Iraqi Journal of Laser

Background: Acne scars are one of the most common problems following acne vulgaris. Despite the extensive list of available treatment modalities, their effectiveness depends upon the nature of the scar. Ablative lasers had been used to treat acne scars; one of them is the fractional CO2 laser. The aim of this study is to evaluate the outcome of fractional CO2 laser in the treatment of acne scars. Methods: Since January 2010 to June 2013, using 10600 nm fractional CO2 laser beams, the acne scar of 400 patients, 188 males and 212 females, mean age of 34 years, have been treated and classified according to severity into four grades following Goodman and Baron classification. Each patient underwent 3-5 sessions once monthly. The mean laser exposure time was 15 minutes, mean operative time was 1-1.5 hours, no hospital stay and the treatment coarse lasted 3-5 months. Patients were followed up for about one year to evaluate the success of the procedure. Results: Investigators and patients graded the improvement on a scale (0=no improvement to grade1 0-25%, grade 2, 25-50% ,grade 3 50-75%,grade 4 more than 75%. Both investigators and patients gave mean improvement scores in the range of 50% to 75% for scar depth, scar margins beveling, better color match, texture, skin tightness and overall improvement of the patients well looking. The degree of improvement increased with each treatment session and continued to increase between the 1-month and 3-month after the last treatment. Conclusion Fraction ablative resurfacing seems to hit a sweet spot between the minimal benefits of traditional nonablative laser treatment and the considerable downtime and complications of ablative resurfacing

Background: Laser etching may be an alternative to acid etching of enamel and dentin. Several characteristics of irradiated dental hard tissues have been considered advantageous, microscopically rough surfaces without demineralization, open dentinal tubules without smear layer production and dentin surface sterilization. The aim of this study is to determine and compare histology the microleakage in class V cavity restored with a light cured composite after conditioning the samples(tooth surface) with 1-acid etching, 2-Q-switched Nd:YAG Laser etching and finally 3- acid and laser etching. Materials and methods: Twenty four non carious human extracted teeth were used in this study. The samples were equally grouped into four groups of six teeth each. A class V cavity was prepared. In group I, tooth surface was etched with a 37% phosphoric acid gel. In group II, the tooth surface was conditioned using a pulsed Nd:YAG Laser alone with a wavelength of 532 nm. The parameters were of pulse energy 60 mJ, pulse repetition rate 6Hz and energy density was 0.48 J/cm2. In group III, the tooth surface was treated with Nd: YAG Laser and then was etched with phosphoric acid. In group IV, the surface was treated with 37% phosphoric acid then irradiated with Nd: YAG Laser; with the same parameters and concentration mentioned in group I and II. The samples immersed in 1% basic fuschin dye to mimic the normal stains in oral cavity and the sections were examined by a stereomicroscope and the readings were scored. Results: The results showed that group IV, in which the surface was treated with 37% phosphoric acid and then irradiated with Nd: YAG Laser) recorded the least microleakage of the four groups, where group III, in which the tooth surface was treated with Nd: YAG Laser and then was etched with phosphoric acid)recorded reasonable results better than group I (group I tooth surface was etched with a 37% phosphoric acid gel) or group II , in which the tooth surface was conditioned using a pulsed Nd:YAG Laser alone) Conclusion: The use of Q-switched Nd:YAG laser in etching the tooth surface was so effective that it can be used in treating or conditioning the tooth surface to enhance bonding and the best parameters among the tested samples were pulse energy of 60mJ, pulse repetition rate of 6Hz and energy density 0.48 J/cm2.

Background: An ingrowing toenail is a common problem affecting mainly adolescents and young adults, with a male predominance of 3:1. The disorder generally occurs in big toes. It is painful and often chronic and it affects work and social activities. Most patients initially complain of pain and later discharge, infection and difficulty in walking occur. The Objectives: The purpose of the study was to evaluate the efficacy and safety of (10600nm) CO2 laser in the treatment of ingrowing toe nail. Patients, Materials & Methods: This study was done in laser medicine research clinics from July 2013 to the end of December 2013; 10 patients including 7(70%) males and 3 (30%) females with age ranging from 18 years to 70 years with mean age of 44 years old. The details of the procedure were explained verbally to the patients. Patients were examined and evaluated clinically and prepared for surgery. A CO2 continuous wave 1-40W laser emitted at 10600 nm; the laser was delivered via an articulated arm. Laser was used for cutting the nail and vaporization of the underlying germinal layer (matrix). Results: The preliminary clinical findings included sufficient hemostasis, coagulation properties and precise incision margin with all of the surgical procedure. The postoperative advantages, i.e., lack of pain, bleeding, infection and, recurrence the good wound healing and overall satisfaction were observed in the clinical application of laser in treatment of ingrowing toenail. Conclusion: The clinical application of the CO2 (10600 nm) laser in surgical procedures prove to be of beneficial effect for daily practice. It can be considered practical, effective and easy to use, and it offers a safe, acceptable, and impressive alternative for conventional techniques of surgical treatment of in growing toenail.

Background: Cervical ectropion is considered to be a physiologic condition caused by columnar epithelium migration from the cervical canal into the vaginal portion of the cervix and usually there is no treatement for clinically asymptomatic cervical ectropion . Treatment can be achieved by thermal cauterization (Electrocautery), Cryosurgery or laser vaporization. Aim of the study: To study the effectiveness of CO2 laser (10600nm) in treatment of symptomatic cervical ectropion . Setting: The study was carried out at Laser Medicine Research Clinic at the Institute of Laser for Postgraduate Studies, University of Baghdad between the first of August 2013 to the end of October 2013. Patients and Methods: Ten female Patients with age range between 25-48 years old were collected from Department of Health (Pap smear unit) at Al-Ilwiya Maternity Hospital. Patients who were diagnosed clinically as having cervical ectropion were subjected to Pap smear in order to exclude an underlying dysplasia. The patients were subjected to CO2 laser vaporization in a continuous mode. Results: All patients were subjected to continuous wave laser and the range of power was from 5 up to 10 W. The exposure time ranged from 1-2 minutes according to size of the ectrpion and patient`s cooperation. There was no bleeding nor pain intraoperatively. No bleeding post operatively and all with rapid return to the normal activity . Only patients with Pap smear findings of trichomoniasis or monilia received the appropriate antibiotic treatment before laser ablation. Most patients didn`t require analgesics nor anesthesia and no need for antibiotics postoperatively. Conclusion: CO2 laser vaporization with a power range of 5-10 W (mean power 7.9 W) and exposure time ranged from 1-2 minutes appears to be quite effective for treatment of cervical ectropion .By laser we can go more precise in the tissue and we can reach squamocolumnar junction and destroy the deepest glands and so the whole region can be treated. There is good and rapid healing, insignificant bleeding and pain postoperatively.

Low-intensity laser irradiation has been explored as an alternative, non-invasive method to encourage chronic wounds to heal. This study aimed to evaluate the effects of low level laser therapy (biostimulation) using semiconductor diode laser with wavelength (785 nm) on the enhancement of chronic wound healing. Fifty patients with chronic wounds were selected to be treated with Low Level Laser Therapy. Their ages ranged between 1 to 76 years. The wound sites were distributed in the lower limb, upper limb, trunk , perineum and head (70%,14%,12%,2%,2%, respectively). Application of laser therapy by noncontact method few millimeters from the skin for 15 minutes per one session twice weekly for two months ; ie,16 sessions for each patient. Results: The responses of wounds (56%), 12 patients with more than toward Low Level Laser Therapy LLLT were different as fallow; 28 patients had complete healing 50% healing (24%),8 patients with less than 50% healing (16%) and 2 of patients did not heal (4%).Conclusions: LLLT is an effective modality for treating chronic wounds. LLLT is an effective method in treating chronic wounds in patients with comorbidity and contraindications or precautions for surgery like epilepsy and chronic hepatitis carrier.

Hyperpigmentation is the increase in the natural color of the skin. The purpose of this study is to evaluate the efficacy and safety of Q-Switched Nd:YAG (1064 & 532 nm) Laser in treatment of skin hyper pigmentation. This study was done in the research clinic of Institute of laser for postgraduate Studies/University of Baghdad from October 2008 to the end of January 2009. After clinical assessment of skin hyperpigmentation color, twenty six patients were divided according to their lesions. Eight Patients with freckles, seven patients with melasma, four patients with tattoo. Cases with tattoo, were subdivided into amateur tattoos two, professional tattoos one, and one traumatic tattoo. Four Patients with post inflammatory hyperpigmentation, one patient with gazzal eye, one patient with spilus nevus, one patient with becker's nevus. The time of treatment session was from 5-20 minutes according to the size of lesion at 3-4 week interval. The distributions of lesions were on different part of body, face, hand, forearm, and back. Twenty two patients completed the study; four patients defaulted from the study for unknown reasons. Conclusion: The use of Q-Switched lasers offers a low risk, effective therapy with minimal side effects because they offer bloodless, low risk, effective treatment, Q-Switched Nd:YAG lasers have replaced other methods and are now considered standard treatment. The Q-Switched Nd:YAG laser have great advantages in removing hyperpigmentation, its longer wavelength (1064nm) would increase dermal penetration and decrease melanin absorption so that it’s used in skin type (III,IV,V,VI) without the risk of depigmentation or hypopigmentation.