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ePaper created 2016-03-16, 11:08:26 | version 1.38.0
48 1_2016 laser 48 laser_case report I case report Fig. 9_Healing implant site two months after implant placement. Fig. 10_Immediately after crown seating (ten weeks after implant placement). Fig. 11_Six months after implant placement. First, the laser system was recalibrated, which en- tailed cleaving of the fibre, aiming of the beam, and initiationofthefibrewitharticulatingpaperandtest- fire of the laser, in order to create a hole at the socket orifice for starting the drilling and for de-epitheliali- sation of the attached gingiva for approximately 3mmaroundthesocketorifice.Duringthetreatment, high-volume suction was used to evacuate the vapour plume and objectionable odours at the site of operation. The carbonised tissue was then removed with a micro-applicator brush soaked in a 3 per cent hydrogen peroxide solution. Theholecreationandgingivalde-epithelialisation (Fig. 5) were performed with a 980 nm diode laser, with a power of 1 W, fibre of 400 µ, initiated fibre, continuous wave and in contact mode. After this procedure, the implant placement was performed (Fig. 6). The laser parameters for the acceleration of the osseointegration were as follows: wavelength of 980 nm, output power of 0.1 W, irradiation time of 20s, spot size of 3 mm, power density of 1.41 W/cm2 at the end of the low-level handpiece, socket diame- ter of 8 mm, irradiation area of πr2 = 0.502.4 cm2 , power density of 0.199 W/cm2 at the target surface, dose of 3.98 J/cm2 , non-contact mode (1 mm from the orifice) and rotating at the orifice of the socket. Both the labial and palatal surfaces of the socket were irradiated at the same dose immediately after implant placement (the total dose for three sites in the first session was 11.94 J/cm²) and then twice weekly with the same protocol, but with an irradia- tion time of 15 s, consequently with a dose of 2.985 J/cm² (the total dose for three sites per session was8.955J/cm²).TheLLLTwasperformedatintervals for two weeks. Finally,atemporarybridgemadeofcompositema- terials was fabricated and seated in order to preserve the aesthetics. _Final result and follow-up Excellentimplantplacementwasobservedwithno bleeding, carbonisation or char. The primary stability of the implant was excellent. The patient did not ex- perience any discomfort and was satisfied with the treatment. The first visit after Type I implant placement was scheduledfortwodaysaftertheprocedure.Theheal- ing process was as expected in that the healing was progressing well and without any swelling or pain. LLLTwasperformedandthenextvisitwasdetermined after two days for the next LLLT session two weeks later. Finally, after two months of follow-up, a suc- 22 I laser 2_2015 Fig. 10 Fig. 11 Fig. 8 Fig. 9