Lasers

Patients are waiting for no drill dentistry. The perception is that a laser can perform this task. As we know, there is a limit to the restorative dentistry that can be performed with this device, although there are some practitioners who have exceeded the expectations and gone outside the curve. A basic understanding of laser types and capabilities is necessary before deciding to be a “laser dentist”. None can do it all although there are some units with multiple laser systems built into one box. Once a laser is in place, the practitioner has a myriad of procedures that were once beyond the capability as well as some procedures that are unique to the laser’s functions. A simple example is rapid reduction of an apthous ulcer. This has normally been treated palliatively with a “time will heal it” protocol. A properly set laser can reduce or eliminate the pain and start the healing in a short visit, adding to revenue and enhancing the patient’s experience.

Lasers are commonly classified as soft or hard tissue lasers for a basis of comparing apples to apples. Some of these listed here can cross the boundaries depending on the operators knowledge and skill using the equipment. A few units have two types of lasers in the same control box

Diode Lasers:

Low level 808-980- These are for soft tissue procedures. The laser is absorbed by pigmented (tissue) areas. Common uses are tissue contouring, toughing for crown impressions. Others are gingivectomy, soft tissue crown lengthening, frenectomies, removal of redundant soft tissue and similar procedures. An apthous ulcer can be “lased” to reduce symptoms and promote healing.

Erbium YAG Lasers:

The energy is absorbed by water, bone and enamel. These are “hard tissue” lasers

Erbium Chromium Lasers:

The energy is absorbed by water, bone and enamel. These are “hard tissue” lasers.

NdYAG lasers:

These are pulsed and go deeper into soft tissues. There has been great success in treating periodontal pockets

CO2 lasers:

These are used for deep soft tissue procedures. The energy is not focused with a fiberoptic bundle, although some models use one for orientation.

ROI is related to multiple procedures that can now performed that were previously referred out or rejected by patients due to apprehension. Hard tissue lasers can perform many cavity preparations, a majority without the use of anesthetic. Crown lengthening is a common issue the practitioner faces with fractured cusps and/or subgingival decay. Soft tissue procedures such as gingivectomies, frenectomies, tissue recontouring, crown lengthening and more can increase the productivity as well as the image of a dental practice. Periodontal procedures such as sulcular debridement and new attachment, while somewhat controversial, are being performed enhancing the patient experience and the practitioner’s bottom line.

Read an excellent review in Dental Economics August 2004 by Dr. Robert Gregg.

Diode

Biloase LaserSmile, Diolase Plus

Comment: lasersmile has tooth whitening attachments.

Biolitec SmilePro 980

Hoya DioDent

Ivoclar Odyssey

Comment- unique retractable fiber enhances portability and cost effectiveness of the unit.

Opusdent Opus5, Opus 10

Zap Softlase

A no frills budget diode.

ND:YAG

Lares Powerlase ST6

Lares Powerlase AT ( dual with ER:Yag)

Milennium Periolase MVP-7

Erbium ER:YAG

Hoya Delight

Opus DUO ( ER and CO2)

Lares Powerlase AT ( dual with ND:Yag)

ErbiumChromium YSGG Er, Cr:YSGG

Biolase Waterlase YSGG

Biolase Waterlase MD

New design offers many operator advantages such as more erogonomic and finberoptic handpiece, better controls.

CO2

Opus Duo

DEKA Smart US20