LASER 

  1. Light amplified stimulated emission of radiation 
  2. RESTING state to emission state. Now it give energy to go back to resting state from emission = CIRCLE FLOWCHART
  3. CO2 and Nd:Yag = mc used
  4. TYPES = soft tissue and hard tissue
Soft tissue Hard tissue
gingiva, tongue, mucosaAffinity towards water and pigmentPrimary effect is heating Diode, Nd:YAG and C02 lasersDiode = 655 – 980Nd;yag = 1064CO2 = 10600enamel and boneAffinity for water and hydroxyapatite’Erbium lasers with wavelength 2780, 2790, 2740
  1. Donot requires LA because laser seals terminal nerve endings 
  2. Less bleeding = because coagulation of blood vessels 
  3. Healing by laser is by secondary intention = scar formation as we dont close wound and no sutures needed 
  4. Hence, For large wounds = less aesthetic 
  5. Healing is slower but less postoperative pain 
  6. Less requirements of medications 
  7. AREAS WHERE LASERS CAN BE USED
    1. Incisions and Excisions = 
      1. disimpaction of third molar = mucopain or benzocaine is applied on mucosa with laser. 
      2. Application of mucoseal = for biopsy 
    2. Dipigemenations 
      1. Gingiva = brownish and blackish 
      2. Melanin = epithelium or superficial layer of connective tissue
      3. Painless procedure 
      4. Heals within 2 weeks and gingiva appears pink 
      5. No bleeding
    3. Pain management
      1. Tmj pain 
      2. Trigeminal neuralgia 
    4. PHOTODYNAMIC THERAPY 
      1. Special use = deep pockets not accessible with instruments and bacteria is still remaining 
      2. Methylene blue or toluidine blue = taken by bacterial cells but not by healthy cells
      3. Laser will generate free radicals = will kill the bacterial cells deep in the pocket 
    5. Low level laser therapy = Triple L 
      1. Fixed wavelength but you can increase the energy source 
      2. More power= more energy = cut faster in thicker tissue. If thin tissue = it leads to charring of tissue 
      3. LLL is used for healing of 
        1. recurrent aphthous stomatitis
        2. herpetic ulcers
        3. Mucositis
        4. lichen planus
        5. pemphigus lesions 
      4. LLL stimulate fibroblasts and collagen fibers = healing potential is increased 

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