Generation of custom modes in a Nd:YAG laser with a semipassive bimorph adaptive mirror

Custom modes at a wavelength of 1064 nm were generated with a deformable mirror. The required surface deformations of the adaptive mirror were calculated with the Collins integral written in a matrix formalism. The appropriate size and shape of the actuators as well as the needed stroke were determined to ensure that the surface of the controllable mirror matches the phase front of the custom modes. A semipassive bimorph adaptive mirror with five concentric ring-shaped actuators and one defocus actuator was manufactured and characterised. The surface deformation was modelled with the response functions of the adaptive mirror in terms of an expansion with Zernike polynomials. In the experiments the Nd:YAG laser crystal was quasi-CW pumped to avoid thermally induced distortions of the phase front. The adaptive mirror allows to switch between a super-Gaussian mode, a doughnut mode, a Hermite-Gaussian fundamental beam, multi-mode operation or no oscillation in real time during laser operation.

Bleeding complications following Nd:YAG laserassisted oral surgery vs conventional treatment in cardiac risk patients: a clinical retrospective comparative study

OBJECTIVE Thermal Nd:YAG laser energy is well known for the purpose of blood coagulation. However, little is known about the bleeding frequency following laser-assisted oral surgery in patients on coumarin drugs. Therefore, the purpose of this study was to compare retrospectively the frequency of bleeding complications following Nd:YAG laserassisted versus conventional local coagulation of blood in oral surgery. METHOD AND MATERIALS In October 2002, minor oral surgical interventions were found to be indicated in a total of 45 cardiac risk patients. In Group 1, blood coagulation was yielded in 24 patients with a Nd:YAG laser system, whereas in Group 2, treatment was performed in 21 patients with conventional means of local hemostasis. All therapies were performed continuing anticoagulant therapy between November 2002 and March 2003. Clinical data were recorded retrospectively from patient charts in May 2007. RESULTS In both Groups 1 and 2, a total of two bleeding complications were recorded. However, local re-interventions were sufficient for local hemostasis. CONCLUSION These results indicate that Nd:YAG laser-assisted local hemostasis was not able to prevent bleeding complications completely. Within the limitations of this retrospective study it was concluded that in patients with anticoagulant treatment undergoing minor oral surgery, Nd:YAG laser-assisted local hemostasis is not superior to conventional methods of blood coagulation with respect to the frequency of bleeding complications.

Treatment of lower extremity telangiectasias in women by foam sclerotherapy vs. Nd:YAG laser: a prospective, comparative, randomized, open-label trial.

BACKGROUND Telangiectasias of the lower extremities are very common. There are no blinded, randomized, controlled clinical trials comparing laser modalities with the gold standard sclerotherapy, while the few available studies encompass small patients cohorts. OBJECTIVE This prospective, randomized, open-label trial compares the efficacy of sclerotherapy with polidocanol vs. long-pulsed neodymium-doped yttrium aluminium garnet (Nd:YAG) laser in the treatment of leg telangiectasias. PATIENTS AND METHODS Fifty-six female patients with primary leg telangiectasias and reticular veins (C1A or S Ep AS 1 PN ) were included in the study. One leg was randomly assigned to get treatment with the multiple synchronized long-pulsed Nd:YAG laser, while the other received foam sclerotherapy with polidocanol 0.5%. The patients were treated in two sessions at intervals of 6 weeks. The patients were evaluated by the handling physician after 6 weeks and 6 months. Two investigators assessed blindly at the end of the study the photographs for clearing of the vessels using a six-point scale from 1 (no change) to 6 (100% cleared). Patients reported about pain sensation and outcome satisfaction. RESULTS According to the handling dermatologist, at the last follow-up, there was an improvement of 30-40% with a median of 3 (IQR 2) and a good improvement of 50-70% with a median of 4 (IQR 2) after laser treatment and sclerotherapy respectively. In contrast, according to the blinded investigators, there was a median of 5 (IQR 1) with a very good improvement of >70% after both therapies. Improvement was achieved more quickly by sclerotherapy, although at the last follow-up visit there was no difference in clearance between the two groups as assessed by the blinded experts (P-value 0.84). The degree of patient's satisfaction was very good and similar with both therapeutic approaches. There was a significant difference (P-value 0.003) regarding pain perception between the types of therapy. Laser was felt more painful than sclerotherapy. CONCLUSION Telangiectasias of the lower extremities can be successfully treated with either synchronized long-pulsed Nd:YAG laser or sclerotherapy. The 1064-nm long-pulsed Nd:YAG laser is associated with more pain and is suitable especially in case of needle phobia, allergy to sclerosants and in presence of small veins with telangiectatic matting, while sclerotherapy can also treat the feeder veins.

Removal of fractured endodontic instruments using an Nd:YAG laser.

OBJECTIVE Fractured endodontic instruments inhibit optimal cleaning and filling of dental root canals, which may result in a less favorable prognosis for the tooth. Several techniques are available to remove fractured instruments; however, healthy tooth substance often must be destroyed in the process. This study was intended to evaluate Nd:YAG laser treatment as a method to remove fractured stainless steel instruments without destroying healthy tooth substance. METHOD AND MATERIALS Stainless steel endodontic instruments were fractured in 33 unprocessed root canals of mandibular central and lateral incisors and premolars in vitro. A brass tube charged with solder was placed at the coronal end of the fractured instrument and laser energy was used to melt the solder, connecting the fractured instrument with the brass tube. The success rates of connecting and removal of fractured instruments from the root channel were recorded for each case. RESULTS Connecting was achieved in every case in which more than 1.5 mm of the fractured instrument was tangible (22 out of 22). In cases where less than 1.5 mm was tangible, the rate for successful connection decreased to 4 out of 11 (36.4%). Fractured endodontic instruments were removed successfully in 17 out of 22 cases (77.3%) in which more than 1.5 mm was tangible. If less than 1.5 mm was tangible, the removal success rate decreased to 3 out of 11 cases (27.3%). CONCLUSION Our data support Nd:YAG laser-mediated connecting of a brass tube to a fractured endodontic instrument as a feasible and tissue conserving removal approach when more than 1.5 mm of the instrument is tangible.

Análisis de la aplicación de Soldadura de acero de calidad "A" mediante láser de Neodimio-YAG en construcción naval

El proceso de soldadura por láser desarrollado en los últimos años ha puesto de manifiesto las posibilidades de aplicación de esta tecnología en diferentes sectores productivos, principalmente en la industria automovilística, en la cual se han demostrado sus ventajas en términos de productividad, eficiencia y calidad. El uso de la tecnología láser, ya sea híbrida o pura, reduce el input térmico al limitar la zona afectada por el calor, sin crear deformaciones y, por tanto, disminuye los re-trabajos post-soldadura necesarios para eliminarlas. Asimismo, se aumenta la velocidad de soldadura, incrementando la productividad y calidad de las uniones. En la última década, el uso de láseres híbridos, (láser + arco) de gran potencia de Neodimio YAG, (Nd: YAG) ha sido cada vez más importante. La instalación de este tipo de fuentes de láser sólido de gran potencia ha sido posible en construcción naval debido a sus ventajas con respecto a las instalaciones de láser de C02 existentes en los astilleros que actualmente utilizan esta tecnología. Los láseres de C02 están caracterizados por su gran potencia y la transmisión del haz a través de espejos. En el caso de las fuentes de Nd:YAG, debido a la longitud de onda a la cual se genera el haz láser, su transmisión pueden ser realizada a través de fibra óptica , haciendo posible la utilización del cabezal láser a gran distancia de la fuente, aparte de la alternativa de integrar el cabezal en unidades robotizadas. El proceso láser distribuye el calor aportado de manera uniforme. Las características mecánicas de dichas uniones ponen de manifiesto la adecuación de la soldadura por láser para su uso en construcción naval, cumpliendo los requerimientos exigidos por las Sociedades de Clasificación. La eficiencia energética de los láseres de C02, con porcentajes superiores al 20%, aparte de las ya estudiadas técnicas de su instalación constituyen las razones por las cuales este tipo de láser es el más usado en el ámbito industrial. El láser de gran potencia de Nd: YAG está presente en el mercado desde hace poco tiempo, y por tanto, su precio es relativamente mayor que el de C02, siendo sus costes de mantenimiento, tanto de lámparas como de diodos necesarios para el bombeo del sólido, igualmente mayores que en el caso del C02. En cambio, el efecto de absorción de parte de la energía en el plasma generado durante el proceso no se produce en el caso del láser de Nd: YAG, utilizando parte de esa energía en estabilizar el arco, siendo necesaria menos potencia de la fuente, reduciendo el coste de la inversión. En función de la aplicación industrial, se deberá realizar el análisis de viabilidad económica correspondiente. Dependiendo de la potencia de la fuente y del tipo de láser utilizado, y por tanto de la longitud de onda a la que se propaga la radiación electromagnética, pueden existen riesgos para la salud. El láser de neodimio se propaga en una longitud de onda, relativamente cercana al rango visible, en la cual se pueden producir daños en los ojos de los operadores. Se deberán establecer las medidas preventivas para evitar los riesgos a los que están expuestos dichos operadores en la utilización de este tipo de energía. La utilización del láser de neodimio: YAG ofrece posibilidades de utilización en construcción naval económicamente rentables, debido su productividad y las buenas características mecánicas de las uniones. Abstract The laser welding process development of the last years shows broad application possibilities in many sectors of industry, mostly in automobile production. The advantages of the laser beam process produce higher productivity, increasing the quality and thermal efficiency. Laser technology, arc-hybrid or pure laser welding, reduces thermal input and thus a smaller heat-affected zone at the work piece. This means less weldment distortion which reduces the amount of subsequent post-weld straightening work that needs to be done. A higher welding speed is achieved by use of the arc and the laser beam, increasing productivity and quality of the joining process. In the last decade use of hybrid technology (laser-GMA hybrid method) with high power sources Nd:YAG lasers, gained in importance. The installation of this type of higher power solid state laser is possible in shipbuilding industrial applications due to its advantages compare with the C02 laser sources installed in the shipyards which use this technology. C02 lasers are characterised by high power output and its beam guidance is via inelastic system of mirrors. In the case of Nd:YAG laser, due to its wavelength, the laser beam can be led by means of a flexible optical fibre even across large distances, which allows three dimensional welding jobs by using of robots. Laser beam welding is a process during which the heat is transferred to the welded material uniformly and the features of the process fulfilled the requirements by Classification Societies. So that, its application to the shipbuilding industry should be possible. The high quantum efficiency of C02 laser, which enabled efficiency factors up to 20%, and relative simple technical possibilities of implementation are the reasons for the fact that it is the most important laser in industrial material machining. High power Nd: YAG laser is established on the market since short time, so that its price is relatively high compared with the C02 laser source and its maintenance cost, lamp or diode pumped solid state laser, is also higher than in the case of C02 lasers. Nevertheless effect of plasma shielding does not exist with Nd:YAG lasers, so that for the gas-shielding welding process the optimal gases can be used regarding arc stability, thus power source are saved and the costs can be optimised. Each industrial application carried out needs its cost efficiency analysis. Depending on the power output and laser type, the dangerousness of reflected irradiation, which even in some meters distance, affects for the healthy operators. For the YAG laser process safety arrangements must be set up in order to avoid the laser radiation being absorbed by the human eye. Due to its wavelength of radiation, being relatively close to the visible range, severe damage to the retina of the eye is possible if sufficient precautions are not taken. Safety aspects are of vital importance to be able to shield the operator as well as other personal. The use of Nd:YAG lasers offers interesting and economically attractive applications in shipbuilding industry. Higher joining rates are possible, and very good mechanical/technological parameters can be achieved.

Análise in vitro da morfologia e da resistência de união da resina composta à dentina erodida e irradiada com laser de Er:YAG com largura de pulso super curta

Lesões dentais por erosão têm sido cada vez mais presentes na prática clínica. A restauração direta com resina composta é uma das opções de tratamento para lesões severas, em que há comprometimento estético/funcional. Com o aprimoramento da tecnologia, a utilização do laser para pré-tratamento da superfície dentinária, antes do condicionamento ácido, tem sido considerada como método alternativo para melhorar a adesão das resinas compostas às superfícies erodidas. Assim, o objetivo deste estudo in vitro foi avaliar a influência da irradiação com laser de Er:YAG (2,94 ?m), de pulso super-curto, na adesão da resina composta à superfície dentinária erodida. Quarenta e seis discos de dentina foram obtidos a partir de 46 dentes terceiros molares humanos. A dentina oclusal planificada de 40 molares humanos teve metade de sua face protegida com fita UPVC (dentina hígida), enquanto na outra metade foi produzida uma lesão de erosão através da ciclagem em ácido cítrico (0,05 M, pH 2,3, 10 minutos, 6x/dia) e solução supersaturada (pH 7,0, 60 minutos entre os ataques ácidos). Metade das amostras foi irradiada com o laser de Er:YAG (50 ?s, 2 Hz, 80 mJ, 12,6 J/cm2) e a outra não (grupo controle). Em cada grupo de tratamento (laser ou controle) (n=10), um sistema adesivo autocondicionante foi utilizado e, então, confeccionados 2 cilindros de resina composta, tanto do lado erodido como no hígido (total de 4 cilindros), os quais foram submetidos à avaliação da Resistência de União através do ensaio de microcisalhamento (1 mm/min), após armazenamento em saliva artificial por 24 h. A análise do padrão de fratura foi realizada em microscópio óptico (40x). Por meio da Microscopia Eletrônica de Varredura (MEV), a morfologia das superfícies dentinárias hígida e submetida ao desafio erosivo, antes e após o tratamento com laser de Er:YAG (n=3), foi avaliada. Os valores obtidos de resistência de união (MPa) foram submetidos ao teste ANOVA e de comparações múltiplas de Tukey (p<0,05) e as análises das eletromicrografias foram feitas de forma descritiva. A análise morfológica da superfície mostrou alterações significativas na dentina hígida irradiada e na submetida à ciclagem erosiva, irradiada ou não. Quanto à resistência de união, houve diferença entre os 4 substratos analisados, sendo: dentina hígida irradiada (12,77±5,09 A), dentina hígida não irradiada (9,76±3,39 B), dentina erodida irradiada (7,62±3,39 C) e dentina erodida não irradiada (5,12±1,72 D). Houve predominância de padrão de fratura do tipo adesiva. Com base nos resultados e nos parâmetros de irradiação utilizados neste estudo, pode-se concluir que a erosão reduz a adesão em dentina e que o tratamento da superfície dentinária com laser de Er:YAG de largura de pulso super curta aumenta a adesão no substrato erodido ou hígido.