i s s n 2 1 9 3 - 4 6 6 5 Vol. 7 • Issue 3/2015 laser international magazine of laser dentistry 32015 | research Use of the Er:YAG laser for initial treatment of chronic periodontitis | case report Periimplantitis and Er:YAG laser | industry Laser snoring and sleep apnoea reduction

Dear colleagues, Prof. Dr Norbert Gutknecht Editor-in-Chief This year, after much time and effort, we have arranged a scientific program featuring a number of interna- tional experts for the annual congress of the Deutsche Gesellschaft für Laserzahnheilkunde (DGL), themed “Wavelengths”. Furthermore, in response to repeated requests from our foreign colleagues, we have expanded the congress to include an international audience. In order to accommodate this change, we have scheduled the first congress day, 27 November, for international lectures which will be interpreted. As you can see in our preliminary program, in addition to guest speakers such as Prof. Jens Malte Baron, a der- matologist from the RWTH Aachen University Hospital, Dr James Carroll, a specialist in low-level laser therapy from the UK, Dr Joshua Weintraub from Stevenson, USA, and Prof. Dr. Peter Rechmann from the University of San Francisco, USA, a substantial number of national and international lecturers will discuss the wide range of wave- lengths for use in laser dentistry. In addition, short presentations will complement the program. Without promising too much, the lectures will offer new insights into the mode of action of lasers concern- ing different tissue types and cell function. At the DGL party on Saturday evening, certificates for the mastership course will be awarded to DGL and in- ternational students. Moreover, all of the major laser manufacturers will be exhibiting their products and offer- ing workshops. It goes without saying that only through your participation at this year’s international DGL conference can the association continue to achieve what distinguishes it: innovation, knowledge transfer, fellowship and friend- ship. Therefore, I would like to encourage all of you to not only participate in our congress in Berlin but also to warmly welcome our international guests to the event. With warm regards, Prof. Dr Norbert Gutknecht Editor-in-Chief editorial I laser 3_ 2015 I 03

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research I As lasers can achieve excellent tissue ablation with strong bactericidal and detoxification effects, they are one of the most promising new technolog- ical modalities for Phase 1 therapy.4 Over the last two decades, the use of different dental lasers has been included in the above regimen. Laser light is a unique, non-ionising form of electromagnetic radi- ation that can be employed as a controlled source for tissue cutting or ablation, depending on specific parameters. There are many different types of lasers, and each produces a specific wavelength of light. Throughout the last decades, clinicians involved in the treatment of periodontitis have used differ- ent dental laser wavelengths. Each wavelength has a somewhat different effect on the dental and peri- odontal structures, owing to the specific absorption of that laser energy by the tissue. Of all lasers emit- ting in the near- and mid-infrared spectral range, erbium lasers are unique in that they are the only lasers that can cut both hard and soft tissue with minimal heat-related side-effects. It has been sug- gested that the erbium wavelengths present the broadest range of application for clinical dentistry and are likely the most suitable lasers for periodon- tal therapy.5–8 During Er:YAG laser irradiation, the laser energy is absorbed selectively by water molecules in bio- logical tissue, causing evaporation of water and or- ganic components, and thus resulting in thermal ef- fects due to the heat generated by photothermal evaporation. Moreover, in hard-tissue procedures, the water vapour production induces an increase in internal pressure within the tissue, resulting in ex- plosive expansion called “micro-explosion”.9 These dynamic effects cause mechanical tissue collapse, resulting in thermomechanical or photomechanical ablation.10 This phenomenon has also been referred to as “water-mediated explosive ablation”.11, 12 Laser treatment has the potential advantage of accomplishing soft-tissue wall treatment effec- tively along with root surface debridement. Aoki et al.13 and Keller and Hibst14 began to investigate the application of the Er:YAG laser to periodontal hard-tissue procedures, such as dental calculus re- moval and decontamination of the diseased root surface. A number of basic studies on Er:YAG laser application to root surface treatment have been reported in clinical studies on non-surgical pocket therapy using laser.15–17 Controlled clinical trials and case report studies have also indicated that non-surgical periodontal treatment with the Er:YAG laser leads to significant gain of clinical attach- ment.18–20 Preliminary clinical results have also indicated that this minimally invasive method may allow instrumentation of very deep pockets without leading to major trauma of the hard and soft tissue, that is, removal of tooth substance and an increase in gingival recession.17, 19 Figs. 1–5_Classical treatment versus laser treatment; results for PBI, PPD, CAL, GR and BL after three months. Fig. 1 The second phase of initial therapy entails closed debridement of periodontal pockets: debridement of root surfaces of plaque and calculus, detoxifica- tion of the root surfaces, root planing and gingival curettage. The removal of pocket epithelium and a portion of infected connective tissue has been a matter of debate,21 but current research results clearly demonstrate the possibility of bacterial colonisation of pocket epithelium and connective tissue.22–24 In our study, we compared gingival curettage and scaling and root planing using an Er:YAG laser ver- sus conventional mechanical hand instrumentation according to clinical indicators of successful treat- ment and/or periodontal stability after non-surgical therapy of patients with chronic periodontal dis- ease. _Materials and methods Patient selection After undergoing a comprehensive periodontal examination, 20 patients older than 35 years with Fig. 2 laser 3_ 2015 I 07

In the test group, closed curettage was per- formed with the LiteTouch laser (Syneron Dental Lasers), which has a direct delivery system and the active medium is built into the handpiece base. For the purpose of the study, a regular handpiece and external water irrigation were used. Clinical param- eters for low-energy settings (50 mJ–100 mJ) to im- prove inflammatory conditions by reducing the bacterial load and inflammatory tissue in the peri- odontal pocket were utilised. Scaling and root planing were performed on the root surface and the laser was kept angled with an in- clination of the fibre tip of 10–15 degrees to the ver- tical axis of the tooth. Instrumentation was per- formed from the coronal to the apical in parallel paths. The laser settings were as follows: hard tissue, chisel tip (0.5 mm × 1.4 mm) × 17 mm, water spray level 6, 100 mJ, 15 Hz, energy density of about 256 mJ/mm2, power density of about 3.85 W/mm2, and pulse width of about 170 ms. The instrumenta- tion with both hand instruments and laser was per- formed until the operator felt that the root surfaces had been adequately debrided and planed. The laser- assisted periodontal pocket debridement (gingival curettage) was performed on the soft tissue with the laser kept at a 20-degree angle between the laser tip and the vertical axis of the tissue with parallel move- ment along the pocket wall, starting from the bottom of the pocket. The laser parameters were as follows: soft tissue, non-contact mode (performed at a dis- tance of 1–2 mm between the tip end and the tissue), 50 mJ, 30 Hz, tip of 0.6 mm × 17 mm, energy density of about 178 mJ/mm2, power density of about 5.35 W/mm2, and pulse width of about 290 ms. Statistical analysis The difference between the two groups (test and control) over the study period was analysed using the Mann–Whitney U test and the Wilcoxon signed- rank test. _Results Clinical data was collected at baseline and three months after treatment. PI, PBI, PPD, CAL, GR and bone level (BL) were measured and analysed. There were no statistically significant differences in the data at baseline between the two groups in any of the examined parameters according to the Mann–Whitney U test (p > 0.05). After three months, an iterative comparison of the data was performed, again using the Mann–Whitney U test. The results showed highly statistically significant differences in PBI, PPD, CAL, GR and BL between patients treated classically with mechanical debridement and those treated with laser (p < 0.01; Figs. 1–5). For PI, there was no statis- tically significant difference between the tested groups after three months (p > 0.05; Fig. 6). Furthermore, the Wilcoxon signed-rank test was used to analyse the data obtained for the laser- treated group at baseline and after three months. The results showed highly statistically significant differences for all parameters (p < 0.01). The same test (Wilcoxon signed-rank test) was used to analyse research I Fig. 5 Fig. 6 laser 3_ 2015 I 09

Master of Science (M.Sc.) in Lasers in Dentistry Next Start: 26th September 2016 Aachen, Germany 4 semesters Become part of the International Dental Elite • Create new economic potential for your practice • Two year career-accompanying postgraduate pro- gramme at the University of Excellence RWTH Aachen • Combination of lectures, skill training sessions, live ops, tutorials, and practical workshops • Internationally accepted and accredited by the German Governent, the European Union, the Washington Accord and the Bologna Process • Science-based and practice-orientated on highest na- tional and international level • Increased patient satisfaction: minimal contact reduced vibration and pain RWTH International Academy Kackertstraße 10 I 52072 Aachen I Germany phone +49 241 80 23543 I fax +49 241 80 92525 info@academy.rwth-aachen.de www.academy rwth-aachen.de PROFESSIONAL EDUCATION PROGRAMMES AALZ GmbH Pauwelsstraße 17 I 52074 Aachen I Germany phone +49 241 47 57 13 10 I fax +49 241 47 57 13 29 info@aalz.de www.aalz.de

1. The observed speckle pattern remains stationary. This indicates that there is no refractive error of the eye. 2. The speckle pattern moves down (up, right or left) when the head and thus the eye goes up (down, left or right). In summary, the speckle pattern moves contrary to the movement of the head. In this case, the eye is myopic.3 3. The speckle pattern moves up (down, left or right) when the head goes up (down, left or right), that is, the speckle pattern moves with the movement of the head. In this case, the eye is hypermetropic.3 Figures 3 to 5 illustrate the observed phenomenon. Figure 3 shows schematically a non-accommodated eye with no refractive error in two different positions (down and up). In this case, the eye is referred to as emmetropic. Since the distance between the lens and the retina corresponds to the focal length of the eye, an incident parallel ray is refracted at the same point of the retina regardless of the position (down or up) of the eye. Figure 4 shows a myopic eye, that is, the eye is too long. In the two positions of the eye (down and up), an incident ray is refracted at two different points of the retina. Since the brain exchanges bottom and top, the perceived speckle pattern moves opposite to the mo- tion of the eye. Figure 5 shows a hypermetropic eye, that is, the eye is too short. In this case, the situation is reversed com- pared with Figure 4. _Conclusion d d d u u u can simulate emmetropia, myopia and hyperme- tropia._ Sources: http://elib.uni-stuttgart.de/opus/volltexte/ 2011/6175/pdf/tiz122.pdf; (Download April 29, 2015) http://groups.jqi.umd.edu/rolston/research/ disordered-neutral-atoms-optical-lattices; (Download September 23, 2015) A speckle pattern is perceived as stationary if a non-accommodated and non-defective eye is moved. If the speckle pattern migrates opposite to or with the movement of the eye, it is myopic or hypermetropic, respectively. You can convince yourself of the de- scribed effect by observing, for example, a white wall illuminated with an expanded laser beam. By wearing different goggles (with different focal lengths), you contact Prof. Dr Axel Donges Naturwissenschaftlich-Technische Akademie Seidenstr. 12–35 88316 Isny/Allgäu Germany Kurz & bündig Betrachtet man eine optisch raue Wand mit kohärentem Licht (Laserlicht), so treten Interferenzeffekte auf. Es lassen sich helle und dunkle Flecken – ein sogenanntes Speckle-Muster – beobachten. Der Speckle-Effekt lässt sich messtechnisch ausnutzen, beispielsweise in der Ophthalmologie. Ein Speckle-Muster wird bei bewegtem, nicht-fehlsichtigem Auge als stationär wahrgenommen. Wandert das Speckle-Muster mit der Bewegung des Kopfes mit, ist das Auge übersichtig. Im anderen Fall ist es kurzsichtig. Durch das Tragen verschiedener Brillen (mit verschiedenen Brennweiten) können zudem Emmetropie, Myopie und Hyper- metropie simuliert werden. research I Fig. 3 Fig. 4 Fig. 5 Fig. 3_An optical ray parallel to the optical axis of the lens is always refracted at the same point of the retina. Fig. 4_An optical ray parallel to the optical axis of a myopic eye is refracted at two different regions of the retina; the point of impact of the ray on the retina moves parallel to the movement of the eye. Fig. 5_An optical ray parallel to the optical axis of a hypermetropic eye is refracted at two different regions of the retina; the point of impact of the ray on the retina moves antiparallel to the movement of the eye. laser 3_ 2015 I 13

24th International Annual Congress of the DGL WAVELENGTHS November 27–28, 2015 Berlin, Germany Hotel Palace Congress President: Prof. Dr Norbert Gutknecht/Aachen, Germany Programme overview Congress opening address President of the DGL, Prof. Dr Norbert Gutknecht/Aachen, Germany Laser Supported Reduction of Specific Microorganisms in the Periodontal Pocket with the Aid of an Er,Cr:YSGG laser Guest speakers Prof. Dr Jens Malte Baron/Aachen, Germany Investigation of the biological effects of laser systems by means of 3-D in vitro skin models Prof. Dr Andreas Braun/Marburg, Germany The 445 nm semiconductor laser in dentistry—Introducing a new wavelength Dr James Carroll/Chesham, UK Debonding ceramic brackets—A minimally invasive laser technology from Aachen Dr Marina Polonsky/Ottawa, Canada Pain perception and need for local anaesthesia during caries removal in Class I–V cavity preparations using an Er,Cr:YSGG laser—A prospective clinical study Dr Alin Odor/Constanta, Romania Clinical study of Er,Cr:YSGG (2,780 nm) and diode (940 nm) laser-supported periodontal treatment concept according to Gutknecht Dr Ioannis Papadimitriou/Athens, Greece Management and removal of gingival hyperpigmentation by means of a diode laser Dr Jaana Sippus/Vaasa, Finland Sleep apnoea and snoring therapy using an Er,Cr:YSGG laser Dr Habib Zarifeh/Beirut, Lebanon Crown lengthening in soft and hard tissues in the aesthetic zone Prof. Dr Gerd Volland/Seville, Spain Colour makes it! Dr Jörg Meister/Bonn, Germany Removal of dentine with a diode-pumped Er:YAG laser—First results Dr Dimitris Strakas/Thessaloniki, Greece Bleaching with Er,Cr:YSGG laser Dr Thorsten Kuypers, Msc/Cologne, Germany One-year NightLase anti-snoring treatment—First experiences Dr. Joshua Weintraub/Stevenson, MD (US) Using the First 9.3 µm CO2 All-tissue Laser for Anesthesia-Free Caries Removal and Cavity Preparation Prof. Dr Peter Rechmann/San Francico (US) In vivo fissure caries prevention using a short-pulsed CO2 laser and fluoride varnish Organisational matters Congress fees* Dentist (DGL member) Dentist (non member) Dental technician/assistant (with proof) Student (with proof) *No VAT is charged on the congress fee. 185,– €* 220,– €* 90,– €* 25,– €* Meeting package fee (all participants) 98,– € plus VAT The meeting package fee (incl. coffee breaks, refreshments and meals) is payable by all participants. DGL Evening event Saturday, November 28, 7.00 p.m. Bon Dia Restaurant, Hotel Palace Berlin Cost per person (incl. food, drinks and live music) 75,– € plus VAT Organiser Deutsche Gesellschaft für Laserzahnheilkunde e.V. (German Society for Laser Dentistry) Universitätsklinikum der RWTH Aachen, Clinic for ZPP / DGL Pauwelsstraße 30 | 52074 Aachen, Germany Tel.: +49 241 8088-164 | Fax: +49 241 803388-164 sekreteriat@dgl-online.de | www.dgl-online.de Organization/Registration OEMUS MEDIA AG Holbeinstraße 29 | 04229 Leipzig, Germany Tel.: +49 341 48474-308 | Fax: +49 341 48474-290 event@oemus-media.de | www.oemus.com www.dgl-jahrestagung.de Venue Hotel Palace Berlin Budapester Straße 45 | 10787 Berlin, Germany www.palace.de For booking of various accommodation types at the hotel PRIMECON | Tel.: +49 211 49767-20 | Fax: +49 211 49767-29 info@prime-con.eu | www.prime-con.eu Continuing education credits The event complies with the guidelines and recommendations of the Kassenzahn - ärztliche Bundesvereinigung (national association of statutory health insurance dentists) from 23 September 2005, including the points evaluation recommendation of the continuing education advisory board of the Bundeszahnärztekammer (German dental association) from 14 September 2005 and the Deutsche Gesellschaft für Zahn-, Mund- und Kieferheilkunde (German society for dental and oral medicine) from 24 October 2005, applicable from 1 January 2006. Participants can earn up to 16 credits.. 24th Annual Congress of the DGL Please fax this form to +49 341 48474-290 or send it via post to OEMUS MEDIA AG Holbeinstraße 29 04229 Leipzig Germany laser 3/15 I hereby register the following persons for the 24th International Annual Congress of the DGL from November 27–28, 2015, in Berlin, Germany: ❏ yes ❏ no Title/Surname/Name, Job Title Title/Surname/Name, Job Title DGL Evening event (Saturday, November 28): ............ (Please enter number of persons.) DGL-Member ❏ yes ❏ no DGL-Member Stamp/Address I hereby accept the terms and conditions of the OEMUS MEDIA AG. Date/Signature E-mail address

Removal of the tartar— decontamination of the titanium This allows: – Mucous membrane to be cleared off of the infiltrated area. – The bone to be cleaned off gran- ulation tissue and yet to be pre- served, without aggression ("cold" laser) in order to avoid any necrotic halos, which can lead to complications or failures. – To preserve the decontaminated titanium which can then, at a later point, be re-osseointegrated. _Clinical case In the present case, a 76-year-old patient visited our clinic and presented us with a poor initial situa- tion indicating very poor dental hygiene, xerostomia, oral thrush, a poorly adapted prosthesis, non-pas- sive, no vestibule. The patient’s first visit to our clinic was in July 2010, although the symptoms of a peri- implantitis had already been developing since 2004. A non-conservative treatment, including the re- moval of the implants and scaling, secondary recon- struction of bone and keratinised mucous mem- brane if necessary (Figs. 1–12) seemed favourable. However, the particular circumstances of the pa- tient’s poor dental health, partially caused by prob- lems with alimentation leaving the patient fragile, led us to try to conserve the highly infected implants, which had peri-implant pockets of over 13 mm wide. _Conclusion There is a multitude of traditional instruments such as curettes, specific ultrasound inserts and tita- nium brushes that are commonly used when treating Kurz & bündig Fig. 13 periimplantitis. This may explain a certain reluctance towards the use of other instruments such as the Er:YAG laser. Each and every instru- ment is unique, in the same way as the characteristics of one laser can differ considerably from those of another. Each type of laser has very specific, sometimes even opposing effects. For instance, diode lasers do not damage the titanium but cause a harmful temperature rise while Nd:YAG lasers will damage the surface of the titanium. With regards to the treatment of periimplantitis, the specific charac- teristics of the Erbium laser prove to be the most ef- fective: it allows the operator to accurately select and precisely remove the pathological tissue and to de- contaminate the titanium without staining it, hence enabling a renewed osseointegration. However, the successful treatment still depends on the individual practitioner and the employed equipment. Further research is needed to improve the procedure and pre- dictability of the desired results. The world of implan- tology is constantly evolving and the revolution of the old implantological treatments lead to new develop- ments and techniques. Facing those changes, den- tists must actively seek and promote all available treatment options, including the use of laser. There is a very good reason for its growing presence._ contact Dr Carole Leconte 14 rue du Croissant 75002 Paris Tel.: + 33 01 53890311 cabinet@drleconte.cab Dieser Artikel beschreibt die Vorteile des Er:YAG-Laser-Einsatzes bei der Behandlung von Periimplantitis. Neben den kon- ventionellen Therapiemöglichkeiten, wie spezielle Ultraschalleinsätze oder Titanbürsten, kann die Nutzung eines Er:YAG-La- sers dabei besonders im Bereich des Zahnfleisches, der Knochen, des krankhaften Gewebes und des Titans von Vorteil sein. Der Er:YAG-Laser hat eine Wellenlänge von 2.940 nm. Der unsichtbare Infrarot-Lichtstrahl wird stark von Wasser und Hydroxylapatit absorbiert. Diese enorme Aufnahme, die durch photoablative Effekte verursacht wird, ermöglicht das präzise und selektive Entfernen von pathologischem Gewebe, während das gesunde Gewebe unberührt bleibt. Aufgrund der sehr fei- nen und lichtdurchlässigen Spitze des Lasers, ist eine sehr gute Sichtkontrolle während der Arbeit ohne direkten Kontakt mög- lich. Das macht den Laser für mehrere wichtige Behandlungsphasen im pathologischen periimplantären Bereich attraktiv. Den- noch sind Laser je nach Wirkung einzusetzen, denn diese sind spezifisch und können sogar gegensätzliche Wirkungen haben. Diodenlaser beispielsweise schaden Titan zwar nicht, verursachen aber einen erheblichen Temperaturanstieg, Nd:YAG-Laser können sogar die Titanoberfläche zerstören. Der Einsatz eines Er:YAG-Lasers gestaltet sich daher am effektivsten, da der Be- diener exakt auswählen, das krankhafte Gewebe entfernen und das Titan dekontaminieren kann und somit eine erneute Os- seointegration ermöglicht wird. case report I Fig. 13_Laser devices have proven to be very effective in the treatment of periimplantitis. laser 3_ 2015 I 17

industry report I Fig. 3b Fig. 4b Fig. 3a Fig. 3c Fig. 4a Fig. 4c Non-surgical treatment options for patients suf- fering from OSA include oral appliances, palatal im- plants, weight loss, alternative medicine and contin- uous positive airway pressure (CPAP) masks.10 Surgi- cal methods include laser-assisted uvulopalatoplasty or uvulopalatopharyngoplasty,11 radiofrequency tis- sue ablation and palatal implants.12–14 _Laser treatment option: NightLase many benefits of treatment with NightLase (Fotona), such as no need for anaesthetic, no pain and only three short 20-minute sessions with immediate re- sults. This case presentation describes the treatment of patients with OSA using an Er:YAG laser, with a long-term follow-up period of 28–36 months. These clinical cases are part of an uncontrolled study to evaluate the usefulness of the laser in snoring and sleep apnoea treatment. Figs. 3a–c_Case #1. Pre-op Class 4 (a). Class 1 after three treatments (b). Class 2 at recall 36 months post-op (c). Figs. 4a–c_Case #2. Pre-op Class 4 (a). Class 1 after three treatments (b). Class 1 at recall 28 months post-op (c). Among other treatments, a minimally invasive laser treatment is now available. In this method, laser light is used for non-ablative thermal heating of the tissue, which subsequently causes shrinking of the collagen fibres. This phenomenon opens up the air- ways and reduces snoring and sleep apnoea. There are _Materials and methods Patients with different OSA levels are included in this case report, all from a general dental practice. 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industry report I with proper examination and exclusion criteria are important to identify the therapy needed. Fig. 8_Total score for snoring reduction after three treatments. _Conclusion NightLase is a safe and very successful treatment for reducing snoring and sleep apnoea, and is sup- ported by evidence-based dentistry. It is a minimally invasive treatment with no need for special arrange- ments, either pre- or postoperatively. Since no anaes- thetic is needed, the treatment is well accepted by pa- tients. Long-lasting effects—from 12 to 36 months— allow for high overall satisfaction among patients._ contact LaserEdu Hovioikeudenpuistikko 20 B 65100 Vaasa, Finland jaana.sippus@laseredu.fi _Results All of the patients using a CPAP mask were able to discontinue use of the mask after the first treatment. After the third treatment, patients reported improve- ment of more than 85 %. Average improvement after one treatment session was 51 % and after the second session, 61 % (Fig. 8). All of the patients were satisfied and stated that they would recommend NightLase therapy. None re- ported discomfort or pain during or after the treat- ment. Only one mentioned dry mouth postopera- tively. All of the patients reported that they could breathe much more easily and that motion-related exhaustion had disappeared; quality of life was also better without daily headaches. _Discussion Both snoring and sleep apnoea are the cause of several health issues and are potentially life-threat- ening.8 Still, most patients are unwilling to undergo treatment owing to multiple side-effects, unsuccess- ful non-surgical and surgical treatments, and un- comfortable procedures.15 In the treatments presented in this article, the suc- cess rate was over 85 % (Fig. 8). Even after 28–36 months, the results remained good. NightLase is an easy treatment to perform, with no pain during or af- ter the treatment. Therefore, it can also be repeated with minimum discomfort to the patient. The proce- dure is safe with no need for anaesthetic or medica- tion. Consequently, it allows a good night’s sleep and better quality of life for the patient and his or her part- ner sharing the same bed. However, patient selection Kurz & bündig Konventionelle Behandlungsmethoden von Schnarchsymptomen und Schlafapnoe (Atemstillstand) umfassten bisher alles, von oralen Apparaturen über Uvulaplastik-Operationen, Radiofrequenz-Gewebeablationen, CPAP-Masken (Continuous Positive Airway Pressure) bis hin zu alternativer Medizin. Eine minimalinvasive Zahnheilkunde mit dem Einsatz eines Lasers ermöglicht die Durchführung einer nicht-ablativen Er:YAG-Straffung des Gaumenzäpfchens, des Gaumensegels sowie des umliegenden Gewebes mit einem partiellen Laser- Handstück. Diese sogenannte „NightLase®“-Behandlung wird von Fotona angeboten. Dieser Case Report beschreibt nun dazu die Behandlung von Patienten mit Schlafapnoe, die langfristig 28 bis 36 Monate lang mit einem Laser therapiert wurden. Die klinischen Fälle sind Teile einer freien Studie, die den Lasereinsatz bei der Schnarch- und Schlafapnoebehandlung auf Effizienz untersucht. Dazu werden repräsentative Fallbeispiele nach Mallampati- Klassifikationen aufgezeigt und die Vorteile der NightLase®-Therapie gegenüber konventionellen Methoden erläutert. Ergeb- nis: Bereits nach der dritten Behandlung bekundeten 85 Prozent der Patienten eine Verbesserung. Bereits 51 Prozent hatten bei dem ersten Lasereinsatz eine Verbesserung gespürt. Alle Patienten (insgesamt 100 Prozent) waren am Ende der Behand- lung zufrieden und würden die NightLase®-Therapie weiterempfehlen. laser 3_ 2015 I 21

D A Fig. 4 Fig. 5 Fig. 6 Fig. 7 gesic effect achieved by starting with Solea. The prep was continued using Solea on the Enamel Setting: 1.00 mm spot size, 15 µs pulse duration, 100 % mist, 10 %–100 % variable speed foot pedal. The prep was completed and decay was removed using Solea on the Dentin Setting: 1.00 mm spot size, 70 µs pulse duration, 100 % mist, 20 %–100 % variable speed foot pedal. The cavosurface margins were beveled with a diamond bur to complete preparation (Fig. 2). The tooth was prepared for restoration with Scotchbond Universal (3M). A layer of Esthet(cid:129)Xflow (DENTSPLY), approximately 0.5 mm thick, was placed on the gingival floor of the proximal box. Restoration was completed with Tetric EvoCeram Bulk Fill (Ivoclar Vivadent) and finished (Figs. 3 and 4). Prior to the development of the Solea laser, I would not have considered performing this procedure without anaesthetic; whether I was using an erbium laser, a laser in conjunc- tion with a conventional hand piece or a conventional handpiece alone. Solea’s consistent analgesic effect made the procedure easy and predictable, while the precision with a 0.25 mm spot size made it possible to create a gingival trough adjacent to the amalgam without hitting the amalgam itself. A major advantage of not anaesthetizing the patient is that checking occlusion was simplified. Most importantly, it was a better experience for the patient as she reported no discomfort during or after the procedure and was delighted to “not feel numb”. _Case 2: Open flapped crown lengthening This case involved #s 16 and 14, adjacent to edentulous #15 site (Fig. 5). Seen radi- ographically with bone level indicated with red arrows (Fig. 6), #16 mesial and #16 distal had inadequate tooth structure due to decay coronal to the alveolus. The patient, a healthy 73-year-old female, was deciding between receiving an implant to replace #14 or a fixed partial denture from #s 16 to 14 with pontic #15. She was encouraged to seek an implant treatment instead of fixed partial denture (bridge) due to longevity, especially with her caries susceptibility. Tooth #14 had endodontic treatment and needs a core and full cov- erage restoration. Tooth #16 will be treated conservatively with a composite restoration if the patient does not choose a fixed partial denture or full coverage (if partial denture is fixed). For the progression of this case in the photos, a red arrow is used in the distobuccal of tooth #14 to denote a reference point relative to tissue level, etc. See the pre-operative photo of #14 distobuccal (Fig. 7). The patient was anaesthetized with 1.7 ml septocaine, 4 % with epinephrine 1:100,000 and 1.8 ml of bupivacaine 0.5 % with epinephrine 1:200,000. Solea was used instead of a scalpel for flap incisions. The initial Solea incision was made along the crest of the eden- tulous ridge using Soft Tissue Setting: 0.25 mm spot size, 65 µs pulse duration, 1 % mist (cid:76)(cid:97)(cid:115)(cid:101)(cid:114)(cid:32) (cid:97)(cid:110)(cid:100)(cid:32)(cid:83)(cid:97)(cid:102)(cid:101)(cid:116)(cid:121) (cid:69)(cid:121)(cid:101)(cid:119)(cid:101)(cid:97)(cid:114) (cid:65)(cid:117)(cid:116)(cid:111)(cid:99)(cid:108)(cid:97)(cid:118)(cid:101)(cid:32)(cid:115)(cid:97)(cid:102)(cid:101)(cid:116)(cid:121)(cid:32)(cid:101)(cid:121)(cid:101)(cid:119)(cid:101)(cid:97)(cid:114)(cid:32)(cid:119)(cid:105)(cid:116)(cid:104)(cid:32)(cid:115)(cid:112)(cid:101)(cid:99)(cid:105)(cid:97)(cid:108)(cid:32)(cid:97)(cid:110)(cid:116)(cid:105)(cid:45) (cid:102)(cid:111)(cid:103)(cid:45)(cid:99)(cid:111)(cid:97)(cid:116)(cid:105)(cid:110)(cid:103)(cid:32)(cid:102)(cid:111)(cid:114)(cid:32)(cid:97)(cid:32)(cid:99)(cid:108)(cid:101)(cid:97)(cid:114)(cid:32)(cid:102)(cid:105)(cid:101)(cid:108)(cid:100)(cid:32)(cid:111)(cid:102)(cid:32)(cid:118)(cid:105)(cid:115)(cid:105)(cid:111)(cid:110)(cid:32)(cid:101)(cid:118)(cid:101)(cid:110)(cid:32)(cid:105)(cid:110)(cid:32) (cid:104)(cid:105)(cid:103)(cid:104)(cid:32)(cid:97)(cid:105)(cid:114)(cid:32)(cid:104)(cid:117)(cid:109)(cid:105)(cid:100)(cid:105)(cid:116)(cid:121)(cid:32)(cid:97)(cid:110)(cid:100)(cid:32)(cid:101)(cid:120)(cid:116)(cid:114)(cid:101)(cid:109)(cid:101)(cid:32)(cid:116)(cid:101)(cid:109)(cid:112)(cid:101)(cid:114)(cid:97)(cid:116)(cid:117)(cid:114)(cid:101)(cid:46) (cid:76)(cid:97)(cid:115)(cid:101)(cid:114)(cid:32)(cid:115)(cid:97)(cid:102)(cid:101)(cid:116)(cid:121)(cid:32)(cid:101)(cid:121)(cid:101)(cid:119)(cid:101)(cid:97)(cid:114)(cid:32)(cid:119)(cid:105)(cid:116)(cid:104)(cid:32)(cid:100)(cid:105)(cid:102)(cid:102)(cid:101)(cid:114)(cid:101)(cid:110)(cid:116)(cid:32)(cid:102)(cid:105)(cid:108)(cid:116)(cid:101)(cid:114)(cid:115)(cid:32) (cid:97)(cid:110)(cid:100)(cid:32)(cid:102)(cid:114)(cid:97)(cid:109)(cid:101)(cid:32)(cid:115)(cid:116)(cid:121)(cid:108)(cid:101)(cid:115)(cid:32)(cid:102)(cid:111)(cid:114)(cid:32)(cid:100)(cid:111)(cid:99)(cid:116)(cid:111)(cid:114)(cid:115)(cid:44)(cid:32)(cid:112)(cid:97)(cid:116)(cid:105)(cid:101)(cid:110)(cid:116)(cid:115)(cid:32)(cid:97)(cid:110)(cid:100)(cid:32) (cid:97)(cid:115)(cid:115)(cid:105)(cid:115)(cid:116)(cid:101)(cid:110)(cid:99)(cid:101)(cid:46) (cid:76)(cid:111)(cid:117)(cid:112)(cid:101)(cid:115)(cid:32)(cid:119)(cid:105)(cid:116)(cid:104)(cid:32)(cid:100)(cid:105)(cid:102)(cid:102)(cid:101)(cid:114)(cid:101)(cid:110)(cid:116)(cid:32)(cid:108)(cid:97)(cid:115)(cid:101)(cid:114)(cid:32)(cid:112)(cid:114)(cid:111)(cid:116)(cid:101)(cid:99)(cid:116)(cid:105)(cid:111)(cid:110)(cid:32)(cid:102)(cid:105)(cid:108)(cid:116)(cid:101)(cid:114)(cid:115)(cid:32) (cid:97)(cid:110)(cid:100)(cid:32)(cid:109)(cid:97)(cid:103)(cid:110)(cid:105)(cid:102)(cid:105)(cid:99)(cid:97)(cid:116)(cid:105)(cid:111)(cid:110)(cid:115)(cid:46) (cid:117)(cid:118)(cid:101)(cid:120)(cid:45)(cid:108)(cid:97)(cid:115)(cid:101)(cid:114)(cid:118)(cid:105)(cid:115)(cid:105)(cid:111)(cid:110)(cid:46)(cid:100)(cid:101) (cid:87)(cid:69)(cid:32)(cid:80)(cid:82)(cid:79)(cid:84)(cid:69)(cid:67)(cid:84)(cid:32)(cid:89)(cid:79)(cid:85)(cid:82)(cid:32)(cid:69)(cid:89)(cid:69)(cid:83)

industry report I Fig. 14 Fig. 15 Fig. 16 returned five days later for a routine postoperative visit. The surgical site had healed extremely well (Fig. 16). _Conclusion These cases show that Solea, a 9.3 µm CO2 laser, is a technology that dramatically improves the dental experience for both the practitioner and patient. The speed and precision of the laser allows me to be more efficient while achieving better clinical outcomes. Although local anaesthetic was used in one of the cases discussed in this paper, I actually perform 93 % of my hard and soft tissue procedures without anaesthesia. Most crown and bridge procedures and more extensive periodontal surgeries (like Case 3 above) typically require anaesthesia, but these are the only exceptions. In soft tissue applications, there is minimal bleeding which maintains a clean surgi- cal site and the reduced need for sutures. Because of this, I take on procedures that I would have referred out prior to having Solea and I am able to complete these procedures approximately 50 % more quickly and with more precision than I could achieve with traditional tools. For my patients, the experience Kurz & bündig Fig. 14_Pre-operative 5 mm x 5 mm x 3 mm lesion right lateral tongue. Fig. 15_Immediate post-operative. Fig. 16_Five-day follow up, healing well. during surgery is dramatically improved and after the procedure they have much less post-operative discomfort. According to feedback from my pa- tients, they love not having to get an injection, hear the “drill”, or feel the vibrations. Patients love that I can work in multiple quadrants during the same visit, reducing their number of appointments, and so do I. Patients are amazed by the experience and are surprised when they find out that this technology is not more common among my peers. I am grateful to be able to practice in a time where such incredible in- struments are available._ contact Joshua P. Weintraub, DDS, USA Stevenson Smiles 10407 Stevenson Rd. Stevenson, MD 21153 USA www.stevensonsmiles.com Im vorliegenden Artikel stellt der Autor mehrere Fallberichte vor, welche die Wirkungsweise eines neuartigen CO2-Lasers mit einer Wellenlänge von 9.3 µm illustrieren. Während CO2-Laser mit einer Wellenlänge von 10.6 µm bisher vor allem bei der Behandlung im Weichgewebebereich eingesetzt wurden, zeigen die Fallberichte Behandlungsoptionen des CO2-Lasers für Weich-, Hart- und Knochengewebe auf. Der hier genutzte CO2-Laser (Solea, Convergent Dental Inc.) kombiniert diese beson- dere Wellenlänge mit computergesteuerten Motoren. Diese bewegen kleine Spiegel innerhalb des Handstücks, um den ur- sprünglich 0,25 mm breiten Laserstrahl auf bis zu 1,25 mm zu vergrößern. So können für jede Behandlungssituation indivi- duelle Modi eingestellt werden. Abhängig vom zu behandelnden Gewebe kann der Laserstrahl somit spezifisch angepasst werden. In insgesamt drei Fallberichten beschreibt der Autor die Anwendung des CO2-Lasers bei einer defekten Amalgamfüllung, einer chirurgischen Kronenverlängerung sowie der Entfernung einer gutartigen Läsion. Im Verlauf der Fallberichte wird deut- lich, dass durch den Einsatz moderner Lasertechnologie, hier in Kombination mit minimaler lokaler Betäubung, der Patienten- komfort sowohl während der Behandlung als auch postoperativ erheblich verbessert und die Behandlungsdauer sowie die An- zahl der notwendigen Sitzungen deutlich reduziert wird. Weitere Vorteile sind geringere Blutungsneigung, die ein übersichtli- ches Operationsfeld und damit einen reduzierten Bedarf für durch Nähte unterstütze Wundheilung nach sich ziehen. laser 3_ 2015 I 25

Return address Deutsche Gesellschaft für Laserzahnheilkunde e.V. c/o Universitätsklinikum Aachen Klinik für Zahnerhaltung Pauwelsstraße 30 52074 Aachen, Germany Tel.: +49 241 8088164 Fax: +49 241 803388164 Credit institute: Sparkasse Aachen IBAN: DE56 3905 0000 0042 0339 44 BIC.: AACSDE 33 Membership application form (English) Name/title: Surname: Date of birth: Approbation: Status: self-employed employed civil servant student dental assistant Address: Practice/office/institute (delete as applicable) ZIP/city: Phone/fax: Private/place: Street: Email: Street: Due to an association agreement of DGL and DGZMK, an additional reduced annual fee for DGZMK is charged (85 EUR p.a. if you are not yet a member of DGZMK). The contribution collection is made by the DGMZK office, Liesegangstr. 17a, 40211 Düsseldorf. You will be addressed hereby. With the application for membership I ensure that I am owing an own practice since and are working with the laser type (exact name) I am employed at the practice I am employed at the University I apply for membership in the German Association of Laser Dentistry (Deutsche Gesellschaft für Laserzahnheilkunde e.V.) Place, date Signature Annual fee: for voting members with direct debit € 150 In case of no direct debit authorisation, an administration charge of € 31 p/a. becomes due. DIRECT DEBIT AUTHORISATION I agree that the members fee is debited from my bank account Name: BIC: IBAN: Credit institute: Signature of account holder This declaration is valid until written notice of its revocation

practice management I Can your patients find you and book an appointment easily with your clinic? Is your clinic characterised by high-technology and do your patients appreciate this? Is your dental clinic in a convenient location, allowing your patients to find you and reach you with ease? _Weaknesses What are the areas that need improvement at your dental clinic? Are your payment options inflexible? Do patients have to wait for more than 5 minutes for their appointment in the waiting area? Is the clinic decoration old and out of fashion? Should you change it? _Opportunities What are current social, financial or other trends that you could benefit from? For example, the de- mand for invisible braces for adults could be useful for an orthodontist to explore. The general dentist could consider including an aesthetic treatment based on the latest trends, such as whitening or restoration with white aesthetic material. _Threats Is there anything happening in your environment that could be detrimental to your clinic? For example, a larger and newer clinic is to be opened in the neigh- bourhood or an existing competitor clinic is installing better technological equipment than that in your clinic. Other threats include political and environ- mental ones, such as an unstable political situation. As a conclusion, it is evident that performing a SWOT analysis for your dental clinic will allow you to be proactive in your marketing strategies, since you will have the information necessary to develop effec- tive strategies for the promotion of your clinic. The second tip of this article is realising the impor- tance of having patients who are not just satisfied but loyal. In order to understand the significance of this, let us explore the major difference between these two categories. _Satisfied patient A satisfied patient is one who comes to the clinic for treatment and is not unhappy with the treatment or the service provided, but when a friend, a relative or a colleague proposes that he or she visit another dentist would do so. Such a patient too would not re- fer the clinic to others or tell others about your good treatment. _Loyal patient A loyal patient, however, is one who will spread through word of mouth what a wonderful dentist you are, and what a brilliant scientist, advising others to visit your clinic and promoting your well-being. This is a patient who comes to your clinic regularly, is ap- preciative of your treatment and demonstrates this. It is important to understand that we do not de- liver a service in isolation, but as part of a culture, the culture of our clinics through the experience that our patients receive. They do not expect us to be the best just in our health care industry. We have to be the best, period. Our patients will not compare us only with other dentists but with all the services they receive and have experienced, such as in a hotel or a restau- I ] L E X P W A R © : E R U T C P [ I laser 3_ 2015 I 29

3rd WALED Congress November 26, 2015 Berlin, Germany Hotel Pullman 24th Annual Meeting of the DGL LASER START UP 2015 November 27–28, 2015 Berlin, Germany Hotel Palace contact Mr. Leon Vanweersch | email: vanweersch@aalz.de 3rd WALED Congress 2015 and the Annual Congress of the DGL e.V. on November 26–27, 2015 in Berlin, Germany. and the Gala Dinner Party and Mastership/Fellowship Certification Ceremony on November 28, 2015 in Berlin, Germany The total fees, including full catering, amount to 380 € register here

Study investigates Attitudes towards drug screenings in dentistry Periodontal disease: Meet your new worst enemy A visit to the dentist has the potential to be more than a dental check-up, researchers from the Co- lumbia University Mailman School of Public Health In the study, the researchers used the responses by 1,802 US dentists on whether they include drug use questions in their health history forms and whether they generally consider substance abuse screenings part of their respon- sibility. Data was taken from a nation- ally representative survey by the American Dental Association Survey Center conducted from 2010 to 2011. They found that sex, age and date of graduation were associated with the belief that drug screenings are part of a dentists role. Younger dentists were more likely to report that their health history form included questions about substance misuse than were older dentists. Similarly, at 62 per cent, den- tists under the median age of 53 were more likely to regard screening for il- licit drug use as part of a dentist’s role, compared with their more senior counterparts at 47 per cent. The study, titled “Screening for Sub- stance Misuse in the Dental Care Setting: Findings from a Nationally Representative Survey of Den- tists”, was published online on July 2 in the Addic- tion journal. [PICTURE: ©HAMSTERMAN] After years of clinical research, both in the laboratory and in the field, a new protocol for treating periodon- tal disease has emerged for Er,Cr:YSGG laser dentists and periodontists. Periodontal disease remains one of the most prevalent oral health issues in the world to- day and the number of patients affected with mild to severe periodontitis is growing. [PICTURE: ©OCSKAY BENCE] Research has shown that periodontal disease may be associated with other chronic inflammatory condi- tions, such as diabetes and cardiovascular disease. Additional reports have linked periodontitis to chronic illnesses, such as rheumatoid arthritis, Alzheimer’s disease and even cancer. As a result, it is incumbent on all dental professionals to play a more active role in the treatment and prevention of the disease. In recent years, a proliferation of published research and studies have shown that the Er,Cr:YSGG laser wavelength is an effective tool for treating periodon- titis. Using specially designed radial firing laser tips that create a corona of laser energy in the periodon- tal pocket, the laser has been proven to be an espe- cially effective instrument for the minimally invasive removal of both subgingival inflamed tissue and cal- culus deposits. This unique combination, as dis- cussed in the literature, sets the laser apart from other methods of treating periodontitis with a laser-based approach. have found. From a survey of US dentists on inte- grating preventive screening and testing alongside dental care, they found that 77 per cent of dentists ask patients about illicit drug use and 54 per cent of dentists believe that such screenings should be their responsibility. SMARTM dental diode laser— Versatile and ingenious LASOTRONIX—a Polish manufacturer—is launching a new diode based laser platform for dentistry, the SMARTM series with a variety of most effective wavelengths increasing a number of applications. SMARTM is offered as a combina- tion of two lasers in one package: 10 W at 980 nm wavelength for a wide range of applications in microsurgery, endodontics, periodontology and whiten- ing as well as 400 mW at 635 nm wavelength for cold therapies like biostimulation and photoactivated disinfection. Combining two wavelengths in one device made our dental laser unique and one of the most advanced in the world for all soft tissue procedures. SMARTM is equipped with a wide range of fibers, ap- plication end tips and an advanced user interface, which makes the unit one of the most versatile dental lasers known so far. It is also upgradable in the field by other wavelengths if needed. If you want to join us and promote our unique innovation please kindly contact us. Source: LASOTRONIX Source: Biolase laser 3_ 2015 I 33

DGL – International Prof. Dr. Norbert Gutknecht DGL-Präsident Sehr geehrte Frau Kollegin, sehr geehrter Herr Kollege, liebe DGL-Mitglieder! In diesem Jahr ist es uns nach langer Zeit wieder gelungen, das wissenschaftliche Programm „WELLENLÄNGEN“ unseres Jahreskongresses nicht nur mit internationalen Referenten zu bestücken, sondern wir haben auch unsere Jahrestagung erstmals, nach wiederholter Anfrage ausländischer Kollegen, wieder international ausgeschrieben. Dies war möglich, indem wir den Freitag als internationalen Vortragstag ins Programm aufgenommen haben und somit alle Beiträge simultan übersetzen lassen. Wie Sie aus dem Programm ersehen können, haben wir neben unse- ren eingeladenen Gastrednern Prof. Dr. Baron, Dermatologe vom Universitätsklinikum Aachen, Dr. James Caroll, Low Level Laser Spezialist aus England, Dr. Joshua Weintraub aus Stevenson, MD, USA, und Prof. Dr. Peter Rechmann aus San Francico, USA, noch eine ganze Anzahl renommierter nationaler und internationaler Referenten, die die unter- schiedlichsten „WELLENLÄNGEN“ vertreten werden. Eine große Anzahl an Kurzvorträgen wird das Programm ab- runden. Ohne Ihnen zuviel versprechen zu wollen – diese Vorträge werden Ihnen neue Einblicke in die Wirkungsweise von Lasern auf und in den unterschiedlichsten Gewebetypen bis hin zur Zellfunktion geben. Außerdem wird am Samstagabend, anlässlich unserer DGL-Party, auch die Verleihung der Urkunden unserer DGL/Internationale Mastership-Teilnehmer stattfinden. Natürlich werden auch alle namhaften Laserhersteller ihre Produkte ausstellen und Workshops anbieten. Selbstverständlich wird unser diesjähriger internationaler DGL-Kongress erst durch Ihre Teilnahme wieder zu dem werden, was uns als DGL auszeichnet: Innovation, Wissensvermittlung, Kollegialität und Freundschaft. In diesem Sinne möchte ich Sie alle motivieren nach Berlin zu kommen, um nicht nur Teilnehmer unseres Kon- gresses zu werden, sondern auch freundliche und offene Gastgeber für unsere internationalen Gäste zu sein. Es grüßt Sie alle ganz herzlich Ihr Prof. Dr. Norbert Gutknecht DGL-Präsident editorial I laser 3_ 2015 I 35

LLLT, Drug free pain relief and better healing James D. Carroll, Chesham, Great Britain Low Level Light / Laser Therapy (LLLT) is the direct application of light to stimulate cell responses (photobiomodulation) in order to promote tissue healing, to reduce inflammation and to induce analgesia. There have been significant studies demonstrating its application and efficacy at various points in the body. Studies also discuss its possible applications regard- ing the treatment of a range of musculoskeletal injuries, degenerative dis- eases and dysfunction. On oral tissue, however, its use has so far been limited. The purpose of this review is to consider the potential of LLLT in dental and oral applications by providing background information on its mechanisms of action and delivery parameters and by drawing parallels with its use in analogous cells and tissues from other sites of the body. A literature search on Medline was performed on laser and light treat- ments in a range of dental/orofacial applications from 2010 to March 2013. The search results were filtered for LLLT relevance. The clinical pa- pers were then arranged to eight broad dental/orofacial categories and reviewed. The initial search returned 2,778 results, when filtered this was reduced to 153. 41 were review papers or editorials, 65 clinical and 47 laboratory studies. Of all the publications, 130 reported a positive effect in terms of pain relief, fast healing or other improvements in symptoms or appear- ance and 23 reported inconclusive or negative outcomes. Direct applica- tion of light as a therapeutic intervention within the oral cavity (rather than photodynamic therapies, which utilise photosensitising solutions) has thus far received minimal attention. Data from the limited studies refer- ring to the oral cavity indicate that LLLT may be a reliable, safe and novel approach for treating a wide range of oral and dental disorders, particu- larly those with unmet clinical needs. The potential benefits of LLLT that have been observed in many health- care fields include improved healing, reduced inflammation and pain con- trol. This suggests that there is a considerable potential for LLLT to be ef- fectively used in treatments of oral tissues. James.Carroll@thorlaser.com Pain perception and need for local anesthesia during caries removal in class 1–5 cavity preparations using Er,Cr:YSGG laser — A prospective clinical study Dr Marina Polonsky DDS, Ottawa, Canada, Prof. Dr Norbert Gutknecht DDS PhD, RWTH University, Aachen, Germany Introduction: A number of studies, going as far back as 20 years ago, have shown effectiveness of Erbium lasers, like Er:YAG and Er,CR:YSGG, in cavity preparation, without thermal side effects on the pulp, with im- proved patience acceptance and reduced pain perception over the tra- ditional mechanical means. Erbium,chromium:yttrium-scandium-gal- lium-garnet (Er,Cr:YSGG), 2,780 nm laser has less evidence in literature supporting reduced pain perception during cavity preparation than Er:YAG laser, but is shown to be equally effective. The study recorded 400 responses from 301 patients (160 males and 141 females) who had carious lesions prepared with Er,Cr:YSGG laser system (iPlus by Biolase , Irvine, California). Two different delivery meth- ods of laser energy were compared: Gold handpiece and Turbo hand- piece. Pain perception using VAS scale and the percentage of patients who needed local anesthesia injection was recorded and analyzed sta- tistically. The study sample consisted of patients, aged 7–93, who gave informed consent to have their carious lesion prepared and restored without the initial use of local anesthetic. Preparations were made with either Gold handpiece with MZ6 firing tip or Turbo handpiece with MZ7 lens tip. Class 1–5 cavities extending into dentin, that fit ICDAS code 3–5 classifica- tions, were the focus of this study. Patients were instructed to stop the cavity preparation and ask for a local anesthetic injection, should they perceive a level of pain greater than they were comfortable with. 400 cavity preparations were made with the Er,Cr:YSGG laser system on 301 patients; 200 using Gold handpiece, with MZ6 tip, and 200 using Turbo handpiece, with MX7 lens tip. It was recorded that a total of 15 % of the preparations were found to have a degree of pain associated with them, however only 6 % requested a local anesthetic injection, whereas the remaining 8 % thought that the level of discomfort was less than the pain of both receiving an injection and the post-operative numbness of several hours. 6 % of patients felt cold-water sensitivity that was not in- terpreted as pain. There was no significant difference found between the two methods of delivery, comparing Gold vs. Turbo handpiece, however cold sensitivity was felt in 9 % of Turbo MX7 preparations, compared to 3 % of Gold MZ6 preparations. No significant differences were observed between male 13 % vs. female 18 % perception of pain from laser cav- ity preparations. Er,Cr:YSGG 2,780 nm laser system offers a very good alternative to lo- cal anesthesia, for cavity preparations not in close proximity to the pulp, in patients not suffering from severe dental anxiety in carious lesions. altavistadental@hotmail.ca laser 3_ 2015 I 37

Non-invasive successful therapy of deep localized periodontal pockets >10 mm Gottfried Gisler, Männedorf, Switzerland The aim of this presentation is to demonstrate that even “hopeless” teeth with very deep localised periodontal pockets larger than 10 mm and high mobility degrees can be saved. The preconditions neces- sary to achieve this goal are a good patient compliance regarding ex- cellent oral hygiene, the elimination of the cause of the pockets, SRP under anaesthesia followed by laser irradiation. The treated teeth must be splinted. Every laser wavelength has its own properties concerning penetration depth, decontamination abilities, biostimulation, deepithelization and calculus removal. The latter two treatments were done by an Er:YAG laser, following SRP. The applied fluence of about 10 J/cm2 is just above the ablation threshold of cal- culus. A photodynamic therapy with methylene blue and a laser wave- length of 670 nm closed the first treatment session. Three or four laser treatments with a diode laser 810 nm and/or PDT in intervals of be- tween four and seven days were executed without anaesthesia. The patients rinsed their mouths with a 0.2 % CHX solution during this pe- riod. No antibiotics and no augmentation procedures were applied. Reduction of the depth of the pocket to normal health levels resulted from both, a shrinking of gingiva and bone regeneration. The bone re- generation mainly depends on the anatomy of the pocket and can be very well predicted. The advantages for the patients of these non-in- vasive treatment protocols compared to any other surgical proce- dures are less pain, less swelling, faster healing times and fewer costs. It is important to recognize laser application as a highly effec- tive, complementary part of the complex puzzle and search for last- ing, successful periodontal treatments. info@zahnarzt-gisler.ch Using the First 9.3 µm CO2 All-tissue Laser for Anesthesia-Free Caries Removal and Cavity Preparation Joshua P. Weintraub, DDS, MD, Stevenson, USA The Solea laser, a 9.3 µm CO2 dental laser has been shown to con- servatively and effectively ablate hard and soft tissue without the need for injectable anesthetic on any tooth or soft tissue in the oral cavity. In this case study, the intra-oral effects of this association will be pre- sented. This case demonstrates the anesthesia-free effect achieved during the treatment of a deep, three surface cavity preparation of a maxil- lary second molar (#15 MOL) without the need of an injectable anes- thetic. The patient, a 69-year-old female, with a significant medical history for anxiety and dental phobia presented with a fractured amal- gam and recurrent decay on tooth #15 MOL. Clinical intra-oral bitew- ing radiograph confirms the location and extent of the lesion. The patient was treated as follows: (1) Topical anesthetic applied to interdental papilla (TAC 20 comprised of Lidocaine 20 % Tetracaine 4 %, Phenylephrine 2 %), for management of comfort for placement of interproximal wedge and matrix. (2) 9.3 µm CO2 laser irradiation outlined the preparation and existing amalgam to a depth of approx- imately 1.5 mm. Laser set at enamel tissue setting, 0.25 mm spot size, 15 µs pulse duration, 100 % mist. (3) Amalgam was removed with high speed turbine handpiece and 245 bur. (4) 9.3 µm CO2 laser irradiation continued preparation, with an enamel tissue setting, 1.00 mm spot size, 15 µs pulse duration, 100 % mist. Completed preparation and decay removal with dentin tissue setting, 1.00 mm spot size, 70 µs pulse duration, 100 % mist followed by slow speed handpiece utilizing a #6 round bur. (5) Cavosurface margins beveled utilizing a high speed turbine handpiece with a diamond bur. Desired analgesic effect maintained throughout entire procedure and clinical results achieved. (6) Tooth was ready for restoration with Scotchbond Universal (3M). (7) An approximately 0.5 mm layer of Esthet(cid:129)Xflow (DENTSPLY) was placed on the gingival floor of the proximal box. (8) Restoration was completed with Tetric EvoCeram Bulk Fill (Ivoclar Vivadent) , composite polished with finishing disc. (9) Bite checked without being inhibited by a local anesthetic onboard. Proper clinical occlusion for patient achieved and confirmed. The results suggested that 9.3 µm CO2 laser can provide a consistent analgesic result in the human mouth. weintraubdds@gmail.com laser 3_ 2015 I 39

Einfluss der Low-Level-Lasertherapie bei einer durch festsitzende Multibandapparaturen induzierten Gingivitis Dr. Steffen Stein, Dr. Michael Schauseil, Prof. Dr. Heike Korbmacher-Steiner, Prof. Dr. Andreas Braun, Marburg Ziel der Studie war es, den Einfluss einer adjuvanten Low-Level-Laser- therapie (LLLT) bei einer durch festsitzende Multibracketapparaturen (MB-App.) induzierten Gingivitis zu untersuchen. Die Studie basiert auf 15 Patienten, deren aktive kieferorthopädische Be- handlung mittels einer MB-App. durchgeführt wurde (8 weiblich; 7 männ- lich; Durchschnittsalter 15,53 Jahre). Nach der Entfernung der MB-App. (T0), wurde zur Quantifizierung der parodontalen Situation der Blutungs- index (BOP) und der Papillenblutungsindex (PBI) im Oberkiefer (OK) erho- ben. Danach erfolgte die standardmäßige Zahnreinigung (ZR). Gemäß dem durchgeführten Split-Mouth-Design, erhielt jeder Patient randomi- siert in einer Oberkieferhälfte eine adjuvante LLLT (Laserseite) und in der anderen keine zusätzliche Laserbehandlung (Kontrollseite). BOP und PBI wurden vom gleichen Untersucher 4 bis 6 Tage nach der LLLT erneut er- hoben (T1). BOP- und PBI-Werte zeigten zum Zeitpunkt T0 der Kontroll- und Laser- seite keinen statistisch signifikanten Unterschied (p > 0,05). Die Mess- werte des BOP und PBI sanken innerhalb der Laser- und Kontrollgruppe vom Zeitpunkt T0 zu T1 statistisch signifikant (p < 0,05). Diese Verbes- serungen waren im Gruppenvergleich zum Zeitpunkt T1 signifikant aus- geprägter in der Lasergruppe (p < 0,05). Die Ergebnisse zeigten, dass sich nach der ZR auf der Kontroll- und Laserseite die Werte des BOP- und PBI-Index vom Zeitpunkt T0 zu T1 statistisch signifikant verbesserten. Die statistisch signifikante Abnahme der BOP- und PBI-Werte vom Zeitpunkt T0 zu T1 auf der Kontrollseite beschreiben damit den natürlichen Heilungsprozess der Gingiva nach Entfernung der MB-App. Der Vergleich der BOP- und PBI-Werte zwischen Laser- und Kontrollseite zum Zeitpunkt T1 zeigt, dass der Einsatz einer adjuvanten LLLT zu einer statistisch signifikant schnelleren Heilung einer durch eine MB-App. induzierten Gingivitis führt. Steffen.Stein@med.uni-marburg.de Fallberichte zur Nutzung eines 445 nm Diodenlasers in der zahnärztlichen Chirurgie Priv.-Doz. Dr. Moritz Kebschull, Bonn, Dr. Claudia Dehn, Prof. Dr. Matthias Frentzen In der prä-prothetischen, plastisch-ästhetischen sowie korrektiven Pa- rodontalchirurgie ist häufig eine modellierende Gingivektomie notwen- dig. Typische Indikationen sind chirurgische Kronenverlängerungen, ge- rade aus ästhetischer Indikation, ohne Notwendigkeit einer begleiten- den ausgedehnten Resektion des Alveolarknochens, etwa beim Vorlie- gen eines „Low Crests“ nach Kois, oder die Optimierung von Weichgewebsübergängen, etwa nach Durchführung eines apikalen Ver- schiebelappens. Bei diesen Indikationen wurde bisher oft auf elektrochirurgische Geräte zurückgegriffen, um bei optimaler Hämostase unter Verwendung zier- licher Elektroden sehr gezielt eine Gingivektomie oder Gingivoplastik durchzuführen. Allerdings ist die Elektrochirurgie durch eine Vielzahl an Einschränkungen und Nachteilen gekennzeichnet. In diesem Vortrag wird anhand von Fallbeispielen aus dem Gebiet der plastisch-ästheti- schen Chirurgie die Anwendung eines 445 nm (Blaulicht) Diodenlasers als sinnvolle Alternative zum Elektrochirurgiegerät demonstriert. Die Anwendung des Blaulicht-Lasers ermöglicht eine sehr kontrollierte Modellation der marginalen Gingiva ohne die charakteristischen Nachteile der Elektrochirurgie und stellt daher für parodontal- und oral- chirurgische Indikationen ein sehr vielversprechendes neues Werkzeug dar. moritz.kebschull@uni-bonn.de Theorie, Anwendung und Abrechnung von Periogreen Dr. Darius Moghtader, Oppenheim Theorie, Anwendung und Abrechnung von Periogreen. Zusätzlich wird beschrieben, ob Bakterientests im Rahmen der Parodontitistherapie sinnvoll sind und welche Hinweise sie uns für die Therapie geben. Zu- sätzlich wird beschrieben, wie durch Anwendung eines Boosters neben der photothermischen Wirkung die photodynamische Funktion von Indo- cyaningrün freigeschaltet und verstärkt werden kann. dr-moghtader@hotmail.de laser 3_ 2015 I 41

Nightlase Anti Schnarch Therapie – Systematik und verbesserte Einteilungen Dr. Steffen Stein, Dr. Michael Schauseil, Prof. Dr. Heike Korbmacher-Steiner, Prof. Dr. Andreas Braun, Marburg Seit nunmehr einem Jahr wenden wir das Nightlase Verfahren in unse- ren Praxen an, um Schnarchen zu therapieren. Es wurden in dieser Zeit sowohl habituelles Schnarchen als auch obstruktives Schnarchen und auch Schlafapnoe behandelt. Es zeigten sich durch unsere Erfahrungen Lücken in der Aufklärung der Patienten und der Patientenselektion. Aufbauend auf diesen Erfahrun- gen entwickelten wir eine erste Systematik, die diese Lücken schließen soll. Wir stellen diese erste Systematik vor, die zur besseren Selektion der Patienten beiträgt. Des Weiteren wollen wir eine verbesserte Aufklä- rung präsentieren, die einer entsprechenden Systematik folgt. Diese soll dazu beitragen, eine Einteilung und Risikoabschätzung des zu er- wartenden Behandlungserfolges zu ermöglichen. Eine anschließende Diskussion soll den Vortrag abrunden. info@dralte.de Kontamination von optischen Fasern im Rahmen endodontischer Laserapplikation Dr. med. dent. Markus Krema, Hachenburg, Dr. Jörg Meister, Bonn, Prof. Dr. Matthias Frentzen, Aachen Ziel der Studie war zu untersuchen, ob es an der Oberfläche einer Laser- Fiber nach erfolgter chemo-mechanischer Wurzelkanalbehandlung zu ei- ner Kontamination kommt und somit ein Risiko zur Kreuzkontamination durch diese Fiber besteht. In-vitro wurden 45 Fiberenden einer optischen Faser mit E. faecaliskonta- miniert, um unterschiedliche, effektive Desinfektionsmaßnahmen zu eva- luieren. Fünf Gruppen wurden gebildet: eine Kontrollgruppe ohne jegliche Desinfektionsmaßnahmen, Wischdesinfektion, Einlage in 70% Alkohol, die Kombination dieser beiden Methoden, und die Sterilisation im Autoklav. In-vivo wurden 10 Zähne von 9 Patienten mit bestehender Pulpanekrose untersucht. Fünf Gruppen wurden gebildet. Eine sterile Papierspitze wurde vor der Wurzelkanalbehandlung in den Kanal eingebracht und auf einer Agar-Platte platziert (Gruppe I). Nach der chemo-mechanischen Wurzel - kanalaufbereitung mit einer modifizierten ProTaperNext™-Methode wurde eine weitere Papierspitze fixiert (Gruppe II). Anschließend wurde die optische Faser desinfiziert, im Kanal zur Dekontamination des Hauptkanals und des umgebenden Dentins verwendet und nach jedem der drei Dekontamina- tionsmaßnahmen auf der Agar-Platte ausgestrichen (Gruppen III–V). Die In-vivo-Studie zeigte in allen Fiberabschnitten der Kontrollgruppe eine massive Infektion. Alle anderen Desinfektionsmaßnahmen waren effektiv gegenüber der bakteriellen Besiedelung (eine Ausnahme in der „Kombi- nationsgruppe“). Die In-vitro-Studie konnte die Infektion eines jeden Zahnes vor chemo-me- chanischer Wurzelkanalbehandlung nachweisen. Keinerlei Bakterien- wachstum konnte an den weiteren Untersuchungsgruppen festgestellt werden – weder an der zweiten eingebrachten Papierspitze, noch an den Ausstrichen der Laser-Fiber. Es wurde keine Kontamination der Oberfläche an der optischen Fiber nach der beschriebenen chemo-mechanischen Wurzelkanalbehandlung und der Desinfektionsmaßnahmen nach der Dekontamination des Wurzel - kanals und des darunterliegenden Dentins festgestellt. Demnach ist nach Gebrauch der beschriebenen Methoden eine Kreuzkontamination durch eine optische Fiber zwischen zwei Wurzelkanälen eines Patienten höchst- wahrscheinlich auszuschließen. zahnarzt@dr-krema.de Antibiotikafreie Kombinationstherapie bei marginaler Parodontitis mit kreuzvernetzter Hyaluronsäure und Laserlicht Jiaoshou (Prof. Shandong University, China) Dr. med. Frank Liebaug, Steinbach-Hallenberg Die positiven Effekte von Laserlicht im biologischen Gewebe sind heute unstrittig. Ebenso ist eine Reihe von heilungsbegünstigenden Eigen- schaften der Hyaluronsäure bekannt. Was liegt da näher, als in einer Studie den klinischen Verlauf der marginalen Parodontitis in einer Kom- binationstherapie aus kreuzvernetzter Hyaluronsäure und Laserlicht der Wellenlänge 1.064 nm zu untersuchen? In einer Zeit, in der immer mehr und häufiger von Antibiotikaresisten- zen berichtet wird, wächst die Zahl der Patienten und Behandler, die nach klinisch relevanten Alternativen mit bestmöglich vorhersagbarem Ergebnis suchen. Die vorgestellte klinische Studie soll in einem Anwendungszeitraum von zwölf Monaten anhand von Patientenfällen neue Wege im Rahmen der systematischen Parodontitistherapie aufzeigen. info@ellen-institute.com laser 3_ 2015 I 43

In-vivo Fissurenkaries-Prävention mit einem kurzgepulsten CO2-Laser und Fluoridlack Prof. Dr. Peter Rechmann, San Francisco, USA Kürzlich wurde über 86 Prozent in-vivo Glattflächendemineralisation- Reduktion nach kurzgepulster 9.6 µm CO2-Laser Bestrahlung berich- tet (Rechmann 2008, 2010). Ziel dieser Arbeit war es, eine 12-mona- tige, einfach-blind, klinische Pilotstudie zur okklusalen Kariesverhin- derung mit einem CO2-Laser durchzuführen. 20 Patienten wurden re- krutiert. Zweite Molaren wurden in Test- und Kontrollgruppen randomisiert. Der Kariesgrad wurde mit dem International Caries De- tection & Assessment System (ICDAS) und mit dem SOPROLIFE Fluo- reszenz Kamerasystem (SOPRO-Acteon) erfasst. Die Testfissuren wur- den mit dem CO2-Laser (Pulse System, NM), Wellenlänge 9.6 µm, Puls- dauer 20 µs, Pulswiederholungsrate 20 Hz, Strahldurchmesser 800 µm, Durchschnittsflussdichte 4.5 ± 0.5 J/cm2, 20 Laserpulse per Bestrah-lungspunkt bestrahlt. Bei jedem Recall wurden die okklusalen Flächen mit ICDAS und dem SOPROLIFE System untersucht. Alle Pa- tienten erhielten Fluoridlack am Start der Studie und nach 6 Monaten. Nach drei Monaten betrug die Durchschnittsänderung der ICDAS Rate für die Testmolaren – 0.10 ± 0.14 und für die Kontrollmolaren 0.30 ± 0.18, nach 6 Monaten – 0.26 ± 0.13 für die Test- und 0.47 ± 0.16 für die Kontrollmolaren, und nach 12 Monaten – 0.31 ± 0.15 beziehungsweise 0.75 ± 0.17, (p = 0.001 für 6 Monate, p < 0.0001 für 12 Monate). Nach drei Monaten zeigte das SOPROLIFE System (blaue Fluoreszenz) statistisch signifikante Unterschiede für die durchschnittliche Änderung zwischen der Test- und der Kontrollgruppe (–0.55 ± 0.15, 0.10 ± 0.16; p = 0.006); für SOPROLIFE im Tageslicht- modus waren die durchschnittlichen Änderungen auch statistisch sig- nifikant unterschiedlich (p zwischen 0.009 und 0.02). Kurzgepulste 9.6 µm CO2-Laser Bestrahlung reduziert über 12 Monate signifikant Fissurenkaries im Vergleich zu alleiniger Fluoridlack- Anwendung. Nach ersten erfolgreichen Labortests werden ähnlich vielversprechende Resultate in einer klinischen Studie zur Prävention von Fissurenkaries mit dem neuen kurzgepulsten 9.3 µm CO2-Solea Laser (Convergent Dental, Natick, MA) erwartet. Peter.Rechmann@ucsf.edu Antimikrobielle Wirkung von blauem Laserlicht Dr. Christoph Engelbach, Bonn, Dr. Jörg Meister, Bonn, Prof. Dr. Matthias Frentzen, Aachen Ziel der Untersuchung war der Nachweis bakterizider Effekte eines neuartigen Blaulicht-Lasers (λ= 445 nm) auf oral-pathogene Keime im Vergleich zu einem kommerziell vertriebenen Diodenlaser mit einer Wellenlänge von 980 nm (SIROLaser Advance®). Die Hauptversuche wurden mit zwei verschiedenen Bakterienstämmen durchgeführt: En- terococcus faecalis ATCC 19433und Streptococcus salivarius subsp. salivarius DSM 20067. S. salivarius wurde aus einer Kryokultur in Brain-Heart-Infusion-Bouillon (Oxoid, Wesel) bei 37 °C aerob kultiviert, während E. faecalis in einer CASO-Bouillon (Merck, Darmstadt) bei 37 °C aerob kultiviert wurde. Die beiden Bakterienstämme Enterococ- cus faecalis und Streptococcus salivarius wurden jeweils aus dem Flüssigmedium mit einer OD von 0,2 zu einem CASO-Underlay-Agar (Merck, Darmstadt) hinzugegeben. Bakterien und Underlay-Agar wur- den nach Vermischung in eine Petrischale (Außendurchmesser 9,4 cm; Greiner Bio-One GmbH, Frickenhausen) gegossen. Zwei zusätzliche Agarplatten mit 10%igem SDS (Sodium Dodecyl Sulfate) bzw. dem Antibiotikum Ampicillin (25 mg/ml) dienten als Positiv-Kontrollen. Nach einem für beide Lasersysteme identischem Schema erfolgte die Be- strahlung an jeweils sieben verschiedenen Stellen, die zuvor an der Unterseite des Petrischalenbodens markiert wurden. Die Bestrah- lungsparameter variierten von 0,1–1 W für den 445 nm- und 0,5–2 W für den 980 nm-Laser bei einer Bestrahlungsdauer von 5–20 s. Der Ab- stand der Faserspitze von der Probenoberfläche betrug 1 mm. Parallel zur Bestrahlung wurde mit einer Thermokamera die Temperaturent- wicklung ermittelt sowie mithilfe eines Leistungs- und Energiemess- gerätes (LabMaxTM-TOP, Coherent GmbH, Dieburg) in Kombination mit einem thermischen Leistungssensor die Transmission gemessen. Die Auswertung der Temperaturdaten und die Definition des Messberei- ches wurden anhand der Software IRBIS 3 professional (InfraTec GmbH, Dresden) vorgenommen. Nach Bestrahlung der mit den Bakte- rien beimpften Petrischalen, erfolgte die Überschichtung der Agar- platte mit 10 ml autoklaviertem 2x CASO-Overlay-Agar (Merck, Darm- stadt), das die für das weitere Bakterienwachstum obligaten nutritiven Substanzen enthält. Die Agarplatten wurden für 48 Stunden aerob bei 37 °C bebrütet und nach definierten Zeitabständen makroskopisch und mikroskopisch untersucht. Der 445 nm-Laser zeigte bereits bei sehr geringen Leistungen und kur- zen Bestrahlungsdauern signifikante bakterizide Effekte bei beiden verwendeten Bakterienstämmen, die nachweislich nicht auf ther- misch-induzierte Effekte zurückzuführen waren. Diese Untersuchung legt nahe, dass der verwendete Blaulicht-Laser effektive antimikro- bielle Wirkungen in Bezug auf die Bakterienstämme E.faecalis und S.salivariuszeigt und somit in der Weichteilchirurgie, Endodontie und Parodontologie von profundem klinischem Interesse sein könnte. c.engelbach@gmx.de laser 3_ 2015 I 45

Tel.: 0241 8088164 Fax: 0241 803388164 E-Mail: sekretariat@dgl-online.de Bank: Sparkasse Aachen IBAN: DE56 3905 0000 0042 0339 44 BIC: AACSDE33 Antwort: Deutsche Gesellschaft für Laserzahnheilkunde e.V. c/o Universitätsklinikum Aachen Klinik für Zahnerhaltung Pauwelsstraße 30 52074 Aachen Aufnahmeantrag (Deutsch) Name/Titel: Vorname: Geb.-Datum: Approbation: Status: selbstständig angestellt Beamter Student ZMF/ZAH Adresse: Praxis/Dienststelle/Institut (Unzutreffendes bitte streichen) PLZ/Ort: Telefon/Fax: Privat/Ort: Straße: E-Mail: Straße: Aufgrund des bestehenden Assoziationsvertrages zwischen der DGL und der DGZMK fällt zusätzlich ein reduzierter Jahres- beitrag für die DGZMK an (85 € p.a., falls Sie noch nicht Mitglied der DGZMK sind). Der Beitragseinzug erfolgt durch die DGZMK-Geschäftsstelle, Liesegangstr. 17a, 40211 Düsseldorf. Sie werden hierfür angeschrieben. Mit der Stellung dieses Aufnahmeantrages versichere ich, dass ich seit dem in der Praxis in der Abt. der Universität in der eigenen Praxis mit einem Laser des Typs arbeite. (genaue Bezeichnung) beschäftigt bin. beschäftigt bin. Ich beantrage die Aufnahme in die Deutsche Gesellschaft für Laserzahnheilkunde e.V. Ort, Datum vollständige Unterschrift Jahresbeitrag: Für stimmberechtigte Mitglieder bei Bankeinzug 150,00 €. Sofern keine Einzugsermächtigung gewünscht wird, wird ein Verwaltungsbeitrag von 31,00 € p.a. fällig. EINZUGSERMÄCHTIGUNG Ich bin einverstanden, dass der DGL-Mitgliedsbeitrag von meinem Konto abgebucht wird. Name: BIC: IBAN: Geldinstitut: Unterschrift des Kto.-Inhabers Diese Erklärung gilt bis auf schriftlichen Widerruf

Einladung zur DGL Mitgliederversammlung DGL Kongress 2015 27. November 2015 in Berlin, Hotel Palace 14.00 – 15.30 Uhr Tagesordnung: TOP 1 Genehmigung der Tagesordnung TOP 2 Bericht des DGL Vorstandes TOP 3 Entlastung des amtierenden Vorstandes TOP 4 Wahl des DGL Vorstandes TOP 5 25. DGL Jubiläumskongress 2016 TOP 6 WFLD Weltkongress 2018/2020 in Deutschland TOP 7 Anträge zur Mitgliederversammlung TOP 8 Verschiedenes dgl-jahrestagung.de startup-laser.de Assoziierte Gesellschaft der DGZMK DGL c/o Universitätsklinikum Aachen, Klinik fü(cid:0) r ZPP, Pauwelsstr. 30, D-52074 Aachen

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