Laser treatment is becoming widely recognised and can be applied to prevent caries from developing and to reduce the progression of caries. The mechanism of laser should be understood before a dentist could apply in his daily practice.
The Enamel surface of tooth is made of crystals called ‘Hydroxyapetite’ and it is permeable in nature therefore, allowing diffusion of ions. During laser treatment, moderate heat(CO2 laser produces temp > 1000 degree celcius) is produced which changes the composition of Enamel from ‘hydroxyapetite’ to ‘carbonated apetite’ in which there is loss of water in the crystals, as a result the pores of Enamel shrink down to form ‘Microspace system’.
The Microspace system provides a means for trapping Calcium, phosphate and fluoride ions which release during demineralization and acts as site for re-precipitation. The trapped minerals phases inside the Enamel and impedes lesion formation and progression causing enhanced resistance against demineralization. As the microspaces are smaller in size, it decreases the permeability of the Enamel thereby reducing the diffusion of ions in and out thereby reducing the demineralization process. Thus a seal is achieved and so is resistance to caries.
The Dentin also gets acid resistance as there is increased mineral content due to burning of organic matter from tissue so there is increased Calcium and Phosphate found in recrystallized Dentin.
LASERS IN ENDODONTICS
Endodontic procedure carried out by conventional methods may not be successful in spite of utmost care. Despite the mechanical removal, irrigation and disinfection of canals, the bacteria can still persist which cannot be reached by conventional techniques. As the technology has advanced, now lasers are used in endodontic procedures to improve the prognosis of the treatment of tooth. Laser light penetrates upto >1000 micrometre into the dentin and provides a distinct advantage since the bacteria can immigrate upto 1000 micrometre into tubules. When in contact with laser, cell membrane gets destroyed due to the impact of direct heat and this damage is enough to stop the growth of the bacteria depending on the wavelength and frequency of laser irradiation used by the dentist. It is a very effective tool for disinfecting the root canal after mechanical root canal treatment as it has sufficient penetration depth.
It is effective in curved canals also and the energy is transported by thin flexible fibres which have diameter of only 200 micrometer. Laser eradicates the microbial flora of root canal and also has same effect on surrounding dentin without affecting the surrounding tissue and has good disinfection mechanism without causing pain and improving the prognosis of the endodontic treatment.
LASERS IN ORAL AND MAXILLOFACIAL SURGERY
Lasers have played an integral part in the evolution of practice of oral and maxillo-facial surgery as the procedures can be executed efficiently with less complication. There are many advantages such as :-
Maintenance of sterile condition.
Precise and accurate
Decreased post-operative swelling
Improved tissue scarring and healing
Less instruments needed
Less cost, staff and time
Laser in Implant (Peri-implantitis)
Laser makes it possible to remove diseased tissue around a dental implant without causing any significant harm to the healthy tissue. It is gentle, reducing inflammation and discomfort while encouraging new bone growth to reinforce and save your implant.
Cosmetic facial Laser surgery
Laser is used to treat facial lesions and skin wrinkles by removing the surface layer of skin allowing the underlying skin to re-epithilialize in a uniform manner. E.g. tissue tags, epidermal nevi, lentigines, superficial pigmentation, skin wrinkles, scar revision, melisma etc.
‘Laser’ in routine dentistry
Frenectomy and Ankyloglossia
- Laser assisted Biopsy