Laser in Dentistry

By Hisham Sindi
 LASER
Light
Amplification
by
Stimulated
Emission
of
Radiation
Stimulated VS. Spontaneous
Production of Laser Energy

Active
Medium
Optical
Resonator
Energy Source
 1) Active Medium
• Solid : (ruby and Nd: YAG)

• Gas : (CO2, argon and He-Ne)

• Liquid : (complex organic dyes)

• Semiconductor : (diodes)

• Metal vapor : (copper)

 2) Optical Resonator
• Left mirror : Flat and full reflection

• Right mirror : Concave and partial transmition

 Energy Source
• High Voltage Power Supply

• Radiofrequency Generator

• Flash Lamp Tube

• Another laser
1) Active medium
2) Energy source
3) Left mirror
4) Right mirror
5) Laser
 Characteristics
• Coherent

• Parallel

• Monochromatic
 Classification of Laser
• Medium

• Heat production

• Output power

• Pumping scheme

• Operation mode
 According to Heat Production
1) Athermic (Soft laser) (LLL) :
• He-Ne

2) Thermic (Hard laser) :

• CO2
• Nd:YAG
• Ruby
 According to Output Power
• Low power : (up to 1000 mW)

• Middle power : (1-3 W)

• High power laser : (3 W and upwards)

 According to Pumping Scheme
• Optical

• Electrical
According to The Operation Mode
• Continuous wave

• Pulsed
 Uses of Laser
1) Commercial

2) Industrial

3) Medical

4) Research

5) Military
 1) Commercial
• Copiers
• Displays
• Communications
• Printing
• Scanning
• Light shows
• Compact Disk (CD)
 2) Industrial
• Alignment
• Cutting
• Drilling
• Sealing
• Construction
• Soldering
 3) Medical
• Ophthalmology
• Invasive Surgery
• Dentistry
• Diagnostic
• Cosmetic Surgery
• Endoscopy
 4) Research
• Fusion
• Spectroscopy
• Velocimetry
 Military
• Navigation
• Ranging
• Illumination
• Weapons
 Biologic effects of Laser Light
1) Thermal effect:
• Photocoagulation
• Photovaporization

2) Non thermal effect:

• Photochemical
• Photomechanical
 Thermal Effect
• 36.5 C˚: No effect
• 37 C˚ : Photoactivation
• 44 C˚ : Tissue denaturation
• 60 C˚ : Tissue degradation
• Whitening of tissue surface
• 65 C˚ : Tissue coagulation
• Hemostasis and Intraluminal thrombosis
• Exceeding 100 C˚ : Vaporization
 Sizes of Cutting Depend on:
• Thermal conduction of the tissue

• The wave length

• The power of energy

 Non Thermal Effect
1) Photochemical :
• Neural
• Activation of enzymes (ATP)
• Cell membrane

2) Photomechanical (Nd-YAG) :
• Extremely high power ultra short pulses.
Laser in Dentistry
 Pulsed Nd-YAG Lasers
1) Soft tissue :
• Gingival retraction
• Gingivectomy
• Gingivoplasty
• Frenectomies
• Apthus ulcers

2) Hard tissue:
• Enamel and dentin etching
• Dentin Hypersensitivety
• Caries detection
• Endodontic treatment (shaping, sterilization and obturation)
 Argon Lasers (476, 488, 514 nm)
• Cure dental bonding agent and composite
resin.

• Recommended for many soft tissue

application
 CO2 Lasers (10600 nm)
• Superficial cutting or vaporizing soft tissue.

• Oral and maxillofacial surgery

• Minimal photocoagulation in deeper tissues

 Er-YAG Lasers
• Strongly absorbed by collagen, hydroxyapatite
and water
• Caries removal and cavity preparation
• Hard dental tissue
• Cut and vaporize with small zones.
Effects of Lasers on Dental Tissues
• Enamel

• Dentin

• Cementum

• Pulp

• Wound healing
 Effect on Enamel
• Modification of the enamel surface
• Melting structural elements
• Increase caries resistance
 Effect on Dentin
• Sealing of dentinal tubules
• Decrease dentin permeability
• Desensitization of dentin
 Effect on Cementum
• Increase resistance

• Reduction of plaque accumulation

• Calculus removal
 Effects in Wound Healing
• Rapid epithelization
• Increase collagen
• Neovasculrization
• Neural regeneration
• Haemostatsis
 Safety Measures
• Protective glasses
• Cover reflective surfaces
• Wet gauze pads
• Remove anesthetic gases
• Suction smoke and vaporized soft tissue
 Contraindications
• Pregnancy

• Heart diseases
 Examples
• Diagnodent

• Waterlase
Thank You