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ABSTRACT Purpose: This study aimed to evaluate the long-term safety and efficacy of neodymium-doped yttrium aluminum garnet (Nd:YAG) vitreolysis for symptomatic vitreous floaters as it remains a controversial procedure due to insufficient robust evidence in the literature for the maintenance of the results and absence of adverse effects. Methods: This is an observational extension to the previously presented prospective, randomized, double-blind clinical trial. Eight of thirteen subjects who underwent vitreolysis with YAG laser returned for a late reevaluation, 18 months after the procedure, to evaluate the efficacy and safety of the procedure. Results: All patients maintained the improvement in symptomatology noted after the procedure, with 25% showing complete improvement and a similar proportion (37.5%) reporting significant or partial improvement. Objective improvement in opacity was similar to that found at 6 months follow-up. The NEI-VFQ 25 quality of life questionnaire showed no statistically significant difference in responses between the 6th and 18th month. No adverse effects were noted on clinical examination or reported by patients. Conclusion: Vitreolysis efficacy observed at 6 months of follow-up was maintained until the eighteenth month, with all patients reporting improvement from the pre-procedure state. No late adverse effects were noted. A larger randomized clinical trial is needed to confirm the safety of the procedure.

RESUMO Objetivos: Avaliar a segurança e eficácia a longo prazo da vitreólise com Nd:YAG laser para moscas volantes sintomáticas, uma vez que permanece como um procedimento controverso devido a falta de evidência científica robusta sobre a manutenção dos resultados e ocorrência de efeitos adversos. Métodos: Este estudo é uma extensão observacional de um ensaio clínico prospectivo, randomizado, duplo cego, previamente publicado. Oito de treze pacientes que foram submetidos a vitreólise com YAG laser foram acompanhados para uma reavaliação tardia, dezoito meses após o procedimento, para avaliar a eficácia e segurança do procedimento. Resultados: Todos os pacientes mantiveram a melhora na sintomatologia notada ao final do procedimento original, com 25% dos casos apresentando melhora completa, e uma proporção semelhante (37,5%) demonstrando melhora significativa ou parcial. A melhora objetiva na opacidade foi similar ao achado no seguimento original de 6 meses. O questionário de qualidade de vida NEI-VFQ 25 não demonstrou diferença estatisticamente significativa nas respostas entre o sexto e o décimo oitavo mês de acompanhamento. Nenhum efeito adverso foi notado no exame clínico ou reportado pelos pacientes. Conclusão: A eficácia da vitreólise observada ao sexto mês do acompanhamento foi mantida até o décimo oitavo mês, com todos os pacientes notando algum grau de melhora quando comparado ao estado pré procedimento. Nenhum efeito adverso tardio foi notado. Um ensaio clínico randomizado maior é necessário para confirmar a segurança do procedimento.

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Abstract This study aimed to evaluate the influence of the Er,Cr:YSGG irradiation and 980-nm diode lasers on the surface roughness (SR) and volume loss (VL) of dentin subjected to cariogenic challenge. Subsequently, 130 specimens of bovine dentin were divided into the following 13 groups: NT: no treatment; FG: fluoride gel; FV: fluoride varnish; Di: 980-nm diode; Di + FG; Di + FV; FG + D; FV + Di; Er: Er,Cr:YSGG; Er + FG; Er + FV; FG + Er and FV + Er. Er,Cr:YSGG laser parameters were as follows: 0.25 W; 5.0 Hz; 4.46 J/cm2 without water and 55% air. Furthermore, the 980-nm diode laser parameters were 2.0 W; 2.0 Hz; 21.41 J/cm2. The samples from each group were subjected to pH cycling. A confocal laser scanning microscope was used to evaluate SR and VL. Difference between the volume of the reference and treated areas + DES/RE was used to determine SR and VL. The mean values of the different groups were subjected to analysis of variance and Tukey's post-hoc test. The VL values were analyzed using the Kruskal-Wallis and Dunn post-hoc test (p < 0.05). The SR of the reference area did not show a statistically significant 1807-3107-bor-38-e025treatment and cariogenic challenge (p > 0.05). Moreover, VL in the FV + Di and FV + Er groups showed a statistically significant difference compared with areas submitted to different types of treatment and cariogenic challenge (p > 0.05). Er,Cr:YSGG and 980-nm diode lasers associated with fluoride varnishes decreased dentin VL in bovine teeth submitted to cariogenic challenge.

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ABSTRACT Introduction: The aim of the study was to investigate clinical and surgical factors associated with early catheter replacement in patients treated with Holmium Laser Enucleation of the Prostate (HoLEP). Materials and Methods: Data of patients treated with HoLEP at our Institution by a single surgeon from March 2017 to January 2021 were collected. Preoperative variables, including non-invasive uroflowmetry and abdominal ultrasonography (US), were recorded. Bladder wall modifications (BWM) at preoperative US were defined as the presence of single or multiple bladder diverticula or bladder wall thickening ≥5 mm. Clinical symptoms were assessed using validated questionnaires. Only events occurred within the first week after catheter removal were considered. Results: Overall, 305 patients were included, of which 46 (15.1%) experienced early catheter replacement. Maintenance of anticoagulants/antiplatelets (AC/AP) therapy at surgery (p=0.001), indwelling urinary catheter (p=0.02) and the presence of BWM (p=0.001) were more frequently reported in patients needing postoperative re-catheterization. Intraoperative complications (p=0.02) and median lasing time (p=0.02) were significantly higher in this group. At univariate analysis, indwelling urinary catheter (p=0.02), BWM (p=0.01), ongoing AC/AP therapy (p=0.01) and intraoperative complications (p=0.01) were significantly associated with early catheter replacement. At multivariate analysis, indwelling urinary catheter (OR: 1.28; p=0.02), BWM (OR: 2.87; p=0.001), and AC/AP therapy (OR: 2.21; p=0.01) were confirmed as independent predictors of catheter replacement. Conclusions: In our experience the presence of indwelling urinary catheter before surgery, BWM and the maintenance of AC/AP therapy were shown to be independent predictors of early catheter replacement after HoLEP.

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Introduction. Over time, efforts have been invested in the design of new instruments that overcome the disadvantages of the gold standard instrument in surgery, the scalpel. As a result, electronic equipment has emerged such as the electric scalpel and laser devices. The available evidence on these instruments suggests that the tissue response is related to each instrument's physical and biological cutting principles. Objective. To compare the histological changes in gingiva samples associated with surgical cutting performed with a 940 nm diode laser, a 2780 nm erbium, chromium: yttriumscandium-gallium-garnet (Er,Cr:YSGG) laser, and an electric scalpel, by presenting a series of cases. Case presentation. We present three cases of healthy patients undergoing cosmetic surgery. The clinical examination revealed exposure of a keratinized gingiva band greater than 4 mm, normal color and texture in gingival tissue, with a firm consistency and no bleeding on periodontal probing. Gingivectomy was indicated with the following protocols: Diode laser of 940 nm at 1 W, in continuous mode; Er,Cr:YSGG laser of 2780 nm at 2.5 W, 75 Hz, H mode, air 20, water 40, gold tip MT4); and electric scalpel in cutting mode at power level four. Gingival tissue samples were taken and stored in 10% formaldehyde for histological analysis. Conclusion. All the evaluated cutting instruments generated histological changes produced by the thermal effect, the main ones being collagen coagulation and carbonization. The depth of thermal damage caused by the 2780 nm Er,Cr:YSGG laser was much lesser than that induced by the electric scalpel and the 940 nm diode laser.

Introducción. Históricamente se ha invertido esfuerzo en el diseño de nuevos instrumentos que superen las desventajas del estándar de referencia en cirugía, el bisturí. Como consecuencia de esto, han surgido equipos electrónicos como el electrobisturí y los diferentes dispositivos de tecnología láser. La información disponible sobre estos instrumentos sugiere que la respuesta del tejido intervenido está influenciada por los principios físicos y biológicos de corte del instrumento. Objetivo. Comparar los cambios histológicos en muestras de encía asociados al corte quirúrgico realizado con láser de diodo de 940 nm, láser de erbio, cromo: itrio-escandio-galio-granate (Er,Cr:YSGG) (2780nm) y electrobisturí mediante una presentación de serie de casos. Presentación de los casos. Se presentan tres casos de pacientes sanos sometidos a cirugía estética. El examen clínico reveló la exposición de una banda gingival queratinizada mayor de 4 mm, tejido gingival de color y textura normales, de consistencia firme y sin sangrado al sondaje periodontal. Se indicó gingivectomía con los siguientes protocolos: láser de diodo de 940 nm a 1 W, en modo continuo; láser de Er,Cr:YSGG de 2780 nm a 2,5 W, 75 Hz, modo H, aire 20, agua 40, punta de oro MT4; y bisturí eléctrico en modo de corte, a nivel de potencia cuatro. Se tomaron muestras de tejido gingival y se almacenaron en formaldehído al 10 % para su análisis histológico. Conclusión. Los tres instrumentos de corte generaron cambios histológicos producidos por el efecto térmico; los principales fueron coagulación del colágeno y carbonización. La profundización del daño térmico causada por el láser de Er,Cr:YSGG de 2780 nm fue mucho menor que la generada por el electrobisturí y por el láser de diodo de 940 nm.

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OBJECTIVE: To describe the technique of transurethral harvesting of bladder mucosal graft using the Holmium:YAG (Ho-YAG) laser and describe the preliminary results from 7 cases where this graft was used for urethroplasty. MATERIALS AND METHODS: We performed a single-stage dorsal onlay urethroplasty using bladder mucosal graft in 7 patients with anterior urethral stricture. Transurethral harvesting was performed with the Ho-YAG laser. We performed a prospective and descriptive analysis with uroflowmetry performed at 30, 90 and 180 days after surgery and applied the PROM translated into Portuguese before and 6 months after urethroplasty. RESULTS: Seven patients were included, 2 (28.5%) with penile urethral stricture, and 5 (71.5%) with bulbar urethral stricture. Mean stricture length was 50mm (range 35-60mm). Stricture etiology was trauma in 3 (42.9%) patients, iatrogenic in 1 (14.3%) patient, and idiopathic in 3 (42.9%) patients. Two patients (28.6%) had previously undergone ventral buccal mucosa urethroplasty. Mean bladder mucosal graft length was 52.86mm (± 13.801), and mean harvest time was 46.43min (± 14.639). Dorsal onlay urethroplasty using bladder mucosa was successfully completed in 5 patients (71.4%). Two patients (28.6%) couldn't have the procedure completed using bladder mucosa, one due to thermal damage of the graft during harvesting, and one due to insufficient graft length. In both cases the procedure was completed using buccal mucosa. Two patients (28.6%) experienced minor hematuria between the twelfth and eighteenth postoperative day, but neither required hospitalization and/or additional procedures. All patients achieved normalization of peak flow, and this was maintained throughout the follow-up period. Mean peak flow was 17.8 ml/s (± 3.271) at 30 days, 20.6 ml/s (± 5.413) at 90 days, and 19.6 ml/s (± 8.019) 180 days. Mean IPSS score decreased from 19.3 to 5.4. Similar improvements were also seen in the ICIQ-MLUTS Score (a mean drop from 3.8 to 2.0) and Peeling's Voiding Picture Score (a mean drop from 4.0 to 2.2). Quality of Life improved post urethroplasty, with increases in EQ-5D (from 0.6371 to 0.7285) and EQ-VAS (from 58.0 to 84.0). CONCLUSION: Transurethral harvesting of bladder mucosa using the Holmium laser (Ho-YAG) is feasible and reproducible. Our preliminary experience suggests that bladder mucosa grafts achieve comparable results to other grafts when used for dorsal onlay urethroplasty. Further research is needed to confirm these results.

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A irradiação da dentina com o laser Nd:YAG mostra-se promissora para a qualidade da adesão, desde que aplicada sob parâmetros específicos e em etapas definidas. O objetivo deste estudo é avaliar de forma comparativa, o impacto da irradiação com laser de Nd:YAG sobre a formação e estabilidade da camada híbrida em dentina humana, pré-tratada com ácido e primer de sistema adesivo convencional, "in vitro". Setenta molares hígidos tiveram suas raízes e porções coronárias seccionadas horizontalmente, até completa exposição de dentina oclusal. As amostras foram divididas em: G1 (controle n=20); G2 (experimental n=20), sendo 10 dentes de cada grupo destinados ao microcisalhamento (MC) e 10 dentes à microscopia eletrônica de varredura (MEV). Nos 30 dentes restantes analisou-se: textura por Tomografia Computadorizada de Feixe Cônico (AT=15); e Espectroscopia de Infravermelho por Transformada de Fourier (FTIR=15) em 3 momentos: dentina controle; após tratamento com ácido + primer; e posterior à irradiação a laser. Estatisticamente, optou-se por ANOVA 1 fator, Qui Quadrado de Pearson, teste T e múltiplas comparações de Tukey com significância de 5%. A FTIR evidenciou redução dos níveis de fosfato e carbonato nos momentos primer e após irradiação laser, porém não havendo desnaturação do colágeno exposto. A análise de textura evidenciou uma tendência à formação de um tecido mais padronizado após o uso do laser. O teste de MC evidenciou valores médios de 36,5 e 35,2MPa para G1 e G2 respectivamente (p>0,05) e portanto, de forma imediata, o laser não mostrou efeitos deletérios ao processo adesivo. Além disso, observou-se maior penetrabilidade do adesivo na avaliação em MEV após a aplicação do laser. Novas pesquisas com avaliação longitudinal mostram-se necessárias para verificar se o efeito do laser pode ter sido protetor da degradação hidrolítica, visto que há uma redução do conteúdo de água local durante a formação da camada híbrida (AU).

Irradiation of dentin with the Nd:YAG laser shows promise for the quality of adhesion, as long as it is applied under specific parameters and in defined steps. The objective of this study is to comparatively evaluate the impact of irradiation with Nd:YAG laser on the formation and stability of the hybrid layer in human dentin, pretreated with acid and primer of conventional adhesive system, "in vitro". Seventy healthy molars had their roots and coronal portions horizontally sectioned, until complete exposure of occlusal dentin. The samples were divided into: G1 (control n=20); G2 (experimental n=20), with 10 teeth from each group destined for microshearing (MC) and 10 teeth for scanning electron microscopy (SEM). In the 30 remaining teeth analyzed: texture by Cone Beam Computed Tomography (AT=15); and Fourier Transform Infrared Spectroscopy (FTIR=15) in 3 moments: dentin control; after treatment with acid + primer; and after laser irradiation. Statistically, we opted for 1-way ANOVA, Pearson's Chi Square, T test and Tukey's multiple comparisons with a significance of 5%. FTIR showed a reduction in phosphate and carbonate levels in the primer moments and after laser irradiation, but there was no denaturation of the exposed collagen. The texture analysis evidenced a trend towards the formation of a more expressive tissue after the use of the laser. The CM test showed mean values of 36.5 and 35.2MPa for G1 and G2 respectively (p>0.05) and therefore, immediately, the laser showed no deleterious effects on the adhesive process. In addition, greater penetrability of the adhesive was observed in the SEM evaluation after laser application. New studies with longitudinal evaluation are necessary to verify if the laser effect could have been protected from hydrolytic degradation, since there is a reduction in the local water content during the formation of the hybrid layer (AU).

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Direct pulp capping induces a local inflammatory process. Several biomaterials have been used for this procedure. The aim of this study was to compare the dentinal bridge thickness using three different pulp capping biomaterials with the conventional technique (high speed diamond bur) or Er-Yag laser, 1 month after pulp effraction. Materials and Methods: Forty two Class V cavities were prepared on the buccal surface of 4 maxillary incisors and 2 mandibular incisors of New Zealand rabbits. Specimens were divided into 6 treatment groups. Teeth were treated with: In Group 1: Er-Yag laser and Biodentine® (Septodont), in Group 2: Er: Yag laser and calcium hydroxide (Dycal® Dentsply), in Group 3: Er: Yag laser and adhesive system (Prime& Bond® NT Dentsply), in Group 4: high speed diamond bur and Biodentine® (Septodont), in Group 5: high speed diamond bur and calcium hydroxide (Dycal® Dentsply), and in Group 6: high speed diamond bur and adhesive system (Prime& Bond® NT Dentsply). The preparation was done with copious irrigation. The animals were sacrificed at 30 days and the teeth were extracted and prepared for histological analysis. Results: In the group of « laser Er-Yag ¼, iatrogenic pulpal wounds treated with Biodentine® were covered with a thick hard tissue barrier after 1 month. The difference was not significant with the groups of Dycal® used with Er: Yag laser and high speed diamond bur. Prime& Bond® NT Dentsply specimens showed a thin dentinal bridge layer. Conclusion: At 1 month, Er-Yag laser proved to be useful with Biodentine® for direct pulp capping procedures

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ABSTRACT Background: We aimed to investigate the clinical efficacy and safety of transurethral flexible ureteroscopic incision and drainage with holmium laser in the treatment of parapelvic renal cysts. Materials and Methods: Between October 2017 and April 2021, the clinical data of 65 patients with parapelvic renal cysts were evaluated retrospectively. Thirty-one patients with parapelvic cysts (Group 1) underwent a transurethral flexible ureteroscopic incision and drainage with a holmium laser, whereas the other 34 patients (Group 2) underwent retroperitoneal laparoscopic unroofing. The patients' clinical features were documented. The surgery time, intraoperative blood loss, hospitalization time, complications and cyst size were recorded and statistically assessed one year following the procedure. Results: All of the patients were successfully treated with flexible ureteroscopic incision and drainage or retroperitoneal laparoscopic unroofing. In terms of clinical parameters, such as age, gender, BMI, location, cyst size, and Bosniak classification of renal cysts, no statistically significant difference was detected between Groups 1 and 2. Compared to the control group (Group 2), Group 1 demonstrated a shorter surgery duration, less intraoperative blood loss, and a shorter hospital stay (p < 0.001). However, no significant differences in complications and cyst size were observed between the two groups one year after the surgery (p > 0.05). Conclusions: Transurethral flexible ureteroscopic incision and drainage with holmium laser in the treatment of parapelvic renal cysts has obvious advantages over traditional surgery, and is worthy of advancement and application, but its long-term effect needs further follow-up studies.

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BACKGROUND: We aimed to investigate the clinical efficacy and safety of transurethral flexible ureteroscopic incision and drainage with holmium laser in the treatment of parapelvic renal cysts. MATERIALS AND METHODS: Between October 2017 and April 2021, the clinical data of 65 patients with parapelvic renal cysts were evaluated retrospectively. Thirty-one patients with parapelvic cysts (Group 1) underwent a transurethral flexible ureteroscopic incision and drainage with a holmium laser, whereas the other 34 patients (Group 2) underwent retroperitoneal laparoscopic unroofing. The patients' clinical features were documented. The surgery time, intraoperative blood loss, hospitalization time, complications and cyst size were recorded and statistically assessed one year following the procedure. RESULTS: All of the patients were successfully treated with flexible ureteroscopic incision and drainage or retroperitoneal laparoscopic unroofing. In terms of clinical parameters, such as age, gender, BMI, location, cyst size, and Bosniak classification of renal cysts, no statistically significant difference was detected between Groups 1 and 2. Compared to the control group (Group 2), Group 1 demonstrated a shorter surgery duration, less intraoperative blood loss, and a shorter hospital stay (p < 0.001). However, no significant differences in complications and cyst size were observed between the two groups one year after the surgery (p > 0.05). CONCLUSIONS: Transurethral flexible ureteroscopic incision and drainage with holmium laser in the treatment of parapelvic renal cysts has obvious advantages over traditional surgery, and is worthy of advancement and application, but its long-term effect needs further follow-up studies.

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ABSTRACT Objective: To evaluate the efficacy of mitomycin C in anatomical and functional success after modified transcanalicular diode laser dacryocystorhinostomy. Methods: A prospective, double-blinded, randomized placebo-controlled study compared the effect of topical mitomycin C on modified transcanalicular diode laser dacryocystorhinostomy. Group 1 had modified transcanalicular diode laser dacryocystorhinostomy with topical saline, while Group 2 had modified transcanalicular diode laser dacryocystorhinostomy with topical mitomycin C. Success was defined as anatomical patency and relief of symptoms at the end of 6 months. Results: Six months after surgery, Group 1 (30 patients) showed anatomical and functional success rates of 86.7% and 83.3%, respectively. Group 2 (32 patients) showed anatomical and functional success rates of 87.5% and 84.3%, respectively. There was no statistically significant difference between the groups 1 and 2 (p = 1.000). Conclusion: The use of mitomycin C did not improve the anatomical and functional success rates of modified transcanalicular diode laser dacryocystorhinostomy compared to placebo.

RESUMO Objetivo: Avaliar a eficácia da mitomicina C no sucesso anatômico e funcional após dacriocistorrinostomia transcanalicular com laser de diodo. Métodos: Estudo prospectivo, duplo-cego, randomizado e controlado por placebo. Comparou o efeito da mitomicina C tópica na dacriocistorrinostomia transcanalicular com laser de diodo. No Grupo 1, foi utilizada apenas solução salina tópica, enquanto no Grupo 2 foi utilizada mitomicina C tópica. O sucesso foi definido como permeabilidade da via lacrimal e alívio dos sintomas ao final de 6 meses. Resultados: Seis meses após a cirurgia, o Grupo 1 (30 pacientes) apresentou taxas de sucesso anatômico e funcional de 86,7% e 83,3%, respectivamente. O Grupo 2 (32 pacientes) apresentou taxas de sucesso anatômico e funcional de 87,5% e 84,3%, respectivamente. Não houve diferença estatística significante entre os Grupos 1 e 2 (p=1,000). Conclusão: O uso de mitomicina C não melhora as taxas de sucesso anatômico e funcional do dacriocistorrinostomia transcanalicular com laser de diodo em comparação ao placebo.

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RESUMEN Existen pocos estudios que comparen la adaptación de cofias de Cobalto-Cromo (Co-Cr) fabricadas por la técnica de cera perdida colada por centrifugación por inducción (CPCI) y fusión selectiva láser (SLM) en diseño y fabricación asistida por computador (CAD/CAM). Objetivo: Evaluar in vitro la adaptación marginal e interna de cofias unitarias de aleación Co-Cr sobre una línea de terminación tipo chamfer, fabricadas con la técnica CPCI y SLM en CAD/CAM. Material y Métodos: Se fabricaron 13 cofias de aleación Co-Cr para cada técnica. Se evaluó la adaptación marginal e interna utilizando la técnica de réplica de silicona. Cada réplica fue seccionada en sentido vestíbulo-palatino y mesio-distal para luego ser analizadas a nivel cervical, axial y oclusal mediante un estéreomicroscopio con aumento de 40X. Resultados: La discrepancia marginal de las cofias Co- Cr fabricadas por la técnica SLM fue 38.1μm y para la técnica CPCI fue 42,22μm sin diferencias significativas (p>0,05). La discrepancia axial para las cofias fabricadas por técnica CPCI fue de 42,02μm y para la técnica SLM de 60,16μm con diferencia significativa (p<0.05). La discrepancia oclusal para las cofias confeccionadas por la técnica CPCI fue de 101,94 μm y para la técnica SLM fue de 232,13μm con diferencia significativa (p<0,05). Conclusiones: La adaptación marginal fue similar para las técnicas CPCI y SLM pero sin diferencias estadísticamente significativas. La adaptación interna fue mejor para la técnica CPCI que para la técnica SLM con diferencias estadísticamente significativas.

SUMMARY There are few studies comparing the fit of cobalt-chromium copings (Co-Cr) manufactured by induction centrifugal casting technique and selective laser melting (SLM) in CAD/CAM. Objective: The purpose of this study was to evaluate in vitro the marginal and internal fit of Co-Cr alloy unit copings on a chamfer termination line manufactured by induction centrifugal casting technique (CPCI) and selective laser melting (SLM) in CAD/CAM. Material and methods: Thirteen Co-Cr unit copings were made for each technique. Marginal and internal fit were evaluated with the replica technique. Each sample was cross sectioned in the vestibular-palatine and mesio-distal direction, then observed in a stereomicroscope at a 40X magnification and measured at the cervical, axial and occlusal areas. Results: The marginal discrepancy of Co-Cr copings manufactured by the SLM technique was 38.1 μm and for the CPCI technique it was 42.22 μm without significant differences (p > 0.05). The axial discrepancy for the copings manufactured by CPCI technique was 42.02 μm and for the SLM technique of 60.16 μm with significant difference (P < 0.05). The occlusal discrepancy for the copings made by the CPCI technique was 101.94 μm and for the SLM technique was 232.13 μm with significant difference (P < 0.05). Conclusions: The marginal adaptation was similar for CPCI and SLM techniques but without statistically significant differences. The internal adaptation was better for the CPCI technique than for the SLM technique with statistically significant differences.

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Nuevas tecnologías nos han permitido migrar de la técnica de cera perdida colada por centrifugado (CPC) a la fabricación aditiva como la fusión selectiva por láser (SLM), proporcionando una mejor adaptación marginal e interna. Objetivos: Comparar la discrepancia marginal e interna en cofias unitarias de Co-Cr sobre 2 líneas de terminación: chamfer y bisel, fabricadas con la CPC y SLM, determinando cual tuvo mejor adaptación marginal e interna. Material y Métodos: Se tuvo 4 grupos de estudio: CPC chamfer (n=13), CPC bisel (n=13), SLM chamfer (n=13) y SLM bisel (n=13). Para evaluar la discrepancia marginal e interna se usó el método de la réplica en silicona, seccionando primero en sentido vestíbulo-palatino (V-P) y segundo en sentido mesio-distal (M-D). Se midió las zonas cervical, axial y oclusal con un estéreo microscopio a 40X. Resultados: Se evaluó los supuestos de normalidad con la prueba de Shapiro-Wilk, y el análisis estadístico fue con las pruebas t de Student y U Mann-Whitney. La menor discrepancia marginal fue para la SLM chamfer con promedios menores de 24,70±10,29 μm en el corte V-P y de 21,82±5,94 μm en el corte M-D, seguido por la SLM bisel en el corte V-P de 34,12±16,23 μm y en el corte M-D de 35,34±8,91 μm. La CPC bisel en el corte V-P fue de 27,17±21,11 μm y en el corte M-D de 47,91±16,77 μm y para la CPC chamfer en el corte V-P fue de 89,65±58,39 μm y en el corte M-D de 91,72±67,13 μm; la diferencia fue estadísticamente significativa solo para las cofias de SLM chamfer comparándolas con la CPC chamfer. En la discrepancia interna los valores en los 4 grupos no tuvieron diferencias estadísticas. Conclusiones: Según los valores, la mejor adaptación marginal fue para la SLM cham- fer, seguida por la SLM bisel, CPC bisel y la CPC chamfer. En cuanto a la adaptación interna, los valores no fueron concluyentes para decir que técnica fue mejor, pero se logró mejor adaptación en la zona axial que la zona oclusal.

New technologies have allowed us to migrate from the spin-wax casting technique (CPC) to additive manufacturing such as selective laser fusion (SLM), providing a better marginal and internal adaptation. Objectives: To compare the marginal and internal discrepancies in Co-Cr unit metal copings on two termination lines: chamfer and bevel, made with CPC and SLM, determining which technique had the best marginal and internal adaptation. Material and Methods: We had 4 study groups: CPC chamfer (n=13), CPC bevel (n=13), SLM chamfer (n=13), SLM bevel (n=13). To assess marginal and internal discrepancies, the silicone replica technique was used, a first sectioning was performed in the vestibular-palatine (V-P) and a secondin the mesio-distal (M-D) direction. The cervical, axial and occlusal zones were measured in a stereomicroscope at 40X. Results: Normality assumptions were evaluated with the Shapiro-Wilk test. Statistical analyzes were Student's t test and U Mann-Whitney test. The less discrepancy marginal was for the SLM chamfer with mean values less than 24.70±10.29 μm in the V-P cut and 21.82±5.94 μm in the M-D cut, followed by the SLM bevel in the P-V cut of 34.12±16.23 μm and in the cut M-D of 35.34±8.91 μm. The CPC bevel in the V-P cut was 27.17±21.11 μm and in the M-D cut of 47.91±16.77 μm and for the CPC chamfer in the V-P cut was 89.65±58.39 μm and in the M-D cut of 91.72±67.13 μm; the difference was statistically significant only for SLM chamfer copings compared to the CPC chamfer. In the internal discrepancy values, no statistical differences were found among the 4 groups. Conclusions: Accord- ing to the descriptive values the best marginal fit was achieved with the SLM chamfer, followed by the SLM bevel, CPC bevel and CPC chamfer. Regarding internal adaptation, the descriptive values were not conclusive enough to decide which technique was better, but a better adaptation was achieved in the axial zone than in the occlusal zone.

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Una buena adaptación marginal disminuye la probabilidad de caries, enfermedad periodontal y fracaso de la restauración. La adaptación interna es el ajuste entre la superficie de la preparación y la superficie interna de la restauración, proporcionando retención. La aleación metálica más usada es la de níquel-cromo (Ni-Cr); sin embargo presenta limitaciones como reacciones alérgicas. La aleación cobalto-cromo (Co-Cr) es una alternativa por tener biocompatibilidad, resistencia mecánica, resistencia a la corrosión y costo aceptable. Las nuevas tecnologías digitalizadas han permitido migrar de la técnica de cera perdida colada por centrifugación (CPC) a la manufactura de fresado o a la fabricación aditiva, como el de fusión selectiva por láser (SLM). Objetivos: Comparar la discrepancia marginal e interna de cofias unitarias de aleación Cobalto-Cromo (Co-Cr) sobre una línea de terminación chamfer, confeccionadas con dos técnicas: CPC y SLM, determinando cual técnica tuvo mejor adaptación marginal e interna. Material y Métodos: Se no hay espacio entre las palabras metálicas unitarias de aleación Co-Cr para cada técnica a evaluar. Se utilizó la réplica de silicona para evaluar las discrepancias marginales e internas, cada muestra fue seccionada en cruz en sentido vestíbulo-palatino y en sentido mesio-distal, luego con un estéreomicroscopio se evaluó la zona cervical, axial y oclusal. Resultados: Se evaluó los supuestos de normalidad con la prueba de Shapiro-Wilk. Los análisis estadísticos fueron la prueba t de Student y U Mann-Whitney. La SLM obtuvo una menor discrepancia marginal en comparación con la CPC encontrándose diferencias estadísticamente significativas (p<0,05) entre ambas técnicas. En cambio, al comparar la discrepancia interna no se encontraron diferencias estadísticas. Conclusiones: La mejor adaptación marginal fue para las cofias metálicas de SLM. En cuanto a la adaptación interna, los valores descriptivos no fueron concluyentes para decidir que técnica fue mejor.

A good marginal adaptation decreases the probability of caries, periodontal disease and failure of there storation. The internal adaptation is the adjustment between the preparation surface and the internal surface of the restoration, providing retention. The most commonly used metal alloy is nickel-chromium (Ni-Cr); how ever it has limitations such as allergic reactions. The cobalt-chromium alloy (Co-Cr) is an alternative to have biocompatibility, mechanical strength, corrosion resistance and acceptable cost. The new digitized technologies havea llowed to migrate from the technique of wax loss cast by centrifugation (CPC) to the manufacture of subtraction or additive manufacturing, such as selective laser melting (SLM). Objectives: To compare the marginal and internal discrepancies of Cobalt-Chromium alloy copings units (Co-Cr) on a chamfer termination line, made with two techniques: CPC and SLM, determining which technique had better marginal and internal adaptation. Material and Methods: 13 Co-Cr alloy unit copings were fabricated for each technique to be evaluated. Silicon replication was used to evaluate the marginal and internal discrepancies. Each sample was cross-sectioned in the vestibular-palatine and mesio-distal directions, then the cervical, axial and occlusal zones were evaluated with a stereomicroscope. Results: The normality assumptions were evaluated with the Shapiro-Wilk test. Statistical analyzes were Student's t test and U Mann-Whitney test. The SLM had a smaller marginal discrepancy compared to CPC, with statistically significant differences (p <0.05) between both techniques. On the other hand, when comparing the internal discrepancy, no statistical differences were found. Conclusions: The best marginal adaptation was for metal fittings of SLM. As for the internal adaptation, the descriptive values were not conclusive to decide which technique was best.

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ABSTRACTPurpose:To evaluate the clinical efficacy of flexible ureteroscope (F-URS) combined with holmium laser lithotripter in treating renal calculi in horseshoe kidney.Materials and Methods:From November 2010 to December 2013, the medical history and charts of sixteen patients (mean age 42.9±11.6 years, range 26-66 years), including 13 males and 3 females were analyzed retrospectively. Mean stone burden was 29±8 mm (range 17-42 mm2). Mean stone digitized surface area (DSA) was 321±94 mm2 (range 180-538 mm2). Under spinal anesthesia in a modified lithotomy position with the head down, rigid ureteroscope was placed firstly into the ureter to reach the level of the pelvis, a zebra guide wire was inserted and following the removal of the rigid ureteroscope, an ureteral access sheath was positioned along the guide wire, then passed the URF P-5 flexible ureteroscope into the renal cavities over the guidewire. After locating the stones, holmium laser lithotripsy was performed.Results:The average operative time was 92±16 minutes (range 74-127 min.). No major complications were encountered. Ten patients obtained stone-free status with one session, four obtained stone-free status after two sessions. Single session stone-free rate was 62.5%, overall stone-free rate was 87.5%. Two patients have small residual stones in the lower pole.Conclusions:F-URS combined with holmium laser lithotripter and nitinol basket, is safe and effective in dealing with moderate stone diameter (<30 mm) in HSKs with high clearance rates and low complication rates.

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The purpose of this study was to investigate the effect of CPP-ACP treatment and Nd:YAG laser on microtensile bond strength (µTBS) of softened dentin. Sixty samples were obtained from thirty sound third molars. All samples were submitted to dentin softening procedure, by the immersion of the specimens in 30 mL of Sprite Zero for 30min. Afterwards, the samples were randomly divided according to the CPP-ACP treatment: CG-Control group; MP-treated with CPP-ACP paste (MI Paste); MPP-treated with CPP-ACP+900 ppm NaF paste (MI Paste Plus). Each group was further divided according to bonding procedure: NL-No laser; L–Laser irradiation after adhesive application and before polymerization. The laser parameters used were 1.4 W, 10 Hz, 140 mJ/pulse, with an optic fiber of 320 µm, generating energy of 174 J/cm2 per pulse. All samples were restored with Clearfil SE Bond/Filtek Z350 XT. After 24 h, the restored samples were cut into beams (± 1 mm2adhesive interface area) and subjected to a µTBS test. Data were analyzed by two-way ANOVA test and Holm-Sidak post-hoc method (α = 0.05). The treatment with CPP-ACP pastes did not significantly affect softened dentin µTBS (p = 0.070). Statistic revealed significant reduction on µTBS values for CG/L, leading to the rejection of the second null hypothesis (p < 0.001). Both CPP-ACP based pastes did not affect µTBS of softened dentin for the adhesive system utilized. The Nd:YAG laser irradiation after application of adhesive system did affect µTBS values of softened dentin samples untreated with CPP-ACP based pastes.

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CONTEXT AND OBJECTIVE: Lasers are widely used in treating symptomatic benign prostatic hyperplasia. In current practice, potassium titanyl phosphate (KTP) lasers are the most common type of laser systems used. The aim here was to evaluate the rapid effect of high-power laser systems after application of hypericin. DESIGN AND SETTING: Experimental animal study conducted in the Department of Urology, Gülhane Military Medical Academy, Ankara, Turkey, in 2012. METHODS: Sixteen rats were randomized into four groups: 120 W KTP laser + hypericin; 120 W KTP laser alone; 80 W KTP laser + hypericin; and 80 W KTP laser alone. Hypericin was given intraperitoneally two hours prior to laser applications. The laser incisions were made through the quadriceps muscle of the rats. The depth and the width of the laser incisions were evaluated histologically and recorded. RESULTS: To standardize the effects of the laser, we used the ratio of depth to width. These new values showed us the depth of the laser application per unit width. The new values acquired were evaluated statistically. Mean depth/width values were 231.6, 173.6, 214.1 and 178.9 in groups 1, 2, 3 and 4, respectively. The most notable result was that higher degrees of tissue penetration were achieved in the groups with hypericin (P < 0.05). CONCLUSIONS: The encouraging results from our preliminary study demonstrated that hypericin may improve the effects of KTP laser applications. .

CONTEXTO E OBJETIVO: Lasers são amplamente utilizados no tratamento de hiperplasia benigna de próstata sintomática. Na prática atual, lasers de fosfato de titanilo de potássio (KTP) são os tipos mais comuns usados dos sistemas. O objetivo foi avaliar o efeito rápido do sistema laser de alta potência após a aplicação de hipericina. TIPO DE ESTUDO E LOCAL: Estudo experimental animal, realizado no Departamento de Urologia, Academia de Medicina Militar de Gülhane, Ancara, Turquia, em 2012. MÉTODOS: 16 ratos foram divididos aleatoriamente em 4 grupos: 120W KTP laser + hipericina; 120W KTP laser somente; 80W KTP laser + hipericina; 80W KTP laser somente. Hipericina foi dada intraperitonealmente duas horas antes da aplicação do laser. As incisões a laser foram feitas através do músculo quadríceps dos ratos. A profundidade e a largura das incisões a laser foram avaliadas histologicamente e registradas. RESULTADOS: Para padronizar o efeito do laser foi utilizada a razão entre profundidade e largura. Estes novos valores nos mostraram a profundidade da aplicação do laser de largura por unidade. Os novos valores adquiridos foram avaliados estatisticamente. Os valores da média de profundidade/largura foram 231,6, 173,6, 214,1 e 178,9 nos grupos 1, 2, 3 e 4, respectivamente. O resultado mais notável foi atingir altos graus de penetração tecidual nos grupos com hipericina (P < 0,05). CONCLUSÕES: Os resultados promissores do nosso estudo preliminar mostraram que hipericina pode melhorar os efeitos das aplicações do laser KTP. .

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O glaucoma maligno é uma doença caracterizada por pressão intraocular elevada com câmara anterior rasa na presença de iridectomia periférica patente. Na sua forma clássica, o glaucoma maligno é raro, e representa uma das mais sérias complicações da cirurgia fistulizante em pacientes com ângulo estreito ou glaucoma de ângulo fechado. O presente trabalho relata um caso de uma paciente do sexo feminino que desenvolveu crise de glaucoma por bloqueio ciliar (maligno) precipitada pela realização de curva tensional diária de pressão intraocular com tonômetro de contorno dinâmico.

Malignant glaucoma is an entity characterized by intraocular pressure (IOP) with a shallow anterior chamber in the presence of a patent peripheral iridectomy. In its classic form, malignant glaucoma is rare but one of the most serious complications of fistulizing surgery in patients with narrow angle or angle closure glaucoma. In this case we have a female patient who developed crisis of ciliary block glaucoma (malignant) during performance of circadian IOP curve with dynamic contour tonometer.

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