Ozone, lasers and other technological support in dentistry /part 2/

SLOWLY, BUT SURELY THE ERA OF THE CLASSIC DENTRISTY IS FALLING INTO OBLIVION, AND THE ERA OD MODERN DEVICES, NEW TECHNOLOGY AND TECHNIQUES IS TAKING ITS PLACE / Written by Niki Ružević, D.M.D. /

Laser is an acronym for Light Amplification by Stimulated Emission of Radiation. More precisely, it is a name for an optic device which emits a coherent beam of photons. A laser beam is a directed beam of light which, once transformed into a thermal energy, can ensure an efficient and manifold therapeutic effect. As opposed to the light emitted by ordinary sources (such as light bulbs), a laser light is almost always monochromatic, that is it is a light of a single wavelength (colour) and it is directional as it is emitted in a narrow beam. The beam itself is coherent which means that the electromagnetic waves are in phase of space and time. A laser beam can operate in a continuous mode (its output power is always the same) or in a pulse mode (very short impulses). Based on its application, lasers are divided in two groups: soft and hard tissue lasers. The difference between the two is the absorption of light in the different tissue. Diode lasers are the representatives of the lasers which operate in continuous beam mode and they differ in wavelength. They have less power and being the lasers of an average power they always work in a continuous mode. Moreover, a diode laser is only used on soft tissue and for disinfection, but they cannot ever be used as deep as the pulse lasers. Also, with the diode lasers you cannot work with different pulse length because they cannot be changed and, therefore, it is impossible to achieve a big peak power in kilowatts (kW). With the lasers which operate in a pulse mode it is possible to change their power, wavelength, frequency, energy, etc. When one has the possibility of changing the pulse length it also means that you can control the work: short pulse – ablation, long pulse – coagulation. There are three basic wavelengths and each of them has a different effect on a human body: Er: YAG; Nd: YAG i KTP Nd: YAG.

Er: YAG laser emits infrared light of the wavelength of 2940 nm. The output of an Er: YAG laser has the strongest capacity of absorption into the tissue due to its high affinity for water-containing tissue and it is, therefore, perfect for doing a precise ablation of the tissue, that is the removal of calculus from the infected teeth. In the whole process, the healthy tissue is not being destroyed, as opposed to a classic dental drill. The new generation of lasers enables the dentist to work on the hard tissue and can remove all fillings, except for the amalgam ones, and the calculus on different structures of the dental tissue and on different depths without having to increase the temperature of the surrounding tissue. This kind of treatment lasts a little longer than the ordinary treatment with filling to which we are used, but it is very comfortable because the laser performs noiseless and, once the filling are polished, they cling better to the tooth surface. Besides being used for removing the dental calculus, lasers can be used in treating more serious dental problems such as gangrene on tooth canals or granuloma which are easily accessible with a fine laser attachment which dries out the bacteria through a canal without having to do a surgical procedure or stitches. Also, Er: YAG laser is used for making incisions and excisions of the soft tissues. Nd: YAG laser emits infrared light of the wavelength of 1064 nm and shows the highest level in homogeneous absorption into the tissue which renders it an ideal laser source for surgery, disinfection and treatment of the deeper tissues. In the area of dentistry, laser, with its homogeneous absorption achieves a very precise and fine performance in removing the tissue while, also, on one hand, sterilizing and coagulating and, on other hand, does an excellent job in disinfecting. Nowadays, lasers are successfully applied in treating the periodontal pockets, that is in doing a sp-called closed curettage, and also in treating half-grown wisdom teeth where the mucous membrane is released without using the anesthesia or inducting any pain to the patient. KTP Nd: YAG laser emits green light of the wavelength of 532 nm and it has a high affinity for oxihemoglobin and melanin, and selective photothermolysis. It is the perfect choice for treating the surfaces of vascular lesions, veins and a wide array of pigment lesions. There are several kinds of hard tissue lasers in restorative dentistry:

  • Laser for detection of calculus – Diagnodent KaVo pen is the most precise and most functional among all the devices.
  • Laser for polymerization – hardening of the composite fillings. EMS SWISS MASTER LIGHT is, with no doubt, the best and the most reliable one.
  • Soft-hard tissue laser – the competition is strong, especially in the last three years.

A place in the very top of the soft-hard tissue lasers, if not even the best one, is, certainly, occupied by Fotona Light Walker Laser AT soft-hard tissue laser, based on its quality, power, speed, efficiency, design and also price.

Advantages of using the lasers:

  • The amount of time spent on the procedure is significantly reduced; this method is comparatively less invasive than the conventional methods. The procedure itself is quite faster and more simple.
  • There is no such a big need for using anesthetics, and in many cases (procedures) the anesthetics (anesthesia) is not even necessary.
  • The pain during and after the very procedure is minimal, while the post-operative edema is reduced and the tissue is minimally damaged.
  • There is less fatigue for the patient, dentist and for the entire staff, a quicker recovery without the possibility of an infection since the high-energy beam destroys the bacteria and sterilizes the area which needs to heal.
  • Laser reduces the post-operative sensitivity because it desensitizes the nerve tissue, it reduces the number and virulence of the bacteria.
  • Laser treatment requires a lesser number of dental appointments and, also, reduced with most of the applications.
  • Laser therapy reduced the bleeding thanks to a positive haemostatic effect since the high-energy light speeds up the coagulation, so the treatment of certain indications with this method is convenient even with the patients with the coagulation disorder.
  • Not less important, there is no the uncomfortable drilling sound or vibrations inside the head, therefore, the procedure is more silent and pleasant for the patient.
  • Laser beams do not damage the healthy tissue (soft or hard), of course, if they are being handled with carefully and with the right choice of the energy.
  • There are no scars after the laser intervention on the soft tissue because the cut is completely sterilized.
  • Sealing lymphatic vessels guarantees a faster recovery and tissue revitalization.

Laser application:

There is, basically, no clinical discipline in dentistry where the laser is not successfully applicable, thusly, completely replacing the classic method! This approach is faster, more simple and efficient than the classic approach in dentistry.

  • Biostimulation in different facial tissue paresis and paralysis, soothing the pain, reducing the swelling after the tooth extraction, with the inflammation of the facial and trigeminal nerves, but also after blows and swellings caused by traffic and other kinds of accidents.
  • Teeth whitening with TouchWhite ™ Laser- Assisted method which is based on the fact that Er: YAG laser’s wavelength of the absorption peak in water.
  • Lengthening of the clinical tooth crown – it is essential for the aesthetic impression of each prosthetic replacement, especially in the front area.
  • “Opening of the implants” – taking off the cover screws, placing the transfer, taking the impression and placing the healing abutment – all in one phase as an indicator of the maximum efficiency and gaining time as opposed to the classic method of doing the incision with a scalpel, placing the healing abutment and waiting for it to heal!