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PRINCIPLES AND USES OF
LASERS IN OMFS

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy...
• The term laser is an acronym for light
amplification by a stimulated emission of
radiation, which serves to explain most...
HISTORY
– The possibility of stimulated emission was
predicted by Einstein in 1917.
– Maiman in 1960 created the first ope...
www.indiandentalacademy.com
www.indiandentalacademy.com
LASER PRODUCTION
Absorption: electron
absorbs energy and
transferred to more
exited state.
Spontaneous emission
of radiati...
• When an atom in exited
state becomes irradiated
with a photon of light of
same wavelength and
frequency that was
previou...
PROPERTIES OF LASER LIGHT

1. Monochromaticity: with all of energy it produces
having same wave length.
2. Directionality ...
PHOTOBIOLOGY

• Photobiologic effects:

1.Photocoagulation
2.Photovaporization
3.Photochemical
4.Photophysiological phenom...
•
•
•
•

PHOTOCOAGULATION

Heating tissues above 60degree c.
Whitening of tissues
Changes in molecular structure of tissue...
www.indiandentalacademy.com
PHOTO VAPORIZATION

• Intense, highly focused laser radiation produces surface temp
exceeding 100 degree C, which causes t...
PHOTOCHEMICAL EFFECT &
PHOTOCHEMICAL THERAPY
• Here a Radiant energy possessing a multitude of
wavelengths is used to trea...
• Systemic administration of Photosensitizing
agent offers conveniance,bypasses the barrier
to radiant energy alone of the...
PHOTODYNAMIC THERAPY (PDT) WITH LAZER
• PDT using the laser is similar to the use of
photosensitizers and radiant energy, ...
• The foundation of PDT is the activation of a
local or systemically administered
photosensitizing agent by radiant energy...
PHOTOMECHANICAL EFFECT
(PHOTODISRUPTION)
• Photodisruption is not a laser application
sought by OMFS as a way of managing
...
www.indiandentalacademy.com
www.indiandentalacademy.com
TYPES OF LASERS
1. CARBON DIOXIDE LASERS
2. NEODYMIUM:YATRIUM-ALUMINIUMGRANETT
3. ARGON LASER
4. HOLMIUM:YTRIUM-ALUMINIUM-...
LASER

DELIVERY

MODES

W.L
In nm

CHROMOPHORE

1

CO2

Articulated arm,
fibroptic

CW, P, UP,
Flash scan

10,600

Water

...
LASER

DELIVERY MODES W.L
In nm

CHROMOPHORE

6

Er:YAG

Fibroptic

P, UP

2940

Water

7

Q-switched
ruby

Articulated
ar...
•
•
•
•

Continous
Pulsed mode
Superpulsed
Ultrapulsed

• Free beam
• Focused
• Contact lasers
• Non contact lasers

www.i...
www.indiandentalacademy.com
HOW TO USE A LASER
• Wide variety of procedures by laser can be
categorised into:
1.Incisional / Excisional techniques
2.V...
Incisional & Excisional

• Co2 laser is used as a light scalpel and is operated in
focused mode (smallest possible spot si...
Incision should be performed in one or two passes
at a rapid rate of motion, slowing the laser motion
will result in deepe...
Care should be
taken to ensure that
the spot size
remains constant
during the
procedure to
achieve the uniform
depth incis...
• Suture closure of areas excised with co2 laser
is not mandatory.
• Excellent hemostasis and less scarring,often
allows l...
VAPOURISATION TECHNIQUE

• Useful in the management of surface lesions such as
hyper keratosis, epithelial dysplasia, lich...
HEMOSTATIC TECHNIQUE

• There are number of laser that are highly
absorbed by hemoglobin, therefore an ideal in
management...
GENERAL PRINCIPLES OF CLINICAL
LASER APPLICATION
•

Careful observation of target tissue

•

Beam should be directed perpe...
•

Both the power density and fluence may change
with small variations in operative technique and
may affect clinical outc...
RATIONAL BASIS FOR USE OF LASERS

• CO2 laser, absorption is proportional to water content.
Therefore, tissues with high a...
SOME OF THE COMMON CILNICAL APPLICATIONS
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.

Incisional and excisional biopsies.
Focal...
www.indiandentalacademy.com
www.indiandentalacademy.com
MANAGEMENT BY ANATOMIC REGION
•
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

TONGUE:
Fibroma
Papilloma
Granular cell tumor
Lingual thyr...
FIBROEPITHELIAL POLYP ON DORSAL SURFACE
OF TONGUE.
www.indiandentalacademy.com
•
1.
2.
3.
4.
5.
6.

LIPS:
Mucocele
Pyogenic granuloma
Fibroma
Actinic cheilitis
Hemangioma
Apthous .

www.indiandentalaca...
•
1.
2.
3.
4.
5.
6.
7.

BUCCAL MUCOSA:
Hyperkeratosis/dysplasia
Fibroma
Payogenic granuloma
Hemangioma/lymphangioma
Saliva...
•
1.
2.
3.
4.
5.
6.
7.

FLOOR OF THE
MOUTH:
Ranula
Salivary gland tumors
Sailolithiasis
Hemangioma
Lymphangioma
Leukoplaki...
GINGIVA:
1.
2.
3.
4.
5.
6.

Lichenplanus
Pyogenic granuloma
Fibroma
Papilloma
Drug induced gingival hyperplasia
Hyperplast...
•
1.
2.
3.
4.
•
1.
2.
3.
4.
5.

SOFT PALATE:
Salivary gland tumors
Hemangiomas/ lymphangiomas
Mucous retention phenomena
P...
•
1.
2.
3.
4.
5.
6.
7.
8.
9.

DERMATOLOGICAL USES:
Angiofibroma
Psoriasis
Neurofibroma
Erythroplasia
Pyogenic granuloma
Ke...
LASER USE IN ANATOMICALLY DIFFICULT AREAS
•

1.
2.
3.
4.

Surgery in and around oral cavity and face is
complicated by the...
www.indiandentalacademy.com
LASERS-TMJ
1.
2.
3.
4.

Anterior disk displacement
Synovectomy
Hypermobility
Perforated disk

www.indiandentalacademy.com
www.indiandentalacademy.com
•

LASERS IN MALIGNANT LESIONS OF
HEAD AND NECK

•

Ability of lasers to seal blood vessels, lymphatics, nerve
endings, de...
www.indiandentalacademy.com
www.indiandentalacademy.com
VASCULAR & PIGMENTED LESIONS
Argon laser
Nd-Yag laser
Pulsed dye lasers
Q-switched Nd-Yag lasers
Examples
Hemangioma
Port ...
www.indiandentalacademy.com
UVELOPLASTY

www.indiandentalacademy.com
HEALING OF LASER WOUNDS

www.indiandentalacademy.com
• Both clinical and laboratory studies demonstrated the CO2
laser produces wounds that heal differently from those made
by...
• The regeneration from the epithelial margins
appears to extend over the fibrinous coagulum
rather than proliferating ben...
• Ductal orifices in the lased field do not demonstrate
any stenosis on healing.
• Laser wounds are thought to produce les...
LASER IN WOUND HEALING
• Lasers employing low level radiant energy have
been claimed to produce a positive effect on the
b...
• Role of lasers in 3rd molar surgery reveals
although helium-neon laser produced a
significant reduction of Trismus, but ...
COMPLICATIONS
• General complications:
1.Post operative infections
2.Contact dermatitis
3.Post operative pain
4.ocular inj...
• Complications unique to extra oral laser
surgery of head and neck:
1.Hyperpigmentation
2.Hypopigmentation
3.Erythema
4.H...
• Complications unique to intra oral laser
procedures:
1.Damage to dentition
2.Damage to oropharyngral tissues.

www.india...
www.indiandentalacademy.com
SAFETY MEASURES
• Shielding devices
• Fire hazards : drapes
alcohol in surgical field
• Specular reflection
• Electric sho...
www.indiandentalacademy.com
www.indiandentalacademy.com
Impacted teeth

www.indiandentalacademy.com
freenectomy

www.indiandentalacademy.com
GINGIVAL HYPERPLASIA

www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
References :
• Laser applications in OMFS- Guy A. Catone
• Lasers in OMFS-Clinics of North America
VOL 16. NO 2. MAY 2004
...
Thank you

www.indiandentalacademy.com
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Principles and uses of lasers in omfs /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

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Transcript of "Principles and uses of lasers in omfs /certified fixed orthodontic courses by Indian dental academy "

  1. 1. PRINCIPLES AND USES OF LASERS IN OMFS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. • The term laser is an acronym for light amplification by a stimulated emission of radiation, which serves to explain most but not all the critical physical interactions that occur within a laser generating cavity. • Surgeons do not necessarily have to be fully tortured on the complex physics required to create the various forms of laser radiant energy. • However, it is pragmatic to have a general knowledge of stimulated emission so that one can evaluate newer laser technologies and understand how lasers affect biologic tissue. www.indiandentalacademy.com
  3. 3. HISTORY – The possibility of stimulated emission was predicted by Einstein in 1917. – Maiman in 1960 created the first operational laser called Ruby laser and it was employed in treating dermatological lesions. – CO2 laser was fabricated by Patel and colleagues in 1964. – Lasers entered OMFS in 1970. www.indiandentalacademy.com
  4. 4. www.indiandentalacademy.com
  5. 5. www.indiandentalacademy.com
  6. 6. LASER PRODUCTION Absorption: electron absorbs energy and transferred to more exited state. Spontaneous emission of radiation: electron returns to its resting state and releases electromagnetic radiation in the form of light. www.indiandentalacademy.com
  7. 7. • When an atom in exited state becomes irradiated with a photon of light of same wavelength and frequency that was previously absorbed, as it returns to its resting state, it will emit 2 photons of light energy of same W.length traveling in the same direction in spatial and temporal phase. • Because of this production of electromagnetic energy it is called LASER ( light amplification by the stimulated emission of radiation) www.indiandentalacademy.com
  8. 8. PROPERTIES OF LASER LIGHT 1. Monochromaticity: with all of energy it produces having same wave length. 2. Directionality : beam can travel considerable distance with a minimal divergence(milliradans). 3. Coherence : is a distinct feature that allows laser beam to remain parallel for long distance and spatially coherent. This helps in extremely fine focusing. 4. Brightness : high brightness- high energy. www.indiandentalacademy.com
  9. 9. PHOTOBIOLOGY • Photobiologic effects: 1.Photocoagulation 2.Photovaporization 3.Photochemical 4.Photophysiological phenomena All these are both wavelength and dose dependent. www.indiandentalacademy.com
  10. 10. • • • • PHOTOCOAGULATION Heating tissues above 60degree c. Whitening of tissues Changes in molecular structure of tissues Collagen shrinkage in blood vessels causes hemostasis . • Laser damage to erythrocytes attracts a population of platelets and causes intraluminal thrombosis. www.indiandentalacademy.com
  11. 11. www.indiandentalacademy.com
  12. 12. PHOTO VAPORIZATION • Intense, highly focused laser radiation produces surface temp exceeding 100 degree C, which causes tissue vaporization of 0.05mm thickness within 1/8 th of a second. • Cellular expansion due to steam production • Over 100deg C destroys cellular proteins • Literally cell explode releasing the confined steam in the form of plumes. • When further heated results in complete or partial combustion and produces smoke and flashes of incandescence. www.indiandentalacademy.com
  13. 13. PHOTOCHEMICAL EFFECT & PHOTOCHEMICAL THERAPY • Here a Radiant energy possessing a multitude of wavelengths is used to treat a host of dermatologic diseases by administrating a Photosensitizing agent to the patient before application of the light. • PSORALENS (Tricyclic Furocoumarins) is used as a Photosensitizing agent in combination with exposure to UV radiations. • Used in the treatment of Psoriasis, Mycosis,Fungoides,Vitiligo, Eczema. www.indiandentalacademy.com
  14. 14. • Systemic administration of Photosensitizing agent offers conveniance,bypasses the barrier to radiant energy alone of the stratum corneum, and may cause a uniform skin concentration of Photoagent. • Because the Photoagent is activated by optical radiant energy, the effects of the Photosensitizer are confined to exposed areas and the penetrative action of the radiant energy is limited to the skin www.indiandentalacademy.com
  15. 15. PHOTODYNAMIC THERAPY (PDT) WITH LAZER • PDT using the laser is similar to the use of photosensitizers and radiant energy, possessing less power and in most cases shorter wavelengths. • Initially PDT used Hematoporphyrin derivative and red light to treat malignant diseases in humans. • PDT therapy requires adequate tissue levels of photosensitizer, oxygen and laser energy. www.indiandentalacademy.com
  16. 16. • The foundation of PDT is the activation of a local or systemically administered photosensitizing agent by radiant energy. • PDT turns on the ability of certain chemicals to accumulate in malignant tissues and to be rendered cellucidal if activated, by exposure to laser energy in the form of low intensity visible or near infrared light. • A range of oral microorganisms responsible for both dental caries and PDL disease are susceptible to the cellucidal effects of PDT. www.indiandentalacademy.com
  17. 17. PHOTOMECHANICAL EFFECT (PHOTODISRUPTION) • Photodisruption is not a laser application sought by OMFS as a way of managing diseased tissues. • Most commonly used by Ophthalmologists. www.indiandentalacademy.com
  18. 18. www.indiandentalacademy.com
  19. 19. www.indiandentalacademy.com
  20. 20. TYPES OF LASERS 1. CARBON DIOXIDE LASERS 2. NEODYMIUM:YATRIUM-ALUMINIUMGRANETT 3. ARGON LASER 4. HOLMIUM:YTRIUM-ALUMINIUM-GRANETT 5. ERBIUM:YTRIUM-ALUMINIUM-GRANETT 6. POTASSIUM TITANYL PHOSPHATE (KTP) www.indiandentalacademy.com
  21. 21. LASER DELIVERY MODES W.L In nm CHROMOPHORE 1 CO2 Articulated arm, fibroptic CW, P, UP, Flash scan 10,600 Water 2 Argon Fibroptic CW, P 488-514 Hemoglobin 3 Nd:YAG Fibroptic CW, P Q-Switched 1064 Hb, melanin 4 HOL: YAG Fibroptic P 2150 Synovium 5 KTP Fibroptic P 532 Hb, melanin, tatoo pigments www.indiandentalacademy.com
  22. 22. LASER DELIVERY MODES W.L In nm CHROMOPHORE 6 Er:YAG Fibroptic P, UP 2940 Water 7 Q-switched ruby Articulated arm P 694 Melanin, carbon tatoos 8 Pulsed dye Fibroptic P 4001000 Hb, tatoos, vascular malformations 9 Copper vapor Fibroptic P 578 Hemangiomas Tatoos Vascular malformations 157-355 Cornea 10 Excimer Flexible arm P www.indiandentalacademy.com
  23. 23. • • • • Continous Pulsed mode Superpulsed Ultrapulsed • Free beam • Focused • Contact lasers • Non contact lasers www.indiandentalacademy.com
  24. 24. www.indiandentalacademy.com
  25. 25. HOW TO USE A LASER • Wide variety of procedures by laser can be categorised into: 1.Incisional / Excisional techniques 2.Vaporization/ Ablation 3.Hemostasis/ Coagulation www.indiandentalacademy.com
  26. 26. Incisional & Excisional • Co2 laser is used as a light scalpel and is operated in focused mode (smallest possible spot size of that laser). • Focused mode – High power per unit- Deep cut. • Planned margin should be atleast 0.5mm beyond margins, failure to do this may cause thermal effect to encroach on the lesion and make pathologic interpretation unreliable. Area should be outlined in a slow to moderate intermittent mode. • Cutting in intermittent mode could result in perforation rather than incising. www.indiandentalacademy.com
  27. 27. Incision should be performed in one or two passes at a rapid rate of motion, slowing the laser motion will result in deeper incisions but also lateral thermal damage. Deeper incisions are best achieved by increasing power or performing additional passes rather than slowing the traverse speed which may cause widening the zone. www.indiandentalacademy.com
  28. 28. Care should be taken to ensure that the spot size remains constant during the procedure to achieve the uniform depth incision. Typical parameters: spot size -0.10.5mm, power setting within 4-10 watts www.indiandentalacademy.com
  29. 29. • Suture closure of areas excised with co2 laser is not mandatory. • Excellent hemostasis and less scarring,often allows laser wound to heal secondarily. • Laser wounds are slow to epitheliase. Fibrinous coagulum acts as biological dressing • If sutures are used, it is advisable to leave them in place somewhat longer, than would be the case with scalpel wound. www.indiandentalacademy.com
  30. 30. VAPOURISATION TECHNIQUE • Useful in the management of surface lesions such as hyper keratosis, epithelial dysplasia, lichenplanus etc… • This technique is used in diffused mode where the spot size is increased, and power density and depth of cut is decreased. • After it is outlined the lesion should vaporise in a continuous series of connecting and paralleling “U” s, this method ensures an even lacing of the entire lesion. • After initial pass is performed the surface carbonization should be gently wiped with moist gauze www.indiandentalacademy.com
  31. 31. HEMOSTATIC TECHNIQUE • There are number of laser that are highly absorbed by hemoglobin, therefore an ideal in management of vascular lesions. • Argon, copper vapor, Potassium titanyl phosphate(KTP), Nd: YAG, Co2 laser. • Dry field should be maintained, other wise water content greater than that present intracellularly will absorb the laser energy and negate its effects. www.indiandentalacademy.com
  32. 32. GENERAL PRINCIPLES OF CLINICAL LASER APPLICATION • Careful observation of target tissue • Beam should be directed perpendicular to the target tissue unless dissection of the underlying tissue is desired. • When using the continuous or rapid mode the surgeon should work expenditiously and with even strokes. www.indiandentalacademy.com
  33. 33. • Both the power density and fluence may change with small variations in operative technique and may affect clinical outcome in sensitive areas like facial skin. Be aware of tissue that is in the path of laser beam beyond the target tissue. • Width of laser cut corresponds to beam diameter, the depth depends on power set and degree of coagulation necrosis on duration of laser exposure. • Heat produced sterilizes the operating field, so no transplantation of pathology occurs even in touch technique or with a free beam laser. www.indiandentalacademy.com
  34. 34. RATIONAL BASIS FOR USE OF LASERS • CO2 laser, absorption is proportional to water content. Therefore, tissues with high aqueous content like epithelium, connective tissues or muscles rapidly absorb the incident beam. • Non aqueous tissues like bone, tendon, fat are poor absorbers and produces more heat and makes these tissues more anhydrous . flaming may occur on prolonged application. Ho:YAG lasers can be used here as they have shorter wave length (less heat production). • Argon has affinity for red pigment of hemoglobin and used in photocoagulation of vascular lesions. • Nd: YAG has affinity for dark pigments like melanin and protein and is most useful for ablation of large volume of tissues particularly when strict hemostasis is desired. www.indiandentalacademy.com
  35. 35. SOME OF THE COMMON CILNICAL APPLICATIONS 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Incisional and excisional biopsies. Focal hyperkeratosis Nicotinic stomatitis Solar chelitis Leukoplakia Erythroplakia Fordysces granules Verrucos carcinoma Oral papillomatosis Lichenplanus Oral melanotic macules . Oral submucosa fibrosis www.indiandentalacademy.com
  36. 36. www.indiandentalacademy.com
  37. 37. www.indiandentalacademy.com
  38. 38. MANAGEMENT BY ANATOMIC REGION • 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. TONGUE: Fibroma Papilloma Granular cell tumor Lingual thyroid Hemangioma Lymphangioma Lingual tonsil Lipoma Pyogenic granuloma Apthous ulcer www.indiandentalacademy.com
  39. 39. FIBROEPITHELIAL POLYP ON DORSAL SURFACE OF TONGUE. www.indiandentalacademy.com
  40. 40. • 1. 2. 3. 4. 5. 6. LIPS: Mucocele Pyogenic granuloma Fibroma Actinic cheilitis Hemangioma Apthous . www.indiandentalacademy.com
  41. 41. • 1. 2. 3. 4. 5. 6. 7. BUCCAL MUCOSA: Hyperkeratosis/dysplasia Fibroma Payogenic granuloma Hemangioma/lymphangioma Salivarygland tumors Scar tissues/ hyperplastic tissues Lichen planus. www.indiandentalacademy.com
  42. 42. • 1. 2. 3. 4. 5. 6. 7. FLOOR OF THE MOUTH: Ranula Salivary gland tumors Sailolithiasis Hemangioma Lymphangioma Leukoplakia/dysplasia Ankyloglossia www.indiandentalacademy.com
  43. 43. GINGIVA: 1. 2. 3. 4. 5. 6. Lichenplanus Pyogenic granuloma Fibroma Papilloma Drug induced gingival hyperplasia Hyperplastic gingival tissue www.indiandentalacademy.com
  44. 44. • 1. 2. 3. 4. • 1. 2. 3. 4. 5. SOFT PALATE: Salivary gland tumors Hemangiomas/ lymphangiomas Mucous retention phenomena Palatal/uvular hypertrophy. HARD PALATE: Salivary gland tumors without bony invasion Papillary hyperplasia Pyogenic granuloma Apthous Gingival hyperplasia www.indiandentalacademy.com
  45. 45. • 1. 2. 3. 4. 5. 6. 7. 8. 9. DERMATOLOGICAL USES: Angiofibroma Psoriasis Neurofibroma Erythroplasia Pyogenic granuloma Keloids Tattoo Scar revision Basal cell carcinoma www.indiandentalacademy.com
  46. 46. LASER USE IN ANATOMICALLY DIFFICULT AREAS • 1. 2. 3. 4. Surgery in and around oral cavity and face is complicated by the proximity to number of vital structures. Salivary glands and their ducts. Nerves, blood vessels Near the Commissures of oral cavity Airway. www.indiandentalacademy.com
  47. 47. www.indiandentalacademy.com
  48. 48. LASERS-TMJ 1. 2. 3. 4. Anterior disk displacement Synovectomy Hypermobility Perforated disk www.indiandentalacademy.com
  49. 49. www.indiandentalacademy.com
  50. 50. • LASERS IN MALIGNANT LESIONS OF HEAD AND NECK • Ability of lasers to seal blood vessels, lymphatics, nerve endings, decreased levels of inflammatory mediators and reduced scarring, aids in surgery with limited complications. Carbondioxide & Nd:YAG 1. 2. 3. 4. 5. 6. Premalignant/displastic lesions Carcinoma of tongue Carcinoma of lip Lesions of tonsils & oropharynx Lesions of the palate Verrucous carcinoma www.indiandentalacademy.com
  51. 51. www.indiandentalacademy.com
  52. 52. www.indiandentalacademy.com
  53. 53. VASCULAR & PIGMENTED LESIONS Argon laser Nd-Yag laser Pulsed dye lasers Q-switched Nd-Yag lasers Examples Hemangioma Port wine stains Neves www.indiandentalacademy.com
  54. 54. www.indiandentalacademy.com
  55. 55. UVELOPLASTY www.indiandentalacademy.com
  56. 56. HEALING OF LASER WOUNDS www.indiandentalacademy.com
  57. 57. • Both clinical and laboratory studies demonstrated the CO2 laser produces wounds that heal differently from those made by a scalpel. • Scalpel wounds contracted significantly and developed rolled margins that remained present 42 days later. • Laser wounds also developed rolled margins , but flattening occurred 28 days after lasing. • Histologically, there are fewer mayofibroblasts present, which appears to be responsible for less scar contraction. • In addition, less collagen formation is noted, and epithelial regeneration is delayed. www.indiandentalacademy.com
  58. 58. • The regeneration from the epithelial margins appears to extend over the fibrinous coagulum rather than proliferating beneath the granulation tissue, as when wounds heal by secondary intention. • Reepithelialization appears to be complete in 6 weeks, with the original wound outline visible. • There is minimal scaring, and the overlying surface remains palpably soft. www.indiandentalacademy.com
  59. 59. • Ductal orifices in the lased field do not demonstrate any stenosis on healing. • Laser wounds are thought to produce less post opp pain. • Vaporization of cellular structure, organelles, and cellular chemical mediators, as well as sealing of nerve endings, is considered responsible. www.indiandentalacademy.com
  60. 60. LASER IN WOUND HEALING • Lasers employing low level radiant energy have been claimed to produce a positive effect on the biologic and biochemical processes of wound reconstitution. • Low level radiant energy of lasers have accelerated wound healing, reduced pain and enhanced neural regeneration. • It also brings about more rapid epithelialization, enhances neo vascularisation . www.indiandentalacademy.com
  61. 61. • Role of lasers in 3rd molar surgery reveals although helium-neon laser produced a significant reduction of Trismus, but there is no evidence of it reducing pain. • All the studies of laser wound healing have focused on proliferative phase of wound healing( the period of 10-14 days after wound healing that is characterised by population of proliferating fibroblasts and the initiation of the synthesis of collagen). www.indiandentalacademy.com
  62. 62. COMPLICATIONS • General complications: 1.Post operative infections 2.Contact dermatitis 3.Post operative pain 4.ocular injuries 5.Air way 6.Injuries to staff www.indiandentalacademy.com
  63. 63. • Complications unique to extra oral laser surgery of head and neck: 1.Hyperpigmentation 2.Hypopigmentation 3.Erythema 4.Hypertrophic scarring 5.Milia and acne outbreaks www.indiandentalacademy.com
  64. 64. • Complications unique to intra oral laser procedures: 1.Damage to dentition 2.Damage to oropharyngral tissues. www.indiandentalacademy.com
  65. 65. www.indiandentalacademy.com
  66. 66. SAFETY MEASURES • Shielding devices • Fire hazards : drapes alcohol in surgical field • Specular reflection • Electric shock • Explosive hazards: ether cyclopropane alcohol • Virus particles • Combustion products are carcinogenic • Anesthetic : endotrachial tubes anesthetic gas mixture www.indiandentalacademy.com
  67. 67. www.indiandentalacademy.com
  68. 68. www.indiandentalacademy.com
  69. 69. Impacted teeth www.indiandentalacademy.com
  70. 70. freenectomy www.indiandentalacademy.com
  71. 71. GINGIVAL HYPERPLASIA www.indiandentalacademy.com
  72. 72. www.indiandentalacademy.com
  73. 73. www.indiandentalacademy.com
  74. 74. www.indiandentalacademy.com
  75. 75. References : • Laser applications in OMFS- Guy A. Catone • Lasers in OMFS-Clinics of North America VOL 16. NO 2. MAY 2004 • Lasers in OMFS and dentistry- Lewis Clayman • Fonseca vol 1. www.indiandentalacademy.com
  76. 76. Thank you www.indiandentalacademy.com

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