laser Interactions Part II

General precautions

• Personnel using this laser product should be familiar with it and

follow the recommendations given below.
• Always wear laser safety eye wear that is optically dense with the
wavelength of operation
• Never look directly in to the operation
• Or reflections even with the eye wear on
• Work in the area well illuminated to avoid the dilatation of the
pupil
EFFECTS ON EYE

• The energy density (measure of energy per unit of area) of the laser beam
increases as the spot size decreases.
• This means that the energy of a laser beam can be intensified up to 100,000 times
by the focusing action of the eye.
• If the irradiance entering the eye is 1 mW/cm2 , the irradiance at the retina will
be 100 W/cm2 .
• Thus, even a low power laser in the milliwatt range can cause a burn if focused
directly onto the retina.
• NEVER point a laser at someone's eyes no matter how low the power of the laser.
EFFECTS ON EYE

• If a laser burn occurs on the fovea, most fine (reading and working) vision may be lost in an
instant. If a laser burn occurs in the peripheral vision it may produce little or no effect on fine
vision.
• Repeated retinal burns can lead to blindness. Fortunately the eye has a self-defense mechanism --
the blink or aversion response.
• When a bright light hits the eye, the eye tends to blink or turn away from the light source
(aversion) within a quarter of a second.
• This may defend the eye from damage where lower power lasers are involved, but cannot help
where higher power lasers are concerned. With high power lasers, the damage can occur in less
time than a quarter of a second.
Occular effects

• Potential injury from the reflection of the instruments

• Cause damage to the operator and patient
• The use of carbonized instruments as they are non reflective
• The primary occular injury is retinal or corneal burn
• Incident beam is increased to 100,000 times due to focusing action of the pupil
• 95% of the beam is absorbed by the pigmented epithelium of the retina and choroid layer
• Thermal damage is more with class 4 laser
• Cataract is more likely within 300-400 nm[ultra violet] region by the absorption of the lens
and cornea.
Relation of wavelength and Corneal injury
RATING OF EYE WEAR

• Eyewear is rated for optical density which is the base-10 logarithm of the attenuation factor
by which the optical filter reduces beam power.
• Eyewear with OD 3 will reduce the beam power in the specified wavelength range by a factor
of 1,000.
Optical density

• The OD (absorbance) is used in the determination of the

appropriate eye protection. OD is a logarithmic function
defined by: Where H0 is the anticipated worst case
exposure conditions (in joules/cm2 or watts/cm2 ) and the
MPE is expressed in the same units as H0.
• Maximum Permissible Exposure (MPE) MPE is the
maximum level of laser radiation to which a person may
be exposed without hazardous effects or biological
changes in the eye or skin. The MPE is determined by the
wavelength of laser, the energy involved, and the duration
of the exposure.
• Restrict the access to the laser area to those who work, or to the patients

• Post warning signs that can be readily seen near the laser area.

• Arrange equipments so that they are not at the eye level.

• Beware of the reflections from the components in the optical path
• Ensure that all electrical connections are made in a safe manner
• Never leave the operating laser unattended.
• Use Signage
WARNING SIGNAGE
Laser effects on dental hard tissues
and pulp
THERMAL EFFECTS

• DENATURATION OF PROTEINS 45-60 DEGREES

• ABOVE 60 DEGREES COAGULATION AND NECROSIS
• ABOVE 100 DEGREES WATER VAPORISES
• ABOVE 300 DEGREES CARBONISATION AND PYROLYSIS
MECHANICAL EFFECTS

• HIGH ENERGETIC AND SHORT PULSED LASER CAN LEAD TO FAST

HEATING
• THE FORMATION OF THE PLASMA CAN BE OBSERVED
• THE ENERGY DISSIPATES EXPLOSIVELY IN A VOLUME EXPANSION THAT
MAY BE ACCOMPANIED BY FAST SHOCK WAVES
• THESE MECHANICAL WAVES CAN LEAD TO VERY HIGH PRESSURE ----
ADJACENT TISSUES ARE DESTROYED.
LASER INTERACTIONS ON THE PULP
• PULSING CAN BE USED IN REDUCING THE EXTENT OF COLLATERAL
DAMAGE
• THIS PRINCIPLE IS INEEFECTIVE IN THE CASE OF DENTAL HARD TISSUES
AS THERE IS DIFFERENCE IN THE DIFFUSION RATE ,RELAXATION TIME
BETWEEN DENTAL HARD AND SOFT TISSUES
• THE USE OF COMBINATION OF AIR AND WATER SPRAY REDUCES THE
HEAT TRANSFER TO THE PULP TISSUES
LASER INTERACTIONS ON ENAMEL
• CO2 -WAVELENGTHS AT 9320 nm9900nm ---THESE ARE HIGHLY ABSORBED BY THE HYDROXY
APATITE CRYSTALS
• VARYING THE PULSE WIDTH, PULSE MODE,SPOT SIZE CAN PRODUCE CHANGES IN THE
SURFACE MORPHOLOGY
LASER INTERACTIONS ON ENAMEL

• CAN CAUSE SURFACE FUSION, ROUGHNESS,PARTIALLY FUSED CRYSTALLITES,CHARRING AND

CRACKING.
• THE ARGON AND Nd YAG possesses reflective properties –needs a photo-absorptive dye
placement for sufficient action- otherwise it produces superheated ,beaded enamel surface.
ENAMEL SURFACE RESPONSE TO LASER ABLATION

MEDIUM WAVE ENAMEL CHARACTERSTICS CLINICAL

LENGTH APPLICATIONS
nm

CO2 10600nm Surface fusion, roughness etching, charred, Resin bonding,enamel

cracking etching,caries
reduction ,fusing
apatite

CO2/Nd YAG ROUGH FUSED CRYSTALLITES RESIN BONDING,

10600/ ENAMEL ETCHING
1064

Nd YAG 1064 DECAY REMOVAL

ETCHING WITH
PLACEMENT OF DYE

Er YAG 2900 ETCHED CAVITATED SURFCE CAVITATION

ENAMEL ETCHING
Thank u