Application of laser radiation in periodontal diseases and gingival hyperplasia

In the last few years, researchers have used Co and Nd: YAG lasers for procedures such as gingivectomy and gingivoplasty, scaling and subgingival curettage, removing dentine sensitivity, and stopping the path of periodontic diseases. Recently, the bactericidal effects of the laser have been used as an alternative to antibiotics in the treatment of prion diseases that are related to plaque. Research has shown that the Nd: YAG laser can remove mineral deposits under the gums, and with laser curettage, the depth of periodontal pockets can be removed. reduced by 2-4mm. In this method, envelopes with a depth of 3-7mm are good candidates. The 320-micron fiber is directed to the depth of the remaining envelope up to 2rm and the area is lasered in a crosswise manner while the fiber slowly exits the envelope. The fiber moves parallel to the contour of the root towards the patient’s epithelial cover and evaporates it. This method is painless for the patient who is not anesthetized. Research has shown that laser energy can significantly reduce subgingival microbial flora.

ND: YA laser in periodontal disease

Since ND: YA laser rays are well absorbed by dark objects, melanin-producing bacteria such as Bacteroides gingivalis and Bacteroides intermedius are selectively targeted, and thus laser curettage, by leaving a sterile environment, can reduce the number of patients who need to restore tissue health. They are candidates for periodontal surgery to reduce.

Excimer lasers in periodontal diseases

Excimer lasers are effective in periodontal diseases. Removal of microbial plaque and pathological cementum from root surfaces by photo ablation can replace manual tools and sonic devices. With the use of a laser, you can clean the narrow grooves and furrow areas that cannot be reached by conventional methods.

ArF laser in periodontal diseases

Investigations have shown that ArF laser radiation with a wavelength of 193 nm can ablate cementum and microbial plaque attached to it. The surface of cement treated by laser has little roughness, it is free of pathogens and there is no news of the grooves that occur during instrumentation.

Investigations carried out on extracted teeth have shown that scaling of the root surface can be done by the phenomenon of photoablation.

Lasers in dentine sensitivity caused by periodontal diseases

Among the problems for which a definitive solution has not been found so far, and if it continues, it can disrupt the peace of mind of the patient and the dentist in Windsor, are dentin sensitivity and tooth sensitivity following periodontal flaps and gingivitis. In recent years, there have been reports of laser as a successful treatment in such cases. Currently, some periodontists use laser radiation on the bare surfaces of the roots after surgery and claim that this procedure removes the sensitivity of the teeth to a great extent. For this purpose, low-power radiation with pulse frequency can be used for three minutes in one or two sessions. It is also stated that the pain-relieving effects of laser can be used before scaling. Using a low-power dental laser before scaling makes this treatment process easier.

CO2 laser in periodontal diseases

In 1987, Rossmann and Gotlieb concluded that Co2 laser radiation can be used to remove the squamous epithelium without damaging the underlying connective tissue. In recent years, lasers have been used a lot for gingivectomy and gingivoplasty. In gingivectomy, the pockets are determined and marked, and an external bolus incision is made to remove the pocket, then the involved tooth is subjected to root planing and a surgical cover is placed. In cases where we are dealing with medicinal hyperplasias, the tissue is usually irregularly bulky. Papillae are often bulbous and move freely, all of which make gingivectomy difficult, at the same time, gingivectomy does not always provide favorable results. Most of the time, the bleeding continues heavily and this is due to the nature of the wound. Patients often have problems and discomfort after the operation, and there is also a chance of infection like any other procedure.

Advantages of using laser rays in periodontal diseases

The advantages attributed to laser gingivectomy are generally the same as those mentioned in the topic of surgery, and among them, reduction of pain and discomfort after surgery, less bleeding, better vision, and reduction of the chance of infection are of particular importance. For laser gingivectomy, determining the amount of gum to be removed requires careful clinical judgment so as not to damage the connective tissue and underlying hard structures.

Problems of using laser rays in periodontal diseases

One of the problems that exist when working with lasers is the lack of contact sensation, which can cause unwanted side effects if not paid attention to. For example, the accidental contact of radiation to the bone can cause damage.

Research on the use of laser rays in the treatment of gingival hyperplasia

However, careful attention to the wear parameters and the surgical process can prevent these problems to a large extent. Pecar, Pick, and Hylton presented cases of gingival hyperplasia that were treated by CO2 laser rays in their articles.

In this review, a new technique to remove gingival hyperplasia caused by phenytoin with | The use of a laser.Co is provided. 12 patients between the ages of 11 and 51 were observed, whose gingival hyperplasia severity varied from partial to complete coverage of the teeth. The characteristics of the laser in this study were: output power of 20 watts, continuous or pulsed in time up to a second, pulse method was used around the dental structures to achieve better control and reduce the damage to the structures adjacent to the teeth. A wax spatula was placed between the tooth and the hyperplastic gum to protect the teeth during radiation. There was no damage to the teeth and alveolar bone in any of the patients. Irradiation was continued in all areas until the natural shape of the gum was obtained. The tissue pieces in the interdental areas were removed by the cortex to prevent possible damage to the enamel and root surface in those areas. Adjacent areas such as lips (with Vaseline), pharynx and larynx (with moist sponge), and face and neck skin (with other moist coverings) were also protected because the CO2 laser beam was absorbed by water and to prevent the risks of accidental radiation to the adjacent areas, precautions were taken. Safety is essential. Except for one patient with hemophilia, bleeding in other patients is less than 5 cc. Was. Because of the laser’s ability to coagulate blood vessels with a diameter of less than 0.5 mm, even bleeding was very low in a hemophiliac. The brief pain after the operation was also relieved with normal painkillers and the epithelial layer was re-formed in 10-11 days.