Dentistry is a sector that constantly renews and improves itself. The aim is always to increase patient comfort and to develop painless and quick-recovery surgeries. Although the use of anesthetic solutions makes painless and painless treatments possible, dental treatments that do not interrupt daily life are the expectation of every individual. As such, the development of technology in line with the needs of each passing day has brought LASER into the field of dentistry. Laser was developed by Mainman in 1960 as a result of the theoretical studies of Basov, Prokhorov and Townes. Laser
It is named after the initials of the words Radiation.
LASERS USED IN DENTISTRY
Laser types depend on the active medium, wavelength, delivery system, emission mode, tissue absorption and clinical applications.
Argon lasers have two wavelengths: 488 nm (blue) and 514 nm (blue-green). The 488 nm wavelength of the argon laser is commonly used in composite resin applications, tooth whitening and caries protection. The 514 nm wavelength has peak absorption in red pigment. Tissues containing hemoglobin, hemosiderin and melanin interact with this laser. It is a useful surgical laser with excellent hemostatic capabilities and is suitable for use in contact with tissue to treat acute inflammatory periodontal disease and highly vascularized lesions such as hemangiomas. Both wavelengths are used for caries detection. When argon laser light illuminates caries, the carious area appears dark orange red and can be easily distinguished from surrounding healthy structures.
2.CARBON DIOXIDE (CO2) LASER
Its wavelength is 10600nm. It is very well absorbed by water. It is used for rapid soft tissue removal and has shallow penetration into the tissue. It is especially useful in cutting dense fibrotic tissue. It has been reported to have a strong hemostatic and bactericidal effect and to produce minimal scar tissue. While the strongest hemostasis is achieved with CO2 laser, the latest healing is also achieved with this laser. While its fast and bleeding-free operation makes the CO2 laser a suitable option for soft tissue surgery, which is its only indication, its use in the vicinity of hard tissues should be carried out under very detailed control such as microscope magnification due to the carbonization it may cause even in the shortest interaction with hard tissues.
3.ND: YAG LASER
It was the first laser system produced and the first to be used in dentistry. It is usually used for cutting and coagulation of dental soft tissues with good hemostatic properties. These lasers can be used for large pathological sterilization and closure. Initially, Nd: YAG lasers were used for excision of large pathological cases, but with the development of fiber optic cables with direct contact delivery systems, not only cutting but also sterilization and sealing can be performed at very low powers. Nd: YAG laser; gingivoplasty, gingivectomy, removal of prosthesis-induced hyperplasia, reduction of gingival hypertrophy, implant uncovering, unerupted tooth uncovering, crown lengthening with soft tissue intervention, curettage, abscess incision and drainage, excisional and incisional biopsies, removal of postoperative granulation tissue, frenectomy, endodontics, removal of canal filling materials such as resin or gutta-percha, treatment of sensitivity in the cole area.
4.HO: YAG LASER
The wavelength is 2120nm.Ho laser is usually used for arthroscopic surgery of the temporomandibular joint.
5.ER: YAG LASER (ERBIUM-DOPED: YTTRIUM, ALUMINUM AND GARNET)
Its wavelength is 2940 nm. It is the best absorbed laser in water. Cuts made with Erbium lasers heal faster than almost all surgical methods. The main reason for this is that the laser causes very little thermal damage to the soft tissue. The advantage of this laser for restorative dentistry is that the carious lesion very close to the gingiva can be treated and the soft tissue can be repositioned with the same instrument. Er: YAG laser can be used for cavity preparation, direct pulp quafage, roughening of the enamel, fissure sealant, removal of filling materials (composite resin, glass ionomer cement, etc.), treatment of sensitivity in the cole area, gingivectomy, intraoral soft tissue surgery, apical resection surgery, preparation of the endodontic cavity, cleaning of root canals, preparation of root canals by expanding, pulp extirpation, pulp amputation.
6.ER, CR: YSGG LASER (ERBIUM, CHROMIUM-DOPED: YTTRIUM, SCANDIUM, GALLIUM AND GARNET)
It is a type of laser with a wavelength of 2780 nm and used only in hard tissue.
We will now tell you about DIODE LASERS here.
Laser devices function according to their wavelengths and pulse numbers. As a result of the researches conducted in our country on diode lasers with a wavelength of 980 nm, it has been understood that it is helpful in wound healing. They contain a diode lamp. This is the difference from Nd YAG laser (Romans G, Nentwig GH). They conducted research on the 980 nm diode laser device and found that it is extremely beneficial in wound healing after surgery in soft tissue.
They found that the laser accelerated wound healing in the gingiva.
USE OF DIODE LASER IN THE MOUTH
- In the insertion of an embedded wisdom shoot,
- For cutting the raised gingiva at the back of half-erupted wisdom teeth,
- Flap opening during apical resection,
- In the incision of the flab to be removed for the implant operation,
- During biopsy collection,
In cases where the mandibular tongue tie restricts the movement of the tongue, the incision effect is used. All these procedures can be performed without a laser device. Here, the incision effect of the diode laser is described and information is given on this subject, not a comparison or superiority.
Diode laser is also used to stimulate wound healing. These wounds
- Mucositis (especially in 40% of patients undergoing chemotherapy),
- Surgery and postoperative management of palatal fibromas,
- In the treatment of aphthae, herpes,
- In the healing of prosthesis striking,
- In the treatment of tissue thickening caused by prosthesis impact,
- Removal of giant cell granuloma in the gums and healing of wound sites,
- Leukaplasia in the cheek area caused by chronic irritation caused by smoking, alcohol and tobacco use, in the treatment and follow-up treatment of fungal lesions under the prostheses,
- In the treatment of thickened tissue on the cheeks and corners of the lips as a result of chronic irritation (habits such as lip biting, lip eating),
- Likewise, they can always be used as an aid in the treatment of papillomas on the tongue due to chronic irritation, depending on the physician’s preference.
- They are used in the treatment of irritations caused by brackets on cheek tissues during orthodontic treatment.
- Diode laser is also used in applications related to dental aesthetics.
- It is also used in gingivectomy (gum manicure) to treat irregularities between the gum levels. Nd-YAG, CO2, Er-YAG lasers can also be used for this procedure. Diode laser is not specific for this procedure.
- In root canal treated teeth, it is common for the filling to stop and the tooth to fracture. In teeth where the fracture extends below the crown, the crown length is lengthened and the teeth are prepared for crown construction.
- After tooth cutting, the gums are retracted and prepared for impression,
- Diode laser is used according to the physician’s preference to restore broken anterior teeth at the gingival level and to lengthen crown lengths.
- It is used for disinfection of the gingival pocket after gingival treatment with its effect on microorganisms in the mouth.
- Especially in the gingival treatment of crowned teeth, in the areas between the teeth where the brush and dental floss cannot reach, in addition to disinfection, it provides stimulation in the regeneration of the gingival tissue.
HOW DOES DIODE LASER PROVIDE BIOSTIMULATION?
Diode laser has entered the field of dentistry intensively in recent years;
It is used for its bone reaction enhancing properties.