lasers

激光器
  • 文章类型: Journal Article
    这项研究旨在评估高强度激光治疗(HILT)对患有颞下颌关节疾病(TMD)的个体的影响。在六个电子数据库中进行了随机对照试验(RCT)的搜索,重点是TMD的HILT:PubMed,Scopus,WebofScience,ScienceDirect,EBSCOhost,科克伦图书馆,PEDro数据库和GoogleScholar(最后更新于2024年7月18日)。合格的研究由独立审稿人选择,并使用Cochrane偏倚风险工具(RoB)评估其质量.主要结果是疼痛强度(VAS),次要结果包括张口(mm),残疾(JFLS-20),和生活质量(OHIP-14)。进行荟萃分析,通过计算这些变量的平均差(MD)来评估合并效应(95%置信水平)。使用I2统计量探索荟萃分析的异质性。三项研究符合选择标准,并被纳入荟萃分析。主要的RoB是对参与者和治疗者的致盲。对于VAS和最大张口观察到有利于HILT的统计学显著差异(p<0.05)。合并效应显示疼痛强度的MD为-14.8mm(95%CI:-27.1,-2.5),张口的MD为3.7mm(95%CI:0.9,6.5),被评估为临床重要的变化。根据等级,证据被评为重要,由于研究之间的异质性,确定性中等。没有进行敏感性分析来解决异质性,主要是由于RCT的可用性有限。已发现HILT可有效缓解短期疼痛并改善TMD的下颌开口,通过促进咀嚼等活动可能提高生活质量,下颚活动能力,和沟通。然而,需要进一步的研究来确认其长期有效性。将HILT与咬合夹板或治疗练习等干预措施相结合,可能会增强其效果。利用支持这些治疗的现有证据。重要的是要注意,与参与者和治疗者缺乏失明相关的高RoB可能会影响数据收集,在一些研究中损害了研究结果的内部有效性。
    This study aimed to assess the effects of High-intensity laser therapy (HILT) on individuals suffering from temporomandibular joint disorders (TMDs). A search was conducted across six electronic databases for randomized controlled trials (RCTs) focusing on HILT for TMDs: PubMed, Scopus, Web of Science, ScienceDirect, EBSCOhost, Cochrane Library, the PEDro database and Google Scholar (last updated on July 18, 2024). Eligible studies were chosen by independent reviewers, and their quality was assessed with the Cochrane risk of bias tool (RoB). The main outcome was pain intensity (VAS), with secondary outcomes including mouth opening (mm), disability (JFLS-20), and quality of life (OHIP-14). A meta-analysis was conducted to assess the pooled effect by calculating mean differences (MD) for these variables (95% confidence level). The heterogeneity of the meta-analyses was explored using the I2 statistic. Three studies met the selection criteria and were included in the meta-analysis. The main RoB was the blinding of participant and treaters. Statistically significant differences (p < 0.05) in favor of HILT were observed for VAS and maximum mouth opening. The pooled effect showed an MD of -14.8 mm (95% CI:-27.1,-2.5) for pain intensity and 3.7 mm (95% CI:0.9,6.5) for mouth opening, changes that were assessed as clinically important. According to GRADE, the evidence was rated as important, and the certainty was moderate due to the heterogeneity between studies. A sensitivity analysis was not performed to address heterogeneity, primarily due to the limited availability of RCTs. HILT has been found effective in short-term pain relief and improvement of jaw opening in TMDs, potentially enhancing quality of life by facilitating activities such as chewing, jaw mobility, and communication. However, further research is needed to confirm its long-term effectiveness. Combining HILT with interventions such as occlusal splints or therapeutic exercises could potentially enhance its effects, leveraging the existing evidence supporting these treatments. It is important to note that the high RoB associated with the lack of blinding of participants and treaters may influence data collection, compromising the internal validity of findings in some studies.
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  • 文章类型: Journal Article
    冷刀尿道切门术于1971年推出,成功率为80%。该领域的新进展揭示了各种激光的使用,如二氧化碳,Nd:YAG,KTP,氩气,Ho:YAG,和准分子激光器.已经观察到,冷刀尿道切开术比激光尿道切开术有更高的复发率,但是两种治疗方式的优越性尚未确定。通过PubMed彻底搜索了数据,Scopus,和临床试验。我们还使用clinicaltrials.gov进行正在进行的和已发表的研究。数据通过R工作室版本2023.12.1(海洋风暴)进行了分析。对于二分变量,使用比值比(OR)来汇集数据,并将标准化的平均差用于具有95%置信区间(CI)的连续变量。共有14项研究,包括1114名参与者被纳入该荟萃分析。综合分析的结果显示,显著相关,平均差为0.99(95%CI:0.37;1.62),并青睐激光集团。总体结果表明,激光具有明显的有利轮廓,表明复发,赔率为0.42(95%CI:0.27;0.65)。接受激光治疗的患者并发症发生率较低(OR0.49,95%Cl:0.35;0.67)。通过这项研究中的分析获得的所有发现都比冷刀技术显着有利于激光,尤其是当平均Qmax时,考虑复发和并发症。
    Cold knife urethrotome was introduced in 1971 and it had an 80% success rate. New advancements in this field have shed light on the use of various lasers such as carbon dioxide, Nd: YAG, KTP, Argon, Ho: YAG, and excimer lasers. It has been observed that cold knife urethrotomy has a higher recurrence rate than laser urethrotomy, but the superiority of either treatment modality has not been established yet. Data were thoroughly searched through PubMed, Scopus, and clinicaltrials.gov. We also used clinicaltrials.gov for ongoing and published research. The data was analyzed via R studio version 2023.12.1 (oceanstorm). For dichotomous variables, Odds Ratio (OR) were used to pool data and standardized mean difference was used for continuous variables with 95% confidence intervals (CIs). A total of 14 studies including 1114 participants were included in this meta-analysis. The results of the combined analysis revealed significant relation with a mean difference of 0.99 (95% CI: 0.37; 1.62), and favored laser group. The overall results have shown the laser to have a significant favorable profile demonstrating a recurrence, Odds Ratio of 0.42 (95% CI:0.27;0.65). Patients with laser therapy had a lower risk of complication rate (OR 0.49, 95% Cl: 0.35; 0.67). All the findings obtained by the analysis in this study favour lasers significantly over the cold knife technique especially when mean Qmax, with recurrence and complications taken into account.
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  • 文章类型: Journal Article
    在许多国家/地区,验光师的当前实践范围包括局部和口服药物,最近在美国(US)的范围内增加了可注射和激光,加拿大,英国(UK)和新西兰(NZ)。这种扩大的验光实践范围改善了眼科护理的机会,这一点至关重要,因为老龄化人口的视力障碍患病率更高,医疗保健成本更高。除了强大的安全记录外,还显示了扩展的范围。这篇综述论文旨在研究美国激光和注射剂的验光实践范围的扩展,英国,加拿大,澳大利亚和新西兰。毕业后教育计划的设计和交付,将讨论高级技能的课程框架和验光师执行的激光程序的指标。美国俄克拉荷马州于1988年首次授权验光师使用激光和注射剂。截至2024年,英国合格的验光师,在美国的12个州,新西兰的专业验光师进行激光手术。然而,激光和注射剂不在澳大利亚和加拿大目前的验光实践范围内。美国已成功设计并实施了诸如东北州立大学俄克拉荷马州验光学院高级程序课程和激光程序课程之类的培训课程,以培训研究生验光师。美国验光师进行的超过146,403次激光手术的结果仅显示出两个负面结果,等于0.001%。这些指标概述了验光师执行的这些程序的有效性,并为未来的验光范围扩展提供了有力的支持。眼部健康专业人士,相关教育机构,倡导团体,并呼吁决策者共同努力,在全球范围内扩大验光实践范围。
    Current scope of practice for optometrists in many countries include topical and oral medication with injectable and lasers being added more recently to scope in the United States (US), Canada, the United Kingdom (UK) and New Zealand (NZ). This expanded scope of optometric practice improves access to eyecare and is critical since an ageing population with a higher prevalence of vision disorders and higher healthcare costs looms. Expanded scope has been shown alongside strong safety records. This review paper aims to investigate the expansion of optometric scope of practice regarding lasers and injectables in the US, UK, Canada, Australia and NZ. The design and delivery of post-graduation educational programs, curriculum frameworks for advanced skills and the metrics of laser procedures performed by optometrists will be discussed. The State of Oklahoma in the US was first to authorise optometrists to use lasers and injectables in 1988. As of 2024, qualified optometrists in the UK, in twelve states in the US, and specialist optometrists in NZ perform laser procedures. However, lasers and injectables are not within the current scope of optometric practice in Australia and Canada. Training courses such as Northeastern State University Oklahoma College of Optometry Advanced Procedures Course and Laser Procedures Course have been successfully designed and implemented in the US to train graduate optometrists. The outcomes of over 146,403 laser procedures performed by optometrists across the US have shown only two negative outcomes, equating to 0.001%. These metrics outline the effectiveness of these procedures performed by optometrists and show strong support for future optometric scope expansion. Eye health professionals, relevant educational institutions, advocacy groups, and policymakers are called upon to work collaboratively to expand the optometric scope of practice globally.
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  • 文章类型: Case Reports
    背景:结节病,以非干酪性上皮样肉芽肿为特征,提出了诊断和治疗的挑战。
    方法:这里我们介绍了一名38岁的女性,她在点阵激光治疗后面部区域出现红斑和浸润的皮肤损伤。
    结果:组织学分析证实皮肤结节病。局部氯倍他索和口服氯喹的初始干预提供了短暂的缓解。随后的门诊管理包括外用他克莫司和氯倍他索,以及全身性甲氨蝶呤,后来用泼尼松替代。逐渐变细导致病变减少。
    结论:该病例强调了皮肤结节病的复杂性和个性化治疗方法的必要性。与整容手术的关联突出了理解潜在触发因素的重要性。所呈现的病例突出并提醒医学界,激光不仅用于治疗目的,而且还可以通过激光治疗引起特定反应。值得注意的是,虽然激光治疗经常用于治疗皮肤结节病,其在诱导结节病中的作用值得进一步研究。
    BACKGROUND: Sarcoidosis, characterized by non-caseating epithelioid granulomas, presents diagnostic and therapeutic challenges.
    METHODS: Here we present a 38-year-old woman who exhibited erythematous and infiltrated skin lesions on her facial region following fractional laser treatment.
    RESULTS: Histological analysis confirmed cutaneous sarcoidosis. Initial interventions with topical clobetasol and oral chloroquine provided transient relief. Subsequent outpatient management comprised topical tacrolimus and clobetasol, as well as systemic methotrexate, later substituted with prednisone. Gradual tapering resulted in lesion reduction.
    CONCLUSIONS: This case underscores the intricate nature of cutaneous sarcoidosis and the necessity for personalized therapeutic approaches. The association with cosmetic procedures highlights the importance of understanding potential triggers. The presented case highlights and reminds the medical community that lasers are not only used for therapeutic purposes but can also induce specific responses through laser therapy. Notably, while laser therapy is frequently employed in treating cutaneous sarcoidosis, its role in inducing sarcoidosis warrants further investigation.
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  • 文章类型: Journal Article
    目的:评估激光显微纹理基台(LMA)与机械加工基台(MA)相比在种植体周围临床和影像学结果中的潜力。
    方法:符合条件的研究包括从MEDLINE检索的随机临床试验(RCT),WebofScience,Scopus,和Embase数据库。这项研究坚持了PRISMA声明,并且该协议已在PROSPERO注册(注册号CRD42023443112)。根据Cochrane偏倚风险工具(RoB2)的第2版评估偏倚风险。采用随机效应模型进行Meta分析。之后,等级方法用于确定证据的确定性。
    结果:共2,876项研究纳入了4项随机对照试验。LMA在6-8周时具有较低的种植体周围沟深度(WMD:-0.69mm;95%CI:-0.97,-0.40;p=0.15,I2=53%)和一年时(WMD:-0.75mm;95%CI:-1.41,-0.09;p=0.09,I2=65%),但是证据的确定性很低。此外,边缘骨丢失有利于LMA组(WMD:-0.29mm;95%CI:-0.36,-0.21;p=0.69,I2=0%),证据中等。LMAs组探查时出血部位较少(WMD:-1.10;95%CI:-1.43,-0.77;p=0.88,i2=0%)。改良牙龈指数和改良菌斑指数组间无统计学差异。此外,所有研究均被归类为存在偏倚风险.
    结论:有低至中等的确定性证据表明,与MA相比,LMA可以支持植入物周围的临床和影像学参数。
    结论:激光显微组织基台可能有利于种植体周围的临床和影像学结果。
    OBJECTIVE: To evaluate the potential of laser-microtextured abutments (LMAs) compared to machined abutments (MAs) in peri-implant clinical and radiographic outcomes.
    METHODS: Eligible studies consisted of randomized clinical trials (RCTs) retrieved from MEDLINE, Web of Science, Scopus, and Embase databases. The study adhered to the PRISMA statement, and the protocol was registered at the PROSPERO (registration number CRD42023443112). The risk of bias was evaluated according to version 2 of the Cochrane risk of bias tool (RoB 2). Meta-analyses were performed using random effect models. Afterward, the GRADE approach was used to determine the certainty of evidence.
    RESULTS: Four RCTs were included from a total of 2,876 studies. LMAs had lower peri-implant sulcus depth at 6-8 weeks (WMD: -0.69 mm; 95% CI: -0.97, -0.40; p = 0.15, I2 = 53%) and at one year (WMD: -0.75 mm; 95% CI: -1.41, -0.09; p = 0.09, I2 = 65%), but the certainty of evidence was low. In addition, the marginal bone loss favored the LMAs group (WMD: -0.29 mm; 95% CI: -0.36, -0.21; p = 0.69, I2 = 0%) with moderate evidence. There were fewer sites with bleeding on probing in the LMAs group (WMD: -1.10; 95% CI: -1.43, -0.77; p = 0.88, i2 = 0%). There was no statistical difference between groups for the modified gingival index and modified plaque index. Furthermore, all studies were classified as having some concerns risk of bias.
    CONCLUSIONS: There was low to moderate certainty evidence that LMAs can favor peri-implant clinical and radiographic parameters compared to MAs.
    CONCLUSIONS: Laser-microtextured abutments may benefit peri-implant clinical and radiographic outcomes.
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  • 文章类型: Journal Article
    背景:种植体周围炎是一种引起植入物周围组织炎症的感染性疾病。本文献系统综述的目的是评估激光在非手术治疗种植体周围炎的效果,以评估其与常规治疗相比的益处。
    方法:评论方案已在PROSPERO国际预期注册处注册。研究策略是根据PRISMA指南进行的。纳入标准为:体内研究,用英语写的,临床参数的测量,最低随访时间为6个月,非手术对照组,关于光动力疗法的研究,随机临床试验,和临床试验。电子(在Pubmed上,科克伦,LILACS和EPC数据库)和手动搜索(在文章参考中)一直进行到2021年7月。借助CochraneCollaboration的工具,评估了每个参考的偏倚风险。
    结果:共有12项随机临床试验,有大量的证据,在本系统综述中进行了选择和调查。表格总结了从这些文章中提取的数据。看来,通过使用激光,参数得到了有利的改善,但没有任何显著差异。
    结论:根据研究分析,我们的结果表明,在非手术治疗种植体周围炎的临床参数方面,具有特定特征的激光治疗可以在短期和中期内对伤口愈合产生有益的治疗效果.关于其长期有用性,这还没有得到证实。然而,其益处仍然有限,因为结果一致认为激光的效果与使用常规疗法获得的效果相似。
    BACKGROUND: Peri-implantitis is an infectious disease that causes inflammation of the tissue surrounding an implant. The aim of this systematic review of the literature is to assess the effect of the use of lasers in the nonsurgical treatment of peri-implantitis in order to estimate its benefits compared to conventional therapies.
    METHODS: the review\'s protocol has been registered on PROSPERO international prospective register. The research strategy was performed according to the PRISMA guidelines. The inclusion criteria were: in vivo studies, written in English, measurements of clinical parameters, minimum follow-up at 6 months and with nonsurgical control group, studies about photodynamic therapy, randomized clinical trial, and clinical trial. Electronic (on Pubmed, Cochrane, LILACS and EPC databases) and manual searches (in articles\' referencies) were conducted until July 2021. Risk of bias was assessed for each reference thanks to the Cochrane Collaboration\'s tool.
    RESULTS: A total of 12 randomized clinical trials, with a high level of evidence, were selected and investigated in this systematic review. A table summarizes data extracted from these articles. It appears that the parameters improve favorably by using lasers, but without any significant difference.
    CONCLUSIONS: in accordance with the analysis of studies, our results show that laser therapy with specific characteristics allows to obtain beneficial therapeutic effects on wound healing in the short and the medium-term concerning the clinical parameters in the nonsurgical treatment of peri-implantitis. Concerning its long-term usefulness, it has yet to be confirmed. However, its benefits remains limited since the results agree that the effects of the laser are similar to those obtained by using conventional therapy.
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  • 文章类型: Journal Article
    本文探讨了激光手术的复杂性,承认固有的风险和并发症。Fitzpatrick光型较高的患者,以独特的生物学特性为特征,在激光治疗期间面临更高的脆弱性。对深色肤色的有限经验需要更高水平的激光专业知识和保守的方法。该研究旨在全面回顾激光治疗的副作用和并发症,特别关注Fitzpatrick光型IV至VI。我们搜索了1972年至2023年的MEDLINE数据库,以巩固知识。结果阐明了与较高光型激光手术相关的微妙挑战。总之,这项研究强调需要加强专业知识和谨慎的激光程序为个人与深色皮肤,提供有价值的见解,以优化患者安全和结果。
    This article explores the intricacies of laser surgery, acknowledging inherent risks and complications. Patients with higher Fitzpatrick phototypes, characterized by unique biological traits, face heightened vulnerability during laser treatments. Limited experience with darker skin tones necessitates a higher level of laser expertise and a conservative approach. The study aims to comprehensively review laser therapy\'s side effects and complications, with a specific focus on Fitzpatrick phototypes IV through VI. We searched the MEDLINE database from 1972 to 2023 to consolidate knowledge. Results illuminate nuanced challenges associated with laser surgery in higher phototypes. In conclusion, this research emphasizes the need for enhanced expertise and caution in laser procedures for individuals with darker skin, offering valuable insights to optimize patient safety and outcomes.
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  • 文章类型: Journal Article
    简介:根尖周病变的牙齿的牙髓治疗存在更多的临床困难。牙髓学中使用了几种方法中的各种激光,它们中的大多数被用作辅助方案,以减少根管系统的细菌负荷。改善的消毒在增强和加速根尖周病变的愈合中起着至关重要的作用。本文旨在总结评估激光对根尖周病变愈合影响的研究。方法:PubMed/MEDLINE,Scopus,Embase,搜索了WebofScience(ISI)的在线数据库,没有出版年份或地位限制,2023年4月的相关文章。使用影像学评估评估激光应用对患者根尖周病变影响的临床研究被认为符合纳入标准。结果:经过仔细筛选获得的文章,纳入了8项研究,首先由他们的标题和摘要,然后由他们的全文。二极管(4),呃,Cr:YSGG(3),使用的Nd:YAG(1)激光器的输出功率从0.75到2瓦不等。在两项研究中采用了光动力疗法,在其他研究中,直接照射根管系统。在所有研究中,根管系统的辐照都是标准准备的辅助手段。用激光治疗的牙齿的愈合不逊于常规治疗的牙齿。在所有纳入的研究中,激光应用优于标准的清洁和成形协议;然而,在大多数研究中,这种改善或更快的愈合没有统计学意义.结论:激光可以加速和改善根尖周病变的愈合过程。由于激光提高了根管系统的清洁质量,很难指出它的确切机制。需要进一步的研究来实现这种治疗方式的有效性并发现潜在的生物学概念。
    Introduction: Endodontic treatment of teeth with periapical lesions presents more clinical difficulty. Various lasers in several methods are used in endodontics, and most of them are utilized as an adjunctive protocol in order to reduce the bacterial load of the root canal system. Improved disinfection plays a crucial role in enhanced and accelerated healing of periapical lesions. This review aims to summarize studies assessing the effect of lasers on periapical lesion healing. Methods: PubMed/MEDLINE, Scopus, Embase, and Web of Science (ISI) online databases were searched, with no publication year or status restriction, for relevant articles on April 2023. Clinical studies evaluating the effect of laser application on the periapical lesion of patients using radiographic assessment were considered eligible for inclusion. Results: Eight studies were included after carefully screening the obtained articles, first by their title and abstract and then by their full texts. Diode (4), Er, Cr: YSGG (3), and Nd: YAG (1) lasers were used with output powers that varied from 0.75 to 2 watts. Photodynamic therapy was employed in two studies, and in other studies, the root canal system was directly irradiated. Irradiation of the root canal system was adjunctive to standard preparation in all studies. The healing of the teeth treated with lasers was not inferior to those conventionally treated. In all of the included studies, laser application outperformed the standard cleaning and shaping protocol; however, this improved or faster healing was not statistically significant in most studies. Conclusion: Lasers might expedite and improve the healing process of periapical lesions. Since lasers enhance the quality of cleaning of the root canal system, it is hard to point out the exact mechanism of it. Further investigations are needed to realize the effectiveness of this treatment modality and to discover the underlying biological concepts.
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  • 文章类型: Systematic Review
    背景:激光辅助孵化(LAH)是去除胚胎中透明带(ZP)的主要技术,主要包括两种方法:钻孔激光辅助孵化(D-LAH)和减薄激光辅助孵化(T-LAH)。目前,这两种方法都有局限性,它们对胚胎植入和临床妊娠的比较疗效仍不确定。
    目的:评估D-LAH和T-LAH对辅助生殖技术(ART)中临床妊娠率的影响。
    方法:我们系统地搜索了电子数据库,包括PubMed,WebofScience,和科克伦图书馆,直到2022年7月20日。本研究包括观察性研究和随机对照试验(RCTs)。使用95%置信区间(CI)评估妊娠结局的风险比(RR)。异质性的水平是用I2统计量来衡量的,考虑超过50%的值作为实质性异质性的指示。
    结果:荟萃分析审查了9项研究,涉及D-LAH的2405例临床妊娠和T-LAH的2239例临床妊娠。研究结果表明,两种技术之间的临床妊娠率没有显着差异(RR=0.93,95%CI:0.79-1.10,I2=71%,P=0.41)。亚组分析也显示没有实质性差异。然而,与T-LAH相比,D-LAH的单胎妊娠发生率明显更高(RR=2.28,95%CI:1.08-4.82,I2=89%,P=0.03)。在包括植入率在内的其他次要结局中没有观察到值得注意的差异,多胎妊娠,正在怀孕,流产,早产,和活产。
    结论:主要发现和亚组分析均显示D-LAH和T-LAH之间的临床妊娠率无明显差异。因此,不同情况的患者应在评估其个体情况后选择首选的LAH技术.然而,由于涉及的研究数量有限,准确衡量这些激光技术对临床结果的影响是具有挑战性的,需要进一步的随机对照试验和高质量的研究来提高ART的成功率。
    背景:PROSPERO:CRD42022347066。
    BACKGROUND: Laser-assisted hatching (LAH) stands as the predominant technique for removing the zona pellucida (ZP) in embryos, primarily consisting of two methods: drilling laser-assisted hatching (D-LAH) and thinning laser-assisted hatching (T-LAH). Presently, both methods have limitations, and their comparative efficacy for embryo implantation and clinical pregnancy remains uncertain.
    OBJECTIVE: Evaluate the impact of D-LAH and T-LAH on clinical pregnancy rates within assisted reproductive technology (ART).
    METHODS: We systematically searched electronic databases including PubMed, Web of Science, and Cochrane Library until July 20, 2022. This study encompassed observational studies and randomized controlled trials (RCTs). A 95% confidence interval (CI) was utilized for assessing the risk ratio (RR) of pregnancy outcomes. The level of heterogeneity was measured using I2 statistics, considering a value exceeding 50% as indicative of substantial heterogeneity.
    RESULTS: The meta-analysis scrutinized 9 studies involving 2405 clinical pregnancies from D-LAH and 2239 from T-LAH. Findings suggested no considerable variation in the clinical pregnancy rates between the two techniques (RR = 0.93, 95% CI: 0.79-1.10, I2 = 71%, P = 0.41). Subgroup analyses also revealed no substantial differences. However, D-LAH exhibited a notably higher occurrence of singleton pregnancies compared to T-LAH (RR = 2.28, 95% CI: 1.08-4.82, I2 = 89%, P = 0.03). There were no noteworthy distinctions observed in other secondary outcomes encompassing implantation rate, multiple pregnancies, ongoing pregnancy, miscarriage, premature birth, and live birth.
    CONCLUSIONS: Both the primary findings and subgroup analyses showed no marked variance in clinical pregnancy rates between D-LAH and T-LAH. Therefore, patients with varying conditions should select their preferred LAH technique after assessing their individual situation. However, due to the restricted number of studies involved, accurately gauging the influence of these laser techniques on clinical outcomes is challenging, necessitating further RCTs and high-quality studies to enhance the success rate of ART.
    BACKGROUND: PROSPERO: CRD42022347066.
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  • 文章类型: Meta-Analysis
    探讨不同类型激光在高龋风险病例中预防牙釉质脱矿的体内和原位效果(正畸托槽周围,修复周围和龋齿易感凹坑和裂缝)。使用以下关键字序列搜索PubMed;(激光治疗或激光照射或激光应用)和(预防釉质龋齿或釉质脱矿或釉质再矿化或早期釉质龋齿或早期釉质龋齿或釉质抵抗或釉质脱钙或白点病变WSLs或早期病变或釉质腐烂或釉质溶解或釉质显微硬度)和(临床试验或随机临床试验或原位研究。最新的文献检索于“2023年1月30日”结束。PubMed用作研究选择的主要数据库。Scopus,EBSCO,在PubMed上进行系统搜索后,我们对Google学者进行了检查。只找到重复项。进行了两次荟萃分析。第一,CO2激光照射釉质后白斑病变(WSLs)发生率的临床荟萃分析。CO2激光离体/原位对牙釉质显微硬度影响的第二次荟萃分析。在每个荟萃分析中包括三项研究。评估偏倚风险。搜索确定了8项研究(4项离体试验和4项临床试验)。关于临床荟萃分析,总体标准化平均差为0.21[95%置信区间(CI):0.15-0.30,p<0.00001].这表明接受低功率CO2激光治疗的患者中新WSL的发生率明显低于安慰剂组。异质性相当大(I2=71%)。在第二个荟萃分析中,总体标准化平均差为49.55[95%置信区间(CI):37.74,61.37,p<0.00001].这表明接受低功率(0.4-5W)CO2激光照射的釉质的显微硬度显著低于对照未经处理的釉质。异质性很大(I2=48%)。在这项研究的局限性内,使用CO2激光的低水平激光治疗概念似乎可有效预防釉质龋齿。Prospero注册号:CRD42023437379。
    To investigate the in vivo and in situ effect of different types of lasers in prevention of enamel demineralization in high caries risk cases (around orthodontic brackets, around restoration and in caries susceptible pits and fissures). PubMed was searched using the following keyword sequence; (Laser therapy OR laser irradiation OR laser application) AND (enamel caries prevention OR enamel demineralization OR enamel remineralization OR early enamel caries OR early-enamel caries OR enamel resistance OR enamel decalcification OR white spot lesions WSLs OR incipient lesion OR enamel decay OR enamel Dissolution OR enamel microhardness) AND (clinical trial OR Randomized clinical trial OR In situ study). The latest literature search was ended by \"30 January 2023\". PubMed was used as a primary data base for study selection. Scopus, EBSCO, and Google scholar are checked in our study after results of systematic search on PubMed. Only duplicates were found. Two meta-analyses were carried out. The first, clinical meta-analysis on incidence of white spot lesions (WSLs) following CO2 laser irradiation of enamel. The second meta-analysis on ex-vivo/in situ effect of CO2 laser on microhardness of enamel. In each meta-analysis three studies were included. Risk of bias was assessed. The search identified eight studies (four ex-vivo and four clinical trials). Regarding the clinical meta-analysis, the overall standardized mean difference was 0.21 [ 95% confidence interval (CI): 0.15-0.30, p < 0.00001]. This indicates that the incidence of new WSLs in patients who received low power CO2 laser treatment was highly significantly lower than placebo groups. The heterogeneity was considerable (I2 = 71%). In the second meta-analysis, the overall standardized mean difference was 49.55 [ 95% confidence interval (CI): 37.74, 61.37, p < 0.00001]. This indicates that microhardness of enamel receiving low power (0.4-5 W) CO2 laser irradiation is highly significantly lower than control untreated enamel. The heterogeneity was substantial (I2 = 48%). Within the limitations of this study, Low level laser therapy concept with CO2 laser seems to be effective in preventing enamel caries.Prospero registration number: CRD42023437379.
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