Lasers in Perio

Question 1

Describe the Physics of Lasers

Answer 1

1) Electron is pumped to a higher energy level
2) Pumping level is unstable, so the electron quickly jumps down to a slightly lower energy level
3) Electron relaxes to a lower energy state and releases a photon
4) Light an electron in an excited energy level produce two photons of the same wavelength and phase
5) Mirror reflects the photons
Lasers are basically just very focused light

Question 2

What are the differences between Incandescent and Laser Light

Answer 2

Incandescent:

• Many wavelengths
• Multidirectional
• Incoherent

Laser

• Monochromatic
• Directional
• Coherent

Question 3

What are the common components of all Lasers

Answer 3

Active Medium
Excitation Mechanism
High Reflectance mirror
Partially Transmissive Mirror

Question 4

What are the different active mediums of lasers?

Answer 4

Solid Crystals
Liquid dyes
Semiconductors

Question 5

What are the different methods of excitation mechanisms and what do they do?

Answer 5

They pump energy into the active medium by one ore more of the different methods:

• Optical
• Electrical
• Chemical

Question 6

Partially Transmissive Mirror

Answer 6

A mirror which reflects less than 100% of the laser light and transmits the remainder
This remainder is what we know as the laser beam

Question 7

T/F - Different laser wavelengths will affect different tissues selectively

Answer 7

True

Question 8

What are the advantages of laser therapy?

Answer 8

Aemostasis
Accuracy
Rapid healing
Reduced inflammation
Lack of scar tissue
Low discomfort - topical anesthetic will suffice

Question 9

What are the disadvantages of laser therapy?

Answer 9

Technial difficulties
Lack of precision of cutting depth
Tissue is not available for histopathy
Hazardous
Dispersal of viable virus particles in the plume - can't be done on HIV positive pts
Large machine

Question 10

What soft tissue surgeries can be done using lasers?

Answer 10

Gingivectomy
Implant uncovery
Frenectomy
Uncovering soft tissue impactions

Question 11

What are the advantages of a Laser Frenectomy

Answer 11

Painless
Anesthetic free
Bloodless

Question 12

What are the disadvantages of a Laser Frenectomy

Answer 12

Recurrence

Unpredictable healing

Question 13

What are the indications for laser tooth exposure?

Answer 13

Soft tissue impactions

Hard tissue palatal impactions

Question 14

What are the contraindications for a laser tooth exposure

Answer 14

Hard tissue impactions with variable bone thickness

Esthetics

Question 15

What is LANAP

Answer 15

Laser modification of the excisional new attachment procedure
Remove sulcular epithelium, modify the root surface, and new attachment will occur

Question 16

What does the first pass of the laser during LANAP do?

Answer 16

Bactericidal
Affect calculus
Denatures pathologic proteins
Removes sulcular lining
Leaves CT intact
Releases tissue tension

Question 17

What do you do between the first and second passes of the laser during LANAP?

Answer 17

3 rounds of scaling with the Piezo scaler

Question 18

What does the second pass of the laser during LANAP do?

Answer 18

Finishes debriding the pocket
Kills gram- bacteria
Initiates stable fibrin clot
Creates a closed system
Releases stem cells from the pdl and bone

Question 19

T/F - Lasers kill gram- and black pigmented bacteria because of selective wavelength

Answer 19

False - black pigmented bacteria aren’t black, just produce black colonies on a blood agar plate

Question 20

T/F - Lasers selectively destroy pathologic tissue

Answer 20

False - pathologic tissue has no distinct phenotype

Question 21

T/F - Lasers get stem cells from bone and pdl during LANAP

Answer 21

False - bone and pdl are not accessed during the procedure

Question 22

T/F - LANAP cannot be counted as osseous surgery

Answer 22

True