Lazer Blazer 2 Flashcards
1
Q
When a laser hits the tissue you get what 2 things?
Immediate coagulation when we use the Water Absorption lasers, specifically…
A
Coagulation and Ablation
CO2
2
Q
Lasers seal what 3 things?
A
BV’s
Lymph
nerve endings
3
Q
What 4 things can lasers do inside the Vermillion Border?
A
Ablate
Incise
Excise
Coagulate
4
Q
Transmission into tissue is dependent on wavelength and pulse duration
A
True
5
Q
Near IR wavelengths:
Why difficult to determine the amount of ablation?
A
808 - 1064
deep penetration
6
Q
Mid IR wavelengths:
good at:
bad at:
A
2780 - 2940
precision, bactericidal
coagulation efficiency
7
Q
IR (far) CO2 laser wavelengths:
3 things good at:
A
9.2 and 10,600 nm
coagulation, ablation, bactericidal
8
Q
Water absorption:
Melanin:
Hemogobin:
Oxyhemoglobin:
***4 main chromophores
A
500 - 10,600
500 - 1100
500 - 1100
500 - 1100
*all in nm
9
Q
Absent in epithelium:
Absent in sub-epithelium:
A
Hb
melanin
10
Q
Diode cut:
CO2 cut:
A
deep charring (hot tip)
smooth (cuts w/ pure photons)
11
Q
3 Melanin types:
What requires least energy?
A
2% very light, 13% moderate, 30% dark
dark
12
Q
Near IR, how much is absorbed in epithelium?
Mid and Long IR, how much absorbed in epithelium?
A
5% (so most transmits into CT, leading to unpredictable side effects)
100%
13
Q
T/F
Less healing time with lasers
A
False
14
Q
Reduced swelling, pain, pain scarring, bacteria, and more precise cut
A
True
15
Q
Improved healing, less traumatic, less scarring, often left unsutured
A
True
16
Q
Healing with Blade (time):
Healing with Laser (time):
A
7-10 days
2-3 weeks
17
Q
Why does it take longer to heal with Laser?
A
BV/lymphatic sealing
18
Q
Denaturation (photocoagulation) starts at what temp?
A
60-100 C
19
Q
BV diameter in the gingiva:
A
21-40 microns
20
Q
What will happen if too much saliva with CO2 laser?
A
saliva will absorb
21
Q
CO2 laser application mode:
focused mode for:
excellent for uncovering…
A
non-contact
cutting
implants
22
Q
CO2 de-focus mode used for apthous ulcer, hemostasis, hyperplasia, white lesions
A
True
23
Q
CO2 laser absorption is too high for what 2 substances:
A
H20-enamel
Bone
24
Q
Nd-YAG and Diode laser is poorly absorbed by what 2 things?
A
HbO2 and Melanin
25
Nd-YAG are _____ lasers, with the exception of apthous ulcers and herpetic lesions and Venous Lake Syndrome
Non-contact
26
Erbium Laser absorbed by?
contact?
coagulation?
used for?
water
non-contact
low characteristics (bleeding)
hard tissue
27
Power per unit area?
Power density
28
Lasers have decreased post op swelling and pain
True
29
Development of Ovoid Pontic form and Gingivectomy:
What laser to design gingival architechture?
808 nm Diode Laser
30
Tissue growing over 2nd Molar...
Use what pre-op? why?
Operculectomy
Erbium laser, poor coagulation
31
What laser to Uncover an Unerupted tooth?
Diode
*among others
32
Fibroma removal with:
CO2 laser
*traction, non-contact
33
Irritation fibroma can be removed with:
Diode laser
*char free if work w/in correct parameters
34
Compared to CO2, Diode laser is a ________ cut
chunky, hot tipped
35
Bluish lesion on lip:
Hemangioma
*check pulse
36
Hemangioma can be Treated with what Lasers of choice:
Diode 810-1064
CO2 9.3 or 10.6
37
If you Tx Hemangioma you need ______, which is why you use Diode or CO2
Hemostasis
*max photocoagulation
38
A Pulsing Hemangioma (found inside cheek), what should you do?
Don't touch
*unless want ER visit for Pt
39
Super Pulsed CO2 laser releases burst of high peak powers with a short duration of ____ milisecs
*this has great what?
10-20
thermal relaxation time
40
Diode lasers, good for ____ and ____ lesions
Bactericidal
Don't use with...
superficial, interstitial
implants
*absorbs Ti
41
2 Lasers highly absorbed by water
CO2
Er-YAG
42
Control of _____ thermal damage is paramount when using lasers
Lateral
43
Incision/Excision: Thin, deep cuts with small spot size measuring:
Outline intended ______
Use _____ mode, low fluence, minimum _______
0.1-0.5 mm
incision
Gated, depth of penetration
44
Ablation/Vaporization: use what mode?
De-focused
45
When neoplasms are involved, must have a Diagnosis prior to Ablating
True
46
Uncover implant with what laser?
10.6 CO2
47
Erbium laser will get what?
Bleeding
*bad coagulation
48
Gingival recontouring can be done with...
Diode laser
49
CO2 laser can do a Frenectomy
CO2 laser can remove Epulis
True
True
50
Exostosis w/ Klinefelter's
Separate muscle fibers
Sub-periosteal sutures
Great result at 4 weeks
51
Ablate, defocus slightly
CO2 laser to expose implant is Ablation
True
True
52
Operculectomy with a _______ laser
Erbium
*CO2 for complications
53
Lip tie can affect breastfeeding
2 passes, vitamin___ gel and Curaprox brush
E
54
Lingual Frenectomy with a CO2 laser or the ____ laser
Get rid of thin ______, otherwise will recur
Diode
muscle attachments
55
Ortho Gingivectomy with _____ laser
CO2
*or diode
56
If there is a lot of gingiva to remove, use electrosurgery followed by lasers
True
57
Mucocele should be Tx aggressively to seal the lumen of a leaker
True
58
What must be done when using a Diode Laser?
Activate the Tip
59
Fiberotomy with Frenectomy will move incisors into position
True
60
Only time use Diode Laser in Non-Contact mode:
Apthous Ulcer
pulsing - just seal off nerve endings
61
Fibroma on tip of tongue, easy to remove with Diode laser
retraction w/ hemostat
True
62
Topical Anesthetic used for Laser:
Oraqix
*prilocaine + lidocaine
63
Trilogy oral debridement better than CHX b/c fibroblasts
True
64
Wounds created by a laser heal more slowly and are via _____ intention healing
Secondary
65
Phases of tissue repair: 7-14 days
What is the biomechanical "bandaid" that occurs during this phase?
Re-epithelialization what day?
Re-epi completed by what day?
Necrotic
thin layer of denatured collagen
w/in 14 days period
21st day
66
Slower healing w/ lasers b/c epithelium has to _____
migrate further
67
Lasers heal faster
False
68
Lasers don't leave scars
False
69
Wound healed after Scalpel surgery are stronger
False
70
4 goals of laser Perio Therapy:
photothermal energy affects:
lowers red/orange complex bacteria
biostimulate
enhance mesenchymal activity
71
Red Complex most closely related to Perio and are what 4 bugs?
P gingivalis
T denticola
B fosythius
E nodatum
72
Mesophilic bacteria temp range:
*most human pathogens are mesophiles
human body temp =
25 - 45 C
37 C
73
Blanching, white gray
Shrinkage
Smoke plume
60-80 C
90-100
100-150
74
Genetic component to Perio:
IL-1 expression
75
Chromophore is targeted in laser perio Tx
True
76
Inflammatory tissue has higher levels of what 2 things
water
pigment
77
Adverse outcomes to perio Tx
temp, dehydration, pain, damage,
78
Why isn't Diode absorbed efficiently by pigments?
*perio
low coefficient of absorption
79
Inside the pocket only use what mode?
non-contact
80
Er-YAG is good for Perio
we don't know yet
81
Nd-YAG is a _____ laser fiber optic tip
Contact mode what forms at tip?
This increases lateral thermal conduction, so don't use where:
pulsed
carbonized tissue
bone
82
Nd YAG free running pulse layer used in what perio procedure?
Utilizes what?
Laser assisted New Attachment Procedure
Regeneration (instead of resection)
83
laser assisted new attachment procedure used Nd YAG and stimulates what?
stem cells
*new root surface of Cementum and new CT
84
Diode laser with ____ micron tip
* used for perio
* calibrate each site
300
85
Perio begins internally and involves weak immune system
True
86
Biostimulation from low level lasers
pain relief
wound healing
87
Calibration:
start at top of pocket, lase to
stop ___ mm short of pocket depth
measure pocket
calibrated depth
1mm
88
Topicals, leave max ___ minutes
5
*otherwise dehydrate if leave longer
89
Epithelium grows ____/2days
Fibroblasts/osteoblasts ___mm/10days
1mm
1mm
90
___% reduction in bleeding
___% control group
96. 9%
| 66. 7%
91
The total amount of energy of the laser is = to that absorbed by tissues
True
92
Lasers will cure Perio by itself
False
93
CT regeneration begins on day
maturing process from ____ weeks to 1 year
5
12
94
pocket depths greater than 3mm, control
junctional epithelium
95
De-epithelialization won't occur with what 2 lasers
De-epithelialization will occur with what 2 lasers
Diode, Nd-YAG
CO2, Erbiums
96
Perio affects 130 million/yr, 60% population
True
97
Dental hygiene, what laser
CO2
*de-epithelialization
98
CO2
Diode
(de-epithelialization?)
yes
no
99
Why is 10 day critical
bacteria re-colonize
epithelial regeneration back into pocket
100
There are no contraindications to CO2 laser
True
*except - disconnect Oxygen
101
CO2 10.6
laser assisted Tx
perio tip parallel to surface
ceramic tip
102
Laser application of CO2 10.6 (Perio) tip should be ____ mm short of pocket
This does what?
1-2 mm short
maximizes thermal air flow
*which minimizes damage
103
CO2 laser removed epithelium w/out damaging underlying CT (in Perio)
True
104
What tip use on CO2 in Perio?
Ceramic
*metal too hot
105
2 places SuperPulsed CO2 lasers have total/complete absorption:
hydroxyapatite
water
106
Ultraspeed (superpulsed) will not damage any hard tissue if settings right in Perio
True
107
CO2 is 100% absorbed in water
True
108
Use water along with topical for sensitive pts
True
109
CO2 10.6 can damage deeper tissues
False
110
Non focused is llike a flashlight and can be effective at only 1-2 mm
True
*CO2 laser
111
CO2 laser used in the Defocused Superpulsed mode has ___ watts of power and ___% duty cycle
average power is ___ watts
2 watts
20%
.4 watts
112
16 seconds per surface CO2 laser (perio)
True
113
Older generation of CO2 lasers had too high energy output and did damage
True
114
SRP isn't always successful b/c of restricted Access
True
*so photons can't hurt
115
Limited success of SRP b/c diffcult to get to subgingival bacteria
SRP depth is related to success
True
True
116
SRP is being improved with lasers
True
117
SRP changes greatest when?
wound healing continues for how long?
1-3 months
3-9 months
118
CO2 laser has what great advantages?
absorbed by water in pocket
inflamed tissue has more water
