LASERS USED IN OPERATIVE DENTISTRY

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  • 1. GOOD AFTERNOON
  • 2. LASERS USED IN OPERATIVE DENTISTRY
    GUIDED BY:
    Prof. H.D.Adhikary Dept. of Conservative Dentistry
    Dr.R.Ahmed Dental College & Hospital
  • 3. CONTENTS
    Introduction
    History of lasers
    Components of lasers
    Types of lasers
    Application of lasers in operative dentistry
    Summary
  • 4. INTRODUCTION
    Dentistry has advanced a lot.
    Among various advances, one which have good scope of improvement is the use oflasersin dentistry.
    Recent advances in laser technology will bring revolution in dentistry.
    Laser is an acronym forlightamplification by stimulatedemission ofradiation.
  • 5. DISCOVERY OF LASERS:
    It was discovered by Shallow & Towns in 1958.
    First working laser was built by Mailman of
    Hughesresearch laboratories in 1960.
    HISTORY OF LASERS IN DENTISTRY:
    Vain used a ruby laser & reported extensive deep
    destruction of carious tissue along with
    melting of dentin.
    Paghdiwala[U.S.A] in 1988,first time tested the
    ability of Er:yag laser on dental hard tissue.
    In 1997,Er:yag laser was cleared for marketing by
    Food & drug administration of U.S.A.
  • 6. COMPONENTS OF LASER
    There are 3 main parts of laser delivery system.
    (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.
  • (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.
    (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.
  • 7.
    • This arrangement allows reflection of photons
    of light, back & across the chamber.
    • It will result in production of intense photo
    resonance within the medium.
  • 8. TYPES OF LASERS
    2 categories of lasers are used in medicine & dentistry
    (1).HARD LESARS
    -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,vapourisation & carbonisation.
  • 9. - They are believed to stimulate circulation
    & cellular activity & causes various effects
    such as anti-inflammatory,vascular,muscle
    relaxant,analgesia& tissue healing.
    There are many types of lasers used in
    dentistry, depending upon their active medium
    (1).CARBONDIOXIDE LASER
    - WAVELENGTH:10.6um
    - USES: SOFT TISSUES , DENTIN DESENSITIZATION
    (2).ARGON LASERS
    - WAVELENGTH:488,514.5um
    - USES: CURING , SOFT TISSUE DESENSITIZATION
  • 10. (3).Nd:YAG[NEODYMIUM:YTTRIUM-ALLUMINIUM
    GARNET] LASER
    - WAVELENGTH:1.064um
    - USES: SOFT TISSUE DESENSITIZATION , ANALGESIA
    TOOTH WHITENING , PERIODONTICS,
    ENDODONTICS
    (4).KTP[POTASIUM-TITANYL PHOSPHATE] LASER
    (5).HELIUM-NEON[He-Ne]
    (6).RUBY LASER
    (7).EXCIMER LASER
  • 11. (8).HOLMIUM[Ho]:YAGLASER
    (9).ERBIUM[Er]:YAG LASER
    - WAVELENGTH:2.94um
    - USES: HARD TISSUE
    (10).ERBIUM-CHROMIUM[Er-Cr]:YSGG LASER
    - WAVELENGTH: 2.79um
    - USES: HARD TISSUE
    (11).DIODE
    - WAVELENGTH: 800-830um
    - USES:SOFT TISSUE , PERIODONTICS
  • 12. Effects of lasers
  • 13. Effects on tissues on certain temperatures
    60`
    100`
    200`
  • 14. APPLICATION OF LASERS IN OPERATIVEDENTISTRY
    DIAGNOSIS OF DENTAL CARIES
    (A).INFRARED LASER FLUORESCENCE
    [DIAGNODENT]
    - Diagnodent is an instrument, recently designed to facilitate the detection of dental caries.
    - Used for detection of caries on occlusal & smooth surface.
  • 15. (B).LASER INDUCED FLUORESCENCE
    -Kutsch in 1992,illuminated carious & non carious tissue with argon laser along with dark field photography.
    - He reported that while illuminating, carious lesion
    has clinical appearance of dark,fiery,orange-
    red colour.
  • 16. CARIES DETECTION
  • 17. CAVITY PREPARATION WITH LASER
    - NUMBER OF STUDIES HAVE BEEN PERFORMED FOR THE USE OF Er:yag LASER FOR CAVITY PREPARATION.
    - Results of studies says that little or no noticeable pulp reaction is produced while preparing the cavity with Er:yag laser.
    - It is safe & can be used for cavity preparation.
  • 18. CAVITY PREPARATION
    WITH LASERS
  • 19. Effect on carious lesions
  • 20. ADDITIONAL BENEFITS
    A.)minimises patient fear of the drill.
    B.)no irritating sound like traditional drills.
    C.)the cavity with laser preparation appears open,patent,fresh & devoid of all debris.
    D.)mono-infection with Enterococcusfaecalis is avoided - hence sterile cavity.
    E.)melts the dentin & blocks the tubules,thus hydrodynamic theory of dentin sensitivity is ruled out.
  • 21. PREVENTION OF DENTAL CARIES WITH
    LASERS
    Laser can be used for prevention of dental caries.
    Different types of lasers increases the resistance to dental caries by reducing the rate of demineralization of substance of enamel & dentin.
    Argon laser alters the surface characteristics of enamel to make it caries resistant.
    -
    -
    -
    -
  • 22. MECHANISM OF ACTION
    Carbonate is lost from carbonated appetite mineral of tooth during laser irradiation
    Pulsed co2 laser irradiation interacts with the
    phosphate group in dental materials
    It gets preferentially absorbed & transformed
    efficiently to heat
    Carbonated hydroxyapetite in the surface & in the
    immediate subsurface of enamel is heated at temp.
    greater than 400`c
    Carbonate is decomposed, leaving behind the a
    hydroxyapetitelike mineral that is less soluble
  • 23. BLEACHING WITH LASERS
    - Power bleaching is the term used for accelerated
    in-office tooth whitening procedures, using laser or
    Xenon plasma arc-curing light.
    (A).ARGON LASER
    - A true laser light is delivered to chemical agent.
    - The action is to stimulate crystals in the chemical.
    - No thermal effect, so less dehydration of enamel.
    - The treatment time is 10sec. per application per tooth.
    It is the advantageous for clinician & patient.
  • 24. (B).DIODE LASER
    - A true laser light produced from a solid state
    source.
    - It is ultra fast, taking 3 to 5 sec. to activate
    bleaching agent.
    - This type of lasers produce no heat.
  • 25. PHOTOPOLYMERIZATION OF COMPOSITE RESIN WITH LASER
    - ARGON LASERS ARE USED FOR THIS PURPOSE.
    - FOR POLYMERIZATION OF CAMPHORQUINONE
    ACTIVATED COMPOSITE RESIN,THE ARGON LASER
    INCREASES;
    ~ THE DEPTH OF CURE
    ~ THE DIAMETRIC TENSILE STRENGTH
    ~ ADHESIVE BOND STRENGTH
    ~ DEGREE OF POLYMERIZATION OF
    MATERIELS.
  • 26. REDUCES;
    ~ Acid solubility of surrounding enamel
    Decreases the time of activation
    Significantly.
  • 27. ADVANTAGES OF LASERS
    (1).Minimal damage to surrounding tissues.
    (2).Haemostatic effect by sealing blood vessels.
    (3).Reduction of postoperative inflammation &
    edema.
    (4).Little postoperative scarring.
  • 28. (5).Reduction in postoperative pain sensation
    since nerve endings are blocked.
    (6).Dressing & suturing is not required for
    wound closer.
    (7).Operating time is reduced.
    (8).Sterilization of wound due to reduction in
    in amount of microorg. exposed to laser
    irradiation.
    (10).Excellentwound healing.
    (11).Laser exposure to tooth enamel causes
    reduction in caries activity.
  • 29. (12).Patient becomes free of fear & anxiety.
    (13).Advantageous for medically compromised patients,since no medication is required like antibiotics or pain-killers.
  • 30. DISADVANTAGES OF LASERS
    (1).Laser beam could injure the patient or operator
    By direct beam or reflected light, causing retinal
    burns.
  • 31. (2).It available only at big hospital & treatment is
    very expensive.
    (3).Specially trained person is needed.
  • 32. SUMMARY
    As the research on use of laser in dentistry isgiving bright results, lasers are getting more &
    more famous among dentists.
  • 33. Special thanks goes to:
    a.) Dr. Soumen Pal
    b.) Mr.AbhisekChatterjee
    c.) Mr.NurulHasanMollah
    d.)Mr.Tousif Ahmed
  • 34. Thank you….