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Versatility of an 810 nm Diode Laser in Dentistry: An Overview


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The breakthrough for dental laser systems came in the mid 1990's. Among the various laser types with corresponding wavelengths, diode laser systems quickly began establishing themselves as compact, competitively priced and versatile additions to the dentist's repertoire, predominantly for performing soft tissue applications. Research has shown that near infrared (NIR) wavelengths are ideally suited for numerous soft tissue procedures due to their high absorption in hemoglobin. This fact gives NIR laser the ability to precisely and efficiently cut, coagulate, ablate or vaporize the target tissue. The added advantage of laser performed surgical procedures is the sealing of small blood and lymphatic vessels, resulting in hemostasis and reduced post-operative edema, disinfection of target tissue due to local heating and production of eschar layer and decreased amount of scarring due to decreased post-operative tissue shrinkage. Among the available NIR wavelengths, research has shown the wavelengths around 810 nm to be one of the most versatile with regard to the number of possible treatment options, as this wavelength range can be effectively used in the field of soft tissue surgery, periodontics, endodontics, implantology and tooth whitening. The versatility of the instrument, combined with the latest achievements in diode laser technology, compact design and affordability, should appeal to dental professionals seeking to optimize the procedures they currently perform and expand the number of services they offer.
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Journal of Laser and Health Academy
Vol. 2007; No. 4;
Versatility of an 810 nm Diode Laser in Dentistry: An
Samo Pirnat
University of Ljubljana, Biotechnical faculty, Ljubljana
The breakthrough for dental laser systems came in the
mid 1990's. Among the various laser types with
corresponding wavelengths, diode laser systems
quickly began establishing themselves as compact,
competitively priced and versatile additions to the
dentist's repertoire, predominantly for performing soft
tissue applications. Research has shown that near
infrared (NIR) wavelengths are ideally suited for
numerous soft tissue procedures due to their high
absorption in hemoglobin. This fact gives NIR laser
the ability to precisely and efficiently cut, coagulate,
ablate or vaporize the target tissue. The added
advantage of laser performed surgical procedures is the
sealing of small blood and lymphatic vessels, resulting
in hemostasis and reduced post-operative edema,
disinfection of target tissue due to local heating and
production of eschar layer and decreased amount of
scarring due to decreased post-operative tissue
shrinkage. Among the available NIR wavelengths,
research has shown the wavelengths around 810 nm to
be one of the most versatile with regard to the number
of possible treatment options, as this wavelength range
can be effectively used in the field of soft tissue
surgery, periodontics, endodontics, implantology and
tooth whitening. The versatility of the instrument,
combined with the latest achievements in diode laser
technology, compact design and affordability, should
appeal to dental professionals seeking to optimize the
procedures they currently perform and expand the
number of services they offer.
Key words: laser; diode; diode lasers; dentistry; soft
tissue; 810 nm
Even though Theodore Maiman had exposed an
extracted tooth to his ruby laser in 1960, the
breakthrough for lasers in the field of the dentistry
came in the mid 1990s, with various laser types
) with
corresponding wavelengths (1064 nm, 2780 nm, 2940
nm, 10600 nm) becoming available to the dentists to
address their needs for hard and soft tissue procedures.
Soft tissue NIR lasers are characterized by a high
absorption in chromophores found in soft tissue, e.g.
hemoglobin, resulting in excellent soft tissue incision,
ablation and coagulation performance as well as
antimicrobial effectiveness, due to relatively deep
highly localized tissue heating. Hard tissue lasers are
highly absorbed in (carbonated) hydroxyapatite and
water chromophores and are thus able to finely ablate
hard tissues without heating of the surrounding tissue.
Soft tissue NIR lasers include solid crystal Nd:YAG
lasers (1064 nm) and diode lasers (810 nm and 980
Among the various lasers appearing in the mid 1990s,
semiconductor diode lasers also made their debut.
With several advantages, including their small size,
price range and versatility regarding the possible
treatment applications, the diode lasers represent a
valuable addition to the dentist's repertoire.
Diode lasers can be used for a multitude of dental
procedures which are predominantly soft tissue
procedures and include soft tissue surgery [1, 2, 3],
periodontal pocket therapy [4, 5], peri-implantitis [6],
but can also be used for certain applications involving
hard tissue (teeth), i.e. endodontics - root canal
disinfection [7, 8, 9] and laser-assisted tooth whitening
[10]. The ability to perform the aforementioned
procedures depends on the appropriate technical
characteristics, which the diode must posses. The most
important characteristic is the wavelength of the diode
laser used as the wavelength determines how the laser
light will interact with the target tissue (absorption in
the appropriate tissue chromophores, penetration
depth into the tissue etc.). To date, research has shown
that NIR (near infrared) laser light around 810 nm to
be one of the most versatile wavelength ranges in
diode lasers available to the dentist with regard to the
number of different treatments it can be used for.
Other characteristics which also need to be considered
include maximum power available to the user
(available power determines the number of procedures
which can be done and the speed with which they can
be done), the way the laser beam can be modulated
(CW continuous wave, pulsed mode) and the mode
of delivery of the laser beam.
© Laser and Health Academy. All rights reserved.
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Versatility of an 810 nm Diode Laser in Dentistry: An Overview
Basic Design of a Diode Laser
One of the advantages of diode lasers in comparison
to other laser systems, which is immediately apparent
to the naked eye, is their size. The development of
micro-structure diode cells which are capable of
emitting laser light has drastically reduced the bulk of
laser systems. The latest dental diode lasers have been
designed to have dimensions similar to a standard
phone [Fig. 1].
Fig. 1 Dental diode laser system (Fotona XD-2)
Only solid material active media (e.g. GaAlAs
Gallium Aluminum Arsenide) is used in diode lasers.
Because of the crystalline nature of the active medium,
the ends of the crystal can be selectively polished
relative to internal refractive indices to produce totally
and partially reflective surfaces thus serving the same
function as the optical resonators of larger laser
systems. The discharge of current across the active
medium releases photons from the active medium,
finally resulting in the generation of laser light of a
specific wavelength, which is determined by the active
medium used [Fig. 2].
At the present, each diode "chip" produces relatively
low-energy output. Some low power diode lasers,
operating in milliwatt range, are usually being
advertised for low level laser therapy (LLLT). In order
to achieve the power necessary for various dental
procedures (e.g. soft tissue surgery), today's dental
diode lasers employ banks of individual diode chips in
parallel to achieve the appropriate power levels (several
watts). Some dental diode lasers can also be set to
lower power (milliwatt range) and can also perform
LLLT procedures.
The design of diode laser systems also brings several
advantages with it. Already mentioned was the small
size of the laser system, which can be of great benefit
as it means the device will take up very little office
space and assures great portability of the laser system
due to its low weight. Also mentioned was the
attractive price range of diode lasers, which makes
them accessible to a wide range of dental professionals,
who want to perform current procedures faster and
more efficiently and wish to expand the services
currently offered in their practice. Other benefits
include a very short time (usually a couple of seconds)
in which the laser treatment beam is available to the
user after switching the system on. Other laser systems
generally need a couple of minutes to reach the ready
status. Also, diode lasers consume very little power
when compared to other laser systems, thus saving the
user money and contributing to the protection the
environment. Another important aspect to consider is
the widespread use and the reliability of diode laser
technology, with more than 40 million pieces produced
annually which are being used in devices ranging from
DVD-players and laser pointers to state of the art
dental diode lasers.
Fig. 2 Simplified schematic outline of a typical diode laser
Laser light emission modes
Lasers are said to be running in either continuous wave
(CW) or pulsed mode. This relates to the rate of
emission of laser light with time and the prime benefit
of a pulsed mode will be the capacity of the target
tissue to cool between successive pulses. The CW
mode is generally the fastest way to ablate tissues but
heat can build up and cause collateral damage to the
target and adjacent tissues. Modern dental diode lasers
can operate in both CW and pulsed mode. The factors
that determine the average power when the diode laser
is operating in pulsed mode are the current power
setting and the duty cycle setting. Duty cycle is a
periodic phenomenon defined as the ratio of the
duration of the phenomenon (pulsewidth) in a given
period to the period (reciprocal value of the current
frequency setting - number of pulses per second). To
clarify the previous statement, consider a following
Journal of Laser and Health Academy
Vol. 2007; No. 4;
example when the diode is set to CW mode and the
power is set to 2 W, the system will emit an average
power of 2 W per second. When operating in pulsed
mode, a power setting of 2 W and the duty cycle set to
½ will result in an average power emission of 1 W per
It is important to familiarize oneself with the various
average and peak powers that can be achieved when
using different emission mode settings of the laser
system in order to achieve an optimal transfer of the
energy from the laser beam to the target tissue,
resulting in a desired therapeutic effect.
Laser light Delivery to the Target Tissue
Most dental diode lasers employ a flexible optic fiber
(usually inserted into an appropriate handpiece for
comfortable handling) to deliver the treatment beam to
the desired area. There are a number of things to
consider when using an optic fiber. When using
parameters mentioned in application notes or in
research papers, always note the diameter of the fiber
described in those papers. Using a smaller diameter
fiber will increase the power density at the fiber tip. As
a result, you may need to decrease the power setting.
Increasing the power may be required when using a
larger diameter fiber. As a rule of thumb, in order to
achieve the same rate of work after changing fiber
diameters, a smaller diameter fiber will require less
power and conversely, a larger diameter will require
more power. Another thing to keep in mind is the
speed of movement of the fiber tip during treatment.
Tissue charring is an undesirable side effect of too
much power and/or the tip moving too slowly. Always
use the least amount of power necessary to complete
your procedure and move the fiber tip using short 1-2
mm "paint brush" type strokes and move quickly when
working on soft tissue. Finally, regularly check the
condition of the optical fiber. Always cleave the fiber
tip after it becomes blackened (2-4 mm from the tip),
because tissue debris accumulate on the tip during
surgery and this causes the fiber tip to retain extreme
heat and begins to act as a "branding iron". This can
lead to unwanted tissue heating and can lead to rapid
tip deterioration and subsequent breakage. It is also
important to properly cleave the fiber so that no shard
is present on the fiber tip, as it may act as a miniature
scalpel and damage the small blood vessels, thus
interfering with hemostasis and coagulation.
The basics
In clinical dentistry, laser light is used to effect
controlled and precise changes in target tissue, through
the transfer of electromagnetic energy [11]. Light
energy interacts with a target medium (e.g. oral tissue)
in one of four ways [12] [Fig. 3]:
Laser beam enters the medium and emerges distally
without interacting with the medium. The beam exits
either unchanged or partially refracted.
When either the density of the medium or angle of
incidence are less than the refractive angle, total
reflection of the beam will occur. The incident and
emergence angles of the laser beam will be the same
for true reflection or some scatter may occur if the
medium interface is non-homogenous or rough.
There is interaction between the laser beam and the
medium. This interaction is not intensive enough to
cause complete attenuation of the beam. Result of light
scattering is a decrease of laser energy with distance,
together with a distortion in the beam (rays travel in an
uncontrolled direction through the medium).
The incident energy of the laser beam is attenuated by
the medium and converted into another form. With
the use of dental diode lasers, the most common form
of conversion of laser energy is into heat or, in the case
of very low energy values, biomodulation of receptor
tissue sites seems to occur [13, 14]. Heat transfer
mediated physical change in target tissue is termed
Fig. 3 Possible laser light - tissue interactions
In any desired laser-tissue interaction, the goal is to
achieve the maximum absorption of laser light by the
target tissue, as this will allow maximal control of the
resultant effects.
Versatility of an 810 nm Diode Laser in Dentistry: An Overview
Absorption is determined by matching incident laser
beam energy (wavelength) to the electron shell energy
in target atoms. Absorption of laser energy in the
target tissue leads to generation of heat and rising heat
levels lead to dissociation of covalent bonds (in tissue
proteins), phase transfer from liquid to vapour (in
intra- and inter-cellular water), onto phase transfer to
hydrocarbon gases and production of residual carbon
[15]. Secondary effects can occur because of heat
generation (through conduction).
When predicting the conversion of electromagnetic
energy to heat effects in target tissue, unwanted change
through conductive thermal spread must be taken into
account and reduced to lowest possible level. The
ability to control a progressively increasing heat
loading of target tissue is termed as thermal relaxation
[16]. Thermal relaxation rates are proportional to the
area of tissue exposed and inversely proportional to
the absorption coefficient of the tissue, assuming fixed
values of thermal and light diffusivity for the tissue in
Factors Associated with Absorption and Thermal
Some of the more important factors that affect the
thermal relaxation of the target tissue and absorption
of laser light by the target tissue (separately and/or
collectively) [17] are:
Laser Wavelength and Tissue Composition
Parts of the tissue that absorb laser light energy are
termed chromophores. Oral tissues contain several
chromophores: hemoglobin, melanin and other
pigmented proteins, (carbonated) hydroxyapatite and
water. The absorption coefficients for the listed
chromophores with regard to the wavelengths used in
dental lasers is shown in Fig. 4. Generally, pigmented
tissues will better absorb visible or NIR wavelengths,
whereas non-pigmented tissues absorb longer
wavelengths. In addition, absorption peaks of water
and hydroxyapatite coincide for example with
Water as a constituent of every living cell will influence
the penetration of longer wavelength laser light into
the tissue, whilst non-pigmented surface components
will enable greater penetration for visible or NIR
wavelengths. For example, a CO
laser might penetrate
the oral epithelium to a depth of 0.1-0.2 mm whilst
NIR wavelengths can result in penetration of 4-6 mm
[18] (when using equal power settings for the
mentioned lasers).
Fig. 4 Absorption coefficients of various tissue
chromophores relative to laser wavelength
Incident Angle of Laser Beam
Maximum control of laser-tissue interaction can be
achieved if the incident laser beam is perpendicular to
the tissue surface. Reducing the incident angle towards
the refractive angle of the tissue surface will increase
the potential for true light reflection with an associated
reduction in tissue change [19].
Exposure time and Laser Emission Mode
Pulsing of laser light delivery will allow some cooling
to occur in-between pulses.
Beam diameter and beam movement
As laser light exits the optic fiber, divergence of the
beam will occur. Consequently, the spot size of the
beam (relative to the target tissue) will determine the
amount of laser energy (fluence J/cm
) being
delivered over an area [20]. The spotsize will increase
with increasing distance (optic fiber – target tissue).
Therefore, thermal changes at the target site can be
effectively controlled by modifying the amount of
energy delivered to the target site via moving the
handpiece closer or farther from the target site. To
summarize, for any chosen power setting, the smaller
the beam diameter, the greater the concentration of
heat effects.
Faster laser beam movement will also reduce heat
build-up in the target tissue and aid thermal relaxation.
Journal of Laser and Health Academy
Vol. 2007; No. 4;
Coolants can control or limit the temperature rise of
target and associated tissues. Coolants can be either
endogenous (e.g. blood flow) or exogenous (e.g. air,
water, pre-cooling of tissue).
NIR Laser light and Soft Tissue Cutting
When correct parameters are used, a central zone of
tissue ablation is surrounded by an area of irreversible
protein denaturation (coagulation, char). Around this
central zone, a reversible, reactionary zone of edema
will develop along a thermal gradient. Ideally, the
incision line will equal the beam diameter. Heat build-
up will also disinfect the targeted and surrounding area
and the production of a surface coagulum discourages
bacterial contamination of the wound. When using
NIR lasers on soft tissue there is minimal or no
bleeding due to a combination of sealing of small
vessels through tissue protein denaturation and
stimulation of Factor VII production in clotting. The
heat buildup also allows for the sealing of small
lymphatic vessels which results in a reduced post-
operative edema. Suturing is usually not necessary also
due to the surface coagulum. The formation of scar
tissue should be minimal due to reduced post-
operative tissue shrinkage [1, 3, 21].
When comparing NIR lasers - the Nd:YAG (1064 nm)
and diode lasers (805 nm, 810 nm), the mentioned
wavelengths have a similarly high absorption in soft
tissue which translates into excellent incision
performance and coagulation of tissue [22, 23].
NIR Laser light and Hard Tissue
NIR wavelengths have little absorption in dental hard
tissue and have the potential to cause thermal cracking
and amorphous change in the hydroxyapatite crystal
structure. Additionally, they can also have a deleterious
effect on pulp tissue due to the intra-pulpal
temperature rise because of relatively high
transmission of NIR wavelengths through enamel and
dentin [24].
From the clinician's viewpoint, two wavelengths have
the ability to effectively interact with dental hard tissue,
Er:YAG (2940 nm) and Er,Cr:YSGG (2780 nm).
Another wavelength which was tested on dental hard
tissues was the CO
laser, but the laser's CW and gated
CW emission modes render its power output low and
have a significantly negative impact on the thermal
relaxation potential, which can lead to disastrous
effects on dental hard tissue [25, 26]. In contrast, both
erbium lasers can reach high peak powers due to their
pulsed emission modes and have relatively high
absorption in water. High peak powers combined with
high absorption in water effectively results in an
instant vaporization of the water content in enamel
and dentin, leading to explosive dissociation of the
tissue and ejection of micro-fragments, resulting in
precise tissue ablation. Both lasers also employ co-axial
water sprays, which help to disperse the ablated tissue
and cool the target [27]. The result is the ability to
selectively ablate carious dental tissue due to higher
water content when compared to healthy enamel and
dentin. Additionally, pulpal temperature rise is minimal
when using erbium laser wavelengths and therefore has
less potential to cause thermal damage to the pulp
when compared to rotary instrumentation [28]. Of the
two erbium laser, the Er:YAG appears to be better
suited for hard dental tissues. Er:YAG wavelength has
a higher absorption coefficient for water (13,000/cm
for Er:YAG vs. 4,000/cm for Er,Cr:YSGG), resulting
in a more efficient ablation of dental hard tissue. For
example, the ablation threshold for enamel is 9-11
for Er:YAG and 10-14 J/cm
for Er,Cr:YSGG
[29]. The precise mode of action of Er,Cr:YSGG laser
on dental hard tissue is another contested issue -
claims have been made as to the involvement of the
atomized water spray, used with the Er,Cr:YSGG
("hydrokinetic effect") [30]. The hypothesis is that
water droplets axial to the laser beam absorb kinetic
energy. The droplets are then accelerated and help with
hard tissue ablation. Research into this effect has
questioned the validity of such claims and as
previously mentioned, with comparable incident
energies, the ablation rate of the Er, Cr:YSGG for
enamel is slightly slower than that of Er:YAG [31].
The Er:YAG is also superior to Er, Cr:YSGG with
regard to heat produced with laser ablation of bone
[32]. Higher water content and lower density of bone
compared to enamel allows faster cutting, through
dislocation of hydroxyapatite and cleavage of the
collagen matrix. The relative ease of bone cutting
establishes the Er:YAG wavelength as the preferred
choice when compared to other laser wavelengths.
"Loose" Soft-Tissue Surgery with the 810 nm
Diode Laser
Applications include the removal of fibromata, labial
and lingual frenectomies, small hemangiomata,
mucocele, denture granulomata, treatment of non-
erosive lichen planus, aphthae and herpes lesions [3,
Versatility of an 810 nm Diode Laser in Dentistry: An Overview
33, 34]. The etiology of the lesion should be assessed
and as with a scalpel, the abnormal tissue should be
placed under tension to enable accurate cleavage
(whenever possible). With regard to diode laser
surgery, the laser handpiece tip is generally held very
close to the tissue surface. This allows the laser energy
to effect the incision and minimizes the build-up of
debris on the tip, which can lead to unwanted thermal
damage to the tissue. For most minor intra-oral
surgical procedures, the recommended average power
setting is in the range of 2-4 W [33].
As was already mentioned, the 810 nm wavelength
diode laser transverses the epithelium and penetrates 2
6 mm into the tissue. When laser cutting is in
progress, small blood and lymphatic vessels are sealed
due to the generated heat, thereby reducing or
eliminating bleeding and edema. Denatured proteins
within tissue and plasma are the source of the layer
termed "coagulum" or "char", which is formed
because of laser action and serves to protect the
wound from bacterial or frictional action. Clinically,
during 48-72 hours post-surgery, this layer becomes
hydrated from saliva, swells and eventually
disintegrates to later reveal an early healing bed of new
tissue [33].
Care must be taken when working near anatomical
sites that might be damaged through excessive power
values [35]. For example, excessive power settings
might cause thermal damage to the underlying
periosteum and bone. Damage to these anatomical
sites can be avoided by using appropriate (lower)
power levels, keeping the laser beam parallel to and
away from the underlying bone and employing proper
irradiation time intervals to allow sufficient tissue
cooling [33].
"Fixed" Soft-Tissue Surgery with the Diode Laser
The 810 nm diode laser can be used for numerous
"fixed" soft tissue procedures including gingival
hyperplasia, tooth exposure and hyperpigmentation.
Additionally, there is a range of gingival adaptation
procedures, both to allow restorative procedures and
to allow access to restorative margins during
restorative procedures [36]. The laser energy will act
primarily as a means of incision, excision or ablation,
with the same advantages over the scalpel that were
mentioned previously (no or minimal bleeding, no
sutures, less chance for infection of the wound). When
possible, any laser surgical procedure in and around
the gingival cuff should seek to preserve a biological
width (the zones of connective and epithelial tissues
attached to the tooth), minimum 3 mm in depth,
which will help to maintain gingival margin stability,
alveolar bone height and health and prevent
overgrowth [37, 38, 39]. Power settings of 1.5-3.0 watts
with intervals should be optimal for most, if not all
gingival procedures [36]. Again care must be taken to
avoid thermal damage to the underlying periosteum
and bone, together with root surface at gingival margin
levels. Therefore assessment of the thickness,
vascularity and position of any target gingival tissue,
together with an assessment of adjacent bone and
tooth tissue, is recommended. Also, to minimize the
buildup of carbonized debris, post-ablation tissue
should be discarded using a curette, damp cotton wool
or gauze [36].
Periodontal Therapy with the 810 nm Dental
Diode Laser
The main use for the 810 dental diode laser in the
periodontal therapy is the removal of diseased pocket
lining epithelium and disinfection of periodontal
pockets. Optic fiber delivery systems, with 200-320 µm
fiber diameters, enable extremely easy access into the
periodontal pocket. After hard and soft deposits have
been removed through scaling and/or root-planing,
the pocket architecture is re-assessed, with emphasis
on the depth. The fiber is then measured to a distance
of one to two millimeters short of the pocket depth
and is inserted at an angle to maintain contact with the
soft tissue wall at all times. The fiber is then used in
light contact, sweeping mode to cover the entire soft
tissue lining. Power setting of 0.8-1 W should suffice
to ablate the epithelial lining. Start with the ablation
near the base of the pocket and slowly proceed
upwards. Often some bleeding of the pocket site will
occur, possibly due to damage to the inflamed pocket
epithelium, but in terms of laser hemostasis, the power
levels used are low and aimed at removing the
epithelial surface and disinfecting the pocket [4, 5, 40].
The fiber tip should be regularly inspected and cleaned
with a damp sterile gauze or cleaved in order to
prevent the buildup of debris on the fiber tip. The
treatment time per pocket should be around 20-30 s,
amounting possibly to 1-2 minutes per tooth site. Re-
treatments should follow at weekly intervals during the
maximum four week period. Pocket probing and
measurement to establish benefits of treatment is not
advised during this period [40]. With regard to the
disinfection of periodontal pockets, studies [4, 41] have
shown the effectiveness of diode laser in eliminating
bacteria commonly implicated in periodontal disease
and bone loss (e.g. Actinobacillus actinomycetemcomitans,
Porphyromonas gingivalis). When using the diode laser,
care must be taken to avoid unwanted heating, both of
Journal of Laser and Health Academy
Vol. 2007; No. 4;
the tooth and periodontal attachment apparatus.
Without tactile feedback, coupled with the "blind"
treatment of non-reflected periodontal flaps, caution is
paramount and a thorough diagnosis of the diseased
periodontium must be obtained prior to laser use [40].
Using the 810 nm Dental Diode Laser in
Implantology and Endodontics
In implantology, the 810 nm dental diode laser can be
used for second stage implant recovery and the
treatment of peri-implantitis.
In second stage implant recovery care must be
exercised to avoid contact with the implant body. Soft
tissue ablation leads to precise and predictable healing
and the procedure can usually be performed with the
use of a topical anesthetic. The appropriate power
setting for the removal of gingival tissue overlying the
implant cover screw is 1-2 W. The advantages of using
a diode laser to perform this procedure are easier
visual access to the cover screw due to hemostasis and
the production of the protective coagulum to aid in
healing and patient comfort [42].
Peri-implantitis is described as one of the most
important causes of implant loss and is not restricted
to any one type of implant design or construction [43,
44]. It can be recognized as a rapidly progressive
failure of osseo-integration [45], in which the
production of bacterial toxins leads to inflammatory
change and bone loss [46]. Always, an assessment must
be made to determine the causative factors associated
with the condition (infection, implant overloading,
occlusion and other local, systemic and life-style
factors), to establish whether the implant can be saved
[42]. Curettage of granulation tissue is especially
important. Research has shown that a diode laser can
be used to perform the procedure with the added
bonus of disinfecting the treated area. Use of
appropriate coolant (eg. water spray) is needed to
avoid any detrimental heat effects to the surrounding
tissues [42, 6]. Effective power range is from 1-1.5 W
In endodontics, published papers [7, 8, 9] indicate the
effectiveness of the diode laser root canal treatment
(disinfection of the root canal), with slightly inferior
bactericidal performance against Enterococcus faecalis
when compared to a solid-state NIR Nd:YAG laser
system [9]. The fine diameters of optic fibers (200-320
µm) enable effective delivery of laser light to the root
canal to help with reduction of bacterial
contamination. The antibacterial effect observed
reaches over 1 mm deep into the dentin [9], surpassing
the effective range of chemical disinfectants, such as
NaOCl and displaying moderate effectiveness against
Enterococcus faecalis even in the deeper layers of dentin.
The procedure can be carried out by drying the root
canal with sterile paper tips enlarging the root canal
opening up to ISO 30. After measuring the canal
depth, the optic fiber should be inserted in the
prepared root canal down to the apex - in no case
further. The optic fiber is then led in slow, circular,
spiral-forming movements from the apical to the
coronal part, while the laser is activated. The
procedure should be repeated four times for five
seconds. Be cautious to always keep the fiber-optic
beam delivery tip moving when the laser is activated to
avoid excessive temperature rise on the tooth surface,
which can be detrimental to the tissues surrounding
the tooth. If necessary, repeat the laser treatment after
three to seven days, but not more than twice in total.
The power should be set in the range of 1-1.5 W [9,
Teeth Whitening using the 810 nm Dental Diode
Teeth whitening procedures continue to grow in
popularity due to the increased desire for whiter teeth
with increasing number of articles being published on
the subject in the popular press and on television in
regular intervals. This has resulted in renewed interest
from the dental profession in the process of teeth
whitening, as the procedure itself is relatively simple
and non-invasive to carry out. Current bleaching
systems are based primarily on hydrogen peroxide
(HP) or carbamide peroxide (CP). These bleaching
systems usually exist in a form of a gel which is applied
on the tooth surface and activated via light, for
example. Activation of HP causes formation of free
radical ions, which immediately seek available targets
to react with. Long-chained molecules that "stain" the
tooth react with the free radicals, altering the optical
structure of the molecule and creating a different
optical structure. The stain on the tooth surface
disappears, or the large molecules become virtually
dissociated into smaller, shorter chained molecules,
giving the tooth surface a brighter appearance. 810 nm
laser light also generates heat on the tooth surface. In
order to prevent excessive conduction of heat to the
pulp and avoid pulpal necrosis, proper laser power
must be used and according to the recently published
research, an up to 2 W setting should be well within
safety margins with regard to the pulp tissue as well as
being high enough to accelerate the bleaching process
by causing the breakdown of the HP gel to reactive
free radicals that penetrate the tooth to cause the
Versatility of an 810 nm Diode Laser in Dentistry: An Overview
oxidation of stain molecules within the tooth structure
[10]. One thing to keep in mind with regard to the
parameters in the aforementioned study [10] is the fact
that no spot size was mentioned, making energy
density (fluence) impossible to calculate. Therefore
manufacturer's instructions should be carefully
examined with regard to the proper spot size and
power settings when performing the procedure.
In conclusion, research has proven that the 810 nm is
the premier wavelength available in today's dental
diode laser systems when considering the versatility of
the system. It can be used for a variety of procedures
which are routinely carried out in a modern dental
practice, including a multitude of soft tissue
procedures, such as soft tissue surgery, periodontal
therapy as well as being an efficient tool for use in
implantology, endodontics and tooth whitening. When
compared to "classical" dental techniques, the 810 nm
dental laser offers distinctive advantages, such as the
ability to cut, coagulate, ablate or vaporize target tissue
elements, enabling dry-field surgery through the sealing
of small blood vessels (hemostasis), disinfection of the
tissue, reduced post-operative edema (through the
sealing of small lymphatic vessels) and decreased
amount of scarring, contributing to faster and more
effective treatment resulting in improved treatment
outcome and increased patient comfort and
The main limitation of the 810 nm diode laser is its
lack of ability to perform hard tissue procedures (e.g.
cavity preparation, bone cutting). The currently
optimal solution for such procedures appears to lie in
the use of an 2940 nm Er:YAG laser. Additionally, the
current technology limits the available peak powers
when compared to solid-state lasers, such as the solid
crystal Nd:YAG laser. The inherent CW emission
mode of the diode lasers means that peak powers
cannot be used as effectively as is the case with
Nd:YAG lasers, which can have an inherent pulsed
emission mode and have a wide variety of available
pulse widths. The solid crystal Nd:YAG laser has a
special position among soft tissue lasers. It is capable
to deliver energy in short bursts with approximately
1000 times higher intensities compared to those of
diode lasers. In addition, the Nd:YAG laser
wavelength has the most homogeneous (2 to 3 mm)
penetration into the oral tissue. For this reason, the
combination of solid state lasers such as an 1064 nm
Nd:YAG and an 2940 nm Er:YAG might represent a
nearly optimal choice when considering the spectra of
possible soft and hard tissue treatment options and the
efficiency and safety with which the procedures can be
performed. When the Nd:YAG laser is incorporated
within a solid crystal Er:YAG laser system, the cost of
this additional solid crystal Nd:YAG laser wavelength
is not very high. However, when considering buying
only a single soft tissue laser, then an 810 diode laser
may be the second best choice due to its lower price
and smaller size. If the clinician's main use for the laser
system lies in soft tissue procedures then the 810 nm
dental diode laser undoubtedly represents a worthwhile
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... Concerning the wavelength irrespective to the power, the results of the current study showed that the 940 nm wavelength showed a higher statistically significant difference on the mean temperature than the 445 nm wavelength as shown in Table 2. This finding can be explained on the basis of the idea that the 445 nm is highly absorbed in hydroxyapatite in comparison to the 940 nm as seen in the laser absorption curve in Fig. 2 [24]. Therefore, the laser had been absorbed in the hydroxyapatite, and it was less dissipated to the pulp simulating material. ...
... Nevertheless, the 940 nm was less absorbed in the hydroxyapatite; thus, it was transmitted directly into the pulp simulating material resulting in an elevation in the pulpal temperature. Pirnat (2007) and Matos (2012) had included the absorption curve scale which proves that the 445 nm diode laser is more absorbed in hydroxyapatite at approximately 10 −2 cm −1 , in comparison to the 940 nm which has a lesser absorption co-efficient than 10 −2 cm −1 [24,25]. In spite of that, the 445 nm diode laser should be handled properly as it is still highly transmitted in hydroxyapatite [18]. ...
... Nevertheless, the 940 nm was less absorbed in the hydroxyapatite; thus, it was transmitted directly into the pulp simulating material resulting in an elevation in the pulpal temperature. Pirnat (2007) and Matos (2012) had included the absorption curve scale which proves that the 445 nm diode laser is more absorbed in hydroxyapatite at approximately 10 −2 cm −1 , in comparison to the 940 nm which has a lesser absorption co-efficient than 10 −2 cm −1 [24,25]. In spite of that, the 445 nm diode laser should be handled properly as it is still highly transmitted in hydroxyapatite [18]. ...
Full-text available
Purpose The purpose of the current study was to compare the effect of two diode lasers with wavelengths (940 nm and 445 nm) using different powers (0.5 W and 1 W) on the temperature rise of a pulp simulating material. Materials and methods This in vitro study involved a total number of 36 permanent molars. The samples were randomly divided into two groups according to different wavelengths (940 nm and 445 nm); 18 teeth were included in each group. Each group was subdivided according to the power settings (0.5 and 1 W) into two subgroups with nine teeth in each subgroup. The occlusal cavities were prepared in sound molars leaving a 1 mm dentin bridge. The selected wavelengths were applied for 5 s with an output of 0.5 W and 1 W. The applied energy was 2.5 J and 5 J. A thermocouple was inserted in the pulp chamber filled with a pulp simulating material, and the temperature changes were monitored in °C throughout the procedure. The data collected were tabulated and statistically analyzed by using tests of normality (Kolmogorov–Smirnov and Shapiro–Wilk tests). Results The results had shown that the 940 nm has a higher statistical significance difference on the mean temperature in comparison to the 445 nm at 0.5 W. The 940 nm showed a higher temperature rise compared to the 445 nm using the 1 W, yet it is insignificant. However, there was no statistically significant difference in the temperature rise between both powers (0.5W and 1 W) in both wavelengths (445 nm and 940 nm). Nevertheless, all the temperature rises that occurred did not exceed 2 °C. Conclusion Both wavelengths increased the temperature of the pulp simulating material. The 940 nm caused a higher increase in temperature. The temperature elevations were within the safe range, providing that both wavelengths can be used safely with the used parameters.
... However, the diode laser is unsuitable for cutting hard tissue such as teeth and bones due to the wavelength and target molecules [5]. Each type of laser uses different materials to produce different wavelengths of light [8][9][10]. Diode laser usually operates between two wavelengths of 810 to 980 nm. ...
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Purpose: It has been demonstrated that diode lasers can be an effective alternative in oral soft tissue surgeries. This study aimed to clinically evaluate the tissue healing around the gingival former of dental implants following the uncovery of areas with different diode laser wavelengths. Materials and Methods: This study was conducted on 72 implants (in the Periodontology Department of the Faculty of Dentistry, Jundishapur University of Medical Sciences in Ahvaz, Iran, in 2015-2016) with two different diode laser wavelengths (940 and 810 nm). The samples were randomly assigned to two groups of 36 implants, including experimental and control. The experimental group was based on the second stage of implant uncovery with a 940nm diode laser, and the control group included the second stage with an 810 nm diode laser. Indicators such as the need for local anesthesia and the amount of anesthesia injected during surgery, the duration of surgery, the amount of bleeding during surgery, pain, inflammation, edema, and the color of the gingiva in the surgical area, were compared in two study groups during surgery. Results: The independent t-test showed no significant difference in the average duration of surgery in the two groups (31.3 and 37.6 seconds in the 940nm and 810nm wavelength of the diode laser, respectively, P=0.073). On day zero and day seven after surgery, pain intensity with 810nm diode laser wavelength was higher than with 940 wavelengths. The average amount of anesthesia injected during surgery of the surgical group with a wavelength of 940 nm was significantly lower than that of the 810nm diode laser. No bleeding was observed in both surgery groups. Conclusion: The 940nm diode laser had better results than the 810nm in the second stage of implant uncover.
... Therefore, surgical procedures in medicine and especially in dentistry include, but are not limited to gingivectomies, frenectomies, excision of soft tissue tumors, and uncovering of submerged dental implants during second-stage implant surgery. 1,2 As a result, the tissue absorbs the emitted laser light energy, which is thereby converted to heat energy, culminating in the breaking of covalent bonds in tissues. 2 The active medium in diode lasers is a solid-state semiconductor, typically consisting of aluminum, gallium, and arsenide. 2 This enables diode lasers to emit laser light in the range of 810-980 nm, which corresponds to the IR category on the electromagnetic spectrum. ...
Objective: This study aimed to demonstrate temperature changes and heat transfer patterns in soft tissues when using infrared (IR) diode lasers, utilizing thermographic techniques. Methods: Bovine tongue slices (5 mm thick) were placed between two glass slides at 11 cm from a thermographic camera. Twenty-two centimeter-long incisions were made along the soft tissue parallel to the camera capture field. Incisions were performed using the 970 and 980 nm lasers (continuous wave, 2-watt, 320 μm-thick glass initiated, and noninitiated fiber tips, 30-sec irradiation). The maximum temperature changes in oC (ΔT) and the vertical and lateral heat transfer (in mm) were recorded for 30 sec, using the thermographic images captured using the IR camera. The ΔT and the amount of lateral and vertical heat distribution were measured in 10-sec intervals for a 30-sec irradiation period. A repeated analysis of variance (ANOVA) (p < 0.05) statistical test was used to analyze the statistical differences between the average ΔT and heat transfer patterns between the initiated and noninitiated lasers. Results: The maximum ΔT for the 970 nm diode laser with initiated tips at the 30-sec mark was 17.81 ± 11.48, while the maximum ΔT for the 980 nm diode laser with initiated tips was 13.24 ± 6.90 (p = 0.041). Statistically significant differences between the vertical and horizontal heat transfer patterns were noted between the initiated and noninitiated diode lasers. The 980 nm diode laser with initiated tips proved to have statistically significant greater vertical and lateral heat transfer when compared to the 970 nm diode laser. The 970 nm diode laser with noninitiated tips proved to have a statistically significant higher heat distribution when compared to the 980 nm laser with noninitiated tips. Conclusions: Different near-IR lasers present differences in lateral heat and tissue penetration, using initiated or noninitiated fibers, and due to these differences, power settings and irradiation period must be considered to avoid risks due to overheating.
... [20] Sarver and Yanosky compared laser with conventional blade surgery, laser excision seemed more convenient in view of lack of bleeding and no sutures required. [21] According to Pirnat [22] using near infrared lasers on soft tissue, there is no bleeding due to a combination of sealing of small vessels through tissue protein denaturation and stimulation of factor VII production in clotting. In a study by Borcher, [16] he stated that there was very minimal bleeding in patients operated with continuous mode when compared to pulsed mode. ...
Full-text available
Background: As dental lasers are becoming more popular in the branch of oral medicine for its various advantages and applications, this study was carried out to evaluate better mode of obtaining oral biopsies which is a common and inevitable procedure for providing final diagnosis in majority of conditions. Methodology: In this study, a total of 60 patients who required biopsy for final diagnosis of oral mucosal lesions as part of diagnosis in department of Oral Medicine were selected, out of which 30 were subjected to scalpel biopsies and 30 patients were subjected to diode laser biopsies. A 980 nm Zolar plus diode laser was used for the study. Out of 30 patients who were subjected to laser biopsies, 3W continuous mode settings were used for 15 patients and 3W pulsed mode was used for 15 patients. The specimens were sent to Department of Oral Pathology for histopathological evaluation to provide the final diagnosis. The time taken for each patient, volume of local anesthesia, during operative, postoperative pain scale, and co-relation of provisional and final diagnosis was noted for comparison purpose and the pathologist comments, peripheral tissue damage and artifact's for each slide were noted. Results: The study results showed the postoperative pain was comparatively less in diodlaser than scalpel, the lasers were patient friendly as the heammorage was negligible when compared to scalpel and suturing was not required. The pulsed mode in diode laser was advantageous over continuous mode when amount of thermal damage and postoperative pain score was compared. Conclusion: The results showed that oral biopsies can be made better using diode lasers, by having thorough knowledge on the device.
... More basic research is needed to clarify the exact etiopathogenesis of ankyloglossia. Ankyloglossia was also found associated in cases with some rare syndromes such as X-linked cleft palate syndrome, 6 Kindler syndrome, 7 van der Woude syndrome, 8 and Opitz syndrome. 9 Nevertheless, most ankyloglossias are observed in persons without any other congenital anomalies or diseases. ...
Full-text available
Management of adult tongue tie by laser
... Diode lasers, which were recently introduced in endodontics, have wavelengths in the range of 800−1064 nm for dental uses and can penetrate to a depth of 500 µm through dentinal tubules for disinfection of the root canal system (Gutknecht et al., 2004). Moreover, they cause thermal photodisruptive activity in unreachable areas of the root canal complex with optimal antibacterial effects within the dentinal tubules (Kimura et al., 2000;Lagemann et al., 2014;Pirnat, 2007). ...
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Objectives This study aimed to compare the effects of three irrigation activation systems (IAS) on postoperative pain (PP) in activating three final irrigants: sodium hypochlorite 5.25%, ethylenediaminetetraacetic acid 17%, and chlorhexidine 2%. Materials and Methods This parallel randomized clinical trial included referred patients with asymptomatic large‐sized apical lesion incisors. A standard method was followed in the canal cleaning and shaping for all included patients in the study. Then, the patients were randomly assigned (1:1 allocation) into three groups: G1 ( n = 20) with passive ultrasonic irrigation activation; G2 ( n = 20) with XP‐Endo Finisher file activation; and G3 ( n = 20) with diode laser (810 nm) activation. PP was estimated in all groups using a visual analog scale after 1, 3, 7, and 14 days of treatment. Comparisons between the groups were made using the Kruskal−Wallis test, whereas the Mann−Whitney U test was used in the pairwise comparisons. Results Sixty patients were followed‐up in this trial. There were significant differences between the groups in terms of PP After 1, 3, and 7 days of treatment ( p = 0.002, p = 0.017, and p = 0.006, respectively). On the first day of treatment, G3 showed the lowest PP compared with G1 and G2 ( p = 0.007 and p = 0.001, respectively). On the third day of treatment, G3 showed less PP compared with G2 ( p = 0.005). On the seventh day of treatment, G2 showed the highest PP compared with G1 and G3 ( p = 0.012 and p = 0.003, respectively). Conclusions The XP‐Endo Finisher file caused the highest PP level especially in the next day and 3 days of the treatment, whereas the diode laser had the lowest PP level during the first week of treatment. It is noteworthy that PP disappeared completely after 2 weeks of treatment with all three IASs. Trial Registration The trial was registered in the ISRCTN registry (Trial ID: SRCTN99457940).
... The smaller size, ease of handling and set-up, and lower cost are among their advantages over other laser types [30]. Diode laser energy in the near infrared region gives coagulation and antimicrobial effects, but has little absorption in dental hard tissues [31,32]. Thus, soft tissue surgery can be performed safely adjacent to dental hard tissues [33]. ...
Full-text available
Vital pulp therapy (VPT) is primarily intended to preserve the vitality of pulp tissues, which have been exposed for any reason. Various materials and techniques have been proposed to improve treatment outcomes, including the use of lasers. This study aimed to review the histological results of different dental lasers including low-level lasers, carbon dioxide (CO2), erbium-doped yttrium aluminum garnet laser (Er:YAG), neodymium-doped yttrium aluminum garnet (Nd:YAG), erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers, and diode lasers for VPT. This focused review included a comprehensive electronic search of Scopus, MEDLINE, Web of Science, and Google Scholar databases from 2000 to 2022 by two independent investigators. Different combinations of keywords were used, and reference mining of related papers was done. The review included studies related to histologic evaluation of laser-assisted vital pulp therapy that stated the laser parameters that were used. Articles with radiographic or clinical assessments or articles lacking necessary data were excluded. Non-English articles were excluded unless their abstract was in English and encompassed the necessary data. Most studies indicated the efficacy of lasers for reduction of inflammation, acceleration of healing, and increasing the thickness of dentinal bridge. According to the evidence, lasers used in combination with pulp capping agents are beneficial to enhance the success rate of VPT.
... There are several techniques to perform the procedure. The conventional technique involves excision of the fraenum using a scalpel, 5 whereas the diode laser technique 6 and CO 2 laser technique are more recent alternatives. 7 Laser technology has been reported in the literature as an alternative to conventional techniques. ...
Full-text available
Background We aimed to compare the clinical and histological secondary healing effectiveness of various types of high-level laser versus scalpel excision in mucosa frenectomy. Methods Forty-five Sprague Dawley rats were used in this study. These rats were divided into two laser intervention groups (CO 2 , n = 15; diode, n = 15) and one control group with scalpel excision (n = 15). The effectiveness of therapy has been assessed based on the comparison of intraoperative, postoperative, and histological parameters on days 7, 21, and 35, and postoperative weight changes as pain indicator. Results Both laser groups demonstrated significantly ( P < 0.05) less bleeding than did the control group during the intraoperative stage, whereas the CO 2 laser showed more precise cutting compared with the diode laser ( P < 0.05). The highest healing score was reported in the CO 2 and scalpel groups on the first week of healing than in the diode group ( P < 0.05). However, no significant difference was observed between the groups on days 21 and 35. Weight loss was significantly ( P < 0.05) demonstrated in the diode group compared to the scalpel and CO 2 groups till day 7. Both laser groups demonstrated delayed healing process compared with the scalpel. Nevertheless, the CO 2 group followed the scalpel trends after day 7. Conclusion Scalpel and CO 2 laser yielded a superior clinical outcome compared with the diode excision of oral mucosa, whereby the CO 2 has been proposed as the most effective laser type at the end of the first postoperative month.
... Additionally, laser speeds up wound recovery and minimises scarring [6]. Diode lasers with an efficient tissue penetration depth of 2 mm close the tiny lymphatic channels, reducing postoperative edoema [7]. ...
... Laser has many advantages over conventional surgical techniques. The laser-assisted lingual frenectomy is an easy procedure which can be performed with precision, causes less discomfort, heals faster with less postoperative bleeding and oedema, and causes minimum to no bleeding due to the capillaries being sealed by protein denaturation and the activation of clotting factor VII synthesis [8]. Complications after laser frenectomy are very rare. ...
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Purpose: In previous studies it has been shown that diode laser at a wavelength of 810 nm is able to kill bacteria in infected root canals. These studies were mostly in vitro studies and dealt only with selected bacterial species. The present clinical study compares the antibacterial activity of a high power diode laser with 5% sodium hypochloriter (NaOCl) solution in root canals. Materials and Methods: Thirty single rooted nonvital teeth from thirty patients were randomly subdivided into two groups. The first group underwent laser treatment in addition to canal preparation and the second group was instrumented and irrigated with 5% NaOCl. Before and after each treatment session, microbiological samples were taken. The teeth were treated in three appointments without intracanal dressing between appointments. Results: All 30 root canals showed cultivable flora before treatment. Endodontic treatment reduced microbes both in terms of number of infected canals and number of species. At the last treatment session, laser application resulted in 11 and NaOCl irrigation in 10 bacteria-free canals (p>0.05 according to the Chi-square test). Conclusion: The study indicates thet the use of diode laser is as effective in disinfecting root canals as irrigation with 5% sodium hypochlorite
Full-text available
Within a general practice setting, there are few benign pathological conditions of the attached or keratinised gingival complex that are not amenable to simple surgical intervention. The majority of surgical procedures are adjunctive to the delivery of restorative dentistry. There is an understandable dogma worldwide towards the management of soft tissues as they interface with restorative procedures. Contemporary teaching, both at undergraduate and postgraduate level, would recognise the need for a period of wound healing and stability, based on scalpel-induced incisional therapy. The use of laser wavelengths, based on predictable evidence-based protocols, has re-defined the surgical management of keratinised mucosa that is bound to the underlying periosteum and bone. This can be seen as being of benefit to the clinician in determining the outcome, and the patient in achieving quality results.
Objective . The sialolithiasis (submandibular and sublingual) isn’t a rare eventuality on daily work and its treatment often depend on important factors. Results.The aim of this case report is to show easier we can remove salivary calculus with a diode laser incomparison with traditional surgical and no-surgical technique (Lithotripsy), in terms of less intra operative stress for our patients and operative advantages like not much pain, clean cur, bloodless operating area, hemostatic properties and no need for sutures.. Conclusion.A lot of Authors, in last years, have suggested alternative methods to the traditional surgery that consist of actions that aren’t always effective in the extirpation of the calculus. The use of the laser diode is a new minimally invasive device which can change established treatment of human sialollithiasis.
It has been established that the ability of erbium lasers to ablate hard dental tissue is due primarily to the laser- initiated subsurface expansion of the interstitial water trapped within the enamel and that by maintaining a thin film of water on the surface of the tooth, the efficiency of the laser ablation is enhanced. It has recently been suggested that a more aggressive ablative mechanism, designated as a hydrokinetic effect, occurs when atomized water droplets, introduced between the erbium laser and the surface of the tooth, are accelerated in the laser's field and impact the tooth's surface. It is the objective of this study to determine if the proposed hydrokinetic effect exists and to establish its contribution to the dental hard tissue ablation process. Two commercially available dental laser systems were employed in the hard tissue ablation studies. One system employed a water irrigation system in which the water was applied directly to the tooth, forming a thin film of water on the tooth's surface. The other system employed pressurized air and water to create an atomized mist of water droplets between the laser hand piece and the tooth. The ablative properties of the two lasers were studied upon hard inorganic materials, which were void of any water content, as well as dental enamel, which contained interstitial water within its crystalline structure. In each case the erbium laser beam was moved across the surface of the target material at a constant velocity. When exposing material void of any water content, no ablation of the surfaces was observed with either laser system. In contrast, when the irrigated dental enamel was exposed to the laser radiation, a linear groove was formed in the enamel surface. The volume of ablated dental tissue associated with each irrigation method was measured and plotted as a function of the energy within the laser pulse. Both dental laser systems exhibited similar enamel ablation rates and comparable ablated surface characteristics. The results of the study suggest that, although the manner in which the water irrigation was introduced differed, the mechanism by which the enamel was removed appeared basically the same for both dental laser systems, namely rapid subsurface expansion of the interstitially trapped water. It is the conclusion of this study that if the proposed hydrokinetic effect exists, it is not effective on hard materials, which are void of water, and it does not contribute in any significant degree in the ablation of dental enamel.
Profiles of light, temperature, and thermal damage distributions in tissue based on measured optical properties are examined theoretically for high power diode laser (810 nm) and Nd:YAG laser 1064 nm). Generally higher absorption and effectively lower optical penetration has been experimentally observed at the wavelength of diode laser as compared to that of Nd:YAG laser. Results of this study indicate that similar thermal damage volumes are expected to be obtained by the two lasers, in general. However, for same irradiation conditions a larger volume of damage and more charring near the surface is predicted when using the diode laser on prostate tissue, and similarly for myocardial tissue. Role of blood presence throughout tissue, in terms of its optical interaction, as well as the role of a small layer of blood between the laser and the tissue is also investigated for both wavelengths.
Lasers: The Perioperative Challenge , second ed By Kay A. Ball 1995, 447 pp $31.95 paperback
Background and Objectives This investigation determined incision characteristics and soft-tissue damage resulting from standardized incisions using a wide range of laser modes and parameters of a diode laser at 810 nm.Study Design/Materials and Methods Histologic examinations were performed to verify vertical and horizontal tissue damage as well as incision depth and width.ResultsIncision depth and width correlated strongly with average powers, but not with laser parameters or the used tips. No laser damage was visible to the naked eye in the bone underlying the incisions in the range between 0.5–4.5 W.Conclusion The remarkable cutting ability and the tolerable damage zone clearly show that the diode laser is a very effective and, because of its excellent coagulation ability, useful alternative in soft-tissue surgery of the oral cavity. Lasers Surg. Med. 25:401–406, 1999. © 1999 Wiley-Liss, Inc.
Background and Objective The aim of this study is to examine the long-term effect of diode laser therapy on periodontal pockets with regard to its bactericidal abilities and the improvement of periodontal condition.Study Design/Materials and Methods: Fifty patients were randomly subdivided into two groups (laser-group and control-group) and microbiologic samples were collected. There have been six appointments for 6 months following an exact treatment scheme. After evaluating periodontal indices (bleeding on probing, Quigley-Hein) including pocket depths and instruction of patients in oral hygiene and scaling therapy of all patients, the deepest pockets of each quadrant of the laser-group's patients were microbiologically examined. Afterwards, all teeth were treated with the diode laser. The control-group received the same treatment but instead of laser therapy were rinsed with H2O2. Each appointment also included a hygienic check-up. After 6 months the final values of the periodontal indices and further microbiologic samples were measured. The total bacterial count as well as specific bacteria, such as Actinobacillus actinomycetemcomitans, Prevotella intermedia, and Porphyromonas gingivalis, were assessed semiquantitatively.ResultsThe bacterial reduction with diode laser therapy was significantly better than in the control group. The index of bleeding on probing improved in 96.9% in the laser-group, whereas only 66.7% in the control group. Pocket depths could be more reduced in the laser group than in the control group.Conclusion The diode laser reveals a bactericidal effect and helps to reduce inflammation in the periodontal pockets in addition to scaling. The diode laser therapy, in combination with scaling, supports healing of the periodontal pockets through eliminating bacteria. Lasers Surg. Med. 22:302–311, 1998. © 1998 Wiley-Liss, Inc.
Background and objectives: In recent years, various laser systems have gained importance in the field of laser-assisted endodontics, namely the Nd:YAG, the diode, the Er:YAG, and the Er,Cr:YSGG laser. Individual studies have been carried out so far, focusing on the respective wavelength, its specific bactericidal capabilities, and potential usefulness is root-canal disinfection. The present in vitro investigation however, was performed to compare the microbicidal effect of these laser systems under standardized conditions and to draw a conclusion upon their relative effectiveness in the deep layers of dentin. Study design/materials and methods: In total, 360 slices of root dentin with a thickness of 1 mm were obtained by longitudinal cuts of freshly extracted human premolars. The samples were steam sterilized and subsequently inoculated with a suspension of either Escherichia coli or Enterococcus faecalis. After the incubation, the samples were randomly assigned to the four different laser systems tested. Each laser group consisted of two different operational settings and a control. The dentinal samples underwent "indirect" laser irradiation through the dentin from the bacteria-free side and were then subjected to a classical quantitative microbiologic evaluation. To assess the temperature increase during the irradiation procedure, additional measurements were carried out using a thermocouple. Results: Microbiology indicated that all laser systems were capable of significant reductions in both test strains. At an effective output power of 1 W, E. coli was reduced by at least three log steps in most of the samples by the tested wavelengths, with the best results for the Er:YAG laser showing complete eradication of E. coli in 75% of the samples. E. faecalis, a stubborn invader of the root canal, showed minor changes in bacterial count at 1 W. Using the higher setting of 1.5 W, significant reductions of E. coli were again observed with all laser systems, where only the diode and the Er:YAG laser were capable of complete eradication of E. faecalis to a significant extent. There was no significant relation between the temperature increase and the bactericidal effect. Conclusions: The present study demonstrates that all the wavelengths investigated are suitable for the disinfection of even the deeper layers of dentin and may prove to constitute valuable tools in state-of-the-art endodontics.