Lasers in dentistry./ dental education in india


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Lasers in dentistry./ dental education in india

  1. 1. LASERS in DENTISTRY INDIAN DENTAL ACADEMY Leader in continuing dental education
  2. 2. INTRODUCTION L A S E R – light amplification of stimulated emission of radiation, is a form of electromagnetic energy in which photons are generated from a medium by stimulating the medium from external energy source. Emergence : 1960 First use in clinics : 1980 Today available in different wavelengths.
  3. 3. ADVANTAGES Excellent visibility. Reduced operating time. Reduced post operative sequelae. Negotiates curves and folds in oral cavity. Vaporize, coagulate or cut tissue. Pain is reduced 90% of the time. Portable and less expensive newer models Patient’s high acceptance.
  4. 4. HISTORY  Early 1900 – Quantum mechanics by Bohr Einstein's atomic theory.  1950 – Townes first amplified microwave frequencies.  1960 – Maiman developed first laser or Maser.  1960 – Pulsed Ruby laser(0.694 µm).  1961 – Neodymium laser by Snitzer. HAD DENTAL RESEARCHERS FOCUSSED ON Nd. LASER SOONER, LASER DENTISTRY MAY HAVE PROGRESSED TO ITS PRESENT STATUS 10 YRS EARLIER .
  5. 5. LASER PHYSICS L ight A mplified by S timulated E mission of R adiation. LASER light is Monochromatic and finely focused. Collimation and Coherency makes it unique. Collimation: constant beam size and shape. Coherency: waves with identical amplitude and identical frequency.
  6. 6. An Atom at excited state releases photon. QUANTUM THEORYQUANTUM THEORY
  7. 7. EINSTEIN’S THEORY An energized atom can absorb additional energy to release 2 identical coherent photons, these photons energizes more atoms and releases more photons resulting in amplification of light energy.
  8. 8. Dental lasers have emission wavelengths of 500µm – 10,600µm. All dental lasers emit either visible light beam or an invisible infra red light beam. Dental lasers are named after the chemical elements/ compounds that compose the medium. - Gas :- argon / co2 - Solid crystal rod :- Al, Arsenide, Garnet, Yttrium, -Added elements :- Cr, Nd, Ho, Erbium.
  10. 10. LASER DELIVERY SYSTEM FLEXIBLE HOLLOW WAVE GUIDE TUBE It has interior mirror finish. Laser energy reflected along this tube strikes the tissue in non contact fashion. GLASS FIBER OPTIC CABLE Glass fiber is encased in a resilient sheath. Cannot be bent into sharp angle. fiber fits snugly into hand piece protruding at the tip or sometimes with attached glass tip. Used in contact fashion.
  11. 11. EMISSION MODE 1. CONTINUOS WAVE MODE. Beam is emitted at one power level continuously as the foot switch is pressed. 2. GATED PULSE MODE. Periodic on and off by the mechanical shutter in front of a continuous wave laser at a duration of few milli seconds. 3. FREE RUNNING PULSE MODE. High energy of laser light is emitted for a few micro seconds followed by a relative long time gap. This is computer controlled.
  12. 12. PRINCIPLE OF EMISSION Light energy strikes tissue for a certain length of time producing thermal interaction, then a time gap for the tissue to cool before the next pulse of laser energy is emitted.
  13. 13. LASERS USED IN DENTISTRY LASERLASER λλ LASERLASER λλ ArgonArgon 488-514 nm488-514 nm Nd:YAPNd:YAP 1.34 µm1.34 µm DiodeDiode 600-908 nm600-908 nm Ho:YAGHo:YAG 2.12 µm2.12 µm He-NeHe-Ne 632 nm632 nm Er:YSGGEr:YSGG 2.79 µm2.79 µm RubyRuby 694.3 nm694.3 nm Er:YAGEr:YAG 2.94 µm2.94 µm Nd:YLFNd:YLF 1.053 µm1.053 µm COCO22 9.3,10.6 µm9.3,10.6 µm Nd:YAGNd:YAG 1.064 µm1.064 µm XeFXeF 0.351 µm0.351 µm
  14. 14. Application of Lasers in Dentistry: Application Possible Laser Types Basic research Laser tissue interaction Technical development of applications of lasers in dentistry All types All types Measurement and diagnosis Holography Laser Doppler flowmetry Spectroscopy (caries diagnosis) He Ne, diodes He Ne, diodes Various types
  15. 15. Application of Lasers in Dentistry: Oral and Maxillofacial Surgery Cutting and Coagulation Photodynamic therapy CO2, Nd: YAG, Ar, dye Dye, Au-Cu vapour Conservative dentistry Preventive dentistry (fissure sealing) Caries treatment Composite resin light Curing Tooth surface conditioning CO2, Nd:YAG, ruby CO2, Nd:YAG, Er: YAG, Excimer Ar, dye, HeCd Excimer, CO2, Nd:YAG, Er:YAG Endodontics Root canal treatment Apicoectomy Nd: YAG, CO2, Excimer CO2, Nd:YAG
  16. 16. Application of Lasers in Dentistry: Periodontics Laser sealing of affected root surfaces Excision of gingival soft tissues CO2, excimer CO2 Analgesic effect and bio-stimulation Stimulation of wound healing Low power laser radiation with analgesic Effects He Ne, diodes Nd: YAG
  17. 17. Application of Lasers in Prosthodontics Removable Prosthetic reconstruction 1.Treatment of unsuitable alveolar ridges 2.Surgical treatment of unsupported soft tissues 3.Enlarged tuberosity 4.Surgical treatment of tori & exostoses. 5.Soft tissue lesions
  18. 18. Application of Lasers in Prosthodontics Fixed Partial dentures 1.Remove excess or intrusive tissue relative tissue relative to restorative margins. 2.To enhance esthetics of a pontic space. 3.To establish increased clinical crown length. 4.Laser gingival retraction
  19. 19. Application of Lasers in Prosthodontics Dental Implantology 1.Welding of titanium framework on multiple implants 2.Salvaging ailing implants by decontaminating their surface with laser energy.
  20. 20. Other applications: Laser processing of dental materials Welding of dental alloys Cobalt – chrome – molybdinum Nickel – chrome – aluminum Silver Palladium Titanium alloys Welding of ceramic materials Still under investigation
  21. 21. LASER SAFETY IN DENTAL PRACTICE A Responsibility that is shared by a Dentist, Educator, Manufacturer and scientist, each having a role from design and development to practical application. Given the proper training and appropriate precautions, lasers may be used safely for the mutual benefit of both the patient and the dentist.
  22. 22. CDRH – Center for Devices and Radiological Health. ANSI – American National Standards Institute. OSHA – Occupational Safety and Health Administration.
  23. 23. LASER HAZARD CLASSIFICATION – ANSI & OSHA CLASSCLASS DESCRIPTIONDESCRIPTION II Low poweredLow powered lasers that are safe to view.lasers that are safe to view. IIaIIa Low powered visibleLow powered visible lasers that are hazardous when viewedlasers that are hazardous when viewed directly for longer than 1.000 sec.directly for longer than 1.000 sec. IIII Low powered visibleLow powered visible lasers that are hazardous when viewedlasers that are hazardous when viewed for longer than 0.25 secfor longer than 0.25 sec IIIaIIIa Medium powered laserMedium powered laser or systems that are non hazardous ifor systems that are non hazardous if viewed for less than 0.25 sec with out magnifying optics.viewed for less than 0.25 sec with out magnifying optics. IIIbIIIb Medium poweredMedium powered lasers (lasers (0.5 w0.5 w) are hazardous if viewed) are hazardous if viewed directly.directly. IVIV High poweredHigh powered laserslasers(>0.5 w)(>0.5 w) produce ocular,skin and fireproduce ocular,skin and fire hazards.hazards.
  24. 24. According to CDRH and ANSI system of classification CLASS IV are Potentially Hazardous from either direct or diffuse reflection. They emit power greater than 5 w. HAZARDS ENCOUNTERED IN CLINICAL PRACTICE 1. OCCULAR INJURY. 2. TISSUE DAMAGE. 3. RESPIRATORY HAZARDS. 4. COMBUSTION & ELECTRICAL HAZARDS.
  25. 25. LASER SAFETY OFFICER (L.S.O.) Identifies and assess the Hazard . Determines the potential hazard zone. Establishes standard operating procedures. Approves use of protective equipment. Ensures safety of all persons within the operating field.
  26. 26. SAFETY RECOMMENDATIONS All class IV Dental lasers are potentially hazardous. Manufacturer safety precautions must be followed. Fire and electric hazards can be avoided by • Dry floor. • Soaking surgical drapes and gauze in sterile saline. • Avoid flammable liquids and gases. Personal protective equipment. • Safety goggles • Mouth masks • High vacuum evacuation • Re-circulatory air filter system • Proper ventilation
  27. 27. CONCLUSION WITH THE NEED FOR, ▪ Fiber optic delivery system. ▪ Multitude wavelengths and pulse widths. ▪ Economical devices. LASER TODAY OFFERS DENTIST NOT ONLY A WINDOW BUT A DOOR INTO THIS HI-TECH, REWARDING AND POTENTIALLY PROFITABLE ARENA.
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