Effect of Hand, Ultrasonic Scaler and Erbium-Doped Yttrium Aluminum Garnet (Er: YAG) Laser on the Morphology of Root Surfaces with Periodontitis: a Comparative in Vitro Scanning Electron Microscopy Study

INTRODUCTION: The main purpose of the present study was to describe the ultra structural changes which happened after treatment of the root surfaces with ultrasonic and hand devices followed by Erbium-Doped Yttrium Aluminum Garnet (Er:YAG) laser irradiation.METHODS: Sixty single-rooted maxillary and mandibular teeth which had been extracted due to periodontal problems were collected. Crown and apical parts of the root were cut off using a diamond bur. The specimens were mounted on an acrylic resin in order to make a plain surface of the root accessible. The samples were assigned as following: group1: samples were root planed using conventional hand curette, group2: were prepared by ultrasonic device, group3: roots after scaling by hand instrumentation were treated by Er:YAG laser with 50 mJ/pulse and frequency of 10 Hz, group4: roots were prepared by ultrasonic scaler and consequently were treated by laser. Furthermore, the teeth were dried, sputter-coated with gold, and monitored with scanning electron microscope (SEM).RESULTS: Photomicrographs from ten samples of root surfaces which were taken at magnifications up to 500X revealed that there were not any severe morphologic changes, such as melting and charring, in any group. However, the samples treated by laser irradiation showed more irregularities and distortions.CONCLUSION: Er:YAG laser setting at 50mj/pulse, as an adjunctive to traditional scaling and root planning, did not induce severe damages to root surfaces, although root surface irregularities were more pronounced in laser treated groups compare to hand instruments

Does Anti-Müllerian hormone vary during a menstrual cycle? A systematic review and meta-analysis

Objective Numerous studies have indicated that the level of the Anti-Müllerian hormone (AMH), one of the main markers for the ovarian reserve, does not fluctuate throughout a menstrual cycle, while some studies have rejected this finding. The purpose of this systematic and meta-analysis study is to consensus on all contradictory studies that have measured AMH levels throughout the menstrual cycle and to investigate the exact extent of AMH variation in a cycle. Methods The protocol for this meta-analysis was registered at PROSPERO before data extraction. Relevant studies were identified by systematic search in PubMed, ScienceDirect, Embase, Cochrane Library, and Google Scholar with no limitation on publication date. Longitudinal studies which have evaluated AMH levels in the follicular and luteal phases of an unstimulated (natural) menstrual cycle in healthy women without endocrinology or ovarian disorders were included. We used the JBI Critical Appraisal Checklist for assessing the quality of studies found eligible for meta-analysis. Results A total of 11 studies involving 733 women with regular menstrual cycles were included. The results showed that the AMH level in the follicular phase was significantly higher than in the luteal phase (95% Cl = 0.11 [0.01 to 0.21]; p < 0.05) and it varies about 11.5% from the luteal phase. The analysis of studies which had also examined the ovulatory phase (n = 380) showed that the serum levels of AMH in the ovulatory phase (about 2.02 ng/ml) did not significantly vary compared to follicular (95% Cl = 0.11 [-0.10 to 0.33]; p = 0.30) and luteal (95% Cl = 0.06 [-0.08 to 0.20]; p = 0.43) phases. Conclusions According to the results of this study, AMH levels differ between follicular and luteal phases which might be due to ovarian response to the gonadotropins. It seems the phase of AMH measurement needs to be considered for interpretation of the serum AMH test