أقلام طبيةحدث طبي

د.وفاء السنيدار/ طبيبة أسنان… Laser in Dentistry

الرعاية الصحية | أقلام طبية 

Laser is an acronym for light amplification by stimulated emission of radiation.
Also can be described as advice for generating a light- intensity; ostensibly parallel beam of monochromatic (single wavelength) electromagnetic radiation.
Laser light can be foused down to a tiny spot assmall as a single wavelength.

*There are three types of dental lasers :

1- surgical laser( soft tissue): this laser replaces traditional surgery for many gum and soft tissue and use for improve treatment results for gum disease; contour gum for smile disease ; surgically correct abnormalities; assist in biopsies; surgical in arresting lesions and canker sores and treat frenum problems

2-curing laser: this laser spectrum light source is used for rapid teeth whitening and placing all tooth colored restorations(fillings) and repair procedures.

3-tooth laser ( hard tissue)/ Thermic laser: this type is used to remove cavities but since this laser cannot be used on existing metal filling, we use micro dentistry.

MICRO DENTISTRY: one of the greatest advancements in the filed of a dentistry. It is also the most tooth conservative dentistry available. About 50% of cavities are candidates for this technique and there is no drilling, no needle, no extra fee, and no pain.

DIAGNOdent Caries Detector: The DIAGNOdent can find cavities that other dental instruments can miss.

Key benefits: A laser examination tool for the early detection of caries, even very small lesions can be detected at the earliest stages.

Most Commonly Used Laser in Dentistry:

1-Co2 laser: wavelength(10,600nm) first laser used routinely for soft tissue in dentistry. Will be absorbed in the water part of all soft tissues. This laser suitable for application of teeth (sealing of pits and fissures , welding of ceramic material to enamel and prevention of dental caries).

2- Er : YAG laser: wavelength(2940nm) coincides with the absorption peak of water. With this laser ,minimal thermal damage to dentin and removed infected and softened carious dentin to the same degree as the bur treatment also application this laser for removal of dental fillings( composite and GIC) but cannot removal of amalgam or gold and ceramic fillings.

3- ND : YAG laser: wavelength(1045nm) solid medium , a crystal of yttrium – aluminum and garnet doped with neodymium so readily absorbed in blood and tissue pigment. These instruments are ideal both for the treatment of periodontitis and for excision of vascularized lesion.

4- HO : YAG: wavelength(2120nm) a crystal of yttrium –aluminum garnet doped with holmium. This laser high affinity to H2O absorption by soft tissue and frequently used for arthroscopy in TMJ.

5- Argon laser: wavelength(488nm and 514nm)peak absorption in red pigments and tissues with abundance Hb , hemosiderin and melanin so specific uses with root planning and curettage and gingival retraction.

Effects the laser on hard tissues:

1-microcracks and zone of necrosis. 2-carbonization. 3- cracks on enamel. 4-microhardness of dentin increases. 5- organic matrix burns off. 6-crystalline structure of HA changes. 7-transformation of apatite to tricalcium phosphate. 8-inhibition of enamel subsurface demineralization ( prevention of dental caries { Yamamoto and Ooya,1974} ).

Effects the laser on dental pulp

Recent evidence suggests that a normal odontoblastic layer, stoma and viable epithelial root sheath can be retained following laser radiation provided damage threshold energy densities are not exceeded i.e. <60 J/cm2 (Abt el at,1992). If pulp temp > 5 c , odontoblastic layer may not be present. Continuous wave – pulpal necrosis , but pulsed mode may result in new dentin formation (Melcar et al, 1987)

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