Erbium Laser Research Articles

Surgical Management of Moderate Rhinophyma with Nasal Nodules: An Electrosurgery Approach

Introduction: Rhinophyma, a severe manifestation of rosacea, is characterized by hypertrophy of sebaceous glands and fibrosis of the nose, often leading to significant aesthetic and functional impairments. Surgical treatment is the preferred approach for advanced cases to restore nasal appearance and function. Case Report: We present the case of a 60-year-old man with moderate rhinophyma and nodules on the nostrils. Surgical management under local anesthesia involved the use of thermal loops for excision of the lesions and bipolar electrosurgery for hemostasis. The patient was also treated for rosacea with topical agents, including metronidazole and azelaic acid, and oral doxycycline for inflammatory lesions. Directed healing followed the surgery, along with LED phototherapy and ablative erbium laser sessions to optimize results. Discussion: The use of thermal loops and electrosurgery allowed for precise excision and control of bleeding. Postoperative care, including daily greasy vaseline dressings, facilitated rapid healing. Mild infection at the excision sites was treated with topical and prophylactic antibiotics. Six sessions of LED therapy combining four types of light (infrared, red, yellow, and blue) improved healing and reduced inflammation. Ablative erbium laser was proposed to further enhance the aesthetic outcome. Conclusion: A combined surgical approach and careful postoperative management yielded satisfactory results in the treatment of rhinophyma.

SEM comparison of hard tissue preparations by erbium lasers

SEM comparison of hard tissue preparations by erbium lasers

Vaginal erbium laser versus pelvic floor exercises for the treatment of pelvic organ prolapse: A randomised controlled trial

ObjectivesTo compare the efficacy of Er:YAG laser for mild to moderate pelvic organ prolapse (POP) to that of pelvic floor exercises (PFE). DesignSingle center randomised controlled trial. SettingTertiary center, Belgium. ParticipantsForty-six women with mild to moderate prolapse were enrolled (23 in each group). There were no missing data for the primary outcome; three patients were lost to follow-up at 24-months. InterventionsComparison of vaginal laser treatment (3–6 applications) to PFE (9–18 sessions). Main outcome measuresSubjective change in prolapse symptoms at four months from baseline measured by the Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6) (primary), adverse events, other subjective outcomes and independent anatomical assessment up to 24 months. ResultsThe mean difference in POPDI-6 scores at 4 months was 1.09 (95 %CI = −6.02;8.12), showing non-inferiority of laser to PFE (p = 0.004). Within groups, the difference in mean POPDI-6 four months following the start of therapy tended to be lower for laser-treatment (65.2 % (15/23) of laser-participants were ‘better’ or ‘much better’) than for PFE (60.9 % (14/23) in the PFE group), yet without difference between groups (OR = 1.21; 95 %CI = 0.39–3.23). There were no obvious between group differences in any other subjective nor objective outcomes. At 24 months, 50 % (11/22) of laser-patients and 43 % (9/21) of PFE-patients requested additional, yet alternative treatment. There were no serious adverse events at any time-point. ConclusionsVaginal laser application and PFE improve symptoms of mild and moderate prolapse to a similar extent. Both treatments had a measurable yet not durable effect. There were no adverse events in either arm. Trial registrationClinicalTrials.gov(NCT04523298) FundingThe laser device was provided by Fotona, Slovenia for the duration of this trial.

Evaluating the Impact of Modern Laser Technologies on Dentistry in European Union Countries

Introduction: In dentistry, understanding laser wavelength interactions with oral tissues enhances patient management. Over two decades, lasers have been used in dental practices for diagnostics, caries detection, calculus identification, hard tissue cutting, and root canal disinfection. They reduce patient anxiety and the need for anesthesia in hard tissue applications Aim. The objective of this research is to provide a review on how European dentistry has been affected by the use of modern laser technology between 2020 and 2024. This was done by classifying the types of lasers, examining their uses in different dental treatments, investigating the problems that may arise as a result, and appraising the benefits for oral health and patient outcomes. Methods: A systematic literature review was conducted from 2020 to 2024, focusing on modern laser technologies in dentistry within European countries. Using the PRISMA flow diagram, studies were identified, screened, and included based on keywords related to dentistry and laser technologies. Initial searches identified 17,130 records, narrowed down to 27 relevant studies through various criteria. Inclusion required studies to focus on dental laser applications in specified European countries, published between 2020 and 2024, and be peer-reviewed. Results: The review covered studies from 2020 to 2024, highlighting various dental specialties and laser technologies like Erbium, CO2, Diode, Nd, Excimer, and Fiber lasers. Findings indicated lasers improved precision, reduced discomfort, and enhanced patient outcomes with minimal postoperative pain and faster recovery times. Noted risks included thermal damage and specific complications like bleeding and pain. Conclusions: The review highlights lasers' transformative potential in EU dental care, offering precision and improved outcomes. Future research should standardize protocols, assess long-term benefits and risks, focus on safety, and integrate patient-centered outcomes to enhance the evidence base supporting laser technologies in routine dental care.

Discrete Mathematics in Dynamic Network Analysis: Long-Term Efficacy Evaluation of Fotona Laser Therapy for Overactive Bladder Syndrome Using Clustering-Based Patient Subgroup Identification.

Dynamic network analysis, a state-of-the-art application of discrete mathematics, offers unprecedented insight into complex, time-evolving clinical data. This technical report demonstrates the value of evaluating the long-term efficacy of Fotona laser therapy (Fotona d.o.o., Ljubljana, Slovenia) in overactive bladder (OAB) syndrome. We analyzed data from 101 female patients aged ≥60 years who underwent Fotona laser treatment, including Vaginal Erbium Laser (VEL) and Urethral Erbium Laser (UEL), between 2020 and 2022. OAB symptom scores (OABSS) were collected at baseline (T0) and at six, 12, 18, and 24 months post treatment. Network graphs were constructed, representing patients as nodes, and symptom similarities as edges. Clustering techniques identify patient subgroups, whereas principal component analysis reduces dimensionality. The dynamic evolution of patient clusters was visualized through changes in average degree centrality over time. This approach revealed three distinct patient clusters with unique treatment response patterns. The results showed a progressive reduction in OABSS, with the total score decreasing by 2.82 ± 3.03 at 24 months. Our method provides novel visualization and analysis of complex longitudinal clinical data, offering insights into personalized treatment strategies for OAB. This report presents one of the first applications of discrete mathematics and dynamic network analysis to evaluate the long-term outcomes of Fotona laser therapy for OAB and introduces an innovative perspective for clinical decision-making in urogynecology.

Hepta-cross-ring based erbium laser with stable single-mode oscillation in L-band range

In this research, a hepta-cross-ring based erbium-doped fiber (EDF) laser is designed and studied to achieve continuous-wave (CW) and single-longitudinal-mode (SLM) tunability in L-band region. The hepta-cross-ring design can introduce the mode-filter function caused by the Vernier effect to effectively suppress dense multi-longitudinal-mode (MLM). Due to the L-band erbium gain medium, the wavelength-tuning range of the fiber laser is achieved from 1567.6 to 1612.0 nm. Furthermore, the output implementations of optical signal to noise ratio (OSNR), corresponding power, stability and wavelength linewidth in the proposed fiber laser are also measured and discussed.

A comparison of surgical scar treatment using various combinations of autologous fat, hyaluronic acid and resurfacing with the 1540 nm non-ablative Erbium laser – a prospective pilot study

ABSTRACT Scars can cause aesthetic or functional disturbance. Several interventions had been described to improve their appearance. We propose that the combination of some of those treatments can synergize their effects on the scar. We designed a prospective pilot study with ten patients using the patient as their own control to compare different interventions. In each patient, the scar was divided into four parts treated differently: 1. No treatment (control), 2. Fat grafting only, 3. Fat grafting and Hyaluronic Acid (HA), 4. Fat grafting, HA and with a non-fractional laser. Each part of the scar was evaluated by the Patient and Observer Scar Assessment Scale (POSAS). Treatment of the scar with the combination of the three modalities showed better results in the observer scale. In addition, a combination of fat injection, HA, and subsequent skin resurfacing with non-ablative laser showed better outcomes for all parameters on the Observer Scale except vascularity, while on the Patient Scale thickness, relief, pliability, surface area, and overall measurement were better. The combination of all three treatments tends to improve scarring results and appears to be safe and effective. However, further studies with larger samples are needed to explore the potential use of this combined treatment.

Intradermal Delivery of Calcium Hydroxylapatite With Fractionated Ablation.

The absorption of biostimulatory particulate matter following its application to fractional skin defects remains poorly understood, and even less is known about its in vivo impact in terms of tissue integration. The objectives of this study are twofold: (1) to evaluate the potential of calcium hydroxylapatite (CaHA) to penetrate through skin treated with a fractional laser; and (2) to assess the effectiveness of clinical laser scanning microscopy technologies in monitoring the effects of such treatment over time. One area on a volunteer's arm was treated with a fractional erbium laser (Sciton Inc., Palo Alto, CA), while a second area received the same laser treatment followed by CaHA topical application. We used reflectance confocal microscopy (RCM) and multiphoton microscopy (MPM) to noninvasively image beneath the surface of the treated skin to study and monitor the effects of these treatments within 1 h of treatment and at four additional time points over a 6-week period. One hour posttreatment, at different depths beneath the skin surface, MPM and RCM provided similar visualizations of laser-induced channels. In skin treated by both laser and CaHA, these two imaging methods provided complementary information. RCM captured the lateral and depth distribution of CaHA microspheres and were seen as bright spheres as they became incorporated into the healing tissue. MPM, meanwhile, visualized the CaHA microparticles as dark shadow spheres within the laser-induced channels and encroaching healing tissue. Furthermore, MPM provided critical information about collagen regeneration around the microspheres, with the collagen visually marked by its distinct second harmonic generation (SHG) signal. This observational pilot study demonstrates that CaHA, a collagen stimulator used as a dermal filler, can not only be inserted into the dermis after fractional laser treatment but remains in the healing skin for at least 6 weeks posttreatment. The noninvasive imaging techniques RCM and MPM successfully captured the presence of CaHA microspheres mid-dermis during the healing phase. They also demonstrated new collagen production around the microspheres, highlighting the effectiveness of these imaging approaches in monitoring such treatment over time.

ATR-FTIR spectroscopy imaging of bone repair in mandibular laser-osteotomy.

The aim of this study was to verify the effectiveness of attenuated total reflectance-fourier transform infrared (ATR-FTIR) spectroscopy in the characterization of bone repair in mandibular osteotomy using erbium, chromium-doped yttrium, scandium, gallium and garnet (Er,Cr:YSGG) laser and multilaminate drill on each side. Two mandible bone fragments were removed from 30 rabbits, and the process of bone repair was studied immediately, 3, 7, 15, 21, and 28 days after the surgery. The histological analysis allowed detecting differences in the early stages of tissue repair after bone cutting performed with the Er,Cr:YSGG laser or multilaminate drill. The ATR-FTIR spectroscopy technique was sensitive to changes in the organic content of bone tissue repair process.

Comparative effects of the conventional, ultrasonic, and laser-activated irrigation on penetration depth of three photosensitizers in the root canal system

ObjectivesThis study compared the effects of conventional, ultrasonic, and laser-activated irrigation (LAI) on penetration depth of three photosensitizers (PSs) in the root canal system. Materials and MethodsIn this in vitro, experimental study, 120 extracted anterior teeth were decoronated such that the remaining root length was standardized at 12 mm. After root canal instrumentation with the ProTaper rotary system and irrigation with 5.25% NaOCl, the roots were assigned to 12 groups for the application of toluidine blue (TB), curcumin, and phycocyanin PSs combined with the LAI using erbium laser with 0.4 mm and 0.6 mm tips, ultrasonic activation, and conventional irrigation. The specimens were sectioned apicocoronally, and the dye penetration depth was quantified in the coronal, middle, and apical thirds under a stereomicroscope at x20 magnification. Data were analyzed by the Kruskal-Wallis and Dunn test (alpha=0.05). ResultsThe effects of irrigation technique, PS type, and their interaction on dye penetration depth were significant at the apical, middle, and coronal thirds (P < 0.0001). TB + LAI with 0.4- and 0.6-mm laser tips showed the highest penetration depth while phycocyanin + LAI or conventional irrigation showed the lowest penetration depth at all areas. Dye penetration depth was the highest in the coronal, and the lowest in the apical third. ConclusionThe LAI technique with erbium laser (0.4- and 0.6-mm tips) enhanced the penetration depth of TB. The tested irrigation techniques had no significant efficacy for enhancement of the penetration depth of curcumin and phycocyanin.

A Comparative Study on the Safety and Efficacy of Erbium Laser Therapy Versus Traditional Treatments in Managing Dentin Hypersensitivity: An Observational Study.

Background This study aimed to explore the potential efficacy and safety of laser therapy compared with traditional desensitizing treatments in the management of dentin hypersensitivity. Methodology A comprehensive observational study was conducted on 138 adult individuals aged 18-65 diagnosed with dentin hypersensitivity. Participants were allocated to either the laser therapy or traditional treatment group. The laser therapy group received treatment using the Fotona LightWalker® Erbium laser at 2,940 nm. The energy density was set at 20 J/cm² using continuous and contact modes, with the laser tip held perpendicularly to the irradiated site. Each session lasted five minutes, conducted bi-weekly for three months. Traditional treatment included the in-office application of 5% sodium fluoride varnish application once every 15 days for three months and the use of desensitizing toothpaste as part of regular oral hygiene routines. Follow-up assessments were conducted 6 and 12 months post-treatment to evaluate the longevity and stability of the treatment effects. Primary outcomes were assessed by dentin hypersensitivity reduction measured using Visual Analog Scale (VAS) scores and tactile hypersensitivity assessments. Results Laser therapy consistently surpassed traditional treatment in reducing dentin hypersensitivity, as reflected by the significantly lower VAS scores. Notably, at 3, 6, and 12 months, laser therapy demonstrated mean VAS scores of 2.5 (±1.5), 1.2 (±0.9), and 0.6 (±0.5), respectively, while the traditional treatment group exhibited higher scores (3.8 ± 1.2, 4.5 ± 1.0, and 4.0 ± 0.7, respectively). Statistical analysis revealed that these differences were highly significant (p < 0.001). Tactile hypersensitivity assessments echoed these findings, with laser therapy consistently maintaining lower scores (0.8 ± 0.7 at 6 months, 0.4 ± 0.3 at 12 months) compared to traditional treatment (3.5 ± 1.0 at 6 months, 4.0 ± 0.7 at 12 months) with statistical significance at all time points (p < 0.001). Conclusions Although this study lacks a randomized controlled design, the observed substantial reduction in VAS scores and tactile hypersensitivity assessments, along with the favorable safety profile of laser therapy, suggest its potential as an effective alternative for managing dentin hypersensitivity.

Comparative Evaluation of Clinical and Microbiological Assessment of Caries Excavation Using Conventional, Smart Bur, Chemomechanical Method and ErCr:YSGG Laser

ABSTRACT Objectives: Caries removal efficacy in terms of microbiological burden using Tungsten Carbide Bur No. 330, Polymer bur, BRIX 3000, and ErCr:YSGG Laser. Methods: Class I open dentinal caries was selected and divided into four groups (n = 15) depending on caries excavation methods. Group I: Tungsten carbide (TC) No 330-bur; Group II: Polymer bur (Smart bur); Group III: Brix 3000 gel; Group IV: Erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er:Cr:YSGG) laser. Two samples of carious material, before and after caries excavation, were taken and cultured on blood agar plates. Multiple comparison of mean CFUs/ml between different groups was done using Dunn’s post hoc test and Wilcoxon signed-rank test. Results: Group I showed significantly lesser mean CFUs/ml followed by Group IV as compared to Group II and Group III. Conclusion: Within the parameters and limitations of the present study, ErCr:YSGG laser can be a helpful aid as a minimally invasive method of caries excavation.

Clinical and Radiographic Evaluation of Diode and Er,Cr:YSGG Lasers as an Alternative to Formocresol and Sodium Hypochlorite for Pulpotomy Techniques in Primary Molars: A Randomized Controlled Clinical Trial.

Background Pulpotomy treatment is one of the vital pulp therapies that can play a major role in the preservation of primary teeth until their natural exfoliation. The objective of this current clinical trial was to assess the clinical and radiographical success of diode and Er,Cr:YSGG lasers as a viable alternative to formocresol (FC) and sodium hypochlorite in the primary molar pulpotomies. Materials and methods Sixty primary molars were selected and randomly allocated to four groups. All treatment groups followed the same clinical protocol, except for the techniques used for hemostasis of the pulpotomy sites. In group A, hemostasis was achieved by applying a 1:5 dilution of FC solution, whereas in group B, 3% sodium hypochlorite was applied to achieve hemostasis. In group C, exposure to a diode laser of 940 nm was performed, whereas for group D, erbium laser irradiation with Er,Cr:YSGG laser of 2,780 nm was employed to achieve hemostasis. Radicular pulp stamps were covered with a 2 mm layer of mineral trioxide aggregate (MTA) paste. Stainless steel crowns were utilized for the final restorations of the primary teeth. The clinical and radiographic outcomes were evaluated at the six- and 12-month follow-up intervals. The investigation was registered with the ClinicalTrials.gov Protocol and Registration System (ID: NCT06002646). Results The overall clinical and radiographic success rates of pulpotomy were 92.3% for FC, 89% for sodium hypochlorite, 98.3% for a diode laser, and 98.7% for Er,Cr:YSGG lasers. There were no statistically significant differences among the four groups (p > 0.05). Conclusions Both the diode and Er,Cr:YSGG lasers showed outcomes comparable to those of FC and sodium hypochlorite. Therefore, they could be promising alternatives to primary tooth pulpotomies.

Effect of Er:YAG laser on debonding zirconia and lithium disilicate crowns bonded with 2- and 1-bottle adhesive resin cements.

Erbium-doped yttrium-aluminum-garnet (Er:YAG) laser debonding of zirconia and lithium disilicate restorations is increasingly used for a range of clinical applications. Using rotary instruments to remove such restorations for any purpose has proven to be challenging. Erbium laser has been reported to be a conservative method for removing ceramic restorations. There is little data in the literature about the effect of adhesive resin cement type on the debonding time of the ceramic restoration using the Er:YAG laser. To evaluate and compare the time required for the Er:YAG laser to debond zirconia and lithium disilicate crowns bonded with a 2- and 1-bottle adhesive resin cement systems. Forty extracted premolar teeth were prepared and scanned for milled 40 CAD/CAM crowns. Teeth were randomly assigned into groups (n = 10 per group): 3 mol% yttria-partially stabilized zirconia crowns 3Y-PSZ (G1a) bonded with Panavia™ V5 (2-bottle adhesive resin cement), Zirconia 3Y-PSZ crowns (G1b) bonded with RelyX™ Ultimate (1-bottle adhesive resin cement), and for the lithium disilicate crowns bonded with the two types of cements (G2a, G2b). Each specimen was irradiated with an Er:YAG laser at 335 mJ, 15 Hz, 5.0 W, and 50-ms pulse duration (super short pulse mode). The irradiation time required for crowns to be successfully debonded was recorded for each specimen. Data were statistically analyzed using ANOVA and Tukey HSD post-hoc test (p < 0.05), at the 95 percent level of confidence. The intaglio surface of the debonded crown was analyzed using scanning electron microscopy (SEM). The mean ± standard deviation times needed for crown debonding were 5.75 ± 2.00 min for the G1a group, 4.79 ± 1.20 min for group G1b, 1.69 ± 0.49 min for group G2a, and 1.12 ± 0.17 for group G2b. There was no statistically significant difference in debonding time between the 2- and 1- bottle adhesive resin cement within the groups G1a and b (p = 0.2914), or between groups G2a b (p = 0.7116). A statistically significant difference (p < 0.05) was found between groups G1a and G2a and b and between groups G1b and G2a and b were SEM analysis showed no changes in the microstructure of the ceramic surface after Er:YAG laser irradiation. Zirconia and lithium disilicate restorations can be debonded using Er:YAG lasers in a safe and efficient manner. There is no significant difference in the debonding time between the 2- and 1- bottle adhesive resin cement systems used in this study. Retrieving zirconia and lithium disilicate ceramics can be a challenging process when using diamond rotary instruments. ER:YAG lasers may efficiently debond these ceramics from the tooth structure, independent of the bonding process used for bonding them.

The effectiveness of erbium laser in the treatment of apical periodontitis: results of clinical observation.

This article demonstrates a clinical case of successful therapeutic treatment of a 43-year-old patient diagnosed with chronic granulomatous periodontitis of tooth 2.4 (K04.5). The patient voluntarily signed informed consent to treatment and publication of personal medical information. Repeated endodontic treatment was carried out, including the infilling of the tooth and the formation of the root canal with K-, H-files and the ProTaper system. Distilled water was used as an irrigant. An Er,Cr:YSGG laser with a wavelength of 2780 nm and a power of 1.5 W was used to disinfect the root canals. Clinical and radiological follow-up was carried out after 6 and 12 months based on CBCT data and the periapical COPI. As a result of a 12-month follow-up, complete restoration of the periapical tissues was achieved. Long-term results indicate the effectiveness of repeated endodontic treatment using an Er,Cr:YSGG laser with a wavelength of 2780 nm.

Clinical experience of using a high-intensity erbium laser for the treatment of chronic wounds

Chronic wounds are a common surgical pathology. Some types of laser radiation allow for eff ective debridement of wounds and stimulation of healing processes. High-intensity erbium laser can comprehensively aff ect tissues in all phases of the wound process, leading to accelerated healing of chronic wounds. The aim of the study was to evaluate the eff ectiveness of using high-intensity erbium laser for treating patients with chronic wounds of various origins compared to traditional treatment. Material and methods: An analysis of the treatment of 144 patients with chronic wounds was conducted in two groups. In the 1st group (n = 71), a high-intensity erbium laser and dressings with water-soluble ointments were used. In the 2nd group (n = 73), standard surgical treatment with similar dressings was performed. Results were evaluated using visual assessment of wound defects, planimetry, bacteriological and cytological studies, assessment of procedure tolerability, and pain intensity before and after treatment. Results: рatients in the 1st group showed signs of healing signifi cantly earlier and more frequently achieved complete epithelialization of wounds. Laser treatment contributed to more effective decontamination of wound defects, and signs of tissue regeneration were more frequently observed in cytological images. Patients tolerated erbium laser treatment better than surgical treatment, although pain intensity after treatment did not differ between groups. Conclusion: The study confi rmed the effectiveness of using high-intensity erbium laser for treating chronic wounds. This method can be recommended for use in surgical practice alongside other technical and pharmacological tools.

A regenerative approach for temporomandibular joint repair: An invitro and exvivo study.

Current clinical approaches to regenerate temporomandibular joint (TMJ) articulating cartilage defects only treat the symptoms (i.e. pain and dysfunction) and do not seek to restore joint integrity for long-term relief. Therefore, we investigated a novel self-assembling tissue-engineered cartilage to overcome this significant clinical issue for TMJ regenerative purposes. Examine the maturation of dynamic self-regenerating cartilage (dSRC) using auricular chondrocytes and evaluate a novel combinatorial approach with fractional laser treatment and dSRC implantation for TMJ cartilage repair. A suspension of 107 freshly harvested rabbit ear chondrocytes was cultured under a continuous reciprocating motion to form the dSRC. After 2, 4 and 8 weeks of culture, dSRC samples were stained with H&E, Safranin-O and Toluidine Blue. Immunohistochemistry (IHC) was performed for collagens type I and II. Channels (300-500 μm diameter and 1.2-1.5 mm depth) were created in six freshly harvested condyles using a fractional Erbium laser. Two groups were tested: dSRC in a laser-ablated lesion (experimental) and an empty laser-ablated channel (control). TMJ condyles were cultured for up to 8 weeks and analysed as described above. H&E staining showed a high cell density in dSRC compared to native cartilage. All dSRC groups demonstrated intense Safranin-O staining, indicating high glycosaminoglycan (GAG) production and intense Toluidine Blue staining showed high proteoglycan content. IHC confirmed that dSRC consisted predominantly of collagen type II. The experimental group showed improved cartilage repair at both time points compared to the empty channels. dSRC viability and successful matrix formation were demonstrated invitro. The combination of fractional laser ablation and dSRC implantation enhanced cartilage repair.

The Effect of the Water Flow Rate During Laser Irradiation on the Bond Strength of Glass Fiber Posts

Objective: This study aimed to investigate the effect of the water flow rate during laser irradiation on the bond strength of GFRC posts. Background: Due to the ablation mechanism, water molecules must be present in the target tissue for effective results with erbium lasers. Materials and methods: Sixty glass fiber posts were divided into six equal groups: control groups, sandblasting with 30 μm Al2O3 particles, 9.5% hydrofluoric acid (HF), and three different flow rates (1%, 50%, and 100%) laser groups (n = 10). Resin cement was applied to the surfaces of the fiber posts. Then, 1 mm thick sections were taken from each specimen and micro tensile bond strength test was applied. The data obtained were statistically analyzed by a one-way analysis of variance and Tukey’s HSD test. Results: According to the statistical analysis results, there was a significant difference between the bond strength values of all the groups (P &lt; 0.001). The highest bonding value was obtained in the sandblasted group (12.25 ± 0.38) and the lowest in the control group (5.64 ± 0.6). After sandblasting, the highest value was observed in the laser applied group (10.57 ± 0.64) at 100% flow rate. Conclusions: As the water flow rate decreases in laser applications, the bond strength between the fiber post and resin cement decreases.

Innovative decision making tools using discrete mathematics for stress urinary incontinence treatment.

In this study, we applied graph theory to clinical decision-making for Stress Urinary Incontinence (SUI) treatment. Utilizing discrete mathematics, we developed a system to visually understand the shortest path to the desired treatment outcomes by considering various patient variables. Focusing on women aged 35-50, we examined the effectiveness of Tension-free Vaginal Tape (TVT) surgery and Vaginal Erbium Laser (VEL) treatment for over 15years. The TVT group consisted of 102 patients who underwent surgery using either the Advantage Fit mid-urethral sling system (Boston Scientific Co., MA, USA) or the GYNECARE TVT retropubic system (Ethicon Inc., NJ, USA). The VEL group included 113 patients treated with a non-ablative Erbium: YAG laser (FotonaSmooth™ XS; Fotona d.o.o., Ljubljana, Slovenia), and there were 112 patients in the control group. We constructed a network diagram analyzing the correlations between health, demographic factors, treatment methods, and patient outcomes. By calculating the shortest path using heuristic functions, we identified significant correlations and treatment effects. This approach supports patient decision making by choosing between TVT and VEL treatments based on individual objectives. Our findings provide new insights into SUI treatment, highlighting the value of a data-driven personalized approach for clinical decision-making. This interdisciplinary study bridges the gap between mathematics and medicine, demonstrating the importance of a data-centric approach in clinical decisions.

The Potential of Non-ablative Erbium (YAG) Laser Treatment for Complications After Midurethral Sling Surgery: A Narrative Review.

Midurethral sling (MUS) surgery, using tension-free vaginal tape and transobturator tape, has been widely adopted for the treatment of stress urinary incontinence (SUI). However, postoperative complications, including persistent urinary incontinence, mesh exposure, and pain, have become problematic, and surgical treatments for these complications face challenges, such as invasiveness, treatment-resistant cases, and recurrence. This review provides an overview of the current evidence regarding these complications and the potential of vaginal non-ablative erbium (YAG) laser (VEL) treatment as a minimally invasive option with low risk of complications. Studies have suggested the effectiveness of VEL treatment, performed using devices such as IncontiLase (SP Dynamis; Fotona d.o.o., Ljubljana, Slovenia), for persistent urinary incontinence after MUS surgery, pain following mesh removal, and asymptomatic mesh exposure. VEL treatment is expected to be a new treatment option for complications following MUS surgery; however, further large-scale comparative trials are required to verify its efficacy and safety and to establish criteria for its indications. Appropriate assessment of the indications and provision of sufficient information to patients is important when presenting VEL as a treatment option.