Module III-Lasers for HAAAHHD Tissue

Question 1

What is the laser of choice for Hard Tissue applications?

Answer 1

Erbium-YAG (Fotona Lightwalker)

Question 2

What are the secondary choice lasers for Hard Tissue?

Answer 2

Er, Cr YSGG (Bolas)

Question 3

What ElectroMagnetic Spectrum is associated with Hard Tissue lasers?

Answer 3

MID-IR spectrum (2790nm, 2940nm)

Question 4

What is the % water found in ENAMEL?

Answer 4

6% water

Question 5

What is the % water found in DENTIN?

Answer 5

30% water

Question 6

What is the % water found in CARIES?

Answer 6

65% water

Question 7

Lasers do not CUT hard tissue, ________ cause micro-removal of hard tissues.

Answer 7

micro-explosions

Question 8

Lasers remove Hard Tissue by “photo_____” means. The Chromophore is ______

Answer 8

“photoTHERMAL”….water (interstitial)

Question 9

How long is the typical PULSE duration of the Er-YAG when removing hard tissue?

Answer 9

250-450 us (microseconds)

Question 10

How deep does the laser typically penetrate the hard tissue?

Answer 10

125 um (micrometers)

Question 11

Is there contact used for Hard Tissue ablation?

Answer 11

NO, its NON-contact

Question 12

Do you need water coolant spray when using a laser to remove hard tissue?

Answer 12

YES

Question 13

Do you need to acid etch when using a laser for hard tissue removal?

Answer 13

YES

Question 14

For our lasers we CAN adjust _____ and ______, but we cannot adjust _______

Answer 14

CAN-Pulse (Hz) and Energy Density…CANNOT adjust WIDTH

Question 15

Where do you hold the laser tip in relation to the enamel rods?

Answer 15

PERPENDICULAR

Question 16

What do you do to the enamel surface before using the laser?

Answer 16

PRE-Etch

Question 17

MIND BOTTLING: SMALLER DIAMETER TIP = _______ ENERGY DENSITY (fluence)

Answer 17

LARGER

Question 18

Which part of the laser is cutting the hard tissue?

Answer 18

its END cutting - the end of the laser beam

Question 19

What do you have to do to cleave loose enamel rods after cutting with the laser?

Answer 19

use a hand instrument (spoon, hatchet)

Question 20

What is an example (in microns) of a WIDER tip size for getting into softer tissues?

Answer 20

600 microns

Question 21

Bleaching molecules are ACTIVATED by ______ light and Pulpal Temperatures ______

Answer 21

LASER…RISE

Question 22

Bleaching: A decrease in DARKLY pigmented ________ structures

Answer 22

carbon ring structures

Question 23

Bleaching: a decrease in LIGHTLY pigmented ________ structures

Answer 23

UNSATURATED structures

Question 24

Bleaching: a decrease in hydrophilic _________ structures

Answer 24

NON-pigmented

Question 25

What is the most essential factor in BLEACHING w lasers?

Answer 25

TIMING

Question 26

OVER bleaching- breakdown of the ______ and therefore a release of _____, _____, and enamel loss

Answer 26

enamel matrix....CO2, H20

Question 27

In laser bleaching we are essentially removing stains imbedded in the _______

Answer 27

enamel tubules

Question 28

In laser bleaching, the ______ is not really bleached so the stains WILL _______

Answer 28

enamel....RE-OCCUR

Question 29

RCT Tx- Removal of organic remnants and open _____ tubules

Answer 29

Dentin

Question 30

RCT Tx- what does P.I.P.S. stand for? What type of laser is used?

Answer 30

Photon Induced Photoacoustic Streaming...Erbium-YAG

Question 31

RCT Tx- Which step can PIPS replace in cleaning the root?

Answer 31

Irrigation with NaOCl

Question 32

RCT Tx-Which two lasers have FDA clearance for endo? which two DO NOT?

Answer 32

Do: Er-YAG and Er/Cr-YSGG....DO NOT: Diode and NdYAG

Question 33

Diagodent detects caries by the laser fluorescence of ______

Answer 33

bacteria

Question 34

What values do you expect to see on the Diagodent with caries into the DENTIN?

Answer 34

values from 20-99

Question 35

What Diagodent values do you see with caries in the enamel?

Answer 35

5-10

Question 36

Diagodent when combined with other caries detecting methods had a ___% success rate in diagnosing caries

Answer 36

90%...BOOM GOES THE DYNAMITE

Question 37

Enamel is transparent to what color light?

Answer 37

RED

Question 38

What are the molecules that create IR fluorescence during the demineralization process?

Answer 38

PORPHYRINS

Question 39

When detecting caries with Diagodent- the surfaces of the teeth MUST be _______ before scanning.

Answer 39

CLEAN

Question 40

What does OCT stand for?

Answer 40

Optical Coherence Tomography

Question 41

In OCT transmission thru the enamel is in the ______ spectrum range.

Answer 41

NEAR IR (1310-1550)

Question 42

How many dimensions can OCT produce in an image? How deep can the scan go?

Answer 42

3D...3mm

Question 43

OCT uses a _______ unit, which splits light and recombines it.

Answer 43

INTER-FER-O-METRY unit

Question 44

OCT is comparable to an optical ________

Answer 44

ultrasound

Question 45

OCT has a higher resolution of ___u because it uses ______ rather than sound or radio frequency.

Answer 45

10u...light

Question 46

Is OCT ionizing or non-ionizing raditaiton

Answer 46

non-ionizing

Question 47

Which laser can we use to get rid of carbonated hydroxyapatite and replace it with fluroapatite?

Answer 47

9.6um CO2 laser

Question 48

The 9.6um CO2 laser CONVERTS remaining mineral to a ______ resistant form (fluroapatite)

Answer 48

caries

Question 49

What is the maximum pulp temp change when using a 9.6um CO2 laser? What are the temps of the walls of the prep?

Answer 49

no more than 4 deg C....80-100 deg C

Question 50

Normal-Healthy tissue emits a bright ______-_____ fluorescence.

Answer 50

white-green

Question 51

What is the wavelength used for dysplasia detection?

Answer 51

430nm (blue)

Question 52

What are the three fluorophores were looking for in the oral mucosa?

Answer 52

NADH, FAD, and Collagen Crosslinks

Question 53

THINK:::Cancer cells have a ______ metabolism compared to normal cells, so there is a decrease in _____ and an increase in _____

Answer 53

higher...decrease in FAD....increase in NADH

Question 54

As cancer increases, new blood capillaries are formed. Blood absorbs at ___nm

Answer 54

410nm

Question 55

Dysplastic tissue- decomposition of ______ matrix, stromal fluorescence is ______

Answer 55

collagen....reduced