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ePaper created 2015-12-29, 14:54:09 | version 1.38.0
39393_2015 laser laser_opis przypadku research I I 11laser2_2015 Figs. 4a–c_Exposure of unerupted tooth 45 with LiteTouch, Er:YAG laser. Er:YAGirradiation.32 Conservativedentistryasitsname says is a part of dentistry that uses more conservative orminimally-invasiveapproachestofulfilitsgoals.That iswhypreparingthehardtoothstructureswithEr:YAG proposesminimalinterventionandpreventionwithre- specttothesoundtissues.Theminimalpenetrationand lackofthermalchangesinthepulppreventtheoccur- renceofcomplications. _Laser Application in soft tissues Maxillaryfrenectomy Theabnormaljunctionofthefrenumonthemaxilla results in diastema between teeth, weak hygiene, gin- gival retraction, and repetitive trauma during tooth brushing.Thebestlaserforthetreatmentofsuchacon- dition is the Erbium laser that is used simultaneously with water spray. This intervention is performed with- outtheneedofsuturing,scartissueformationandany problems in healing. Usually, frequencies between 30–45Hz and an energy between 35–55mJ are used. On the other hand, with the use of laser, limitation of theamountofhemorrhageduringthesurgeryhelpsto provide a better field view for surgeon. Furthermore, patient’scomfortaftersurgeryiswithoutdoubtsoneof thebiggestadvantagesforpatients.54-56 Figures2a-cshowacaseofa6-year-oldboywitha revision of the maxillary frenum. When the labial frenum is penetrating the palate or papilla it will have thepotentialfordevelopingorthodonticabnormalities, discomfort,difficultarticulationorevencariouslesions from poor hygiene. That’s why an early frenectomy of suchaharmfulfrenumcouldpreventthedevelopment ofthementionedpathology. Lingualfrenectomyinankyloglossia Ankyloglossiaisafrequentfindinginnewbornsthat cancausesignificantproblemsintermsofbreastfeed- ing, nutrition and speech if the adhesion is severe. For thetreatmentofthisconditionErbiumlaserwithtopi- cal anaesthesia or little needle anaesthetic are used (Figs.3a–c).57 Thelingualfrenumisincisedwithlowen- ergy50mJ,10–15Hz.Theparametersmustbechanged ifmorefibrotictissueispresentorhaemostaticeffectis necessary.Laserfrenectomyofthelingualfrenumpre- ventsspeechdisorders,asthecorrectphonetic,thatare formed during the first ages of life. When there is me- chanical reason such as thick and tight lingual frenum that limits the mobility of the tongue the feeding will also be disturbed. Restoration of the normal tongue mobilitymakeseasiertheclinicalworkontherestofthe dentition. Exposureofuneruptedteethduring orthodontictreatment For soft tissue removal and exposure of unerupted permanent teeth for orthodontic objectives it is possi- ble to use different wavelengths of lasers, including Er;Cr:YSGG, Nd:YAG, Er:YAG and Diode laser. Erbium laser has the ability to remove soft and hard tissues. Whenusingthislaser,oneshouldpaycloseattentionto theenamelinthesurgicalpointsurroundings.Thisrisk doesn’t exist when using diode and Nd:YAG since their wavelengthsdonotinteractwithhardtissues.Fortooth exposure,onlysofttissueremovalisnecessary.Mostof thetimethesurgerycanbeperformedwithouttheneed of a local anaesthesia but with the application of topi- cal anaesthetic only, which is a big advantage in the treatment of small patients. The parameters should be Fig. 4a Fig. 4b Fig. 4c