Laser Surgery

Question 1

Diode lasers limit tissue removal to the ___

Answer 1

Soft tissue.

Question 2

What are some advantages of the diode laser?

Answer 2

Ease of use

Ability to maintain hemostatic environment

Minimal discomfort to patient with topical anesthetic

Soft tissue specificity

No requirement for sutures

Question 3

What are some clinical uses with diode lasers?

Answer 3

Slowly erupting teeth and gingival overgrowth no longer delay treatment tcompletion

Unaesthetic gingival contours and margins, along with gingival hyperplasia, can now be managed in coordination with incisal recontouring to produce the most esthetic treatment outcome

Question 4

Name 6 procedures that an orthodontist should consider using with a laser?

Answer 4

Gingival recontouring

Removal of hypertrophic tissue

Apthous ulcer management

Facilitation of tooth eruption

Operculum removal

Frenectomies

Question 5

Gingival recontouring is indicated in patients with ____, where inflamed gingiva, pseudopockets and difficulty brushing and flossing are present

Answer 5

Poor hygiene

Question 6

Why would an orthodontist recountor gingiva prior to bracket placement?

Answer 6

Excessive gingival tissue may prevent the orthodontist from placing brackets in their ideal position. The removal of this excess gingival tissue permits the orthodontist to bond a bracket to the tooth in the desired position in a timely manner

Question 7

With a diode laser, the orthodontist has the ability to lase the apthous ulcer, which result in what two things?

Answer 7

Relieves patient of pain

Speeds up the healing of the lesion

Question 8

When a diode laser is used for apthous ulcer management, the diode laser is activated for ___ seconds at a very low wattage or with a ___ tip, and kept at a distance of __-__mm away from the lesion.

Answer 8

30

Non-activated

1-2

Question 9

Apthous ulcers generally take up to __ days to heal, but with laser treatment, the ulcers may heal within ___ after laser treatment.

Answer 9

1 day

Question 10

True or false… many months of treatment can be saved in cases with labially placed high cuspids that are taking a long time to erupt through excessively tough gingival tissue.

Answer 10

True.

Unerupted teeth should be palpated, visualized, and localized by radiographic images to determine if laser uncovering is warranted

Question 11

After operculum removal of second molars, how long should the orthodontist wait to place a band or bond the tooth?

Answer 11

They should place it immediately

Question 12

With the diode laser, the light energy is absorbed by ____, which allows exceptional control of ___ at the surgical site.

Answer 12

Melanin pigment found within the cells

Bleeding

Question 13

True or false… with the diode laser, the laser tip actually is intended to gently touch the surgical site.

Answer 13

True, which allows the operator to have tactile feedback during ablation

Question 14

With the diode laser, the wavelength is roughly ___, which is readily absorbed by ___ and ___, and poorly absorbed by tooth structure and metal, making diode lasers ideal for soft tissue surgeries

Answer 14

810-980nm

Melanin
Hemoglobin

Question 15

The ideal maxillary central incisor should be approximately ___ width compared to height. It is important to assess if a tooth disproportion is due to ___, ___, or ___. Depending on the cause of disproportion, what are the three treatments?

Answer 15

66%-80%

Short clinical crown
Gingival overgrowth
Delayed passive eruption

Waiting for eruption
Gingival recountoring
Dental restoration

Question 16

What is the gingival shape of mandibular incisors and maxillary laterals?

Answer 16

Symmetrical half-oval/circle; therefore their gingival zenith should be located within their longitudinal axis

Question 17

What is the gingival shape of maxillary centrals and canines?

Answer 17

Elliptical with a gingival zenith that is distal to the longitudinal axis

Question 18

Most orthodontists will use the ___ to determine bracket placement height because…

Answer 18

Incisal edge

They find that they may be unable to place a bracket in an ideal location because of gingival overgrowth or delayed passive eruption. In these cases, it would be very helpful for the orthodontist to be able to remove any excess gingival tissue in order to place the brackets in an ideal position rather than waiting for eruption or referring the patient to a periodontist to have the teeth uncovered.

Question 19

____ can sometimes cause redundant tissue to appear, especially in conjunction with poor oral hygiene. Removal of this tissue allows the patient to keep these areas under hygienic control and allows for more effective ___

Answer 19

Closing large extraction spaces

Space closure

Question 20

When performing a gingivectomy, apply topical anesthetics and use a probe to mark height guides, leaving __ of sulcus when finished to preserve ___

Answer 20

1mm

The biologic width

Question 21

After ideal contours are achieved in laser gingival recountoring, what should you do?

Answer 21

Clean the area with a micro brush or cotton roll with 3% hydrogen peroxide

Question 22

What is the technique for performing a frenectomy with a laser?

Answer 22

First place topical anesthetic

Hold the upper lip and lightly pul the lip forward until the frenum is taut

With the laser set at 1.0 watts, lase the frenum horizontally approximately 3mm from the frenum base, and use light, continuous strokes until the lip is released from tension, leaving a V-shaped wound approximately 1cm wide

Continue to lase any deeper fibrous attachments to prevent reattahment

Then, Lansing parallel to the gingiva, smooth the remaining tissue at the base of the frenum

Clean the surgical site with 3% hydrogen peroxide on a microbrush