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ePaper created 2017-10-26, 15:28:59 | version 1.38.0
| case report Laser in second-stage implant surgery Authors: Dr Habib F. Zarifeh, M.Sc., Dr Mayssam Bachacha, MS & Dr Monique Hanna, MS, Lebanon The usage of laser devices has provided less invasive management options for dental procedures. Thereby, the erbium laser is the most used laser in dentistry nowadays. It presents the most application possibil- ities since it can be used on both soft- and hard- Fig. 1: Second-stage surgery on implants in the upper maxillary jaw. Fig. 2: During laser performance. Fig. 3: Haemostasis of the implant site 23 after implant removal. Fig. 1 tissues. When it comes to soft surgery, there are many indications including gingivectomy, gingivoplasty, sulcular debridement of diseased fibrous tissue1, le- sion removal, fibroma removal, tissue retraction, aph- thous ulcers, gingival hyperplasia (excision and re- contouring), crown lengthening, operculectomy, frenectomy, and photocoagulation.2 In addition, the erbium laser may be used for peri- odontal procedures3, including laser soft tissue curettage, laser removal of diseased, infected, in- flamed or necrotised soft tissue within the periodon- tal pocket, removal of highly inflamed oedematous tissue affected by bacteria penetration of the pocket lining and junctional epithelium4. In this article, we present a case where the Er,Cr:YSGG laser was used in a second-stage dental implant surgery. Case presentation A patient presented with dental implants previ- ously inserted in the maxilla. Topical anaesthetic was administered before the procedure for three minutes, second-stage surgery was performed with an Er,Cr:YSGG laser (Waterlase MD, Biolase Technology, Inc., USA), using a Gold handpiece in S contact mode Z6 tip (2.78 µm, 3 W, 50 Hz, water 30 %, air 15 %). The settings for the procedure strictly followed the manufacturer’s instructions. Fig. 2 Discussion Er,Cr:YSGG laser for soft tissue oral surgery is be- coming widely used.5 It’s beneficial effects include sufficient haemostasis, absence of swelling and pain and precise incision margin.6 When in contact with the tissue, the laser light can be reflected, scattered, be absorbed, or be transmitted to the surrounding tissues.7 The presence of free wa- ter molecules in biological tissue are vaporised as they absorb laser energy, causing the increase of intra- tissue pressure, producing vapour within the tissue Fig. 3 14 laser 3 2017