Special laser treatments

IMPLANTODENT – one of the first private dental clinics in Romania which in early 2000s has introduced laser units in current practice, powerful ones for surgical and restorative treatments, as well as “soft” lasers, with therapeutic effect, used both in physiotherapy and in pain therapy.

Not every device that emits light is a dental laser!

Unfortunate and shameful, yet true! Several dental practices promote all kinds of “lanterns” with colored light, medically total inefficient, that can be bought for prices varying between a few dozen euros to a few hundred euros, as being dental lasers. False! A dental laser is a complex device, with special markings, produced by well-known manufacturers (Fotona, Biolase, Sirona, Kavo, etc.) varying in acquisition price between few thousands up to 70-80 000 euro! “Fake” laser treatments are offered cheaply, yet their efficiency is close to zero!

A stomatology clinic cannot be named modern as long as it operates only with dental drills. Those belong to a period of sad remembrance of dental medicine when going to the stomatologist was an achievement itself. For regular dental practices, many people still find it difficult to gather courage and energy resources to endure a classic dental treatment session and therefore, postpone visiting the dentist. Unfortunately this attitude does nothing more than allow dental disease to advance.

Today, we find ourselves at the 4th generation of lasers, covering all dental medicine procedures, especially in:

  • oral surgery and implantology;
  • periodontology;
  • pediatric dentistry;
  • odonto-therapy;
  • orthodontics;
  • esthetics and dental cosmetics;

The dental laser represents a modern technology that leads to minimally invasive precision treatments, most of the time painless, fast, significantly reducing bleeding and recovery/healing period.

10 reasons to choose laser in your dental treatments

  1. Advantages of cavity cleaning with lasers: superior preservation of structures unaffected by decay. Explanation: Structures affected by decay are more sensible to the laser’s action than the healthy ones, so when the laser fascicle passes above the decayed tissue, it will be removed without damaging the healthy tissue.
  2. Total elimination of fissure and microfracture risks in the enamel and dentin. Explanation: Mechanical cleaning of decay with the dental drill is impossible without producing vibrations. The energy of these vibrations is picked up by the healthy dental structure which simply cracks due to the high intensity characteristic of these vibrations. These fissures and microfractures will favor a secondary decay emergence shortly after the filling or dental incrustation was applied. Laser doesn’t produce vibrations therefore doesn’t produce microfractures.
  3. Tissue sterilization where work has been performed. Explanation: Besides the selective elimination of diseased tissues, in the end, be it a cavity, canal, periodontal pocket or bone infection, lasers sterilize the tissue in question. Therefore, healing is far superior and relapses and unlikely. Periodontal disease, either in natural teeth level or implants is characterized by highly pathogen microbes present in the bacterial plaque and dental calculus. The use of laser for these treatments brings extraordinary results, without pain and bleeding, without scalpel or suture wires. In other train of thoughts, root canal infections rebel to the classic treatment can be efficiently treated with laser, in a single treatment session. Laser cuts and sterilizes tissues!
  4. Superior grip and therefore long lasting fillings. Explanation: Executing a quality obturation (filling), to last in time, assumes a proper unity between the dental structure and filling material. For this, classically, before the filling, the dentist uses certain acid substances that applied on the tooth can “condition” (dehydrate) it by producing retention microcavities in the enamel, procedure named “acid engraving”. This technique has drawbacks such as prolonged time, incomplete and uncontrolled dehydration (microscopic), and acid could accidentally damage sensitive tissues. Laser on the other hand vaporizes water on the beam direction totally and rapidly, creating uniform retention microcavities, thus ensuring ideal conditions for an adherent coating of filling material to the tooth.
  5. Lack of sensitivity and pain. Explanation: Laser beam, at certain intensity, acts directly on the nerve endings from dentin tubules, assuring automatic anesthesia of the nerve ending. Therefore, sensitive teeth, with gum retraction, dental cervix or dental root decay can be perfectly treated with laser. In addition, in most cases there is no sensitivity associated with profoundly decayed teeth, with a recent filling, mechanically traumatized by the dental drill and chemically by the filling material.
  6. Oral surgery treatments (including dental implantology) with no side effects such as bleeding, pain and edema (swelling). Explanation: Laser sections but at the same time coagulates (closes) blood vessels, having also an anti-inflammatory effect over the tissues. Compared with the drill or surgical saw, when sectioning, laser does not reach bone tissue so therefore does not determine vibrations and overheating, namely tissue necrosis. When excising soft tissue growths, we perform frenectomies or gingivectomies, incisions are precise, bleeding is minimal or nonexistent and healing is sensational. Most of the times we don’t even use local anesthetic and eliminate scalpel and suture wires
  7. Extremely well tolerated by children. Explanation: the lack of unmistakable dental turbine noise produces a fantastic psychological comfort. In addition, for the classic method, most of the times local anesthesia is needed, meaning taking a shot. Besides the sting, after anesthesia, children cannot feel their lip or cheek and the risk of biting themselves increases. The anesthetic effect the laser can achieve removes these shortcomings from the start.
  8. Without risk of hurting tongue, cheeks or lips. Explanation: turbines used in stomatology don’t stop immediately after the dentist suspends their action and therefore there is a risk that through an unforeseen movement, certain mouth areas, such as tongue, lip or cheek can be caught in the rotation movement of the turbine drill (350 000 rot/min) damaging the structure more or less severe. In addition, the laser beam doesn’t produce air vortices like the drill, which can catch soft parts towards it, generating unpleasant accidents.
  9. Far superior psychological comfort for anxious (frightened) patients. Explanation: dental turbines emit a characteristic and unmistakable sound, of high intensity, which some patients can feel “up to the brain”. Laser is based on a totally different principle so these unpleasant high intensity sounds are replaced by low intensity and low volume sounds, much easier to tolerate.
  10. Lack of dental sensitivity. Explanation: dental drill vibrations, air vortices generated by the rotor as well as heat generated by friction have an irritating effect over nerve endings from dentin canaliculi. Therefore, although the procedure over the tooth was correct, teeth often remain with certain sensitivities after preparation. As the laser doesn’t generate air “vortices” to elongate nerve endings it doesn’t produce friction and conversely heat to be transmitted to tissues, being “non-contact” and doesn’t produce vibrations as there are no rotating dental drills, the risk of nervous sensitivity being null.

The laser beam destroys microbial flora and cancer cells from the region where it passed with major contribution in reducing post-surgery complications. Absence of direct contact between a metallic instrument and tissues excludes the possibility of infection (no risk of HIV, hepatitis B, etc.). In Germany, there are “laser therapy clinics” that use laser in all dental medicine areas practicing what is called “bloodless surgery”. We are offering you the possibility in Romania to also benefit from the same laser technology advantages for over 50 disorders.

Laser types used in stomatology

Dental medicine uses laser systems with powers comprised between 1W and 25W, sometimes even more. Usually, they are named according with the incorporated element.

Dental lasers for soft and hard tissues

A large range of lasers can be used to diagnose, assist and perform different dental procedures. However, two large laser categories can be discussed:

  • Hard tissue lasers: Basic use of hard tissue lasers is to perform sections within bone and teeth. Hard tissue lasers are often used with the purpose of cleaning the tooth of decay, preparing surfaces for filling, removing dental structures for crown covering, to cut and model maxillary bones.
  • Soft tissue lasers: We can section, cut and remove gum, mucous, tumors and frenulums from the oral cavity. Canal nerves can be removed through vaporization, we can sterilize periodontal pockets and infected canals. Soft tissue lasers penetrate the soft tissue closing blood vessels and nerve endings. This is the main reason for which people never experiment any post-operatory pain after laser use. Also, soft tissue lasers allow faster tissue regeneration.

For example, some dental lasers contain a wavelength which is highly absorbed by hydroxyapatite (calcium phosphate salt identified within bone and dental structure) and water, making them more efficient in hard tissue sectioning. The most used lasers for hard tissues include Erbium YAG and Erbium YSGG.

Other dental lasers contain a wavelength strongly absorbed by water and hemoglobin (oxygenating blood cells proteins), making them more efficient in control over soft tissue. The most used lasers include Neodymium YAG (Nd: YAG) and diode lasers, that can be used as a periodontal treatment component, being able to kill bacteria and actively regenerate tissues.

  1. Erbium YAG laser – can replace dental drills, penetrating hard tissues of the teeth and bone. Also, it can be used for gingival depigmentation, to restore the colored gum into its natural color, pink. It is frequently used for tooth decay treatment.
  2. Carbon dioxide laser – used for small surgical procedures (gingivectomy, excision of soft tissue tumors from the mouth), without pain and with proper wound hemostasis (stopping post-surgical bleeding). However, it is used in a small scale in stomatology.
  3. Argon laser – used for minor surgical interventions, its beam uses argon as a transition environment, being led to the wound through optic fiber or magnifiers, of green-blue color. Rarely used in stomatology.
  4. ND YAG laser – used for gingival retraction cases, endodontics (root canal treatments) and oral surgery. Usually, these types of treatments don’t require anesthesia. Extremely useful in periodontal pocket treatment, when the dentist will place the beam between the root and bone, in pocket’s depth, for sterilizing and healing stimulation of damaged tissues, so that the gums can again adhere to the dental cervix (neck).
  5. Diode laser – introduced in stomatology practice in late 1990s. Efficient in endodontic and oral surgery treatments. It helps in treating most oral cavity disorders and esthetic defect recovery. Being a complex device, it is often used in soft tissue procedures.
  6. Biostimulation (therapeutic) lasers – have a low power level and are used as dental therapy adjuvants, improving blood circulation in tissues and aiding in tissue regeneration. At the same time, there are devices based on this technology, used for tooth decay detection.

The advantages of using dental laser

Dental laser is considered to be a precise and effective way of executing multiple dental procedures. Patients seeking maximum safety and comfort can opt for dental laser treatments.

Dental laser’s potential of stomatology treatment improvement is derived from the precision with which lasers can treat a certain surface, from control the doctor has over the laser’s power and from the beam exposure time over the tissues.

What are the advantages of laser therapy?

Comfort – once with the laser use and dental drill noise removal, you will feel more comfortable and relaxed on the stomatology chair. Also, you will not feel any kind of pain as it would have been caused by dental drill vibrations and generated heat during tooth friction.

Anesthetic reduction – For many patients, the best part of surgical laser therapy is not using needles for treatment or surgery, anesthesia being reduced or even removed.

Reduction of bleeding – bleeding is reduced to minimum and suture necessity can be eliminated. Laser also provides sterilization of treated area. Dental laser attenuates bleeding because the high energy light beam helps exposed blood vessels clotting (coagulation), thus preventing blood loss, an extremely important aspect for patients with diabetes, heart conditions and hemophilia.

Disinfecting and sterilizing – of contaminated tissues, such as the root canals or periodontal ones. Laser is a great help when used for infection treatment, whether we’re talking about endodontic, periodontal or surgical treatments.

Minimally invasive – due to the precisely controlled beam, laser produces a minimum tissue sacrifice, considerably reducing treatment duration and post-operatory recovery. When cleaning enamel and dentin, laser sections with precision, and with the lack of vibration, prevents enamel fractures, as dental drills would have caused.

Quick post-operatory recovery and comfort – post-operatory pain, discomfort and inflammation are reduced, and the laser’s accuracy ensures healthy tissue protection from neighboring areas and quick post-operatory recovery.

Dental treatments in children – Main advantage is the fact that anesthesia is not always necessary, and also, the short period of treatment.

High-risk patients – due to maximum control over bleeding, there is no hemorrhage or post-operatory infection risk. Bacterial infections are reduced to minimum due to the high energy light beam which sterilizes tissues where procedures are performed.

Treatments with dental lasers?

Introduction of lasers in dental medicine offers stomatology doctors the chance of performing a variety of dental procedures which, otherwise couldn’t have been realized. Stomatology doctors who use dental lasers have become adepts of incorporating this precision technology in a series of regular or less common procedures.

Benign tumors: dental lasers can be used in pain-free removal, without suture, of benign tumors from the gums, palate, cheek lining and lips.

Tooth decay detector: dental lasers with reduced intensity for soft tissues can be used in early detection of tooth decay, providing analysis for secondary tooth decay generated products.

Tissue and gum analysis: optical coherence tomography is a safer way to penetrate inside teeth and gums in real time.

Sores: dental lasers with low intensity reduce associated pain with dental sores and minimize healing time.

Dental crown elongation: dental lasers can remodel gingival tissues and bone to obtain a more elongated shape from short and unaesthetic teeth. Also called dental crown elongation, such a reshaping ensures a safer base for dental esthetic procedures.

Dental fillings: dental lasers for soft tissues can eliminate the need of a local anesthesia shot or use of the traditional drill. Lasers used for dental cavity cleaning can kill bacteria from the decayed cavity, which can lead to long term dental restorations. The major advantage is represented by the minimally invasive procedure, laser removing only decayed tissues, without damaging healthy ones. There are no vibrations and friction forces like in dental drills, so, the risk of painful overheating or fissure and enamel fractures disappears.

Laser frenectomy or the lip or tongue string removal, represents an ideal option of treatment for children who suffer from lingual fibrous frenulum (tied tongue) and for babies who cannot be properly fed from the mother’s breast due to limited tongue motion. Laser frenectomy can also help remove several speech impediments. When the frenulum is inserted between the teeth, they develop unaesthetic, spaced, generating diastema or popularly speaking teeth midline spaces. Laser frenectomy is quick, painless and without scars.

Tissue regeneration: photobiomodulation can be used for damaged nerve regeneration, for closing sectioned blood vessels and healing keloid scars.

Sleep apnea: in cases where sleep apnea is the result of tissue inflammation from the neck area (which sometimes occurs with age progression), a laser assisted uvuloplasty or uvulopalatoplasty (LAUP – Laser assisted uvulopalatoplasty) can remodel surplus soft tissues from the neck region and can free narrowed airways, associated with sleep apnea.

Gingival tumors (Epulis): laser devices can be used for pain-free removal, without suture, of soft tissue growths often caused by ill adapted dental crowns or inadequate prostheses.

Teeth whitening: laser units with low intensity for soft tissues can be used to accelerate the chemical process of whitening products performed within the dental practice.

Temporomandibular joint treatment: dental lasers can be used to quickly reduce pain and inflammation of the temporomandibular joint

Gingival smile: with dental lasers excess gingival tissues that cover the crown can be reshaped, leading in healthy bone and dental structure exposure, considerably improving smiles in which excess gums are exposed.

Dental sensitivity: dental lasers can be used to seal tubules in which nervous filaments are located, found within the dentin, responsible for the occurrence of sensitivity to different physical or chemical agents such as cold, hot, sweet, and sour.

Dental laser use is not recommended when working on metals inside the oral cavity such as amalgam obturation, onlays or dental crowns.