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Lasers: Revolution in orthodontics: the laser

For many a reason it is considered one of the most important inventions of the XX century. The orthodontic laser is a medical tool that generates a highly concentrated beam of light. The beam sterilises the target-area and at the same time coagulates the blood vessels thereby reducing the risk of infection or bleeding. Results: dental visits become much more relaxing, and in most cases there is no need of anesthesia. Some procedures can be carried out at a fraction of the time required by the same intervention without laser, with evident benefits on the duration of “dentist-chair-time”. Laser efficiency is based on absorption peak rates of the materials contained in the target-area (hard or soft) and of other dental materials (for example haemoglobin, water, hydro peroxide, etc.) of a single wave length. The optimal energy is provided with the least possible emission, based on the single and unique absorption characteristics of the wave lengths. Some of these wave lengths have an affinity with water and with red pigmentations, which is why they are precisely efficient for the soft tissues of the buccal cavity.

Practical application: interaction with the oral cavity tissues.

There are four possible interactions when the laser comes into contact with the dental tissues: reflection, absorption, transmission and scattering. Reflection occurs when the laser light reflects the dental tissue; with absorption, the laser energy is absorbed thus beginning treatment (vaporisation, ablation, coagulation, etc.); transmission is a process in which the laser's energy is directly transferred through the tissue, usually without any effect, and instead when laser energy comes into contact with the tissue, hence expanding and dividing in a greater area, we are speaking of scattering.

Stop with the drill, against caries there is now a painless laser

The old, terrible drill is now retiring, as is the long and fearsome needle used to inject anaesthetic into the gums. Thanks to technology the dentist is now a friend that no longer is scary.

To cure cavities (caries) there is now the erbium laser. It is a tool, born in military ambit for intelligent missile guidance systems and satellite defence, that has found a wonderful application in daily life. It allows the exportation of ruined dental enamel without harming the healthy part of the tooth.

The laser eliminates only the ill part by concentrating upon it a thin beam of light of variable commanded intensity. The cavity is eliminated by a storm of micro explosions that remodel the tooth surface. The patient will only feel a slight tingle, but not the slightest pain. On the contrary, the hated drill of ancient memory had to dig holes and spaces in order to prepare room for the filling. Today this invasive and loathsome procedure is substituted by the laser which automatically executes preparations without harming the healthy tissue. It allows much smaller fillings in respect of the tooth. In this way we avoid the many devitilisations that were once necessary.

However the magic, if we can in this way define that which is science, is that the tooth does not perceive the laser treatment. Even in the case of important caries it is possible to export the decayed tissue and insert the new aesthetic filling without having to inject anaesthetics and without pain. All of this allows a better time management, hence allowing more fillings to be carried out in the same session.

The dental surface treated with the laser also presents a particular crater like structure that allows an optimum adhesion of the new aesthetic materials. In the many niches present on the tooth's surface it is possible to apply a layer of highly fluid resin on which the new filling can be glued. Its adhesive power will not render likely filling break or loss.

The laser in dental implants

In dental implants the laser can help to decontaminate the sites where bacteria may deposit, and helps activate the healing process. It seems to be particularly efficient in post-extraction implants with immediate loading. That is, when a new tooth is to be inserted over a titanium root soon after having extracted the damaged dental root. Practically speaking, the ill or fractured tooth is extracted and the empty alveolar bone space is decontaminated by laser. Thus, the new implant and the new tooth are inserted. This way an immediate aesthetic and masticatory ability is regained in the same day. Let's remember however that whatever tool is only an aide in the hands of a doctor who must be able to explain to the patient the limits, the possibilities, and the correct applications. No intervention for as innovative as it may be must give way to the hope of a “miracle”: a deep and trusting relationship between patient and dentist constitutes the basis of a good cure.

last update: 21 January 2008

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