By – Dr. Sana Farista
The LASER is one among dentistry’s most exciting advances with unique patient benefits. This device complemented and in some cases replaces the scalpel. Today there are many indications of various Dental Laser devices. This article briefly describes clinical applications of particularly the diode LASER, which seems to be promising, especially in cases were operative and post-operative blood loss, post-operative discomfort and swelling is to be considered. The application of lasers is wavelength specific and depends on its absorption and interaction in different oral tissues. Over the last four decades, various wavelengths have been successfully used in dentistry, for the management of procedures like tooth exposure, frenectomy, crown lengthening, depigmentation, removal of mucocele and ulcer healing. Thus, the use of LASER in clinical dentistry may lead to an alteration in conventional clinical practice and will help to establish the best management strategy with minimal invasion.
Case 1: Tooth Exposure
Conventionally, the exposure of the tooth was performed using scalpel followed by bonding an orthodontic bracket and a ligature wire. The tooth is then gradually repositioned using controlled forces. The problems associated were morbidity of the procedure and the difficulty in maintaining isolation for bonding. A Diode Laser has been used in this case to illustratethe minimally invasive technique of exposing a canine for orthodontic repositioning (Fig 1 to 4). Since the canine tip was out of the bone, it was possible to use a soft tissue laser. In cases where the tooth is embedded in bone, a hard tissue laser, such as the Erbium;Cr:YSGG or Erbium YAG, is recommended.
Case 2: Labial/Lingual Frenectomy
The diode laser is an effective tool for the surgical excision of the lingual or labial frenum. The procedure can be performed under topical anesthesia in cooperative patients. Since it has a hemostatic effect, it provides a bloodless field of operation (Fig 5 to 9).
Case 3: Gingival Depigmentation
Hypermelanin pigmentation of the gingiva does not present a medical problem, patient`s complaint of ‘black gums’ is more of an esthetic problem. When treated with laser, protein coagulum forms on the wound surface, which serves as a biological wound dressing and thus, does not require a periodontal dressing. (Fig 10 to 11)
Case 4: Lasing of Ulcers with Low Level Laser Therapy (LLLT)
Treatment of recurrent aphthous stomatitis is quite challenging owing to the multifactorial etiology. With evolving technology, lasers have indeed proven to be a boon as they provide immediate analgesia and aid in rapid healing compared to any other treatment modalities. (Fig 12 to 15)
Looking to the future, it is expected that minimally invasive laser technologies will become essential components of contemporary dental practice as long as the clinician receives the proper training to use this technology safely and effectively.