Flashcards in Lazer Blazer 2 Deck (118):
When a laser hits the tissue you get what 2 things?
Immediate coagulation when we use the Water Absorption lasers, specifically...
Coagulation and Ablation
Lasers seal what 3 things?
What 4 things can lasers do inside the Vermillion Border?
Transmission into tissue is dependent on wavelength and pulse duration
Near IR wavelengths:
Why difficult to determine the amount of ablation?
808 - 1064
Mid IR wavelengths:
2780 - 2940
IR (far) CO2 laser wavelengths:
3 things good at:
9.2 and 10,600 nm
coagulation, ablation, bactericidal
***4 main chromophores
500 - 10,600
500 - 1100
500 - 1100
500 - 1100
*all in nm
Absent in epithelium:
Absent in sub-epithelium:
deep charring (hot tip)
smooth (cuts w/ pure photons)
3 Melanin types:
What requires least energy?
2% very light, 13% moderate, 30% dark
Near IR, how much is absorbed in epithelium?
Mid and Long IR, how much absorbed in epithelium?
5% (so most transmits into CT, leading to unpredictable side effects)
Less healing time with lasers
Reduced swelling, pain, pain scarring, bacteria, and more precise cut
Improved healing, less traumatic, less scarring, often left unsutured
Healing with Blade (time):
Healing with Laser (time):
Why does it take longer to heal with Laser?
Denaturation (photocoagulation) starts at what temp?
BV diameter in the gingiva:
What will happen if too much saliva with CO2 laser?
saliva will absorb
CO2 laser application mode:
focused mode for:
excellent for uncovering...
CO2 de-focus mode used for apthous ulcer, hemostasis, hyperplasia, white lesions
CO2 laser absorption is too high for what 2 substances:
Nd-YAG and Diode laser is poorly absorbed by what 2 things?
HbO2 and Melanin
Nd-YAG are _____ lasers, with the exception of apthous ulcers and herpetic lesions and Venous Lake Syndrome
Erbium Laser absorbed by?
low characteristics (bleeding)
Power per unit area?
Lasers have decreased post op swelling and pain
Development of Ovoid Pontic form and Gingivectomy:
What laser to design gingival architechture?
808 nm Diode Laser
Tissue growing over 2nd Molar...
Use what pre-op? why?
Erbium laser, poor coagulation
What laser to Uncover an Unerupted tooth?
Fibroma removal with:
Irritation fibroma can be removed with:
*char free if work w/in correct parameters
Compared to CO2, Diode laser is a ________ cut
chunky, hot tipped
Bluish lesion on lip:
Hemangioma can be Treated with what Lasers of choice:
CO2 9.3 or 10.6
If you Tx Hemangioma you need ______, which is why you use Diode or CO2
A Pulsing Hemangioma (found inside cheek), what should you do?
*unless want ER visit for Pt
Super Pulsed CO2 laser releases burst of high peak powers with a short duration of ____ milisecs
*this has great what?
thermal relaxation time
Diode lasers, good for ____ and ____ lesions
Don't use with...
2 Lasers highly absorbed by water
Control of _____ thermal damage is paramount when using lasers
Incision/Excision: Thin, deep cuts with small spot size measuring:
Outline intended ______
Use _____ mode, low fluence, minimum _______
Gated, depth of penetration
Ablation/Vaporization: use what mode?
When neoplasms are involved, must have a Diagnosis prior to Ablating
Uncover implant with what laser?
Erbium laser will get what?
Gingival recontouring can be done with...
CO2 laser can do a Frenectomy
CO2 laser can remove Epulis
Exostosis w/ Klinefelter's
Separate muscle fibers
Great result at 4 weeks
Ablate, defocus slightly
CO2 laser to expose implant is Ablation
Operculectomy with a _______ laser
*CO2 for complications
Lip tie can affect breastfeeding
2 passes, vitamin___ gel and Curaprox brush
Lingual Frenectomy with a CO2 laser or the ____ laser
Get rid of thin ______, otherwise will recur
Ortho Gingivectomy with _____ laser
If there is a lot of gingiva to remove, use electrosurgery followed by lasers
Mucocele should be Tx aggressively to seal the lumen of a leaker
What must be done when using a Diode Laser?
Activate the Tip
Fiberotomy with Frenectomy will move incisors into position
Only time use Diode Laser in Non-Contact mode:
pulsing - just seal off nerve endings
Fibroma on tip of tongue, easy to remove with Diode laser
retraction w/ hemostat
Topical Anesthetic used for Laser:
*prilocaine + lidocaine
Trilogy oral debridement better than CHX b/c fibroblasts
Wounds created by a laser heal more slowly and are via _____ intention healing
Phases of tissue repair: 7-14 days
What is the biomechanical "bandaid" that occurs during this phase?
Re-epithelialization what day?
Re-epi completed by what day?
thin layer of denatured collagen
w/in 14 days period
Slower healing w/ lasers b/c epithelium has to _____
Lasers heal faster
Lasers don't leave scars
Wound healed after Scalpel surgery are stronger
4 goals of laser Perio Therapy:
photothermal energy affects:
lowers red/orange complex bacteria
enhance mesenchymal activity
Red Complex most closely related to Perio and are what 4 bugs?
Mesophilic bacteria temp range:
*most human pathogens are mesophiles
human body temp =
25 - 45 C
Blanching, white gray
Genetic component to Perio:
Chromophore is targeted in laser perio Tx
Inflammatory tissue has higher levels of what 2 things
Adverse outcomes to perio Tx
temp, dehydration, pain, damage,
Why isn't Diode absorbed efficiently by pigments?
low coefficient of absorption
Inside the pocket only use what mode?
Er-YAG is good for Perio
we don't know yet
Nd-YAG is a _____ laser fiber optic tip
Contact mode what forms at tip?
This increases lateral thermal conduction, so don't use where:
Nd YAG free running pulse layer used in what perio procedure?
Laser assisted New Attachment Procedure
Regeneration (instead of resection)
laser assisted new attachment procedure used Nd YAG and stimulates what?
*new root surface of Cementum and new CT
Diode laser with ____ micron tip
*used for perio
*calibrate each site
Perio begins internally and involves weak immune system
Biostimulation from low level lasers
start at top of pocket, lase to
stop ___ mm short of pocket depth
Topicals, leave max ___ minutes
*otherwise dehydrate if leave longer
Epithelium grows ____/2days
___% reduction in bleeding
___% control group
The total amount of energy of the laser is = to that absorbed by tissues
Lasers will cure Perio by itself
CT regeneration begins on day
maturing process from ____ weeks to 1 year
pocket depths greater than 3mm, control
De-epithelialization won't occur with what 2 lasers
De-epithelialization will occur with what 2 lasers
Perio affects 130 million/yr, 60% population
Dental hygiene, what laser
Why is 10 day critical
epithelial regeneration back into pocket
There are no contraindications to CO2 laser
*except - disconnect Oxygen
laser assisted Tx
perio tip parallel to surface
Laser application of CO2 10.6 (Perio) tip should be ____ mm short of pocket
This does what?
1-2 mm short
maximizes thermal air flow
*which minimizes damage
CO2 laser removed epithelium w/out damaging underlying CT (in Perio)
What tip use on CO2 in Perio?
*metal too hot
2 places SuperPulsed CO2 lasers have total/complete absorption:
Ultraspeed (superpulsed) will not damage any hard tissue if settings right in Perio
CO2 is 100% absorbed in water
Use water along with topical for sensitive pts
CO2 10.6 can damage deeper tissues
Non focused is llike a flashlight and can be effective at only 1-2 mm
CO2 laser used in the Defocused Superpulsed mode has ___ watts of power and ___% duty cycle
average power is ___ watts
16 seconds per surface CO2 laser (perio)
Older generation of CO2 lasers had too high energy output and did damage
SRP isn't always successful b/c of restricted Access
*so photons can't hurt
Limited success of SRP b/c diffcult to get to subgingival bacteria
SRP depth is related to success
SRP is being improved with lasers
SRP changes greatest when?
wound healing continues for how long?