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BACKGROUND: Multiple miliary osteoma of the face is a rare entity with at least 50 cases described in the literature. It is characterized by multiple fragments of adult bone in the dermis. The pathophysiology of the disease is not clear, but it is often presented as a late sequela in a patient with acne vulgaris. It presents as papular neoformations similar to milia, which mainly affects the face. The diagnosis is confirmed by the histopathology. CLINICAL CASE: A female patient with multiple miliary osteomas associated with hyperparathyroidism and a history of acne vulgaris. CONCLUSIONS: It is important to know about the disease and to have an adequate approach of it, in search of the causes or associated diseases. [ABSTRACT FROM AUTHOR]

Las úlceras crónicas de los miembros inferiores (UCMI) tienen una elevada prevalencia, etiología diversa y son de difícil curación. El objetivo del presente estudio es evaluar los resultados alcanzados en su curación mediante el empleo de un láser de Erbium:YAG con tecnología RecoSMA. Este láser y sistema de tecnología emite energía en forma de miles de microhaces induciendo microablación de la epidermis y actuación en las células de la dermis por efecto mecánico-acústico. Tratamos con irradiación semanal 17 pacientes durante 3 meses. La evaluación de resultados se realizó mediante cuestionarios y correlación clínica e histológica, realizando fotografías antes de cada sesión de tratamiento (12 en total), y su correspondiente análisis con asistencia de un programa informático. Los resultados mostraron curación completa, o reducción del área de las úlceras en aproximadamente el 50% de su superficie inicial en más del 50% de los pacientes. En el estudio estadístico empleamos t de Student y test exacto de Fisher y obtuvimos resultados estadísticamente significativos, con p < 0,05. El láser de Er:YAG y la tecnología RecoSMA basada en ópticas que convierten el haz del láser en miles de microhaces no solamente se absorbe en la superficie del tejido, sino que penetra en la dermis y, por mecanismo mecánico-acústico, produce efectos de resonancia eficaces para producir regeneración tisular. Su empleo en las UCMI de difícil solución es una alternativa de tratamiento eficaz y seguro.

Este trabalho analisa o efeito da reparação cutânea do laser erbium:yttrium aluminunn garnet (YAG) (Er:YAG) em pele de ratos através de estudo histológico e morfométrico. Tatuaram-se duas figuras no dorso de cada animal (n = 35), denominadas controle e experimento. Na figura experimento, aplicaram-se três passadas de laser Er:YAG com parâmetros padronizados. Cinco animais foram eutanasiados nos dias 0, 7, 14, 28, 56, 84 e 112 de pós-operatório. O estudo histológico demonstrou no dia 0 dano de ablação médio de 215,24 micrômetros (mm), sendo homogêneo com vaporização da epiderme e porções superficiais da derme. O dano térmico residual foi pequeno (média de 41,45mm), observando-se áreas onde estava praticamente ausente. A fibroplasia cicatricial já estava presente no dia 7 (média de 55,58mm), aumentando rapidamente até o dia 28 (média de 209,49mm), quando atingiu um platô e se manteve até o dia 112. Não houve sinais de processo inflamatório agudo no dia 7 e a reepitelização já estava completa. Concluiu-se que a aplicação de laser na pele de ratos induz reparação cutânea ao longo de 112 dias nas condições do experimento.This study analyses the skin contracture effect of the erbium:YAG (Er:YAG) laser on the skin of rats by light microscopic histological and morphometrical evaluations. Two squares of back skin were precision tattooed on each of the animals (n = 35), that were termed control and experimental skin. The experimental skin was treated with three passes of the Er:YAG laser with standardized parameters. Five animals were killed and skin specimens were analyzed at 00, 07, 14, 28, 56, 84 and 112 days. Histologic examination demonstrated a mean of 215.24 micrometers ablative damage that was homogeneous with complete vaporization of the epidermis and superficial dermis. The residual thermal damage was small (mean of 41.45 micrometers) observing areas where it was absent. The cicatritial fibroplasy was present at day 07 (mean 55.58 micrometers) rising quickly until day 28 (mean of 209.49 micrometers) when it reaches a plateau and maintaining it until day 112. There are no signs of acute inflammatory process at day 07 and the reepithealization was complete at this day. This study revealed that the laser had induced shortening of the treated areas which persisted beyond the 112 days.

O presente estudo tem como objetivo analisar, do ponto de vista anatomopatológico, os efeitos térmicos encontrados na pele de ratos wistar após a aplicação do laser de CO2 e do laser erbium. Utilizaram-se oito ratos submetidos a tricotomia em toda a região toracodorsal. Selecionaram-se duas áreas separadas, as quais receberam a aplicação do laser. Na primeira foram realizadas duas passadas do laser de CO2 e na segunda, duas passadas do laser erbium. A área-controle correspondeu àquela imediatamente adjacente à área submetida ao laser. A análise microscópica da lesão causada pelo laser de CO2 revela lesão em forma de U, com ablação completa da epiderme em toda a sua extensão. A derme superficial apresenta degeneração do colágeno, correspondendo ao dano térmico residual, e a transição deste para a derme normal é bem demarcada. Na pele lesada com laser erbium observa-se também extensa área de pele lesada em forma de platô, com algumas pequenas áreas de pele não-lesada. Pode-se observar, ainda, dano do colágeno na derme superficial, porém mais discreto que aquele causado pelo CO2.

Chronic lower extremity ulcers (CLEU) have a high prevalence, present various aetiologies and are difficult to heal. The aim of the present study is to evaluate the results achieved in healing CLEU using an Erbium:YAG with RecoSMA technology. This laser emits energy in thousands of microbeams causing superficial epidermal ablation by thermal effect, and a limited cell membrane destruction in dermis due to a mechanical- acoustic effect. Evaluation of results achieved was carried out in 17 patients enrolled in the study by questionnaires, histologies and clinical visual correlation of progress by photographs taken before each session (12 session in total), which were analyzed with the help of a computer program. Results after 12 treatment sessions showed complete healing of ulcers or a decrease of their initial area in at least 50% in more than 50% of patients treated. The t Student test and Fishers' exact test were used for the statistical analysis noticing that results obtained were statistically significant with p<0,05. The Er:YAG laser and RecoSMA technology, based on a system of optics which converts the laser beam in thousands of microbeams, it is not only absorbed in the tissue surface, but penetrates in the dermis. The acoustic-mechanical mechanism produces effective resonance effects to achieve tissue regeneration. This technology used on difficult CLEU offers an effective and safe treatment alternative. [ABSTRACT FROM AUTHOR]

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Background Data: Enamel microcrack formation has a high incidence after mechanical debonding of ceramic brackets. This may be due to high delivered shear bond strength values when enamel is priorly etched by phosphoric acid. It is still not well elucidated in the literature if laser etching affects enamel the same way. The aim of the research was to analyze different Er,Cr:YSGG and Er:YAG laser etching settings as an alternative to phosphoric acid, in an attempt to prevent enamel microcrack formation during laser etching and mechanical debonding, while reducing the shear bond strength to the minimal clinical acceptable value., Materials and Methods: One hundred and thirty-three teeth were randomly divided into 7 experimental groups according to their etching modalities. Settings used for enamel etching were in Er,Cr:YSGG groups: Er,Cr:YSGG (1.5Watt, W/20Hertz, Hz); Er,Cr:YSGG (1.5W/15Hz) and Er,Cr:YSGG (2W/20Hz) and settings used for enamel etching in Er:YAG groups were: Er:YAG (60 millijoules, mJ), Er:YAG (80mJ) and Er:YAG (100mJ). Group C etched with 37% phosphoric acid served as control. Microscopic analysis was performed to assess presence of enamel microcracks. Shear bond strength was evaluated after thermocycling using Weibull survival analysis., Results: All groups showed a reduction in additional microcracks after debonding when compared to control, but only group Er:YAG (60mJ) exhibited a statistically significant difference. Groups Er:YAG (80mJ), control and Er:YAG (100mJ) showed respectively the highest probability of survival at various stress levels followed by groups Er:YAG (60mJ); Er,Cr:YSGG (1.5W/15Hz); Er,Cr:YSGG (2W/20Hz) and Er,Cr:YSGG (1.5W/20Hz) that presented a relatively considerable risk of failure, even at low stress levels., Conclusions: When considering reduction of enamel microcrack formation and clinical acceptable shear bond strength, none of the groups succeeded both. Etching by Er:YAG (60mJ) and Er,Cr:YSGG (1.5W/15Hz), showed the least overall microcrack incidence between groups, but Er:YAG (60mJ) displayed significant reduction compared to phosphoric acid. However, etching by Er:YAG (80mJ) had the most predictable results in term of shear bond strength., (Copyright © 2019 CEO. Published by Elsevier Masson SAS. All rights reserved.)