2. Light
Amplification by
Stimulated
Emission of
Radiation
http://spaceplace.nasa.gov/en/kids/laser/index.shtml

3.  Gas laser (CO2-welding, surgery)
Excimer UV laser (LASIK)
 Solid-State laser
Semiconductor
(Telecom, Optical Storage, Laser Pointers)
Fiber Hosted
(the PILOT Diode Laser)
 Others--
◦ Chemical Laser,
◦ Photonic Crystal Laser,
◦ Dye Laser,
◦ Free Electron Laser, etc.

4. High Power Lasers and Low Level
Lasers

5. High Power Lasers:
Used to cut, coagulate and evaporate tissues.
Often called surgical lasers because they can
replace the scalpel of the surgeon.
i.e. CO2 laser
Low Level Lasers:
Used for the stimulation of cell function.
Their biological effect is not thermal, as is the
case with surgical lasers.
i.e. LED laser

6. Based on Various Settings:
 High Power Laser Actions
◦ Vaporization
◦ Hemostasis
◦ Decontamination
 Low Level Laser Therapy
◦ Biostimulation
◦ Modulation of Pain

7. Vaporization = Cutting
◦ The diode laser’s wavelength is absorbed
by pigmented tissues and cellular
structures resulting in an incision similar
to a surgical blade
◦ Less thermal damage than other Surgical lasers!
 CO2 laser works by boiling water in tissues
and rupturing cell membranes

8. CO2 Laser works by thermal
action, therefore,
some thermal damage is inevitable!

9. Less thermal damage results in less
inflammation,
and therefore, less swelling and pain

10.  The diode laser’s wavelength is
absorbed by hemoglobin
 Surrounding tissue collagen contraction
results in the restriction of blood
vessels in the targeted area

11. Active Bleeding Greatly Reduced on Treated Half

17. OPTIONS:
“Cut & Sew”
Hemorrhage
Difficult in small mouth
Electrosurgery
Post-op swelling
CO2 Laser
Risk of charring or lasing pharynx
Diode Laser ?

18. •Zero bleeding
•Limited charring in portion
used as “cutting”
•Portion used as “pre-coag”
followed by blade worked well
•No dyspnea during recovery
•Eating baby food in 18 hours

20. Treatment with Diode Laser

21. Simple, Fast Extraction Site Closure

22.  Also Known As
◦ Biostimulation
◦ Photobiomodulation
◦ “Cold Laser” therapy
◦ 3LT
Because…
The mechanism is
photochemical rather
than thermal

23. Light is absorbed by mitochondria in cells
 Stimulation of cellular ATP production
and up-regulation of nitric oxide
 Secretion of growth factors, activation
of enzymes and other secondary
messengers
◦ Enhanced cell proliferation and
differentiation

24.  Increased neovascularization and
temporary vasodilation
 “Photomodulation of Blood”– new
term in medicine
◦ Enhanced leukocyte (WBC)
infiltration
◦ Increased macrophage activity

25.  Increased proliferation of cells
◦ Fibroblasts
◦ Endothelial cells
◦ Keratinocytes
 Shown to be true of hypoxic or
stressed cells
 Healthy cells show little or no
response

26.  Rapid Regeneration of:
◦ Skin
◦ Muscle
◦ Tendon
◦ Ligament
◦ Bone
◦ Nerves

28. 24 Hours– no “red line”
Gingivitis Resolved

29. Chronic Scalp Wound
Following Trauma
Minimal healing over 1st month
-Duoderm Paste used

30. Lesion size after 1 month– outlined in red
Lesion size 24 hours later, following treatment with the Pilot
Diode Laser- outlined in green

31.  Lesion-- 7 days, four treatments later

32. •Base of skull on right to caudal scapula
•E. Coli was cultured from the wound
•Littermates also affected

33.  Immediately Post-Op
Treated only caudal half of incision with diode laser following
typical debridement

34. Day 4 post-op-
Caudal (treated) half shows epithelialization

35. Day 4 post op-
Cranial (non-treated) half has more scabbing and
inflammation, no epithelialized areas
Following day 4, the entire the wound was treated with
the Pilot Diode Laser

36. At 15 days post-op, the entire wound was nicely
healed with an atypically large amount of new hair
growth.

38. Infectious dermatitis in
this frog was non-
responsive to antibiotic
baths and topical
treatment.
The prognosis was
terminally poor.

39. When laser therapy was
introduced, antimicrobial treatment
was discontinued.
 Diode laser
therapy was
applied at
2.0 watts for
2
seconds, twi
ce weekly
for four
weeks.
Leg after 2 Weeks of Diode Laser Therapy

40.  Leg following 4 weeks of Diode Laser Therapy

41.  Complete Degloving Injury of Left Humerus

42. Treated with Diode Laser at 2.0 watts for 2
minutes Every Other Day for 2 Weeks

43. No scabbing of the wound was ever noted
The owl was released into the suburban wild at 2 weeks

44. In General
 Increases release of endorphins
 Increases serotonin
 Resolution of inflammation at least
equivalent to NSAIDs
 Suppression of nociceptor action
◦ Inhibits nerve conduction in small and
medium diameter peripheral nerves

45. Joint Pain Specifically
 Joint capsule and synovial membrane stimulation
result in increased intra-articular circulation and
◦ healthier synovial fluid is generated
◦ Chondroblastic cellular formation is accelerated

46.  Suppression of nociceptor action
◦ Localized treatment
◦ Inhibits nerve conduction in small and medium
diameter peripheral nerves
 Induces neural blockade reducing central nerve
sensitisation (pain memory)
◦ Spine and trigger point treatment

47. There are > 50 positive Double Blind studies that
show clear evidence that Low Level Laser Therapy
(LLLT) is highly effective for the following conditions:
 chronic pain  acne, eczema  migraines
 acute  inflammatory
(traumatic) skin conditions
pain  wounds and  sinusitis, tonsil
 tendonitis burns litis
 carpal tunnel  non-healing  TMJ disorders
syndrome ulcers
 tennis/golfer  rheumatoid  Minere’s
elbow arthritis disease
 fibromyalgia  Tinnitis
 lymph edema  vertigo
 osteoarthritis
http://www.drz.org/asp/cp/laser2.asp

48.  Cosmetic Uses
◦ Hair Re-growth
◦ Dental bleaching
◦ Non-surgical face lift and wrinkle correction and
body contouring
◦ Non-surgical liposuction
◦ Laser enhanced breast augmentation

50.  Back Pain
 Bowed tendons
 Navicular disease
 Bucked shins
 Laminitis
 Cellulitis
 Joint Pain
 Suspensory ligament desmitis

51. De-gloving injuries
Chronic Otitis
Externa
Gingivitis/Perio
Tooth abscesses
Bite wounds
Hot Spots
Folliculitis
Pododermatitis
Lick Granuloma
Anal Gland abscesses
Rhinitis

53. Safety features
Patented fiber
management system 9 watt maximum
Bright and easy to
read display
Easy to use Programmable
handpiece and tips
Portable – light weight

54.  Variable 0.1 - 9 Watts
 400 micron fiber
 Continuous or pulse mode
 Portable – 5.5 lbs
 Unique/patented fiber management
 20 ft. of optical fiber
 Easy and intuitive to use
 Wireless foot pedal
 Aiming beam
 Disposable tips

55. The patented fiber
management system
goes where you want it.
The handpiece feels
and acts like a scalpel.

56. Minimal invasion into
surgical area. Fiber will
extend out to 20 ft.

57. Easy to use.
Straight or curved.

58. This essential feature aids
the surgeon in visualizing
exactly where the laser will
ablate and incise
tissue, before laser energy
is delivered.

59. .1 - 9 Watts of power.
Delicate enough for
biostimulation while
powerful enough for
daily surgery.

60. Laser fiber easily inserts
through laser port
Works with any scope
procedure…unlike CO2

61. Procedures
Pre-coagulation Followed by Steel Blade
Photo-contraction causing Hemostasis
Controlled Bleeding

62. Procedures
Bleeding No Bleeding
Photo taken within 5 seconds of incision

63. Procedures

64. Procedures
Induce perianesthesia with
laser, excise mass with
scissors, coagulate and vaporize lesion
to char 5 days/week

65. Procedures

66. Procedures
Scalpel-like cutting with No bleeding

67. Procedures

68. Procedures
Apex Decontamination

69. Procedures

70. Procedures