Laser Applications In Dentistry Research Articles

Indications and limitations of Er:YAG laser applications in dentistry

Indications and limitations of Er:YAG laser applications in dentistry

A resource guide for practice development through technology

A resource guide for practice development through technology

The current status of laser applications in dentistry.

A range of lasers is now available for use in dentistry. This paper summarizes key current and emerging applications for lasers in clinical practice. A major diagnostic application of low power lasers is the detection of caries, using fluorescence elicited from hydroxyapatite or from bacterial by-products. Laser fluorescence is an effective method for detecting and quantifying incipient occlusal and cervical carious lesions, and with further refinement could be used in the same manner for proximal lesions. Photoactivated dye techniques have been developed which use low power lasers to elicit a photochemical reaction. Photoactivated dye techniques can be used to disinfect root canals, periodontal pockets, cavity preparations and sites of peri-implantitis. Using similar principles, more powerful lasers can be used for photodynamic therapy in the treatment of malignancies of the oral mucosa. Laser-driven photochemical reactions can also be used for tooth whitening. In combination with fluoride, laser irradiation can improve the resistance of tooth structure to demineralization, and this application is of particular benefit for susceptible sites in high caries risk patients. Laser technology for caries removal, cavity preparation and soft tissue surgery is at a high state of refinement, having had several decades of development up to the present time. Used in conjunction with or as a replacement for traditional methods, it is expected that specific laser technologies will become an essential component of contemporary dental practice over the next decade.

From the Editors: Emerging Applications of Lasers in Dentistry

Summary The use of lasers in dentistry is already a clinical reality. New and exciting developments are presently being studied with the expectation of clinical implementation in the next few years. Since the invention of the first laser in 1960 the use of lasers for dental applications has been of great interest, not only in science and medicine, but also amongst the general public. Some expectations have yet to be accomplished, while others are already met. The early dream of removing caries (dental decay) without contact and appreciable pain, for example, has become reality, and is carried out in daily dental practice in several countries. Also other laser applications are already in clinical use. These include caries detection, etching of enamel and dentine for adhesive restorations, polymerisation of composites, bacteria reduction in root canals and in the periodontal pocket, calculus removal, laser assisted tooth whitening, and several types of soft tissue surgical procedures. The contributions compiled in this issue cover some of the most interesting questions regarding actual and future dental laser applications. For the logical development of potential indications, a basic understanding of interactions between laser irradiation and dental hard tissues is indispensable. The first paper in this issue (Featherstone and Fried) provides such information. As a special focal point the topic of laser assisted caries prevention is highlighted. Caries prevention is also one of the dreams of the pioneers of laser dentistry. Initial attempts to vitrify enamel by high temperatures resulting from treatment with lasers led to the desired reduction in enamel solubility but were not applicable clinically due to excess heat which caused major tissue damage. Now with a true scientific understanding of laser/tissue interactions research is quickly approaching achievement of this aim. In order to prevent progression of dental caries it must be detected at an early stage so that sound tissue can be retained intact while intervention therapy is in progress. For early detection of caries (laser) light induced fluorescence has been demonstrated to be a powerful method. One such device is currently in use clinically, but much work is still experimental. The following two papers describe two complementing approaches: (a) excitation by green light for quantitative analysis of initial caries (Tranaeus et al.), and (b) excitation by red light for detecting and monitoring of “hidden” caries covered by macroscopically intact enamel (Hibst et al.). For caries removal and cavity preparation pulsed Er:YAG lasers have been shown to be a safe and nearly painless alternative to mechanical drills. They have been approved by the American Food and Drug Administration (FDA) and are used in clinical practice. Whereas prior investigations were performed on adult subjects, the paper by Den Besten et al. reports for the first time a clinical study using this technology on children. Er:YAG lasers can also be used in periodontology for calculus removal. The effect of this and other lasers is reviewed by Rechmann and Hennig. Special emphasis is given to selective calculus removal as demonstrated for the frequency doubled Alexandrite laser. Last, but not least, certain lasers can be used for treatments of the root canal. One important application is the killing of bacteria, but there are also a variety of other applications. These are summarised and illustrated by De Paula Eduardo and Gouw-Soares. These comprehensive overviews, which include the latest results, are not only addressed to respective scientists and clinicians, but also should provide all other interested readers with state-of-the-art information on emerging applications of lasers in dentistry.

LASERS IN ENDODONTICS

The first application of lasers in dentistry was the surgical treatment of tumors in the oral cavity, and various lasers, including semiconductor diode, carbon dioxide, helium-neon, neodymium:yttrium-aluminum-garnet, argon, erbium, and erbium chromium, have been developed since and applied in dentistry. This article describes the current and possible future clinical indications, laser devices, techniques, assessment methods, and mechanics.

Primarily Research

Abstract: Composite materials have become an integral part of the wide range of filling materials currently available. Conditioning is necessary to achieve adequate bonding of the composite material to enamel and dentin. Normally, this is done by applying acid preparations to the dental surfaces. These acids have an etching effect that causes surface roughening. The increasing application of lasers in dentistry has introduced another possibility. Laser irradiation can cause roughening of enamel and dentin surfaces. Another interesting alternative is the so‐called kinetic cavity preparation technique. This method also results in distinct surface roughening. The purpose of the present study, was to compare the described methods. Tensile bond strength tests and shear bond tests were carried out to examine the adhesion of a composite material to surfaces treated with these methods. Laser irradiation with certain devices and the air‐abrasive technique yielded results similar to those with acid etching.

Laser applications in dentistry: a review of the literature.

While there are many applications of lasers in dentistry, few have advantages over existing technology. To date, lasers should be considered to be an adjunct to conventional techniques. There are also considerations of cost and rapid obsolescence of current laser equipment. The possible adverse effects of lasers on the tissues adjacent to those being irradiated, to users and to patients must also be considered.

Current laser dentistry.

Current laser dentistry since our initial studies in 1964 is reviewed. Three areas are considered: routine dental office practice, tooth restoration, and oral surgery. For tooth restoration and oral surgery, CO2 and neodymium:YAG lasers are used and lasers are used in photodynamic therapy for oral cancer. Dental office practice today is concerned mostly with uncontrolled studies of biostimulation and requires more basic research and controlled clinical studies. The laser industry in the United States should take a more active interest in defining the applications of lasers in dentistry.

Laser Application in Dentistry

Laser Application in Dentistry