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ePaper created 2017-03-17, 12:41:55 | version 1.38.0
| industry Diode lasers and microsurgery Author: Dr Isabelle Nguyen, France Many families of dental lasers have become avail- able in recent years. Throughout this article we will review a diode laser, which is unusual in that it supports three different wavelengths in the same device. A large number of studies have awakened interest in near infrared wavelengths, 970 nm for example, which enable the use of high penetration lasers for disinfecting endodontic canals and perio- dontic pockets. The 660 nm wavelength promotes biostimulation. Diode lasers can be used for surgical applications in mucous tissue, though it should be noted that bleed- ing from the tissue has always occurred because the rays penetrate the tissue below, thus requiring cau- tion when heating the tissue underlying the target tissue. The factors above resulted in a new wave- length of 445 nm—in the blue range—as a potential solution for dealing with mucous tissue as it is more readily absorbed by haemoglobin (Fig. 1). As it is not possible to cover the wide range of potential uses of diode lasers in a single article, we will focus here on their microsurgical applications. Creating pontics In the presented case, there was an old bridge with three incisors and reduced intercanine space, but the patient refused orthodontic treatment. Figure 2a shows the initial state in which two pontics were im- plemented with a 970 nm 3 W CW diode laser to rec- reate the emplacement for two central posts under local anaesthesia with air/water irrigation (Fig. 2b). There was no bleeding, which simplified the work of preparing and installing the temporary resin bridge (Fig. 2c). An examination of scar healing was per- formed seven days later (Fig. 2d). An impression was then made for the permanent bridge (Fig. 2e). Figure 2f shows the permanent bridge when installed. Widening the sulcus The diode laser is an excellent alternative to the conventional technique for widening the sulcus be- fore creating an impression. It makes avoiding unde- sired secondary gingival retractions possible as its use in these cases requires less force, and since the HEMOGLOBIN MELANIN WATER 10,000 1,000 100 10 1 0.1 0.01 0.001 0.0001 ) 1 - M C ( T N E I C I F F E O C N O I T P R O S B A g r u b r a M y t i s r e v i v n U s p p i l i h P , n u a r B s a e r d n A . r D . f o r P t h g i r y p o C Fig. 1: Influence of different laser wavelengths on haemoglobin, melanin and water. 445 660 810 940 970 WAVELENGTH (NM) 26 laser 1 2017