Fundamentals of Laser Dentistry Kirpa Johar
INDEX
A
Ablated enamel 35
Abscesses of periodontium 94
Absorption 3
of laser 5
Access cavity preparation 88
Accessories for CO2 unit 108
Activation of
fluoride gel 22
stannous fluoride gel 56
Adhesion and margin seal of laser prepared cavities 36
Advantages of
low level laser therapy 132
nd: YAG laser application 97
Aggressive periodontitis 94
Aluminum 57
Ankyloglossia 113, 114
Apical sealing 87
Application of
bleaching
agent 67
gel 69
desensitizing gel post-bleaching 68
fluoride gel on tooth 22
gel 69
gingival barrier 69
rubber dam 41
thin layer of stannous fluoride gel in cervical area 56
tolonium chloride solution 136
Argon
ion laser 7
laser unit 48
Arsenide 57
Articulated arm of CO2 unit 108
Assisted teeth whitening 68
B
Bacterial plaque 55
Basic scheme of laser 3
Beam delivery system 4, 16
Benefits of ultrashort laser pulses 40
Bio-active and biocompatible glasses 56
Bleaching 63
mechanism of teeth 64
Bonding of fixed orthodontic appliance 122
C
Calcification 54
Calcium hydroxide 55, 76
Camphoroquinone absorption coefficient curve 47
Caries 63
resistance 24
Causes of tooth discoloration 62
Cavity preparation
using lasers 33
with numerous pulses in
dentin 36
enamel 36
Ceramic scissor 102
Cervical recession causing hypersensitivity 54
Chemical breakdown of carbamide peroxide 65
Chronic
gingivitis 99
periodontitis 94
Classification of
different wavelengths of light 13
light 12
Clinical procedure of laser 68
Closure of diastema with orthodontic appliance 124
CO2
laser unit 108
surgical laser 77
Complications in wound-healing process 107
Composition of light cured filling materials 46
Conventional
access cavity preparation 88
bleaching 64
pulp capping 76
therapy 95, 107
treatment 22, 55
Cosmetic facial laser surgery 112
Crown lengthening procedure 70
Cryosurgery 107
D
Dental
hard tissues 23
office in 21st century 140
Dentin hypersensitivity 56
Dentinal receptor mechanism 54
Dentist's team vision 140
Dentistry 130
Development of laser-assisted cavity preparation 32
Diode
handpiece 8
laser 8, 85, 96
handpiece used for teeth whitening 66
handpiece with metal guides 102
machine 96
tip 8
unit 113
machine 6
Direct pulp capping 76
Diseases of
jaw joint 130
nerval structures 130
Display of cavity 41
Distribution of water in tissue 38
Dye lasers 6, 7
E
Effect of
argon lasers 27
CO2 lasers on caries 25
different laser wavelengths on eye 13
er: YAG 29
laser on periodontal tissues 99
laser beam on eye 13
nd: YAG laser on periodontal tissues 97
temperature on target tissue 6
Electrotomy 107
Embeded tooth exposed 79
Emission modes 5
Endodontic problems 82
Er : YAG laser 8, 98
unit 78, 97
Erbium
and erbium-chromium lasers 9
hand piece 41
Excimer laser 7
Extrusion of canine 123
F
Finishing and restoration of cavity 42
Formaldehyde 55
Four level system 4
Frenectomy 113
Frequency-doubled alexandrite laser 100
Full mouth laser-assisted bleaching 67
Function of laser involving 2
G
Gallium 57
Gas lasers 6
Gaussian beam and laser resonator 4
Gingival
guard 67
hyperplasia in relation to maxillary posterior region 104
inflammation and bleeding on probing 98
Gingivitis 92, 94
Glass-ionomer cement 56
Granuloma interna 63
H
Helium-neon laser 57
Hemostasis techniques 110
Ho:YAG laser 41
Home bleaching 64
Host crystals 9
I
Iatrogenic discoloration 63
Impact
of laser beam on skin 13
on skin 13
Indications of pad technique 135
Infantile oral soft tissue 79
Inflamed gingival margins 99
Insertion of laser fiber into periodontal pocket 98
Intraoperative bleeding 106
K
Kinetic cavity preparation 33
L
Labial vestibuloplasty 115
Laser
activation of bleaching gel 70
assisted
biopsy 115
bleaching of non-vital teeth 67
bonding 122
crown lengthening procedure 70
excision of ulcer 117
frenectomy 124
gingival depigmentation procedure 72
lingual frenectomy using diode laser 114
periodontal therapy 96
pulp capping 77
pulpotomy 78
root canal sterilization 84
tooth exposure 122, 123
cable stripper 102
classes 13
cured materials 50
furnishes pocket debridement and establishes coagulation 101
in implant dentistry 111
integral part of 21st century dental office 140
photo polymerization 47
protective eyewear 17
radiation safety 15
safety
education 12
goggles 17
officer 19
supported
cavity 34
root canal sterilization 83
root canal therapy 89
therapy 95, 101, 107
tissue interactions 5
used in pad 135
veneer and enamel modification 35
warning sign 12
L
Light cure composite resin 42
Limitations of ultrashort pulse laser systems 40
Lingual
frenectomy 114
vestibuloplasty 115
Lower output power lasers 57
Luxation of tooth after bone cutting 118
M
Main components of laser 3
Marketing laser dentistry 141
Maximum permissible exposure 12
Metal guide being fed to hand piece 103
Middle output power lasers 57
Mucocele in relation to lower lip 117
N
Natural pulpal defense mechanisms 54
Nd: YAG laser 41, 84, 97
Necrotizing
periodontal diseases 94
ulcerative periodontitis 94
Nomination of laser safety officer 19
O
Operculectomy 79
Oral and maxillofacial surgery 108
Oxalate containing products 56
P
Parts of er:YSGG laser unit 34
Pericoronitis 112, 113
Peri-implantitis 111
Periodontitis 92, 94
Periodonto pathogenic bacteria 93
Photo polymerization reaction 46
Photodynamic therapy 134
Pre-eruption trauma 63
Preventive dentistry 23
Properties of
laser light 38
light 2
Protection of eyes 18
Pulpotomy 78
Pulse repetition rate 38
Q
Q-1000 soft laser 131
R
Reaction of bacteria to laser light 83
Recurrent aphthous ulcer treatment 115
Reflection of laser by target tissue 5
Removal of caries 42
Requirements of root canal filling material 89
Root canal
filling 89
preparation 85
shaping 88
sterilization 82
S
Safety
goggles 103
in laser treatment 87
Scalpel 107
Several kinds of extrinsic discolorations 62
Sodium
fluoride 55
monofluorophosphate 55
Soft
laser therapy 132
tissue
lasers applications 78
lesions 130
Solid state lasers 8, 9
Strawberry flavored fluoride gel 28
Stripping of laser cable 102
Strontium 55
Supporting periodontal therapy 95
Systemic
diseases 63
factors of metabolic illness 93
T
Target tissue 5
Temporary filling material 77
Terra quant solo soft laser 130
Tetracycline staining 62
Theories of dentin hypersensitivity 54
Thermal diffusivity K 38
Three level system 4
Types of laser 41
V
Vestibuloplasty 115
W
Wound healing 128
×
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1Fundamentals of LASER DENTISTRY2
3Fundamentals of LASER DENTISTRY
Kirpa Johar BDS Masters Degree Certificate Laser Dentistry (Vienna) Director Johar's Laser Dental Clinic Brigade Road, Bengaluru, Karnataka, India Foreword Naresh Thukral
4Published by
Jaypee Brothers Medical Publishers (P) Ltd
Corporate Office
4838/24, Ansari Road, Daryaganj, New Delhi 110 002, India
Phone: +91-11-43574357, Fax: +91-11-43574314
Offices in India
Overseas Offices
Fundamentals of Laser Dentistry
© 2011, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
First Edition: 2011
9789350253779
Typeset at JPBMP typesetting unit
Printed in India
5Dedicated to
My father Dr BS Johar, who has been my inspiration in dentistry and in life.
My mother Mrs Paramjit Johar, who taught me the values of integrity, sincerity and hard work.
My best friend and wife, Harleen Johar, for her unconditional support and for making my life more meaningful.
My sisters, Mrs Jasmine Suri and Mrs Mansha Sood, for always being there when I needed them.6
7Foreword
It was ten years ago that I first started using three different wavelengths of Dental Lasers. With no training available in India at that time, I had to travel to different countries, wherever someone was willing to teach me. A few years later, SOLA Academy in Vienna was started and I went through my Masters Degree Certificate.
I was then determined to start an academy in India to popularize and help spread the knowledge of Lasers. Kirpa was amongst the first few to join and successfully complete the Masters.
Today, he is keeping alive my dream of spreading the light of lasers in our fraternity and the result is this simple guide to using lasers in the Dental Clinic. One can feel the sincerity with which he has compiled and brought forth this book.
I do hope that the Dentists will find this book a must for guiding them for a better treatment plan.
I wish him all the success.
Naresh Thukral bds
Masters Degree Certificate Laser Dentistry (Vienna)
Founder President, SOLA India8
9Preface
Fundamentals of Laser Dentistry has been conceptualized and written with the aim to make the study of lasers both exciting and easy to understand. There is immense potential for this wonderful tool, especially in oral laser application. Today, there is tremendous change and constant advancement and I believe that laser is one key component that can revolutionize dental treatment and practice.
From the beginning of my laser study and throughout my masters program, I felt the need for a comprehensive book covering the basic concepts of Laser-assisted Dentistry, which ranged from basics to clinical practice. After careful thought, I tried to pen down a single book with all the key topics of laser physics, different wavelengths and its clinical applications. This textbook has been prepared in a manner that is easy to understand. Numerous diagrams, charts, photographs and schematic illustrations have been included to further enhance the understanding of the subject.
I have recently launched Laser Dentistry Research and Review (www.ldrr.org) in lieu for the need for a platform for the dental fraternity to access and exchange the latest techniques and procedures in the field of laser dentistry.
This book aims to be a concise but precise guide to Laser-assisted Dentistry. Laser has made considerable forays into routine dental practice such as cavity cutting, endodontics and periodontal therapy; laser-assisted cosmetic procedures such as teeth whitening and crown lengthening, to name some of the procedures are common. This is further supported by studies that validate the use of hard tissue and soft tissue laser that enhances conventional therapy and plays a significant role in the delivery of the twenty-first century health care. The trend is growing steadily. The noninvasive nature of lasers makes it more favorable for the patient. Limited postoperative pain, faster recovery, bloodless and sutureless procedures are other advantages of using laser resulting in better patient compliance and satisfaction.
An attempt has been made to bring about a textbook that is easy to understand and comprehend. This journey has been a truly humbling experience. I fervently desire that this work will help those who wish to pursue laser dentistry, those who look forward to upgrade their current practice and for those who have just started to practice laser dentistry, as a ready-reference.
I will be glad if the dental fraternity, students and peers find it useful.
Kirpa Johar10
11Acknowledgments
It is with sincere appreciation and thanks that I would like to acknowledge the invaluable inputs and help received from my peers and associates to complete this book.
I would first like to extend my gratitude to Jaypee Brothers Medical Publishers (P) Ltd, New Delhi for giving me this opportunity. Writing this book has been one of my most cherished aspirations and it would not have been possible without their faith and encouragement.
I am most grateful to Dr KG Ghorpade, who has been my guide and the source of valuable insight on the various aspects of book writing. Writing on various topics often requires a collective effort. I appreciate the invaluable support I have received from Dr Vikram, Director, Vikram Perfect Center for Advanced, Dermatology, Cosmetic Surgery and Dentistry (Mysore); Dr Anita Nitin and Dr Anil SR of Vikram Perfect (Mysore), in the form of case studies and for sharing their exceptional work with the readers.
I would like to extend my regards to Mrs Shanta Chandrashekar for proofreading the manuscript and Mr Ravi and his team at Omega Lasertech for typing the manuscript and the tables with patience and sitting through the endless hours of corrections with me. I am grateful to Mr Babu for clerical assistance.
The textbook is incomplete without illustrations and diagrams. Web pepper has let me its expertise in this regard, my heartfelt thanks to www.webpepper.in
Dr Vinod has been indispensible with his help on reference work. Also, I would like to mention Mr B Sabrish of Studio Bangalore, Bengaluru, Karnataka for the very professional photography of the laser instruments.
I would like to sincerely thank Dr Naresh Thukral, Dr Anil C Shah, Dr Mohan Vakade, Dr Vivek Hegde and Dr Sanjay Jain of Society of Oral Laser Application (SOLA), India. They have been a source of constant inspiration and a guiding force in my journey of Laser Dentistry. I would also like to thank Dr Moritz and Dr Beer of SOLA International for introducing me to the fascinating world of Laser Dentistry.
I am extremely thankful to Mr Peter Rowland, Vice President, Biolase; Mr Aneja of Fatona; Mr Ashish Mittal, Country Manager Sirona, India. Confident Group, Marketing Partner for ARC and Syneron Laser Systems, AMD Lasers-Picasso and Deka Lasers have graciously allowed me to use the photographs of their laser equipments. I would also like to acknowledge the other laser companies whose equipment, photographs have been used for illustration purposes.
My special thanks goes to Dr Afshan Shoiab, who has assisted me on various laser dental cases that gave her the basic knowledge of lasers. This proved to be a boon as she gave constructive inputs to the content, Dr Reena Joseph who has offered valuable suggestions and contributed towards the final compilation of the manuscript and Dr Amogha Kannan, a part-time writer, who contributed with the final draft of the textbook and in compiling case photographs and illustrations.
Last but not least, I would like to convey my gratitude to all my wellwishers who have helped me in various ways make this work a realty.