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27 4 2016 laser industry | Fig. 5: The clinical situation following LLLT around the extracted tooth 12 after one day. Fig. 6: The clinical situation of tooth 12 one week after surgery. Fig. 7: The clinical situation of tooth 12 three weeks after surgery. have the aforementioned advantages. In the mean- time, we now have convincing long-term studies for diodelasersaswellasnumerousscientificstudiesthat have shown positive results. Diode lasers are suitable forallpatients,includingthosefittedwithheartpace- makers (in contrast to electrosurgery). Additionally, patients can avoid being unnecessarily anaesthe- tised.Thelasersarealsoextremelycost-effectiveand long lasting. The advantages of the new three-diode laser The SIROLaser Blue (made by Dentsply Sirona) is a third-generation laser and the world's first dental laserequippedwithablue(445 nm),infrared(970 nm) and red (660 nm) diode. In my view, combining three wavelengths in a single device that now only weighs a little more than 1 kg makes the new model user friendly. According to the manufacturer, it is suitable for 20 medical indications, and in terms of the treat- ment provided at my clinic, that includes primarily periodontitis, peri-implantitis, dentine hypersensi- tivity, herpes infection, endodontics, minimal-inva- sive laser surgery, the treatment of abscesses, for haemostasisandforgingivectomy.Onepracticalfea- ture is that the device can be programmed individu- ally, although even the factory default settings save time and effort. Inmyclinic,wemostlyuseredlaserlight(660 nm), as part of soft laser applications like low-level laser therapy (LLLT) and biostimulation. I use the infrared light (980 nm) for reducing germs in periodontology and endodontics. The blue 445 nm diode is used for incisions and advanced laser surgery. Every week I treat about 30 patients for periodontitis or peri-im- plantitis. Therefore, we prefer using curettage and de-epithelialisation. During surgery, I use the wave- lengths 445 nm and 980 nm. To help wounds heal more quickly, I then follow up with the red laser light (660 nm) again. Safe and precise contact-free incisions Because blue light is absorbed much better by per- fused soft tissue, the new 445 nm blue laser can also makebetterincisionsatlowerpowerthantheinfrared laser light. Non-contact incision is particularly prac- tical because it means no coagulation at the instru- ment tip, more precise incisions and less bleeding. Thatmakesitidealforfrenulumoperations,forexam- ple. I also use the blue laser light for faster reliable light-curing of composites. In my opinion, the diode laser provides everything you need for the treatment ofsofttissuesandmuchmore.Agoodexampleisthe effective germ reduction in root canals. The diode laser provides more limited treatment opportunities when working with hard tissues such as bones and teeth. However, other types of lasers are available for this purpose. Remarkable results: red light with low power The red 660 nm diode is used for what are known as soft-laser applications (LLLT and biostimulation). When the wavelength is absorbed in the mitochon- dria and cytoplasm, a chemical reaction occurs. Therefore, the biological effect of low-level visible light therapy happens through photochemistry (probably by the photo activation of enzymes). This chemical reaction leads to biostimulation. Abergel et al. (1984) found that the irradiation of fibroblasts in culture at 633 nm stimulated the synthesis of col- lagen, which helps close the wound and prevent post-operative complications.1 Furthermore, it was shown that the diode was beneficial in reducing the pain(Walkeretal.1987).2 Allinall,thepositiveeffects of the red diode have been scientifically proven for 30 years, as recent reviews have shown.2,3 Some studies by Tina Karu, an internationally rec- ognised leader in the science of laser phototherapy, even showed that LLLT improves ATP production as well as DNA + RNA synthesis in the mitochondria.4 A study from Franca CM (2009) demonstrated a posi- tive effect of low intensity red laser (660 nm) by pre- ventinganoralmucositis.5 TaconKC(2011)observed afasterwoundhealingafterusingthe660 nmdiode6 . Iabsolutelyagreewiththat.Inmyopinion,wounds heal much faster and with fewer complications after using red laser light, and the wound area is cleaner with less scaring. The risk of intimal hyperplasia is re- duced and my patients generally no longer require Fig. 5 Fig. 6 Fig. 7 42016