cosmetic dentistry_ beauty & science

30 I I industry report _ lasers Figs. 1a & b_Crown lengthening before treatment (a). Crown lengthening 6 months after treatment (b). Figs. 2a & b_Gingival depigmentation before treatment (a). Gingival depigmentation 7days after treatment (b). cosmeticdentistry 1_2013 _The exciting possibilities offered by the worldofaestheticdentistryarebeingexperienced by an increasing number of dentists and patients worldwideasnewmaterials,techniquesandtools become widely available. One such example is the laser, of which there are many for use in dentistry. To appreciate laser dentistry to its fullest, however, it is necessary to gain accurate information from unbiased sources, firstly about laser safety and the physics of laser–tissue interaction, and secondly about the specific uses of lasers in practice. The most commonly used laser types in den- tistry are erbium lasers (with two variants: 2,940 nm Er:YAG and 2,780 nm Er,Cr:YSGG), neodymium lasers (1,064 nm Nd:YAG) and diode lasers (810, 940 or 980 nm). Each type of laser has a different wavelength, and each wavelength has a different interaction with the specific body tissue being treated. Crown lengthening or gingival levelling (Figs. 1a & b) is a routine procedure for laser-assisted aesthetic interventions. All lasers can be used for this procedure; however, there are two main ad- vantages of using erbium lasers in crown length- ening.Firstofall,theycanbeusedwithoutanaes- thesia, as they do not cause thermal damage to the tissue. This results in a stable gingival height after the procedure. Since diode and Nd:YAG lasers work in a more thermal manner, a longer healing time should be expected for the tissue to settle. A prerequisite for success in crown lengthening is, of course, to respect biologic width. If there is less than 3 mm between the desired gingival level and the bone, the bone level must be decreased. While this is possible to do with erbium lasers (even flapless), neither diode nor Nd:YAG lasers are suitable for this, since they are only capable of removing soft tissue. The same conditions are applicable for uncov- ering implants with erbium lasers, so it is possible to take the impressions for prosthetic procedures on the same day or within a short period. If it is necessary to remove bone or soft tissue for either indication, erbium lasers with adjustable pulse duration (referred to as VSP technology in Fig. 2a Fig. 2b Fig. 1a Fig. 1b Lasers in aesthetic dentistry Authors_Drs Ilay Maden, Zafer Kazak & Özge Erbil Maden, Turkey