Lazer Blazer 2 Flashcards Preview

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Flashcards in Lazer Blazer 2 Deck (118):
1

When a laser hits the tissue you get what 2 things?

Immediate coagulation when we use the Water Absorption lasers, specifically...

Coagulation and Ablation

CO2

2

Lasers seal what 3 things?

BV's

Lymph

nerve endings

3

What 4 things can lasers do inside the Vermillion Border?

Ablate

Incise

Excise

Coagulate

4

Transmission into tissue is dependent on wavelength and pulse duration

True

5

Near IR wavelengths:

Why difficult to determine the amount of ablation?

808 - 1064

deep penetration

6

Mid IR wavelengths:

good at:

bad at:

2780 - 2940

precision, bactericidal

coagulation efficiency

7

IR (far) CO2 laser wavelengths:

3 things good at:

9.2 and 10,600 nm

coagulation, ablation, bactericidal

8

Water absorption:

Melanin:

Hemogobin:

Oxyhemoglobin:

***4 main chromophores

500 - 10,600

500 - 1100

500 - 1100

500 - 1100

*all in nm

9

Absent in epithelium:

Absent in sub-epithelium:

Hb

melanin

10

Diode cut:

CO2 cut:

deep charring (hot tip)

smooth (cuts w/ pure photons)

11

3 Melanin types:

What requires least energy?

2% very light, 13% moderate, 30% dark

dark

12

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)

100%

13

T/F
Less healing time with lasers

False

14

Reduced swelling, pain, pain scarring, bacteria, and more precise cut

True

15

Improved healing, less traumatic, less scarring, often left unsutured

True

16

Healing with Blade (time):

Healing with Laser (time):

7-10 days

2-3 weeks

17

Why does it take longer to heal with Laser?

BV/lymphatic sealing

18

Denaturation (photocoagulation) starts at what temp?

60-100 C

19

BV diameter in the gingiva:

21-40 microns

20

What will happen if too much saliva with CO2 laser?

saliva will absorb

21

CO2 laser application mode:

focused mode for:

excellent for uncovering...

non-contact

cutting

implants

22

CO2 de-focus mode used for apthous ulcer, hemostasis, hyperplasia, white lesions

True

23

CO2 laser absorption is too high for what 2 substances:

H20-enamel

Bone

24

Nd-YAG and Diode laser is poorly absorbed by what 2 things?

HbO2 and Melanin

25

Nd-YAG are _____ lasers, with the exception of apthous ulcers and herpetic lesions and Venous Lake Syndrome

Non-contact

26

Erbium Laser absorbed by?

contact?

coagulation?

used for?

water

non-contact

low characteristics (bleeding)

hard tissue

27

Power per unit area?

Power density

28

Lasers have decreased post op swelling and pain

True

29

Development of Ovoid Pontic form and Gingivectomy:

What laser to design gingival architechture?

808 nm Diode Laser

30

Tissue growing over 2nd Molar...

Use what pre-op? why?

Operculectomy

Erbium laser, poor coagulation

31

What laser to Uncover an Unerupted tooth?

Diode

*among others

32

Fibroma removal with:

CO2 laser

*traction, non-contact

33

Irritation fibroma can be removed with:

Diode laser

*char free if work w/in correct parameters

34

Compared to CO2, Diode laser is a ________ cut

chunky, hot tipped

35

Bluish lesion on lip:

Hemangioma

*check pulse

36

Hemangioma can be Treated with what Lasers of choice:

Diode 810-1064

CO2 9.3 or 10.6

37

If you Tx Hemangioma you need ______, which is why you use Diode or CO2

Hemostasis

*max photocoagulation

38

A Pulsing Hemangioma (found inside cheek), what should you do?

Don't touch

*unless want ER visit for Pt

39

Super Pulsed CO2 laser releases burst of high peak powers with a short duration of ____ milisecs

*this has great what?

10-20

thermal relaxation time

40

Diode lasers, good for ____ and ____ lesions

Bactericidal

Don't use with...

superficial, interstitial

implants

*absorbs Ti

41

2 Lasers highly absorbed by water

CO2

Er-YAG

42

Control of _____ thermal damage is paramount when using lasers

Lateral

43

Incision/Excision: Thin, deep cuts with small spot size measuring:

Outline intended ______

Use _____ mode, low fluence, minimum _______

0.1-0.5 mm

incision

Gated, depth of penetration

44

Ablation/Vaporization: use what mode?

De-focused

45

When neoplasms are involved, must have a Diagnosis prior to Ablating

True

46

Uncover implant with what laser?

10.6 CO2

47

Erbium laser will get what?

Bleeding

*bad coagulation

48

Gingival recontouring can be done with...

Diode laser

49

CO2 laser can do a Frenectomy

CO2 laser can remove Epulis

True

True

50

Exostosis w/ Klinefelter's

Separate muscle fibers

Sub-periosteal sutures

Great result at 4 weeks

51

Ablate, defocus slightly

CO2 laser to expose implant is Ablation

True

True

52

Operculectomy with a _______ laser

Erbium

*CO2 for complications

53

Lip tie can affect breastfeeding

2 passes, vitamin___ gel and Curaprox brush

E

54

Lingual Frenectomy with a CO2 laser or the ____ laser

Get rid of thin ______, otherwise will recur

Diode

muscle attachments

55

Ortho Gingivectomy with _____ laser

CO2

*or diode

56

If there is a lot of gingiva to remove, use electrosurgery followed by lasers

True

57

Mucocele should be Tx aggressively to seal the lumen of a leaker

True

58

What must be done when using a Diode Laser?

Activate the Tip

59

Fiberotomy with Frenectomy will move incisors into position

True

60

Only time use Diode Laser in Non-Contact mode:

Apthous Ulcer

pulsing - just seal off nerve endings

61

Fibroma on tip of tongue, easy to remove with Diode laser

retraction w/ hemostat

True

62

Topical Anesthetic used for Laser:

Oraqix

*prilocaine + lidocaine

63

Trilogy oral debridement better than CHX b/c fibroblasts

True

64

Wounds created by a laser heal more slowly and are via _____ intention healing

Secondary

65

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?

Necrotic

thin layer of denatured collagen

w/in 14 days period

21st day

66

Slower healing w/ lasers b/c epithelium has to _____

migrate further

67

Lasers heal faster

False

68

Lasers don't leave scars

False

69

Wound healed after Scalpel surgery are stronger

False

70

4 goals of laser Perio Therapy:

photothermal energy affects:

lowers red/orange complex bacteria

biostimulate

enhance mesenchymal activity

71

Red Complex most closely related to Perio and are what 4 bugs?

P gingivalis

T denticola

B fosythius

E nodatum

72

Mesophilic bacteria temp range:

*most human pathogens are mesophiles

human body temp =

25 - 45 C

37 C

73

Blanching, white gray

Shrinkage

Smoke plume

60-80 C

90-100

100-150

74

Genetic component to Perio:

IL-1 expression

75

Chromophore is targeted in laser perio Tx

True

76

Inflammatory tissue has higher levels of what 2 things

water

pigment

77

Adverse outcomes to perio Tx

temp, dehydration, pain, damage,

78

Why isn't Diode absorbed efficiently by pigments?

*perio

low coefficient of absorption

79

Inside the pocket only use what mode?

non-contact

80

Er-YAG is good for Perio

we don't know yet

81

Nd-YAG is a _____ laser fiber optic tip

Contact mode what forms at tip?

This increases lateral thermal conduction, so don't use where:

pulsed

carbonized tissue

bone

82

Nd YAG free running pulse layer used in what perio procedure?

Utilizes what?

Laser assisted New Attachment Procedure

Regeneration (instead of resection)

83

laser assisted new attachment procedure used Nd YAG and stimulates what?

stem cells

*new root surface of Cementum and new CT

84

Diode laser with ____ micron tip

*used for perio

*calibrate each site

300

85

Perio begins internally and involves weak immune system

True

86

Biostimulation from low level lasers

pain relief

wound healing

87

Calibration:

start at top of pocket, lase to

stop ___ mm short of pocket depth

measure pocket

calibrated depth

1mm

88

Topicals, leave max ___ minutes

5

*otherwise dehydrate if leave longer

89

Epithelium grows ____/2days

Fibroblasts/osteoblasts ___mm/10days

1mm

1mm

90

___% reduction in bleeding

___% control group

96.9%

66.7%

91

The total amount of energy of the laser is = to that absorbed by tissues

True

92

Lasers will cure Perio by itself

False

93

CT regeneration begins on day

maturing process from ____ weeks to 1 year

5

12

94

pocket depths greater than 3mm, control

junctional epithelium

95

De-epithelialization won't occur with what 2 lasers

De-epithelialization will occur with what 2 lasers

Diode, Nd-YAG

CO2, Erbiums

96

Perio affects 130 million/yr, 60% population

True

97

Dental hygiene, what laser

CO2

*de-epithelialization

98

CO2

Diode

(de-epithelialization?)

yes

no

99

Why is 10 day critical

bacteria re-colonize

epithelial regeneration back into pocket

100

There are no contraindications to CO2 laser

True

*except - disconnect Oxygen

101

CO2 10.6

laser assisted Tx

perio tip parallel to surface

ceramic tip

102

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

103

CO2 laser removed epithelium w/out damaging underlying CT (in Perio)

True

104

What tip use on CO2 in Perio?

Ceramic

*metal too hot

105

2 places SuperPulsed CO2 lasers have total/complete absorption:

hydroxyapatite

water

106

Ultraspeed (superpulsed) will not damage any hard tissue if settings right in Perio

True

107

CO2 is 100% absorbed in water

True

108

Use water along with topical for sensitive pts

True

109

CO2 10.6 can damage deeper tissues

False

110

Non focused is llike a flashlight and can be effective at only 1-2 mm

True

*CO2 laser

111

CO2 laser used in the Defocused Superpulsed mode has ___ watts of power and ___% duty cycle

average power is ___ watts

2 watts

20%

.4 watts

112

16 seconds per surface CO2 laser (perio)

True

113

Older generation of CO2 lasers had too high energy output and did damage

True

114

SRP isn't always successful b/c of restricted Access

True

*so photons can't hurt

115

Limited success of SRP b/c diffcult to get to subgingival bacteria

SRP depth is related to success

True

True

116

SRP is being improved with lasers

True

117

SRP changes greatest when?

wound healing continues for how long?

1-3 months

3-9 months

118

CO2 laser has what great advantages?

absorbed by water in pocket

inflamed tissue has more water

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