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PubMed1988

Intranasal adhesion formation following surgery for chronic nasal obstruction.

Several publications have addressed the problem of atrophic rhinitis and ozaena following turbinate resection for chronic nasal obstruction, but little attention has been given to the problem of intranasal adhesion formation following this procedure. To determine the incidence of postoperative intranasal adhesion formation, a retrospective study of 479 operations on the inferior turbinate and nasal septum, either alone or in combination, was carried out. Adhesion formation complicated 36.2% of turbinate resections, 30.6% of turbinate resections in combination with septal surgery and only 6.8% of all the other procedures. There was also a significantly higher incidence of postoperative haemorrhage following turbinate resection (7.4%) than that following other procedures (1.9%). There was no noted occurrence of atrophic rhinitis, rhinitis sicca or ozaena.

Hemorrhage↗
PubMed1999

Contributory and exacerbating roles of gaseous ammonia and organic dust in the etiology of atrophic rhinitis.

Pigs reared commercially indoors are exposed to air heavily contaminated with particulate and gaseous pollutants. Epidemiological surveys have shown an association between the levels of these pollutants and the severity of lesions associated with the upper respiratory tract disease of swine atrophic rhinitis. This study investigated the role of aerial pollutants in the etiology of atrophic rhinitis induced by Pasteurella multocida. Forty, 1-week-old Large White piglets were weaned and divided into eight groups designated A to H. The groups were housed in Rochester exposure chambers and continuously exposed to the following pollutants: ovalbumin (groups A and B), ammonia (groups C and D), ovalbumin plus ammonia (groups E and F), and unpolluted air (groups G and H). The concentrations of pollutants used were 20 mg m-3 total mass and 5 mg m-3 respirable mass for ovalbumin dust and 50 ppm for ammonia. One week after exposure commenced, the pigs in groups A, C, E, and G were infected with P. multocida type D by intranasal inoculation. After 4 weeks of exposure to pollutants, the pigs were killed and the extent of turbinate atrophy was assessed with a morphometric index (MI). Control pigs kept in clean air and not inoculated with P. multocida (group H) had normal turbinate morphology with a mean MI of 41.12% (standard deviation [SD], +/- 1. 59%). In contrast, exposure to pollutants in the absence of P. multocida (groups B, D, and F) induced mild turbinate atrophy with mean MIs of 49.65% (SD, +/-1.96%), 51.04% (SD, +/-2.06%), and 49.88% (SD, +/-3.51%), respectively. A similar level of atrophy was also evoked by inoculation with P. multocida in the absence of pollutants (group G), giving a mean MI of 50.77% (SD, +/-2.07%). However, when P. multocida inoculation was combined with pollutant exposure (groups A, C, and E) moderate to severe turbinate atrophy occurred with mean MIs of 64.93% (SD, +/-4.64%), 59.18% (SD, +/-2.79%), and 73.30% (SD, +/-3.19%), respectively. The severity of atrophy was greatest in pigs exposed simultaneously to dust and ammonia. At the end of the exposure period, higher numbers of P. multocida bacteria were isolated from the tonsils than from the nasal membrane, per gram of tissue. The severity of turbinate atrophy in inoculated pigs was proportional to the number of P. multocida bacteria isolated from tonsils (r2 = 0.909, P < 0.05) and nasal membrane (r2 = 0.628, P < 0.05). These findings indicate that aerial pollutants contribute to the severity of lesions associated with atrophic rhinitis by facilitating colonization of the pig's upper respiratory tract by P. multocida and also by directly evoking mild atrophy.

Air Pollution, Indoor↗
PubMed2004

A massive superior concha bullosa: case report and literature review.

The superior turbinate was the most neglected of the turbinates in the past. With the advent of functional endoscopic sinus surgery and coronal computed tomography imaging, considerable attention has been concentrated exclusively on the lateral nasal wall anatomy, including the hidden turbinate, whose symptomatic concha bullosa is extremely rare. Only a very few cases have been reported to date. This seemingly interesting as well as rare case report is concerned with unilateral hyperpneumatization of the superior turbinate, which contacts the septum and leads to headache, associated with bilateral massive concha bullosa of the middle turbinate.

Adult↗
PubMed1990

Diagnostic value of acoustic rhinometry: patients with allergic and vasomotor rhinitis compared with normal controls.

By means of the acoustic reflection technique, termed acoustic rhinometry, cross-sectional areas along the whole upper airway can be measured by an acoustic click. This paper describes the normal values obtained from 134 probands. The normal curve shows the minimal cross-sectional area (I-notch) to be located at the isthmus nasi. The second narrowest segment of the nasal cavity is located at the head of the inferior concha (C-notch). In patients with turbinate hypertrophy due to allergic or vasomotor rhinitis the minimal cross-sectional area is sited at the head of the inferior turbinate. Furthermore, acoustic rhinometry allows exact measurements of size and location of the congested mucosa following challenge with allergens in patients affected with allergic rhinitis. After anterior turbinoplasty of patients with turbinate hypertrophy improved nasal breathing was associated with an enlargement of the cross-sectional areas at the head of the anterior inferior turbinate. Acoustic rhinometry not only enables to distinguish the various deviations of the nasal structures from normal (valve stenosis, septal deviation, turbinate hypertrophy, tumour masses) concerning their location and size, but also allows to demonstrate exactly the efficacy of rhinosurgical techniques.

Adult↗
PubMed1989

Interactions between Bordetella bronchiseptica and toxigenic Pasteurella multocida in atrophic rhinitis of pigs.

Three strains of Bordetella bronchiseptica were compared for their ability to assist colonisation of the nasal cavity of gnotobiotic pigs by toxigenic Pasteurella multocida. Toxigenic P multocida (counted in nasal washings) colonised the cavity in large numbers in pigs previously infected with a cytotoxic phase I strain of B bronchiseptica (B58), whereas it colonised only in small numbers in those previously infected with B65, a phenotypic phase III variant of B58. Toxigenic P multocida colonised pigs infected with a non-cytotoxic phase I strain of B bronchiseptica (PV6) in fewer numbers than were seen in pigs infected with the cytotoxic phase I strain but in greater numbers than in pigs infected with the phase III strain. The turbinates of pigs infected with the cytotoxic phase I strain of B bronchiseptica and toxigenic P multocida were most severely affected and those in pigs infected with the non-cytotoxic phase I strain and toxigenic P multocida were moderately reduced in size. The turbinates of pigs infected with the phase III strain and toxigenic P multocida were slightly reduced in size except for one piglet whose turbinates were severely affected. Pigs infected with the non-cytotoxic phase I strain of B bronchiseptica alone showed no signs of atrophy and their turbinates were used to calculate reductions (per cent) in those infected with P multocida. The reduction (per cent) in size of turbinates and total numbers of P multocida isolated from the nasal washings of each pig were linearly related.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Growth kinetics of equine respiratory tract viruses in cell and organ cultures.

Growth kinetics of equine influenza virus-A1, equine herpesvirus-1, and equine rhinovirus-1 were determined in susceptible cell monolayers and in organ cultures of equine fetal tracheal and nasal turbinate epithelium. Equine influenza virus-A1 was replicated in cell and organ cultures and was released more readily and for longer periods from nasal turbinate epithelium than from tracheal epithelium. Equine herpesvirus-1 was also replicated in cell and organ cultures. During the first 24 hours after inoculation, equine herpesvirus-1 was released more readily from tracheal epithelium than from nasal turbinate epithelium. Beyond postinoculation day 1, virus was released more readily and for longer periods from nasal turbinate epithelium than from tracheal epithelium. Equine rhinovirus-1 replicated in cell and organ cultures, but almost exclusively from nasal turbinate epithelium.

Animals↗
PubMed1982

Long-term effect of Bordetella bronchiseptica infection in neonatal pigs.

A total of 62 gnotobiotic pigs were inoculated with Bordetella bronchiseptica at 7 days of age. There were 25 noninoculated controls. Thirteen of the inoculated pigs were killed and 6 pigs which died were examined between 3 and 5 weeks after inoculations were done (group A). Of these 19 pigs, 16 had severe pneumonia and B bronchiseptica was isolated from the lungs of 17. The turbinates in most of the pigs appeared to have some atrophy. Four other pigs died of pneumonia after they were transferred to the floor in isolation rooms, and 9 inoculated pigs were examined at necropsy at about 112 days of age (group B). Bordetella bronchiseptica was isolated from 8 of the latter 9 pigs, and 7 of the pigs had pneumonic lesions. The turbinates all appeared normal. Thirty inoculated pigs (group C) were killed at 180 days of age. Of these, 22 had pneumonic lesions. Bordetella bronchiseptica was reisolated from the turbinates of 2 of 30 pigs, although the turbinates in all appeared normal. The noninoculated controls examined at necropsy at 3 to 5 weeks, 112 days, and 180 days of age did not have any pulmonic lesions, and their turbinates appeared normal. The inoculated pigs killed at 112 days of age gained an average of 0.25 kg/day, and the control pigs gained 0.31 kg. At 180 days of age, the inoculated pigs had gained 0.41 kg/day and the controls, 0.49 kg. Bordetella bronchiseptica infection in susceptible pigs can cause a severe pneumonia which can persist and reduce the growth rate.

Animals↗
PubMed1982

X-ray tomographical observations of the interrelationships among structures of the nasal airway.

In order to elucidate upon the interrelationships among the different structures in and around the nasal cavity, the noses of 95 adults without severe rhinitis, paranasal sinusitis, cysts or tumors were examined by means of X-ray tomography. The results indicate a close correlation between the width of the nasal cavity and 1) the width of the maxillary sinus, 2) the size, form and height of the inferior turbinate, 3) the size of the middle turbinate or 4) the nasal septal deviation; between the height of the nasal cavity and the length and height of the inferior turbinate or the length of the middle turbinate, and also between the degree of septal deviation and the width of the nasal cavity, the nasal meatus or olfactory slit or the form of the inferior turbinate. In conclusion, it is recognized that correction of the abnormal interrelationships among the different structures is important for functional nasal surgery.

Adult↗
PubMed1998

Nasal osteotomy and airway changes.

The purpose of this prospective investigation was to evaluate the factors involved in the constricting effect of nasal bone osteotomy on the nasal airway. Immediately before the osteotomy, observations were made and recorded in regard to both the position of the inferior turbinates and the length of the nasal bones. During the osteotomy, the nasal bone movement was graded and the type of osteotomy was documented. The two types of osteotomy were defined as either high-to-low or low-to-low. Each side of the nose was assessed independently. Forty-eight consecutive patients, 8 men and 40 women, were included in this study, providing 96 nasal sides for evaluation. There were 42 normal, 32 short, and 22 long nasal bones. The patients with short nasal bones exhibited less diminution in the airway than those patients with normal nasal bones (p < 0.05). The position of the inferior turbinates was designated as anterior in 48 sites, 12 were considered normal, and 28 were deemed posterior. The narrowing of the airway was significant when the inferior turbinates were positioned anteriorly when compared with posteriorly positioned inferior turbinates (p < 0.05). Twenty-four nasal bones were shifted slightly, 48 intermediately, and 22 significantly. Major nasal airway constriction was observed when the medial positioning of the nasal bone was significant (p < 0.05). Eighty-four osteotomies were classified as low-to-low, and 12 were high-to-low. High-to-low osteotomies resulted in the least narrowing of the nasal passage (p < 0.005). It is concluded from this study that the nasal osteotomy does constrict the nasal airway in most incidences. The length of the nasal bones, the degree of nasal bone repositioning, the position of the inferior turbinates, and the type of osteotomy are definite factors contributing to airway narrowing after nasal bone osteotomy.

Adolescent↗
PubMed1994

Increased ion transport in cultured nasal polyp epithelial cells.

OBJECTIVE: To measure transepithelial bioelectric properties of cultured human nasal polyp and turbinate epithelial cells to test the hypothesis that nasal polyps have increased rates of ion transport. DESIGN: Cohort study. SETTING: Private referral center. PATIENTS: Individuals undergoing surgery for symptomatic nasal obstruction due to polyps caused by cystic fibrosis, nonatopic rhinosinusitis, or allergic rhinosinusitis. METHODS: Epithelial cells were removed from separated polyp and turbinate samples by protease disaggregation and cultured on permeable collagen matrix supports. Transepithelial potential difference and resistance were measured daily. At the time of maximal transepithelial potential difference, the cultures were mounted in modified Ussing chambers and exposed to a sodium-positive channel blocker (amiloride hydrochloride) and to selected chloride-negative channel agonists (isoproterenol bitartrate, adenosine triphosphate). OUTCOME MEASURES: Maximal transepithelial potential difference, resistance, and equivalent short-circuit current. Bioelectric responses to amiloride, isoproterenol, and adenosine triphosphate. RESULTS: Polyp cultures had higher transepithelial potential difference and equivalent short-circuit current than turbinate cultures. The mediator responses were greater for polyp than for turbinate cultures. CONCLUSIONS: Polyp epithelia have increased Na+ absorption and Cl- permeability relative to turbinate epithelia. These results are consistent with the hypothesis that increased epithelial fluid absorption contributes to the development of nasal polyps.

Absorption↗
PubMed2005

Sinonasal distribution of topically applied particles: computerized tomographic detection and the effects of topical decongestion.

OBJECTIVE: Determine the efficacy of computerized tomography (CT) in detecting the intranasal distribution of sprayed radio-enhanced particles and the effects of topical decongestion on particle distribution. STUDY DESIGN: Sinonasal distribution of a radio-enhanced spray solution was studied using CT imaging in 14 adults with no sinonasal symptoms. One nostril was sprayed with oximetazoline 5 minutes prior to particle application. Serial CT imaging of the sinonasal cavity in approximately 11 minutes was carried out to detect particle distribution into the nasal vestibule, turbinate surfaces, middle meatus and osteomeatal complex area, and the nasopharynx. RESULTS: Particle detection within the nasal vestibule was possible in all cases while distribution into the anterior nasal chamber was visible in 22 cases. Particles could be detected on the inferior turbinate in 7 nasal cavities (25%) and in only 2 cases on the middle turbinate (7.5%). Particles were detected in the middle meatus in 1 case and in no instances in the osteomeatal complex area. Oximetazoline application reduced the amount of particle deposition on the inferior turbinate but did not enhance distribution on the middle turbinate or into the middle meatus. CONCLUSION: Detection of radio-enhanced sprayed particles within the sinonasal cavity using CT imaging can be a reliable method to study the principles of intranasal particle distribution. Our study failed to show particle distribution into OMC, or any positive effects of nasal decongestion on particle distribution.

Administration, Intranasal↗
PubMed1996

Laser-Doppler blood flowmetry measurement of nasal mucosa blood flow after injection of the greater palatine canal.

Laser-Doppler blood flowmetry was used to measure the mucosal blood flow of the inferior turbinate before and after injection of the greater palatine canal with 2 ml of a 0.5 per cent bupivicaine hydrochloride solution. Injection of the greater palatine canal is a useful technique in the control of posterior epistaxis. The arterial blood supply to the inferior turbinate is via a single descending branch of the sphenopalatine artery. We conjectured that injection of the pterygopalatine fossa, via the greater palatine canal, would result in a reduction of blood flow to the inferior turbinate. In this study injection of the pterygopalatine fossa caused only a 4.7 per cent decrease in blood flow to the inferior turbinate mucosa (p = 0.571). Elevation of the head by an angle of 20 degrees reduced nasal mucosal blood flow by 38.3 per cent (p < 0.0001). Depression of the head by an angle of 20 degrees increased nasal mucosal blood flow by 74.7 per cent (p < 0.0001). We conclude that there is an adequate collateral blood circulation to the anterior portion of the inferior turbinate.

Adult↗
PubMed2006

Quantification of cerebrospinal fluid transport across the cribriform plate into lymphatics in rats.

A major pathway by which cerebrospinal fluid (CSF) is removed from the cranium is transport through the cribriform plate in association with the olfactory nerves. CSF is then absorbed into lymphatics located in the submucosa of the olfactory epithelium (olfactory turbinates). In an attempt to provide a quantitative measure of this transport, 125I-human serum albumin (HSA) was injected into the lateral ventricles of adult Fisher 344 rats. The animals were killed at 10, 20, 30, 40, and 60 min after injection, and tissue samples, including blood (from heart puncture), skeletal muscle, spleen, liver, kidney, and tail were excised for radioactive assessment. The remains were frozen. To sample the olfactory turbinates, angled coronal tissue sections anterior to the cribriform plate were prepared from the frozen heads. The average concentration of 125I-HSA was higher in the middle olfactory turbinates than in any other tissue with peak concentrations achieved 30 min after injection. At this point, the recoveries of injected tracer (percent injected dose/g tissue) were 9.4% middle turbinates, 1.6% blood, 0.04% skeletal muscle, 0.2% spleen, 0.3% liver, 0.3% kidney, and 0.09% tail. The current belief that arachnoid projections are responsible for CSF drainage fails to explain some important issues related to the pathogenesis of CSF disorders. The rapid movement of the CSF tracer into the olfactory turbinates further supports a role for lymphatics in CSF absorption and provides the basis of a method to investigate the novel concept that diseases associated with the CSF system may involve impaired lymphatic CSF transport.

Animals↗
PubMedDate not supplied

Distribution of eosinophil granule proteins in nasal mucosa of atopic patients with nasal polyposis.

Nasal polyposis is characterized by heavy eosinophilic infiltration into nasal polyp tissue. Nasal polyps have a predilection for the anteroinferior aspect of the middle turbinate and middle meatal area. To elucidate the pathogenesis of nasal polyps, the authors investigated the distribution of eosinophil infiltrating into nasal polyp tissue, especially at its pedicle, in comparison with the apparently normal nasal mucosa of the middle and inferior turbinates of the same patients. Tissue samples were taken from 12 allergic rhinitis patients with nasal polyps during endoscopic sinus surgery. Three kinds of monoclonal antibodies, EG1, EG2 and BMK-13, were used for immunohistochemical staining. The average number per high-power field of EG1+ cells was 6.33 at the pedicle of polyps and 4.68 and 4.36 at the middle and inferior turbinates, respectively; for EG2+ cells, it was 6.16 at the polyp pedicle and 2.06 and 2.47 at the middle and inferior turbinates, and for BMK-13+ cells, 4.20 at the polyp pedicle and 5.17 and 4.81 at the middle and inferior turbinates. There were no significant differences in the distribution of EG1+ and BMK-13+ cells, but a relatively larger number of activated eosinophils (EG2+ cells) was noted at the pedicle of polyps compared with the other sites (p < 0.025). In addition, the EG2+ cell/EG1+ cell ratio was significantly higher at the pedicle of polyps compared with the other sites (p < 0.01). The results of this study suggest that the activation of eosinophils is significant in the pathogenesis of nasal polyps in atopic patients rather than the number of eosinophils.

Adult↗
PubMed1996

Changes in nasal cavity volume and target area of exposure to nasal drops with age in rats.

The changes in the nasal cavity volume of rats with age and the area exposed to nasal drops administered into the nasal cavity were investigated. Results indicated that the nasal cavity volume lineally increased as rats grew older. In 7-week-old rats, the exposed area in the case of an administration volume of 25 microliters, based on practice, was naso-, maxillo-, and ethmoid turbinate and this volume was enough to expose the whole area of the nasal cavity including the ethmoid turbinate. On the other hand, in 27-week-old rats, administration volumes of 10 and 25 microliters were not enough to expose the ethmoid turbinate. This indicated that the exposed area tended to become narrower in 27-week-old rats than in 7-week-old rats, but the exposed area in the case of an administration volume of 50 microliters was naso-, maxillo-, and ethmoid turbinate in 27-week-old rats. In this case, the volume was enough to spread to the ethmoid turbinate. Differences in the exposed area might be caused by differences in the volume of the nasal cavity. It was also indicated that the main exposed area was the inferior meatus in the 30 min immediately after administration. At all administration volumes, however, notice should be taken of the outflow of nasal drops into the oral cavity through the nasopalatine.

Administration, Intranasal↗
PubMed1997

Inflammatory cytokine expression on nasal polyps developed in allergic and infectious rhinitis.

To investigate the expression of cytokine mRNAs in nasal polyps and the role of allergy in the pathogenesis of nasal polyposis, we studied the expression of IL-4, IL-5, and IFN-gamma mRNAs using the RT-PCR and Southern blot. Nasal polyp specimens were obtained from 14 patients with infectious rhinitis and 5 patients with perennial allergic rhinitis. Turbinate mucosa specimens were obtained from 10 patients with allergic rhinitis and from 10 healthy subjects as controls. IL-4, IL-5 and IFN-gamma mRNA were expressed in most specimens of allergic turbinate mucosa. The expression of these cytokines was less frequent in normal healthy turbinate mucosa. The density ratios of IL-4, IL-5 and IFN-gamma to beta-actin were individually determined in both polyp and turbinate tissues. The density ratio for each cytokine was relatively higher in polyp tissues than in healthy turbinate mucosa; however, there was no significant difference in the density ratios determined for polyps associated with allergic rhinitis as compared with polyps associated with infectious rhinitis. These findings indicate that nasal polyposis may differ from allergic rhinitis in the mechanism by which IL-4 and IL-5 are increased. It is concluded that allergy may have an insignificant role in the development of nasal polyps.

Adult↗
PubMed1989

[A proposal for endonasal middle meatal antrostomy].

With increase of cases with mild chronic sinusitis, especially the cases combined with nasal allergy, endonasal sinus surgery has been substituted for Caldwell-Luc or some other modified sinus surgery in recent years. The classical inferior meatal antrostomy for maxillary sinusitis is one of the treatments of choice, though this opening is easily closed and is somewhat different from normal sinus physiology. In the middle meatal antrostomy, the opening was made via the inferior turbinate or the middle meatal wall perforated with nasal forceps. Reported here is a new technique for middle meatal antrostomy which can be easily and safely performed. At the beginning, mucosal incision is made from the agger nasi to the anterior of the inferior turbinate, dividing the mucous membrane inferomedially. Then the mucous membrane of the inferior turbinate is cut along the upper margin of it and reflected downwards. With this procedure, the frontal process of the maxilla, lacrimal bone and inferior turbinate are well exposed and well oriented in the surgical field. The pars membranacea is then cut from anterior to inferior, and removed with the uncinate process, thus entering the maxillary antrum. The antrostomy opening is made at least 1 by 1.5 cm wide. Then, the intranasal ethmoidectomy is usually done and the reflected mucous membrane of the inferior turbinate returned to its normal position. This surgery was applied to 34 patients (7 children, 27 adults), (2 antrochoanal polyps, 5 optic neuritis, 3 maxillary sinusitis, 17 pansinusitis, and 7 pansinusitis associated with nasal allergy). We have not experienced surgical complications and none of them also had closure of the antrostomy opening.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2002

Pulp histology after Er:YAG laser cavity preparation in subhuman primates--a pilot study.

UNLABELLED: The aim of the study was to make a direct comparison of the pulpal effects of laser and turbine preparations in subhuman primates. One female baboon (Papio Ursinus ursinus), weighing 15 kg, was used. General anaesthesia was administered (ketamine 100 mg/ml/kg body weight) and maintained with acepromazine (10 mg/ml/kg body weight). Class V cavities were prepared buccally in a total of 28 teeth (7 in each quadrant). Teeth in the upper right and lower left quadrants were prepared using a conventional 330 carbide bur in a high-speed fibre-optic handpiece with copious water spray. Teeth in the upper left and lower right quadrants were prepared using an Er:YAG laser drill (Fotona Twinlight, Llubljana, Slovenia) delivering 500 mJ at a pulse rate of 10 Hz and a wavelength of 2940 nm. The animal was sacrificed after 25 days. After general anaesthesia as described before, perfusion fixation of the head was accomplished with 10% neutral buffered formalin, pumped through a catheter inserted into the left carotid artery. The jaws were removed and, using a 330 carbide bur in a high speed handpiece, a continuous groove was cut through the bone and the roots at the level of the middle third of all the roots to promote thorough fixation of pulpal tissue. Decalcification and grading of the severity of the pulpal responses were conducted according to standard procedures. RESULTS: Owing to procedural errors seven teeth, FDI numbers 23, 24, 31, 34, 35, 44 and 45, had to be eliminated. The turbine-prepared teeth (N = 11) had a mean remaining dentine thickness (RDT) of 0.77 mm (SD = 0.42) and the laser-prepared teeth (N = 10) had a mean RDT of 0.81 mm (SD = 0.60). All pulps appeared normal except in one turbine-prepared tooth (12 with RDT = 0.20) and one laser-prepared tooth (27 with RDT = 0.30, where irreversible damage was caused. The only other deviations from normal were seen in the laser-treated 41 (RDT = 0.69) and the turbine-treated 36 (RDT = 0.77) where moderate hyperaemia was seen. Within the limitations of this study it can be concluded that there is no significant difference between dental pulp of teeth where Class V cavities were prepared with an Er:YAG laser drill compared with those prepared with a standard turbine drill.

Animals↗