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Soft
tissue can act
as a barrier inTeeth,
many casesBrackets
during
Uncovering the Tooth:
The Diode
Laser
and Implants.
Soft tissue
can act to
as a Uncover
barrier in many cases
during
r
!
Introduction:
r
Soft tissue can act as a barrier in many cases during
Soft tissue can act as a barrier in many cases during
Although monopolar
r
Although monopolar
In this months edition of DentistryeToday, I look at the role of the diode laser in helpingAlthough
safely
and
efficiently
around
dental
hard tissue (tooth structure and bone) as well as
monopolar
e
with removing tissue that covers
three separate areas: natural teeth, orthodontic
around metals ( brackets, implants, amalgam, gold etc.). Although monopolar
e
brackets and dental implants. Soft tissue can act as a barrier in many cases during
electrosurge units can be used around dental hard tissues, they cannot be safely used
regular dental treatment and the diode laser can be used to routinely remove tissue
around metals as they can cause catastrophic iatrogenic damage (1-3), so the diode
s
laser can be a tremendous alternative in those situations.
U
U
Although monopolar
e
teeth
Uncovering
e
U
U
r
The diode laser can be used to uncover teeth in many situations where tissue is acting
( can be
In completed
this edition,
as a barrier to successful completion of restorations. The simple laser gingivectomy
be completed
which ais the most common procedure a laser dentist encounters (4) can can
be completed
h
a
at low settings of around 0.7 - 1.1 watts continuous wave (CW) with an initiated tip. (5-7)
a
(Fig1-3)
By Dr. Glenn van As
In contrast with
I will cover how a diode laser can be used to reduce gingival
can be completed
I
can be completed
a
Other articles
haveadvent
also shown
the value of
diode laser
in
With the
of bonding
ofthe
brackets,
and
o
t
a
2
Fig. 2 Diode to expose tooth structure.
Diode
to
expose
tooth structure.
Fig.22Diode
Diode
expose
tooth
structure.
Fig. 1. Prep of fractured upper premolar. Fig. 2 Fig.
toto
expose
tooth
structure
become accepted by both
In a
Fig.
Diode
expose
tooth structure.
Fig.2 3.
Notetoclamp
placement
during
endodontic
treatment.
Gingivectomies around Orthodontic Brackets
Fig. 2 Diode to expose tooth structure.
In a former article I have discussed how the diode laser could be used safely around
metals such as gold Other
crowns,Other
amalgam,
and orthodontic
brackets
reduce
articles
haveshown
also
shown
the value
the diode
articles
have
also
the tovalue
ofgingival
theof
diode
laser
(8) Other articles have also shown the value of the diode laser in
o
ohyperplasia.
orthodontics. (9-15) (Figs.4-6)
laser in
in
o
Other articles have also shown the value
theImmediate
diode laserpostop.
in
Figof5.
F
Many monopolar
e
Many monopolar
e
A
If the implant
the diode
i
l
These
If the implant
c diode
the
i
l
Orthodontic appliances can
as well as ulceration, clefts and poor
Fig 5. Immediate postop.
c
g
5. Immediate
postop.
Fig 5.Fig
Immediate
postop.
F
Fig. 4. Gingival hyperplasia around brackets.
e
Fig. 5. Immediate
post-op.
Many
monopolar
Many monopolar
Fig 5. Immediate postop.
Fig. 6. Eight-day
healing
of soft
tissue
after after
gingivectomy.
Eight day
healing
of soft
tissue
laser gingivectomy.
e
Many monopolar
e
Inflammation affects the
Uncovering tissue for Dental Implants
a two
stage technique where an implant is placed surgically and covered with soft
Soft tissue management around dental implants can be a problem that is difficult to If the implant
IfInthe
implant
tissue
in the initial stage, the implant must be uncovered at the 2nd stage. If the implant
solve
with
i
i traditional means such as electrosurge, or surgical blades. Many monopolarthe diode
the diode
is crestal or slightly supra crestal,o and there is adequate soft tissue existing,
the diode
electrosurge
l
l units can cause osseointegration to reverse with inadvertent contact with
Fig. 8 Implant
exposed.
laser can be used to safely remove overlying soft tissue. (16-18) .(Figs. 7-9).
the implants after a matter of seconds.(1-2)
Fig. 8 Implant exposed.
t
Eight day healing of soft tissue after laser gingivectomy.
IF
If the implant
i
the diode
F
Eight day healing of soft tissue after laser gingivectomy.
l
F
F EightEight
day healing
oftissue
soft tissue
after laser
gingivectomy.
day healing
of soft
after laser
gingivectomy.
o
Fig.
Fig. 8 Implant
exposed.
Fig.88.Implant
Implantexposed.
exposed.
Diode
readycollars
to uncover
implant.
FFig. 7.Four
healing
in place
after diode texposure of implants.
In conclusion, the diode laser can be an invaluable tool to remove tissue in many
situations such as around teeth, orthodontic
appliances
dental implants. The ability
Fig.
8 Implantand
exposed.
to work in a bloodless field, quickly and efficiently without fear of interaction with metallic
or dental structures makes the diode laser an indispensable tool for the restorative
dentists armamentarium.
References
Fig. 8 Implant exposed.
in place
place after
after diode
diodeexposure
exposureofofimplants.
implants.
Fig. 9.Four
Four healing
healing collars
collars in
tissue laser technology and cosmetic gingival contouring. Am J Orthod Dentofacial
Orthop. 2005;127:85-90.
I
t
7. de Oliveira Guaré R, Costa SC, Baeder F, de Souza Merli LA, Dos Santos MT. Druginduced gingival enlargement: biofilm control and surgical therapy with gallium1. Massei G, Szmukler-Moncler S. Thermo-explantation. A novel approach to remove
aluminum-arsenide (GaAlAs) diode laser-A 2-year follow-up. Spec Care Dentist. 2010
osseointegrated implants. European Cells and Materials Vol.7. Suppl. 2, 2004 (page
Mar;30(2):46-52.
48).
8. van As G. The diode laser- the diode laser for gingivectomies in orthodontics. Dent
2. Wilcox Cw, Wilwerding TM, Watson P, Morris JT. Use of electrosurgery and lasers in
Today. 2011 Oct;30(10):176.
the presence of dental implants. Int J Oral Maxillofac Implants 2001;16(4): 578-82.
9. Sarver DM. Principles of cosmetic dentistry in orthodontics:
part 1.healing
Shape and
F
Four
collars in
3. van As G, The Diode Laser as an Electrosurgery Replacement. Dentaltown. June
proportionality of anterior teeth. Am J Orthod Dentofacial Orthop. 2004;126:749-53.
2010. pgs. 56-64.
10.Sarver DM, Yanosky M. Principles of cosmetic dentistry in orthodontics: part 2. Soft
I
4. White JM, Swift EJ. Lasers for Use in Dentistry. Journal of Esthetic and Restorative
tissue laser technology and cosmetic gingival contouring.
Am J Orthod Dentofacial
F 2005
Four healing
inafter
placediode
after
diode exposure
of implants.
Four
healing
collarscollars
in place
exposure
of implants.
Dentistry. Vol 17, Issue 1, pageF60, January
Orthop. 2005;127:85-90.
5. Adams TC, Pang PK. Lasers in aesthetic dentistry. Dent Clin North Am. 2004 Oct;48
11. Sarver DM, Yanosky M. Principles of cosmetic dentistry
in orthodontics: Part 3.
t
(4):833-60, vi.
Laser treatments
for tooth eruption and soft tissue problems. American Journal of
I healing collars in place after diode exposure
FI
Four
of implants.
6. Meeks T. Creating beautiful smile symmetry: tissue considerations. Dent Today. 2009
Orthodontics and Dentofacial Orthopedics , Volume 127, Number 2, 262-4.
TheManagement
ability and
The
Oct;28(10):98,100-1.
12. Sarver DM. Use of the 810nm Diode Laser:
Softability
Tissue
It
7
t
Orthodontic Applications of Innovative Technology. Pract Proced Aesthet Dent. 2006
The ability
Oct;18(9):suppl 7-13.
1
t
38 (5):266-73 (2004).
1
laser treatments. European Journal of Paediatric Dentistry. Vol. 11/1-2010;44-48.
1
Journal of Orthodontics and Dentofacial Orthopedics. Vol. 133, issue 4, Suppl., Apr.
DENTISTRYTODAY.COM • JANUARY 2012
2008, Pgs S110-S114.
tissue laser technology and cosmetic gingival contouring. Am J Orthod Dentofacial
1
Orthop. 2005;127:85-90.
1
L
1
L
13.Hilgers JJ, Tracey SG. Clinical Uses of Diode Lasers in Orthodontics. J Clin Orthod
38 (5):266-73 (2004).
14. Genovese MD, Olivi G. Use of laser technology in orthodontics: hard and soft tissue
laser treatments. European Journal of Paediatric Dentistry. Vol. 11/1-2010;44-48.
15. Kravitz ND, Kusnoto B. Soft-tissue lasers in orthodontics: An overview. American
Journal of Orthodontics and Dentofacial Orthopedics. Vol. 133, issue 4, Suppl., Apr.
2008,
Pgsdiode
S110-S114.
place
after
exposure of implants.
16. van As G. The diode laser- The diode laser in second stage implant recovery. Dent
Today. 2011 Sep;30(9):144.
17. Catone GA (1997) Lasers in periodontal surgery. In: Catone GA, Alling CC (eds)
abilityPhiladelphia, pp 181–
Laser applications in oral and maxillofacial surgery.The
Saunders,
196.
18. Romanos GE, Everts H, Nentwig GH (2000) Effects of diode and Nd:YAG laser
irradiation on titanium discs: a scanning electron microscope examination. J
Periodontol 71:810–815. doi:10.1902/ jop. 2000.71.5.810
The ability