Electro Medical Systems Research Articles

Wettability of Different Zirconia Implant Surfaces after Glycine and Erythritol Treatment.

This in-vitro study aims to investigate whether the wettability of two zirconia implant disk surfaces is affected by glycine and erythritol air-polishing, using saline, bovine serum albumin, bovine thrombin, and bovine artificial blood as the testing mediums. Zirconia disks were provided by two implant companies: SDS. (Swiss Dental Solutions, Plymouth, MA, USA) (n=6) and Patent. (Zircon Medical AG, Altendorf, Switzerland) (n=6). Surface parameters (Sa, Sz, Sdr, Ssk, Sku, and Spd) were measured to determine their initial surface roughness. Air-polishing was completed using glycine or erythritol powders using the AIRFLOW. PERIO device (Manufactured by Electro Medical Systems (EMS)). The wettability of the disk surfaces was evaluated by the contact angle analysis applied on treated and untreated disks using four wetting solutions, saline, bovine serum albumin (BSA), bovine thrombin, and bovine artificial blood. In total, 720 contact angle measurements were completed with n=30 per group. Statistical analysis was performed using the one-way analysis of variance and post-hoc Tukey HSD test. The results indicate SDS. has a greater wettability than Patent. before and after air-polishing. The wettability of surfaces treated with glycine was hydrophobic in some cases. Erythritol increased the surface wettability of zirconia disks compared to glycine. BSA and bovine artificial blood had lower contact angles than saline and bovine thrombin for both untreated disks. The initial wettability of zirconia disks differs between manufacturers, and air-polishing with erythritol powder increases the wettability of zirconia implant disks for saline, bovine serum, bovine thrombin, and bovine artificial blood.

Scanning electron microscopy evaluation of enamel surfaces using different air-polishing powders in the orthodontic setting: an invitro study.

The aim of this invitro study was to quantify and compare changes of the enamel surface caused by periodical use of different air-polishing powders during multibracket therapy. Bovine high-gloss polished enamel specimens were air-polished using an AIR-FLOW® Master Piezon with maximum powder and water settings. Each specimen was blasted with sodium bicarbonate (AIR-FLOW® Powder Classic, Electro Medical Systems, Munich, Germany) and erythritol (AIR-FLOW® Powder Plus, Electro Medical Systems). Blasting duration was adapted to the powders' cleaning efficacy and corresponded to 25air-polishing treatments in apatient with braces. Aspindle apparatus ensured uniform guidance at adistance of 4 mm and a90° angle. Qualitative and quantitative assessments were performed with the use of low vacuum scanning electron microscopy. Following external filtering and image processing, arithmetical square height (Sa) and root mean square height (Sq) were determined. Both prophy powders caused asignificant increase in enamel roughness. Surfaces blasted with sodium bicarbonate (Sa = 64.35 ± 36.65 nm; Sq = 80.14 ± 44.80 nm) showed significantly (p < 0.001) higher roughness than samples treated with erythritol (Sa = 24.40 ± 7.42 nm; Sq = 30.86 ± 9.30 nm). The observed defects in enamel structure caused by sodium bicarbonate extended across prism boundaries. Prism structure remained intact after air-polishing with erythritol. Both applied air-polishing powders led to surface alterations. Despite shorter treatment times, sodium bicarbonate was significantly more abrasive than erythritol. Clinicians must compromise between saving time and abrasively removing healthy enamel.

Contact ureterolithotripsy of a giant ureteral stone in a 3-year-old child

Giant ureteral stones in young children are extremely rare and their surgical treatment tactics are variable. The present case describes a case of effective and safe endoscopic treatment of giant ureteral stones in a young child. The patient is a 3-year-old male child. Examination findings of abdominal pain and fever verified a left distal ureteric stone up to 30 mm complicated by ureterohydronephrosis. The first treatment stage was ureteral stenting, in which the stone migrated to the middle ureteral third. The second treatment stage was contact ureterolithotripsy with a 9 Ch semi-rigid ureteroscope («Richard Wolf» GmbH, Knittlingen, Germany) and Swiss LithoClast® 2 pneumatic lithotripter («E.M.S. Electro Medical Systems» S.A., Nyon, Suisse), ureteral stenting (2-way PigTail, 4.5 Ch). The third treatment stage in the delayed period was extracorporeal shockwave lithotripsy of the steinstrasse using the Dornier Compact Sigma («Dornier MedTech» GmbH, Weßling, Germany) and stent removal. Residual stones were not revealed according to the follow-up examination. No treatment complications were registered. The multimodal staged treatment of a giant ureteral stone resulted in its complete elimination. Next-step ureteral endoscopy made it possible to identify concomitant pathology of the proximal ureter, which required its evaluation in the delayed period. Ureteral stenting contributed to the restoration of renal function. The result achieved reflects the maximum efficiency and high safety of the surgical technique applied.

A Randomized, Single-Blind Clinical Trial Comparing Robotic-Assisted Fluoroscopic-Guided with Ultrasound-Guided Renal Access for Percutaneous Nephrolithotomy.

We conducted a randomized, single-blind clinical trial comparing the surgical outcomes of robotic-assisted fluoroscopic-guided (RAF group) and ultrasound-guided (US group) renal access in mini-percutaneous nephrolithotomy (PCNL). We recruited patients who underwent mini-PCNL with ureteroscopic assistance for large renal stones between January 2020 and May 2021. Block randomization was performed using online software. Automated needle target with x-ray was used for fluoroscopic-guided renal access in the RAF group. PCNL was performed by residents using a pneumatic lithotripsy system with 16.5Fr/17.5Fr tracts. The primary outcome was single puncture success, and the secondary outcomes were stone-free rate, complication rate, parameters measured during renal access and fluoroscopy time. In total, 71 patients (35 in US group, 36 in RAF group) were enrolled. No difference was seen in the single puncture success rate between the US and RAF groups (34.3% and 50.0%, p=0.2). In 14.3% cases in the US group vs no cases in the RAF group, the resident was unable to obtain access due to difficult targeting (p=0.025). The mean number of needle punctures was significantly fewer, and the median duration of needle puncture was shorter in the RAF group (1.83 vs 2.51 times, p=0.025; 5.5 vs 8.0 minutes, p=0.049, respectively). The stone-free rate at 3 months after surgery was 83.3% and 70.6% in the RAF and US groups, respectively (p=0.26). Multivariate analysis revealed that RAF guidance reduced the mean number of needle punctures by 0.73 times (p=0.021). RAF renal access in mini-PCNL may have further potential applications in this field.

The clinical outcomes of laser with suction device in mini-percutaneous nephrolithotomy

ObjectiveTo evaluate the safety, efficacy and feasibility of laser with suction device in mini-percutaneous nephrolithotomy (mini-PCNL). MethodsA retrospective study was conducted including 200 patients who underwent mini-PCNL for renal stones. All patients underwent PCNL using Electro-Medical Systems laser. In addition to the laser in 100 patients, a suction device was used (laser with suction [LWS]). In the other 100, suction device was not used (laser with no additional suction [LOS]). Mini-PCNL was performed using standard technique and Karl Storz minimally invasive PCNL-medium system was used. Primary end point was stone clearance. ResultsBoth the groups were comparable in terms of demographic data. Mean stone size was 15.24±5.90 mm and 16.16±5.53 mm in LWS and LOS, respectively. Mean Hounsfield unit of stone was 1285.64 and 1206.79 in LWS and LOS, respectively. Operative time was less in LWS group (56.89±19.65 min) as compared to LOS (62.01±28.81 min). At one-month follow-up, radiological complete clearance was 96% in LWS and 92% in LOS. On subgroup analysis of stones larger than 18 mm, the clearance rate was in favour of LWS (85.7% vs. 100%) and also the need for nephrostomy placement was less in LWS group. ConclusionsLWS device is safe and efficacious when used with mini-PCNL. For stones greater than 18 mm, it has a better stone free rate as compared to using no suction.

Mechanical Properties and Wear Resistance of Commercial Stainless Steel Used in Dental Instruments.

The aim of this study was to investigate the element composition and grain size of commercial dental instruments used for ultrasonic scaler tips, which are composed of stainless-steel materials. The differences in mechanical properties and wear resistances were compared. The samples were classified into 4 groups in accordance with the manufacturer, Electro Medical Systems, 3A MEDES, DMETEC and OSUNG MND, and the element compositions of each stainless-steel ultrasonic scaler tip were analyzed with micro-X-ray fluorescence spectrometry (μXRF) and field-emission scanning electron microscopy (FE-SEM) with energy-dispersive X-ray spectroscopy (EDS). One-way ANOVA showed that there were significant differences in shear strength and Vickers hardness among the stainless-steel ultrasonic scaler tips depending on the manufacturer (p < 0.05). The mass before and after wear were found to have no significant difference among groups (p > 0.05), but there was a significant difference in the wear volume loss (p < 0.05). The results were then correlated with μXRF results as well as observations of grain size with optical microscopy, which concluded that the Fe content and the grain size of the stainless steel have significant impacts on strength. Additionally, stainless-steel ultrasonic scaler tips with higher Vickers hardness values showed greater wear resistance, which would be an important wear characteristic for clinicians to check.

SEM Analysis of Enamel Abrasion after Air Polishing Treatment with Erythritol, Glycine and Sodium Bicarbonate

The aim of this in vitro study was to evaluate the enamel surface topography after treatment with three air polishing powders: Glycine (A), erythritol (B), and sodium bicarbonate (C) (Air Flow Soft, Plus and Classic powders, EMS Electro Medical Systems S.A., Nyon, Switzerland). Fifteen extracted incisors were randomly divided into three groups of five teeth each, A, B and C, respectively. The teeth were blocked in plaster bases, washed, dried and half-covered with polytetrafluoroethylene strips before treatment. In this way, each half-treated dental element became test and control of itself. Comparative statistical analysis of Rq (geometric average of the deviations occurring in roughness profile) was performed. The scanning electron microscope (SEM) analysis showed different degrees of surface roughness between the groups, decreasing after treatment. In addition, a statistically significant reduction p &lt; 0.05 was present in group C (Rq mean non-treated 108.17 µm, 95% CI: 97.29–124.01 and Rq mean treated 86.78 µm, 95% CI: 80.63–93.70). A decrease in surface roughness post-treatment was not observed in group A and B. Therefore, it may be concluded that the air flow powders tested herein can be used on dental enamel to reduce the surface roughness due to function and the action of dental therapies.

Radial extracorporeal shock wave therapy for adhesive capsulitis of the shoulder: A prospective, randomized, placebo controlled, double-blind study with subjective and objective endpoints

This study tested the hypothesis that radial extracorporeal shock wave therapy (rESWT) is effective and safe in the treatment of adhesive capsulitis of the shoulder (adC-S). One hundred and six patients (mean age, 55.8 years; range, 39–77) with pain and limitations in shoulder mobility due to adC-S lasting for averaged 11.6 months (range, 9–14) were randomly allocated to either rESWT ( n = 53) (four sessions, one session per week, Swiss DolorClast [Electro Medical Systems S.A., Nyon, Switzerland], radial handpiece, 15-mm applicator, 2000 rESWT impulses per session, positive energy flux density 0.14 mJ/mm 2 , rESWT impulses applied at 8 Hz) or placebo treatment ( n = 53). Patients completed the Visual Analog Scale (VAS) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire at baseline (BL) as well as at one month (M1), six months (M6) and twelve months (M12) after baseline. Moreover, passive and active abduction of the arm (pA and aA) as well as passive external rotation of the shoulder (pER) were measured at BL, M1, M6 and M12. All patients completed the final review at M12 and were included in the study. Mean pretreatment VAS scores, DASH scores and pA, aA and pER measurements for the rESWT and control groups were 6.3 and 6.3 (VAS), 73.5 and 72.5 (DASH), 98.2 and 99.3 degrees (pA), 65.8 and 68.8 degrees (aA), and 20.3 and 22.0 degrees (pER), respectively. Compared to placebo treatment rESWT resulted in statistically significantly reduced VAS score (by averaged 3.5 points) and statistically significantly improved DASH score (53.8 points), pA (63.9 degrees), aA (79.1 degrees) and pER (43.3 degrees) at all follow-up examinations. rESWT as performed in the present study is an effective and safe treatment for adhesive capsulitis of the shoulder.

MP68-13 THE NEXT GENERATION: IN VITRO COMPARISON OF A NOVEL SINGLE-PROBE DUAL-ENERGY LITHOTRIPTER TO CURRENT DEVICES

You have accessJournal of UrologyStone Disease: Surgical Therapy IV1 Apr 2018MP68-13 THE NEXT GENERATION: IN VITRO COMPARISON OF A NOVEL SINGLE-PROBE DUAL-ENERGY LITHOTRIPTER TO CURRENT DEVICES Daniel Wollin, Evan Carlos, Brenton Winship, Michael Gustafson, Westin Tom, Daniela Radvak, Ruiyang Jiang, Charles Scales, Michael Ferrandino, W Neal Simmons, Glenn Preminger, and Michael Lipkin Daniel WollinDaniel Wollin More articles by this author , Evan CarlosEvan Carlos More articles by this author , Brenton WinshipBrenton Winship More articles by this author , Michael GustafsonMichael Gustafson More articles by this author , Westin TomWestin Tom More articles by this author , Daniela RadvakDaniela Radvak More articles by this author , Ruiyang JiangRuiyang Jiang More articles by this author , Charles ScalesCharles Scales More articles by this author , Michael FerrandinoMichael Ferrandino More articles by this author , W Neal SimmonsW Neal Simmons More articles by this author , Glenn PremingerGlenn Preminger More articles by this author , and Michael LipkinMichael Lipkin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2217AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The LithoClast Trilogy (ElectroMedical Systems (EMS)) is a novel single-probe, dual-energy lithotripter with ultrasonic (US) vibration and electromagnetic impact force. The ShockPulse (Olympus) and LithoClast Select (EMS) are existing lithotripters that also use a combination of US and mechanical impactor. Our aim was to compare the in vitro efficacy of these devices in stone clearance and fixed-weight drilling and characterize the tip motion of the new device. METHODS 1 cm3 15:3 Begostones mimicking calcium oxalate monohydrate stones were used in all trials. Test groups were Trilogy, ShockPulse, Select US only and Select US/pneumatic. For clearance testing, a stone was placed in a submerged hemispherical silicone support. Each lithotripter was used by hand to fragment one stone with 300cc/min of suction and comparable energy settings. Time to stone clearance was recorded; 10 trials were performed per device. For drill testing, a hands-free apparatus with a submerged balance was used to apply 1 or 2lbs of pressure on a stone in contact with the device tip. 10 trials were performed per device; 5 at each weight. Active device tip motion was assessed using high-speed photography. RESULTS Clearance tests revealed differences between groups by one-way ANOVA (p=0.001). The Select US/Pneumatic was slowest and Trilogy fastest by Tukey′s HSD (p<0.01). For drill testing, one-way ANOVA was significant at both 1 and 2lbs (p<0.0001, p=0.035, respectively). At 1lb, the Select US-only was slowest by Tukey′s HSD (p=0 .001). At 2lbs, the ShockPulse was faster than the Select US-only (p=0.027), but did not significantly outpace the Trilogy or Select US/pneumatic. At either weight, there was no significant difference between the Trilogy and ShockPulse (Figure). High-speed photography illustrates up to 0.04mm tip displacement during ultrasonic movement in the Trilogy relative to 0.02mm in the ShockPulse. Both devices demonstrated about 0.25mm impactor movements. CONCLUSIONS In an in-vitro setting, the novel Lithoclast Trilogy was more efficient than currently available devices at stone clearance. Drill testing revealed no difference between the Trilogy and the ShockPulse. High-speed imaging shows greater displacement in ultrasonic movement of the Trilogy which may explain the observed results. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e921-e922 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Daniel Wollin More articles by this author Evan Carlos More articles by this author Brenton Winship More articles by this author Michael Gustafson More articles by this author Westin Tom More articles by this author Daniela Radvak More articles by this author Ruiyang Jiang More articles by this author Charles Scales More articles by this author Michael Ferrandino More articles by this author W Neal Simmons More articles by this author Glenn Preminger More articles by this author Michael Lipkin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Efficacy of glycine powder air-polishing combined with scaling and root planing in the treatment of periodontitis and halitosis: A randomised clinical study.

IntroductionThis study was performed to evaluate the clinical efficacy of using the Perio-Flow device (Electro Medical Systems, Nyon, Switzerland) adjunctively with mechanical instrumentation on periodontal parameters and halitosis.Materials and MethodsSixty patients who presented with a 4- to 6-mm probing pocket depth were recruited for the study. Patients were randomly assigned to scaling and root planing (SRP) or SRP + glycine powder air-polishing (GPAP). For both groups, the plaque index, gingival index, pocket depth, bleeding on probing, and clinical attachment level scores were recorded at baseline and 1 month. Volatile sulphur compounds (VSCs) were measured by a Halimeter (Interscan Corp., Chatsworth, CA, USA) at baseline, immediately after treatment, and at 7, 14, and 30 days.ResultsBoth groups showed significantly lower plaque index, gingival index, pocket depth, bleeding on probing, and clinical attachment level gain scores at 1 month than at baseline. No significant differences were found between the groups at any time point. The VSCs were significantly different at 1 month compared with baseline in both groups. However, the intergroup comparisons of VSCs were not statistically significant at any time point.ConclusionWithin the limits of this study, SRP is effective for treatment of periodontitis and halitosis. However, using GPAP adjunctively with mechanical instrumentation has no beneficial effects on halitosis or periodontal parameters.

Variable Pulse Duration From a New Holmium:YAG Laser: The Effect on Stone Comminution, Fiber Tip Degradation, and Retropulsion in a Dusting Model

To more clearly define the efficiency and potential benefits of variable pulse-width laser technology for ureteroscopic lithotripsy, we performed comparative in vitro evaluations assessing stone comminution, laser fiber tip degradation, and stone retropulsion. All experiments were conducted using a Swiss LaserClast Holmium:YAG laser (Electro Medical Systems, Nyon, Switzerland) with adjustable pulse duration (300 µs-1500 µs). To assess comminution efficiency and fiber tip degradation, a "dusting" model was employed; the laser fiber tip was moved by a 3-dimensional positioning system in a spiral motion across a flat BegoStone surface submerged in water. Comminution efficiency was measured as the loss of stone mass while fiber tip degradation was measured simultaneously. The same laser and fiber were used in a pendulum model to measure stone retropulsion with a high-speed resolution camera. In our dusting model, comminution was significantly greater at high energy (2 J/5 Hz). At the high energy setting, comminution was significantly greater with long pulse duration than short pulse, although this difference was not seen at the high frequency setting (1 J/10 Hz). Tip degradation was increased at high energy settings and was even more pronounced with short pulse duration than long pulse. Short pulse duration caused far more retropulsion than the long pulse setting. In an in vitro dusting model, a longer laser pulse duration provides effective stone comminution with the advantage of reducing laser fiber tip degradation and stone retropulsion.

Pain perception during debridement of hypersensitive teeth elicited by two ultrasonic scalers

ObjectivesThe ultrasonic NO PAIN technology (Electro Medical Systems, Nyon, CH) promises minimal pain during debridement due to linear oscillating action combined with a sinusoidal power output and feedback control. The aim of the present study was to measure pain perception on a visual analogue scale (VAS) during supportive periodontal therapy including debridement of hypersensitive teeth. Two ultrasonic scalers were used, one with and one without NO PAIN technology.Material and methodsIn a randomized-controlled clinical study with split-mouth design, 100 hypersensitive teeth matched for air blast hypersensitivity were either treated with the ultrasonic device Piezon Master 700 or the Mini Piezon (both EMS, Nyon, CH). Pain perception during debridement was assessed by a VAS (range 0–10).ResultsThe average VAS for the test device Piezon Master 700 with NO PAIN technology was 3.16 ± 2.10, and for the control device Mini Piezon without NO PAIN technology 3.40 ± 2.59 (p = 0.490). Placing an arbitrary threshold at the VAS score of 3 for significant pain experience, 60 % of the subjects experienced no significant pain with either instrument.ConclusionNo statistically significant difference in perceived pain between the instruments used was found.Clinical relevanceBoth ultrasonic devices showed very small pain intensities during debridement of highly hypersensitive teeth and can therefore be recommended for supportive periodontal therapy.

Radial Shock Wave Devices Generate Cavitation.

BackgroundConflicting reports in the literature have raised the question whether radial extracorporeal shock wave therapy (rESWT) devices and vibrating massage devices have similar energy signatures and, hence, cause similar bioeffects in treated tissues.Methods and FindingsWe used laser fiber optic probe hydrophone (FOPH) measurements, high-speed imaging and x-ray film analysis to compare fundamental elements of the energy signatures of two rESWT devices (Swiss DolorClast; Electro Medical Systems, Nyon, Switzerland; D-Actor 200; Storz Medical, Tägerwillen, Switzerland) and a vibrating massage device (Vibracare; G5/General Physiotherapy, Inc., Earth City, MO, USA). To assert potential bioeffects of these treatment modalities we investigated the influence of rESWT and vibrating massage devices on locomotion ability of Caenorhabditis elegans (C. elegans) worms.ResultsFOPH measurements demonstrated that both rESWT devices generated acoustic waves with comparable pressure and energy flux density. Furthermore, both rESWT devices generated cavitation as evidenced by high-speed imaging and caused mechanical damage on the surface of x-ray film. The vibrating massage device did not show any of these characteristics. Moreover, locomotion ability of C. elegans was statistically significantly impaired after exposure to radial extracorporeal shock waves but was unaffected after exposure of worms to the vibrating massage device.ConclusionsThe results of the present study indicate that both energy signature and bioeffects of rESWT devices are fundamentally different from those of vibrating massage devices.Clinical RelevancePrior ESWT studies have shown that tissues treated with sufficient quantities of acoustic sound waves undergo cavitation build-up, mechanotransduction, and ultimately, a biological alteration that “kick-starts” the healing response. Due to their different treatment indications and contra-indications rESWT devices cannot be equated to vibrating massage devices and should be used with due caution in clinical practice.

Temperature rise during removal of fractured components out of the implant body: an in vitro study comparing two ultrasonic devices and five implant types.

BackgroundUltrasonic instrumentation under magnification may facilitate mobilization of screw remnants but may induce heat trauma to surrounding bone. An increase of 5°C is considered detrimental to osseointegration. The objective of this investigation was to examine the rise in temperature of the outer implant body after 30 s of ultrasonic instrumentation to the inner part, in relation to implant type, type of ultrasonic equipment, and the use of coolants in vitro.MethodsTwo ultrasonic devices (Satelec Suprasson T Max and Electro Medical Systems (EMS) miniMaster) were used on five different implant types that were provided with a thermo couple (Astra 3.5 mm, bone level Regular CrossFit (RC) 4.1 mm, bone level Narrow CrossFit (NC) 3.3 mm, Straumann tissue level regular body regular neck 3.3 mm, and Straumann tissue level wide body regular neck 4.8 mm), either with or without cooling during 30 s. Temperature rise at this point in time is the primary outcome measure. In addition, the mean maximum rise in temperature (all implants combined) was assessed and statistically compared among devices, implant systems, and cooling mode (independent t-tests, ANOVA, and post hoc analysis).ResultsThe Satelec device without cooling induces the highest temperature change of up to 13°C, particularly in both bone level implants (p < 0.05) but appears safe for approximately 10 s of continuous instrumentation, after which a cooling down period is rational. Cooling is effective for both devices. However, when the Satelec device is used with coolant for a longer period of time, a rise in temperature must be anticipated after cessation of instrumentation, and post-operational cooling is advised.ConclusionsThe in vitro setup used in this experiment implies that care should be taken when translating the observations to clinical recommendations, but it is carefully suggested that the EMS device causes limited rise in temperature, even without coolant.

Predictability of the individual clinical outcome of extracorporeal shock wave therapy for cellulite.

BackgroundExtracorporeal shock wave therapy has been successfully introduced for the treatment of cellulite in recent years. However, it is still unknown whether the individual clinical outcome of cellulite treatment with extracorporeal shock wave therapy can be predicted by the patient’s individual cellulite grade at baseline, individual patient age, body mass index (BMI), weight, and/or height.MethodsFourteen Caucasian females with cellulite were enrolled in a prospective, single-center, randomized, open-label Phase II study. The mean (± standard error of the mean) cellulite grade at baseline was 2.5±0.09 and mean BMI was 22.8±1.17. All patients were treated with radial extracorporeal shock waves using the Swiss DolorClast® device (Electro Medical Systems, S.A., Nyon, Switzerland). Patients were treated unilaterally with 2 weekly treatments for 4 weeks on a randomly selected side (left or right), totaling eight treatments on the selected side. Treatment was performed at 3.5–4.0 bar, with 15,000 impulses per session applied at 15 Hz. Impulses were homogeneously distributed over the posterior thigh and buttock area (resulting in 7,500 impulses per area). Treatment success was evaluated after the last treatment and 4 weeks later by clinical examination, photographic documentation, contact thermography, and patient satisfaction questionnaires.ResultsThe mean cellulite grade improved from 2.5±0.09 at baseline to 1.57±0.18 after the last treatment (ie, mean δ-1 was 0.93 cellulite grades) and 1.68±0.16 at follow-up (ie, mean δ-2 was 0.82 cellulite grades). Compared with baseline, no patient’s condition worsened, the treatment was well tolerated, and no unwanted side effects were observed. No statistically significant (ie, P<0.05) correlation was found between individual values for δ-1 and δ-2 and cellulite grade at baseline, BMI, weight, height, or age.ConclusionRadial shock wave therapy is a safe and effective treatment option for cellulite. The individual clinical outcome cannot be predicted by the patient’s individual cellulite grade at baseline, BMI, weight, height, or age.

UP-03.096 Minimally Invasive Endourologic Management of Calculi in Continent Urinary Reservoirs: Experiences Using the Swiss Lithoclast® Master

Continent urinary diversion (CUD) is used in various benign and malignant conditions. Among long-term complications is the development of calculi in the reservoir. The endoscopic treatment is often time consuming and repeated procedures are frequently required to obtain clearance of stone material, especially when the stone burden is large. In a consecutive series of patients with large stone burden in CUD we evaluate the use of the Swiss Lithoclast Master® (SLM), Electro Medical Systems, Nyon, Switzerland.

Performance of Ultrasonic Retrograde Systems

The aim of this study was to evaluate variations in power output of different Piezon-Master 400 (Electro Medical Systems, Nyon, Switzerland) ultrasonically driven generators and analytic handpieces at a range of power settings. A scanning laser vibrometer was used to measure the maximum vibration displacement amplitude of a KiS 2D tip. Ten repeat scans were made of the unloaded tip oscillation at six power settings. Data were acquired from four different generators and handpieces. Linear trend lines fitted to all tip data showed that none of the generator/handpiece combinations produced a linear increase in tip displacement amplitude with increasing power setting. A univariate analysis of variance (general linear model) showed that generator, handpiece, and power were all significant variables (p<0.0001). This study showed that there is significant variability in the power output between generators, and not all Analytic handpieces performed consistently when compared with each other.

Light-curing time reduction with a new high-power halogen lamp

Orthodontic brackets are routinely bonded with light-cured adhesives. Conventional halogen lights used in bonding have the disadvantage of a long curing time, and the available alternatives (laser and plasma lights) are expensive. Our aim was to investigate the minimum time necessary to bond brackets with a new, relatively low-priced, high-power halogen light. Five groups of 15 deciduous bovine incisors were bonded with stainless steel brackets (Mini Diamond Twin, Ormco, Orange, Calif) by using different lamps and curing times. Three of the groups were bonded by using a high-power halogen light (Swiss Master Light, Electro Medical Systems, Nyon, Switzerland) for 2, 3, and 6 seconds, respectively. The fourth group, bonded with a fast halogen light (Optilux 501, Sybron Dental Specialties, Danbury, Conn) for 40 seconds, served as the positive control group. The fifth group, the comparison group, was bonded with a plasma light (Remecure, Remedent, Deurle, Belgium) for 4 seconds. After storage for 24 hours in the dark at 37 degrees C in water, shear bond strength was measured with a universal testing machine. A curing time of 2 seconds with the high-power halogen light negatively affected the bond strength and the probability of bond survival. The adhesive remnant index scores were not significantly different among the groups. Most failures (> 60%) occurred at the bracket base/adhesive interface. The high-power halogen light seems to be a cost-effective solution to reducing curing time. The recommended curing times to bond stainless steel brackets are 6 seconds and, with caution, even 3 seconds.

A new insight into the oscillation characteristics of endosonic files used in dentistry

The aim of this study was to assess the oscillation characteristics of unconstrained endosonic files using a scanning laser vibrometer (SLV). Factors investigated included file vibration frequency and node/antinode location as well as the variation in file displacement amplitude due to increasing generator power setting. A 30 kHz Mini Piezon generator (Electro-Medical Systems, Switzerland) was used in conjunction with a #15 and #35 K-file. Each file was fixed in position with the long axis of the file perpendicular to the SLV camera head. The laser from the SLV was scanned over the length of the oscillating file for generator power settings 1 to 5 (minimum to half power). Measurements were repeated ten times. The fundamental vibration frequency for both files was 27.50 kHz. Scans of each file showed the positions of nodes/anti-nodes along the file length. The #15 file demonstrated no significant variation in its mean maximum displacement amplitude with increasing generator power, except at power setting 5, where a decrease in displacement amplitude was observed. The #35 file showed a general increase in mean maximum displacement amplitude with increasing power setting, except at power setting 4 where a 65% decrease in displacement amplitude occurred. In conclusion, scanning laser vibrometry is an effective method for assessing endosonic file vibration characteristics. The SLV was able to demonstrate that (unloaded) file vibration displacement amplitude does not increase linearly with increasing generator power. Further work is being performed on a greater variety of files and generators. Vibration characteristics of files under various loads and varying degrees of constraint should also be investigated.

Clinical experience with a new ultrasonic and LithoClast combination for percutaneous litholapaxy.

To assess a new lithotripter for intracorporal lithotripsy, which combines the mechanically driven pneumatic LithoClast (Electro-Medical Systems, Nyon, Switzerland) and a new ultrasonic device (Electro-Medical Systems), for use in percutaneous nephrolitholapaxy (PNL). The new lithotripter consists of a LithoClast Master with 12 Hz repetition rate and a new ultrasonic device. The 1.0 mm LithoClast probe is advanced off-centre through the hollow 3.3 mm ultrasonic probe and protrudes about 1 mm. A new irrigation system with a pinch valve compressing the irrigation tube, a foot-switch for activating the ultrasound, the LithoClast and both together, and a stone bucket at the outlet tube are new features. Between February 1999 and August 2001, 68 patients were treated by PNL with the new device; 35 had complete and 33 had partial staghorn calculi. PNL was administered under fluoroscopic control and with the patient prone. The mean (range) duration of surgery was 61 (42-119) min. The complete stone-free rate was 66% after the first PNL; of the 68 patients, 16 received a second PNL, giving a final stone-free rate of 76% and 80%. The stone was composed of calcium oxalate monohydrate (COM) in 13%, COM with uric acid in 35%, apatite in 20% and cystine in 11%. Clinically the new lithotripter was very effective, producing smaller stone particles and thus fewer residual stone fragments after PNL than with the LithoClast or ultrasonic fragmentation alone. The new lithotripter provides easily managed and highly effective stone fragmentation of all stones, regardless of their composition.