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VOLUME 1 , ISSUE 1 ( January-March, 2017 ) > List of Articles


Thalassemia and its Management during Pregnancy

Tania Banerjee, Rohit B Aniyery

Citation Information : Banerjee T, Aniyery RB. Thalassemia and its Management during Pregnancy. World J Anemia 2017; 1 (1):5-17.

DOI: 10.5005/jp-journals-10065-0002

License: CC BY-ND 3.0

Published Online: 00-03-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Thalassemia, also known as Mediterranean anemia, can be considered as the most common monogenetic disease prevailing all across the world. This disorder involves production of abnormal amounts of hemoglobin in the body, which poses a significant burden on the health and economic status of the patients as well as their families. Generally, patients with the thalassemia trait have a normal life expectancy, but individuals with beta thalassemia major mostly die from cardiac complications due to iron overload by the time they reach 30 years of age. Each year, nearly 70,000 babies are born with thalassemia worldwide. Conventional treatment procedures available (e.g., lifelong red blood cell transfusion, iron chelation therapy, and splenectomy) have levied high expenses on the health-care systems. Thalassemia during pregnancy could be associated with significant complications to the mother as well as her fetus. Therefore, universal antenatal screening for thalassemia carriers should be implemented in populations having a high prevalence of this condition. In order to improve survival among children born with thalassemia, there is a requirement for combined treatment and prevention program during pregnancy. Preconception genetic counseling is strongly advised for all patients with thalassemia. Among the high-risk parents, the most important method for diagnosis of thalassemia is invasive prenatal diagnosis. Following a standard management plan and close monitoring of the maternal and fetal condition during pregnancy helps in considerably reducing the mortality and morbidity associated with this condition. Novel treatment approaches are recently being developed to correct the resulting α/β globin chain imbalance, in an effort to move beyond the palliative management of this disease and tackle the exact genetic defect involved in its pathogenesis. Three methods for medical treatment of thalassemia have been envisioned: fetal globin gene renaissance by pharmacological compounds being injected into patients, allogeneic hematopoietic stem cell transplantation, and gene therapy. These medical strategies can be considered as the best options prevailing now and are currently under research and clinical studies.

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  1. Whipple GH, Bradford WL. Mediterranean disease: thalassemia (erythroblastic anemia of Cooley). J Pediatr 1936 Sep;9(3):279-311.
  2. Rund D, Rachmilewitz E. Beta-thalassemia. N Engl J Med 2005 Sep 15;353(11):1135-1146.
  3. Fawdry AL. Erythroblastic anaemia of childhood (Cooley's anaemia) in Cyprus. Lancet 1944;1:171-176.
  4. Weatherall DJ. The thalassemias. In: Beutler B, Lichtman MA, Coller BS, Kipps TJ, Seligsohn S, editors. Williams hematology. 6th ed. New York: McGraw-Hill; 2001. p. 562-564.
  5. Thalassaemia and Other Haemoglobinopathies [accessed Mar 2017]. Agenda Item 5.2. 59th World Health Assembly, 2006 May 27. EB118.R1. Available from: http://www.who. int/gb/ebwha/pdf_files/EBSS-EB118-2006-REC1/english/ Res/res-eb118_2006_rec1-en.pdf.
  6. Global Distribution of Thalassemia [online] [Accessed 2017 Mar]. Available from: www.iawesome12.blogspot. in/2012/03/global-distribution-of-thalassemia.html.
  7. Marengo-Rowe AJ. The thalassemias and related disorders. Proc (Bayl Univ Med Cent) 2007 Jan;20(1):27-31. 8 Hemoglobin. and. Myoglobin. –. The. Medical. Biochemistry. [online] [Accessed 2017 Mar]. Available from: www.themedicalbiochemistrypage. org/hemoglobin-myoglobin.php.
  8. Marengo-Rowe AJ. Haemoglobinopathies. Br J Hosp Med 1971;6:617-630.
  9. Wood WG. Increased HbF in adult life. Baillieres Clin Haematol 1993 Mar;6(1):177-213.
  10. Clegg JB, Weatherall DJ, Na-Nakorn S, Wasi P. Haemoglobin synthesis in beta-thalassaemia. Nature 1968 Nov 16;220(5168):664-668.
  11. Schroeder WA, Huisman TH, Shelton JR, Shelton JB, Kleihauer EF, Dozy AM, Robberson B. Evidence for multiple structural genes for the gamma chain of human fetal hemoglobin. Proc Natl Acad Sci USA 1968 Jun;60(2):537-544.
  12. Muncie HL, Campbell JS. Alpha and beta thalassemia. Am Fam Physician 2009 Aug 15;80(4):339-344.
  13. Nathan DG, Lodish HF, Kan YW, Housman D. Beta thalassemia and translation of globin messenger RNA. Proc Natl Acad Sci USA 1971 Oct;68(10):2514-2518.
  14. Shinar E, Rachmilewitz EA. Oxidative denaturation of red blood cells in thalassaemia. Semin Hematol 1990 Jan;27(1): 70-82.
  15. Weatherall DG, Clegg JB. The thalassemia syndromes. 4th ed. Oxford (UK): Blackwell; 2000.
  16. Pootrakul P, Sirankapracha P, Hemsorach S, Moungsub W, Kumbunlue R, Piangitjagum A, Wasi P, Ma L, Schrier SL. A correlation of erythrokinetics, ineffective erythropoiesis, and erythroid precursor apoptosis in Thai patients with thalassemia. Blood 2000 Oct 1;96(7):2606-2612.
  17. Olivieri NF. The beta-thalassemias [published correction appears in N Engl J Med 1999;341(18):1407]. N Engl J Med 1999;341(2):99-109.
  18. Cunningham MJ, Macklin EA, Neufeld EJ, Cohen AR, Thalassemia Clinical Research Network. Complications of beta-thalassemia major in North America. Blood 2004 Jul 1; 104(1):34-39.
  19. Ryan K, Bain BJ, Worthington D, James J, Plews D, Mason A, Roper D, Rees DC, de la Salle B, Streetly A, et al. Significant haemoglobinopathies: guidelines for screening and diagnosis. Br J Haematol 2010 Apr;149(1):35-49.
  20. Thalassemia. Centers for Disease Control and Prevention [Accessed 2017 Mar]. Available from: ncbddd/thalassemia/index.html.
  21. Fucharoen S, Winichagoon P, Thonglairoam V, Siriboon W, Siritanaratkul N, Kanokpongsakdi S, Vantanasiri C. Prenatal diagnosis of thalassemia and hemoglobinopathies in Thailand: experience from 100 pregnancies. Southeast Asian J Trop Med Public Health 1991 Mar;22(1):16-29.
  22. Sirichotiyakul S, Saetung R, Sanguansermsri T. Prenatal diagnosis of beta-thalassemia/Hb E by hemoglobin typing compared to DNA analysis. Hemoglobin 2009;33(1):17-23.
  23. Cao A, Galanello R. Beta-thalassemia. Genet Med 2010 Feb;12(2):61-76.
  24. Eldor A, Rachmilewitz EA. The hypercoagulable state in thalassemia. Blood 2002 Jan 1;99(1):36-43.
  25. Cappellini MD, Robbiolo L, Bottasso BM, Coppola R, Fiorelli G, Mannucci AP. Venous thromboembolism and hypercoagulability in splenectomized patients with thalassaemia intermedia. Br J Haematol 2000 Nov;111(2):467-473.
  26. Jensen CE, Tuck SM, Agnew JE, Koneru S, Morris RW, Yardumian A, Prescott E, Hoffbrand AV, Wonke B. High prevalence of low bone mass in thalassaemia major. Br J Haematol 1998 Dec;103(4):911-915.
  27. Modell B, Khan M, Darlison M. Survival in beta-thalassaemia major in the UK: data from the UK Thalassaemia Register. Lancet 2000 Jun 10;355(9220):2051-2052.
  28. Royal College of Obstetricians and Gynaecologists. Management of beta thalassaemia in pregnancy green-top guideline no. 66. London: RCOG; 2014.
  29. Cao A, Kan YW. The prevention of thalassemia. Cold Spring Harb Perspect Med 2013 Feb 1;3(2):a011775.
  30. Pennell D, Porter JB, Cappellini MD, Li CK, Aydinok Y, Lee CL, Kattamis A, Smith G, Habr D, Domokos G, et al. Efficacy and safety of deferasirox (Exjade®) in reducing cardiac iron in patients with ß-thalassaemia major: results from the cardiac substudy of the EPIC trial [abstract]. Blood 2008;112:3873.
  31. Leung TN, Lau TK, Chung TKh. Thalassaemia screening in pregnancy. Curr Opin Obstet Gynecol 2005 Apr;17(2):129-134.
  32. Cao A, Rosatelli MC. Screening and prenatal diagnosis of the haemoglobinopathies. Baillieres Clin Haematol 1993 Mar;6(1):263-286.
  33. Weatherall DJ. Thalassaemia in the next millennium. Keynote address. Ann N Y Acad Sci 1998 Jun 30;850:1-9.
  34. Spencer DH, Grossman BJ, Scott MG. Red cell transfusion decreases hemoglobin A1c in patients with diabetes. Clin Chem 2011 Feb;57(2):344-346.
  35. De Groot L, Abalovich M, Alexander EK, Amino N, Barbour L, Cobin RH, Eastman CJ, Lazarus JH, Luton D, Mandel SJ, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2012 Aug;97(8):2543-2565.
  36. Lupton M, Oteng-Ntim E, Ayida G, Steer PJ. Cardiac disease in pregnancy. Curr Opin Obstet Gynecol 2002 Apr;14(2): 137-143.
  37. Borgna-Pignatti C, Rugolotto S, De Stefano P, Zhao H, Cappellini MD, Del Vecchio GC, Romeo MA, Forni GL, Gamberini MR, Ghilardi R, et al. Survival and complications in patients with thalassemia major treated with transfusion and deferoxamine. Haematologica 2004 Oct;89(10):1187-1193.
  38. Olivieri NF, Brittenham GM. Iron-chelating therapy and the treatment of thalassemia. Blood 1997 Feb 1;89(3):739-761.
  39. Jensen CE, Tuck SM, Agnew JE, Koneru S, Morris RW, Yardumian A, Prescott E, Hoffbrand AV, Wonke B. High incidence of osteoporosis in thalassaemia major. J Pediatr Endocrinol Metab 1998;11 (Suppl 3):975-977.
  40. Walsh JM, McGowan CA, Kilbane M, McKenna MJ, McAuliffe FM. The relationship between maternal and fetal vitamin D, insulin resistance, and fetal growth. Reprod Sci 2013 May;20(5):536-541.
  41. Origa R, Piga A, Quarta G, Forni GL, Longo F, Melpignano A, Galanello R. Pregnancy and β-thalassemia: an Italian multicenter experience. Haematologica 2010 Mar;95(3): 376-381.
  42. Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. Lancet 1991 Jul 20;338(8760): 131-137. 44 Orr. D. Difficult.intubation: a hazard in thalassaemia–a case report. Br J Anaesth 1967 Jul;39(7):585-586.
  43. Neinstein Ls Katz B. Patients with hematologic disorders need careful birth control counseling. Contracept Technol Update 1985 Mar;6(3):43-46.
  44. Cazzola M, Borgna-Pignatti C, Locatelli F, Ponchio L, Beguin Y, De Stefano P. A moderate transfusion regimen may reduce iron loading in beta-thalassemia major without producing excessive expansion of erythropoiesis. Transfusion.1997 Feb;37(2):135-140.
  45. Borgna-Pignatti C. The life of patients with thalassemia major. Haematologica 2010 Mar;95(3):345-348.
  46. Modell B, Khan M, Darlison M, Westwood MA, Ingram D, Pennell DJ. Improved survival of thalassaemia major in the UK and relation to T2* cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2008 Sep 25;10:42.
  47. Thuret I, Pondarre C, Loundou A, Steschenko D, Girot R, Bachir D, Rose C, Barlogis V, Donadieu J, de Montalembert M, et al. Complications and treatment of patients with betathalassemia in France: results of the National Registry. Haematologica 2010 May;95(5):724-729.
  48. Ganz T. Hepcidin and iron regulation, 10 years later. Blood 2011 Apr 28;117(17):4425-4433.
  49. Liu J, Sun B, Yin H, Liu S. Hepcidin: a promising therapeutic target for iron disorders. Medicine (Baltimore) 2016 Apr;95(14):e3150.
  50. Roberts DJ, Brunskill SJ, Doree C, Williams S, Howard J, Hyde CJ. Oral deferiprone for iron chelation in people with thalassaemia. Cochrane Database Syst Rev 2007 Jul 18;(3):CD004839.
  51. Rachmeitewitz EA, Giardina PJ. How I treat thalassemia. Blood 2011 Sep 29;118(13):3479-3488.
  52. Oliveri NF, Brittenham GM, McLaren CE, Templeton DM, Cameron RG, McClelland RA, Burt AD, Fleming KA. Longterm safety and effectiveness of iron-chelation therapy with deferiprone for thalassemia major. N Engl J Med 1998 Aug 13;339(7):417-423.
  53. Angeliucci E, Barosi G, Camaschella C, Cappellini MD, Cazzola M, Galanello R, Marchetti M, Piga A, Tura S. Italian Society of Hematology practice guidelines for the management of iron overload in thalassemia major and related disorders. Haemtologica 2008 May;93(5):741-752.
  54. Taher AT, Porter JB, Kattamis A, Viprakasit V, Cappellini MD. Efficacy and safety of iron-chelation therapy with deferoxamine, deferiprone, and deferasirox for the treatment of iron-loaded patients with nontransfusion-dependent thalassemia syndromes. Drug Des Devel Ther 2016 Dec 15;10: 4073-4078.
  55. Angelucci E, Santini V, Di Tucci AA, Quaresmini G, Finelli C, Volpe A, Quarta G, Rivellini F, Sanpaolo G, Cilloni D, et al. Deferasirox for transfusion-dependent patients with myelodysplastic syndromes: safety, efficacy, and beyond (GIMEMA MDS0306 trial). Eur J Haematol 2014 Jun;92(6):527-536.
  56. Besa EC, Advani P. Beta thalassemia medication [online] [Accessed 2017 Mar]; 2016. Available from: www.emedicine.
  57. Medications for Thalassemia [online] [Accessed 2017 Mar]. Available from: html. 60 Perrine. SP. Fetal.globin.induction.– Hematol Am Soc Hematol Educ Program 2005: 38-44.
  58. Kiefer CM, Hou C, Little JA, Dean A. Epigenetics of betaglobin gene regulation. Mutat Res 2008 Dec 1;647(1-2): 68-76.
  59. Mabaera R, Richardson CA, Johnson K, Hsu M, Fiering S, Lowrey CH. Developmental- and differentiation-specific patterns of human gamma- and beta-globin promoter DNA methylation. Blood 2007 Aug 15;110(4):1343-1352.
  60. Yin W, Barkess G, Fang X, Xiang P, Cao H, Stamatoyannopoulos G, Li Q. Histone acetylation at the human beta-globin locus changes with developmental age. Blood 2007 Dec 1;110(12):4101-4107.
  61. Thomas ED, Buckner CD, Sanders JE, Papayannopoulou T, Borgna-Pignatti C, De Stefano P, Sullivan KM, Clift RA, Storb R. Marrow transplantation for thalassaemia. Lancet 1982 Jul 31;2(8292):227-229.
  62. Carey BW, Markoulaki S, Hanna J, Saha K, Gao Q, Mitalipova M, Jaenisch R. Reprogramming of murine and human somatic cells using a single polycistronic vector. Proc Natl Acad Sci USA 2009 Jan 6;106(1):157-162.
  63. Lucarelli G, Galimberti M, Polchi P, Angelucci E, Baronciani D, Giardini C, Politi P, Durazzi SM, Muretto P, Albertini F. Bone marrow transplantation in patients with thalassemia. N Engl J Med 1990 Feb 15;322(7):417-421.
  64. Chin JY, Kuan JY, Lonkar PS, Krause DS, Seidman MM, Peterson KR, Nielsen PE, Kole R, Glazer PM. Correction of a splice-site mutation in the beta-globin gene stimulated by triplex-forming peptide nucleic acids. Proc Natl Acad Sci USA 2008 Sep 9;105(36):13514-13519.
  65. Lucarelli G, Clift RA, Galimberti M, Polchi P, Angelucci E, Baronciani D, Giardini C, Andreani M, Manna M, Nesci S, et al. Marrow transplantation for patients with thalassemia: results in class 3 patients. Blood 1996 Mar 1;87(5): 2082-2088.
  66. Giardini C, Galimberti M, Lucarelli G. Bone marrow transplantation in thalassemia. Annu Rev Med 1995;46:319-330.
  67. Lucarelli G, Galimberti M, Polchi P, Angelucci E, Baronciani D, Durazzi SM, Giardini C, Agostinelli F, Donati M, Giorgi C, et al. A new approach to bone marrow transplantation in thalassemia. Ann N Y Acad Sci 1990;612:394-397.
  68. Sadelain M, Wang CH, Antoniou M, Grosveld F, Mulligan RC. Generation of a high-titer retroviral vector capable of expressing high levels of the human beta-globin gene. Proc Natl Acad Sci USA 1995 Jul 18;92(15):6728-6732.
  69. Wilber A, Hargrove PW, Kim YS, Riberdy JM, Sankaran VG, Papanikolaou E, Georgomanoli M, Anagnou NP, Orkin SH, Nienhuis AW, et al. Therapeutic levels of fetal hemoglobin in erythroid progeny of β-thalassemic CD34+ cells after lentiviral vector-mediated gene transfer. Blood 2011 Mar 10;117(10):2817-2826.
  70. Xu BJ, Han LK, Zheng YN, Lee JH, Sung CK. In vitro inhibitory effect of triterpenoidal saponins from Platycodi Radix on pancreatic lipase. Arch Pharm Res 2005 Feb;28(2):180-185.
  71. Yoshizumi K, Hirano K, Ando H, Hirai Y, Ida Y, Tsuji T, Tanaka T, Satouchi K, Terao J. Lupane-type saponins from leaves of Acanthopanax sessiliflorus and their inhibitory activity on pancreatic lipase. J Agric Food Chem 2006 Jan; 54(2):335-341.
  72. Upadhyay SN, Yadav RP, Ansari A, Rao SH. Agent and compositions comprising the same for inhibiting lipases and phospholipases in body fluids, cells and tissues. United States Patent Application Pub. No. US/2008/0182787 A1. 2008.
  73. Duck FA. Physical properties of tissue. Academic Press London- Toronto, 1990.
  74. Ishii J, Fujita K, Komori T. Laser surgery as a treatment for oral leukoplakia. Oral Oncol 2003;39(8):759-69.
  75. Katzir A. Lasers and optical fibers in medicine. Academic Press, Inc, San Diego-Boston 1993.
  76. Nathan MI, Dumke WP, Burns G, Dill Jr FH, Lasher G. Stimulated emission of radiation from GaAs p-n junctions. Appl Phys Lett 1962;1(3):62-64.
  77. Prahl SA. Optical absorption of hemoglobin. Oregon Medical Laser Center: index.html
  78. Strassl M, Kassenbacher A, Wintner E. Ultrashort laser pulses in dentistry. J Oral Laser Appl 2002;2(4):213-22.
  79. Stabholz A, Zeltzser R, Sela M, Peretz B, Moshonov J, Ziskind D. The use of lasers in dentistry: Principles of operation and clinical applications. Compend 2003;24:811-24.
  80. Kreisler M, Daublander M, Willershausen-Zonnchen B, d‘Hoedt B. Effect of diode laser irradiation on the survival rate of gingival fibroblast cell cultures. Laser Surg Med 2001a;28(5):445-50.
  81. Rastegar S, Jacques SL, Motamedi M, Kim BM. Theoretical analysis of equivalency of high- power diode laser and Nd:YAG laser for coagulation. Lasers in Dentistry, SPIE 1646:150-60, 1992.
  82. Theodoro LH, Haypek P, Bachmann L, Garcia VG, Sampaio JE, Zezell DM, Eduardo C de P. Effect of Er:YAG and diode laser irradiation on the root surface: Morphological and thermal analysis. J Periodontol 2003;74(6):838-43.
  83. White JM, Gekelman D, Shin K, Park X, Swenson T, Rouse B, Tran K, Bullard S, Scott- Beckles B, Oto MJSB, Yamamoto A. Laser interaction with dental soft tissues: What do we know from our years of applied scientific research? Lasers in Dentistry, SPIE 2002;4610:39-48.
  84. Adams TC, Pang PK. Lasers in Aesthetic Dentistry. Dent Clin North Am 2004;48:833-60.
  85. Bach G, Neckel C, Mall C, Krekeler G. Conventional versus laser- assisted therapy of peri-implantitis: A five year comparative study. Implant Dent 2000;9:247-51.
  86. Clayman L, Kuo PC. Soft tissue excision techniques. In Clayman L, Kuo P. Lasers in Maxillofacial Surgery and Dentistry. Thieme Publ, Stuttgart 1997;63-83.
  87. Convissar RA, Diamond LB, Fazekas CD. Laser treatment of orthodontically induced gingival hyperplasia. Gen Dent 1996;44(1):47-51.
  88. Goharkay K, Moritz A, Wilder-Smith P, Schoop U, Kluger W, Jakolitsch S, Sperr W. Effects on oral soft tissue produced by a diode laser in vitro. J Oral Surg 1978;36:932-37.
  89. Olbricht SM, Stern RS, Tang SV, Noe JM, Arndt KA. Complications of cutaneous laser surgery: A survey. Arch Dermatol 1987;123(3):345-49.
  90. Pinheiro AL, Limeira Jr FA, Gerbi MEM, Ramalho LMP. Effect of 830 nm laser light on the repair of bone defects grafted with inorganic bovine bone and decalciûed cortical osseous membrane. J Clin Laser Med Surg 2003;21(6):383-88.
  91. Romanos GE. Atlas der chirurgischen Laserzahnheilkunde. Urban und Fischer Verlag, München 1999.
  92. Romanos GE, Nentwig GH. Present and future of lasers in oral soft tissue surgery: Clinical applications. J Clin Laser Med Surg 1996;14(4):179-84.
  93. Strauss RA. Laser management of discrete lesions. In : Laser applications in oral maxillofacial surgery. (Eds) Catone G A, Alling C C, Saunders, Philadelphia, 1997
  94. White JM, Goodis HE, Horton J, Gold S. Current status of lasers in soft tissue dental surgery. J Periodontol 1994;65(7):733-35.
  95. Yousuf A, Hossain M, Nakamura Y, Yamada Y, Kinoshita J, Matsumoto K. Removal of gingival melanin pigmentation with the semiconductor diode laser: A case report. J Clin Laser Med Surg 2000;18:263-66.
  96. Zeinoun T, Nammour S, Dourov N, Aftimos G, Luomanen M. Myofibroblasts in healing laser excision wounds. Lasers Surg Med 2001;28:74-79.
  97. Al-Watban FA, Zhang XY. The comparison of effects between pulsed and CW lasers on wound healing. J Clin Laser Med Surg 2004;22(1):15-18.
  98. Gutknecht N, Gogswaardt D, Conrads G, Apel C, Schubert C, Lampert F. Diode laser radiation and its bactericidal effect in root canal wall dentin. J Clin Las Med Surg 2000;57:57-60.
  99. Parkins F. Lasers in pediatric and adolescent dentistry. Dent Clin N Amer 2000;44:821-30.
  100. Santaella MR, Braun A, Matson E, Frentzen M. Effect of diode laser and fluoride varnish on initial surface demineralisation of primary dentition enamel: An in vitro study. Int J Paed Dent 2004;14:199-203.
  101. Tuner J, Hode L. The laser therapy handbook. Grängesberg 2004;231.
  102. Gherlone EF, Maiorana C, Grassi RF, Ciancaglini R, Cattoni F. The use of 980 nm diode and 1064 nm Nd: YAG laser for gingival retraction in fixed prostheses. J Oral Laser Applications 2004;4:183-90.
  103. Glauche CE, de Freitas PM, Vieira ND, Marques JL. Qualitative microanalysis of ions and ultrastructuralchanges in dentin exposed to laser irradiation. Lasers Surg Med 2005;36(4): 334-39.
  104. Gutknecht N, Zimmermann R, Lampert F. Lasers in periodontology: State of the art. J Oral Laser Applications 2001a;1:169-79.
  105. Kreisler M, Haj HA, d‘Hoedt B. Clinical efficacy of semiconductor laser application as an adjunct to conventional scaling and root planning. Lasers Surg Med 2005;37:350-55.
  106. Mester E, Spiry T, Szende B, Tota JG. Effect of laser rays on wound healing. Am J Surg 1971;22:532-35.
  107. Patruta S, Franz A, Beer F, Goharkhay K, Sperr W, Moritz A. In vitro stimulatory effect of diode laser on the secretion of tissue inhibitor of matrix mealloproteinases 1(TIMP-1) in human gingival fibroblast: A preliminary report. J Oral Laser Applications 2004;4(3):167-70.
  108. Silveira LB, Silveira JB, Ribeiro MS, Garrocho AA, Novelli MD, Marigo H, Growth EB, et al. In vivo study on mast cells behavior following low intensity visible and near infrared laser radiation (abstract 304). Lasers Surg Med 2002;82.
  109. Bach G, Koch HK, Hellerich U, Venzke T. Konventionelle Diodenlaser versus Hochpulstechnik. Laser Journal 1/2008:18-20.
  110. Deppe H, Horch HH. Laseranwendungen in der chirurgischen Zahn-,Mund-und Kieferheilkunde. Laser Zahnheilkunde 2007;4:219-22.
  111. Horch HH, Deppe H. Laser anwendungen im Mund-Kiefer- Gesichtsbereich. In Horch HH: Mund-Kiefer-Gesichtschirurgie. München: Elsevier 2007;797-820.
  112. Roodenburg JL, Witjes MJ, deVeld DC; Tan IB, Nauta JM: Lasers in dentistry. Use of lasers in oral and maxillofacial surgery. Ned Tijdschr Tandheelkd 2002;109:470.
  113. Maiorana C, Salina S. Oral soft tissue pathologies: Long-term evaluation after laser treatment. J Oral Laser Appl 2001;1:20.
  114. Crippa R. Report on 103 cases of precancerous and other oral lesions treated with a diode laser. J Oral Laser Appl 2001;1:26.
  115. Bach G. Er:YAG versus Diode-Zwei Wellenlängen made in Baden-Württemberg. Laser Zahnheilkunde 2007;4:283-87.
  116. Andersen K. Laser technology- a surgical tool of the past, present and future. Aorn J 2003;78:794-802.
  117. Eichler J, Schneeweiss-Wolter C. Wirkung von Laserstrahlung auf Gewebe. MTA 1999;14:255.
  118. McKenzie AL. Physics of thermal processes in laser- tissue interaction. Phys Med Biol 1990;35:1175-209.
  119. Sullins KE. Diode laser and endoscopic laser surgery. Vet Clin North Am Small Anim Pract 2002;32:639-648.
  120. Svaasand LO, Boerslid T, Oeveraasen M. Thermal and optical properties of living tissue: Application to laser-induced hyperthermia. Lasers Surg Med 1985;5:589-602.
  121. Welch AJ, Motamedi M, Rastegar S, LeCarpentier GL, Jansen D. Laser thermal ablation. Photochem. Photobiol 1991;53: 815-23.
  122. Lippert BM, et al. Wound healing after laser treatment of oral and oropharyngeal cancer. Lasers Med Sci. 2003;18(1):36-42.
  123. Grossenbacher R. Laser surgery in the oral cavity. J Clin Laser Med Surg 1992;10(1):19-21.
  124. Guttenberg SA, Emery RW. Laser resurfacing and oral and maxillofacial surgeons. Dermatol. Surg 1999;25(6):519.
  125. Coleton S. Laser treatment of atypical oral pigmentation. A case report. NY State Dent J 2006;72(2):22-23.
  126. Damante CA, et al. Histomorphometric study of the healing of human oral mucosa after gingivoplasty and low-level laser therapy. Lasers Surg Med 2004;35(5):377-84.
  127. Eichler J, Eichler HJ. Laser. Springer Verlag, Berlin- Heidelberg- New York 1991.
  128. Manni J. Surgical diode lasers. J Clin Laser Med Surg 1992;10: 377-80.
  129. Pick RM, Powel GL. Lasers in dentistry, soft tissue procedures. Dent Clin North Am 1993;37:281-97.
  130. Scherer H, Fuhere A, Hopf J. Current status of laser surgery of benign diseases in the area of soft palate. Laryngol Rhinol Otol 1994;73:14-18.
  131. Morita T, Okamura Y, Ookub K, et al. A new instrument for hemostatic vascular management in endoscopic surgery: Diode laser(STATLaser-SDL) and it‘s hand piece (Dual Hook). J Clin Laser Med Surg 1999;17:57-61.
  132. Claus PN. Comparative study on CW mode versus pulsed mode in AlGaAs diode lasers. SPIE Proc 2001;4249:44-49.
  133. Krause F, Frentzen M. Dioden- Laser in der zahnmedizinischen Anwendung. DGL Zeitschrift für Laserzahnheilkunde 2007;3/ 07:151-58.
  134. Coluzzi DJ. Lasers and soft tissue curettage: An update. Compend Contin Educ Dent 2002;23:1104-111.
  135. Dederich DN. Laser curettage: An overview. Compend Contin Educ Dent 2002;23:1097-103.
  136. Schwarz F, Sculean A, Berakdar M, Szathmari L, Geoerg T, Becker J. In vivo and in vitro effects of an Er:YAG laser, a diode laser, and scaling and root-planning on periodontally diseased root surfaces: A comparative histologic study. Lasers Surg Med 2003;32:359-66.
  137. Fontana CR, Kurachi C, Mendonca CR, Bagnato VS. Temperature variation at soft periodontal and rat bone tissue during a medium- power diode laser exposure. Photomed Lasres Surg 2004;22:519-22.
  138. Gold SJ, Vilardi MA. Pulsed laser beam effect on gingiva. J Clin Periodontol 1994;21(6):391-96.
  139. Borrajo JL, Varela LG, Castro LG, Rodriguez-Nunez I, Torreira MG: Diode laser (980 nm) as an adjunct to scaling and root planning. Photomed Laser Surg 2004;22:509-12.
  140. Kreisler M, Al Haj H, Daublander M, Gotz H, Duschner H, Willershausen B, D‘Hoedt B. Effect of diode laser irradiation on root surface in vitro. J Clin Laser Med Surg 2002;20:63-69.
  141. Meister J, Franzen R. Dentale Lasersysteme Teil II: Der Dioden- Laser. DGL Zeitschrift für Laserzahnheilkunde 2007;3/07: 185-89.
  142. Alam T, Dawasaz AA, Thukral N, Jangam D. Surgical diode laser excision for peripheral cemento-ossifying fibroma: A case report and literature review. J Oral Laser Applications 2008;8:43- 49.
  143. Convissar RA. An overview of laser wavelength used in dentistry. Dent Clin North Am 2000;44:753-765.
  144. Kreisler M, Meier C, Stender E, Daubländer M, Willershausen- Zönnchen B, de Hoedt B. Effect of diode laser irradiation on the attachment rate of periodontal ligament cells: An in vitro study. J Periodontol Oct 2001;72(10):1312-17.
  145. Black P. Der Dentallaser in der oralen Chirurgie-Masterthese- Teil2 Laser Journal 1/2007: 16-21, 2007 146. Van Hillegersberg R: Fundamentals of Laser Surgery Eur J Surg Jan 1997;163(1): 3-12.
  146. Haina D, Landthaler M, Braun-Falco O, Waidelich W. Comparison of the maximum coagulation depth in human skin for different types of medical lasers. Lasers Surg Med 1987;7(4): 355-62.
  147. Sullins KE. Diode laser and endoscopic laser surgery. Vet Clin North Am Small Anim Pract May 2002;32(3):639-48.
  148. McKenzie AL. Physics of thermal processes in laser-tissue interaction. Phys Med Biol Sep 1990;35(9):1175-209.
  149. Reinisch L. Laser physics and tissue interaction. Otolaryngol Clin North Am Dec 1996;29(6):893-914.
  150. Coluzzi DJ. Fundamentals of dental lasers: Science and instruments. Dent Clin North Am 2004;48:751-70.
  151. Maiorana C, Salina S. Versatility of superpulsed diode laser in oral surgery: A clinical report. J Oral Laser Appl 2006;6: 193-99.
  152. Gold SI, Villardi MA. Pulsed laser beam effects on gingiva. J Clin Periodontol 1994;21:391-96.
  153. Kamp M Halbleiterlaser. Vorlesung WS 2006, Technische Physik, Uni Würzburg 2006.
  154. Schäfer O. Die Entwicklung des Diodenlasers bis zur Digitalpulstechnik. Laser Journal 2/2008:6-7.
  155. Nanami T, Shiba H, Ikeuchi S, Nagai T, Asanami S, Shibata T. Clinical applications and basic studies of laser in dentistry and oral surgery. Keio J Med Dec.1993;42(4):199-201.
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