Lasers in oral medicine

Content
What is laser
Types of lasers
Properties of lasers
Lasers for diagnosis
Lasers in treatment
Advantages of lasers
Disadvantages of lasers
Precautions
LASER (Light amplification by stimulated emission of
radiation) .
It is a device which can operate in the infrared , visible
or ultraviolet region of the spectrum
and
which amplifies electromagnetic waves by stimulated
emission of radiation
CHARACTERISTICS OF LASERS
Monochromatic
Directional
Coherent

Laser light is highly directional and travels in a narrow

beam, the sides of which stay almost parallel.
Laser produces coherent light, that is it has only one
frequency.
Laser light is of a single color. Laser light is powerful
with very high intensity.
MECHANISM OF ACTION

Photochemical interaction
 Photothermal interaction
 Photomechanical interaction
 Photoelectrical interaction
A.Photochemical Interaction:
 This type of interaction includes the interaction of
the beam with the chemical process of the tissue.
 It is further subdivided
1. Biostimulation: It describes the stimulatory effect of
laser light on biochemical and molecular processes
that normally occur in tissue like healing and repair.
2. Photodynamic therapy: It is the therapeutic use of
lasers for the treatment of pathological conditions.
It is beneficial in treating potentially malignant
disorders, such as oral leukoplakias.
 Useful as an adjunct therapy in removal of areas of
field cancerization adjacent to cancer sites.
3. Fluorescence: This can be used to detect light reactive
substances in the tissues.
B. Photothermal:
• Photoablation: This is nothing but removal of the
tissue by vaporization and superheating of the tissue
fluids, coagulation or hemostasis.
 Photopyrolysis: It is burning away of the tissues.
C.Photomechanical Interaction:
Photodisruption or photodissociation: it is nothing
but breaking apart of the structure by laser light.
 Photoacoustic: It is removal of the tissues with
shockwave therapy.
D.Photoelectrical Interaction:
Photoplasmolysis: This describes how tissue is
removed through the formation of electrically charged
ions.
TYPES OF LASER
High-power Lasers (Hard, Hot) therapeutic effects
through thermal interactions. output power of more
than 500 mW.
 Intermediate-power Lasers These lasers leave their
therapeutic effects without producing significant heat
output powers ranging from 250 to 500 mW.
Low-power Lasers (Soft, Cold) It is also known as low
level laser photobiostimulation or photobiochemical
reaction. Output power of these lasers is less than 250
mW.
LASERS USED IN ORAL MEDICINE
Carbon Dioxide
Nd:YAG
Ho:YAG
 Er:YAG
Diode Lasers
Lasers are used in the
1. Diagnosis and
2. Treatment
LASERS used in Diagnosis
Diagnosis •
1.  Laser fluorescence- Detection of caries, bacteria and
dysplastic changes in the diagnosis of cancer
2. Detection of pulp vitality
3. Doppler flowmetry.
4. Spectroscopy
5. Optical coherence tomography
DIAGNOdent™ Pen  Caries Detection Aid
Laser Doppler Flowmetry
Laser Doppler flowmetry allows continuous real-
time measurement of local microcirculatory
blood flow .
Spectroscopy originated through the study of  visible
light  dispersed according to its wavelength , by a 
prism.
Used in diagnosing potentially malignant disorders
Optical coherence tomography
Optical coherence tomography (OCT) is a noninvasive
diagnostic technique providing cross-sectional images
of biologic structures based on the differences in
tissue optical properties.
Soft tissue pathoses: Diagnosis of oral soft tissue
disease with comparable results to pathologic
diagnosis in near future (optical biopsy).
Dental education Use of 3D constructed images based
on OCT can be used in educational simulation
systems.
Therapeutic uses of
LASERS
Leukoplakia
Oral Lichen Planus
 Oral Submucous Fibrosis Oral submucous fibrosis
(OSMF)
Ulcers of oral mucosa
Malignant ulcers
Herpes Simplex Virus Infections Herpes simplex virus
types 1 and 2
Recurrent Aphthous Ulcers
Photodynamic therapy for malignancies
Reflexotherapy or laser acupuncture
Mucositis pain
Trigeminal neuralgic pain
Myofacial pain
PHOTODYNAMIC THERAPY
Used in treating lichen planus
SOFT TISSUE APPLICATION

Wound healing
Post herpetic neuralgia and apthous ulcer
Photoactivated dye disinfection using lasers
Photodynamic therapy for malignancies
Removal of inflamed, hypertrophic tissue, and
miscellaneous tissue removal
Orofacial pain
Less pain in some instances (reducing the need for
anesthesia) Reduce anxiety in patients uncomfortable
with the use of the dental drill.
 Minimize bleeding (high-energy beam
photocoagulation) and swelling.
Removal of sialoliths: Carbon Dioxide Lasers are used
ideally for superficial lesions, resurfacing of the skin.
Advantages
 Lesser Noise
 No Stitches
 Takes Lesser time
 No discomfort
 Fast recovery
Disadvantages:
Lasers can't be used in many commonly performed
dental procedures.
Cannot be used in acute pain.
 Do not eliminate the need for anesthesia.
 More expensive since the cost of the laser is much
higher.
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