PATIENT-INFORMATION

Diode Lasers in Dentistry

In dentistry, diode lasers are used for a variety of applications: cut soft tissue, evaporate bacteria in periodontal pockets or teeth, coagulate vessels, accelerate wound healing, reduce pain, accelerate tooth whitening, trigger acupuncture points, reduce swellings or inflammations - and many more.

Find a laser dentist

Many dentists use dental lasers today. If you are looking for a laser dentist, we may help you find one - please get in contact and tell us, what you need and where.

Laser treatments and their benefits

laser surgery

Surgical interventions on the soft tissues of the oral cavity are always necessary when excess tissue formation is caused by acute inflammatory processes or chronic irritation, for example soft tissue abscesses, fibroids, the epulis or gum hyperplasia.

Conventionally, after anesthesia, the affected tissue is cut out with a scalpel. The edges of the wound are then fixed with sutures and the bleeding stopped with a compression bandage.

Using the laser makes it possible to perform a number of surgical procedures more comfortably, quickly and safely.

By converting the laser light in the tissue, the soft tissue is selectively vaporized. At the same time, opened blood vessels are closed (= coagulation). Therefore, there is no bleeding. For this reason, wound treatment with sutures and a compression bandage can be dispensed with in most cases. In addition, the wound surface is sterilized by the effect of the laser light. A whitish fibrin coating often forms on the wound surface, which is to be understood as the body's own "wound plaster". It shouldn't be removed either. It disappears by itself once the wound has healed. Laser surgery also requires only half as much anesthetic as conventional treatment with a scalpel.

For you as a patient this means:

  • Treatment is faster and more comfortable because a scalpel, sutures and wound dressings are no longer needed.
  • Bleeding is reduced to a minimum or does not occur at all during and after the operation.
  • Wound healing is less disturbed because blood vessels are closed and the wound surface is sterilized. In addition, there are no annoying irritations of the otherwise necessary seams.
  • The removal of sutures in a follow-up session is no longer necessary.
  • Wound healing without pain and without scarring

Endodontics (laser sterilization of inflamed tooth roots)

Endodontitis means an inflammation of the tooth pulp (= tooth nerve tissue inside the tooth) caused by migrating bacteria. The migration of bacteria through the hard tooth substance (enamel/dentine) to the pulp takes place via carious defects in the tooth. Once the bacteria have reached the pulp of the tooth, they can multiply quickly there, triggering massive inflammatory reactions with the typical severe toothache.

The aim of root canal treatment is to remove the inflamed pulp, clean the inner wall of the root canal, which is contaminated with bacteria, and then seal the root canal as hermetically as possible. This therapeutic procedure is referred to as root canal treatment or endodontics and is intended to prevent renewed bacterial colonization of the root canal and the above-described spread of inflammation in the jawbone.

If the inflammation spreads beyond the root canal to the root tip in the surrounding jawbone, the result is usually the famous "fat cheek" (= soft tissue abscess due to inflammation of the root tip). Root canal treatment alone is often unable to heal the focus of inflammation at the tip of the root (=granuloma). In such cases, a root tip resection is required - a surgical procedure in which the root tip is removed from the jaw together with the granule.

In all cases of inflammation of the pulp of the tooth and especially in the case of inflammation of the root tip, laser treatment of the inside of the root canal is recommended in addition to the conventional chemical-mechanical preparation of the root canal. A thin glass fiber is used for this purpose, which guides the laser energy into the root canal. The laser energy kills a very large part of the bacteria (up to 97%) in the root canal wall (= root canal sterilization) that remained in the canal and the tooth root wall after the chemical-mechanical treatment.

In addition, the laser energy causes a closure of the so-called dentine tubules on the inner walls of the canal. These dentine tubules are the finest canals in the root wall, which, like the main root canal, are connected to the root surface of the tooth. The closure of these canals by the laser thus prevents colonization of the root environment with bacteria from the root canal (=hermetic closure). If a granuloma already exists, the laser treatment means that in most cases the otherwise necessary root tip resection can be avoided. After the laser treatment described above, the organism is usually able to dissolve the granuloma at the root tip again. The regeneration of the jaw boil at the root tip must be checked by another X-ray 4-6 months after the laser-assisted root canal treatment.

The supporting use of the laser thus causes a maximum reduction in germs in the root canal and an optimized closure to the tooth environment. Even severely infected teeth can come to rest that could not have been preserved with conventional means.

For you as a patient, this means:

  • Time savings: A canal treated with the laser can often be treated in one or very few sessions.
  • The security in terms of preventing the spread of inflammation in the root environment is enormously increased.
  • Even in difficult cases where conventional methods fail, treatment with the laser is still successful in most cases (= cost savings, since tooth loss requires expensive dentures as a result).
  • The usual surgical intervention (root tip resection) for granuloma formation can be avoided with the use of lasers.

Periodontal treatment (laser disinfection of the gum pocket)

Periodontitis means inflammation of the gums and, as a result, damage to the entire periodontium (= gums and jawbone). This leads to long-term loss of teeth. This condition is usually caused by poor oral hygiene. We can help you here with professional oral hygiene training and professional tooth cleaning, which must be carried out before every periodontal treatment to ensure the lasting success of the subsequent gum treatment. It is then necessary to remove the damage below the gum line, which can no longer be reversed despite perfect oral hygiene. The aim of the treatment is to achieve the lowest possible level of germs in the gingival pocket (= sulcus) that has undergone inflammation and on the bacterially contaminated root surface. As before, the root surface must first be freed from all inflammation-promoting deposits (= concretions and smear layers), as these represent the breeding ground for the bacteria. Following this, the inflamed gums are often shortened with a scalpel using the previous therapy method and the edges of the wound are then sewn up.

The laser makes it possible to perform periodontal treatment in a much less traumatizing manner.

The gum pocket and the root surface are freed from germs that cause inflammation using laser light. The laser treatment of these areas of the periodontium leads to the greatest possible removal of the smear layer on the root surface, which is highly bacterial in nature, and a significant reduction in free sulcus bacteria (swimmers), which cannot be achieved using conventional means. Studies have shown that pigmented bacterial strains are reduced by up to 99% and non-pigmented strains by up to approx. 75%. With PA treatment without a laser, only up to 25% of the bacteria are eliminated. The significantly higher level of bacterial destruction using the laser explains the significantly better wound healing. In addition, with pocket depths of up to approx. 7 mm, there is no need to surgically open up the gums. As a result, the PA treatment is usually less invasive and the postoperative symptoms are easier to bear for the patient due to the less tissue trauma. Periodontal treatment, which is often fraught with anxiety, is becoming more comfortable, more efficient and more pleasant. The laser treatment is carried out at the same time as conventional tooth root planing under local anesthesia. In severe cases, repeated lasering of the periodontal pocket may be necessary.

For you as a patient, this means:

  • In contrast to conventional treatment, the inflamed periodontal pocket can be freed from germs that cause the inflammation using a laser (=pocket decontamination) much more effectively. Treatment carried out in this way usually leads to very good results even in cases in which dentists would be inclined to surgically open the periodontal pocket according to old procedures.
  • In many cases, this means that opening and shortening of the gums can be dispensed with, or the extent of the shortening is significantly smaller. As a result, the usual seam is no longer needed in many areas.
  • When passing through the periodontal pocket with the only 0.2 mm thin light guide, the smallest blood vessels are closed, so that the bleeding symptoms are significantly reduced. The bleeding stops faster.
  • In addition, the laser light is able to free the root surface of the teeth from pathogens and at the same time to condense the hard tissue of the tooth (= root cement mineralization).
  • The tissue is less traumatized during treatment, which is why wound healing is faster and associated with less postoperative discomfort.
  • The cleaning of the interdental spaces can usually be carried out again one to two days after the treatment due to the fewer healing problems.
  • Due to the minimally invasive treatment method, the gum line does not shrink as much as with conventional treatment. The necks of the teeth are therefore not as visible.

Periodontal treatment / root canal treatment / "Photodynamic Therapy"

Antimicrobial photodynamic therapy (aPDT) is a gentle procedure in which germs - for example in gum pockets or in teeth - are destroyed using a laser-activated dye. The healthy tissue is spared and there are no systemic side effects, such as those that can arise from taking antibiotics, for example.

Photodynamic therapy is used for periodontal, peri-implant, endodontic and other superficial inflammations.

The dye is brought to where the germs are - for example in the periodontal pocket or in the tooth. There the dye is allowed to take effect for a short time, i.e. to connect with the germs. The excess dye is washed out or rinsed off.

Now the laser is used to irradiate the dye. This irradiation is completely painless, since a very gentle laser light is sufficient for this. As a result of the irradiation, the dye forms reactive oxygen, which destroys the germs - or their shells/membranes - so that the bacterium bursts and the remains are then "disposed of" by the body.

In addition, the gentle laser energy, which is not absorbed in the dye, has a photobiological effect that supports healing - at the same time reducing bacteria.

HERPES treatment

Herpes labialis is a frequently recurring mucosal disease. About 16-45% of the population is infected with the herpes simplex virus 1 (HSV1). Many of the latent virus carriers suffer from frequent recurring changes in the mucous membrane or skin (= efflorescence). They are characterized by extremely unpleasant itching or burning of the skin in connection with the efflorescence (groups of blisters on a reddened background). After the blisters burst, they slowly dry out and usually heal after about 3 weeks. The secretion of the blisters is extremely contaminated with herpes viruses and is therefore highly infectious.

Conventional antiviral drugs are used for treatment. However, it has been shown that there are increasingly virustatika-resistant HSV strains in which these ointments are no longer effective.

The use of the laser in the treatment of herpes and aphthous ulcers lies in the destruction of the pathogens (in the case of herpes the HSV1 virus) located in the skin (primary efflorescence). The affected mucosal area is irradiated with the laser light and the germs on the wound surface are killed.

Studies have shown that the use of lasers shortens the healing phase and reduces the tendency for the disease to recur (=recurrence) on the laser-treated mucosal area. Immediately after the treatment, the irradiated wound surface is less sensitive to external stimuli, which immediately reduces the subjective pain symptoms.

For you as a patient, this means:

  • The efflorescence heals much faster with laser irradiation than with conventional treatment.
  • The treatment is non-contact and painless.
  • Constant application of ointments is not required.
  • Wound healing without pain and without scarring.
  • Reduced tendency for recurrence in the irradiated treatment area.

Laser-assisted precision impression

The precise representation of prepared tooth stumps on the dental master model is still one of the most important interfaces between dentist and dental technician. In the production chain to the finished crown, the dentist plays a key role. Only he can create the conditions for a perfect model with his reproducible and precise impression method and thus avoid inaccurate fitting of the crown to be made. This is particularly important because inaccuracies in the fit of crown restorations (over- and under-extension of the crown edge, excessively large edge gap) often cause a multitude of perioprosthetic and aesthetic problems.

Since the preparation border or the preparation edge usually runs 0.5 to 1.5 mm below the gum line (=subgingival), the gums are usually injured during the preparation of the tooth. As a result, there is increased bleeding at the edge of the gums (= sulcus).

There are two problems with the subsequent impression of the prepared tooth stumps. On the one hand, the soft tissue surrounding the tooth must be pushed away from the preparation edge (=retraction) and on the other hand, no blood must get onto the surface of the tooth to be molded during the impression. Inadequate retraction and bleeding in the sulcus prevent accurate impression taking. The impression must be repeated.

With the help of the laser, these two can now for the first time. main problems are dealt with as best as possible.

The laser selectively vaporizes disturbing tissue parts in the sulcus and at the same time stops tissue bleeding through its haemostatic effect. The tissue damage (= trauma) is minimal. Due to this minimally traumatizing effect, the subsequent wound healing is much less painful than with the electrosurgical removal that was common in the past. In the course of healing, the tendency of the gum line to shrink is also significantly lower. This promotes the aesthetic appearance of the integrated crown in the tooth neck area, since the crown edge area remains below the gum line.

For you as a patient this means:

  • Perfect impression and thus perfect marginal fit of the crown
  • Significantly better wound healing than when working with the electrotome. The patient has significantly fewer postoperative complaints with the laser-assisted sulcus expansion.
  • Healing without scarring: This minimizes gum shrinkage and optimizes the aesthetics in the crown edge area.
  • Repetitions of the impression due to insufficient precision are reduced to a minimum. This significantly reduces your physical stress during the treatment, as experience has shown that new impressions are extremely time-consuming and may have to be anaesthetised.
  • Reduction of perioprosthetic problems: Perfect crown edge fit, tooth contour and emergence angle of the crown can be reconstructed by the dental technician due to the high impression precision.
  • Increase in the long-term stability of the tooth stump, as the perfect crown edge fit counteracts the formation of renewed caries on the crown edge.

 

Yes: There is much more that a laser can do!
If you want to learn more, please get in contact with your dentist.