LASER ORTHO

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LASERS IN ORTHODONTICS

INTRODUCTION:

INTRODUCTION DEFINITION AND LASER PHYSICS LASER is an acronym for ‘light amplification by stimulated emission of radiation’. Fundamentally, a laser beam is a focused source of electromagnetic radiation, or lightenergy .. COMPONENTS OF A LASER All lasers consist of three basic components: • The laser medium ( “ACTIVE ELEMENT “) • The pump source • The optical cavity or optical resonator LASER LIGHT ENERGY is defined by three properties: • Monochromatic (of one color or wavelength) • Directional • Coherent. The DEGREE OF TISSUE ABSORPTION is influenced by: • Laser wavelength (measured in nanometers ) – a component of the laser media • Electrical power of the surgical unit (measured in watts) • Exposure time • Composition and thickness of the tissues.

HISTORICAL PERSPECTIVE:

HISTORICAL PERSPECTIVE 1917, American physicist Albert Einstein first proposed the theory of ‘stimulated emission’, 1954 , Charles Towne - ‘maser ’ In 1958, Arthur Schawlow, Townes’s brother-in-law, proposed the operation of optical and infrared masers, or ‘lasers’ – a term first coined by physicist Gordon Gould in 1957 . In 1962, Robert Hall developed the first diode or semiconductor laser. The carbon dioxide gas laser was invented by Kumar Patel in 1964 In 1985, Paghidiwala , tested the erbium-doped solid state laser ( Er:YAG ) on dental hard tissue. in 1997, the United States Food and Drug Administration (FDA) approved the Er:YAG solid-state laser for hard tissue surgery.

two most popular lasers used in dentistry:

two most popular lasers used in dentistry Diode lasers are almost exclusively used for soft tissue surgery Diode lasers convert electrical energy into light energy. Diode lasers are known as semiconductors, as they use a media of gallium and arsenide, and occasionally indium and aluminium , whose ability to conduct electricity is between that of conductors and insulators . The wavelengths produced by diode lasers range between 810 nm and 980 nm Before surgery with a diode laser, the fiberoptic tip must be conditioned or primed. Solid-state lasers, on the other hand, can be used for both soft and hard tissue surgery Solid-state lasers use a gain medium that is a solid, rather than a liquid or gas Two common matrices are the yttrium aluminium garnet (YAG) and the yttrium scandium gadolinium garnet (YSGG ). The wavelengths produced by erbium-doped solid-state lasers range between 2780 nm and 2940 nm . Priming is not required as the solid state lasing medium does not absorb pigmentation DIODE LASERS SOLID STATE LASERS

LASER USE IN ORTHODONTIC PRACTICE:

LASER USE IN ORTHODONTIC PRACTICE In orthodontic practice, lasers have many common applications , ACCELERATION OF TOOTH MOVEMENT biostimulatory effects of LLLT- the amount of bone formation and rate of cellular proliferation on the tension side and the number of osteoclasts on the pressure side were both significantly increased in the irradiation area. BONE REMODELING, LLLT increases fibroblast proliferation and the quantity of osteoid tissue ENAMEL ETCHING PRIOR TO BONDING, Laser etching produces an acid‑resistant surface. Laser radiation of dental hard tissues modifies the calcium‑to‑phosphorus ratio, reduces the carbonate‑to‑phosphate ratio, reduces water and organic component content and leads to the formation of more stable, less acid‑soluble compounds (thus reducing susceptibility to acid attack and caries ) .

LASER USE IN ORTHODONTIC PRACTICE:

LASER USE IN ORTHODONTIC PRACTICE DEBONDING OF CERAMIC BRACKETS With the application of laser irradiation, the adhesive resin can be softened, allowing light force to be applied during debonding PAIN REDUCTION AFTER ORTHODONTIC FORCE Low‑level laser therapy (LLLT), in which the energy output is sufficiently low to prevent a temperature rise above 36.5°C (normal body temperature) in the target tissue , can be used as a convenient analgesic therapy for orthodontic patients . PREVENTION OF ENAMEL DEMINERALIZATION the laser‑irradiated enamel becomes acid resistant by altering its crystalline structure

CLINICAL APPLICATION IN ORTHODONTICS:

CLINICAL APPLICATION IN ORTHODONTICS Soft‑tissue applications such as Frenectomy for midline diastema correction Canine exposure in labial sulcus Canine exposure on palatal aspect Gingivoplasty Gingivectomy Ablation of minor aphthous ulceration Laser assisted circumferential supracrestal fibrotomy /LACSF/ pericision

FRENECTOMY FOR MIDLINE DIASTEMA CORRECTION:

FRENECTOMY FOR MIDLINE DIASTEMA CORRECTION

GINGIVAL AESTHETICS:

GINGIVAL AESTHETICS Gingivectomy is the surgical removal of a portion of gingival tissue for improved oral health, functional contour or esthetic appearance (Glossary of Periodontal Terms, 2001) Gingivoplasty is the surgical reshaping and re-contouring of the outer surface of gingival tissue for cosmetic, physiological, or functional purposes, usually done in combination with gingivectomy .

Exposure of unerupted and partially erupted teeth :

Exposure of unerupted and partially erupted teeth

CANINE EXPOSURE IN LABIAL SULCUS:

CANINE EXPOSURE IN LABIAL SULCUS Use of 810nm diode laser

CANINE EXPOSURE ON PALATAL ASPECT :

CANINE EXPOSURE ON PALATAL ASPECT DIODE LASERS

REPLACING THE NEED FOR A TISSUE PUNCH WHEN PLACING MINISCREWS IN UNATTACHED GINGIVA:

REPLACING THE NEED FOR A TISSUE PUNCH WHEN PLACING MINISCREWS IN UNATTACHED GINGIVA

LASER SAFETY AND HARMFUL EFFECTS OF LASERS :

LASER SAFETY AND HARMFUL EFFECTS OF LASERS According to the standards of American National Standards Institute and Occupational Safety and Health Administration, lasers are classified into four different classes based on potential danger, as follows : Class I: These are low‑powered lasers that are safe to view Class IIa : These are low‑powered visible lasers. They do not cause damage unless one looks directly along the beam for longer than 1,000 s Class II b: These are low‑powered visible lasers. They are dangerous when viewed along the beam for longer than 0.25 s Class IIIa : These are medium‑powered lasers that are not dangerous when viewed for less than 0.25 s Class IIIb : These are medium‑powered lasers that are dangerous when viewed directly along the beam for any length of time Class IV: These are dangerous high‑powered lasers that can cause damage to the skin and eyes. Even the reflected or radiated beams are dangerous. It is necessary to take appropriate safety measures. Most of the lasers used for medical and dental purposes are in this category .

LASER SAFETY AND HARMFUL EFFECTS OF LASERS:

LASER SAFETY AND HARMFUL EFFECTS OF LASERS In addition, the inhalation of laser deposits consisting of organic materials, water vapor , carbon monoxide, carbon dioxide and hydrocarbon gas can be dangerous . It is known that lasers operating at wavelengths below 400 nm (although not typically used in dentistry) have a detrimental effect to the skin . Lasers operating at non‑visible wavelengths (ultraviolet and infrared) and reflection of laser light from various surfaces can also increase potential danger . Because the biggest risk is for the eyes, protective glasses must be worn by the patient and the practitioner during laser therapy .

CONCLUSION:

CONCLUSION Thus lasers as an adjunctive procedure, has helped many orthodontists elevate the level of patient care by increasing treatment efficacy, improving oral hygiene around fixed appliances during orthodontic treatment, and enhancing final smile esthetics

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