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80 American Society for Laser Medicine and Surgery Abstracts
one grade decrease in the severity of cellulite, as assessed by
photography by the blinded observers.
Conclusion: This study demonstrates AWT as an effective and
well-tolerated treatment for cellulite in pre-menopausal and low-
BMI women. More studies are warranted to investigate this novel
approach to an age-old problem.
#267
BOTULINUM TOXIN A FOR THE EFFECTIVE
TREATMENT OF TMJ AND BRUXISM
Elizabeth VanderVeer, Dianna Burget
VanderVeer Center, Portland, OR
Background: Temperomandibular Joint Disorder (‘‘TMJ’’) and
Repetitive grinding of the teeth (‘‘Bruxism’’) cause a significant
amount of pain, distress, and alteration of daily activities for those
who suffer from these disorders. Over 10 million people in the US
experience TMJ and/or Bruxism, and 90% of all patients are
women. These problems take a heavy financial toll (time loss;
repeated dental work; poor sleep, etc.), and there are often comorbidities
seen such as depression or fibromyalgia. Botulinum
toxin A is a known potent muscle relaxer. The purpose of this
study was to observe the in vivo response to injecting the masseter
muscle the TMJ with botulinum toxin A.
Study: Three female patients with severe ‘‘TMJ’’ and/or
‘‘Bruxism’’ were selected to receive botulinum toxin A into their
masseter muscles for a total of five treatments at 6-week intervals
to see if any improvement could be observed in their symptoms.
Fifty units of botulinum toxin A were injected in a total of ten sites
(five per side). The injections were restricted to the masseter
muscle.
Results: All patients reported a significant improvement in their
symptoms within 1 week after treatment. All three patients
experienced some degree of relief at first, with the full
symptomatology returning at approximately 4 weeks after
injection. However, after repeated treatments, not only did the
symptoms continue to improve, but each time, they were
significantly milder in nature. After the completion of five
treatments over 30 weeks, all patients were able to extend their
time between treatments to nearly 12 weeks. None of the women
needed a nighttime dental appliance or required dental work
during the period of this study, and all three women rated the
improvements in their symptoms as ‘‘exceptional.’’
Conclusion: From this small study, it appears that TMJ and
Bruxism symptoms can be effectively treated with botulinum
toxin A.
#268
TREATMENT OF POST-INFLAMMATORY
HYPERPIGMENTATION WITH 1,927 NM THULIUM
FRACTIONAL LASER
Jill Waibel, Dan Wasserman, Elizabeth Houshmand,
Emily Tierney
Miami Dermatology and Laser Institute, Miami, FL;
Total Skin and Beauty Dermatology Center, Birmingham, AL;
Wright State University, Dayton, OH;
South Shore Skin Center, Cohasset & Plymouth, MA
Background: Cutaneous hyperpigmentation is created when
melanocytes produce excessive melanin resulting in either
epidermal or dermal melanosis. Hyperpigmentation caused by
irritation or inflammation is known as post-inflammatory
hyperpigmentation (PIH). PIH is usually transient in nature,
however, it may last for several months and is often poorly
tolerated by patients. The treatment of PIH may be a difficult and
prolonged process that often takes 6–12 months to achieve the
desired results of depigmentation. Most conventional treatment
options potentially improve epidermal hypermelanosis, however,
dermal hypermelanosis is more challenging. Laser therapy may
be a proposed treatment since fractional lasers are able to
penetrate to the depths of dermal pigment. The 1,927 nm nonablative
fractional thulium laser reaches depths between 150 and
250 mm and thus treats superficial conditions such as
pigmentation. This study examined efficacy and safety of
1,927 nm laser in improving PIH.
Study: Ten patients of Fitzpatrick types I–IV with various
etiologies of both acute and long-standing hyperpigmentation
were enrolled in a prospective study to examine efficacy of
1,927 nm fractional laser on PIH. Subjects received one or
two treatments at 20 mJ, and coverages from 25% to 65%.
Three blinded investigators evaluated photographs taken at
baseline and 1 month after the final laser treatment.
Scores were assigned using a quintile improvement scoring
system.
Results: Patients tolerated the procedures well with minimal
edema, erythema and desquamation. No severe adverse events
were noted. The level of pigmentation improvement showed a
mean investigator score of 4.2/5.0. Forty percent of the subjects
received very significant (75–100%) improvement of
hyperpigmentation and 30% of subjects received marked (51–
75%) improvement of hyperpigmentation.
Conclusion: The 1,927 nm non-ablative fractional laser can
penetrate to depths to target both epidermal and dermal
hyperpigmentation and can effectively and safely improve acute
and chronic post-inflammatory hyperpigmentation in minimal
treatment sessions.
#269
CLINICAL RESEARCH STUDY TO EVALUATE THE
EFFECTS OF PROTOTYPE DENTIFRICES ON
SOFT-TISSUE ARCHITECTURE
Joseph Youssef, Steven Duong, Travis Tucker,
Jun Zhang, Kathryn Osann, Petra Wilder-Smith
Beckman Laser Institute and Medical Clinic,
University of California, Irvine, CA
Background: Dry mouth can be caused by a plethora of factors
such as dehydration and side effects of certain medications.
Therefore, the aim of this project is to investigate the potential of
non-invasive in vivo Optical Coherence Tomography (OCT)
imaging to determine the response of patients with clinically
diagnosed severe dry mouth (xerostomia), to the use of a dry
mouth dentifrice versus a placebo.
Study: This project was a double-blind, crossover, placebocontrolled
study in six subjects diagnosed with severe xerostomia.
Two products were tested, with one dentifrice as the active dry
mouth treatment and the other a placebo. Baseline clinical exam
and OCT imaging were recorded before the subjects used the first
dentifrice (Product A) for 15 days. After a 7-day wash out period
using regular Colgate toothpaste, another 15-day period using the
second supplied dentifrice (Product B) occurred. Standard
toothbrushes and floss were provided to the subjects; however, no
other form of oral healthcare was permitted. OCT imaging and
clinical exams, dry mouth questionnaires, and photographs were
acquired at 5-day intervals.