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ePaper created 2016-07-29, 16:53:04 | version 1.38.0
| industry 14 laser 2 2016 Biomodulation in dentistry Case series on the use of a new flat-top handpiece Authors: Alberico Benedicenti, Andrea Amaroli, Wayne Selting, Nicola Deangelis & Stefano Benedicenti, Italy Introduction The influence of electromagnetic energy on bio- logical tissue has been recognised since the 19th century, with the basic concept of photochemistry dramatically demonstrated in photosynthesis. Photobiomodulation (PBM) is the term applied to the manipulation of cellular behaviour using low-intensity light sources. It works on the princi- ple of inducing a biological response through en- ergy transfer.1 PBM has been used in clinical prac- tice for more than 40 years and its mechanisms of action at cellular and molecular levels have been studied for about 30 years.2 As photonic energy ir- radiates tissue, it modulates biological processes withinthattissueand,atleastindirectly,withinthe biologicalsystemofwhichthattissueisapart.3 Itis generally accepted4, 5 that the mitochondria of eukaryotic cells are the initial absorption sites for laserradiationinthevisibletonear-infraredoptical region,andcytochromecoxidaseistheresponsible photoacceptor. Therearetwoprimarymethodsofinfluencingtis- sue with laser energy — photochemical and photo- thermal interaction. The most frequently used mechanism of photon energy conversion in laser medicine is photothermal. Very significant heating of irradiated samples occurs with all surgical meth- ods of tissue interaction (cutting, vaporisation, co- agulation, and ablation). However, at low light in- tensities, photochemical conversion of the energy absorbed by a photo acceptor prevails. In order to produce effective photobiomodulation, it is neces- Fig. 1: Intrabony defect of tooth #23. Fig. 2: Pre-existent gingival recession. Fig. 3: Debridement of the granulation tissue. Fig. 4: Placement of a graft. Fig. 5: Irradiation points after the surgery. Fig. 6: Genova handpiece. Fig. 7: Situation after six months. Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 6 Fig. 5 Fig. 7 22016