Laser Assisted Dentistry

Lasers have been used successfully in medicine and dentistry for many years. The important thing is to use the laser that is suitable for the procedure to be performed, the tissue to be treated and that the physician using it has sufficient knowledge about lasers.

Two main laser groups are generally used in dentistry.

The first is the Erbium group lasers, also known as hard tissue lasers, which allow cutting hard tissue, i.e. bone and tooth.

The second group can be broadly classified as soft tissue lasers. The most commonly used lasers in this group are Diode and Nd:YAG lasers. With lasers in this group, procedures such as gingival treatments, disinfection of root canals, surgeries involving soft tissue, biostimulation, elimination of joint disorders and whitening can be performed.

We can summarize the treatments that can be performed with lasers used in dentistry under the following headings;

Laser Assisted Filling

Laser Assisted Gum Treatment

Laser Assisted Soft Tissue Surgery

Laser Assisted Whitening

Laser Assisted Joint Treatment

Laser Assisted Filling Unfortunately, the blue UV light that hardens composite or white fillings can be confused with dental lasers. Contrary to popular belief, Erbium lasers used to remove hard tissue work with water and air and are invisible to the eye. Erbium lasers have been found clinically advantageous in studies, especially in roughening tooth tissue and long-term filling success. It is possible to perform caries removal using hard tissue lasers.

Due to the characteristics of the laser, only the carious tissue can be cleaned without removing the healthy tissue. Since the decay can be removed without anesthesia, it can be preferred in patients with anesthesia allergies, pregnant women and children. However, it is not possible to clean amalgam fillings with lasers. They need to be removed conventionally.

In addition, in tooth fractures that may develop due to falls and accidents, if the broken piece is stored under appropriate conditions and delivered to the physician quickly; It can also be used to roughen and bond both the tooth and the broken piece with the laser.

(*Sources: Analysis of Surface Roughness of Enamel and Dentin after Er,Cr:YSGG Laser Irradiation Hossain, M., Nakamura, Y., Yamada, Y., Suzuki, N., Murakami, Y. and Matsumoto, K. Journal of Clinical Laser Medicine & Surgery Vol. 19(6), pp. 297-303, Microleakage of composite resin restorations in cervical cavities prepared by Er,Cr:YSGG laser radiation Shahabi, S., Ebrahimpour, L. and Walsh, L.J. Australian Dental Journal Vol. 53(2), pp. 172-175, Case report: laser-assisted rebonding of a central incisor tooth due to a severe trauma - 4 years of follow-up. BERK N., BERK G., Uluçam S. Eur Arch Paediatr Dent. 2011 Apr;12(2):96-9.)

Laser Assisted Gum Treatment

During gingival treatments, in addition to conventional treatments, hard and/or soft tissue lasers can be used depending on the patient's condition. In studies, Erbium lasers have been found to be very successful, especially in the treatment of root surfaces. Diode and Nd:YAG lasers have been used successfully for many years for the elimination of bacteria in the gingival pocket.

Erbium lasers can also be used in addition to conventional surgery in the treatment of infected implants.

(*Source: Evaluation of Contaminated Implant Surfaces Irradiated by Er,Cr:YSGG Laser. BERK G, Franzen R, Atici K, Hakkı SS, BERK N, Gutknecht N. The Journal of Implant and Advanced Clinical Dentistry, April 2013; Vol. 5 No.4: 19-26., Comparison of Er,Cr:YSGG laser and hand instrumentation on the attachment of periodontal ligament fibroblasts to periodontally diseased root surfaces: an in vitro study. Hakki SS, Korkusuz P, BERK G, Dundar N, Saglam M, Bozkurt B, Purali N. J Periodontol. Aug 2010; 81(8):1216-25., Treatment of periodontal pockets with a diode laser. Moritz A, et al. Lasers in Surgery and Medicine 1998;22(5): 302-11)

Laser Assisted Soft Tissue Surgeries

Depending on the type of treatment to be performed, hard or soft tissue lasers may be preferred. While anesthesia is not required in soft tissue surgeries performed with hard tissue lasers, anesthesia is required in the majority of surgeries to be performed with soft tissue lasers.

Surgically;

Dark gums can be treated by depigmentation procedure

Gingival levels can be aesthetically corrected

Enlarged or irregular gums can be corrected

Lip and tongue ligaments can be cut (frenectomy)

Pregnancy tumors can be surgically removed

(*Source: Treatment of Gingival Pigmentation with Er,Cr:YSGG Laser. BERK G., Atıcı K., BERK N. J Oral Laser Applications 2005; 5: 249-253., Treatment of Gingival Hyper-Pigmentation with the Er,Cr:YSGG laser. Clinical observation and one-year follow-up. BERK G., Atici K, BERK N. International Magazine of Laser Dentistry, 2011; Vol.3 Issue 4: 6-8., Er,Cr:YSGG laser labial frenectomy: a clinical retrospective evaluation of 156 consecutive cases. Olivi, G., et al., Gen Dent. 2010 May-Jun;58(3):e126-33)

Laser Assisted Whitening/Bleaching

It is a bleaching method using a laser instead of the UV light source used in conventional bleaching techniques. The bleaching gel developed for use with the laser is activated by the laser light and can provide whitening faster than conventional methods. However, the success of the treatment varies from patient to patient as in every method.

(*Source: Efficacy of diode laser irradiation during dental bleaching in preventing enamel damage caused by bleaching. Azarbayjani et. al., Dent Res J (Isfahan). 2018 Sep-Oct; 15(5): 320–326.)

Laser Assisted Temporomandibular Joint Treatment

In addition to splints and appliances used in the treatment of temporomandibular joint disorders; Diode lasers are used to accelerate healing in the region, reduce swelling and pain and reduce muscle spasm. In studies, it has been found to be effective in correcting the mouth opening and relieving pain due to joint discomfort.

With the same method, diode lasers can be used to reduce temporary pain in the joint following prolonged dental treatments.

Laser Assisted Dentistry

Treatments