Lasers in Dentistry

A general overview of the uses of lasers in the field of dentistry

1. Lasers In dentistry 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

3. Introduction Definition: L A S E R A device that emits light through a process of optical amplification based on the stimulated emission of electromagnetic radiation

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

7. Dental Lasers 1993 : Nd:YAG Laser. 1994: CO 2 Laser. 1996: Laser welder. 1998 : Er:YAG Laser.

8. Mechanism of Action Laser Physics Design of Laser Medium Tissue- Laser Interaction

9. Laser Physics

10. Design of Laser Medium Components of a typical laser: 1. Gain medium 2. Laser pumping energy 3. High reflector 4. Output coupler 5. Laser beam

11. Tissue-Laser Interaction Laser light can have four different interactions with the target tissue, depending on the optical properties of that tissue :

12. Different Laser-Tissue Interactions

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.

14. Different Temperature Effects

15. Applications of Lasers in Dentistry The rapid development of laser technology has seen its introduction into various fields of dentistry.

16. Types of Lasers Used in Dentistry

17. Carbon Dioxide Laser Mode : vaporisation, cutting (>100˚C) Specification : 10.6 micron wavelength Used effectively in treating patients with oral lesions with blood dyscrasias . Oral indication: a. Excision of pre-malignant lesions b. Excision/biopsy c. Hemiglossectomy d. Adhesive microvascular /macro neural Disadvantages : -Cornea at risk -Haemostasis may not be adequate on very vascular area (posterior tongue)

18. ND-YAG Laser (Neodymium doped- Yttrium Aluminium Garnet) Mode: coagulation (>60˚c), central vaporisation Specification : 1.06 micron wavelength Can be combined with CO2 (combo laser) or KTP 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 Disadvantages: - Retina at risk - Penetration could cause inadvertent spread - Oedema more than CO2 laser

19. KTP Laser (Potassium Titanyl Phosphate) Modality : cutting with moderate coagulation Specification : 0.53 micron wavelength Can be combined with Nd -YAG laser Oral indications a. Excision in vascular areas, eg . Tonsillectomy Disadvantage - Retina at risk

20. Comparison of The Lasers

21. Advantages and Disadvantages of Lasers Advantages: Less pain in some instances (reducing the need for anesthesia) Reduce anxiety in patients uncomfortable with the use of the dental drill. Minimize bleeding (high-energy beam photocoagulation) and swelling. Reduce bacterial infections (sterilizes the area being worked on) Preserve more healthy tooth during cavity treatment.

22. Disadvantages: Lasers can’t be used on teeth with fillings that are already in place. 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. Traditional drills may still be needed to shape the filling, adjust the bite, and polish the filling even when a laser is used. Do not eliminate the need for anesthesia. More expensive since the cost of the laser is much higher.

23. Safety Measures Dental lasers generally fall into Class 4

24. Precautions: Safety goggle (should be worn by patient and operator) Lock the door during the treatment Never look directly into the laser beam Never point the laser hand-piece at any person except at the treated area Never use the laser in the presence of flammable anaesthetics Never step on or abruptly bend the fibre optic cable Never move the laser machine during operation

25. Examples of Dental Laser Therapies Leukoplakia

26. Gingivectomy

27. Operculectomy

28. Pyogenic Granuloma Excision

29. Frenectomy

30. Video Presentation

31. Conclusion Traditional Surgery Laser Surgery Subject Yes No or mild Anesthesia Yes depends on operating zone No or minimal Bleeding Sedation depended Slight irritation Pain Time consuming Less time Time Yes in invasive procedures No need Suturing Less expensive Expensive Cost More Minimal Postoperative complications

32. Traditional Surgery Laser Surgery Subject Slower Rapid Healing Traumatic excision Dehydration and carbonization Method of pathology elimination Slight worse <depended> Better Dentist comfort More convenient Complicated Procedure Less More Team work Same Same Experience

33. Thank You.