CATEGORIES

Cosmetic Dentistry

Laser Dentistry

( Light Amplification by Stimulated Emission of Radiation)

In traditional dentistry, we all are aware, requires the use of a rotary tool that has many useful attachments. Among these are cleaning brushes, drills, and sanding heads. All of them require rough physical contact that can leave you nauseous and stressed out. Most of them also require water and suction to help clear out the byproducts associated with each head. If the thought of that drill operating anywhere in your mouth gives you the chills or cold sweats, particularly the wailing children, then maybe it's time to investigate laser dentistry. Laser dentistry eliminates many of the common complaints of traditional dentistry. A laser device replaces the rotary tool and can be used for everything from surgery to tooth bleaching.

LASERS have multiple applications in a variety of fields including medical and have evolved to a role in dentistry too. In 1987 FDA (Food And Drug Administration; see the approved list below) of USA approved a prototype of Laser to study on dental patients. Most lasers, including those used in dentistry, are engineered and designed to perform special functions without changing or damaging the surrounding tissues or materials.

The time span of a laser treatment can vary depending on the usage. Some treatments with the laser may only last a few moments, while others could last minutes. When it comes to surgery, laser dentistry offers several significant improvements. Lasers are focused beams of light energy, and they have the ability to make swift, efficient changes to teeth and gums, with little or no post-operative pain or swelling. Not surprisingly, laser treatment is rapidly replacing more traditional methods in the dental office, including the scalpel, the needle and the dental drill. There's not a big need for anesthesia, bleeding and swelling are reduced, and there's not much discomfort afterwards.

For tooth bleaching, a laser can speed up and enhance the action of the bleaching agents. Natural-looking fillings for cavities can be cured in minutes and patients can eat immediately afterwards. The benefits of laser dentistry are numerous and exciting! Most dentists find it is an affordable alternative for people who are afraid of drills. Though the cost of the equipment and training must eventually be passed on to the patient, people who want laser dentistry seldom mind.

There are currently four areas of dental care that are enjoying the benefits of laser technology

Cavity removal can be accomplished with two currently available (and FDA approved) laser machines. Both have the ability to remove decay within a tooth, and prepare the surrounding enamel for bonded fillings. The need for anesthesia is greatly reduced or eliminated over the traditional methods. Laser energy dramatically reduces the bacteria found in dental decay, and has been demonstrated to enhance the tooth's ability to "heal" in situations where "deep cavities" had existed. There are, however, several limitations to laser decay removal including the inability to adequately remove silver fillings, onlays, and crowns.

Curing , or hardening bonding materials is another area where lasers have become important. These lasers drastically reduce the time it takes to finish a filling, and create what some researchers have shown to be a stronger restoration.

Whitening teeth can be accomplished with special solutions that are applied to the tooth surface in the dental office and activated by laser energy. Color changes of several shades are possible in a very short time. When combined with at-home tray based whitening systems, dramatic changes can be seen in even the most difficult cases. The main comparison between laser whitening and tray systems does not seem to be major side effects, but rather time versus cost. Laser whitening is a much faster process, however, it is generally more expensive.

Periodontal , or gum related care is the fourth area benefiting from laser technology. Lasers are currently used for recontouring or reshaping gums (often described as "plastic surgery for the smile"), removing extra or diseased gum tissue associated with the use of certain medications or periodontal disease, and removing the bacteria in periodontal pockets to promote healing. Healing time and post-operative discomfort can be significantly reduced over the traditional surgical methods.

Laser types and usage:

The CO2 laser can be used to perform surgical procedures within the oral cavity such as frenulectomy, gingivectomy, and removal of small tumors of the mucosa and of other lesions, for example, leukoplakias, and for modeling the neck in order to take impressions. These can all be performed during an office visit and with practically no bleeding. For hard tissues, the CO2 laser can be used to vaporize small, superficial caries and seal the dentin tubules for vitrification of the dentin.

The pulsed Nd:YAG laser was introduced in odontostomatology in the 1990s, essentially for treatment of gingival pockets. Inserting the fiber between the gingiva performs the technique and the tooth that results in sterilization of the part treated and stimulation of the tissue, which, in turn, causes renewed adhesion between the gingiva and the neck. Another application is emptying and sterilization of the root canals by introducing the fiber which, when it radiates the laser energy, vaporizes and disinfects the canal, eliminating the risk of apical damage and guarantying a complete and sterile emptying of the canal.

Various versions of the Erbium laser are currently used in odontostomatology, because of its evident potential in the treatment of hard tissue (enamel, dentin, cement and bone). The huge absorption by both water and hydroxyapatite of the radiation at a wavelength of approximately 2.9 µm permits tissue removal with minimal or no damage to the surrounding structures.

No measurable effect is seen beyond the intended target site. Lasers are very specific in regard to the wavelength produced. The procedures are performed without anesthesia in most cases, to the great relief of patients.

Application Preparation Soft Tissue Coagulation Crown Lengthening Curettage Frenectomy Gingivectomy Gingival Hyperplasia Lesion Removal Hard Tissue Caries Removal Cavity Preparation Enamel Etching Fissure Sealing Non-Surgical Curing light-activated materials (Composites) Sterilizations of instruments

Advantages of Laser Dentistry:

• Cut and coagulate precisely, in one step
• Eliminate collateral tissue damage
• Minimize post-operative inflammation and discomfort
• Clean, bloodless operating field
• Radiant coagulation: seal blood vessels without cauterization via conductive heat or carbonization
• Controlled depth of laser penetration
• Achieve immediate results
• Hemostasis provides excellent visibility-even down in the pocket
• Minimize the need to pack cord
• Enhance patient recovery time
• Increase patient turnover rates with more efficient laser procedures
• Eliminate tissue recession

Reduce patient discomfort and the need for anesthetic

Complete FDA clearance list:

• Class I, II, III, IV and V cavity preparation
• Caries removal
• Hard tissue surface roughening or etching
• Enameloplasty, excavation of pits and fissures for placement of sealants For use on adult and pediatric patients
• Tooth preparation to obtain access to root canal
• Root canal preparation including enlargement
• Root canal debridement and cleaning
• Cutting, shaving, contouring and resection of oral osseous tissues (bone)
• Excisional and incisional biopsies
• Exposure of unerupted teeth
• Fibroma removal
• Frenectomy and frenotomy
• Gingival troughing for crown impressions
• Gingivectomy
• Gingivoplasty
• Gingival incision and excision
• Hemostasis
• Implant recovery
• Incision and drainage of abscesses
• Leukoplakia
• Operculectomy
• Oral papillectomies
• Pulpotomy
• Pulp extirpation
• Pulpotomy as an adjunct to root canal therapy
• Root canal debridement and cleaning
• Reduction of gingival hypertrophy
• Soft tissue crown lengthening
• Sulcular debridement (removal of diseased of inflamed soft tissue
• Treatment of canker sores, herpetic and aphthous ulcers of the oral Mucosa
• Vestibuloplasty

Performed on Diagnodent:

1) Cross-Sections of a Molar

2) Cross-section 4 of the molar showing the large cavity which is nearly into the nerve of the tooth but has a barely visible opening from the groove.

3) Cross-section 13 of the molar shows tiny opening from the pit of the tooth but a 12X larger cavity underneath the opening .