Laser Assisted Dentistry Applications
With the new generation dental laser, it is possible to work without contacting the tooth and other tissues. In this way, there may be no need to anesthetize the tooth, as pain due to heat, vibration and friction will not occur. For this reason, it can be preferred for patients of all ages who have a fear of dentists.
Disinfection and sterilization are provided in the area where the laser is used.
The selective behavior of the laser beam, whose power can be adjusted, ensures that the treatment is completed with less material loss. (It removes only the rotten area from the tooth.)
In laser surgical applications, there is almost no bleeding during the procedure. The possibility of complications, swelling and discomfort that may occur after each surgical application is reduced and a faster recovery is achieved.
It is possible to get better results in a very short time in laser “teeth whitening” procedures.
It is successful in root canal treatment, root canal disinfection in teeth with apical lesions.
In patients with genetically excessive purple discoloration (hyperpigmentation) on the gums, this problem can be eliminated by laser peeling in 3 or 4 sessions.
Laser applications and composite filling applications, which are known as laser filling and hardened with a light source, should not be confused with each other.
LASER APPLICATIONS IN DENTISTRY
Laser Assisted Implant Applications
Laser use in cavity preparation in filling
In terms of cavity opening, hard tissue work can be done most effectively with Er:YAG laser and TEA-CO2 laser with current possibilities. Removal of small particles from the tissue by thermomechanical effect
found to be more advantageous than evaporation. Selective caries removal: With laser energy, dental caries in all dental tissues (enamel, dentin, cementum) can be removed. Since there is no contact with the tooth, the patient does not experience pain and there is no need for anesthesia. In addition, due to the feature of laser energy, a sterile environment is created and bruises that may occur later are prevented. It is possible to work with less energy in carious tissue than in solid hard tooth tissue. Thus, it is possible to clean only the carious tissue without causing any change in the healthy tissues with the power-adjusted laser system.
Laser use in dentin roughening
According to the raster electron microscope images of the dentin surface, it is seen that the surface roughness equivalent to etching with phosphoric acid is achieved in the operations performed with excimer laser and Er:YAG laser. The dulled color difference that appears macroscopically in these two lasers is an indication that the desired result has been achieved.
Laser use in bone tissue
Er:YAG laser with a wavelength of 2.94 nm and a short pulsating CO2 laser with a wavelength of 9.6 nm are used in skull base, spine surgery, finger surgery and inner ear bone operations where difficult anatomical conditions are present. There is no condition that requires absolute indication in oral surgery. Due to its anticoagulant effect, an indication for maxillofacial surgery can be considered in patients with hemophilia.
Laser use in Periodontology (Gum Diseases)
Gingivectomy – Gingivoplasty:
It is a fact that gingival length adjustments made with laser bring much better results in providing gingival aesthetics. After cutting and shaping the gingiva without anesthesia with laser, other procedures can be started without the need to wait for the bleeding to stop and the tissue to heal.
Tooth Surface Cleaning:
After deep gingival cleaning with laser without anesthesia, gingival pockets heal very quickly.
Pigmentation treatment:
In practical methods, hyperpigmentations that occur due to increased pigmentation in the gums are treated by peeling with a scalpel under anesthesia. There is no need for anesthesia in pigmentation treatments with laser and the patient can continue his life without any discomfort after the procedure.
The use of the laser in the periodontal pocket is not at the desired level since the appropriate technique has not been developed yet. The light must be applied perpendicular to the root surface to prevent damage to the intact periodontal fibers. Adaptation of flexible applicators to work in this way in a small area is not yet at a level to be used in practice.
Laser use in soft tissue surgery
Nd:YAG laser provides good thermocoagulation and is effective up to a depth of 1-4 mm, so it is used in superficial interventions. It provides an important advantage by helping coagulation in severe bleeding. The CO2 laser is the most suitable choice for effective incision in all aspects of soft tissue. It provides a great advantage in areas such as tongue root, floor of mouth, lip corner where postoperative recovery and function may be a problem. Epithelialization is completed in 2-3 weeks, there is no noticeable bleeding during the operation, and postoperative pain and edema are minimal. It can be used very successfully in excision of precancerous lesions, removal of benign tumoral masses such as hemangioma, lymphangioma, papilloma, fibroma, removal of prosthetic fibroplasia in preprosthetic surgery, deepening of the vestibule sulcus, frenectomy, and removal of pigmentations for aesthetic purposes.
Laser use in early diagnosis of caries
Studies are carried out with computers that direct the fluorescent light formed by sending the argon laser light to the tooth to the spectrometer and record it in the photoreceptors. The system is not yet suitable for practice.
Laser use in Endodontics (Canal Treatment)
Laser energy is used in various ways in endodontic diagnosis, vital pulp treatments, root canal treatment and endodontic surgery.
Indications for laser in endodontic treatment:
1. In teeth with purulent pulpitis or pulp necrosis
2. In teeth with pulp gangrene
3. In teeth with periapical lesions
4. Devital teeth with lateral canals
5. In cases where the apex is resorbed due to inflammation or trauma
6. In cases where endodontic treatment is unsuccessful for at least three months
