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Laser KD

The document discusses the application of laser technology in endodontics, highlighting its advantages such as precision, minimally invasive procedures, and effective disinfection of root canals. It outlines the history of laser development, characteristics of laser beams, and various applications in dental practices, including pulp vitality assessment, pulp capping, and apical surgery. While the integration of lasers in endodontics shows promise, challenges such as high costs and the need for further research remain.

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21 views11 pages

Laser KD

The document discusses the application of laser technology in endodontics, highlighting its advantages such as precision, minimally invasive procedures, and effective disinfection of root canals. It outlines the history of laser development, characteristics of laser beams, and various applications in dental practices, including pulp vitality assessment, pulp capping, and apical surgery. While the integration of lasers in endodontics shows promise, challenges such as high costs and the need for further research remain.

Uploaded by

brodaace20
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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KATHMANDU MEDICAL COLLEGE

BDS Programme
Duwakot, Bhaktapur

Laser Application in
Endodontics

Submitted to: Submitted by:


The Department of Kanchan Dhakal
Conservative Dentistry and Roll no: 65016
Endodontics BDS Final Year, 8th
Batch

1
TABLE OF CONTENTS

Topics Page no
Introduction 3

Chronology of Laser 4
Development

Characteristics of laser beam 5

Classification of Dental Lasers 6

Applications of Dental Lasers in 7


Endodontics

Conclusion 10

2
Introduction

The term LASER stands for "light amplification by the stimulated


emission of radiation." Light, a form of electromagnetic energy, travels as
waves composed of photons. Ordinary light is diffused and non-focused,
consisting of various photons. Photons are released when an atom absorbs
energy and moves to a higher energy state, resulting in spontaneous
emission. This emission produces noncoherent and polychromatic light
waves. Laser beam generation involves an active medium (solid, liquid, or
gas) in a container, energized by an electric current or flash lamp.
Stimulated emission occurs, leading to population inversion when more
atoms are in an excited state than in the ground state. Coherent and
collimated laser light is produced, directed by mirrors, and delivered to the
target tissue. Lasers have shown to remove caries selectively while leaving
the sound enamel and dentin. They can be used without application of
local aesthetics. Commonly used lasers for caries removal are
Erbium:yttrium-aluminium garnet lasers and erbium, chromium-yttrium-
scandium-gallium-garnet lasers. These lasers can remove soft caries as
well as hard
tissue. Added
advantages of
lasers include
little noise, no
smell and
vibrations.

3
Chronology of Laser Development

1916—Albert Einstein: Theory of spontaneous


emission of radiation
1953—Charles Townes: Microwave amplification by the
stimulated emission of radiation (MASER)
1960—Theodore Maiman: Ruby laser
1964—Stern, Sognnaes, and Goldman: Lasers in dentistry
1971—Weichman and Johnson: Lasers in endodontics
1979—Adrian and Gross: Argon laser sterilization of
dental instruments
1985—Shoji et al.: Laser-aided pulpotomy
1986—Zakariasen et al.: Sterilization of root canals
1988—Miserendino: Apicectomy with CO2 laser
1990—Potts and Petrou: Laser-aided photopolymeriza-
tion of camphoroquinone-activated resins
1993—Paghdiwala: Er:YAG lasers for root resection and
retrograde cavity preparation
1994—Morita: Nd:YAG lasers in endodontics
1998—Mazeki et al.: Root canal shaping with Er:YAG laser

4
Characteristics of Laser Beam
1. Monochromatic: In other words, a single wavelength): The laser light
has one specific color
2. Collimated:Having specific spatial boundaries and a very low
divergence, ensuring a constant size and shape of the beam
3. Coherency:Indicates that the light waves pro- duced by a laser have a
specific form of electromagnetic energy and are in phase with one
another.
4. Intense
in
nature

5
6
Dental Lasers

In dental lasers, there are two types of delivery systems: the hollow tube
delivery system and the glass fiberoptic delivery system. The hollow tube
system utilizes a flexible tube with an interior mirror finish. Laser energy
is reflected along the tube, exiting through a handpiece at the surgical end
without directly touching the tissue. On the other hand, the glass fiberoptic
system involves a flexible glass cable in various diameters, encased in a
resilient sheath. The glass fiber, with sizes ranging from 200 to 1000 μ, fits
into a handpiece, and it can be used in both contact and noncontact modes
for directing laser energy onto tissues.

Applications of Lasers in Endodontics:

Endodontics, the field of dentistry focused on the study and treatment of


dental pulp and periapical tissues, has witnessed significant advancements
with the integration of laser technology. Lasers have emerged as valuable
tools, offering precise and minimally invasive solutions in various aspects
of endodontic procedures. This introduction explores the diverse
applications of lasers in endodontics, ranging from vascular vitality
assessment of pulp to disinfection of root canals, and discusses the
potential benefits and challenges associated with the integration of laser
technology in this specialized branch of dentistry.

I. Vascular Vitality Assessment of Pulp:


• Traditional methods (heat, cold, electric pulp testers) assess neural
vitality and may lead to false positives.
• Laser Doppler flowmetry (LDF) accurately assesses blood flow,
providing a valuable tool for pulp vitality evaluation.
II. Pulp Capping and Pulpotomy:
• Conservative pulp therapy alternatives to pulpectomy.
• Pulp capping for exposure ≤ 1.0 mm, especially in young patients.
• Pulpotomy in immature permanent teeth.

7
• Laser-assisted procedures ensure a potentially bloodless field, sterile
wound surfaces, and improved prognosis.
• Studies show CO2 and Nd:YAG lasers enhance success rates in clinical
trials.
III. Disinfection of Root Canals:
• Bacterial persistence after cleaning contributes to endodontic failures.
• CO2 and Nd:YAG lasers disinfect dentinal tubules.
• Various lasers, including XeCl, Er:YSGG, Er:YAG, diode, Nd:YAP,
and argon, are used.
• Limitations include incomplete
irradiation due to canal dimensions
and curvature.
• Safety concerns exist for
inadvertent laser transmission into
periradicular regions.
IV. Obturation:
• Thermoplasticized gutta-percha
obturation systems efficiently achieve a fluid-impermeable seal.
• Lasers, such as argon, CO2, Nd:YAG, and Er:YAG, have been explored
for softening gutta-percha.
V. Apical Surgery:
• Indicated when nonsurgical means fail post-root canal therapy.
• Lasers offer advantages: coagulation for bloodless surgical fields,
sterilization of the site, and precision in cutting hard dental tissues.
• CO2 and Er:YAG lasers show potential in apical surgery, improving
healing and patient comfort.

8
• Limit
ed

clinical acceptance due to high costs and the need for multiple laser
frequencies for comprehensive endodontic applications.

9
Conclusion
The application of lasers in endodontics, specifically in
treating infected and affected dentin, marks a significant
advancement in dental technology. The precision and
minimally invasive nature of laser technology offer notable
benefits in root canal therapy, providing effective
disinfection and removal of diseased tissues. Lasers
demonstrate their efficacy in targeting bacteria within
dentinal tubules, leading to improved outcomes in root
canal procedures. While further research and clinical
studies are needed to explore the long-term success rates
and broader acceptance of laser technology in endodontics,
the current evidence suggests a promising future for its
integration as a valuable tool in enhancing the quality and
efficiency of dental treatments. As technology continues to
evolve, the role of lasers in endodontics is poised to
expand, offering innovative solutions for addressing
complex dental challenges.

10
References :

Grossman’s Endodontic practice 14th edition, V.


Gopikrishna
Textbook of Operative Dentistry 3rd edition, Nisha
Garg, Amrit Garg
https://www.mdpi.com/2306-5354/10/3/296
https://www.lansfamilydentistry.com/treatment/
laser-therapy/
https://www.encinodentalassociates.com/blog/laser-
dentistry-an-alternative-to-traditional-dental-
treatment/

11

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