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Laser

The application of Laser in Dentistry

Dental Medicine has undergone a rapid and continuous evolution. Much is due to the development of minimally invasive techniques that aim to preserve oral structures, such as the laser.

The laser (Light Amplification by Stimulated Emission of Radiation) has been used in stomatology since 1989 and has different applications. It is a collimated ray of light with different wavelengths whose properties can be used therapeutically in other areas and that does not cause harmful changes in the cells’ core, as ionising radiations do.

Dentistry uses three types of lasers:

  • Laser Diode;
  • Laser Neodymium,;
  • Laser erbium.

Within these groups, different types of lasers are classified according to their wavelength and therefore have various applications. The erbium laser, a high-power laser, has the most significant applicability in dentistry and has been proven to be very safe.

Considering its advantages in clinical practice, what are the laser’s main indications?

Generally, the laser can be used for all ablative dental procedures, such as caries lesion removal, dental veneer detachment or surgery. In addition, it can be used in gingivoplasty, wisdom teeth or dental implant surgery, lesion or tumour removal, gingival depigmentation, decontamination of canals in devitalizations, decontamination of the surface of dental implants, and treatment of peri-implantitis, among others.

Due to its anti-inflammatory, analgesic, and biostimulant action, the laser can be used for tissue repair after root canal treatment or traumatic injuries to reduce edema.

Laser therapy has also effectively treated dental hypersensitivity associated with acute, sudden, and short-lasting pain. This hypersensitivity may occur during or after dental restoration (due to gum recession) and after dental whitening. It is also indicated in the presence of simple herpes and shingles. It is also indicated in the presence of simple herpes and shingles.

It can also be used in cases of ronchopathy upon preliminary evaluation The soft tissues causing the disease become firmer due to the action of the laser, reducing airway obstruction and, as such, the sound generated by the flaccidity of these same tissues.

Laser application areas

In addition to the examples above, we now highlight other possible laser applications by field of speciality in dentistry:

Oral Rehabilitation

  • Removal of ceramic dental veneers without wearing down the remaining tooth structure;
  • Gum contouring of the smile through gingivectomy;
  • Gingival peeling with the removal of melanin;
  • Removal of maladjusted composite resin or ceramic restorations.

Oral implantology

  • Precise and minimally invasive bone ablation (cutting);
  • Facilitated dental implant exposure surgeries;
  • Effective treatment for peri-implantitis;
  • Selective decontaminating unhealthy bone;
  • Promotes implant integration into the bone by stimulating bone growth factors.

Periodontology

  • Debridement of pockets and promoting bactericidal effect (disinfection);
  • Precise and selective ablation;
  • Selective and precise calculus removal;
  • Minimally invasive surgery with rapid bone and gum healing;
  • Reduced infection and post-operative discomfort.

General Dentistry

  • Precise and selective ablation of lesions;
  • No vibration, micro-fractures and no temperature increase (due to excessive rotation of the instruments);
  • Bactericidal effect: decontamination of remaining dentin;
  • No need for anaesthesia in most cases.

Pediatric Dentistry

  • The method preferred by children: less noise and no vibrations, decreasing fear;
  • Simple, precise and minimally invasive treatments;
  • Excellent disinfection of contaminated dentin – the guarantee of successful restorative procedures;
  • Efficient disinfection of occlusal points and fissures, even in the most profound areas.

Endodontics

  • Minimally invasive accesses (no heating or microfractures);
  • Bactericidal efficiency – removes the smear layer, cleans and disinfects the canals;
  • Apicectomy – performed in a minimally invasive manner, with easy access.

Oral Surgery

  • Bone cutting performed in a precise and selective approach, maintaining the tissue integrity;
  • Atraumatic osteotomies (without trauma);
  • Bone wear without heating;
  • Stimulates growth factors, enabling efficient bone healing.

Oral Pathology

  • Minimally invasive surgery for oral tumours;
  • Precise cutting for biopsy and histological diagnosis safely;
  • A very appropriate tool for treating osteonecrosis in patients undergoing treatment with bisphosphonates;
  • Efficiently reduces symptoms in a wide range of oral pathologies.

Benefits from Laser Treatment

Laser is not a simple tool, but rather an alternative that presents benefits to other solutions, such as:

  • Almost no pain during the treatment;
  • Reduced bleeding;
  • Rapid healing;
  • Reduction of discomfort, such as post-operative edema;
  • Decontaminating function, avoiding (in specific procedures) the need for the use of antibiotics and reducing the incidence of postoperative infections;
  • In the case of dental veneers removal, it allows them to be removed without wearing away the enamel and without increasing dental sensitivity (caused by overheating of the drills), preserving the dental structure as much as possible;
  • The number of appointments can be reduced – by not requiring sutures (stitches); it also dismisses the suture removal appointment.

 

Who can be treated with Laser?

All patients are amenable to laser treatment. However, it is contraindicated in cases such as:

  • Pregnant women for safety reasons;
  • Oncology patients not fully healed or during active treatment since, if not used safely, it can stimulate neoplastic cells;
  • Patients with active labial or intraoral herpes;
  • Patients under treatment with isotretinoin (acne) for their hypersensitivity to radiation (in the same way, they should be cautious with solar radiation).

In any application, it should always be used following strict safety protocols for doctors and patients.