INTRODUCTION OF LASERS IN ORAL AND MAXILLOFACIAL SURGERY
INITIAL USE IN ORAL AND MAXILLOFACIAL SURGERY
CHARACTERISTICS OF LASER LIGHT
CLASSIFICATION OF LASERS
TISSUE INTERACTION
TYPES OF LASERS
ADVANTAGES AND DISADVANTAGES
LASER SAFETY IN SURGERY AND ANESTHESIA
PATIENT SELECTION
APPLICATIONS
SURGICAL LASER TECHNIQUE
APPLIED ASPECTS
RECENT ADVANCES
COMPLICATIONS
Lasers in oral & maxillofacial surgery/oral surgery courses by indian dental ...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Lasers and its role in endodontics/certified fixed orthodontic courses by Ind...Indian dental academy
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INTRODUCTION OF LASERS IN ORAL AND MAXILLOFACIAL SURGERY
INITIAL USE IN ORAL AND MAXILLOFACIAL SURGERY
CHARACTERISTICS OF LASER LIGHT
CLASSIFICATION OF LASERS
TISSUE INTERACTION
TYPES OF LASERS
ADVANTAGES AND DISADVANTAGES
LASER SAFETY IN SURGERY AND ANESTHESIA
PATIENT SELECTION
APPLICATIONS
SURGICAL LASER TECHNIQUE
APPLIED ASPECTS
RECENT ADVANCES
COMPLICATIONS
Lasers in oral & maxillofacial surgery/oral surgery courses by indian dental ...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Lasers and its role in endodontics/certified fixed orthodontic courses by Ind...Indian dental academy
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.
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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.
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The presentation deals with the basics required for studying TMJ ankylosis. The text has been simplified and presented. It is well supported with illustrations.
Suggestions and feedback will be well appreciated. :)
Principles and uses of lasers in omfs /certified fixed orthodontic courses by...Indian dental academy
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
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The presentation deals with the basics required for studying TMJ ankylosis. The text has been simplified and presented. It is well supported with illustrations.
Suggestions and feedback will be well appreciated. :)
Light is an integral part of our life. Advances in technology are increasing and changing the ways that the patient experience dental treatment. One of the milestones in technological advancements in dentistry is the use of lasers The early 20th century saw one of the greatest inventions in science & technology, in that LASERS which later went on to became a gift to health sciences. Albert Einstein is usually credited for the development of the laser theory. He was the first one to coin the term “Stimulated Emission” in his publication “Zur Quantentheorie der Strahlung”, published in 1917 in the “Physikalische Zeitschrift”
Lasers are devices that produce beams of coherent and very high intensity light. The word LASER is an acronym for “Light Amplification by Stimulated\Emission of Radiation”. A crystal or gas is excited to emit light photons of a characteristic wavelength that are amplified and filtered to make a coherent light beam. The effect of the laser depends upon the power of the beam and the extent to which the beam absorbed. Several types of lasers are available based on the wavelengths. These range from long wavelengths (infrared), to visible wavelengths, to short wavelengths (ultraviolet), to special ultraviolet lasers called excimers. Lasers are used nowadays in many areas in the field of dentistry It is of the most captivating technologies in dental practice. Even though, introduced as an alternative to the traditional halogen curing light, laser now has become the instrument of choice, in many dental applications. Its advancements in the field of dentistry are playing a major role in patient care and well being.
explained with Limited matter moreover I have included all the images. if you go through a standard textbook and referred to this PPT it will help you so much I hope It helps you
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
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ASA GUIDELINE
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
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13. Components
of laser
• The inner part of laser, or the
components of laser, are as follows:
• A)Optical cavity
• B) Two mirrors- one at each end of
optical cavity
• (C) Excitation sources
• (D) Cooling system
• (E) Focusing lenses
• (F) Other controls
20. Two mirrors-
• Mirrors are parallel to each other
• Partially- reflective mirror with 5-10% transmission
21. • Principle of interference-
Constructive interference – when the waves are in phase
Destructive interference – when waves not in phase
22. • Dielectric mirrors: A dielectric mirror, also known as a Bragg mirror, is a type
of mirror composed of multiple thin layers of dielectricmaterial, typically
deposited on a substrate of glass or some other optical material.
23. • Alternating pattern of high and low RI materials
• Depending on the number of layers in the mirror – 20 or more layers – the
reflectance is 100% for atleast one particular wave length
24. EXCITATION SOURCES
This applies to the energy or excitation level of a laser medium.
The energy possessed α external or internal energy from a source.
E.g.
Electrical discharge – CO2 laser, He:Ne, Krypton
Chemical reaction
External high powered radiant source as xenon or krypton flash lamp – Nd:YAG, Ruby
laser.
Alternating magnetic fields – X-ray lasers
Excitation sources
25. This causes a
process called
OPTICAL PUMPING,
in which energy is
driven into the
resonant chamber.
This energy is used
to change the
energy level or
quantum state.
27. Thermal effect of LASER radiation
Temperature
37 0C
45 0C
50 0C
60 0C
80 0C
100 0C
150 0C
300 0C
Effect
Normal
Hyperthermia
Reduction in enzyme activity, cell immobility
Denaturation of proteins and collagen, coagulation
Permeabilization of membranes
Vaporization, thermal decomposition
Carbonization
Melting
28. Potential advantages of
LASER
• No-touch techniques
• Reduced blood loss.
• Limited fibrosis.
• Fiber optic delivery.
• Reduction in spread of
metastasis.
29. • Fewer instruments in the field.
• Reduce post-operative pain.
• Sterilization of the impact site.
• Dry surgical field.
• Reduced edema.
Potential advantages of LASER
30. • Corneal or retinal burns (or both). Chronic exposure to excessive
levels may cause corneal or retinal injury
• Severe burns & scarring.
• Electrical hazard
• Fire
Potential hazards of LASER
31. 1. Fiber optic delivery system
2. Hollow Fiber: Er: YAG and CO 2 lasers
TYPES OF LASER LIGHT DELIVERY
32. 3. Articulated arm delivery system
4. Handpieces-close contact and non-contact handpiece
TYPES OF LASER LIGHT DELIVERY
36. Effect of distance of laser beam on the spot-size at
target tissue surface Effect of focused and defocused laser beam on
target tissue
Focused beam results in well-defined incision whereas a defocused beam
causes ablation.
37. • The exposure time is the amount of time the operator keeps the laser
light directed at the tissue.
38. Tissue is vaporised with each pulse and no significant and no thermal damage
occurs beyond the site of laser impact.
Selective Photothermolysis
This was first theorised by Anderson and Parrisch in 1983.
39. Lasers used in dental practice can be classified into several
categories according to:
(1)the range of wavelength,
(2) the lasing medium, such as gas laser and solid laser
(3) tissue penetration - soft tissue and hard tissue lasers
(4) The risk related to laser application, and
(5) potential hazards.
CLASSIFICATION OF LASERS
47. CARBON DIOXIDE LASERS
• Developed by Patel in 1964
• Emits light in the invisible mid infrared portion of the spectrum at a
wavelength of 10600 nm.
• Uses a mixture of carbon dioxide, nitrogen,
and helium as its medium.
• Excited by a high-voltage electrical current.
48. CARBON DIOXIDE LASERS
• Invisible, a red helium-neon laser is often used in
parallel, as an aiming beam.
• Chromophore that absorbs the carbon dioxide
wavelength is water
• The depth of penetration can be as shallow as 0.2 mm,
with very little scatter, reflection, or transmission.
49.
50. Advantages
of CO2 Laser
1. Sterile surgical field, bactericidal, viricidal
2. Minimal cicatrix formation
3. Access to difficult areas by reflection
4. Ability to coagulate, vaporize and incise
5. Good haemostasis
6. Reduced local tissue trauma and edema
7. Precise delivery of energy to diseased tissue
via microscopes
8. Reduced pain – neuron sealing, decreased
pain mediator release.
9. Minimized tumor cell dispersion by
lymphatic sealing.
55. ER: YAG LASERS
Erbium: YAG (Er:
YAG) laser
An active medium
of a solid crystal of
yttrium aluminium
garnet that is
doped with
erbium.
For facial
resurfacing
Incision and
ablation of soft
tissue.
The presumed
advantage of the
Er: YAG laser
system is its ability
to remove
superficial skin
layers
56. ER, Cr: YSGG
LASERS
• (Er,Cr):YSGG (yttrium scandium gallium garnet) laser -
(2.780nm).
• Active medium of a solid crystal of yttrium scandium
gallium garnet that is doped with erbium and chromium.
• There is absence of melting, charring and carbonization.
• Absorption in water is two to three times lower than
Er:YAG laser
• Thermal effects on the tissue are much higher if not
administered correctly.
• The erbium wavelengths have a high empathy for
hydroxyapatite and the highest absorption of water
compared to other dental laser wavelengths.
• This is the preferable laser for treatment of dental hard
tissue, but also, in contact mode with special surgical
tips, it can be used to cut soft tissues.
57. Benefits-
• Bactericidal effects, which can sterilize the area,
• Analgesic effect on the target tissues, similar to the Nd:YAG devices.
• Erbium laser energy applied to bone releases growth factors that enhance regeneration of
The difference between CO2 and Er:YAG laser lies in their differing absorption coefficients:
Er:YAG lasers are much more strongly absorbed in the water. On the other hand, CO2 lasers
show very high absorption on the tissue surface.
58.
59.
60. ARGON LASERS
• Delivers a green-blue light beam in the 488- or 514-nm range,
placed in the visible spectrum.
• Active medium -argon gas that is energized by a high-current
electrical discharge.
• It is fibre optically delivered with fibre diameter 300μm
in continuous wave and gated pulsed modes.
• Because the argon beam is highly absorbed by hemoglobin and
melanin, it has excellent hemostatic capabilities.
• Neither wavelength is well absorbed in dental hard tissues or
in water.
61. Argon LASER
These lasers are useful in the treatment of-
• pigmented lesions,
• vascular anomalies and
• soft tissue incisions and ablations.
62.
63. ND: YAG LASERS
• Geusic and coworkers in 1964, with
wavelength of 1064 nm
• A flashlamp used as energy source
• Nd: YAG penetrates water upto 6mm depth
before attenuated to 10% of its original
strength.
• Energy. scattered rather than absorbed.
• Uses
64. Excellent for the treatment of-
• vascular lesions
• intraoral and extraoral pigmented lesions
• achieving hemostasis.
• open TMJ arthroplasty,
• malignant lesion excision,
• black and blue tattoo pigment removal,
With ND: YAG laser procedures anesthesia is required in less than 50% of
cases.
65. KTP LASER
• This laser is a modified version of the
Nd: YAG laser.
• With the addition of a frequency-
doubling crystal, this laser emits
laser light at the 532-nm wavelength
• Uses
66.
67. DIODE LASER
• Wavelength - 800nm to 980nm, 1-10W power
• Light energy
• Employs a flexible optic fibre
• They run in either CW or pulsed mode.
• Diode laser is one of the most versatile possible treatments options.
68. In oral surgery, these machines can be used in numerous clinical procedures,
• soft tissue surgery,
• second stage implant recovery, in peri-implantitis,
• sub-gingival curettage etc.
ADVANTAGES-
• Disinfects the treated area.
• Ease of operation, due to the sub-millimetre dimension and their extreme
compactness.
69.
70. HOL: YAG LASER
THE HOLMIUM: YTTRIUM-ALUMINUM-
GARNET (HOL:YAG) LASER EMITS LASER
LIGHT AT 2140 NM
EXTENSIVELY USED IN ENDOSCOPIC
ORTHOPEDIC SURGERY.
IT IS ALSO EXTENSIVELY USED IN THE TMJ
FOR LYSIS OF ADHESIONS AND SCULPTING
OF FIBROCARTILAGINOUS DISK TISSUE.
71. Q-SWITCHED
RUBY LASER
• To treat some pigmented lesions
and tattoos effectively.
• The slightly longer wavelength
allows for greater depth of
penetration and is more effective in
the removal of deeper lesions
72. FLASHLAMP-PUMPED
PULSED DYE (FLPPD) LASER
• pigmented and hemopigmented
lesions, tattoo removal.
• scar revision,
• achieving hemostasis,
• photodynamic cancer therapy,
• ablation of salivary gland and kidney
stones,
73. COPPER VAPOR
LASER
• At wavelengths of 511 and 578
nm,
• used to ablate some pigmented
lesions such as lentigines,
ephelides, lentiginous nevi, and
tattoos
74.
75. • These lasers emit ultraviolet light at 193 to 351 nm,
• Active medium- Halide gas
• It is currently used for keratotomy to reshape corneal tissues and to
correct poor vision.
EXCIMER LASER
76. LASER SAFETY IN SURGERY AND ANESTHESIA
Personnel
safety
Drapes: Not
recomm
ended
Paper Plastic Recommend
ed
Cloth
saturate
d with
water
around
the field
Laser
resistant
drapes for
personnel,
anesthetic
circuit.
77.
78. • Class 1 : 1M
• Class 2: 2M
• Class 3R
• Class 3B
• Class 4
There is no such thing as an “eyesafe” Class 3b
or Class 4 laser!!!
79. • Class 1 : 1M
• Class 2: 2M
• Class 3R
• Class 3B
• Class 4
There is no such thing as an “eyesafe” Class 3b
or Class 4 laser!!!
80. • Field preparation
Alcohol as a part field is to be avoided
If not the alcohol should vaporize completely before draping.
Protection of patient’s throat and delicate oral tissues from accidental beam impact
Use of wet gauze packs or towels to avoid reflection from shiny metal surfaces
Adequate high speed evacuation should be used to capture laser plume, which is biohazard
• Specular reflection
The surgical beam should be tested for alignment prior to each use of the machine.
No instruments are passed across the intended path of laser.
LASER SAFETY IN SURGERY AND ANESTHESIA
81. Anesthetic agents
• Inflammable agents like ether and cyclopropane is absolutely
contraindicated in laser surgeries.
• Instead halothane, enflurane, isoflurane and sevoflurane
• If surgery along the airway – helium and oxygen can be used
83. Eye
• Retinal damage
• Even if eyes closed it can penetrate the eye lids
• Only normal saline is used to lubricate the eye,
petroleum based is avoided.
84. Skin
• Avoid alcohol preparation
• Hairs near the field can ignite. It can be kept
moist.
Teeth
• Etching and disfigurement of enamel
• Dental splints fabricated from laser resistant
material.
85. • Endotracheal tubes
Nonmetallic
• Red rubber, PVC, silicon – red rubber is overall better.
• Tubes wrapped with metallic foil – mucosal injury
• Wrapped with metallic tape of copper or silver.
• Silver anode sheet that has spongy water-absorbant material outside and adhesive inside
• Ceramic coated endotracheal tube by Xomed (Florida)
Metallic
• Norton and Devos endotracheal tubes , Porch tube are used through oropharynx or trachea.
• Cuffed metallic tubes are available.
• Water is injected in to the cuff to inflate
86. 1. Post signs that lasers are being used at all possible entry points
2. Eye shields must be worn by all personnel at all times
3. Safety shields must be used
4. A bucket of sterile water should be immediately available in the
operating room
5. Credentialing of surgeons for the use of each type of laser and
laser apparatus is needed.
6. Short bursts, intermittent lasing, and changing from area of the
lesion to other sequentially
7. Cooled irrigation to keep the tissues from heating
97. Applications in OMFS
• Gingivectomy.
• Frenectomy.
• Removal of granulation tissue.
• Removal of melanin pigmentation and metal tattoos.
• Subgingival debridement and curettage.
• Osseous recontouring as well as in implant surgery. Maintenance
of implants.
• Low Level Laser Therapy.
98. Soft Tissue Clinical Applications-
The most popular and effective lasers nowadays for soft tissue procedures are CO2, Nd:YAG
and Diode lasers.
There are many categories of soft tissue procedures that can be treated by lasers, such as
• de-epithelialization of reflected flaps,
• depigmentation,
• second stage exposure of dental implants,
• sub-gingival debridement curettage,
• incisional and excisional biopsies of both benign and malignant lesions,
• removal of granulation tissue,
• coagulation of free gingival graft donor site,
• irradiation of apthous ulcers,
• removal of diseased tissue around the implants etc.
99.
100. FACIAL SKIN RESURFACING
Indications:
1. Photo damage: Dyschromias & Rhytides
2. Atrophic (depressed) scars : Post acne
Chromophore: water
Mechanism: Thermal ablation of Epidermis
& papillary dermis
Lasers
a) Single pass CO2
b) Modulated Er : YAG
101.
102. VASCULAR LESIONS
Chromophore– Oxyhaemoglobin
Absorption wavelengths – 418, 542, 577 nm
Laser of Choice: FPPDL – wavelength – 585, 590, 595, 680 nm
Fluence –5-14 J/cm2
Spot Size – 2-10 mm
Density – Less than 10%
Pulse Duration: 1.5-40 milliseconds
Delay between pulses – 10-500 milliseconds
103.
104. • Commonly used is pulsed dye laser at 580 nm &short
pulses 450 microseconds
• Haemangiomas
• Venous malformations
Vascular lesions
116. Peripheral Ossifying Fibromas
These occurs solely on the soft tissue overlying the alveolar
process. It is a
common gingival growth that usually arises from the interdental
papilla.
These lesions can be effectively treated with Er,Cr:YSGG.
Iyer VH et al. reported that the outcome was painless experience to
the patient, minimal intraoperative bleeding in the surgical field
and excellent healing of the operated area in 1 week period.
Iyer VH, Sarkar S & Kailasam S (2012) Use of the Er,Cr:YSGG Laser in the Treatment of Peripheral
Ossifying Fibroma. International Jour-nal of Laser Dentistry 2, 51-55.
117. Denture-induced fibrous hyperplasia
This is a response of tissues to a chronically ill fitting denture and present as
a benign condition which frequently coexists with denture stomatitis.
Kumar NJ et al. successfully treated the case of denture induced fibrous
hyperplasia with the help of carbon dioxide laser and concluded that CO2
lasers could be an excellent alternative to conventional modalities.
Kumar NJ & Bhaskaran M (2007) Denture-induced fibrous hyperplas-ia:treatment with carbon
dioxide laser and a two year follow-up. I Journal of Dental Research 18, 135-7e.
118. Mucoceles
These are benign lesions of the oral cavity that develop due to extravasation or
retention of mucous from salivary glands in the subepithelial tissue generally in
response to trauma.
Pedron IJ et al. on the basis of findings of their study concluded that laser
treatment provides satisfactory results and allowed for a satisfactory
histopathological examination of the excised tissue in case of mucocele.
Pedron IG, Galletta VC, (2010) Treatment of mucocele of the lower lip with diode laser in pediatric
patients: presentation of 2 clinical cases. Pediatric Dentistry 32, 539-41.
119. Hemangiomas
These are benign vascular proliferations consisting of numerous capillary
structures usually present on the tongue, lips, mucous membrane and
gingiva.
Genovese WJ et al concluded that application of gallium arsenide (GaAs) have
high potency diode laser in the treatment of hemangionma reduced bleeding
during excisional surgery, with a consequent reduction in operating time and
promoted rapid postoperative hemostasis.
Apfelberg DB et al recommended the laser treatment for excisional surgery of
hemangioma.
Genovese WJ, dos Santos MT,Faloppa F & de Souza Merli LA (2010) the use of surgical diode laser in
oral hemangioma: a case re-port. Photomedicine and Laser Surgery 28,147-51.
Apfelberg DB, Maser MR, Lash H & White DN (1985) Benefits of the CO2 laser in oral hemangioma
excision. Plastic and Reconstruc-tive Surgery 75, 46-50.
120. Lymphangioma
It is often asymptomatic and a slow growing
painless cystic mass covered by healthy mucosa.
Despite being a congenital benign lesion,
lymphangioma may cause severe esthetic
deformities, and surgical excision is the main
treatment.
Dos Santos et al reported that the use of CO2 laser
was practical, easy to carry out and effective on
the treatment of oral lymphangiomas, with no
lesion recurrence.
dos Santos Aciole GT, Santos NRS, (2010) Surgical Treatment of Oral Lymphangiomas with CO2 Laser:
Report of Two Uncommon Cases. Brazilian Dental Journal 21,365-9.
121. Premalignant and malignant lesions
Laser resection/ablation is recommended for oral dysplasia to prevent not only
recurrence and malignant transformation but also postoperative oral
encountered by other conventional modalities.
Van der Hem PS et al concluded that leukoplakia or hyperkeratotic lesions
cryotherapy ablation and CO2 laser is used and the operated area heals
This is an effective, non- morbid, inexpensive, quick, and relatively painless
method of managing such condition.
Kok & Ong concluded that the use of CO2 laser in the treatment of oral lichen
planus and lichenoid reaction shows positive results in relieving symptoms.
Van der Hem PS, Nauta JM, van der Wal JE & Roodenburg JL (2005) the results of CO2 laser surgery in
patients with oral leukoplakia: a 25 year follow up. Oral Oncology 41, 31-7.
Kok TC & Ong ST (2001) the effects of CO2 lasers on oral lichen planus and lichenoid reactions. Annals
of Dentistry University of Maaya 8, 35-42.
126. Infectious lesions
Erbium laser may be used for ablation or decontamination of infective lesions.
Lasers are used in treatment of herpetic, candidiasis, and papilloma virus
lesions.
Gaeta GM (2013) laser treatment in medicine and oral pathology.
Http://www.Giovannimariagaeta.It/laser %20book%202010.Pdf
127. Dentigerous cysts
These are benign odontogenic cysts associated with the crown of
an unerupted tooth. They can expand the cortical bone and cause
displacement of teeth and root resorption in the adjacent teeth.
Boj JR treated a case of dentigerous cyst by preparation of mucous
fenestration using an erbium laser followed by drainage of the fluid
content and curettage and the injury was success-fully resolved.
Boj JR, Poirier C (2007) Laser-assisted treatment of a dentigerous cyst: case report. Ped dent 29, 521-4.
128. Cancer
The CO2 laser currently has the greatest significance in otorhinolaryngology,
predominantly in the treatment of carcinomas of the upper aerodigestive tract.
The neoplastic cells can be removed by hyperthermic (cells are destroyed by
laser heat or photodynamic combination of special photosensitive drug with
specific type of laser) methods.
López-Álvarez F,Rodrigo JP,(2011) Transoral laser microsurgery in advanced carcinomas of larynx
and pharynx. Acta Otorrinolaringológica Española 62, 95-102.
133. Hard Tissue Clinical Applications
• removal of impacted teeth under bone,
• apicoectomies,
• osseous re-contouring,
• implant and bone osteotomies,
• bone grafting,
• jaw continuity defects,
• removal of inflammatory tissues around implants,
• crown lengthening,
• uncovering of permanent teeth for orthodontic purposes etc.
Erbium (Er) family of lasers can be the lasers of choice.
Er lasers use extremely short pulse durations and can easily ablate layers
of calcified tissue with minimal thermal effects.
134. Hard Tissue Clinical Applications
Prevention of caries
Detection of incipient caries
Cavity preparation
Enamel etching
Desensitization
135. Hard Tissue Clinical Applications
Bleaching/ fluorosis
t/t of fractured tooth
Pulpotomy
Removal of old restoration-gold, ceramic
Root canal therapy
Temporomandibular Joint Treatment: reduce pain and
141. • Photodynamic therapy (PTD) is
currently being evaluated for the
treatment of head and neck, skin, intra-
abdominal, and other types of cancers.
• carbon dioxide laser and other lasers
have also been used in the micro
anastomosis of nerve and vascular tissue
with some success.
142.
143.
144.
145.
146. CONCLUSION
Lasers - alternative to conventional surgical systems
Lasers are a “new and different scalpel” (optical knife, light
scalpel)
The application of lasers has been recognized as an adjunctive or
alternative approach in soft tissue surgeries. Laser treatments
have been shown to be superior to conventional mechanical
approaches with regard to easy ablation, decontamination and
hemostasis, as well as less surgical and postoperative pain in soft
tissue management.
147. REFERENCES
1. Fonseca, oral and maxillofacial surgery, vol. 1
2. Clinics of North America, LASERS in OMFS, vol.16, May2004
3. Fundamentals of LASER dentistry, Kripa Johar
4. Theodoros Tachmatzidis, Nikolaos Dabarakis ,Technology of Lasers and
Their Applications in Oral Surgery: Literature Review, BALKAN
JOURNAL OF DENTAL MEDICINE ISSN 2335-0245
5. Dragana Gabrić, Advanced Applications of the Er:YAG Laser in Oral and
Maxillofacial Surgery, A Textbook of Advanced Oral and Maxillofacial
Surgery Volume 2, chapter 34