DTME1010

_Diode lasers The diode laser is a solid-state semiconductor laser that typically uses a combination of Gallium (Ga), Arsenide (Ar), and other ele- ments such as Aluminum (Al) and Indium (In) to change electrical energy into light energy. The wavelength range is about 800–980nm.Thelaserisemittedin continuouswave and gated- pulsedmodes,andisusuallyoper- ated in a contact method using a flexible fiber optic delivery sys- tem. Laser light at 800–980 nm is poorly absorbed in water, but highly absorbed in hemoglobin and other pigments (ALD 2000). Since the diode basically does not interact with dental hard tissues, the laser is an excellent soft tissue surgical laser (Romanos G, 1999), indicatedforcuttingandcoagulat- ing gingiva and oral mucosa, and forsofttissuecurettageorsulcular debridement. TheFDAapprovedoralsofttis- sue surgery in 1995 and sulcular debridementin1998bymeansofa diode laser (GaAlAs 810 nm). The diode laser exhibits thermal ef- fects using the ‘hot-tip’ effect caused by heat accumulation at theendofthefiber,andproducesa relatively thick coagulation layer on the treated surface (ALD 2000). The usage is quite similar to elec- trocauterization. Tissue penetra- tionofadiodelaserislessthanthat of the Nd:YAG laser, while the rate of heat generation is higher (Rastegar S 1992), resulting in deeper coagulation and more charring on the surface compared to the Nd:YAG laser. The width of thecoagulationlayerwasreported to be in excess of 1.0 mm in an in- cision of bovine oral soft tissue in vitro (White JM 2002). The advan- tages of diode lasers are the smaller size of the units as well as the lower financial costs. _Argon laser Theargonlaserusesargonion gas as an active medium and is fiber optically delivered in contin- uous wave and gated pulsed modes. This laser has two wave- lengths,488nm(blue)and514nm (bluegreen), in the spectrum of visible light. The argon laser is poorly absorbed in water and therefore does not interact with dental hard tissues. However, it is well absorbed in pigmented tis- sues, including haemoglobin and melanin, and in pigmented bacte- ria. The argon laser was approved by the FDA for oral soft tissue sur- gery and curing of composite ma- terials in 1991 and for tooth whitening in 1995. Considering the advantages of eradication of pigmentedbacteria,thislasermay be useful for the treatment of peri- odontal pockets. _Alexandrite laser The Alexandrite laser is a solid-statelaseremployingagem- stone called Alexandrite, which is chromiumdoped: Beryllium-Alu- minum-Oxide chrysoberyl (Cr+3; BeAl2O4) and is one of the few trichroic minerals. Rechmann & Henningfirstreportedthatthefre- quency-doubledAlexandritelaser (wavelength 337 nm, pulse dura- tion 100 ns, double spikes, q- switched) could remove dental calculus in a completely selective mode without ablating the under- lying enamel or cementum. The development of this laser for clini- caluseiswidelyexpectedduetoits excellent ability for selective cal- culus removal from the tooth or root surface without ablating the tooth structure. _Excimer laser Excimer lasers are lasers that use a noble-gas halide, which is unstable, to generate radiation, usually in the ultraviolet region of the spectrum. Frentzen et al. demonstrated that the ArF ex- cimer laser, wavelength 193 nm, could effectively remove dental calculus without causing any damage to the underlying surface. Thecementumsurfacewasclean, and only a slight roughness could be observed after irradiation, sup- porting the use of excimer lasers for laser scaling. Folwaczny et al. have reported that the 308 nm wavelength XeCl excimer laser could effectively ablate dental cal- culuswithoutthermaldamagesor smear layer production. _Frenectomy procedure using diode lasers Diode laser (A.R.C. Fox™) with wavelength of 810 nm wasselectedfortheprocedure.No local anaesthesia was given to the patient.Thefrenumwasstretched to visualize its extent. The diode laser was applied in a contact mode with focused beam for exci- sion of the tissue. The ablated tis- sue was continuously mopped us- ing wet gauze piece. This takes care of the charred tissue and pre- vents excessive thermal damage to underlying soft tissue. The tis- suewaslaseduntilalltheunderly- ing muscle fibers were dissected. No sutures were placed at the end of this procedure. Patients were asked to take analgesics only if needed. Advantages of Laser over Conventional technique: _No need of local anaesthesia. Hence it’s a painless procedure. 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