LASERs in Dentistry

AN EVERYDAY HANDY TOOL

Ayman EL-Amin
Assistant Researcher – National Research Center
BDS - Cairo University
Mastership LASER Dentistry – AACHEN University - GERMANY
Fellow World Academy of LASER Dentistry- AALZ - GERMANY
Certified LASER Safety Officer – AACHEN University - GERMANY
M.D. Operative Dentistry – Cairo University
Member of IADR
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 WHAT IS LASER ?

 It is Light Amplification by Stimulated Emission of Radiation

 It is generated from a high-technology device that generates a beam of

concentrated light.

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HISTORY
1917- Einsteen Theory of stimulated emission

1958 – Townes & Schawlow Laser principle

1960 - Maiman Ruby laser

1961 - Johnson Neodymium ion doped yttrium

aluminium garnet rod
1964 - Patel CO2 Laser

1977 - Shafir First documented case in OMFS

using lasers
1989 – Terr Myers First Dental Laser – Nd:YAG

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 Monochromaticity
Directionality
Coherence

PROPERTIES OF LASER

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LASER DEVICE

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(1).LASING OR ACTIVE MEDIUM

• It is the material which is capable of absorbing the energy produced by the

external source through subatomic configuration of its component molecules &
subsequently giving the excess energy as photons of light.

• It can be solid, liquid or gas.

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(2).ENERGY OR PUMPING SOURCE

• It is used to excite or pump the atoms in lasing medium to their higher energy
levels that are essential for laser production.

• It can be electrical, thermal, chemical or optical.

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(3).OPTICAL OR RESONATING CHAMBER

• The lasing medium is located within the optical chamber.

• It is a cylindrical structure with fully reflecting mirror on one side & partially
reflecting mirror on other side--parallel to each other.

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• This arrangement allows reflection of photons of light, back &
across the chamber.

• It will result in production of intense photo resonance within the

medium.

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TYPES OF LASERS

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(1).ARGON LASERS

(2).KTP[POTASIUM-TITANYL PHOSPHATE] LASER

(3).HELIUM-NEON[He-Ne]

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(4).RUBY LASER

(5).EXCIMER LASER

(6).HOLMIUM[Ho]:YAG LASER

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DIODE LASER 810 – 980 nm

NEODYMIUM YAG [Nd-YAG] LASER 1064 nm

ERBIUM YAG [Er-YAG] LASER 2940 nm

ERBIUM-CHROMIUM[Er-Cr]:YSGG LASER 2780 nm

CARBONDIOXIDE [CO2] LASER 9300 – 10600 nm

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(1).HARD LASERS “ ALL-Tissue LASERs”
- Longer wavelength

- Cuts the tissue by ablation.

- Used for tooth & bone applications.

(2).SOFT LASERS OR LOW LEVEL LASERS

- Low energy wavelengths

- Cuts tissues by coagulation, vaporization & carbonization.

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ERBIUM YAG [Er-YAG] LASER 2940 nm

ERBIUM-CHROMIUM[Er-Cr]:YSGG LASER 2780 nm

CARBONDIOXIDE [CO2] LASER 9300 – 10600 nm

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ERBIUM YAG [Er-YAG] LASER 2940 nm

ERBIUM-CHROMIUM[Er-Cr]:YSGG LASER 2780 nm

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Safe and Cool cutting with
water energy
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CARBONDIOXIDE [CO2] LASER 9300 – 10600 nm

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NEODYMIUM YAG [Nd-YAG] LASER 1064 nm

DIODE LASER 810 – 980 nm

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NEODYMIUM YAG [Nd-YAG] LASER 1064 nm

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DIODE LASER 810 – 980 nm

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DIODE LASERs
810 – 980nm
445 – 980 nm

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 940 nm

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 940 nm

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 940 nm

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 940 nm

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 940 nm

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 940 nm

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 810 nm

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 810 nm

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 970 nm

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445 nm 660 nm 970 nm

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 970 nm

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 810 nm

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 810 nm

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 980 nm

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 980 nm

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 980 nm

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 980 nm

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635 nm 980 nm

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980 nm 810 nm

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 980 nm

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445 nm 660 nm 810 nm 940 nm

Wavelength ?????

970 nm 980 nm

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LASER Dental Applications

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 RESTORATIVE
APPLICATIONS

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LASER Restorative Applications

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FISSURE SEALING

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 Cavity preparation of
incipient caries

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 CLASS I CAVITY PREPARATION

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 CLASS III

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 PALATAL CARIES

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 CLASS V WITH GINGIVAL INVOLVEMENT

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 Compound Cavity Preparation

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 TRAUMATIC FRACTURES

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 PULP CAPPING

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 Filling Removal &\or Repair

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 VENEER REMOVAL

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 PEDIATRIC DENTISTRY

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 PULPECTOMY &
PULPOTOMY

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 TEETH
DESENSITIZATION

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 Laser Assisted Tooth Whitening

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 Why ERBIUM ?

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 More Surface area for bonding
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 Intact collagen fibers after laser treatment
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 Preserved collagen fibrils of the intertubular
dentin at the entrances to the dentinal tubules
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SURGICAL & SOFT TISSUE
APPLICATIONS

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 Diode LASER
THE MAGIC STICK IN EVERYDAY DENTAL & SOFT
TISSUE APPLICATIONS

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OPERCULECTOMY

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 SURGICAL
EXTRACTION

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SOFT TISSUE CROWN
LENGTHENING

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GUMMY SMILE
CORRECTION

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 GINGIVAL
DEPIGMENTATION

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LIP DEPIGMENTATION

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IMPLANTOLOGY

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FRENECTOMY
“LABIAL & LINGUAL”

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FIBROMA

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TOOTH EXPOSURE

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 EXCISIONAL &
INCISIONAL BIOPSIES

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ABSCESS INCISION &
DRAINAGE

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 GINGIVAL
TROUGHING

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PULPECTOMY &
PULPOTOMY

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TEETH WHITENING

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LASER BLEACHING
“THE TRUE ONE”

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Up to 10 shades of whitening enhancement in
just 20 minutes

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A Y M A N E L - A M I N
A Y M A N E L - A M I N
A Y M A N E L - A M I N
A Y M A N E L - A M I N
A Y M A N E L - A M I N
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ROOT CANALS
DISINFECTION

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 Decontamination of the root canal
• Introducing the laser fiber into the root
canal after preparation

• Irradiate with 1 W, besides, pull out the

laser fiber under rotation of the root
canal

• This procedure is repeated from 2 to 3

times, then the canal is sealed

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POCKET THERAPY

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 LLLT
“LOW LEVEL LASER THERAPY”

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 Low level laser therapy (LLLT), also referred to as phototherapy or
photobiomodulation, uses light energy from lasers or light
emitting diodes to elicit cellular and biological responses in the
body.
 Light photons work on various cell processes to stimulate the
release of cellular energy, which can be used to facilitate the
restoration of normal cell morphology and function

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BIOSTIMULATION AND PAIN CONTROL
1-biostimulation of lesions
Aphthous lesions, stomatitis, Herpetic lesions

2-Hard-tissue level
Acceleration of orthodontic movement

3-Neural effects
Analgesia, neural regeneration, reduction of
temporo-mandibular pain, Postsurgical pain
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 Deep Tissue
Handpiece

LaserWhite
Handpiece

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Ideal when combined with the TMJ diagnostics of NewTom or D3D CBCT

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 Laser irradiation will significantly decrease pain, swelling, bruising
and inflammation after an extraction thus requiring a decreased
(or eliminated) need for post-operative analgesics.
 The speed of healing of the extraction site will also be increased
and there will be a reduced likelihood of a dry socket (although
in cases where a dry socket does occur, LLLT will dramatically
decrease the pain and stimulate the covering of the exposed
bone through the stimulation of fibroblasts).

POST SURGICAL

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 In any case of a dental infection, the laser can be applied to the
submandibular lymph nodes to increase the lymphatic flow of
the infected area,
 reduce the inflammatory cells and bring neutrophils to the site of
infection for faster healing (Figure 4). Laser therapy will not
preclude the use of
 antibiotics in most cases but will help to potentiate the uptake of
the antibiotic into the blood stream.

DENTAL INFECTIONS

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 Laser irradiation during the preparation and placement of
implants will decrease the pain and inflammation of the surgical
procedure and improve
 the integration of the implant into the bone. Many studies
investigating the effect of LLLT during implant placement have
demonstrated an
 improved bone formation around the implant with a substantial
decrease in post-operative pain.

IMPLANTS

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 In addition to reducing the pain felt during orthodontic
treatments, laser irradiation has also been shown to increase the
velocity of tooth movement.
 A recent study demonstrated that over 60 days, the canines on
the laser treated side moved 34% more than the control.
 It has been postulated that the increased speed of tooth
movement is a result of the stimulation of the
osteoblast/osteoclast turnover.

ORTHODONTICS

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 Laser therapy can be used very effectively for facial pain
treatment, either acute or chronic.
 A major complaint a lot of patients have after long dental
appointments is facial pain and muscle tension.
 Application of the laser to the masseter muscle after the
appointment will reduce or eliminate the muscle trismus and joint
pain.
 In chronic TMJ cases, laser therapy can be used in conjunction
with other therapeutic tools to reduce the pain and muscle
tension, while stimulating healing within the joint

FACIAL PAIN/NEURALGIA

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 ???

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 Many patients have a sensitive gag reflex making dental work
very stressful for both the patient and dentist. Application of the
laser to the P6 acupuncture point of the wrist will decrease the
gagging and nausea sensations many patients feel during dental
treatments, impressions and xrays.
 The P6 acupuncture point is one of a triad of points that calms
your parasympathetic nervous system.
 Application of these points is also effective for patients who are
anxious and nervous.

NAUSEA AND GAGGING

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 Soft tissue lesions, such as herpes lesions, denture sores, angular
chelitis and lichen planus, respond very well to LLLT.
 Research has indicated that LLLT can prevent cold sores from
erupting if treated in the prodromal stage (when the tingling
starts) and speed the healing in cases where the sore has
erupted.

SOFT TISSUE LESIONS

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 TEETH
DESENSITIZATION

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 LLLT can assist with pain and inflammation after endodontic
procedures and surgery, treat pulp hyperemia, help diagnose
irreversible pulpitis and reduce the need to post-operative
analgesics. Further, laser irradiation is very effective in treating
dentine hypersensitivity.
 A recent study demonstrated that combining laser therapy with
a chemical agent produced an average success rate of more
than 85%.

DENTIN
HYPERSENSITIVITY/ENDODONTICS

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GP COMPACTION
“UNDER STUDY”

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BENEFITS OF LASER DENTISTRY

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 Ability
to do more than one procedure in a single
appointment thereby saving you time and money

 No vibration and pressure as found with

conventional instruments.

 More healthy tooth structure is preserved

 Reduced post-operative complications such as

sensitivity, inflammation, swelling and pain.

 Less need for anesthesia or injections

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 Less need for separate surgical appointments

 Increased bone healing

 Faster healing

 Reduced risk of infection

 Less bleeding

Ayman EL-Amin
 Versatile and effective for root canal preparation.

 More sterilized canals giving better endo ttt results

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 LASER SAFETY

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 LASER OWNER
≠
LASER USER
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CLASSIFICATION OF LASERS

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Primary Hazards:
 Caused directly by laser beam
 Endangers mainly two organs- Eyes and Skin
 In case of eyes it damages retina , cornea , & the lens
and slight carelessness can destroy vision permanently

 Secondary Hazards :
 It’s related to operation of the laser and are
independent of radiation characteristics.

LASER HAZARDS
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 Post signs that lasers are being used

 Eye shields to be worn by all personnel in operating room

 Safety shields must be used

 A laser safety officer should be stationed at the laser unit

PERSONNEL SAFETY

Ayman EL-Amin
 Use of eye shields for the patient

 Use of non inflammable materials

 Use of laser resistant shielding materials for surgical field

 Avoid alcohol based topical anesthetic and gauze

 Protect tissues adjacent to surgical site

PATIENT SAFETY

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 WANT BIG IMPACT?
Be BIG ! ;)

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 KNOWLEDGE
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Aymanelamin@gmail.com Aymanelamindentalclinic