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Lasers in Dentistry
1. Dept. of Oral and Maxillofacial Surgery
By,
DINESHWARRAN RAJENDRAN (CRI)
Guided by,
DR. R.KANNAN, MDS
Professor of Oral and Maxillofacial Surgery
2. Topics
⢠Introduction
⢠History
⢠Mechanism of Action
⢠Application of Lasers in Dentistry
⢠Advantages and Disadvantages of Lasers
⢠Safety Measures
⢠Examples of Dental Laser Therapies
⢠Video Presentations
⢠Conclusion
4. Features: Spatially coherent, which means that either
the light is emitted in a narrow, low divergence beam.
Many uses of lasers in daily life includes :
- In consumer devices such as DVD players, laser printers,
and barcode scanners
- In medicine for laser surgery and various skin treatments
- In industry for cutting and welding materials
- In military and law enforcement devices for marking targets
and measuring range and speed
5. In Dentistry,
Laser dentistry A precise and effective way to perform
many dental procedures. The potential for
laser dentistry to improve dental
procedures rests by allowing for treatment
of a highly specific area of focus without
damaging surrounding tissues.
6. History
1917
Albert Einstein established the
theoretical foundations for the laser
Quantum Theory of Radiation.
1959
Gordon Gould published the term
LASER in the paper The LASER.
May 16, 1960,
Theodore H. Maiman operated the
first functioning laser, the Ruby laser
at 694 nanometers wavelength
13. ⢠Using the principle of selective photothermolysis, these laser target
different chromophores in the skin, which selectively absorb the laser or
light energy as heat and yield the desired response.
Chromophores
absorb the
light
Physical,
mechanical,
chemical,
temperature
changes may
occur
This energy
travels at
different
wavelength
and is
absorbed by a
âtargetâ
15. Applications of Lasers in
Dentistry
⢠The rapid development of laser technology has seen its
introduction into various fields of dentistry.
16. 1. Diagnosis
⢠¡ Detection of pulp vitality
⢠¡ Doppler flowmetry
⢠¡ Laser fluorescence- Detection of caries, bacteria and dysplastic changes in the
diagnosis of cancer
2. Hard tissue applications
⢠¡ Caries removal and cavity preparation
⢠¡ Re-contouring of bone (crown lengthening)
⢠¡ Endodontic (root canal preparation ,sterilization and Apicectomy)
⢠¡ Laser etching
⢠¡ Caries resistance
3. Soft tissue applications
⢠¡ Laser-assisted soft tissue curettage and peri-apical surgery
⢠¡ Bacterial decontamination
⢠¡ Gingivectomy and Gingivoplasty
⢠¡ Gingival retraction for impressions
⢠¡ Implant exposure
17. Soft tissue applications (cont.)
⢠¡ Biopsy incision and excision
⢠¡ Treatment of aphthous ulcers and Oral lesion therapy
⢠¡ Coagulation / Hemostasis
⢠¡ Tissue fusion - replacing sutures
⢠¡ Laser-assisted flap surgery
⢠¡ Removal of granulation tissue
⢠¡ Pulp capping, Pulpotomy and pulpectomy
⢠¡ Operculectomy and Vestibuloplasty
⢠¡ Incisions and draining of abscesses
⢠¡ Removal of hyperplastic tissues and Fibroma
4. Laser-induced analgesia
5. Laser activation
⢠¡ Restorations (composite resin)
⢠¡ Bleaching agents
6. Other
⢠¡ Removal of root canal filling material and fractured instrument
⢠¡ Softening gutta-percha
⢠¡ Removal of moisture/drying of canal
18. Lasers in Dentistry
Soft tissue lasers
CO2
Laser
ND YAG
Laser
Hard tissue lasers
ER YAG Excimer
Types of Lasers Used in Dentistry
19. Carbon Dioxide Laser
ďą Mode : vaporisation, cutting (>100ËC)
ďą Specification : 10.6 micron wavelength
Used effectively in treating patients with oral lesions with
blood dyscrasias.
ďą Oral indication:
a. Excision of pre-malignant lesions
b. Excision/biopsy
c. Hemiglossectomy
d. Adhesive microvascular/macro neural
ďą Disadvantages :
-Cornea at risk
-Haemostasis may not be adequate on
very vascular area (posterior tongue)
20. ND-YAG Laser (Neodymium doped-
Yttrium Aluminium Garnet)
ďą Mode: coagulation (>60Ëc), central vaporisation
ďą Specification : 1.06 micron wavelength
Can be combined with CO2 (combo laser) or KTP
ďą Oral indications:
a. Coagulation of very vascular lesions or near major
blood vessel
b. Excision in vascular areas such as posterior tongue
d. Gingivectomy
e. Frenectomy
ďą Disadvantages:
- Retina at risk
- Penetration could cause inadvertent spread
- Oedema more than CO2 laser
21. KTP Laser (Potassium Titanyl
Phosphate)
ďą Modality : cutting with moderate coagulation
ďą Specification : 0.53 micron wavelength
Can be combined with Nd-YAG laser
ďą Oral indications
a. Excision in vascular areas, eg. Tonsillectomy
ďą Disadvantage
- Retina at risk
23. Advantages and Disadvantages
of Lasers
Advantages:
ď§ Less pain in some instances (reducing the need
for anesthesia)
ď§ Reduce anxiety in patients uncomfortable with
the use of the dental drill.
ď§ Minimize bleeding (high-energy beam
photocoagulation) and swelling.
ď§ Reduce bacterial infections (sterilizes the area
being worked on)
ď§ Preserve more healthy tooth during cavity
treatment.
24. Disadvantages:
ď§ Lasers canât be used on teeth with fillings that
are already in place.
ď§ Lasers can't be used in many commonly
performed dental procedures. Eg. lasers can't be
used to fill cavities located between teeth,
cavities around old fillings, and large cavities.
ď§ Traditional drills may still be needed to shape the
filling, adjust the bite, and polish the filling even
when a laser is used.
ď§ Do not eliminate the need for anesthesia.
ď§ More expensive since the cost of the laser is
much higher.
26. Precautions:
ď Safety goggle (should be worn by patient and
operator)
ď Lock the door during the treatment
ď Never look directly into the laser beam
ď Never point the laser hand-piece at any person
except at the treated area
ď Never use the laser in the presence of flammable
anaesthetics
ď Never step on or abruptly bend the fibre optic
cable
ď Never move the laser machine during operation
33. Conclusion
Traditional
Surgery
Laser SurgerySubject
YesNo or mildAnesthesia
Yes depends on
operating zone
No or minimalBleeding
Sedation dependedSlight irritationPain
Time consumingLess timeTime
Yes in invasive
procedures
No needSuturing
Less expensiveExpensiveCost
MoreMinimalPostoperative
complications