Combined CO2 Laser Research Articles

Carbon dioxide laser in dental caries prevention.

To describe CO2 laser characteristics and to review the literature regarding its effects on caries inhibition in enamel and dentin. Another aim of this review is to discuss the effects of CO2 laser in combination with fluoride. The literature was searched for review and original research papers relating CO2 laser characteristics, CO2 laser effects on enamel and dentin, use of CO2 laser in dental caries prevention and the effects of CO2 laser in combination with fluoride. The articles have been selected using Medline and manual tracing of references cited in key papers otherwise not elicited. Dental studies pertinent to key aspects of review, and those that focus on CO2 laser. Irradiation of dental enamel by specific wavelengths and fluencies of CO2 laser alters the hydroxyapatite crystals reducing the acid reactivity of the mineral; CO2 laser irradiation in combination with fluoride treatment is more effective in inhibiting caries-like lesions than CO2 laser irradiation or fluoride alone; When laser and fluoride are combined, it is possible to reduce laser energy density and fluoride levels; If this laser technology becomes available at a reasonable cost and the results can be applied in clinical practice, there will be a promising future for this laser in caries prevention.

The combined endoscopic CO(2) laser posterior cordectomy and total arytenoidectomy for treatment of bilateral vocal cord paralysis.

Upper airway obstruction, because of bilateral vocal cord paralysis, presents a serious challenge to the Otolaryngologist. Various surgical techniques have been advocated for the management of patients with vocal cord paralysis. Among these techniques, the individual use of laser CO(2) arytenoidectomy and posterior cordotomy has gained wide acceptance. In this report, we describe our experience in the management of bilateral vocal cord paralysis by combining posterior partial cordotomy as described by Dennis and Kashima, with total arytenoidectomy as described by Ossoff et al. We report the long-term results in the management of 18 patients treated in our department during the last 8 years.

Longterm comparison of soft palate scars after UPPP made by CO(2), contact Nd-YAG or combined CO (2) and Nd-YAG laser beams.

C0(2) laser, contact Nd-YAG laser and Combolaser (combined CO(2) and Nd-YAG laser beam) vary distinctively in the way they interact with target tissue. To study the quality of mature scars produced by these lasers, the ultrastructure and amount of collagen in soft palate scars after 60 uvulopalatopharyngoplasty (UPPP) operations were analysed. The CO(2) laser was used in 19, contact Nd-YAG in 21 and Combolaser in 20 operations. At a clinical follow-up examination carried out, on average, 51 (range 34-74) months postoperatively, a specimen was obtained from the soft palate scar for collagen analysis. Postoperative complaints of the patients were acknowledged. No differences between the laser groups were observed concerning the gross appearance of the scars or the amount and ultrastructure of collagen. Neither the frequency nor the quality of post-operative symptoms showed any differences between the lasers. Although the initial tissue effects are different, long-term remodelling produces nearly identical soft palate scars after the use of CO(2), contact Nd-YAG and Combolaser beams.

Combination carbon dioxide laser vermilionectomy and wedge excision of the lip

Dermatologic surgeons are very familiar with the use of the carbon dioxide (CO2) laser for treating actinic cheilitis. When squamous cell carcinoma is proven or suspected in the affected lip, then combined CO2 laser vermilionectomy and wedge excision as a one stage procedure has significant advantages for the patient.

A combined endoscopic Co2 laser and external approach for treatment of glottic cancer involving the anterior commissure: an animal study.

Endoscopic laser resection usually has been discouraged for anterior commissure (AC) carcinoma because of inadequate exposure and close proximity to underlying cartilage. A new technique combining endoscopic CO2 laser incision and an external approach, creating a window in the thyroid cartilage, was tested in this in vivo study of six dogs. An en bloc specimen including adjacent cartilage was excised while preserving the thyroid framework. The glottic reconstruction was accomplished with external placement of a sternohyoid muscle flap, by either using a bipedicled muscle flap with overlying skin or a unipedicled muscle flap with a graft of free mucosa. The results showed a satisfactory anatomic reconstruction and acceptable functions. The bipedicled muscle flap was superior to the unipedicled muscle flap due to a better AC reconstruction. It is believed that this new combined technique may overcome limited access with endoscopic technique and excessive cartilage resection with the external partial laryngectomy.

Combined Carbon Dioxide Laser Resurfacing and TCA Chemical Peel

Currently, various modalities such as phenol and TCA peels and dermabrasion are available for regeneration of the aged skin. A prior study by our group has demonstrated the clinical effectiveness of CO2 laser resurfacing in treating actinically damaged skin of the entire face with concomitant histologic improvement characterized by elimination of the solar elastosis and replacement by new collagen bundles. In the present study, we have taken this approach one step further and are presenting results of a series of 130 patients treated with combined CO2 laser resurfacing and trichloracetic acid (TCA) chemical peeling. The laser is used primarily for wrinkles, keratotic lesions, and pigmentary changes; and TCA is used to blend affected and unaffected skin. Fewer complications were noted with CO2 laser resurfacing/TCA peels than with phenol peels or dermabrasion. This combined technique can be a useful modality in the cosmetic as well as therapeutic treatment of the aged skin, as marked clinical and histologic improvement has been demonstrated.

Laser Assisted Urethral Closure in the Rat: Comparison of CO2 and Neodymium-YAG Laser Techniques

In 65 male rats a comparative study was undertaken to investigate a Neodymium-YAG and CO2 laser system for the microsurgical repair of longitudinal incisions of the rat urethra. Postoperative investigations included patency tests, necropsy and light microscopy. Use of the laser systems did not reduce operation time. The highest rate of postoperative strictures (90%), urethral fistulas (30%), urinomas (20%) and postoperative deaths (70%) was seen in the Neodymium-YAG laser group. CO2 laser repair was almost as efficacious as microsuture repair, except for a higher rate of urethral fistulas resulting from the initially weak laser weld. Based on these findings, the Neodymium-YAG laser seems unsuitable for urethral repair. Further studies in larger animals are warranted using a CO2 laser in combination with postoperative cystostomy for urinary diversion in order to avoid fistulas in the early postoperative period. (J. Urol., 144: 1000–1003, 1990)