<p> The characteristics of small-signal gain in a TE CO₂ laser amplifier are investigated using a new technique based on gain measurements of the sequence, hot and regular CO₂ laser bands. This new technique enables us, for the first time, to determine accurately the rotational and vibrational temperatures characterizing the CO₂ laser system. The gain ratio of the sequence band to the regular band provides a simple and accurate determination of the ν₃ mode vibrational temperature. The variation of this ν₃ mode vibrational temperature with discharge energy enables us to determine the net pumping efficiency to the ν₃ mode levels as a function of input energy. It is found that the ν₃ mode vibrational temperature saturates at high input energy. This saturation sets an upper limit to the gain attainable in TE CO₂ laser amplifiers. Once this saturation occurs, increasing background gas temperature causes a reduction in gain at high input energy. </p> <p> As we can measure all the characteristic temperatures relevant to the gain medium, a comparison between the calculated and experimental gain can be carried out with no adjustable parameters. The result of such a direct comparison confirms both the validity of the conventional "mode temperature" model for CO₂ laser dynamics and the validity of our measurement technique for vibrational temperatures. </p> <p> The results of the present study have shown the existence of a de-excitation mechanism occurring in the discharge, which reduces drastically the pumping efficiency to the ν₃ mode at high discharge energy. It is therefore essential to incorporate such a de-excitation mechanism in the accurate modeling of CO₂ laser dynamics. The present study contributes to a better understanding of CO₂ laser dynamics at high discharge energies. </p> / Thesis / Master of Science (MSc)

Diante do aumento de lesões de erosão e a necessidade de métodos que controlem a sintomatologia dolorosa a elas relacionada, o objetivo deste estudo foi avaliar, através de um modelo in situ, crossover 2 x 2, o efeito de um dentifrício dessensibilizante associado ao laser de CO2 em controlar a permeabilidade da dentina radicular erodida. Oitenta fragmentos de dentina radicular bovina (3 x 3 x 2 mm) foram submetidos a um desafio erosivo inicial (ácido cítrico 0.3%, 2 h), seguidos por um período de remineralização em saliva artificial (24 h). Os espécimes foram divididos de acordo com o tratamento dentinário: dentifrício dessensibilizante, dentifrício dessensibilizante + laser CO2, dentifrício anticárie com flúor e dentifrício anticárie com flúor + laser de CO2. Após um período de lead-in de 2 dias, dez voluntários utilizaram dispositivo palatino contendo 4 fragmentos de dentina radicular em duas fases de 5 dias cada. Durante a fase intraoral, um dos lados do dispositivo era imerso em ácido cítrico 0.3%, e o lado oposto em água deionizada, quatro vezes ao dia. Uma hora após as imersões os espécimes foram escovados com slurry dos dentifrícios fornecido pelo pesquisador. Na primeira fase, metade dos voluntários tratou os espécimes com dentifrício dessensibilizante, enquanto a outra metade utilizou o dentifrício anticárie com flúor. Após um período de 7 dias de wash-out, os voluntários foram cruzados quanto ao dentifrício. Ao final de cada fase os espécimes foram submetidos à coloração histoquímica e seccionados para serem analisados quanto à permeabilidade por meio de microscopia óptica. Os dados obtidos foram analisados através da ANOVA e não houve diferenças significantes (p=0,272) entre os tratamentos realizados na dentina radicular de dentes bovinos. Pode-se concluir que dentifrícios anticárie com flúor ou dessensibilizante, independente da associação com laser de CO2, podem controlar a permeabilidade em dentina radicular erodida. / Facing the increased prevalence of erosive lesion and the need of preventive means to control painful symptoms related to them, the aim of this study was to evaluate, through a crossover 2 x 2 in situ trial, the effect of a desensitizing dentifrice combined with CO2 laser irradiation to control the permeability of eroded root dentin. Eighty slabs of bovine root dentin (3 x 3 x 2 mm) were subjected to initial erosive challenge (citric acid 0.3%, 2 h), followed by a remineralizing period in artificial saliva (24 h). Specimens were then divided according to dentin treatment: desensitizing dentifrice, desensitizing dentifrice + CO2 laser, fluoride anticaries dentifrice and fluoride anticaries dentifrice + CO2 laser. After a 2-day lead-in period, ten volunteers wore an intraoral palatal appliance containing 4 root dentin slabs, in 2 phases of 5 days each. During the intraoral phase, one side of the appliance was immersed in 0.3% citric acid, and the opposite side in deionized water, four times a day. One hour after the immersions, all specimens were brushed with dentifrice slurry provided by the researcher. At the first phase, half of volunteers brushed the specimens with desensitizing dentifrice, and the other half used the fluoride anticaries dentifrice. After a 7-day wash-out period, volunteers were crossed-over on the dentifrice. Completed each phase the specimens were stained and sectioned to be assessed for permeability through optical microscope. Data were analyzed using ANOVA and no significant difference (p=0,272) was found between the surface treatments performed on bovine root dentin. It can be concluded that fluoride anticaries or desensitizing dentifrice, regardless of association with the CO2 laser irradiation, were able to permeability of eroded root dentin.

Das Ziel dieser Studie war die Analyse der Ergebnisse der mikrochirurgischen Therapie von Akustikusneurinomen (AN) über den transtemporalen Zugangsweg unter Einsatz eines flexiblen CO2-Faserlasers (Omniguide®). Zu diesem Zweck wurde eine prospektive nicht randomisierte klinische Studie durchgeführt. Bei 20 aufeinander folgenden Patienten, bei denen eine mikrochirurgische Exstirpation des Tumors über den transtemporalen Zugangsweg erfolgte, wurde die Tumorresektion mit Hilfe des flexiblen CO2-Lasers durchgeführt (Lasergruppe, LG). Als Vergleichsgruppe wurden 20 Patienten mit vergleichbarer Tumorgröße und gleichem präoperativen Hörvermögen aus einer Kohorte von 76 Patienten ausgewählt (matched pairs), die zu einem früheren Zeitpunkt vom selben Operateur ohne Zuhilfenahme des Lasers operiert worden waren (Kontrollgruppe, KG). In der frühen postoperativen Phase konnte bei jeweils sechs Patienten beider Gruppen eine Facialisschwäche nach House-Brackmann (HB) Grad 2-4 festgestellt werden. Nach drei Monaten zeigte sich lediglich bei einem Patienten der KG noch eine leichte Facialisschwäche (HB-Grad 2). Der Erhalt der Facialisfunktion (HB-Grad 1 und 2) lag bei beiden Gruppen bei 100 %. Der Hörerhalt (Gardner-Robertson-Klasse 1 und 2 prä- und postoperativ) lag in der LG bei 72 % und in der KG bei 82 % ohne statistisch signifikanten Unterschied. Die absolute Operationszeit (Schnitt-Naht-Zeit) betrug in der KG 157 min und in der LG 160 min. Die Präparationszeit des Tumors lag in der KG bei 23,2 min und bei der LG bei 36,1 min. Durch den Einsatz des CO2-Lasers konnte zwar keine Reduktion der Operationszeit erreicht werden, jedoch zeigten sich im Vergleich zur konventionellen Technik postoperativ die gleichen guten funktionellen Ergebnisse, so dass der CO2-Laser eine sinnvolle Ergänzung für spezielle Fälle sein kann (z.B. bei stark vaskularisierten Tumoren). / The aim of this study was to analyze the results of microsurgery in vestibular schwannomas (VS) with assistance of a flexible CO(2) laser fiber (Omniguide(®)) using the middle cranial fossa (MCF) approach. For that purpose we performed a prospective non-randomized clinical trial. In 20 consecutive patients suffering from VS and elected for microsurgery via the MCF approach, tumor resection was performed with the aid of the flexible CO(2) laser ("laser group", LG). Twenty patients with similar tumor volume and pre-operative hearing status out of a cohort of 76 patients previously treated by the same surgeon without laser were used as comparison group ("conventional group", CG) (matched-pair-technique). Facial weakness (House-Brackmann (HB) 2-4) was seen in early postoperative (p.o.) days in six patients in each group and all recovered completely by 3 months p.o., except one patient with HB 2 in CG. Facial nerve preservation rate (HB 1 + 2) was 100% in both groups. Hearing preservation rate (Gardner/Robertson class 1 + 2 or AAO-HNS A + B, pre- and postoperatively) was 72% in LG and 82% in CG, without significant difference. Overall time from incision to skin suture was 157 min (SD 55.9) in CG and 160 min (SD 39.7) in LG. Tumor preparation time was 23.2 min (SD 19.7) in CG and 36.1 min (SD 33.8) in LG. The use of a handheld flexible CO(2) laser fiber in VS-microsurgery is safe and subjectively facilitates tumor resection especially in "difficult" (e.g., highly vascularized) tumors. However, in this limited prospective trial the excellent functional outcome following conventional microsurgery could not be further improved, nor the surgical time reduced by means of the non-contact laser-tool. Focusing the use of the flexible CO(2) laser on "difficult" tumors may lead to different results in future.

Diante do aumento de lesões de erosão e a necessidade de métodos que controlem a sintomatologia dolorosa a elas relacionada, o objetivo deste estudo foi avaliar, através de um modelo in situ, crossover 2 x 2, o efeito de um dentifrício dessensibilizante associado ao laser de CO2 em controlar a permeabilidade da dentina radicular erodida. Oitenta fragmentos de dentina radicular bovina (3 x 3 x 2 mm) foram submetidos a um desafio erosivo inicial (ácido cítrico 0.3%, 2 h), seguidos por um período de remineralização em saliva artificial (24 h). Os espécimes foram divididos de acordo com o tratamento dentinário: dentifrício dessensibilizante, dentifrício dessensibilizante + laser CO2, dentifrício anticárie com flúor e dentifrício anticárie com flúor + laser de CO2. Após um período de lead-in de 2 dias, dez voluntários utilizaram dispositivo palatino contendo 4 fragmentos de dentina radicular em duas fases de 5 dias cada. Durante a fase intraoral, um dos lados do dispositivo era imerso em ácido cítrico 0.3%, e o lado oposto em água deionizada, quatro vezes ao dia. Uma hora após as imersões os espécimes foram escovados com slurry dos dentifrícios fornecido pelo pesquisador. Na primeira fase, metade dos voluntários tratou os espécimes com dentifrício dessensibilizante, enquanto a outra metade utilizou o dentifrício anticárie com flúor. Após um período de 7 dias de wash-out, os voluntários foram cruzados quanto ao dentifrício. Ao final de cada fase os espécimes foram submetidos à coloração histoquímica e seccionados para serem analisados quanto à permeabilidade por meio de microscopia óptica. Os dados obtidos foram analisados através da ANOVA e não houve diferenças significantes (p=0,272) entre os tratamentos realizados na dentina radicular de dentes bovinos. Pode-se concluir que dentifrícios anticárie com flúor ou dessensibilizante, independente da associação com laser de CO2, podem controlar a permeabilidade em dentina radicular erodida. / Facing the increased prevalence of erosive lesion and the need of preventive means to control painful symptoms related to them, the aim of this study was to evaluate, through a crossover 2 x 2 in situ trial, the effect of a desensitizing dentifrice combined with CO2 laser irradiation to control the permeability of eroded root dentin. Eighty slabs of bovine root dentin (3 x 3 x 2 mm) were subjected to initial erosive challenge (citric acid 0.3%, 2 h), followed by a remineralizing period in artificial saliva (24 h). Specimens were then divided according to dentin treatment: desensitizing dentifrice, desensitizing dentifrice + CO2 laser, fluoride anticaries dentifrice and fluoride anticaries dentifrice + CO2 laser. After a 2-day lead-in period, ten volunteers wore an intraoral palatal appliance containing 4 root dentin slabs, in 2 phases of 5 days each. During the intraoral phase, one side of the appliance was immersed in 0.3% citric acid, and the opposite side in deionized water, four times a day. One hour after the immersions, all specimens were brushed with dentifrice slurry provided by the researcher. At the first phase, half of volunteers brushed the specimens with desensitizing dentifrice, and the other half used the fluoride anticaries dentifrice. After a 7-day wash-out period, volunteers were crossed-over on the dentifrice. Completed each phase the specimens were stained and sectioned to be assessed for permeability through optical microscope. Data were analyzed using ANOVA and no significant difference (p=0,272) was found between the surface treatments performed on bovine root dentin. It can be concluded that fluoride anticaries or desensitizing dentifrice, regardless of association with the CO2 laser irradiation, were able to permeability of eroded root dentin.