LASERS : THE 21ST CENTURY

RACERS IN PROSTHODONTICS

• Light Amplification by Stimulated Emission of Radiation

• Term coined by GORDON GOULD ,1957

• Father of laser: Albert Einstein • Laser light is a man-made single

photon wavelength.

LASER LIGHTVISIBLE LIGHT

Why Lasers In Prosthodontics• Prosthodontics takes all concepts of dentistry and

integrates effective comprehensive treatment planning.

• It include a wide variety of patients seeking a diverse range of care:

• Fearful patients

• Patients with complex medical histories

• Patient allergic to anesthetics

Lasers have become an integral part of treatment for these patients

ADVANTAGES

Painless, Bloodless &

Clean surgical field.

No or minimal need

for anesthesia.

Laser kills bacteria, risk of infection is

reduced

No postoperative

discomfort, and swelling.

Superior and faster healing

LASER

LASERS ON BASIS OF

APPLICATION IN DENTISTRY

• SOFT TISSUE LASERS

• HARD TISSUE LASERS

SOFT TISSUE LASERS

• No suturing

• Little or No bleeding

• Painless

• Quicker

• A traumatic

HARD TISSUE LASERS

• Quicker

• More accurate

• More comfortable

• Better results

Application in

FIXED PROSTHETICS/ESTHETICS

• Soft tissue management around abutments.

• Crown lengthening.

• Osseous crown lengthening.

• Troughing.

• Formation of ovate pontic sites.

• Modification of soft tissue around laminates

SOFT TISSUE MANAGEMENT

AROUND ABUTMENTS

• ARGON laser provide excellent Hemostasisand Coagulation

• Gingival Retraction for making impression during a crown and bridge procedure becomes easy

CROWN LENGHTNING

INDICATIONS

Insufficient clinical crown length

Caries at gingival margin

Endodontic perforations near alveolar crest.

Unaesthetic gingival architecture.

Cosmetic enhancement.

LASER TROUGHING

• A trough is created around a tooth before impression making using Nd:YAG laser.

• This can entirely replace the need for retraction cord, electro cautery, and the use of haemostatic agents.

Gingival troughing with the diode laser exposes finish lines

FORMATION OF OVATE PONTIC SITES

• Two most common causes of unsuitable pontic site:

Insufficient compression of alveolar plates after an extraction

Non replacement of a fractured alveolar plate.

Unsuitable pontic site results in un esthetic and non self cleansing pontic design.

• For favorable pontic design laser re-contouring of soft and bony tissue may be needed

MODIFICATION OF SOFT TISSUE

AROUND LAMINATES

The removal and re-contouring of gingival tissues around laminates can be easily accomplished with the Argon laser

REMOVABLE PROSTHETICS

Tuberosity reduction

Torus reduction

Soft tissue lesions

Residual ridge modification

TUBEROSITY REDUCTION• The most common reason for enlarged Tuberosity

usually is soft tissue hyperplasia

• It affects stability of prosthesis

• Surplus soft tissue should be excised using soft tissue lasers

TORUS REDUCTION• Tori and exostoses are formed mainly of compact bone.

• They may cause ulceration of oral mucosa.

• They may also interfere with lingual bars or flanges of mandibular prostheses.

• Soft tissue lasers may be use to expose the exostoses and Erbium lasers may be use for the osseous reduction.

SOFT TISSUE LESIONS

Epulis fissurata, Denture stomatitis

• Persistent trauma from a sharp denture flange

• Over compression of the posterior dam area

• The lesion can be excised with any of the soft tissue lasers and the tissue allowed to re epithelialize.

RESIDUAL RIDGE MODIFICATION

• For proper retention, stability and support for the prosthesis, residual ridge modification is done with lasers, in pre prosthetic preparation phase for

• Under cuts

• Flabby tissue

IMPLANTOLOGY

• Second stage uncovering.

• Implant site preparation.

• Peri-implantitis.

SECOND STAGE UNCOVERING

• Following the placement of implant and its Osseo integration, Er:YAG laser can be used to uncover implants

• Little blood contamination (haemostatic effects)

• Minimal tissue shrinkage

• Eliminate trauma to the tissues during flap reflection

• Impressions can be obtained at the same appointment

ADVANTAGES OVER CONVENTIONAL SURGERY

Two implants are being uncovered using a scalpel.

Excess soft tissue beingremoved using laser

Immediately healing caps are laser exposed and soft tissue is re contoured

Soft tissue healing within 2 weeks

IMPLANT SITE PREPARTION

• Lasers can be used for the placement of mini implants especially in patients with potential bleeding problems, to provide essentially bloodless surgery in the bone

PERI-IMPLANTITIS

• Lasers can be used to repair ailing implants by decontaminating their surfaces with laser energy.

• Lasers can also be used to remove inflamed granulation tissue around an already osseointegrated implant.

• Diode, CO2 & Er:YAG lasers can be used for this purpose.

RECENT ADVANCES IN LASERS

MAXILLOFACIAL

PROSTHESIS

• Topologic data of the patient’s deformity is acquired using laser surface digitizing, the procedure is called Laser Holography Imaging

• Lasers aid in creating a visually realistic prosthesis that can provide an illusion of normal appearance.

Laser welding

No need for investment and soldering alloy

Working time is decreased

Easy to operate

Minimal heat damage to denture base resin

Advantages over Conventional Soldering

An attractive alternative method to join dental casting alloys such as broken clasp

• Ultraviolet (helium-cadmium) laser-initiated polymerization of liquid resin in a chamber, to create surgical templates for implant surgery and major reconstructive oral surgery.

• Laser scanning of casts can be linked to computerized milling equipment for fabrication of restorations from porcelain and other materials.