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ePaper created 2018-02-16, 10:54:19 | version 1.38.0
laser dentistry case report | Fig. 3 Fig. 4 Fig. 5 Fig. 6 A constant movement must be performed in order to avoid thermal damage deep into the tissue. Water irrigation can be used as coolant during the treatment. There is no surface ablation of the pigmented mucosa but rather the haemo- globin and melanin absorbing the laser energy (Fig. 2). This technique (Figs. 3–6) showed a treatment time of two minutes compared to the ablative technique time up to 30 minutes in an Figs. 3–6: Depigmentation on upper arch using 810 nm at 30 W, 20 kHz, 16 μsec, pre-op (Fig. 3), immediate coagulation (Fig. 4), three weeks post-op (Fig. 5), eight years post-op (Fig. 6). Fig. 7: Absorption Spectra of biological materials. (Courtesy of J. Meister) cosmetic dentistry 1 2017 Fig. 7 37 (Fig. 1).6–9 By incorporating the optical properties and absorption characteristics of 810 nm together with specific power parameters, a non-ablative technique was developed (Fig. 2).10, 11 Another similar non-ablative technique described as microcoagulation was also reported using a 20 W 980 nm diode laser.12 The 445 nm blue wavelength was introduced in the dental market in 2015. By using 320 μm uninitiated fiber deliv- ering 1 W continuous wave of 445 nm, the same non-ablative procedure and result can also be realised. Background with non-ablative technique Diode laser at 810 nm is poorly absorbed in water, but it is well absorbed by pigment such as haemo- globin and melanin. The use of high power, short pulse duration concentrated the thermal energy on the surface over deep tissue thermal conduction with lower power and long pulse.13, 14 The author has used the 810 nm wavelength ( elexxion claros 810 nm diode laser, elexxion AG, Singen, Germany) with the power parameters of 30 W, 20 kHz, 16 μsec giving an average power of 10 W. Under local anaesthesia, a non-initiated 600 μm fiber was used. The fiber was placed at a distance of 2 mm to 5 mm from the pigmented mucosa. Coagulation can be observed with im- mediate effect upon irradiation.