LASERS IN PROSTHODONTICS THE 21st CENTURY RACERS

LASERS : THE 21ST CENTURY RACERS IN PROSTHODONTICS

Light Amplification by Stimulated Emission of Radiation

Term coined by GORDON GOULD ,1957 Father of laser: Albert Einstein Laser light is a man-made single photon wavelength.

LASER LIGHT

VISIBLE LIGHT

Why Lasers In ProsthodonticsProsthodontics takes all concepts of dentistry and integrates effective comprehensive treatment planning.It include a wide variety of patients seeking a diverse range of care:

Fearful patients Patients with complex medical histories Patient allergic to anesthetics

ADVANTAGES

LASER

LASERS ON BASIS OF APPLICATION IN DENTISTRYSOFT TISSUE LASERS

HARD TISSUE LASERS

SOFT TISSUE LASERS

No suturingLittle or No bleedingPainlessQuickerA traumatic

HARD TISSUE LASERSQuicker More accurateMore comfortableBetter results

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Application in

FIXED PROSTHETICS/ESTHETICSSoft tissue management around abutments.

Crown lengthening.

Osseous crown lengthening.

Troughing.

Formation of ovate pontic sites.

Modification of soft tissue around laminates

SOFT TISSUE MANAGEMENT AROUND ABUTMENTSARGON laser provide excellent Hemostasis and Coagulation

Gingival Retraction for making impression during a crown and bridge procedure becomes easy

CROWN LENGHTNING Insufficient clinical crown length Caries at gingival margin

Endodontic perforations near alveolar crest. Unaesthetic gingival architecture. Cosmetic enhancement.

LASER TROUGHINGA trough is created around a tooth before impression making using Nd:YAG laser.This can entirely replace the need for retraction cord, electro cautery, and the use of haemostatic agents.

Gingivaltroughing with the diodelaserexposes finish lines

FORMATION OF OVATE PONTIC SITESTwo most common causes of unsuitable pontic site: Insufficient compression of alveolar plates after an extraction Non replacement of a fractured alveolar plate.

Unsuitable pontic site results in un esthetic and non self cleansing pontic design. For favorable pontic design laser re-contouring of soft and bony tissue may be needed

MODIFICATION OF SOFT TISSUE AROUND LAMINATES The removal and re-contouring of gingival tissues around laminates can be easily accomplished with the Argon laser

REMOVABLE PROSTHETICS

Tuberosity reduction

Torus reduction

Soft tissue lesions

Residual ridge modification

TUBEROSITY REDUCTIONThe most common reason for enlarged Tuberosity usually is soft tissue hyperplasia

It affects stability of prosthesis

Surplus soft tissue should be excised using soft tissue lasers

TORUS REDUCTIONTori and exostoses are formed mainly of compact bone.They may cause ulceration of oral mucosa.They may also interfere with lingual bars or flanges of mandibular prostheses.

Soft tissue lasers may be use to expose the exostoses and Erbium lasers may be use for the osseous reduction.

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SOFT TISSUE LESIONS Epulis fissurata, Denture stomatitis Persistent trauma from a sharp denture flange Over compression of the posterior dam area

The lesion can be excised with any of the soft tissue lasers and the tissue allowed to re epithelialize.

RESIDUAL RIDGE MODIFICATIONFor proper retention, stability and support for the prosthesis, residual ridge modification is done with lasers, in pre prosthetic preparation phase for

Under cuts

Flabby tissue

IMPLANTOLOGY Second stage uncovering. Implant site preparation. Peri-implantitis.

SECOND STAGE UNCOVERINGFollowing the placement of implant and its Osseo integration, Er:YAG laser can be used to uncover implants

Little blood contamination (haemostatic effects)Minimal tissue shrinkageEliminate trauma to the tissues during flap reflection Impressions can be obtained at the same appointment

Two implants are being uncovered using a scalpel.Excess soft tissue being removed using laser

Immediately healing caps are laser exposed and soft tissue is re contouredSoft tissue healing within 2 weeks

IMPLANT SITE PREPARTIONLasers can be used for the placement of mini implants especially in patients with potential bleeding problems, to provide essentially bloodless surgery in the bone

PERI-IMPLANTITISLasers can be used to repair ailing implants by decontaminating their surfaces with laser energy.

Lasers can also be used to remove inflamed granulation tissue around an already osseointegrated implant.

Diode, CO2 & Er:YAG lasers can be used for this purpose.

RECENT ADVANCES IN LASERS

MAXILLOFACIAL PROSTHESISTopologic data of the patients deformity is acquired using laser surface digitizing, the procedure is called Laser Holography Imaging

Lasers aid in creating a visually realistic prosthesis that can provide an illusion of normal appearance.

Laser welding No need for investment and soldering alloy

Working time is decreased

Easy to operate

Minimal heat damage to denture base resin

An attractive alternative method to join dental casting alloys such as broken clasp

Ultraviolet (helium-cadmium) laser-initiated polymerization of liquid resin in a chamber, to create surgical templates for implant surgery and major reconstructive oral surgery.

Laser scanning of casts can be linked to computerized milling equipment for fabrication of restorations from porcelain and other materials.