Professional Documents
Culture Documents
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Frank Licht, RDH, BSDH
Clinical Supervisor
Tennessee State University
Certifications
Local Anesthesia
Nitrous Oxide Administration
Nitrous Oxide Monitoring
Periodontal Laser Therapy
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• Brief History and Science of
Lasers
• Lasers and their use in Dentistry
• Lasers in the Treatment of
Periodontal Disease
• LBR and LAPT Procedures
• What else you can do with this
knowledge
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1960
First Laser Developed by:
Theodore Maiman
He called it “Maser”
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1965 Gold used Ruby and CO2 Lasers
1970’s CO2 and Nd:YAG tooth Prep
1980’s Emphasis switched to incision
of soft tissue with CO2
1990’s Introduction of Diode and
Er:YAG and pulsed Nd:YAG
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Diode – 810, 940, 980 nm
Nd:YAG – 1064 nm
Er:YAG – 2780 nm
CO2 – 10,000 nm
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Light Amplification by
Stimulated Emission of
Radiation was
developed by
ALBERT EINSTEIN
1916
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External Stimulus
Collimated
Coherent
Light Amplified by
Stimulated Emission of Radiation
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Laser Mediums – Gas, Liquid or Solid
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Absorption Affects infected tissue
**** Most Important Affect***
2. Increase Circulation
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Bio-Stimulation
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CO2
Diode
Erbium
Neodymium
Argon
Holmium
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10,000 nm mostly continuous wave (millisecond pulsing
offered in some)
Non contact.
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940nm (810nm and 980nm also)
Produced from a Solid Medium
Absorbed by:
Water
Hydroxyapetite
Hemoglobin
Melanin
Fiberoptic Delivery
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Nd:YAG 1064Nm
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Effects of Exposure Duration
The Zone of Necrosis is the area of tissue affected by the laser’s energy and heat.
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Benefits of Laser Treatment
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High Bactericidal effect
Reduce Post-op Inflammation & Edema
Increased productivity – Less wait time
Greater Hemostasis
Minimal wound contraction – skin shrinkage
Retard epithelial proliferation apically along healing
root surface to enhance periodontal tissue regeneration
Reduce Noise factor
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Laser irradiation can interact with tissues even in the
non-activated mode. Meaning laser beams can reach
the client’s eye and other tissues surrounding the target
in the oral cavity
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Patients on Blood Thinners are not required to stop
medication… Why?
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Dental lasers can NOT be implemented in the
following clients.
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Glasses
Each laser must have several pairs of protective
eyewear related to its wavelength. You and your
patient MUST wear protective eyewear to avoid any
possible retinal damage.
Signage
It is recommended that signs are posted in the
cubicle where laser therapy will be performed. Make
sure other employees know not to enter when the sign
is posted.
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200 Million US Adults and nearly 95% have some form
of Periodontal disease with 30% having Moderate to
Severe Periodontitis
• Cost of Procedure
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Consequences of
Traditional Therapy:
• Recession
• Sensitivity
• Morbidity
• Cost
• Long Junctional
Epithelium Loss
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Porphyromonas Gingivalis
Tannerella forsythia
Mutans streptococci
Streptococcus mutans
Streptococcus sobrinus
Streptococcus Intermedius
Prevotella intermedia
Treponema denticola
Lactobacilli
Aggregatibacter actinomycetemcomitans
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Uses heat to “Melt” Tissue
Excellent for Hemostasis and effective clotting
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Want to Destroy Quantity and Quality of Bacteria
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Addresses all Treatment Objectives
Better Decontamination of Pocket
Bio-Stimulatory and Regenerative
Shorter Treatment - weeks vs. months or years
Less Invasive and Lower risk than Surgery
Not Necessary to Go Off Anti-Coagulants
Better Patient compliance
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Laser Function
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• Decrease Bacterial Levels
• Reduce Inflammation
• Eliminate Infected tissue
• Reduce Pocket Depths
• Gain Clinical attachment
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L.A.P.T.
Laser Assisted Periodontal Therapy
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Laser Assisted Periodontal Therapy
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• No Probing for three months
• No sub-gingival scaling for three months
• Hand scalers and coronal polish – Supra Only
• Ultrasonic on low power just to gingival margin
• Fluoride treatment OK
• Low level laser treatment OK for LBR
- 1 to 2 mm Subgingival only.
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http://www.youtube.com/watch?feature=player
_embedded&v=l5rOvglzjD0
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Certification
You must be certified to provide laser therapy to your patients. The State
Of Tennessee requires that you be taught by someone who has had laser
training.
mowens@advancedlasertraining.com
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What can you do with this knowledge…???
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Operculectomy
- 940 nm
Operculectomy
- 980 nm
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You can use Diode lasers to work around around metal
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Contouring
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Gingivectomy
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Aphthous Ulcer Treatment
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Curettage
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Contouring
Gingivectomy
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Please remember to fill out course
evaluations and sign your name on the
attendance sheet.
flicht@tnstate.edu
(615) 963-1475
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Aykol, G., Baser, U., Maden, L., Kazak, Z., Onan, U., Tanrikulu-Kucuk, S., ... Yalcin, F.
(2011, March 2011). The Effect of Low-Level Laser Therapy as an Adjunct to Non-Surgical
Periodontal Treatment. Journal of Periodontology, 82, 481-488. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/20932157
Blayden, J., & Mott, A. (2013). Soft-Tissue Lasers in Dental Hygiene. Ames, Iowa: Wiley-
Blackwell.
Christodoulides, N., Nikolidakis, D., Chondros, P., Becker, J., Schwarz, F., Rossler, R., &
Sculean, A. (2008, September 2008). Photodynamic Therapy as an Adjunct to Non-
Surgical Periodontal Treatment: A Randomized Clinical Trial. Journal of Periodontology,
79, 1638-1644. Retrieved from
http://www.helbo.de/fileadmin/docs/wissenschaft/Christodoulides_et_al._PDT_JP_090
8.pdf
Goldstep, F. (2009). Diode Lasers for Periodontal Treatment: The Story So Far. Retrieved
from http://www.oralhealthgroup.com/news/diode-lasers-for-periodontal-treatment-
the-story-so-far/1000349901/
Infective Endocarditis. (2014). Retrieved from
http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/TheImpactofCo
ngenitalHeartDefects/Infective-Endocarditis_UCM_307108_Article.jsp
Kamma, J. J., Vasdekis, V. G., & Romanos, G. E. (2006). The Short-Term Effect of Diode
Laser (980 nm) Treatment on Aggressive Periodontitis. Evaluation and Clinical
Microbiological Parameters. The Journal of Oral Laser Applications, 2, 111-121. Retrieved
from www.ncbi.nlm.nih.gov/pubmed/19196111
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Lui, J., Corbett, E. F., & Jinn, L. (2011). Combined Photodynamic and Low-Level Laser
Therapies as an Adjunct to Nonsurgical Treatment of Chronic Periodontitis. Journal of
Periodontal Research, 46, 89-96. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/20860592
Moritz, A., Schoop, U., Goharkay, K., Schauer, P., Doertbudak, O., Wernisch, J., & Sperr,
W. (1998). Treatment of Periodontal Pockets With a Diode Laser. Lasers in Surgery and
Medicine, 22, 302-311. Retrieved from www.ncbi.nlm.nih.gov/pubmed/9671997
Qadri, T., Miranda, L., Turner, J., & Gustafsson, A. (2005). The Short-Term Effects of
Low-Level Lasers as Adjunct Therapy in the Treatment of Periodontal Inflammation.
Journal of Clinical Periodontology, 32, 714-719. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/15966876
Qadri, T., Poddani, P., Javed, F., Turner, J., & Gustafsson, A. (2010, August 2010). A Short-
Term Evaluation of Nd:YAG Laser as an Adjunct to Scaling and Root Planing in the
Treatment of Periodontal Inflammation. Journal of Periodontology, 81, 1161-1166.
Retrieved from http://www.joponline.org/doi/pdf/10.1902/jop.2010.090700
Ustun, K., Erciyas, K., Sezer, U., Gundogar, H., Ustun, O., & Oztuzcu, S. (2014). Clinical
and Biochemical Effects of an 810 nm Diode Laseras an Adjunct to Periodontal Therapy:
A Randomized Split-Mouth Clinical Trial. Photomedicine and Laser Surgery, 32, 61-66.
Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24444428
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