Laser in dentistry: An innovative tool in modern dental practice

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Abstract

The term LASER is an acronym for ‘Light Amplification by the Stimulated Emission of Radiation’. As its first application in dentistry by Miaman, in 1960, the laser has seen various hard and soft tissue applications. In the last two decades, there has been an explosion of research studies in laser application. In hard tissue application, the laser is used for caries prevention, bleaching, restorative removal and curing, cavity preparation, dentinal hypersensitivity, growth modulation and for diagnostic purposes, whereas soft tissue application includes wound healing, removal of hyperplastic tissue to uncovering of impacted or partially erupted tooth, photodynamic therapy for malignancies, photostimulation of herpetic lesion. Use of the laser proved to be an effective tool to increase efficiency, specificity, ease, and cost and comfort of the dental treatment.

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Incidence of white spot formation after bonding and banding.

Leonard Gorelick, Arnold Geiger, A.John Gwinnett (1982)

White spot or areas of decalcification are carious lesions of varying extent. The incidence and severity of white spots after a full term of orthodontic treatment were studied among patients in the separate private practices of two of the authors. To establish a base line of comparison, the presence of white spots in a random sample of untreated persons was observed. The incidence of white spots among patients treated by a multibonded technique was recorded at the time of debonding. In addition, white spots were sought in the before- and after-treatment Kodachrome slides of persons whose maxillary incisors had been handed. It was found that individual teeth, banded or bonded, exhibited significantly more white spot formation than was found in the control group. For the teeth studied, there was no difference in white spot formation in those that were banded or bonded. The labiogingival area of the maxillary lateral incisors had the highest incidence of white spots. When studied by segments, the highest incidence occurred among the maxillary incisors; the lowest was in the maxillary posterior segment. No white spots were found on the lingual surfaces of mandibular canines and incisors after prolonged use of a canine-to-canine bonded retainer. These findings suggest a relationship between resistance to white spot formation and the rate of salivary flow. Despite the lack of any preventive fluoride program among the study groups, 50% of the patients demonstrated resistance to white spot formation. The obvious degree of latrogenic damage during orthodontic treatment suggests the need for preventive programs using fluoride. Further clinical research is needed.

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Low-level laser therapy for wound healing: mechanism and efficacy.

K Arndt, George J Dover, David Wrone … (2005)

Given the recent interest in light-emitting diode (LED) photomodulation and minimally invasive nonablative laser therapies, it is timely to investigate reports that low-level laser therapy (LLLT) may have utility in wound healing. To critically evaluate reported in vitro models and in vivo animal and human studies and to assess the qualitative and quantitative sufficiency of evidence for the efficacy of LLLT in promoting wound healing. Literature review, 1965 to 2003. In examining the effects of LLLT on cell cultures in vitro, some articles report an increase in cell proliferation and collagen production using specific and somewhat arbitrary laser settings with the helium neon (HeNe) and gallium arsenide lasers, but none of the available studies address the mechanism, whether photothermal, photochemical, or photomechanical, whereby LLLT may be exerting its effect. Some studies, especially those using HeNe lasers, report improvements in surgical wound healing in a rodent model; however, these results have not been duplicated in animals such as pigs, which have skin that more closely resembles that of humans. In humans, beneficial effects on superficial wound healing found in small case series have not been replicated in larger studies. To better understand the utility of LLLT in cutaneous wound healing, good clinical studies that correlate cellular effects and biologic processes are needed. Future studies should be well-controlled investigations with rational selection of lasers and treatment parameters. In the absence of such studies, the literature does not appear to support widespread use of LLLT in wound healing at this time. Although applications of high-energy (10-100 W) lasers are well established with significant supportive literature and widespread use, conflicting studies in the literature have limited low-level laser therapy (LLLT) use in the United States to investigational use only. Yet LLLT is used clinically in many other areas, including Canada, Europe, and Asia, for the treatment of various neurologic, chiropractic, dental, and dermatologic disorders. To understand this discrepancy, it is useful to review the studies on LLLT that have, to date, precluded Food and Drug Administration approval of many such technologies in the United States. The fundamental question is whether there is sufficient evidence to support the use of LLLT.

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Differences in bonding to acid-etched or Er:YAG-laser-treated enamel and dentin surfaces.

Irma Rivera, Alfredo Santana, Vandeclécio da Silva … (2000)

Er:YAG (erbium-doped yttrium aluminium garnet) lasers have been effective in the removal of dental tissues. It has been suggested that they are also useful for preparing dental surfaces for adhesion, but results to date have been controversial. This study compared the tensile strength of bracket-tooth bonds obtained after preparation of the surface for adhesion (dentin or enamel) by conventional acid-etching or by Er:YAG laser etching and investigated microstructure of resin-tooth interfaces using the 2 procedures. Eighty healthy human premolars were used. Brackets were cemented to acid-etched enamel, laser-etched enamel, acid-etched dentin, or laser-etched dentin (20 teeth per group). Dentin was previously exposed using a high-speed handpiece. Acid-etching was with 37% orthophosphoric acid (15 seconds for enamel, 5 seconds for dentin). Laser etching was with Er:YAG laser (four 200 mJ pulses per second for enamel; four 160 mJ pulses per second for dentin). Brackets were bonded with autocuring resin paste, having first applied a primer (dentin only) and then light-cured bonding resin. Tensile strength was determined with a universal testing machine. Data were analyzed with 2-way ANOVA and subsequent t test with Bonferroni correction. Fracture patterns were compared by the Wilcoxon test with Bonferroni correction. For SEM studies of the resin-tooth interface, a total of 12 premolars were used (3 for each tissue per treatment combination). Mean tensile bond strength for acid-etched enamel (14.05 +/- 5.03 MPa) was significantly higher (P<.05) than for laser-etched enamel (8.45 +/- 3.07 MPa), and significantly higher (P<.05) for acid-etched dentin (4.70 +/- 2.50 MPa) than laser-etched dentin (2.48 +/- 1.94 MPa). Bond failure after laser etching was due to microcohesive fracture of tooth tissue. SEM studies of both resin-enamel and resin-dentin interfaces indicated extensive subsurface fissuring after laser etching. Adhesion to dental hard tissues after Er:YAG laser etching is inferior to that obtained after conventional acid etching. Enamel and dentin surfaces prepared by Er:YAG laser etching show extensive subsurface fissuring that is unfavorable to adhesion.

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Author and article information

Journal

Journal ID (nlm-ta): Natl J Maxillofac Surg

Journal ID (iso-abbrev): Natl J Maxillofac Surg

Journal ID (publisher-id): NJMS

Title: National Journal of Maxillofacial Surgery

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 0975-5950

ISSN (Electronic): 2229-3418

Publication date (Print): Jul-Dec 2012

Volume: 3

Issue: 2

Pages: 124-132

Affiliations

[1]Department of Orthodontics and Dental Anatomy, Aligarh Muslim University, Aligarh, India

Author notes

Address for correspondence: Dr. Sanjeev Kumar Verma, Department of Orthodontics and Dental Anatomy, Dr. Z. A. Dental College, Aligarh Muslim University, Aligarh - 212 001, India. E-mail: dr.vermask@ 123456rediffmail.com

Article

Publisher ID: NJMS-3-124

DOI: 10.4103/0975-5950.111342

PMC ID: 3700144

PubMed ID: 23833485

SO-VID: 41dd446b-b5c3-4bf0-87f7-26dbbf1ad17a

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Laser in dentistry: An innovative tool in modern dental practice

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25th European Students' Conference

Most cited references 100

Incidence of white spot formation after bonding and banding.

Low-level laser therapy for wound healing: mechanism and efficacy.

Differences in bonding to acid-etched or Er:YAG-laser-treated enamel and dentin surfaces.

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