Techn. Hochsch., Diss., 2005--Aachen.

Light-based therapies are becoming increasingly important and widely applied within the clinical practice. Their advantages over more traditional therapies have created an expanding market which is driving the development of more efficient and sophisticated devices. These devices allow a more precise control of the characteristics of the optical output to maximise benefits of the treatment. Although many studies have been conducted on light, and more specifically lasers, both from a therapeutic and a technological perspective, there is still much research to be undertaken. Laser systems have been used for more than two decades for the treatment of vascular lesions. Indeed the application of selective photothermolysis utilising the monochromaticity of the laser system has become the treatment of choice. However the treatment of larger blood vessels remains problematic. Many workers have, for theoretical and clinical reasons, elected to choose the YAG laser for the treatment of larger thread veins and vascular lesions containing larger vessels. The therapeutic output has been mixed and the need for further work identified. This thesis describes the design of a novel approach to the control of the temporal profile of the YAG laser. The design aspect of the work includes a computer modelling study which shows that careful control of the temporal parameters can in principle improve the therapeutic output. A novel approach to the digital control of the flashlamps pumping the YAG crystal is also described. The digital control of the flashlamp translates to sensitive control of the temporal profile of the laser output in a way that has not been described to date. The thesis therefore concludes that control of the temporal output of the YAG laser, if possible, should give improved therapeutic output and that the necessary level of control can be achieved by advanced digital techniques. Future clinical work should prove improved therapeutic results.

No tratamento endodôntico, várias fases de igual importância são necessárias para a realização de uma terapêutica bem sucedida, entre elas podemos citar a instrumentação. Apesar de todas as técnicas e instrumentos propostos para a Endodontia, o sucesso esperado ainda não foi alcançado. Tanto a instrumentação manual quanto à rotatória não resulta na limpeza das áreas polares dos canais radiculares com achatamento mésio-distal. No intuito de obter melhor resultado clínico, avaliou-se “in vitro” a remoção da camada de “smear” das paredes dos canais radiculares de 40 dentes incisivos inferiores portadores de achatamento mésio-distal submetidos à instrumentação rotatória por meio da técnica “Free Tip Preparation”, utilizando o laser de Er: YAG nos parâmetros de 140 e 250 mJ. Para tanto, a fibra óptica do aparelho foi deslocada lentamente, com velocidade de 2 mm/s, até o orifício cervical na câmara pulpar, na parede vestibular e lingual da raiz; e sua eficácia na remoção da “smear” foi comparada aos grupos onde se utilizou apenas Hipoclorito a 2,5% e Hipoclorito de sódio a 2,5% alternado com EDTA a 17%. Os dentes foram analisados por meio de microscopia eletrônica de varredura, e as fotomicrografias das áreas mais representativas dos terços médio e apical foram avaliadas por três examinadores diferentes, com grau mínimo de Mestre, que observaram a quantidade da camada de “smear” presente nas amostras em relação a três padrões. Os examinadores, sem que tivessem o conhecimento prévio de qual dos grupos estavam avaliando, atribuíram escores de 1 a 4 as fotomicrografias, de acordo com a quantidade da camada de “smear” visualizada. Os dados obtidos foram submetidos à análise estatística não-paramétrica, comparando-se os diferentes grupos estudados (teste de Kruskal-Wallis) e os terços radiculares (teste de Wilcoxcon). Os resultados mostraram que, quanto à quantidade da “smear” encontrada nos grupos estudados, o grupo que utilizou Hipoclorito a 2,5% alternado com EDTA apresentou os canais radiculares mais limpos seguido do grupo do laser 250 mJ e posteriormente pelos grupos do laser Er: YAG a 140 mJ e do hipoclorito a 2,5%, que não apresentaram diferença estatisticamente significante entre si. Quanto aos terços, o apical apresentou maior quantidade da “smear” em comparação com o terço médio (p< 0,01). / Manual or rotary instrumentation techniques do not efficiently clean mesio-distal flattened root canals. This study evaluated, in vitro, smear layer removal of 40 mesio-distal flattened root canals after rotary instrumentation. The teeth were then divided into 4 groups: group 1: rotary instrumentation and 2.5% sodium hypochlorite used as irrigating solution; group 2: instrumented as group 1 and followed by Er: YAG laser irradiation (140mJ input/10Hz), withdrawn at 2mm/s from the apical to the cervical region touching the buccal walls the procedure was then repeated for the lingual wall); group 3: instrumented as group 1 and followed by Er: YAG laser irradiation (250mJinput/10Hz) withdrawn at 2mm/s from the apical to the cervical region touching the buccal walls the procedure was then repeated for the lingual wall) and group 4: instrumented as group 1 and alternated with 17% EDTA Teeth were split longitudinally and prepared for examination under scanning electron microscopy. Scores from 1 to 4 were given to the fotomicrographs by three independent evaluators, and these data was submitted to statistical analysis. The teeth where alternated 17% EDTA were used (group 4) showed less amount of smear layer, followed by the group irradiated with 250mJinput/10Hz (group 3), the group irradiated with 140mJ input/10Hz and the group where only sodium hypochlorite was used. The apical third presented more smear layer than the middle third (p<00.1).

No tratamento endodôntico, várias fases de igual importância são necessárias para a realização de uma terapêutica bem sucedida, entre elas podemos citar a instrumentação. Apesar de todas as técnicas e instrumentos propostos para a Endodontia, o sucesso esperado ainda não foi alcançado. Tanto a instrumentação manual quanto à rotatória não resulta na limpeza das áreas polares dos canais radiculares com achatamento mésio-distal. No intuito de obter melhor resultado clínico, avaliou-se “in vitro" a remoção da camada de “smear" das paredes dos canais radiculares de 40 dentes incisivos inferiores portadores de achatamento mésio-distal submetidos à instrumentação rotatória por meio da técnica “Free Tip Preparation", utilizando o laser de Er: YAG nos parâmetros de 140 e 250 mJ. Para tanto, a fibra óptica do aparelho foi deslocada lentamente, com velocidade de 2 mm/s, até o orifício cervical na câmara pulpar, na parede vestibular e lingual da raiz; e sua eficácia na remoção da “smear" foi comparada aos grupos onde se utilizou apenas Hipoclorito a 2,5% e Hipoclorito de sódio a 2,5% alternado com EDTA a 17%. Os dentes foram analisados por meio de microscopia eletrônica de varredura, e as fotomicrografias das áreas mais representativas dos terços médio e apical foram avaliadas por três examinadores diferentes, com grau mínimo de Mestre, que observaram a quantidade da camada de “smear" presente nas amostras em relação a três padrões. Os examinadores, sem que tivessem o conhecimento prévio de qual dos grupos estavam avaliando, atribuíram escores de 1 a 4 as fotomicrografias, de acordo com a quantidade da camada de “smear" visualizada. Os dados obtidos foram submetidos à análise estatística não-paramétrica, comparando-se os diferentes grupos estudados (teste de Kruskal-Wallis) e os terços radiculares (teste de Wilcoxcon). Os resultados mostraram que, quanto à quantidade da “smear" encontrada nos grupos estudados, o grupo que utilizou Hipoclorito a 2,5% alternado com EDTA apresentou os canais radiculares mais limpos seguido do grupo do laser 250 mJ e posteriormente pelos grupos do laser Er: YAG a 140 mJ e do hipoclorito a 2,5%, que não apresentaram diferença estatisticamente significante entre si. Quanto aos terços, o apical apresentou maior quantidade da “smear" em comparação com o terço médio (p< 0,01). / Manual or rotary instrumentation techniques do not efficiently clean mesio-distal flattened root canals. This study evaluated, in vitro, smear layer removal of 40 mesio-distal flattened root canals after rotary instrumentation. The teeth were then divided into 4 groups: group 1: rotary instrumentation and 2.5% sodium hypochlorite used as irrigating solution; group 2: instrumented as group 1 and followed by Er: YAG laser irradiation (140mJ input/10Hz), withdrawn at 2mm/s from the apical to the cervical region touching the buccal walls the procedure was then repeated for the lingual wall); group 3: instrumented as group 1 and followed by Er: YAG laser irradiation (250mJinput/10Hz) withdrawn at 2mm/s from the apical to the cervical region touching the buccal walls the procedure was then repeated for the lingual wall) and group 4: instrumented as group 1 and alternated with 17% EDTA Teeth were split longitudinally and prepared for examination under scanning electron microscopy. Scores from 1 to 4 were given to the fotomicrographs by three independent evaluators, and these data was submitted to statistical analysis. The teeth where alternated 17% EDTA were used (group 4) showed less amount of smear layer, followed by the group irradiated with 250mJinput/10Hz (group 3), the group irradiated with 140mJ input/10Hz and the group where only sodium hypochlorite was used. The apical third presented more smear layer than the middle third (p<00.1).

This work deals with the interaction of intense 100 ps laser pulses with double-layer foil targets, consisting of one dielectric (Mylar) layer and one metallic layer. The diagnostics of the evolving plasmas is done by the means of shorttime interferometry, time-resolved X-ray spectroscopy, and methods of ion dosimetry in polymer nuclear track detectors (CR-39). / Die Arbeit beschäftigt sich mit der Wechselwirkung intensiver 100-ps-Laserpulse eines Nd:YAG-Lasersystems mit Zweischicht-Folientargets, die aus einer dielektrischen Schicht (Mylar) und einer metallischen Schicht bestehen. Die entstehenden Plasmen werden mittels Kurzzeitinterferometrie und zeitaufgelöster Röntgenspektroskopie sowie mit Methoden der Ionendosimetrie in Polymer-Kernspurätzdetektoren (CR-39) untersucht.

The main purpose of this research was to investigate new medical applications of femtosecond laser ablation. A near-infrared femtosecond laser was tested and proved to be able to overcome the existing limitations and outperform the conventional long-pulse lasers in the areas of human urinary calculus (kidney stone) lithotripsy and skin treatment. The two primary objectives of my research are: 1) to investigate the feasibility of using femtosecond pulsed laser radiation to ablate urinary calculus of various compositions. The laser-calculus interaction mechanism was characterized using pump probe imaging and fast flash imaging. A novel fiber delivery system was developed to transmit and focus high energy femtosecond pulses for urinary calculus lithotripsy. The successful demonstration of the femtosecond laser lithotripsy provided a promising treatment method better than the existing long-pulse laser lithotripsy in a few different aspects, including less collateral damage to surrounding tissue, small-size debris and more controlled experimental condition. 2) to investigate the depth limitation of femtosecond subsurface ablation in scattering skin sample and develop a prototype tissue optical clearing device to enhance femtosecond beam penetration for deeper subsurface cavitation production in the skin. The successful demonstration of the device has potential benefits to new femtosecond-based therapies for reshaping or removing subcutaneous tissues. / text

Zugl.: Aachen, Techn. Hochsch., Diss., 2006.

Konstanz, Univ., Diss., 2008.

Zugl.: Braunschweig, Techn. Univ., Diss., 2008

Techn. Universiẗat, Diss., 2003--Berlin.