Some aspects of the use of a diode laser in outpatient dental practice. Expensive but effective. Features of the use of laser technology as a scalpel

The method of using the CO 2 laser used in dentistry dates back to 1968, which was first used in soft tissue surgery. Although it was only in the mid-eighties, the creation of laser dental treatment associated with the healing of tissues with a solid foundation began. Currently, this method of treatment has gained popularity in various applications operational way.

Types of laser

These therapies have electromagnetic and low-energy radiation. The principles of technology for influencing an object are applied in dosed radiation, depending on its type.

• Argon - has the same beam length (488 nm) similar to a polymerization lamp. The application of this laser has superior hemostasis unlike conventional lamps.
• Diode - having the value of the beam range (792-130 nm) of study. It has the property of healing in pigmented cells and has a hemostatic effect, promotes a stimulating quality. Radiation passes under the polymer quartz, light - input by radiation, which improves the availability of work in an inconvenient place.
• Nd:YAG Laser - neodymium laser in dentistry with a beam size (1064 nm) in water is worse, but pigmented tissue is perfectly absorbed.
• Non-Ne laser helium-neon wavelength (610-630 Nm) has the effect of photo stimulation, which is applied in physiotherapy. This is a kind of laser that the patient can use on their own due to the fact that it is available for sale.
• CO2 laser - carbon dioxide beam size (10600 nm) has a significant absorption, absorbs less in hydroxyapatite. It is applied on bone cells, beware in cases of overheating of the bone and enamel. They give in to others systemic principles applications.
• Erbium laser - the magnitude of this beam exposure (2940-2780 nm) with excellent absorption by hydroxyapatite. Considered an innovation in laser systemic therapy, it is applied on hard tooth cells. Has property of use to all diseases of a jaw.

The use of laser in dentistry

IN initial development caries favorable therapy is the use of a laser. It removes the lesions of the tooth without touching the healthy enamel. A targeted method is considered to be the filling of wedge-shaped defects in hard places of the tooth. To the excellent outcome of the treatment and the insensitivity of the operation, it has reason to achieve in the use of periodontal - a logical operation.

In cases of bad breath and bleeding gums, treatment is facilitated by laser treatment and photodynamic procedure with laser and algae. Also, a high-quality cure of periodontal tissue cells and hardening of enamel. These drugs are used for any stitches when removing fibroids. The biopsy procedure is performed sterile, on soft tissues desired operation carried out without blood. Successfully treated oral mucosa:

• Lichen planus (red).
• Therapy of aphthous ulcers.
• Hyperkeratosis.
• Leukoplakia.

Also used in the application of a denture, the laser creates an accurate micro-lock for the crown, which helps not to grind the teeth in the neighborhood. Lasers allow you to find a place for implants and rapid healing. Laser treatment is considered effective methodology, towards traditional ways therapy.

Indications

Treatment includes the following indications:

1. Carisogenic process - contributing to the defeat of tooth enamel and dentin, which are removed without adverse effects on healthy tissues.
2. When bleeding from the gums.
3. With the treatment of periodontitis and pulpitis associated with the neutralization of root canals.
4. Getting rid of bad smell from the mouth, with the destruction of bacteria.
5. When strengthening the gums, periodontal disease is irradiated to build immunity.
6. When whitening enamel.
7. In the case of a neoplasm on the cells of dental tissue.
8. In the treatment of cysts for the effect of cleaning the bases of the channels of an unfavorable focus.
9. For complete removal of sensations from hard tissues and build-up of implants.

Contraindications

1. Violation nervous system.
2. With a strong sensitivity of tooth enamel.
3. Changes in the endocrine system.
4. Pathological lung diseases caused by infectious diseases and respiratory failure.
5. Diseases associated with the cardiovascular system.
6. Weak blood clotting.
7. neoplasm having malignant appearance in the oral cavity and in the body.
8. The recovery period as a result of the intervention of surgeons.

Diode laser in dentistry

Regardless of the saturation of the lasers used, the method of application is considered to be popular. diode laser(Ka Vo GENTLE ray 980). Security - this type has appreciated in recognition of European dentists, it is usually used in the field of:

• surgery,
• periodontics,
• endodontics.

Although they are more in demand in surgical intervention. It has an anti-inflammatory property with a bacteriostatic effect.

Diode laser in dentistry 7.0 W

The diode beam laser has applications in significant procedures that were previously difficult for surgeons to perform with suturing, bleeding and similar negative consequences. Depending on the fact that laser beams have waves of coherent monochromatic action, the beam length is (800-900 nm).

Also, the laser has positive influence on soft tissue cells, where a small area of ​​necrosis contours the cells. This is an opportunity to apply in smile contouring, prepare teeth and take an impression in one visit. This method is used in such traditional areas as:

1. Surgery – frenectomy, implant release, flap surgery, gingivectomy, tissue removal. With infection of the mucosa, herpes, aphthae.
2. Endodontics - canal sterilization, pulpotomy.
3. Prosthetics - an increase in the periodontal sulcus without retraction threads.
4. Periodontology - getting rid of the infected tissue area, decontamination of pockets, gum formation, removal of marginal epithelium.

Therapy of diseases

Therapy for caries given use it is used in laser treatment in dentistry, passes without any drilling, using a beam with a small beam force produces an effect on the affected area. This action suppresses the increase in the autogenous environment and excludes microcracks and chips. Such therapy has several stages:

• diagnosis, study of sensitivity and method of treatment;
• with the need to use painkillers;
• cleaning plaque from the carious cavity;
• knowledge of the length of channels;
• preparation of a carious area with a laser with a slow decrease in beam power. High power is applied to the enamel, low power is applied to the pulp;
• closure of dentine channels;
• cavity formed by coating with adhesive mortar;
• after which a filling is placed;
• recent restoration of part of the crown.

Granulomas - laser exposure is considered conservative method without removing the affected area. The removal method is the same as in the case of caries in stages, they have the same properties of preparation and conduct surgical intervention. Relapse is extremely rare if you follow the rules:

1. It is often necessary to rinse the gum cavity with antiseptic solutions.
2. Do not drink food or water for 4 hours after the procedure.

Periodontitis - this treatment is applied at the first stage of development. The laser beam cuts the deposit on the neck of the tooth and disinfects the gum pocket and accumulated pathogenic viruses preventing relapse. The operation is completely painless, the appearance of the effect after 2 hours.

The price of treatment types, laser

Dental laser treatment for children

Children, according to dentists, are a special contingent in the treatment of teeth associated with the fact that the child experiences fear at the sight of dental instruments. With the new method of laser therapy, the procedure is painless. IN given time therapy is gaining popularity among children and adults.

Laser dentistry for children helps to solve a number of the following problems:

1. Disappearance of fear.
2. Reducing the duration of the procedure.
3. Saving the result with a longer time with painless manifestations in milk teeth.

At a young age, treatment has applications such as:

1. Teeth whitening.
2. Getting rid of pulpitis and caries.
3. Treatment of periodontal canals.
4. Getting rid of retention cysts.
5. A therapy conducive to the treatment of aphthous symptoms.
6. Correction of the frenulum of the tongue or lips.

Methods

There are four types of laser therapy:

• Contact - in this case, the emitter is pressed against the surface of the problem area, which allows you to penetrate as deeply as possible into the tissue cells. It is used for photophoresis and has the properties of irradiation of the alveolar sockets and undertakings associated with pathology.
• Non-contact - a gap is left (1-8 cm), this method is not used more than this gap. It causes scattering and reflection of the beam. This technique is used for external irradiation of an infected focus, reducing edema and anesthesia.
• Stable - used with a minimum field (less than 1 cm) is used when the pathology corresponds to the diameter of the beam wave.
• Labile - with a significant and painful defeat hearth. It has a method of applying point irradiation with movement throughout the area of ​​origin.

According to written reviews from people, it seems that painless laser dentistry is the most effective way.

There are several types of dental laser: diode, argon, neodymium, erbium, carbon dioxide. The difference between the devices lies in the power, wavelength, point or constant flow of pulses. Each type of laser beam is used for specific procedures. It is used with equal success for both therapeutic treatment and surgical intervention.

Therapeutic laser dental treatment

IN therapeutic dentistry laser therapy apply in the following cases:

• Removal of inflammation. In the treatment of gingivitis, stomatitis or herpes, electromagnetic waves are directed to the source of infection and destroy pathogenic bacteria.
• Sterilization. A diode laser is used to process periodontal pockets and a tooth canal before installing a filling.
• Caries treatment. Affected tissues are effectively removed using an erbium apparatus.
• Sealing. Light polymer fillings are cured under the influence of an argon laser.
• Teeth whitening. The laser beam activates the hydrogen peroxide-based whitening gel without heating the tooth tissue, i.e. without the risk of overheating or burning the pulp. Thanks to the local impulse action The patient does not experience any discomfort during the procedure.

The use of laser in dental surgery

During surgery laser machine used for painless and bloodless dissection of tissues - during the procedure, the beam instantly seals the vessels. The incision is smaller and thinner than with a scalpel, so no sutures are required during the operation, and there are no scars or scars after the wound heals. IN surgical dentistry The laser is used to solve the following problems:

• Removal of neoplasms. The fluid inside the papilloma, cyst or fibroma evaporates under the influence of electromagnetic waves.
• Carrying out dental implantation. Thanks to the laser, the installation of the implant is delicate. Thanks to laser implantation, the contour of soft tissues is better preserved.
• Plastic frenulum of the lips and tongue. The fold is excised along or across, depending on the clinical case.
• Gingival correction. Excess tissue is trimmed before prosthetics, fillings or orthopedic treatment. The laser is also used for gingival plasty after implantation or in the presence of other indications.

Indications and contraindications

With the help of electromagnetic waves, it is possible to achieve positive results therapy even in the most difficult situations, and the absence of the need for anesthesia allows the use of the device for people with allergies to painkillers. The use of a laser in dentistry is one of the safest and most effective ways treatment that is shown to almost everyone. However, there is still a small list of contraindications.

• Disorders of the nervous system
• Diabetes last stage
• kidney failure
• Oncological diseases
• Pregnancy (1 - 6 months)
• open tuberculosis
• Enhanced level hormones thyroid gland
• Allergy to sun rays

Attention!

Insufficient specialist qualifications and non-compliance with safety rules significantly increase the risk to the patient's health during laser treatment. Contact only trusted clinics where the eyes are protected from radiation special glasses and provides bright room lighting during the procedure.

Advantages of the method

Today laser dental treatment in Moscow widely used in dentistry. Despite the high cost, it enjoys well-deserved popularity among patients who appreciate the advantages of laser treatment.

1. Delicacy. The absence of unpleasant noise and vibration makes it easier to transfer the operation.
2. Short duration of procedures. Depending on the nature of the manipulations, the process takes from two to twenty minutes.
3. No need for anesthesia. The device does not touch the tissues of the teeth and gums, but acts at a distance, so there is no pain from mechanical impact.
4. Accuracy. The rays are directed only to the affected tissues, healthy areas are not damaged.
5. Reduced trauma. The laser seals the vessels and edges of the wound, so even complex operations do not require stitches and bandages to stop bleeding.
6. Fast recovery. After treatment, the incision heals within hours and is not accompanied by swelling or pain.

Laser treatment of cysts and granulomas

Granuloma usually occurs as a result of poor-quality treatment of caries and pulpitis. The disease is asymptomatic at the first stage, and later it is accompanied by swelling of the gums, pain and darkening of the enamel. When treating a tooth granuloma with a laser, the affected area is drilled, an electromagnetic beam is directed into the hole, destroying the contents of the cyst and sealing the vessels. The doctor then places the filling.

Without timely treatment the granuloma develops into a cyst that can provoke even more serious complications. sparing laser tooth cyst treatment considered a good method, as it allows you to save the tooth. The procedure takes place without pain, stress and suturing. In addition, the treatment of a tooth cyst with a laser without removal eliminates the risk re-development inflammation. The comfort of the patient and the absence of complications justify the additional costs, because the price of treating a tooth cyst with a laser is higher than when using other methods.

Painless laser dental treatment for children

Laser therapy is suitable for both adults and children over the age of 7 years. The technique is used to process temporary and permanent teeth. It is possible to treat a tooth root cyst with a laser in a child and use electromagnetic waves to remove carious lesions on initial stage diseases. In general, the procedure for laser dental treatment in children is often performed in the presence of an allergy to anesthetics and is no different from the treatment for adult patients.

How much does laser dentistry cost?

Usually, prices for laser dental treatment in Moscow depends on the type dental disease and the severity of the pathology. We must be prepared for the fact that in any case it will be much higher than when using classical methods. Treatment of caries initial stage diseases will cost from 800 rubles. The price of treating a tooth cyst with a laser without removal will be approximately from 1,500 to 2,000 rubles. Behind laser whitening you will have to pay from 8,000 to 11,000 rubles.

Obviously, the high cost of therapy is the only drawback of this technology. However, numerous rave reviews about laser dental treatment confirm the fact that patients are willing to pay for comfort, efficiency and peace of mind, absence annoying sounds drills and the frightening prospect of using anesthetics.

Introduction

Lasers and laser systems in dentistry: description, classification and characteristics

The effect of lasers on tissue

Interaction of laser with hard tooth tissue

The mechanism and features of laser preparation of hard tissues of the tooth

Bibliography

Introduction.

In the 1960s, the first lasers for medical purposes were introduced. Since then, science and technology have made a huge leap in development, allowing the use of lasers for huge amount procedures and techniques. In the 1990s, lasers made a breakthrough in dentistry, they began to be used to work with soft and hard tissues. Currently, lasers are used in dentistry for the prevention of dental diseases, in periodontics, restorative dentistry, endodontics, surgery and implantology. The use of lasers is an expedient method for daily assistance to dentists in many types of work. For some procedures, such as frenulotomies, lasers have proven to be so clinically effective that they have become the gold standard among physicians. They allow you to work in a dry field, which provides excellent visibility and reduces operation time. With lasers, scarring is very low and virtually no sutures are required. They also ensure the absolute sterility of the working field, which in most cases is an absolute necessity, for example when sterilizing a root canal.

Lasers and laser systems in dentistry: description, classification and characteristics

Laser devices produce different wavelengths that interact with certain molecular components in animal tissues. Each of these waves affects certain tissue components - melanin, hemosiderin, hemoglobin, water and other molecules. In medicine, lasers are used to irradiate tissues with a simple healing effect, for sterilization, for coagulation and resection (surgical lasers), as well as for high-speed preparation of teeth. Laser light is absorbed by a certain structural element that is part of the biological tissue. The absorbing substance is called a chromophore. They can be various pigments (melanin), blood, water, etc. Each type of laser is designed for a specific chromophore, its energy is calibrated based on the absorbing properties of the chromophore, as well as taking into account the field of application.

Laser interactions with calcium-containing tissues have been studied using different wavelengths. Depending on such laser parameters as pulse duration, discharge wavelength, penetration depth, the following types of lasers are distinguished: pulsed dye, He-Ne, ruby, alexandrite, diode, neodymium (Nd: YAG), goldmium (No: YAG), erbium (Er: YAG), carbon dioxide (CO2).

In medicine, lasers are used for tissue irradiation with a preventive or therapeutic effect, sterilization, for coagulation and cutting of soft tissues (surgical lasers), as well as for high-speed preparation of hard dental tissues. Lasers produce superficial changes in enamel such as cratering, melting and recrystallization.

In dentistry, the most commonly used CO2 laser for soft tissue and erbium laser for hard tissue preparation. There are devices that combine several types of lasers (for example, for influencing soft and hard tissues), as well as isolated devices for performing specific highly specialized tasks (lasers for teeth whitening).

There are several modes of laser operation: pulsed, continuous and combined. In accordance with the mode of operation, their power (energy) is selected.

Table 1. Laser types, penetration depth and chromophores

* depth of light penetration h in micrometers (millimeters), at which 90% of the power of the laser light incident on the biological tissue is absorbed.

In dentistry, the most commonly used CO2 laser is for soft tissues, and the erbium laser for hard tissue preparation.

Mode of operation of lasers and their energetics.

Erbium:

Pulse, energy/imp. ~300…1000 mJ/imp.

CO2 laser:

Pulse (up to 50 mJ/mm2)

Continuous (1-10W)

Combined

A typical laser device consists of a base unit, a light guide and a laser handpiece, which the doctor directly works in the patient's mouth. For ease of use, different types of handpieces are available: straight, angled, for power calibration, etc. All of them are equipped with a water-air cooling system for constant temperature control and removal of prepared hard tissues.

When working with laser technology, special eye protection equipment must be used. The doctor and the patient during the preparation must be in special glasses. It should be noted that the risk of loss of vision from laser radiation is several orders of magnitude less than from a standard dental photopolymerizer. The laser beam does not scatter and has a very small illumination area (0.5mm² versus 0.8cm² for a standard light guide).

The laser operates in mode, sending about ten beams every second on average. The laser beam, falling on hard tissues, evaporates the thinnest layer of about 0.003 mm. The preparation is fast enough, but the doctor can control the process by immediately interrupting it with one movement. After preparation with a laser, an ideal cavity is obtained: the edges of the walls are rounded, while with the preparation of a turbine, the walls are perpendicular to the surface of the tooth, and after that you have to carry out additional finishing.

In addition, the cavity after laser preparation remains sterile, as after long-term antiseptic treatment, since laser light kills pathogenic flora.

Laser preparation is a non-contact procedure, the components of the laser unit do not directly contact tissues - the preparation takes place remotely. In addition to the undoubted practical advantages, the use of a laser helps to significantly reduce the cost of treatment. Working with a laser, you can completely eliminate borons, antiseptic solutions, and acid for enamel etching from everyday expenses. The time spent by the doctor for treatment is reduced by more than 40%.

Laser technologies have long left the pages of science fiction novels and the walls of research laboratories, having gained a strong position in various areas human activities, including medicine. Dentistry, as one of the most advanced branches of medical science, has included a laser in its arsenal, arming doctors with a powerful tool to combat various pathologies. The use of lasers in dentistry opens up new possibilities, allowing the dentist to offer the patient wide range minimally invasive and actually painless procedures meeting the highest clinical standards of dental care.

Introduction

The word laser is an acronym for Light Amplification by Stimulated Emission of Radiation. The foundations of the theory of lasers were laid by Einstein in 1917, but only 50 years later these principles were sufficiently understood, and the technology could be implemented in practice. The first laser was designed in 1960 by Maiman and had nothing to do with medicine. A ruby ​​was used as a working medium, generating a red beam of intense light. This was followed in 1961 by another crystal laser using neodymium yttrium aluminum garnet (Nd:YAG). And only four years later, surgeons who worked with a scalpel began to use it in their activities. In 1964. physicists at Bell Laboratories have made a laser with carbon dioxide(CO 2) as working medium. In the same year, another gas laser was invented, which later proved to be valuable for dentistry - argon. In the same year, Goldman proposed the use of a laser in the field of dentistry, in particular, for the treatment of caries. Pulsed lasers were later used for safe work in the oral cavity. With the accumulation of practical knowledge, the anesthetic effect of this device was discovered. In 1968, the CO 2 laser was first used for soft tissue surgery.

Along with the increase in the number of laser wavelengths, indications for use in general and maxillofacial surgery. The mid-1980s saw a resurgence of interest in the use of lasers in dentistry to treat hard tissues such as enamel. In 1997, the Food and Drug Administration (USA) finally approved for use on hard tissues well-known and now popular laser - erbium (Er:YAG).

Benefits of laser treatment

Despite the fact that lasers have been used in dentistry since the 60s of the last century, a certain prejudice of doctors has not yet been completely overcome. You can often hear from them: “Why do I need a laser? I will make a boron faster, better and without the slightest problem. Extra headache!" Of course, any work in the oral cavity can be performed on a modern dental unit. However, the application laser technology can be characterized as better and more comfortable, expanding the range of possibilities, allowing the introduction of fundamentally new procedures. Let's dwell on each point in more detail.

Treatment quality: using a laser, you can clearly organize the treatment process, predicting the results and terms - this is due technical specifications and how the laser works. The interaction between the laser beam and the target tissue produces a well-defined result. In this case, pulses equal in energy, depending on the duration, can produce different actions on the target tissue. As a result, by changing the time from one pulse to another, it is possible to obtain a variety of effects using the same energy level: pure ablation, ablation and coagulation, or only coagulation without destruction of soft tissues. Thus, by correctly selecting the parameters of duration, magnitude and repetition rate of pulses, it is possible to select an individual mode of operation for each type of tissue and type of pathology. This allows almost 100% of the laser pulse energy to be used to perform useful work avoiding burns to surrounding tissues. Laser radiation kills pathological microflora, and the absence direct contact instrument with tissue during surgical intervention eliminates the possibility of infection of the operated organs (HIV infection, hepatitis B, etc.). When using a laser, tissues are processed only in the infected area, i.e. their surface is more physiological. As a result of treatment, we get large area contact, improved marginal fit and significantly increased adhesion filling material, i.e. better filling.

Treatment comfort: the first and, perhaps, the most important thing for the patient is that the action of light energy is so short-lived that the effect on nerve endings minimum. During treatment, the patient experiences less pain, and in some cases it is possible to refuse anesthesia at all. Thus, the treatment can be performed without vibration and pain. The second and important advantage is that the sound pressure generated by the laser is 20 times less than that of high-speed turbines. Therefore, the patient does not hear any frightening sounds, which is psychologically very important, especially for children - the laser "removes" from dental office the sound of a working drill. It should also be noted that the recovery phase is shorter and easier compared to traditional interventions. Fourth, it is also important that the laser saves time! Reducing the time spent on the treatment of one patient is up to 40%.

Capabilities expansion: the laser provides more opportunities for the treatment of caries, for conducting preventive "laser programs" in pediatric and adult dentistry. Appear huge opportunities in bone and soft tissue surgery, where treatment is performed using a surgical maniple ( laser scalpel), in implantology, prosthetics, in the treatment of mucous membranes, removal of soft tissue formations, etc. A method has also been developed to detect caries using a laser, in which the laser measures the fluorescence of bacterial waste products in carious lesions located under the surface of the tooth. Studies have shown excellent diagnostic sensitivity this method compared to traditional.

Diode laser in dentistry

Despite the diversity lasers used in dentistry, The most popular for a number of reasons today is the diode laser. The history of the use of diode lasers in dentistry is already quite long. Dentists in Europe, who have long adopted them, can no longer imagine their work without these devices. They are distinguished by a wide range of indications and a relatively low price. Diode lasers are very compact and easy to use in clinical setting. The level of safety of diode laser machines is very high, so hygienists can use them in periodontics without the risk of damaging tooth structures. Diode laser devices are reliable due to the use of electronic and optical components with a small amount moving elements. Laser radiation with a wavelength of 980 nm has a pronounced anti-inflammatory effect, bacteriostatic and bactericidal action stimulates regeneration processes. Traditional areas Applications for diode lasers are surgery, periodontology, endodontics, with the most popular being surgical procedures. Diode lasers make it possible to perform a number of procedures that were previously performed by doctors with reluctance - due to heavy bleeding, the need for suturing and other consequences surgical interventions. This is because diode lasers emit coherent monochromatic light with a wavelength between 800 and 980 nm. This radiation is absorbed in a dark environment in the same way as in hemoglobin, which means that these lasers are effective at cutting tissues in which there are many vessels. Another advantage of soft tissue laser application is the very small area of ​​necrosis after tissue contouring, so the tissue edges remain exactly where the doctor has positioned them. This is a very significant aspect from an aesthetic point of view. With the help of a laser, you can contour your smile, prepare your teeth and take an impression in one visit. When using a scalpel or electrosurgical units, several weeks must elapse between tissue contouring and preparation for the incision to heal and the tissue to shrink before the final impression is taken.

Incision edge position prediction is one of the main reasons why diode lasers are used in aesthetic dentistry for soft tissue recontouring. It is very popular to use a semiconductor laser for frenectomy, which is usually underdiagnosed because many doctors do not like to perform this treatment according to standard techniques. In a conventional frenectomy, sutures must be applied after the frenulum has been cut, which can be uncomfortable in this area. In the case of laser frenectomy, there is no bleeding, no stitches are needed, healing is more comfortable. The absence of the need for suturing makes this procedure one of the fastest and easiest in the practice of a dentist. By the way, according to surveys conducted in Germany, dentists offering laser diagnostics and treatment to patients are more visited and successful...

Types of lasers used in medicine and dentistry

The use of lasers in dentistry is based on the principle of selective action on various tissues. Laser light is absorbed by a certain structural element included in the biological tissue. The absorbing substance is called a chromophore. They can be various pigments (melanin), blood, water, etc. Each type of laser is designed for a specific chromophore, its energy is calibrated based on the absorbing properties of the chromophore, as well as taking into account the field of application. In medicine, lasers are used for tissue irradiation with a preventive or therapeutic effect, sterilization, for coagulation and cutting of soft tissues (surgical lasers), as well as for high-speed preparation of hard dental tissues. There are devices that combine several types of lasers (for example, for influencing soft and hard tissues), as well as isolated devices for performing specific highly specialized tasks (lasers for teeth whitening). In medicine (including dentistry), the following types of lasers have found application:

Argon laser(wavelength 488 nm and 514 nm): radiation is well absorbed by the pigment in tissues such as melanin and hemoglobin. The wavelength of 488 nm is the same as in curing lamps. At the same time, the speed and degree of polymerization of light-cured materials by a laser is much higher. When using an argon laser in surgery, excellent hemostasis is achieved.

Nd:AG laser(neodymium, wavelength 1064 nm): radiation is well absorbed in pigmented tissue and worse in water. In the past it was most common in dentistry. Can work in impulse and continuous modes. Delivery of radiation is carried out through a flexible light guide.

He-Ne-laser(helium-neon, wavelength 610-630 nm): its radiation penetrates well into tissues and has a photostimulating effect, as a result of which it is used in physiotherapy. These lasers are the only ones that are commercially available and can be used by patients themselves.

CO 2 laser(carbon dioxide, wavelength 10600 nm) has good absorption in water and average in hydroxyapatite. Its use on hard tissues is potentially dangerous due to the possible overheating of enamel and bone. Such a laser has good surgical properties, but there is a problem of delivering radiation to tissues. At present, CO 2 systems are gradually giving way to other lasers in surgery.

Er:YAG laser(erbium, wavelength 2940 and 2780 nm): its radiation is well absorbed by water and hydroxyapatite. The most promising laser in dentistry, can be used to work on hard tooth tissues. Delivery of radiation is carried out through a flexible light guide.

diode laser(semiconductor, wavelength 7921030 nm): radiation is well absorbed in pigmented tissue, has a good hemostatic effect, has anti-inflammatory and repair-stimulating effects. The radiation is delivered through a flexible quartz-polymer light guide, which simplifies the surgeon's work in hard-to-reach areas. The laser device has compact dimensions and is easy to use and maintain. On this moment this is the most affordable laser device in terms of price / functionality.

Diode laser KaVo GENTLEray 980

There are many manufacturers offering laser equipment on the dental market. KaVo Dental Russland presents, along with the well-known universal laser KaVo KEY Laser 3, called the "clinic on wheels", the diode laser KaVo GENTLEray 980. This model is presented in two modifications - Classic and Premium. The KaVo GENTLEray 980 uses a wavelength of 980 nm, and the laser can operate in both continuous and pulsed modes. Its rated power is 6-7 W (at the peak up to 13 W). As an option, it is possible to use the “micropulsing light” mode at a maximum frequency of 20,000 Hz. The areas of application of this laser are numerous and, perhaps, traditional for diode systems:

Surgery: frenectomy, implant release, gingivectomy, removal of granulation tissue, flap surgery. Mucosal infections: aphthae, herpes, etc.

Endodontics: pulpotomy, canal sterilization.

Prosthetics: expansion of the gingival sulcus without retraction threads.

Periodontology: decontamination of pockets, removal of marginal epithelium, removal of infected tissue, gingiva formation. Consider a clinical example of the use of KaVo GENTLEray 980 in practice - in surgery.

Clinical case

In this example, a 43-year-old patient had a fibrolipoma on the lower lip that was successfully treated surgically with a diode laser. He turned to the Department of Surgical Dentistry with complaints of pain and swelling of the mucosa. lower lip in the buccal region for 8 months. Despite the fact that the risk of a traditional lipoma in the head and neck is quite high, the appearance of a fibrolipoma in the area oral cavity, and especially on the lip - rare case. To determine the causes of neoplasms, it was necessary to conduct a histological examination. As a result clinical research it was found that the neoplasm was well separated from the surrounding tissues and covered with an intact mucous membrane (Fig. 1 - fibrolipoma before treatment). For the purpose of making a diagnosis given education was removed surgically local anesthesia when using a diode laser with a 300 nm light guide and a power of 2.5 watts. The suturing of the edges was not necessary, since no bleeding was noticed either during the surgical procedure or after it (Fig. 2 - fibrolipoma 10 days after the intervention). Histological studies the tissue taken for analysis showed the presence of mature non-vacuolated fat cells surrounded by dense collagen fibers (Fig. 3 - histology). Morphological and structural changes in tissues due to the thermal effect of the diode laser were not observed. The postoperative course of treatment was calm, with a visible decrease surgical scar 10 days later and without signs of recurrence within the next 10 months.

Bottom line: in the described case, the surgical operation to remove the fibrolipoma of the lower lip passed without hemorrhages, with minimal tissue damage, which allows for subsequent conservative treatment. Also noted fast recovery patient. The possibility of avoiding noticeable sutures after excision is also undoubtedly positive factor in terms of aesthetics. Conclusion: surgery benign neoplasms oral mucosa with a diode laser is an alternative to traditional surgery. The effectiveness of this method was confirmed by the results of the removal of lip fibrolipoma.