Laser

in
Periodontology

Dr. Hussain Al-Sarhan

PGHD Periodontology & Implantology
 L A S E R
Light Amplification Stimulated Emission Radiation
Stimulated Emissions
 • Monochromatic- Concentrate in a narrow range of
wavelengths (one specific color).
Laser beam properties • Coherent- All the emitted photons bear a constant
phase relationship with each other in both time and phase
• Collimated- perfectly parallel beam of directional light
• Directional- A very tight beam which is very strong and
concentrated.
Laser Tissue
Effect
•Laser can be classified cording to
• Emission medium :
Solid state , gas , liquid and semiconductor
( diode laser )

•function :
Soft tissue , hard tissue , resin curing

•Mode of action :
Contact ,non-contact

•Level of anergy :
Soft low level , hard high level

•Generating of beam :
Continuous ,single pulse ,multiple timed Pulse.

• Wavelength .
Wavelength
range
• Laser is a non-ionizing radiation
• Dose not cause any DNA changes
• It is safe if its used correctly
•Diode laser penetrates tissue 1-3 mm it is highly
absorbed by pigmented tissue and hemoglobin .
•Poor absorbing by water .
Emission mode
Diode Laser

•Semiconductor laser active

medium is (Indium-gallium-
arsenide-phosphid
InGaAsP ,Gallium-aluminium-
arsenide GaAlAs )
•It is a soft tissue laser
•Action by thermal cutting
Diode laser
parts
1. Control panel
2. Fiber optic ( different types )
3. Handpiece
4. Delivery tip (different size & types)
5. Foot switch
6. Power source
Continuous Mode Gated –Pulse mode
Beam emitted at one power level as long -Periodic alternation of laser energy
the foot switch is pressed. -By opening & closing of mechanical shutter
in front of beam path of continuous wave.

Super Pulsed Mode

Beam emitted at max power level for
millisecond .
Chromophor
e
•It’s the affinity of the tissue to
absorb a specific wavelength of
laser beam
•Each wavelength produce high
effect of its chromophore
The coagulation Tip activation or
performance of an carbonization
810 nm diode laser
is best , touching
Diode lasers can only cut
laser
when their fiber tips are
( tip must be carbonized (activated).
activated ) Because their wavelengths
an activated tip have a very low coefficient of
results in absorption for pigmentation,
coagulation that is the only way that cutting can
5 times greater than be achieved is through the
use of a generation of heat at the tip of
nonactivated one the fiber.
the ablation level is nearly
double that of 810 nm by using
the 980 nm wavelength.

non-touching laser using pure

photon energy and a
nonactivated tip
Dule wavelength laser device

Devices that uses both 810 and 980

The benefit of a dual-wavelength diode laser comes from the combined use of both wavelengths to
provide a greater effect on the tissue while delivering less energy. To prevent collateral damage to the
tissues,
 FDA approved in 1995 for
surgery &1998 for
debridement

What laser beam can

do
Soft tissue:
 Cut, coagulate, ablate or vaporize target
tissue elements
 Sealing of small blood vessels
 Sealing of small lymphatic vessels
 Sterilizing of tissue- Eschar
 Decreased post-operative tissue shrinkage
 Increase blood flow ( low laser energy pain
thrapy)
 Treat dentin hypersensitivity
Application of Diode Lasers in Periodontics
Gingivectomy & Crown
lengthening
•Either perpendicular to the base of the pocket
•At 45 ° angle to the long axis of the tooth
•Or vertical with the long axis step by step cutting
perpendicular to the base of the pocket
 Vertical With
The Long Axis
Step By Step
Cutting
…
Laser vs Blade
 LANAP
(laser assisted new attachment procedure )
Gold and Villardi 1994
Depigmentation
Implant
exposure
Operculectomy (removal of gingival tissue distal to molar)
Low Level Laser Pain
Therapy
Thank
you