/or KP showed always a very significant inhibition, as the combination of erythrosine and KP did, but no difference was observed with respect to the treatment with erythrosine alone. Again, combination of green diode laser and KP gave a significant inhibition, although paradoxically lower than the one obtained with KP alone. Treatment with KP alone, while reducing biofilm viability did not cause death in the adopted experimental conditions. On the contrary, combined treatment with blue laser, curcumin and KP, as well as green laser, erythrosine and KP led to death most cells. The combination of laser light at a fluence of 10 J/cm and the appropriate photosensitizing agent, together with the use of KP, proved to exert differential effects on biofilm.
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http://dx.doi.org/10.5978/islsm.28_19-OR-14DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6923346PMC
September 2019

Nd:YAP laser in the treatment of dentinal hypersensitivity: An ex vivo study.

J Photochem Photobiol B 2020 Jan 13;203:111740. Epub 2019 Dec 13.

Faculty of Dentistry, Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Pole Odontologie, Nice, France; Micoralis Laboratory EA7354, Faculty of Dentistry, Université Côte d'Azur, 24 Avenue des Diables Bleus, 06357 Nice, France. Electronic address:

Purpose: The aims of this ex vivo study were to evaluate the effectiveness of the Nd:YAP laser in the treatment of dentin hypersensitivity, to compare the temperature rise during laser irradiation at three different dentine thicknesses, and to analyse the composition of the dentine-lased surface.

Methods: A total of 33 teeth were used in this study. For scanning electron microscopy (SEM) observation, 24 teeth were transversely sectioned and divided into 4 groups: group A was irrigated with EDTA; group B was irradiated by Nd:YAP laser with 180 mJ energy/per pulse, 0.9 W average power, and 5 Hz frequency (power density [PD] = 229 W/cm); group C was irradiated by Nd:YAP laser with 280 mJ energy/pulse, 1.4 W average power, and 5 Hz frequency (PD = 356 W/cm); and group D was irradiated by Nd:YAP with 360 mJ energy/pulse, 1.8 W average power, and 5 Hz frequency (PD = 458 W/cm). Energy-dispersive spectroscopy (EDS) analysis was performed on the same teeth evaluated for SEM observations. For temperature increase evaluation performed with thermocouples, 9 teeth were transversely sectioned at 3 different thicknesses (3 for each group) of 1, 2, and 3 mm.

Results: Statistical analysis showed significant changes in the diameter of the dentinal tubule orifices among all groups; EDS did not show modification of the Ca/P ratio. Temperature increase under irradiation exceeded 5.5 °C only in the group D samples.

Conclusions: This ex vivo study, based on temperature recording, SEM observation, and EDS analysis, demonstrated that Nd:YAP laser at a PD of 356 W/cm, corresponding to an average power of 1.4 W, defines the best treatment for dentine hypersensitivity in terms of compromise between efficacy of the treatment and safety of the pulp.
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http://dx.doi.org/10.1016/j.jphotobiol.2019.111740DOI Listing
January 2020

Photobiomodulation in Oral Medicine.

Photobiomodul Photomed Laser Surg 2019 Dec;37(12):837-861

Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran.

To provide a review of the literature about the photobiomodulation therapy (PBMT) dental treatment protocols in oral medicine based on validated clinical studies that have been published so far. The lack of effective therapies for the treatment of various types of oral diseases or the presence of invasive therapeutic methods along with the use of a wide range of medications has had a significant impact on the quality of life of these patients. PBMT as a noninvasive and nondrug method can play an influential role in the treatment of oral diseases. In this study, published clinical studies up to April 2019 were reviewed from library sources, Google Scholar, PubMed and Medline, Elsevier, Embase, Cochrane, Scopus, and Web of science (ISI). In general, the findings of this study showed that PBMT has had a positive effect on the treatment of oral lichen planus, recurrent aphthous stomatitis, hyposalivation, pemphigus vulgaris, recurrent herpes simplex, burning mouth syndrome, bisphosphonate-related osteonecrosis of the jaw, trigeminal neuralgia, facial nerve paralysis, geographic tongue, and chronic sinusitis. PBMT can be effective (as an alternative treatment or in combination with other therapies) in improving symptoms or in the complete treatment of oral diseases. However, further clinical studies are still necessary to achieve more robust results.
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http://dx.doi.org/10.1089/photob.2019.4706DOI Listing
December 2019

Photobiomodulation in Pediatric Dentistry: A Current State-of-the-Art.

Photobiomodul Photomed Laser Surg 2019 Dec;37(12):798-813

UFR Odontologie, Laboratoire MicOralIS (Microbiologie Orale, Immunothérapie et Santé) EA7354, Université Nice Sophia Antipolis, Nice, France.

Given the tremendous progress in biophotonics applications in biology and engineering, we sought to examine the evidence for the use of low-dose biophotonics treatments, termed photobiomodulation (PBM) therapy, in pediatric dentistry. PBM therapy has been noted to alleviate pain and inflammation while promoting tissue healing and regeneration. These basic processes contribute to the fundamental etiopathogenesis of various oral diseases, and hence, there is now a growing list of potential clinical applications with PBM therapy in children. An exhaustive literature search was conducted for PBM studies in pediatric dentistry that includes patients up to 21 years of age. An analysis of the quality of the included studies was also performed to evaluate the rigor of the evidence. Specific emphasis was placed on the treatment efficacy on the relevant specified outcomes for individual applications. From a total of over 420 initial hits, 19 studies were deemed suitable for inclusion in this review. Among them, PBM therapy has been used in pediatric dentistry for prevention and treatment of oral mucositis associated with oncotherapy (chemotherapy, radiation, and transplants), for postsurgical oral pain and for pulpotomies. Overall, all studies reported therapeutic benefits, and no adverse effects were reported. This review noted that PBM therapy is a safe and effective treatment modality for various clinical applications in pediatric dentistry. Despite potential positive publication bias, there appears to be clear evidence of clinical benefit with this treatment, and we recommend well-designed randomized, placebo-controlled human clinical trial be pursued.
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http://dx.doi.org/10.1089/photob.2019.4722DOI Listing
December 2019

Erbium-Doped, Yttrium-Aluminum-Garnet Laser Debonding of Porcelain Laminate Veneers: An Study.

Contemp Clin Dent 2018 Oct-Dec;9(4):570-573

Department of Stomatology, Shijiazhuang 2nd Hospital, Shijiazhuang, Hebei, China.

Background: The use of ceramic laminate veneer has considerably and successfully grown to improve anterior tooth esthetics in recent years. The removal of ceramic laminate veneers with laser is reported only in a scanty number of publications and for this reason the importance and the aim of this study consist to verify the ability of Er: YAG laser for laminate veneers debonding with the preserving of the tooth structures (scanning electron microscopy [SEM] observations).

Aim: The purpose of this study consists to verify if erbium-doped, yttrium-aluminum-garnet (Er:YAG) laser, at low fluences, is able to debond porcelain veneers, successfully used to improve anterior tooth esthetics, without damaging the tooth structures.

Settings And Design: A total of 12 freshly extracted teeth were used, and samples were decontaminated, stored, and bonded to obtain veneers adhesion. One week after, Er:YAG laser with a non-contact sapphire tip with air-water spray was used for veneer debonding at 100 mJ of energy and 30 Hz of frequency (Fluence 19.94 J/cm).

Results: Results demonstrated that veneer debonding is possible with an Er:YAG laser and the total number of pulses seems not related to its efficiency. SEM observation confirms that residual tooth structure is not altered when using these low fluences.

Conclusions: Low fluences with Er:YAG laser are able to debond veneers while preserving the tooth structures and SEM observation confirmed that residual tooth structure is not altered with low fluences.
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http://dx.doi.org/10.4103/ccd.ccd_632_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6868627PMC
November 2019

Photobiomodulation Therapy in Oral Medicine: A Guide for the Practitioner with Focus on New Possible Protocols.

Photobiomodul Photomed Laser Surg 2019 Nov 7;37(11):669-680. Epub 2019 Oct 7.

Micoralis Research Laboratory EA 7354, Faculty of Dentistry, University of Côte d'Azur, Nice, France.

Photobiomodulation (PBM) is the term to define the wide range of laser applications using low-energy densities and based on photochemical mechanisms where the energy is transferred to the intracellular mitochondrial chromophores and respiratory chain components. In literature, a great number of works are reported showing the advantages of PBM use in many oral diseases such as recurrent aphthous stomatitis, herpes infections, mucositis, and burning mouth syndrome. Different factors may explain the increasing reported use of PBM in oral medicine: the absence of side effects, the possibility of safely treating compromised patients such as oncologic patients, the possibility of a noninvasive approach not associated with pain or discomfort, and the possibility of performing short sessions. The review's aim is to describe the possible applications of PBM in oral medicine, giving practitioners simple guide for practice together with the information of a new treatment possibility "at home" performed by the patient himself under supervision.
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http://dx.doi.org/10.1089/photob.2019.4624DOI Listing
November 2019

Antimicrobial Photodynamic Therapy Protocols on with Different Combinations of Wavelengths and Photosensitizing Dyes.

Bioengineering (Basel) 2019 May 10;6(2). Epub 2019 May 10.

Laboratoire MICORALIS (MICrobiologie ORALe, Immunothérapie et Santé) EA7354, Université Nice Sophia Antipolis, UFR Odontologie, Avenue des Diables Bleus, 06000 Nice, France.

The aim of the study is to test the application of different laser wavelengths, with and without different photosensitizing dyes on different types of cultures. Laser irradiation was realized on in both solid and liquid culture media in continuous mode at three different fluences (10, 20, and 30 J/cm) with a red diode (650 nm) with toluidine blue dye, a blue-violet diode (405 nm) with curcumin dye, and a green diode (532 nm) with erythrosine dye. Without a photosensitizer, no growth inhibition was obtained with the red diode at any fluence value. Inhibition rates of 40.7% and 40.2% were obtained with the blue diode and green diode. The blue diode laser used with curcumin obtained results in terms of growth inhibition up to 99.26% at a fluence of 30 J/cm. The red diode laser used with toluidine blue obtained results in terms of growth inhibition up to 100% at fluences of 20 and 30 J/cm. The KTP (potassium-titanyl-phosphate) laser used with erythrosine was able to determine a complete growth inhibition (100%) at the different fluence values. The combination of a laser and its proper color may dramatically change the results in terms of bactericidal effect. It will be interesting to confirm these data by further in vivo studies.
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http://dx.doi.org/10.3390/bioengineering6020042DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6631272PMC
May 2019

Effect of laser irradiation on aphthae pain management: A four different wavelengths comparison.

J Photochem Photobiol B 2018 Dec 20;189:1-4. Epub 2018 Sep 20.

2(nd) Hospital, International Department of Stomatology, Shijiazhuang, Hebei Province, China; University of Côte d'Azur, Micoralis Research Laboratory EA 7354, 24 Avenue des Diables bleus, 06357 Nice, Cedex 4, France; Micoralis Laboratory EA7354, Faculty of Dentistry, University of Côte d'Azur, 24 Avenue des Diables bleus, 06357 Nice, Cedex 4, France. Electronic address:

Recurrent Aphthous Stomatitis (RAS) is an oral condition characterized by painful ulcerations of the mucosa, healing spontaneously in 10-14 days but sometimes, due to their number, size and frequency of recurrence, lesions may be the cause of a severe disconfort with an impact on the quality of life of the patients due to the increased difficulty to eat, swallow and speak. For RAS, different protocols and treatments have been proposed as standard topical treatment to provide symptomatic relief, immunomodulating drugs as thalidomide, colchicine and steroids have been also proposed with the outcome to relief the pain, accelerating the healing process and increase the duration of ulcer-free period but without definitive results and without side effects. In this study we analysed the effect of laser treatment of aphthous lesions with four devices available on the market, two with wavelength in the infra-red region (2940 nm 808 nm) and two with a wavelength in the visible region (450 nm and 635 nm). Diode lasers 808 nm and 450 nm defined almost the same results with an improvement starting already after the application and gradually improving until 7 days after treatment without any statistically significant difference between them. Diode 635 nm was the device gaining the earliest effect reducing the pain already during the treatment and maintaining it at low level immediately after the laser application and after 3 and 7 days with levels of pain comparable with them obtained with 808 nm and 450 nm lasers. Er:YAG laser with the used parameters obtained a pain relief only during the treatment. The originality of this study was to compare different laser wavelengths, some of them never used for this purpose, and to compare also the two different ways to use lasers, the photobiomodulation (LLLT) and the high-power irradiation.
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http://dx.doi.org/10.1016/j.jphotobiol.2018.09.016DOI Listing
December 2018

Hard dental tissues laser welding: a new help for fractured teeth? A preliminary study.

Laser Ther 2018 Jun;27(2):105-110

Department of Engineering and Architecture, University of Parma, Parco Area delle Scienze 181/A, 43124 Parma, Italy.

Background And Aim: An important surgical goal is to provide a first intention wound healing without trauma produced by sutures and for this aim in the past several methods have been tested. The aim of this preliminary study was to demonstrate the capacity of a 1070 nm pulsed fiber laser to treat the dental fractures by enamel and dentine melting with the apposition of hydroxyapatite nanoparticles as filler.

Methods: Out of thirty freshly-extracted human third molars, decay-free, twenty-four cylinders of 5 mm thickness were obtained to perform the test.The device used was a 1070 nm Yb-doped pulsed fiber laser: this source has a maximum average output power of 20 W and a fixed pulse duration of 100 ns, while the repetition rate ranges from 20 kHz to 100 kHz. The samples were divided in three groups (a, b, c) of eight teeth and each specimen, with the two portions strictly placed side by side, was put inside the box and irradiated three times, the first and the second at 30 kW and the last at 10 kW peak power (average powers of 60 and 20 W).The repetition rate was maintained at 20 kHz for all the tests as well as the speed of the beam at 10 mm/sec.The samples of the group a were irradiated without apposition, in the group b nanoparticles (< 200 nm) of hydroxyapatite were put in the gap between the two portions while in the group c, a powder of hydroxyapatite was employed.

Results: Only the specimens of the group b showed a real process of welding of the two parts, while specimens of groups a and c did not reach a complete welding process.

Conclusion: This preliminary study, based on the enamel and dentine welding obtained by a 1070 nm pulsed fiber laser associated to the hydroxyapatite nanoparticles, may represent a new and original approach for the treatment of the fractured teeth, even if further studies will be necessary to confirm these results.
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http://dx.doi.org/10.5978/islsm.18-OR-09DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6062682PMC
June 2018

Combined Approach to Treat Medication-Related Osteonecrosis of the Jaws.

J Lasers Med Sci 2018 20;9(2):92-100. Epub 2018 Mar 20.

MICORALIS Laboratory EA7354, Faculty of Dentistry, Université "Côte d'Azur", 24 Avenue des Diables Bleus, 06357 Nice, France.

The proper therapeutic plan for medication-related osteonecrosis of the Jaw (MRONJ) is still lacking long-term data up to today. They were several high-technological appliances proposed for the different intervention steps, in addition to tissue repair promoters. The reason for proposing an integrated technique is justified, beyond better compliance of the patients associated to the pain and inflammation reduction and bleeding control, there is also achieving better hard and soft tissues healing. Patients diagnosed with bisphosphonates-related osteonecrosis of the jaws (BRONJ) at the Odontostomatology and Maxillo-Facial Surgery Unit of the Hospital of Piacenza undergone surgical intervention. The intervention was performed by using different devices: Piezosurgery for removing the necrotic bone tissue and for obtaining the bone specimen essential for histological analysis; Er:YAG laser (2940 nm) to vaporize necrotic hard tissue until reaching the bleeding bone; platelet-rich plasma (PRP) to stimulate hard and soft tissue healing; and finally diode laser (808 nm) to perform a biostimulation of the surgical site. All treated patients demonstrated a good postoperative comfort even without using painkillers, no bleeding, and a fast healing process. Most of the patients (92.85%) reached complete healing with a minimum follow up at 6 months. Histological exams demonstrated a good quality without artifacts. Sequential utilization of different high-technologies devices during all the steps of MRONJ treatment allows to perform a faster and less invasive surgery with a more comfortable postoperative healing process and it may represent a new and original approach for treating this severe adverse event.
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http://dx.doi.org/10.15171/jlms.2018.19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6046388PMC
March 2018

Multicenter randomized, double-blind controlled trial to evaluate the efficacy of laser therapy for the treatment of severe oral mucositis induced by chemotherapy in children: laMPO RCT.

Pediatr Blood Cancer 2018 08 4;65(8):e27098. Epub 2018 May 4.

Pediatric Hemato-Oncology Unit, IRCCS materno infantile Burlo Garofolo, Trieste, Italy.

Objectives: To demonstrate the efficacy of laser photobiomodulation (PBM) compared to that of placebo on severe oral mucositis (OM) in pediatric oncology patients. The primary objective was the reduction of OM grade (World Health Organization [WHO] scale) 7 days after starting PBM. Secondary objectives were reduction of pain, analgesic consumption, and incidence of side effects.

Methods: One hundred and one children with WHO grade > 2 chemotherapy-induced OM were enrolled in eight Italian hospitals. Patients were randomized to either PBM or sham treatment for four consecutive days (days +1 to +4). On days +4, +7, and +11, OM grade, pain (following a 0-10 numeric pain rating scale, NRS) and need for analgesics were evaluated by an operator blinded to treatment.

Results: Fifty-one patients were allocated to the PBM group, and 50 were allocated to the sham group. In total, 93.7% of PBM patients and 72% of sham patients had OM grade < 3 WHO on day +7 (P = 0.01). A significant reduction of pain was registered on day +7 in the PBM versus sham group (NRS 1 [0-3] vs. 2.5 [1-5], P < 0.006). Reduced use of analgesics was reported in the PBM group, although it was not statistically significant. No significant adverse events attributable to treatment were recorded.

Conclusions: PBM is a safe, feasible, and effective treatment for children affected by chemotherapy-induced OM, as it accelerates mucosal recovery and reduces pain.
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http://dx.doi.org/10.1002/pbc.27098DOI Listing
August 2018

Platelet-Rich Plasma (PRP) Rinses for the Treatment of Non-Responding Oral Lichen Planus: A Case Report.

Biomedicines 2018 Feb 6;6(1). Epub 2018 Feb 6.

Dentistry, Special Needs and Maxillo-Facial Surgery Unit, Hospital "Guglielmo da Saliceto", 29100 Piacenza, Italy.

Platelet-rich plasma (PRP) has been proposed for different applications in the medical field and in maxillofacial surgery thanks to its many growth factors, such as epidermal growth factor (EGF), fibroblast growth factor (FGF), and keratinocyte growth factor (KGF). Oral lichen planus (OLP) is a disease that affects the oral mucosa in a chronic way. This disease frequently worsens the quality of life of patients, particularly when clinical manifestations are of the erythematous or erosive/ulcerative type. The properties of PRP that are supported by scientific literature in both oral medicine and other medical fields have suggested the introduction of PRP in clinical practice for the medical treatment of different soft tissues diseases, such as when OLP patients do not respond to conventional therapies, or when conventional treatments have some contraindications or side effects. The aim of this work is to describe the use of PRP used as an oral rinse for the treatment of a patient diagnosed as affected by OLP at the Dentistry, Special Needs and Maxillo-Facial Surgery Unit of the Hospital of Piacenza. PRP protocol was started after the failure of conventional therapies based on the use of topical and systemic corticosteroids, hydroxychloroquine, and low-level laser therapy applications.
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http://dx.doi.org/10.3390/biomedicines6010015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874672PMC
February 2018

Use of 1070 nm fiber lasers in oral surgery: preliminary study with FBG temperature monitoring.

Laser Ther 2017 Dec;26(4):311-318

Department of Engineering and Architecture, University of Parma, Parco Area delle Scienze 181/A, 43124 Parma, Italy.

Background And Aims: The aim of this study was to demonstrate the performances of 1070 nm fiber lasers for the ablation of oral tissues through the evaluation of the histological modifications made by a blind pathologist and the measurement of the thermal elevation during laser irradiation by a sensor based on a fiber Bragg grating.

Materials And Methods: The source used was a pulsed fiber laser emitting at 1070 nm, with 20 W maximum average output power and 100 ns fixed pulse duration. Different tests were performed by changing the laser parameters, particularly the peak power of the pulses and the repetition rate.

Results: The tissue of the measurements demonstrated that the best properties in term of cutting capability and, at the same time, the lower thermal damages to the tissues can be obtained with a peak power of 3 kW, a repetition rate of 50 kHz and a speed of 5 mm/s.

Conclusions: This study showed that 1070 nm fiber lasers can be very useful in oral surgery, since they provide a reduced thermal elevation in the irradiated tissues, thus consequently respecting their biological structures. Moreover, this work demonstrates that FBG sensors, based on the optical fiber technology as the laser source considered for the tests, may be good instruments to record thermal elevation when applied to the studies on animal models.
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http://dx.doi.org/10.5978/islsm.17-OR-21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801457PMC
December 2017

Disilicate Dental Ceramic Surface Preparation by 1070 nm Fiber Laser: Thermal and Ultrastructural Analysis.

Bioengineering (Basel) 2018 Jan 31;5(1). Epub 2018 Jan 31.

Department of Engineering and Architecture, University of Parma, Parco Area delle Scienze 181/A, 43124 Parma, Italy.

Lithium disilicate dental ceramic bonding, realized by using different resins, is strictly dependent on micro-mechanical retention and chemical adhesion. The aim of this in vitro study was to investigate the capability of a 1070 nm fiber laser for their surface treatment. Samples were irradiated by a pulsed fiber laser at 1070 nm with different parameters (peak power of 5, 7.5 and 10 kW, repetition rate (RR) 20 kHz, speed of 10 and 50 mm/s, and total energy density from 1.3 to 27 kW/cm²) and the thermal elevation during the experiment was recorded by a fiber Bragg grating (FBG) temperature sensor. Subsequently, the surface modifications were analyzed by optical microscope, scanning electron microscope (SEM), and energy dispersive X-ray spectroscopy (EDS). With a peak power of 5 kW, RR of 20 kHz, and speed of 50 mm/s, the microscopic observation of the irradiated surface showed increased roughness with small areas of melting and carbonization. EDS analysis revealed that, with these parameters, there are no evident differences between laser-processed samples and controls. Thermal elevation during laser irradiation ranged between 5 °C and 9 °C. A 1070 nm fiber laser can be considered as a good device to increase the adhesion of lithium disilicate ceramics when optimum parameters are considered.
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http://dx.doi.org/10.3390/bioengineering5010010DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874876PMC
January 2018

Laser-assisted surgery and bioscaffold for the treatment of rhinophyma.

Indian J Dermatol Venereol Leprol 2018 Sep-Oct;84(5):629-631

Special Needs and Maxillo-Facial Surgery Unit, Hospital "Guglielmo da Saliceto", Piacenza, Italy; MicOralIS Laboratory EA7354, UFR of Odontology, University of Nice-Sophia Antipolis, Nice, France.

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http://dx.doi.org/10.4103/ijdvl.IJDVL_781_16DOI Listing
August 2019

Laser and Platelet-Rich Plasma to treat Medication-Related Osteonecrosis of the Jaws (MRONJ): a case report.

Laser Ther 2017 Sep;26(3):223-227

Odontostomatology and Maxillo-Facial Surgery Unit - Special care dentistry "Guglielmo da Saliceto" Hospital - Piacenza - Italy.

Aims: The appropriate management of Medication-Related OsteoNecrosis of the Jaw (MRONJ) is still a challenge for dentists and oral surgeons and in these last years high-technology instruments have been proposed at the different steps of interventions, also combined with promoters of tissue repair.The aim of this report is to show the advantages of a combined approach (laser and PRP) for the treatment of MRONJ.

Methods: It is described the case of a patient positive for MRONJ observed at the Odontostomatology and Maxillo-Facial Surgery Unit of the Hospital of Piacenza where surgical approach was performed by using different devices: Er:YAG laser (2940 nm) to remove and vaporize necrotic hard tissue until bleeding bone; Platelet-Rich Plasma (PRP) to stimulate hard and soft tissue healing; diode laser (808 nm) to biostimulate the surgical site.

Results: At the time of suture removal, wound closure was observed and the complete healing of the MRONJ site was observed for the 2 years follow up.

Conclusion: This case may suggest that this kind of combined approach during all the steps of MRONJ treatment allows to perform a faster and less invasive surgery with a more comfortable postoperative healing process and it represents an innovative approach in this severe adverse event.
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http://dx.doi.org/10.5978/islsm.17-CR-04DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675913PMC
September 2017

Use of photo-Fenton's reaction by 400-nm LED light for endodontic disinfection: A preliminary in vitro study on Enterococcus faecalis.

J Photochem Photobiol B 2017 Jun 27;171:85-89. Epub 2017 Apr 27.

MICORALIS Laboratory, Faculty of Dentistry, Université Côte d'Azur, France.

One of the biggest challenges in endodontics is the complete disinfection of root canals. In addition to mechanical preparation, the technique traditionally also involves channel disinfection with other agents such as sodium hypochlorite, hydrogen peroxide, chlorhexidine, or a combination of these. Some bacterial species are particularly resistant to eradication. Using Enterococcus faecalis in this preliminary study, we tested the bactericidal effectiveness of the Fenton reaction and the photo-Fenton reaction using an LED light with a 400-nm wavelength. Discs of hydroxyapatite were incubated in brain-heart broth contaminated with Enterococcus faecalis. After 4days, they were decontaminated with different bactericidal agents, including some with proven and well-known efficacy (5% sodium hypochlorite and 3% hydrogen peroxide) and other treatments using solutions of 1.5% hydrogen peroxide and 0.15% iron gluconate (Fenton reaction) plus LED light at a Fluence of 4.0J/cm (photo-Fenton reaction). The photo-Fenton reaction demonstrated comparable performance to that of sodium hypochlorite in eliminating Enterococcus faecalis.
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http://dx.doi.org/10.1016/j.jphotobiol.2017.04.033DOI Listing
June 2017

At-home laser treatment of oral neuronal disorders: Case reports.

J Clin Exp Dent 2017 Apr 1;9(4):e595-e598. Epub 2017 Apr 1.

Micoralis Laboratory EA7354 - University of Nice "Sophia Antipolis", 24 Avenue des Diables Bleus, Nice - France.

The neuronal disorders occurring in the oral district are mainly anaesthesia, paraesthesia, hypoesthesia and hyperaesthesia and they may occur frequently after surgical procedures. Medical treatment depends on degree of severity of the nerve injury but, in every case, it must be immediately carried out to reduce immune inflammatory reaction. The aim of this report is to investigate the effectiveness in the recovery of the peripheral nerve lesions of a new laser device recently proposed by the commerce that, due to its reduced size and to be a class I laser according the ANSI classification, may be used at home by the patient himself. Three different cases were treated with this "at-home approach": complete resolution of symptomatology was obtained after laser treatment with a good compliance for the patient and without reporting any side effect. Laser, biomodulation, low level laser therapy, oral neuronal disorders, at-home treatment, paresthesia.
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http://dx.doi.org/10.4317/jced.53373DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5410685PMC
April 2017

Effect of different wavelengths and dyes on Candida albicans: In vivo study using Galleria mellonella as an experimental model.

Photodiagnosis Photodyn Ther 2017 Jun 24;18:34-38. Epub 2017 Jan 24.

Unit of Oral Pathology, Medicine and Laser Surgery, Department of Biomedical, Biotechnological and Translational Sciences (S.Bi.Bi.T.), University of Parma, Parma, Italy.

Background: Studies on photodynamic inactivation against microorganisms had a great development in recent years. The aim of this work was to test the application of different laser wavelengths with or without different photosensitizing dyes on Candida albicans cells in vitro and in photodynamic therapy protocols in vivo in larvae of Galleria mellonella.

Methods: Laser application was realized on C. albicans cells suspended in saline solution or cultured on solid medium for the in vitro study, and in a model of G. mellonella candidal infection for the in vivo study. Three wavelengths (650, 405, and 532nm) were used in continuous mode with different values of applied fluences: 10, 20 and 30J/cm for the in vitro study and 10J/cm for the in vivo study, without and with photosensitizing dyes.

Results: No growth inhibition was obtained on yeast cells in saline solution without photosensitizers. The maximum inhibition of growth (100%) was obtained with 405nm diode laser and curcumin at any used fluence. No growth inhibition was observed for yeast cells cultured on solid medium after laser application without dyes. An inhibition was observed after laser application when curcumin and erythrosine were added to the medium. The survival curves of G. mellonella larvae infected with C. albicans with or without the different dyes and after laser application showed a statistically significant difference (p<0.001) in comparison with the proper control groups.

Conclusions: These results show the efficacy of photodynamic inactivation exploiting a suitable combination of light and dyes against C. albicans and the potential of photodynamic therapy for the treatment of candidal infections.
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http://dx.doi.org/10.1016/j.pdpdt.2017.01.181DOI Listing
June 2017

Histological evaluation of three techniques for caries removal.

J Oral Sci 2016 ;58(4):583-589

Micoralis Laboratory EA 7354, Faculty of Dentistry, University of Nice Sophia Antipolis.

A number of concepts and devices have been proposed for caries removal. Among these, the Er:YAG laser is a potential alternative to conventional mechanical treatment. This study compared the effectiveness of the Er:YAG laser with that of low-speed rotary instruments for removal of carious tissue in 26 extracted human molars and premolars with severe decay (i.e., large occlusal or proximal decay but no pulpal contact). The teeth were divided into three groups of eight teeth, and two teeth were used as controls. After sectioning all the teeth through the center of the carious lesion before excavation, each group was randomly assigned to three groups-Er:YAG laser versus tungsten bur, Er:YAG laser versus polymer bur, and polymer bur versus tungsten bur-to evaluate the efficacy of the three techniques. The time required for carious treatment of each half was recorded, and samples were then histologically examined. Mean duration of caries removal did not significantly differ in relation to the technique used. Histological analysis of tooth halves treated with the Er:YAG laser revealed a regular 5-µm-thick stained layer that appeared to be denatured collagen. A smear layer was often detectable in halves treated with carbide burs. A superficial disorganized layer, which was found to be affected dentin, was observed in halves treated with polymer burs. The present findings indicate that the three techniques were clinically and histologically effective in removing the infected dentin layer.(J Oral Sci 58, 583-589, 2016).
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http://dx.doi.org/10.2334/josnusd.16-0225DOI Listing
November 2017

450 nm Blue Laser and Oral Surgery: Preliminary ex vivo Study.

J Contemp Dent Pract 2016 Oct 1;17(10):795-800. Epub 2016 Oct 1.

Department of Information Engineering, University of Parma Parma, Italy.

Introduction: Dental diode lasers were started to be used at the end of the 1990s and were shown to possess several important characteristics, such as small size and low cost, as well as the advantage of optic fibers delivering system. Although only two wavelengths (810 and 980 nm) had been the most used dental diode lasers, a wavelength emitting in the blue portion of the spectrum has recently been proposed.

Aim: The aim of this ex vivo study was to compare the effectiveness of five different fiber-delivered laser wavelengths (450, 532, 808, 1064, and 1340 nm) in the oral soft tissue ablation.

Materials And Methods: Specimens were surgically collected from the dorsal surface of four bovine tongues and, while deep thermal increase was measured by two thermocouples at 0.5 and 2 mm depth, surface temperature was recorded by an infrared thermometer. Subsequently, specimens were fixed in 10% buffered formalin solution, cut into slices, and embedded in paraffin blocks, and a pathologist made a morphological analysis by optic microscope assigning a score based on the quality of the cut and tissue damage.

Results: The analysis showed the best quality of the cut and the lowest temperature increase on the specimens obtained with the shortest laser wavelength (450 nm).

Conclusion: Even considering this as preliminary study, the use of 450 nm blue diode laser in oral surgery may be suggested to the clinician in their daily practice.

Clinical Significance: This study opens a new perspective in oral surgery. Blue diode laser has demonstrated a good quality of the cut with a low energy causing a minimal thermal damage to the tissue, promising a better comfort to patients.
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http://dx.doi.org/10.5005/jp-journals-10024-1933DOI Listing
October 2016
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