Diode laser in dentistry. Laser in dentistry. Lasers and laser systems in dentistry: description, classification and characteristics

S.I. Drawn, professor, doctor of medical sciences,
O.N.Risovannaya, professor, doctor of medical sciences

What is happening in laser dentistry today?

The most important thing that has happened in recent years is that the laser has ceased to be an “expensive toy” for dentists. In principle, there have been no major changes in technical terms in recent years, simply because it is a well-established, proven and proven technology that has proven its effectiveness. It became clear not today and not yesterday.

What was really lacking in laser dentistry was that it was taken seriously by dentists. And it seems that this milestone has been overcome.

There are several types of lasers currently in use in dentistry.

We will look at two of them:

Erbium laser- work on hard tissues. This type of laser is widely used in the preparation of a cavity for a filling, making it possible to practically avoid the work of a drill machine. It is perfect for working on the bone - if there is an inflammatory process, with the help of an erbium laser, you can remove the granulations that are on the bone.

diode laser who found in dentistry the most wide application(including because of its affordable price). This is, first of all, a laser for soft tissues, in addition, it can be used as an endodontic laser - it can be used to sterilize canals, seal dentinal tubules. In addition, it can be used for teeth whitening.

Also grows in recent times the popularity of systems that allow BTS therapy- for disinfection of dentinal tubules of teeth, in which there are large inflammatory processes.

As for the appearance universal laser for all types of interventions, it is hardly possible. Dentistry, unlike, for example, cosmetology, which works with a homogeneous tissue, is forced to work with all types of tissues - muscles, fat, bone (of different types), enamel, dentin, blood vessels, and mucous membranes. There is no single tool that equally affected all these heterogeneous structures. In this way, dentistry is radically different from other types of medicine.

The laser was originally designed to selectively affect one type of tissue. Therefore, one type of laser is needed to work on the bone, another for soft tissue rich in blood vessels, and a third for whitening enamel. Therefore, there is no need to wait for a universal laser for dentistry ...

Clinical case No. 1.
Laser frenulectomy

Low attached massive frenulum of the upper lip

Condition after laser frenuectomy

Soft tissues before fixation of orthopedic constructions

The final stage of orthopedic treatment 10 days after frenulectomy

What about the popular belief that lasers are very traumatic?

You have to be able to work with any tool. Both a scalpel and a bur can cause damage, but no one says because of this that this is a traumatic tool and not applicable in dentistry.

For example, if you learn not to injure tissues with a diode laser (and it really causes serious damage if used ineptly), then they can work very effectively. Like any tool...

Although there is no need to go to the other extreme and try to do everything with a laser without regard to the readings.

For example, we believe that it is really easier to perform large operations with a scalpel. Why? Because there is a thermal necrosis, and then a thermal rehabilitation later. In addition, it is no secret that surgeons are more accustomed to trusting the scalpel than the laser. A scalpel is an incision, then the wound is connected and grows together, and a laser wound is, in addition to the incision, also the distance between the flaps.

I repeat once again - you need to work according to the indications, understanding well in which situation which tool is better.

Then the natural question is - in what situation is the laser better? What is the decisive factor: laser or traditional means?

Decisive factor

If you need to perform a standard operation, for example, the installation of implants, of course, you take a scalpel, a dental unit with cooling in your hands and work according to the traditional scheme: folding the bone flap, working on the bone, placing the implant, suturing, etc.

If, for example, you have an epole, an overgrowth of soft tissue between the teeth, an enlarged, inflamed dental papilla, then what to work with if not with a laser?

Yes, you can use a scalpel. But… if there is hypertrophy of soft tissues, an increase in soft tissues under prostheses, prosthetic stomatitis - what, will you cut this section of the mucosa with a scalpel?! Then wait until he heals by secondary intention, and the patient will not use the prosthesis all this time? Or cut out the flap and sew?

In general, the use of a laser is indicated if there is an inflammatory component. The laser works, we will say so - cleaner. If you make an incision in tissues where there is inflammation, bleeding occurs. The laser has the ability to coagulate blood vessels (CO2) and is an excellent hemostat, sealing vessels up to 0.3 mm in diameter.

An excellent indication for laser work is the tongue and lips in children. A few minutes after the completion of the operation of removing the frenulum of the tongue, the children begin to say the letter "r". This cannot be achieved with a scalpel. There is no blood, no needles, no flap retraction, no relapses either.

In general, pediatrics is, unambiguously, only lasers. Everything related to pediatric dentistry, including preparation, all operations on soft tissues From my point of view, it should be done with a laser.
Children perceive the laser as a toy, they are completely stress-free, they are even interested in it, everything goes very quickly and beautifully.

The same is the preparation of milk teeth. Mostly children come to our clinic who have already gone through "all the circles of hell" - they already come with a phobia and are really afraid of everything related to dentistry.

The laser is excellent for lengthening clinical crowns. With its help, the required height of the clinical crown is modeled and impressions can be taken immediately. With a carbon dioxide laser, I remove soft tissues, with a bur (or using an erbium laser) I remove the bone around the tooth, increase clinical crown, and that's it - I can prosthetize. The final contour of the gums is also immediately set by the laser.

In our clinic, very few teeth are removed due to the fact that indications for prosthetics are expanding, very rarely teeth are removed for endodontic indications. Cause? We have two big advantages: the 980 nm diode laser, which sterilizes the canal due to the thermal factor and penetration depth, and the 662 mm diode laser, which performs photodynamic therapy, which ensures complete sterilization of all dentinal tubules to a depth 100 microns, (this is where endodontic pathogens lie, and this is where singlet oxygen occurs, which destroys them). Therefore, there is little work for surgeons in our clinic ...

And, of course, the laser definitely expands the readings. For example, there are contraindications to many surgical procedures: hypertension, diabetes mellitus, thyroid disease. When we use a laser, these contraindications do not in any way prevent us from finishing the job.

All questions have an answer. Hypertonic disease? Excellent coagulation properties of laser radiation Diabetes? Excellent biostimulating effect. Thyroid disease? The level of osteocalcin after laser exposure increases by 62%. In fact, this is the treatment of general somatic diseases due to the fact that dental manipulations are performed with a laser.

The laser is an excellent biostimulant and has a noticeable biostimulating effect. This has been proven - both in our works and in the works of foreign authors. CO2 laser, erbium laser, diode laser - they all have a biostimulating effect. We compared laser wounds and scalpel wounds - a laser wound heals several days faster than a scalpel wound.

And, of course, an important advantage of the laser is the great aesthetics of the manipulations carried out in the oral cavity. None at all scar tissue, it is simply not visible, we can form a papilla, carry out gingivoplastic manipulations that cannot be performed with any traditional tools: neither with a scalpel, nor with a drill, nor with thermo- or electrocoagulators - nothing. With a laser, the aesthetics come out great.

In addition, with the development of laser technology, the list of what can generally be done is expanding. So, no one in dentistry has ever talked about peeling before (such a concept is not used at all in dentistry) - now layer-by-layer removal of the mucous membrane to a depth of 0.4 mm is possible.

Or, for example, laser depigmentation. Pigments that exist on the gum can now be removed with a laser.

Or laser whitening teeth - deep enough whitening that does not injure the enamel in any way, which even strengthens the enamel and improves its structure. The use of hardware and home whitening leads to hypersensitivity. There is no hypersensitivity after the laser.

Those are the decisive factors. There are no miracles, the laser is not a universal substitute for traditional tools. But there are situations (and there are many of them) when the laser provides a lot of advantages. It is important to understand when it is indicated, and, of course, to be able to take advantage of these benefits.

Clinical case #2

Caries of the vestibular surface of the 11th and 21st teeth and the distal surface of the 11th tooth in a 12-year-old child

View of laser-prepared surfaces

Completed restoration

You mentioned the use of a laser in endodontics to sterilize root canals…

Yes, it's a wonderful and well-functioning technology.

Introduced into the channel special composition, a sensor that is then activated with a specific wavelength of laser light. In this case, singlent oxygen is released, which breaks the shell of the microbial cell. When the laser operates in a pulsed mode, it becomes possible to damage the microbial membrane of endodontic pathogenic microflora. According to the literature data, it has a very thick, simple microbial shell, which cannot be penetrated in a constant mode, but in a pulsed mode with the help of a sensor, it is destroyed, as well as the existing biofilm.

And when working in a pulsed mode, there is no increase in temperature?

No, when operating in a pulsed mode, the temperature, on the contrary, decreases, this was proved in my doctoral dissertation. We conducted thermal studies using thermocouples, on animals - the temperature decreases when any laser operates in a pulsed mode. Moreover, when we conduct BTS therapy, we try to do it without anesthesia, so that there is adequate control between the patient and the doctor. It should not hurt, because if pain sensitivity occurs, then tissue overheats, and overheating of more than 42 degrees leads to coagulation. That is, if the doctor does not know this and works under anesthesia, then he can get tissue overheating, necrosis and complications from working with a laser. And this is one of the problems that novice doctors may encounter.

So we come to the problem of overheating and carbonation (and the associated poor healing), which scares many specialists away from lasers ...

You must immediately understand that if carbonization occurs, then the doctor has a problem. Its formation should not be allowed, if it occurs, then the laser does not work in the mode in which it is necessary, this is already a violation of technology. It is necessary to reduce the laser power in order to remove the primary carbonized layer that occurs when working with a laser. If this is not done and the wound is left with black patches of burnt tissue - how can the wound heal? How can it epithelize, how can it quickly recover? Of course not.

If, nevertheless, the doctor allowed carbonization, you must first remove the charred tissue. By the way, this is easy to do with a swab, saline and hydrogen peroxide.

No overheating and thermal necrosis of tissues during correct work laser does not occur, because the depth of absorption of CO2 laser radiation is 0.4 mm - only to this depth does the laser beam penetrate into the tissue. That is, below 0.4 mm, neither overheating nor tissue damage occurs. Need more in-depth processing? Work "in layers", as when applying a composite, but in no case increase the power - then both overheating and carbonization are provided.

If everything is done correctly, then this problem does not arise. Overheating and thermal necrosis are myths cultivated by those "specialists" who simply do not know how to work with a laser.

Principle of photoactivated disinfection

Interaction of photosensitizer with microbial cells

Singlent oxygen formation

Lack of microflora at the end of the procedure

Clinical Case #3

Intracanal administration of a photosensitizer

FAD using a light guide for endodontic treatment

X-ray 47th tooth. Chronic granulomatous periodontitis

X-ray of the 47th tooth 6 months after FAD

X-ray of the 47th tooth 2 years after FAD

What about contraindications to the use of a laser? They are?

They are not here. The only limitation is that I would not use lasers for oncology, because the biostimulating effect that it has on the body extends to the tumor.

However, I am not talking about precancerous conditions and benign formations. It is possible to work with leukoplakia with a laser, with excision of fibroids in the oral cavity too.

Fortunately, our patients did not meet oncological patients, and for us this is a theoretical contraindication. in practice, we do not refuse laser treatment to any of our patients.

What prevents the widespread introduction of lasers into daily practice?

Definitely - there is not enough more affordable price. If the price were lower, the laser would be in every dental office.

The ignorance of both doctors and, of course, the population, what laser technologies are and what their capabilities are, is very hampering.

It also happens that an educated patient comes to the clinic to do laser vestibuloplasty, and he is told that this is impossible, simply because they do not have a suitable tool at their disposal. And the method is being discredited...

Neither the population nor doctors still differentiate that lasers are different - for soft and hard tissues, high-energy and "soft" therapeutic, and each of them does its job. How to solve this issue? Obviously, through the training of doctors, who are still very poorly versed in the issue and cannot adequately answer patients' questions.

In general, laser education is a rather painful topic. You should not start working on this device without at least a short-term training course. Very much so that lasers are sold along with training. I don’t know who this question is for - manufacturers or dealers, but this is very, very important ...

Any device you need to learn how to use. You cannot sit on a bicycle and ride if you saw it for the first time. And with a drill, when it is picked up for the first time, with great difficulty it will be possible to prepare a tooth. Similarly, laser technology requires a learning curve. Some have it shorter, some have longer, but there must be a learning curve with laser technology.

But the basic manual and theoretical knowledge of the average doctor allows him to work with lasers?

They allow, although they require the adaptation of manual skills, especially when working in a non-contact mode.

The problem is different - the laser is fundamentally different from all other devices and tools that we use. All other tools provide visualization - what we do is what we see. And the laser, in addition to visual changes, also has changes that we cannot see - this concerns the biostimulating effect and photothermal deep penetration. Most likely, for this reason, doctors are afraid to use a laser - they do not see the second part of its effect on biological tissue, and in order to understand what it is, training and self-education is necessary.

This is especially important for maintaining the temperature regime.

It is very easy to cross the border of 42 degrees - protein coagulation temperature - by working with a laser during anesthesia. Therefore, 10 years ago there were several publications that said that laser technologies are harmful, great discomfort for the patient due to burns, osteomelitis, etc.

In 12 years of working with a laser, I have not seen a single burn, not a single complication that would be caused by a laser. But for this you need to understand how the technology works and be aware of where the limit is. If there is such an understanding, there will be no problems. If it is not, then it is really better for such a specialist to do without a laser.

And what will be the resume? Has laser technology reached a level where it is available to the “mass dentist”?

The laser is a powerful and wonderful tool that allows you to raise the quality of treatment to new heights, but for it, like for any other tool in the dentist, you also need a clear head.

Understanding of processes and quality training is a must. On the this moment- this is the most important question, all other problems are generally solved.

Another point that theoretically should increase the attractiveness of laser dentistry is the emergence of affordable “non-erbium” systems of a new generation (more on this in the next DM issue - ed. note), which allow using one device to work with 4 areas at once - cosmetology, endodontics, whitening and surgery. In this sense, progress does not stand still, and laser dentistry has every chance to successfully develop further. But still primary. human factor- knowledge, skills and abilities of a dentist. And, you see, this is quite good ...

In addition to its other advantages, the laser is a great marketing tool. The flow of patients who come to the clinic "for a laser" has already been formed. This is already a reality. In today's difficult times, when attracting patients is sometimes quite difficult, the use of a laser can be a competitive advantage.

DentalMarket Magazine №3-2009

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State budgetary educational institution higher professional education

Novosibirsk State Medical University

Faculty of Dentistry

Laser technologies in dental practice

Novosibirsk 2013

Introduction

1. The principle of the laser beam

Conclusion

Literature

Introduction

Today, we can say with firm confidence that the use of lasers in dentistry is justified, cost-effective and is a better alternative to existing methods of treatment and prevention. dental diseases, as evidenced by a large number of studies conducted by domestic and foreign scientists. The use of laser technology opens up completely new possibilities, allowing the dentist to offer the patient a wide range of minimally invasive, virtually painless procedures in safe, sterile conditions that meet the highest clinical standards of dental care.

The process of widespread introduction of laser technologies into dental practice was held back for a long time as high cost. surgical lasers, and bulkiness, difficulties in operation, requiring a powerful three-phase electrical network, liquid cooling, and qualified technical personnel. But now the situation has changed radically due to the improvement of laser systems. The new generation of medical devices is characterized by:

*small dimensions and weight;

* low power consumption from a conventional single-phase network;

* no need for liquid cooling;

*high reliability and long service life;

* high stability of parameters;

*Easy management and maintenance;

*low sensitivity to mechanical and climatic factors.

Today, lasers are successfully used in almost all areas of dentistry: it is the prevention and treatment of caries, endodontics, aesthetic dentistry, periodontology, treatment of diseases of the skin and mucous membranes, maxillofacial and plastic surgery, cosmetology, implantology, orthodontics, orthopedic dentistry, technologies for the manufacture and repair of prostheses and devices.

The use of lasers makes it possible to clearly organize the treatment process, which is due to the technical characteristics and principle of operation of the laser. The interaction between the laser beam and the target tissue produces a well-defined result. Properly selecting the parameters of duration, magnitude and frequency of repetition of pulses, you can choose an individual mode of operation for each type of tissue and each type of pathology.

laser dentistry cloth

1. The principle of the laser beam

Main physical process, which determines the action of laser devices, is the stimulated emission of radiation. This emission is formed in the close interaction of a photon with an excited atom at the moment of exact coincidence of the photon energy with the energy of the excited atom (molecule). As a result of this close interaction, the atom (molecule) passes from an excited state to an unexcited one, and the excess energy is emitted in the form of a new photon with exactly the same energy, polarization and direction of propagation as the primary photon. The simplest principle The operation of a dental laser is to oscillate a beam of light between optical mirrors and lenses, gaining strength with each cycle. When sufficient power is reached, the beam is emitted. This release of energy causes a carefully controlled reaction.

2. Interaction of laser with tissue

The impact of laser radiation on biological structures depends on the wavelength of the energy emitted by the laser, the energy density of the beam and the temporal characteristics of the beam energy. The processes that can occur in this case are absorption, transmission, reflection and scattering.

Absorption - The atoms and molecules that make up tissue convert laser light energy into high temperature, chemical, acoustic or non-laser light energy. Absorption is affected by wavelength, water content, pigmentation, and tissue type.

Transmission - laser energy passes through the tissue unchanged.

Reflection - Reflected laser light does not affect tissue.

Scattering - individual molecules and atoms receive a laser beam and deflect the beam's strength in a direction other than the original one. Ultimately, the laser light is absorbed in a larger volume with a less intense thermal effect. Scattering is influenced by the wavelength.

3. Types of lasers in dentistry

In medicine, including dentistry, various types of lasers have found application:

1. Argon laser with a wavelength of 488 nm and 514 nm (radiation is well absorbed by the pigment in tissues, such as melanin and hemoglobin hemoglobin). In the presence of certain positive aspects (when using an argon laser in surgery, excellent hemostasis is achieved), there are strong disadvantages of this laser for medical use - deep penetration into tissues requires the use of energy, which can lead to the formation of a scar in the tissues of the mucous membranes. This greatly reduces the possibility of using the argon laser in dentistry, and it has now been replaced by newer and more selective lasers;

2. Helium-neon laser with a wavelength of 610 - 630 nm (its radiation penetrates well into tissues and has a photostimulating effect, as a result of which it finds its application in physiotherapy). These lasers are widely used in therapy and are poorly used in dentistry due to their main disadvantage - low output power, not exceeding 100 mW;

3. Neodymium (Nd:YAG) laser with a wavelength of 1064 nm (radiation is well absorbed in pigmented tissue and worse in water). In the past, it was common in dentistry, but its role in dental procedures is currently declining due to the price / functionality ratio - due to its limited scope (suitable for soft tissue surgery, but not used for whitening teeth, removing carious lesions and cavity treatment);

4. Erbium (EnYAG) laser with a wavelength of 2940 and 2780 nm (its radiation is well absorbed by water). In dentistry, it is used for the preparation of hard tissues of the tooth. But the use of this laser has significant drawbacks - the methods of its use have limited capabilities and the laser cannot be used for all types of dental intervention. And also the big disadvantages include the very high cost of the laser device and, accordingly, the rather high cost of procedures with its participation, which are necessary to pay for the laser;

5. Carbon dioxide (CO2) with a wavelength of 10600 nm (has good absorption in water). Its use on hard tissues is potentially dangerous due to the possible overheating of enamel and bone. There is also the problem of delivering radiation to tissues. The impact of a CO2 laser can cause the appearance of rough scars due to the conduction of heat and heating of the surrounding tissues, and when working on hard tissues, it can also cause the effect of carbonization (charring) and melting of hard tissues. At present, CO2 lasers are gradually giving way to other lasers in surgery;

6. Diode laser (semiconductor) with a wavelength of 630 - 1030 nm (radiation is well absorbed in pigmented tissue, has a good hemostatic effect, has anti-inflammatory and repair-stimulating effects). The radiation is delivered through a flexible light guide fiber, which simplifies the work of the dentist in hard-to-reach areas. The laser device has compact dimensions and is easy to use and maintain. The safety level of diode laser devices is very high. At the moment, this is the most affordable laser device in terms of price / functionality. And, despite the variety of lasers applicable in dentistry, the most popular today is the diode laser.

The use of diode lasers is based on two main

principle:

* alternative application high-intensity laser radiation as a scalpel as a multidisciplinary surgical instrument;

* a physical factor with a wide range of biological effects.

4. Classification of lasers according to technical characteristics

I. By type of working substance

1. Gas. For example, argon, krypton, helium-neon, CO 2 laser; group of excimer lasers.

2. Dye lasers (liquid). The working substance is represented by an organic solvent (methanol, ethanol or ethylene glycol) in which chemical dyes such as coumarin, rhodamine, etc. are dissolved. The configuration of the dye molecules determines the operating wavelength.

3. Metal vapor lasers: helium-cadmium, helium-mercury, helium-selenium lasers, copper and gold vapor lasers.

4. Solid state. In this type of emitters, crystals and glass act as the working substance. Typical crystals used are yttrium aluminum garnet (YAG), yttrium lithium fluoride (YLF), sapphire (aluminum oxide), and silicate glass. A solid material is usually activated by the addition of a small amount of chromium, neodymium, erbium or titanium ions. Examples of the most common options are Nd:YAG, titanium-sapphire, chromium-sapphire (also known as ruby), chromium-doped strontium-lithium-aluminum fluoride (Cr:LiSAl), Er:YLF, and Nd:glass (neodymium glass).

5. Lasers based on semiconductor diodes. Currently, in terms of the combination of qualities, they are one of the most promising for use in medical practice.

II. According to the laser pumping method, those. along the path of transferring atoms of the working substance to an excited state

Optical. As an activating factor, electromagnetic radiation is used, which differs in quantum mechanical parameters from that generated by the device (another laser, incandescent lamp, etc.)

Electrical. The excitation of the atoms of the working substance is carried out due to the energy of the electric discharge.

Chemical. To pump this type of laser, the energy of chemical reactions is used.

III. According to the power of the generated radiation

Low intensity. The power of the luminous flux is generated on the order of milliwatts. Used for physiotherapy.

High intensity. They generate radiation with a power of the order of watts. In dentistry, they are widely used and can be used for preparation of enamel and dentin, teeth whitening, surgical intervention on soft tissues, bone, and for lithotripsy.

Some researchers identify separate group medium intensity lasers. These emitters occupy an intermediate position between low and high intensity and are used in cosmetology.

5. Classification of lasers according to the field of practical application

Therapeutic. As a rule, they are represented by low-intensity emitters used for physiotherapeutic, reflexotherapeutic effects, laser photostimulation, photodynamic therapy. This group includes diagnostic lasers.

Surgical. High-intensity emitters, the action of which is based on the ability of laser light to cut, coagulate and ablate (evaporate) biological tissue.

Auxiliary (technological). In dentistry, they are used at the stages of manufacturing and repair of orthopedic structures and orthodontic appliances.

6. Application of laser in dentistry

With the help of laser systems, caries is successfully treated initial stage, while the laser removes only the affected areas, without affecting the healthy tissues of the tooth (dentin and enamel).

It is advisable to use a laser when sealing fissures (natural grooves and grooves on chewing surface tooth) and wedge-shaped defects.

Carrying out periodontal operations in laser dentistry allows you to achieve good aesthetic results and ensure complete painlessness of the operation. Laser treatment of gums and photodynamic therapy using a special laser device and algae eliminates gum bleeding after the first session, as well as bad smell from mouth. Even in the presence of deep pockets, it is possible to “close” the pockets in several sessions. In this case, there is a faster recovery of periodontal tissue and strengthening of teeth.

Dental laser devices are used in the removal of fibromas without suturing, a clean and sterile biopsy procedure is performed, and bloodless surgical operations on soft tissues are performed. Diseases of the oral mucosa are successfully treated: leukoplakia, hyperkeratosis, lichen planus, aphthous ulcers in the patient's mouth (nerve endings are closed).

In the treatment of dental canals (endodontics), a laser is used for disinfection root canal with pulpitis and periodontitis. The effectiveness of the bactericidal action is 100%.

The use of laser technology helps in the treatment of increased sensitivity of the teeth. At the same time, the enamel microhardness increases up to 38%.

AT aesthetic dentistry with the help of a laser, it is possible to change the contour of the gums, the shape of the gum tissue to form a beautiful smile, if necessary, the frenulum of the tongue is easily and quickly removed. The most popular in recent years has received effective and painless laser teeth whitening with a lasting result for a long time.

When installing a denture, the laser will help create a very accurate micro-lock for the crown, which allows you not to grind adjacent teeth. When installing implants, laser devices allow you to ideally determine the installation site, make a minimal tissue incision and ensure the fastest healing of the implantation area.

Laser dental treatment has other advantages - for example, in the traditional preparation of a tooth for filling, it can be very difficult for a dentist to remove softened dentin completely and not touch healthy tooth tissues. The laser copes with this task perfectly - it removes only those tissues that have already suffered as a result of the development of the carious process.

Therefore, laser dental treatment is much more effective than traditional technologies, because the service life of fillings largely depends on the quality of the carious cavity preparation. In addition, in parallel with the preparation, the laser provides antibacterial treatment of the cavity, which avoids the development of secondary caries under the filling. Laser caries treatment, in addition to the listed qualities, provides pain-free dental treatment and does not affect healthy tooth tissues. Due to such serious advantages of this technology, laser dental treatment is widely used not only in adult, but also in pediatric dentistry.

The latest dental units allow not only laser treatment of teeth, but also a variety of surgical procedures without the use of anesthesia. Thanks to the laser, the healing of mucosal incisions is much faster, the development of edema, inflammation and other complications that often occur after dental procedures is excluded.

In surgical dentistry, there is almost always a risk of wound infection after tooth extraction, dental implantation, and other interventions. Tissue injury resulting from a surgical operation, non-compliance by the patient with the recommendations can cause the development of a secondary infection. The use of a laser in surgical dentistry can significantly reduce the likelihood of wound infection, reduce the amount of anesthetic administered, and significantly reduce the bleeding of the surgical wound.

It is also important that after the use of the laser during surgical procedures, there is a rapid healing of the wound, which leads to a more comfortable state of the patient after the operation.

The antibacterial properties of the laser make it possible to use it for the treatment of not only caries, but also periodontitis. The laser effectively processes the roots of the teeth and provides complete sanitation of pathological pockets, resulting in a reduction in the treatment time, and the manipulations themselves do not cause discomfort to patients.

Laser dental treatment is especially indicated for patients suffering from hypersensitivity of teeth, pregnant women, patients suffering from allergic reactions for painkillers. So far, no contraindications to the use of the laser have been identified. The disadvantage of laser dental treatment can be considered only higher, compared with traditional methods, price. Prices for laser dental treatment are much higher and this is due, first of all, to the high cost of laser equipment. Despite this, the benefits of laser dental treatment justify the costs. This is evidenced by the rave reviews of patients who have experienced laser dental treatment.

7. Application of high-intensity laser radiation

The use of high-intensity laser radiation as a scalpel as a multidisciplinary surgical instrument. Etiologically targeted, local, periodontal therapy includes the complete removal of the subgingival microbiological film, granulations and subgingival deposits. To implement it, clinicians must assess and ensure:

1) access to periodontal pockets (infection areas);

2) control of the etiological factor - to reduce dental plaque, calculus and endotoxins;

3) the appearance of a response reparative reaction of the periodontium;

4) performing the above procedures with minimal removal of tooth cementum and damage to the surface of the restorations.

The periodontal pocket, which is, in fact, an infected wound, requires treatment based on the general principles of the treatment of such wounds:

1) surgical treatment of the wound;

2) disinfection;

3) creation of conditions for healing due to defensive forces organism.

With the aim of efficient removal(evaporation) of subgingival microflora, dental plaque and biofilm, sterilization of treated tissues, improvement of adhesion of fibroblasts to the root surface, laser technologies are used.

Method of laser curettage: a glass fiber is inserted into the periodontal pocket, the laser is activated, the fiber moves 2-3 times from the apex to the crown parallel to the root surface. Thus, the tooth is irradiated from all sides. Treatment of one periodontal pocket takes approximately 30-60 seconds. depending on its depth. The appearance of the lung bleeding from the pocket is an indicator of the end of the treatment procedure.

If necessary, a laser can be used to change the contour of the gums, gingivectomy, gingivoplasty.

Laser exposure can be used to treat diseases of the oral mucosa, in order to evaporate pathologically altered soft tissues and stimulate the regeneration of neighboring areas. To do this, use different modes of exposure.

During debridement, the optical fiber must be held almost perpendicular to the diseased tissue, which is removed by small circular movements of the laser tip. The procedure is completed when the entire pathologically altered surface is coagulated and covered with a crust. The implementation of the manipulation of surgical treatment, as a rule, does not require the use of anesthesia. There is no bleeding during treatment.

Benefits of laser surgery

* Bloodless operation gives the surgeon an excellent view during the entire procedure, which reduces the time of the operation. Wounds stay open more a short time which reduces the risk of infection.

* Simultaneous tissue disinfection reduces the likelihood of infection, which is one of the most frequent complications after operations.

* Reduced need for local anesthesia - little or no pain after laser surgery will give the patient more comfort and reduce the time of the surgical procedure.

* The absence of the need for suturing after laser surgery is a normal situation and therefore increases patient comfort to an even greater extent.

* Laser surgery provides faster wound healing with less postoperative discomfort and swelling.

The most common and popular indications for laser surgery include:

* Oral surgery with a laser - operations to remove hemangiomas, fibromas, epulida, opening of an abscess (septic operations), etc.;

* frenectomy;

* gingivectomy, atraumatic gingivoplasty, reshaping of the gums and papilla;

* formation of a gingival groove;

* removal of hyperplastic tissues;

* ensuring hemostasis and obtaining a dry surface for impressions.

Gingivectomy for hyperplasia

The laser is used to make an incision along the borders of the desired gum area in a focused mode and then excise or ablate the excess hyperplastic tissue. The advantages of this procedure include no bleeding, more precise control than is possible with electrosurgery, and no need for a postoperative periodontal dressing.

Cosmetic gum reshaping

In cases of asymmetric gingival tissues or excess gingival tissue in certain areas, a laser can be used to precisely contour the tissues. It is also a convenient technique for papillary hypertrophy after orthodontic treatment or when changing the unaesthetic shape of the papilla. Removal of greater tissue thickness can be achieved by evaporation in a direction perpendicular to the tissue.

Gingivectomy to gain access

A laser can be used to remove tissue where there is no access to subgingival lesions. This procedure is similar to gingival recontouring, but care must be taken to preserve the gingival attachment. Pocket depth should be measured prior to surgery. The absence of bleeding allows immediate restoration or impression taking.

Frenectomy

With the help of a laser, you can easily and quickly excise the frenulum of the tongue or lips. Excision can be carried out in continuous or pulsed mode. In any case, there is no need for a bandage and healing is usually excellent. The absence of bleeding and the elimination of sutures make this technique ideal for children and adults. Manipulation is usually performed without local anesthesia.

Removal of benign tumors

The laser is perfect tool to remove cosmetically undesirable benign neoplasms or hemartoma lesions. If the diagnosis of benignity has been confirmed, the laser is used to excise the lesion or to ablate. In the same way, a laser can be used to remove fibromas, granulomas, hemangiomas, lymphangiomas of the gums and tongue, etc.

Opening of the gingival sulcus

Diode and neodymium lasers are convenient for bloodless opening of the sulcus before taking an impression. This eliminates the need for a retraction cord and vasoconstrictors. The tip of the laser fiber is placed below the margin of the sulcus and the tissue is removed in a ledge to expose the margin of the preparation.

Conclusion

Lasers are comfortable for the patient and have a number of advantages over traditional methods of treatment. At present, the advantages of using lasers in dentistry have been proven by practice and are undeniable: safety, accuracy and speed, the absence of undesirable effects, the limited use of anesthetics - all this allows for gentle and painless treatment, acceleration of treatment terms, and therefore creates more comfortable conditions for both the doctor and the patient.

The use of modern laser technologies also makes it possible to obtain an economic effect by reducing the patient's disability period.

The main indications for the use of a diode and neodymium laser are:

1) periodontal diseases (epulis, hypertrophic gingivitis, pericoronoritis, etc.);

2) diseases of the mucous membrane of the mouth and lips (long-term non-healing erosion of the mucous membrane of the tongue and cheeks, limited hyper- and parakeratosis, erosive-ulcerative form lichen planus, leukoplakia, etc.);

3) benign neoplasms of the oral cavity and lips (fibroma, retention cyst of minor salivary glands, hemangioma, radicular cyst, candyloma, papilloma, etc.);

4) elimination of the pathology of the anatomical and topographic features of the structure of the soft tissues of the oral cavity (small vestibule of the oral cavity, short bridle tongue, a short frenulum of the upper and lower lip and etc.);

5) carrying out the second stage of intraosseous implantation (disclosure of the implant), etc.

Literature

1. Burgonsky V.G. Theoretical and practical aspects of the use of lasers in dentistry // Modern dentistry. - 2007. - No 1. - S. 10-15.

2. Burgonsky V.G. Possibilities of using laser technologies for the purpose of treatment and prevention at periodontal and surgical dental appointments // Modern Dentistry. - 2009. - No 5. - S. 64-69

3. Kodylev A.G., Shumsky A.V. The use of an erbium-chromium laser in complex treatment periodontitis // Endodontics today. - 2008. - No. 1. - pp. 36-40

4. Kunin A.A. Modern Aspects endodontic treatment // Clinical dentistry. - 2003. - No. 1. - pp. 18-19

5. Burgonsky V.G. Information about the seminar on the use of laser technologies in dental practice // Modern Dentistry. - 2008. - No 1. - S. 135.

6. Zubachik V.M., Barilyak A.Ya. Rationale for the use of laser radiation in combination with silver nanoparticles for disinfection of the root canal of a tooth // Modern Dentistry. - 2008, No 3. - S. 27-30.

7. Markina N.V. Lasers in dentistry: modern achievements and development prospects // Russian Dental Journal. - 2002. - No 4. - С/ 41-44.

8. The choice of the wavelength of the laser unit and the effectiveness of the treatment of various diseases of the oral mucosa and periodontal // Lasers in science, technology, medicine: Sat. scientific Proceedings.-M., 2005.-S.115-116 (Co-authored with L.A. Grigoryants).

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Types of lasers used in medicine and dentistry

The use of lasers in dentistry is based on the principle of selective action on various tissues. Laser light is absorbed by a certain structural element included in the biological tissue. The absorbing substance is called a chromophore. They can be various pigments (melanin), blood, water, etc. Each type of laser is designed for a specific chromophore, its energy is calibrated based on the absorbing properties of the chromophore, as well as taking into account the field of application. In medicine, lasers are used for tissue irradiation with a preventive or therapeutic effect, sterilization, for coagulation and cutting of soft tissues (surgical lasers), as well as for high-speed preparation of hard dental tissues. There are devices that combine several types of lasers (for example, for influencing soft and hard tissues), as well as isolated devices for performing specific highly specialized tasks (lasers for teeth whitening). In medicine (including dentistry), the following types of lasers have found application:

Argon laser(wavelength 488 nm and 514 nm): radiation is well absorbed by the pigment in tissues such as melanin and hemoglobin. The wavelength of 488 nm is the same as in curing lamps. At the same time, the speed and degree of polymerization of light-cured materials by a laser is much higher. When using an argon laser in surgery, excellent hemostasis is achieved.

Nd:AG laser(neodymium, wavelength 1064 nm): radiation is well absorbed in pigmented tissue and worse in water. In the past it was most common in dentistry. It can work in pulsed and continuous modes. Delivery of radiation is carried out through a flexible light guide.

He-Ne-laser(helium-neon, wavelength 610-630 nm): its radiation penetrates well into tissues and has a photostimulating effect, as a result of which it is used in physiotherapy. These lasers are the only ones that are commercially available and can be used by patients themselves.

CO 2 laser(carbon dioxide, wavelength 10600 nm) has good absorption in water and average in hydroxyapatite. Its use on hard tissues is potentially dangerous due to the possible overheating of enamel and bone. Such a laser has good surgical properties, but there is a problem of delivering radiation to tissues. At present, CO 2 systems are gradually giving way to other lasers in surgery.

Er:YAG laser(erbium, wavelength 2940 and 2780 nm): its radiation is well absorbed by water and hydroxyapatite. The most promising laser in dentistry, can be used to work on hard tooth tissues. Delivery of radiation is carried out through a flexible light guide.

diode laser(semiconductor, wavelength 7921030 nm): radiation is well absorbed in pigmented tissue, has a good hemostatic effect, has anti-inflammatory and repair-stimulating effects. The radiation is delivered through a flexible quartz-polymer light guide, which simplifies the surgeon's work in hard-to-reach areas. The laser device has compact dimensions and is easy to use and maintain. At the moment, this is the most affordable laser device in terms of price / functionality.

Diode laser KaVo GENTLEray 980

There are many manufacturers offering laser equipment on the dental market. KaVo Dental Russland presents, along with the well-known universal laser KaVo KEY Laser 3, called the "clinic on wheels", the diode laser KaVo GENTLEray 980. This model is presented in two modifications - Classic and Premium. The KaVo GENTLEray 980 uses a wavelength of 980 nm, and the laser can operate in both continuous and pulsed modes. Its rated power is 6-7 W (at the peak up to 13 W). As an option, it is possible to use the “micropulsing light” mode at a maximum frequency of 20,000 Hz. The areas of application of this laser are numerous and, perhaps, traditional for diode systems:

Surgery: frenectomy, implant release, gingivectomy, removal granulation tissue, flap surgery. Mucosal infections: aphthae, herpes, etc.

Endodontics: pulpotomy, canal sterilization.

Prosthetics: expansion of the gingival sulcus without retraction threads.

Periodontology: decontamination of pockets, removal of marginal epithelium, removal of infected tissue, gingiva formation. Consider a clinical example of the use of KaVo GENTLEray 980 in practice - in surgery.

Clinical case

In this example, a 43-year-old patient had a fibrolipoma on the lower lip that was successfully treated surgically using a diode laser. He applied to the Department of Surgical Dentistry with complaints of pain and swelling of the mucous membrane of the lower lip in the buccal region for 8 months. Despite the fact that the risk of a traditional lipoma in the head and neck is quite high, the appearance of a fibrolipoma in the oral cavity, and especially on the lip, is rare case. To determine the causes of neoplasms, it was necessary to conduct a histological examination. As a result clinical research it was found that the neoplasm was well separated from the surrounding tissues and covered with an intact mucous membrane (Fig. 1 - fibrolipoma before treatment). In order to make a diagnosis, this mass was surgically removed under local anesthesia using a diode laser with a 300 nm light guide and a power of 2.5 watts. Edge suturing was not necessary, as no bleeding was observed either during or after the surgical procedure (Fig. 2 - fibrolipoma 10 days after the intervention). Histological studies of the tissue taken for analysis showed the presence of mature non-vacuolated fat cells surrounded by dense collagen fibers (Fig. 3 - histology). Morphological and structural changes in tissues due to the thermal effect of the diode laser were not observed. The postoperative course of treatment was uneventful, with a visible reduction in the surgical scar after 10 days and no signs of recurrence over the next 10 months.

Bottom line: in the described case, the surgical operation to remove the fibrolipoma of the lower lip passed without hemorrhages, with minimal tissue damage, which allows for subsequent conservative treatment. There is also a rapid recovery of the patient. The ability to avoid visible sutures after excision is also undoubtedly a positive factor in terms of aesthetics. Conclusion: surgical treatment of benign neoplasms of the oral mucosa using a diode laser is an alternative to traditional surgery. The effectiveness of this method was confirmed by the results of the removal of lip fibrolipoma.

The first ruby laser was developed in 1960, and many others have since been created. Since the advent of lasers, dentists have begun to explore their potential. In 1965, Stern and Sognnaes reported that the ruby laser could vaporize enamel. The thermal effect of continuous wave lasers at that time damaged the pulp. Lasers with different wavelengths have been studied over the following decades to determine their applicability to hard and soft oral tissues.

Practitioners and researchers have been trying for a long time to create the necessary mode of using CO 2 and Nd:YAG soft tissue lasers in medicine. And only in 1990 the first pulsed Nd:YAG laser was created, designed specifically for dentistry. In 1997, the first true dental hard tissue laser, the Er:YAG laser, followed a year later by the Er and Cr:YSGG lasers.

Diode lasers based on semiconductors appeared in the late 1990s. And also recently CO 2 laser was approved for use on hard tissues of the tooth.

CO2 laser - carbon dioxide laser (CO 2 laser) - one of the first types of gas lasers (invented in 1964). One of the most powerful continuous-wave lasers beginning of XXI century. Their efficiency can reach 20%. Wavelength 10600 nm, has good absorption in water and moderate absorption in hydroxyapatite. Its use on hard tissues is potentially dangerous due to the possible overheating of enamel and bone. Such a laser has good surgical properties, but there is a problem of delivering radiation to tissues. Currently, CO 2 systems are gradually giving way to other lasers in surgery.

Helium neon laser- a laser whose active medium is a mixture of helium and neon. Helium-neon lasers are often used in laboratory experiments and optics. It has an operating wavelength of 632.8 nm, located in the red part of the visible spectrum. Its radiation penetrates well into tissues and has a photo-stimulating effect, as a result of which it finds its application in physiotherapy. These lasers are the only ones that are commercially available and can be used by patients themselves.

excimer laser- a kind of ultraviolet gas laser, widely used in eye surgery and semiconductor manufacturing. Excimer XeF wavelength (xenon-fluoride)— 351 nm, XeCl (xenon-chlorine) — 308 nm, KrF (krypton-fluoride) - 248 nm and ArF (argon-fluoride) - 193 nm.Argon-fluoride and krypton-fluoride are well absorbed by water and hydroxyapatite.

Argon laser - a continuous gas laser that is capable of emitting light with different wavelengths of blue(488 nm) and green (514 nm) ranges. It is well absorbed by melanin and hemoglobin. The wavelength of 488nm is the same as that of the polymer and for ation lamps. At the same time, the speed and degree of polymerization of light-cured materials by a laser is much higher than similar indicators when using conventional lamps. But it must be remembered that the acceleration of polymerization leads to an increase in the degree of stress in the composite. When using an argon laser in surgery, excellent hemostasis is achieved.

Titanyl Potassium Phosphate Laser (KTP) is a diode-pumped solid-state laser emitting light at a wavelength of 532 nm (green range).The application is similar to the argon laser.

diode laser - a semiconductor laser built on the basis of a diode. His work is based on the occurrence of population inversion in area p-n transition upon injection of charge carriers. It emits infrared radiation with a wavelength of 812 and 980 nm. It is well absorbed by pigmented tissue, has a good hemostatic effect, has anti-inflammatory and repair-stimulating effects. The radiation is delivered through a flexible quartz-polymer light guide, which simplifies the surgeon's work in hard-to-reach areas. The laser device has compact dimensions and is easy to use and maintain. At the moment, this is the most affordable laser device in terms of price / functionality.

neodymium laser - a laser that generates optical radiation due to quantum transitions between the energy states of trivalent Nd ions 3+ placed in a condensed medium (matrix), for example, dielectric crystals and glasses, semiconductors, metal, organic or inorganic liquids.Wavelength 1064 nm. X well absorbed by pigmented tissue ew and worse in water. In the past it was most common in dentistry. It can work in pulsed and continuous modes. Delivery of radiation is carried out through a flexible light guide.

Erbium laser - a laser whose active medium and, possibly, its resonator are elements of an optical fiber. Dwavelength 2940 nm. Aterbium-chromium laser - 2780 nm. Its radiation is well absorbed by water and hydroxyapatite. The most promising laser in dentistry, can be used to work on hard tooth tissues. Delivery of radiation is carried out through a flexible light guide. Indications for the use of a laser almost completely repeat the list of diseases that a dentist has to deal with in his work. The most common indications include:

(preparation of hard tissues);
Sterilization of the root canal, exposure to the apical focus of infection;
Pulpectomy;
Treatment of periodontal pockets;
Processing (sterilization) of implants;
Gingivotomy and gingivoplasty;
frenulectomy;
Treatment of diseases of the oral mucosa;
Removal of neoplasms;
Preparation of soft tissues in dentistry;
Removal of teeth.

A detailed description of the lasers is shown in the figure.

The method of using the CO 2 laser used in dentistry dates back to 1968, which was first used in soft tissue surgery. Although it was only in the mid-eighties, the creation of laser dental treatment associated with the healing of tissues with a solid foundation began. Currently, this method of treatment has gained popularity in various applications operational way.

Types of laser

These therapies have electromagnetic and low-energy radiation. The principles of technology for influencing an object are applied in dosed radiation, depending on its type.

Argon - has the same beam length (488 nm) similar to a polymerization lamp. The application of this laser has superior hemostasis unlike conventional lamps.
Diode - having the value of the beam range (792-130 nm) of study. It has the property of healing in pigmented cells and has a hemostatic effect, promotes a stimulating quality. Radiation passes under the polymer quartz, light - input by radiation, which improves the availability of work in an inconvenient place.
Nd:YAG Laser - neodymium laser in dentistry with a beam size (1064 nm) in water is worse, but pigmented tissue is perfectly absorbed.
Non-Ne laser helium-neon wavelength (610-630 Nm) has the effect of photo stimulation, which is applied in physiotherapy. This is a kind of laser that the patient can use on their own due to the fact that it is available for sale.
CO2 laser - carbon dioxide beam size (10600 nm) has a significant absorption, absorbs less in hydroxyapatite. It is applied on bone cells, beware in cases of overheating of the bone and enamel. They are inferior to other system principles of application.
Erbium laser - the magnitude of this beam exposure (2940-2780 nm) with excellent absorption by hydroxyapatite. Considered an innovation in laser systemic therapy applied on hard cells of the tooth. Has property of use to all diseases of a jaw.

The use of laser in dentistry

In the initial development of caries, the use of a laser is considered a favorable therapy. It removes the lesions of the tooth without touching the healthy enamel. A targeted method is considered to be the filling of wedge-shaped defects in hard places of the tooth. To the excellent outcome of the treatment and the insensitivity of the operation, it has reason to achieve in the use of periodontal - a logical operation.

In cases of mouth odor and bleeding gums, treatment is facilitated by laser treatment and photodynamic procedure with laser and algae. Also, a high-quality cure of periodontal tissue cells and hardening of enamel. These drugs are used for any stitches when removing fibroids. The biopsy procedure is performed sterile; on soft tissues, the necessary operation is performed without blood. Successfully treated oral mucosa:

Lichen planus (red).
Therapy of aphthous ulcers.
Hyperkeratosis.
Leukoplakia.

Also used in the application of a denture, the laser creates an accurate micro-lock for the crown, which helps not to grind the teeth in the neighborhood. Lasers allow you to find a place for implants and rapid healing. laser treatment counts effective methodology compared to traditional therapies.

Indications

Treatment includes the following indications:

Carisogenic process - contributing to the defeat of tooth enamel and dentin, which are removed without adverse effects on healthy tissues.
When bleeding from the gums.
With the treatment of periodontitis and pulpitis associated with the neutralization of root canals.
Getting rid of bad breath, with the destruction of bacteria.
When strengthening the gums, periodontal disease is irradiated to build immunity.
When whitening enamel.
In the case of a neoplasm on the cells of dental tissue.
In the treatment of cysts for the effect of cleaning the bases of the channels of an unfavorable focus.
For complete removal of sensations from hard tissues and build-up of implants.

Contraindications

Violation of the nervous system.
With a strong sensitivity of tooth enamel.
Changes in the endocrine system.
Pathological diseases of the lungs, which are caused by infectious diseases and respiratory failure.
Diseases associated with the cardiovascular system.
Weak blood clotting.
neoplasm having malignant appearance in the oral cavity and in the body.
The recovery period as a result of the intervention of surgeons.

Diode laser in dentistry

Regardless of the saturation of the lasers used, the method of using a diode laser (Ka Vo GENTLE ray 980) is considered popular. Safety - this type is highly rated in recognition by European dentists, it is usually used in the field of:

surgery,
periodontics,
endodontics.

Although they are more in demand in surgical intervention. It has an anti-inflammatory property with a bacteriostatic effect.

Diode laser in dentistry 7.0 W

The diode beam laser has applications in significant procedures that were previously difficult for surgeons to perform with suturing, bleeding, and similar adverse effects. Depending on the fact that laser beams have waves of coherent monochromatic action, the beam length is (800-900 nm).

Also, the laser has a positive effect on soft tissue cells, where a small area of necrosis is contouring cells. This is an opportunity to apply in smile contouring, prepare teeth and take an impression in one visit. This method is used in such traditional areas as:

Surgery – frenectomy, implant release, flap surgery, gingivectomy, tissue removal. With infection of the mucosa, herpes, aphthae.
Endodontics - canal sterilization, pulpotomy.
Prosthetics - an increase in the periodontal sulcus without retraction threads.
Periodontology - getting rid of the infected tissue area, decontamination of pockets, gum formation, removal of marginal epithelium.

Therapy of diseases

Caries therapy - this use is used in laser treatment in dentistry, takes place without any drilling, using a beam with a small beam force, it acts on the affected area. This action suppresses the increase in the autogenous environment and excludes microcracks and chips. Such therapy has several stages:

diagnosis, study of sensitivity and method of treatment;
with the need to use painkillers;
cleaning plaque from the carious cavity;
knowledge of the length of channels;
preparation of a carious area with a laser with a slow decrease in beam power. High power is applied to the enamel, low power is applied to the pulp;
closure of dentine channels;
cavity formed by coating with adhesive mortar;
after which a filling is placed;
recent restoration of part of the crown.

Granulomas - laser exposure is considered a conservative method without removing the lesion. The removal method is the same as in the case of caries in stages, they have the same properties of preparation and conduct surgical intervention. Relapse is extremely rare if you follow the rules:

It is often necessary to rinse the gum cavity with antiseptic solutions.
Do not drink food or water for 4 hours after the procedure.

Periodontitis - this treatment is applied at the first stage of development. The laser beam cuts the deposit on the neck of the tooth and disinfects the gum pocket and accumulated pathogenic viruses, preventing recurrence. The operation is completely painless, the appearance of the effect after 2 hours.

The price of treatment types, laser

Dental laser treatment for children

Children, according to dentists, are a special contingent in the treatment of teeth associated with the fact that the child experiences fear at the sight of dental instruments. With the new method of laser therapy, the procedure is painless. At present, therapy is gaining popularity among children and adults.

Laser dentistry for children helps to solve a number of the following problems:

Disappearance of fear.
Reducing the duration of the procedure.
Saving the result with a longer time with painless manifestations in milk teeth.

At a young age, treatment has applications such as:

Teeth whitening.
Getting rid of pulpitis and caries.
Treatment of periodontal canals.
Getting rid of retention cysts.
A therapy conducive to the treatment of aphthous symptoms.
Correction of the frenulum of the tongue or lips.

Methods

There are four types of laser therapy:

Contact - in this case, the emitter is pressed against the surface of the problem area, which allows you to penetrate as deeply as possible into the tissue cells. It is used for photophoresis and has the properties of irradiation of the alveolar sockets and undertakings associated with pathology.
Non-contact - a gap is left (1-8 cm), this method is not used more than this gap. It causes scattering and reflection of the beam. This technique is used for external irradiation of an infected focus, reducing edema and anesthesia.
Stable - used with a minimum field (less than 1 cm) is used when the pathology corresponds to the diameter of the beam wave.
Labile - with a significant and painful lesion of the focus. It has a method of applying point irradiation with movement throughout the area of origin.

According to written reviews from people, it seems that painless laser dentistry is the most effective way.