Laser Application in Constractive Dentistry

MUST University
Faculty Of Dentistry
Operative dentistry division
Lasers application
in conservative
dentistry
OPDENT DIVISION INTERNS - FALL
2023/2024
Contents :
●INTRODUCTION
●Types OF LASERS
●PROPERTIES OF LASER
●EFFECTS OF LASERS
●LASER- TISSUE INTERACTION
●TYPES OF LASERS APPLICATIONS IN
CONSERVATIVE DENTISTRY
●ADVANTAGES AND DISADVANTAGES
●CONCLUSION
Laser
Is An Acronym For ‘Light Amplification
By The Stimulated Emission Of Radiation
Dentistry has advanced a lot.
Among various advances, one
which have good scope of
improvement is the use of in
dentistry.
Recent advances in laser
introduction technology will bring revolution
in dentistry.
Laser is an acronym for light
amplification by stimulated
mission of radiation.
Types of Lasers
2 categories of lasers are used in
medicine & dentistry
(1) HARD LESARS (2) SOFT LASERS OR

- Longer wavelength LOMISTESTASETS
- Cuts the tissue by ablation - Low energy wavelengths
- Used for tooth & bone - Cuts tissues by coagulation,
applications. vaporisation & carbonisation.
- Monochromacity (The Same
Color)
- Coherence (All Of The Light
Waves Are In Phase Both
Spatially And Temporally)
- Collimation (All Rays Are
Parallel To Each Other And Do
Not Diverge Significantly Even
Over Long Distances)
Properties of lasers
EFFECTS OF
LASERS
PHOTO- • Ablation of tissues by
THERMAL vaporization
PHOTO- • Bio-stimulation by
CHEMICAL stimulated ATP production.
PHOTO- • Dehydration, burning &

ACOUSTIC carbonization.
Laser-tissue interactions
Light can interact with tissue in four key ways :
transmission, reflection, scattering, and absorption.
Transmission refers to the passage of light through a
tissue without having any effect on that tissue or on
the properties of the light. Reflection refers to the
repelling of light off the surface of the tissue without
an entry into the tissue. Approximately 4% to 7% of
light is reflected off skin. The amount of light
reflected increases with increasing angle of incidence
with the least.
TYPES OF LASERS
APPLICATIONS IN
CONSERVATIVE
DENTISTRY
CLINICAL APPLICATIONS :
- Diagnostic / Curing Lasers

- Cavity Preparation
- Restoration Removal
- Etching
- Photopolymerisation
- CAD/CAM Technology
- Caries Prevention
- Laser Desensitization
DIAGNOSTIC/CURING
LASERS
The DIAGNOdent is used for caries and calculus detection by
emitting a nonionizing laser beamThis diagnostic
technology, in which the photons of this laser wavelength
are absorbed into any existing bacteria in these areas of the
patient’s tooth, is called laser-induced fluorescence. The
instrument’s digital display indicates the number of bacteria
in this area of the tooth and it may correspond to the extent
of decay of the existence of the calculus
CAVITY PREPARATION
The Er: YAG laser was tested for preparing dental hard
tissues for the first time in 1988. It was successfully
used to prepare holes in the enamel and dentine with low
‘fluences’ . Even without water-cooling, the prepared cavities
showed no cracks and low or no charring, while the increase
in the mean temperature of the pulp cavity was about
4.3degrees C). In 1989, it was demonstrated that the Er: YAG
laser produced cavities in the enamel and dentine without
any major adverse side effects .
RESTORATION REMOVAL
The Er: YAG laser is capable of removing
cement, composite resin and the glass ionomer. The
efficiency of the ablation is comparable to that of enamel
and dentine. Lasers should not be used to ablate the
amalgam restorations, however, because of the potential
release of mercury vapour. The Er: YAG laser is incapable of
removing gold crowns, cast restorations and ceramic
materials because of the low absorption of these materials
and the reflection of the laser light. These limitations
highlight the need for adequate operator training in the use
of lasers .
Etching
Laser etching has been evaluated as an alternative to the
acid etching of enamel and dentine. The Er: YAG laser
produces micro-explosions during hard tissue ablation
that result in microscopic and macroscopic irregularities.
These micro-irregularities make the enamel surface
micro retentive and they may offer a mechanism of
adhesion without acid-etching. However, it has been
shown that adhesion to the dental hard tissues after Er:
YAG laser etching is inferior to that which is obtained
after conventional acid etching.
Photopolymerisation
The argon laser is one promising source, as the
wavelength of the light which is emitted by this
laser is optimal for the initiation of polymerization of the
composite resins. The argon laser at 488nm (blue) is
used. The argon wavelength activates camphor
Quinone , a photo initiator that causes polymerization of
the resin composites. The argon laser radiation is also
able to alter the surface chemistry of both the enamel
and the
root surface dentine, which reduces the probability of
the recurrent caries.
CAD/CAM Technology
This technology eliminates the need for conventional
intra-oral impression materials. Instead, laser scanners
take an optical impression of a prepared tooth and the
opposing dentition and they take a bite registration to
produce an interactive three-dimensional image. This
three-dimensional laser- based imaging technology
enables the dentist to take an optical impression and to
create a computer file with this data. A virtual model is
created, based on the transmitted data and a precise
master model is made. The physical model is sent to the
laboratory where a final restoration is made
CARIES PREVENTION
Controversial results can be found in the literature regarding
the demineralization and the acid-resistance of enamel and
dentin after the Er:YAG laser treatment. An increased
temperature is necessary to achieve the photothermal effect
and the enhancement of the enamel acid resistance.
According to Fried et al (1989), the energy density which is
necessary to reach the enamel acid resistance by using the
Er,Cr:YSGG laser is approximately 8-13 J/cm2. This is
expected to decrease the enamel solubility by promoting the
thermal decomposition of the more soluble carbonate
hydroxyapatite into the less soluble hydroxyapatite, with
corresponding changes in its crystallinity .
LASER DESENSITIZATION
Dentinal hypersensitivity is one of the most common
complaints in the dental clinical practice. Various treatment
modalities such as the application of concentrated fluoride to
seal the exposed dentinal tubules have been tested
to treat the condition. However, the success rate can be
greatly improved by the ongoing evaluation of lasers in hard
tissue applications. A comparison of the desensitising effects
of an Er:YAG laser with those of a conventional desensitising
system on cervically exposed hypersensitive dentine showed
that the desensitizing of hypersensitive dentine with an Er:
YAG laser was effective, and that the maintenance of a
positive result was more prolonged than with other agents
ADVANTAGES
AND
DISADVANTAGES
advantages
• They are often less painful and so this
reduces the need for administering
anaesthesia.
• Some people are afraid of the
conventional drill. They are more at ease
with lasers.
• When soft tissue has to be handled, lasers
lessen the swelling and the bleeding.
• During cavity treatment, lasers help in
retaining more of the tooth that is intact.
• When a tooth has already got a filling, it is not possible to use a laser there.
• The treatments for which lasers can be used are very limited. They can’t be
manoeuvered around cavities which are present between two teeth or around bigger
cavities that need to be
fitted with a crown. Nor can they be used where there are old fillings, or to remove silver
fillings, or damaged crowns. Laser technology is also not helpful in preparing the teeth
for
receiving bridges.
• Even where a laser is utilized, the conventional drill is still required for the bite
adjustment, and for shaping and polishing the filling.
• Though laser can reduce the need for the administration of anaesthesia,
it cannot eliminate it totally.
• Above all, the treatment does not come cheap.
• Lasers produce an intense, highly directional beam that is absorbed
to some degree if it is directed, reflected, or focused
on an object. The eye is a critical target for laser injuries.
disadvantages
By :
hanan nasr 78632
shahd el-kholy
Under supervision :
dr. Mary sabry
Thank you

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MUST University

(1) HARD LESARS (2) SOFT LASERS OR

PHOTO- • Dehydration, burning &

- Diagnostic / Curing Lasers

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