Prepared by:

Athraa A. Mahmood
M.Sc. of Periodontics
 Introduction
High power lasers such as:
Carbon dioxide (CO2)
Neodymium- doped: Yittrium-Aluminium-Garnet (Nd:YAG)
Diode lasers
were approved for soft tissue treatment in oral cavity because of their excellent soft
tissue ablation and homeostatic characteristics.

The Erbiumdoped: Yittrium-Aluminium-Garnet (Er:YAG) laser: was approved in

1997 for hard tissue treatment in dentistry. which will be able to clinical dental
practice, in particular periodontal treatment. It was introduced as an
alternative or an adjunctive to conventional scaling and root debridement.
 Advantages of Laser Surgery
1. Decreased tissue damage and thus enhanced healing: No incisions,
stitches, post-op bleeding, swelling, pain, gum recession, tooth
sensitivity.
2. Patient comfort :less chair time.
3. Hemostasis and coagulation are possible, making the laser
essential for medically compromised patients.
4. Some procedures can be performed with topical anesthesia only.
5. The concept of minimally invasive dentistry (MID) can be achieved.
6. Lasers are safe to use if the user adheres to protocols.

Disadvantages
Laser irradiation
the cost and size of laser device
APLICATION OF LASER IN PERIODONTIC

A. Soft tissue applications

B. Hard tissue applications
A. Soft tissue applications
1. Gingivectomy
When patients present with problems of tissue overgrowth or
hyperplasia from various causes, laser are used effectively to
perform laser gingivectomy.
 2. Gingivoplasty
For small tissue aberrations, pseudopockets seen after
periodontal surgery, or small areas of reverse tissue architecture
with an otherwise healthy periodontium.
all of the dental lasers are effective in performing gingivoplasty.
 3. Frenectomy
All types of laser systems can be used ; however, Depth of
penetration of Diode & Nd:YAG more than Erbium & CO2.
Lingual frenectomy
4. Removal of benign lesions

Before 3 Months post operation

 5. Incisional or excisional biopsy

Before

6 Weeks post operation

 6. Exposure of Implants
Lasers can be used to uncover implants, whether single or multiple

Before After
 7. Mucogingival surgery
For coagulation of bleeding areas, seal of soft-tissue graft
(donor sites), lasers are excellent in controlling the bleeding.
Recontour of recipient area and more esthetic results
 For vestibuloplasty:

Before

Two-day postoperative Two-week postoperative

8. Soft tissue crown lengthening
Lasers are effective for crown lengthening related to excessive
soft tissue or in areas of passive eruption.
laser type : Diode, Nd:YAG & CO2.
 9. The Laser Assisted New Attachment Procedure

Periodontal probe Laser irradiation, selectively Ultra sonic & special

indicates excessive dissects epithelium, diseased tissue hand instruments
pocket depth. & pathological proteins, tactile used to remove root
feedback from the fiber alerts the roughness.
practitioner to the presence of root
roughness, & opens that pocket for
access & visibility.
Laser finishes debriding pocket The tissue is compressed against the
& establishes coagulation. root surface & a stable fibrin clot
forms at the gingival crest.
 10. Melanin hyperpigmented gingiva
Diode & Nd:YAG are attracted by hyperpigmented tissue
with melanin so we need less power than coral pink
gingiva.

Melanin Post-operative
hyperpigmented gingiva result in 2 weeks

Final result after orthodontic

and restorative treatment
 B. Hard tissue applications

1. Scaling &
root planning.

2. Bone procedures.
3. Whitening procedure
 4. Hard tissue crown lengthening
Alter underlying osseous structure >> Erbium Laser to
clear removal of bony defect.

Preoperative views

Immediate postoperative views