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Medical problem 3 4

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  • 1. Islam Kassem, BDS , MSc, MOMS RCPS Glasg,FFD RCSIConsultant Oral & Maxillofacial SurgeonMedical Topics inOrthodonticsikassem@dr.com
  • 2. Criteria of selected techniqueEffect on healingEffect on painEffect on edemaEffect on intra operative bleedingEffect on Tooth structureikassem@dr.com
  • 3. L A S E RLight AmplificationbyStimulatedEmissionofRadiationLasersLaser theoryikassem@dr.com
  • 4. Model of an atom by Niels BohrBorn in Copenhagen1922: Nobel Physics PrizewinnerLasersLaser theory - basicsikassem@dr.com
  • 5. The laser – a very special lightikassem@dr.com
  • 6. Laser CharacteristicsMonochromaticCollimatedCoherentHigh energyikassem@dr.com
  • 7. Coherence: Temporal and spatialsynchronization of wavemovementLasersLaser theory – Basics: laser lightNormal light Laser light (coherent)TemporalcoherenceSpatialcoherenceLaserikassem@dr.com
  • 8. LasersDesign of a laserFully reflectingmirrorResonatorReflectorSemipermeable mirrorReflectorMediumFlash lampLaser mediumikassem@dr.com
  • 9. According towave lengthIR Visible Ultravioletikassem@dr.com
  • 10. Accordingto deliveryArticulatedarmWaveguideFiber opticikassem@dr.com
  • 11. Laser ClassificationsAccording tolaser mediumSolid(ND:YAG Liquid (Dye) Gas (CO2)ikassem@dr.com
  • 12. Accordingto modeCW PulsedSuper andUltra pulsedikassem@dr.com
  • 13. Laser tissue InteractionLaser maybeScattered Reflected Absorbedikassem@dr.com
  • 14. Warm-up37 – 60°CnonenonePenetrationof protein60 – 65°CWhitish-graycoloration,increaseddispersionDecompositionDesiccation90 – 100°CConstantdispersionShrinkage,dehydrationCarbonizationSeveral hundred °CBlackcoloration,increasedabsorptionStrongmechanicaldamageVaporizationCombustionFormationof smokeand gasAblationTemperatureProcessOpticalchangeMechanicalchangeLasersInteractions between laser light and tissueikassem@dr.com
  • 15. LasersEffect of the laser on biological tissueDamagereversible irreversibleVaporizationCarbonizationCoagulationLaser beamTissueHyperemiaikassem@dr.com
  • 16. Laser tissue interactionPhotothermal(CW)Photochemical(CW ,PulsedPhotoablationPulsed)ikassem@dr.com
  • 17. Effects on human tissueTransmissionAbsorptionReflectionLasersLaser-tissue interaction: Beam trajectoryDispersionikassem@dr.com
  • 18. A therapeutic effect is attainedonly if the tissue absorbs the laser energy!LasersLaser-tissue interactionikassem@dr.com
  • 19. ChromophoresAccording to the optical properties oftissues. For example CO2  WaterThis Character is strongly affected by thelaser physical properties .ikassem@dr.com
  • 20. Carbon dioxide laserPatel et al., working in Bell laboratories in 1964,were the first to develop the CO2 laser.Carbon dioxide (CO2 ) lasers have been used indentistry in the specialty practice of oral surgeryand periodontology since the early 1980s, in thepast five years, the use of these lasers hasextended into general practice.CO2 laser was the first laser approved by the FDAikassem@dr.com
  • 21. Of greatest significance is the high degree ofabsorption by oral mucosal tissues, which arecomposed of 90% water. Absorption of the laserby intracellular water results in a photo thermaleffect that is manifested by cellular rupture.This cellular vaporization is the basis for the use ofthe CO2 laser as a surgical tool.Heat is generated and conducted into surroundingtissues, creating a zone of lateral thermal damage;this zone of necrosis has been found to be 500mm or less Lateral thermal damage results incoagulation of vessels up to 500 mm in diameterand is clinically manifested by homeostasis.ikassem@dr.com
  • 22. Post surgical bacteremia also has been foundto be greatly reduced with laser use as aresult of sealing of blood vessels andlymphatic compared with other methods ofincision Laser wounds exhibit histologicalfeatures that confer significant advantagesover those created by scalpel .ikassem@dr.com
  • 23. ikassem@dr.com
  • 24. Laser HazardsClass ILaser videodiskClass IILaser PointerClass IIISurgical laserClass IVFire laserikassem@dr.com
  • 25. Laser Safety & Protection1- Eye protection2- protection to lips , skin of the face3- Protection from fire , toxic gases .4- Laser reflection from surgical instrument.5-Hazards of laser smokesikassem@dr.com
  • 26. ikassem@dr.com
  • 27. Clinical applicationsikassem@dr.com
  • 28. ikassem@dr.com
  • 29. ikassem@dr.com
  • 30. Low level laserikassem@dr.com
  • 31. ikassem@dr.com
  • 32. My Contact ikassem@dr.com You can ge thelectures form http://www.slideshare.net/islamkassem/newsfeedikassem@dr.com

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