LASERS IN DENTISTRY

CONTENTS

Introduction History Fundamentals of lasers Commonly used lasers in dentistry Application of lasers Protection Conclusion

INTRODUCTION

Laser is an acronym, which stands for Light Amplification By Stimulated Emission Of Radiation

Light shows, disc players

Device that converts electrical/chemical energy into light energy

HISTORY

1960-first laser 1993 Nd:YAG Laser 1993 Kinetic Cavity Preparation 1994 CO2 Laser, Argon Laser 1996 Laser welder 1997 Nd:YAP Laser 1998 Er:YAG Laser

Fundamentals of lasers

LightAmplificationby theStimulatedEmissionofRadiation

Light

Form of electromagnetic energy Properties of laser

Monochromatic Collimation Coherency Efficiency

Monochromatic-Characterized by radiation in which all waves are of same frequency and wavelength.

Collimated: all the emitted waves are parallel and the beam divergence is very low. This property is important for good transmission through delivery systems.

A laser is a device that creates and amplifies a narrow, intense beam of coherent light.

LIGHT

•Radiates light in random directions at random times.•A jumble of photons going in all directions.

Single or just a few frequencies going in one

precise direction

LASER NEON LIGHT

COHERENT INCOHERENT

A- Amplification means that a very bright intense beam of light can be created. The laser may be activated by a few photons which then act to produce many more, and the initial light generated is computed to make a very bright compact beam

S – Stimulated : ME-Emissionn

If an atom in the excited state is struck by a photon of identical energy as the photon to be emitted, the emission could be stimulated to occur earlier than would occur spontaneously. This stimulated interaction causes two photons that are identical in frequency and wavelength to leave the atom.

Laser Design

A laser medium or active medium-solid, liquid or gas

Housing tube or optical cavity External power source-pumps

Process of supplying energy for amplification-pumping

Laser Light Delivery

Articulated arms-CO2 laser

Waveguide delivery system

Fiber optic delivery system

Laser Types

Based on wavelength-Soft lasers-Hard lasers

Based on the type of active / lasing medium used

ArF excimer, KrF excimer, XeCl excimer, Argon ion, Nd: YAG,Er: YAG, CO2

Nd: YAG laser

DIAODE LASERSEMICONDUCTOR LASER

Gallium Arsenide chipNo mirror to clean and alignNo gas tube, flash-lamps, laser rod, water cooling

PortableNo special power

No cooling connectionNo heat

QuietAffordable

More powerful, less traumatic250microsecond-10sec

0.05 Hz - 200 HzExpand Practice* Sulcular debride-

ment* Root canal treat-ment

Laser interaction with biologic tissues

Four different interaction Reflection Scatter Absorption Transmission

Processes

Incision

Excision

Ablation

Advantages

No anesthesia, no drill

Less blood loss, Less pain

Reduce post –operative edema

Early healing, rapid regeneration, reduce

post sensitivity in restorations

Less chances of metastasis

Sterilization of treatment site-no infection

Disadvantages

Lasers can't be used :

- fill cavities located between teeth

- cavities around old fillings and large cavities

(crown)

- remove defective crowns or silver fillings

- prepare teeth for bridges

Laser - more expensive

APPLICATIONS-GENERAL

Eye surgery

Cancer treatment

Removal of tattoos

Cosmetic surgery

Hair removal

• Cold Sores

• Nerve Regeneration

NO PAIN

Future Trends in Dentistry

HARD TISSUES

Prevention of caries

Detection of incipient caries

Cavity preparation

Enamel etching

Desensitization

Bleaching/ fluorosis

t/t of fractured tooth

Pulpotomy

Removal of old restoration-gold,

ceramic

Root canal therapy

Temporomandibular Joint Treatment:

reduce pain and inflammation

BLEACHING

SMILE

Crown lengthening

Soft tissues

Frenectomy Tongue tie Incisional and excisional biopsiesInflammatory papillary hyperplasia

Aphthous ulcer Operculectomy Removal of hyperkeratotic lesions Removal of malignant lesions Soft tissue crown lengthening Vestibuloplasty Removal of granulation tissue Removal of vascular lesions-

Hemangioma Pyogenic granuloma Implants – Stage II – at the time of

recovery

Laser Gingivectomy

A Gingivectomy is a periodontal surgery that removes and

reforms diseased gum tissue or other gingival buildup

Performed in a dentist's office, the surgery is primarily

done one quadrant of the mouth at a time under local

anesthetic.

CO2 laser with wavelength of 10,600nm

GINGIVECTOMY

FRENECTOMY

Removal of inflammatory hyperplasia

Why Fiberoptic is important? 1. Light weight 2. Easy to approach 3. Easy sterilization 4. Tactile sensation

LASER HAZARD CONTROL MEASURES

· The small flexible fiber optic , hand pieces or tip must be steam sterilized in sterilizing pouches

· Use of protective wear

- Use of screen & curtains should be promoted

· Use of proper clothing

· Use of anti-fire explosive

· Proper training and courses

LASER FILTRATION MASKS

prevents air borne contamination

FOOT PEDAL CONTROL SWITCH WITH PROTECTIVE HOOD

prevents accidental depression by surgical staff.

CONCLUSION Lasers - alternative to conventional

surgical systems

Lasers are a “new and different scalpel” (optical knife, light scalpel)