Dental lasers have been commercially available for several decades. They have been thoroughly documented in the dental literature. Lasers are an exciting technology, widely used in medicine, kind to tissues, and excellent for healing. So why have they not been more widely embraced by the practicing dentist? There is a wide perception that the dental laser is not useful, too complicated, and too expensive. This has changed with the arrival of the diode laser onto the dental scene. There is now a convergence of documented scientific evidence, ease of use and greater affordability that makes the diode laser a “must have” for the dental practice.
DIODE LASER: SCIENCE IN BRIEF
L A S E R is an acronym for Light Amplification by Stimulated Emission of Radiation. Lasers are named for the substance which is stimulated. In the diode laser this substance is semiconductor (a class of materials which are the foundation of modern electronics including computers, telephones and radios). This innovative technology has produced a laser that is compact and lower in cost. Most of the research has focused on the 810nm diode laser. This wavelength is ideally suited for soft tissue procedures since it is highly absorbed in haemoglobin and melanin. This gives the diode laser the ability to precisely cut, coagulate, ablate or vaporize the target tissue.
Treatment with the 810nm diode laser has been shown to have a significant long-term bactericidal effect in periodontal pockets. A. Actinomycetemcomitans, an invasive pathogen associated with the development of periodontal disease and generally difficult to eliminate, responds well to laser treatment. Scaling and root planning outcomes are enhanced with the addition of diode laser therapy. The patient is typically more comfortable, and gingival healing is faster and more stable.
DIODE LASER: WHY DO I NEED THIS TECHNOLOGY?
The 810nm diode laser is specifically a soft tissue laser. This wavelength is ideally suited for soft tissue procedures since it is highly absorbed in haemoglobin and melanin, both of which are prevalent in soft tissues. This gives the diode laser the ability to precisely cut, coagulate, ablate or vaporize the target tissue with less trauma, improved post-operative healing, and faster recovery times. Given the incredible ease of use and its versatility in treating soft tissue, the diode laser becomes the “soft tissue hand piece” in the dentist’s armamentarium. The dentist can use the diode laser soft tissue hand piece to remove, refine and adjust soft tissues in the same way that the traditional dental hand piece is used on enamel and dentin. This extends the scope of practice of the general dentist to include many soft tissue procedures.
The following procedures are an easy entry point for the new laser user:
- Gingivectomy Haemostasis Gingival Troughing for impressions.
The diode laser makes restorative dentistry a breeze. Any gingival tissue that is covering a tooth during preparation can be easily removed and haemostasis achieved simultaneously. The restoration is no longer compromised because of poor gingival conditions. There is no more battling with unruly soft tissue and blood.
Gingival troughing prior to impression taking helps to ensure an accurate impression and an improved restorative outcome. Packing cord is no longer necessary.
With these procedures, restorative dentistry becomes less stressful, more predictable and more enjoyable for the dental team and the patient.
- Operculectomy Gingival Hyperplasia: Excision and/or recontouring of gingival hyperplasia.
These procedures are usually not offered or performed by the general dentist. They are examples of the expanded range of services readily added to the general practice. The dentist becomes more proactive in dealing with hyperplastic tissues that can increase risk of caries and periodontal disease
- Laser Assisted Periodontal Treatment
The use of the diode laser in conjunction with scaling and root planning is more effective than scaling and root planning alone. It enhances the speed and extent of the patient’s gingival healing and post-operative comfort. This is accomplished through laser bacterial reduction, debridement and bio stimulation
- Actinomycetemcomitans which has been implicated in aggressive periodontitis may also be implicated in systemic disease. It has been found in atherosclerotic plaque9 and there has been recent data suggesting that it may be related to coronary heart disease. 10 The diode laser is effective in decreasing A. actinomycetemcomitans and thereby indirectly improving the patient’s heart health.
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The soft tissue diode laser is rapidly becoming a “must have” mainstream technology for the general practice. The science, ease of use, and affordability make it simple to incorporate. It becomes the essential “soft tissue hand-piece” for the practice. The time may soon come when a diode laser will be placed in each restorative and each hygiene treatment room. Restorative dentistry becomes easy, predictable and less stressful. The scope of practice is expanded to include new soft tissue procedures that keep patients in the office. The patient’s gingival health is improved in a minimally invasive, gentler manner. Every time the Dentaire picks up the diode laser the question every patient has is: Where have you been all my life?