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Master's Dissertation
Full name
José Emilio Fehr Pereira Lopes
Knowledge Area
Date of Defense
São Carlos, 2003
Bagnato, Vanderlei Salvador (President)
Rodrigues, Edson
Silva Júnior, Orlando de Castro e
Title in Portuguese
O efeito da incidência do laser de CO2 em ossos
Keywords in Portuguese
Laser cirúrgico
Laser de CO2
Abstract in Portuguese
O Laser de Alta potência, também denominado, Laser Cirúrgico, tem sido usado em procedimentos médicos, para coagulação e vaporização dos tecidos. O maior problema, hoje encontrado, pela medicina no uso deste Laser, especialmente o laser de CO2, é a destruição térmica, causada pelo acúmulo de energia, convertida em calor, nos tecidos adjacentes, por ele irradiado. Uma vez absorvida esta energia, o tecido acumulará mudanças, que ocorrerão, durante o processo de irradiação e resfriamento. Estas variações poderão ir desde: uma mudança física, química e alterando completamente, os mecanismos biológicos, antes efetuados, pelo tecido irradiado. Este estudo tem como objetivo, analisar tais mudanças, verificando as diferenças morfológicas e geométricas, bem como utilizar experimentação para reconhecer, as zonas limitantes, ao processo de ablação. Para isto, quatro partes iguais de uma mandíbula bovina, foram usadas. Sendo que, cada uma destas, recebeu uma potência, diferente de laser. A cada amostra, foi aplicada a potência escolhida, em cinco diferentes tempos, mantendo uma distância aproximada de 250mm, entre uma aplicação e outra, com uma distância focal de 6mm. Em primeiro, observou-se característica macroscópica da região de interação, utilizando-se de um modelo zonal, para análise. Através de uma análise, mais aprofundada, com o uso de microscopia eletrônica, pode-se notar as variações imprevistas, ocorridas pelo processo de acúmulo e condução térmicos, advindos da ablação. A região de interação foi delineada em zonas de variações, denominadas as mesmas, como: Z I, Z2, e Z3. Sendo que a Z1, é o diâmetro formado pelo ponto de penetração da luz no tecido, ora irradiado.(Cratera). Z2 é o diâmetro envolvendo, a primeira camada de alteração do tecido irradiado, circundante a cratera. Z3, determina todo o diâmetro das alterações, por nós verificadas nas microfotografias. A partir deste ponto, usamos as amostras irradiadas, para calcular a quantidade de material removido, pela ablação. Através de um corte histológico, parafinado, analisamos todas profundidades, dos orifícios de entrada, formadas pela interação, por nós estudadas. Para cada lâmina, foi feita uma medida, da profundidade, formada pela entrada do raio, e pela material removido pela ablação. Tendo-se as medidas dos orifícios das crateras, as profundidades das mesmas, calculamos, aproximadamente, o material removido pela ablação. Considerando para isto, que os orifícios de penetrações, sendo, todos eles, de formatos de circunferências e as profundidades, em formatos Gaussianos. Obtendo, portanto, um formato conforme, para cada cratera. . Obtivemos, a partir do calculo matemático, o volume de massa de material retirado por ablação
Title in English
The effect of the CO2 laser incidence in bones
Keywords in English
CO2 laser
Surgical laser
Abstract in English
The high power lasers are being widely used in surgical procedures, where there are vaporization and coagulation of the soft tissues. For hard tissues, such as, bones and teeth, pulsed lasers are stranded out because they may cause less thermal damage, as an example, the CO2 laser. Termal effects on tissue are recognized as being an accumulation of changes that occur during the entire period of irradiation and ensuing cooling (Mc KENZIE 1990). Located heating is affected by termal conductivity and convection by blood flow. Upon heating tissue experiences an alteration in a variety of physical, chemical and biological mechanism at the scale of chemical, organelle cell and tissue. Changes in tissue geometry and local microcirculation, could be affected. The purpose of these studies was to verify the physical and chemical variation and also reactions during the process of light exposure in the bone parts, especially the laser beam ablation patters. The generation of craters and other abnormal superficial termal damage, and craters that's show irregular wall contours. The relation and interaction between medicai CO2 laser beam and animal, human, and other biological tissues. For this experiment, a cattle' s jaw, of four years old, were chosen for these experimental. Procedure to be described in this paper Those jaws were cut in four different pieces, in an effort, those parts were kept in the same shape and size, so no different variation of depth or length, would make it improper for the studies about to be made. Numbers were put in each different piece, showing in each sample, the time and the potency that were applied in that part. All samples were under favorable conditions (with long pulses and without water spray). Since classical pathology techniques for characterizing thermal damage to tissue are based on the microscopic examination of prepared tissue specimens for evidence of coagulation necrosis (nuclear psychoses, disintegration of organelles, hyalinization of collagen, loss of birefringence in muscle tissue, carbonization, etc.) Once the experimental appliance were done, a different colored circle were clear and optical visible around each bole, In a suggestion of that changes have happened in the material, used indeed. For almost, all the averages of the holes, in the electronic microscope, could be seeing the presence of minimal layer of superficial carbonization in the remaining bone. Therefore, the bone that received irradiation caused by CO2 laser, in a agreement with the proposal methodology, showed a variation of the tissue, that changed as the exposure changed the TIME/POWER. For each different pulse, the samples were analyzed. The tissues response to extreme temperature change in this zone usually consists of immediate coagulation necrosis, coagulation of vessels and macroscopic destruction of the tissue. An intermediary volume Between the necrosis core and the reversibly affected region is referred to as the Marginal Zone". Therefore in this task, we called each analyzed zone as Z1 for the crater's diameter and Z2 for following areas, and finally, Z3 for the total diameter of the affected tissue. . All the measured zones, contains the shift from perfusion increases to coagulation, and the transition from structurally intact cells to dead cells. The most interest, issue that this study, may bring up, is for the clinical for the future's procedures because it contains the boundaries between the reversible and the irreversible tissue changes. Very few studies describe the presence and the address the consequences of the ablative aberrations, which can frequently and randomly happen during laser surgery. The knowledge of the different boundaries, of the affected areas, could predict severe impacts on the quality of the final surgical outcome, specially, when precision surgery techniques are required. The results of this discussed experiment shows how important it is to constantly and carefully observe, both the irradiated tissue's structure and the beam's broadening at the surface during the ablation.
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