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Tim's Cards > Lazer Blazer 2 > Flashcards

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

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2
Q

Lasers seal what 3 things?

A

BV’s

Lymph

nerve endings

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3
Q

What 4 things can lasers do inside the Vermillion Border?

A

Ablate

Incise

Excise

Coagulate

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4
Q

Transmission into tissue is dependent on wavelength and pulse duration

A

True

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5
Q

Near IR wavelengths:

Why difficult to determine the amount of ablation?

A

808 - 1064

deep penetration

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6
Q

Mid IR wavelengths:

good at:

bad at:

A

2780 - 2940

precision, bactericidal

coagulation efficiency

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7
Q

IR (far) CO2 laser wavelengths:

3 things good at:

A

9.2 and 10,600 nm

coagulation, ablation, bactericidal

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8
Q

Water absorption:

Melanin:

Hemogobin:

Oxyhemoglobin:

***4 main chromophores

A

500 - 10,600

500 - 1100

500 - 1100

500 - 1100

*all in nm

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9
Q

Absent in epithelium:

Absent in sub-epithelium:

A

Hb

melanin

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10
Q

Diode cut:

CO2 cut:

A

deep charring (hot tip)

smooth (cuts w/ pure photons)

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11
Q

3 Melanin types:

What requires least energy?

A

2% very light, 13% moderate, 30% dark

dark

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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%

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13
Q

T/F

Less healing time with lasers

A

False

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14
Q

Reduced swelling, pain, pain scarring, bacteria, and more precise cut

A

True

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15
Q

Improved healing, less traumatic, less scarring, often left unsutured

A

True

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16
Q

Healing with Blade (time):

Healing with Laser (time):

A

7-10 days

2-3 weeks

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17
Q

Why does it take longer to heal with Laser?

A

BV/lymphatic sealing

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18
Q

Denaturation (photocoagulation) starts at what temp?

A

60-100 C

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19
Q

BV diameter in the gingiva:

A

21-40 microns

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20
Q

What will happen if too much saliva with CO2 laser?

A

saliva will absorb

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21
Q

CO2 laser application mode:

focused mode for:

excellent for uncovering…

A

non-contact

cutting

implants

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22
Q

CO2 de-focus mode used for apthous ulcer, hemostasis, hyperplasia, white lesions

A

True

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23
Q

CO2 laser absorption is too high for what 2 substances:

A

H20-enamel

Bone

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24
Q

Nd-YAG and Diode laser is poorly absorbed by what 2 things?

A

HbO2 and Melanin

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25
Q

Nd-YAG are _____ lasers, with the exception of apthous ulcers and herpetic lesions and Venous Lake Syndrome

A

Non-contact

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26
Q

Erbium Laser absorbed by?

contact?

coagulation?

used for?

A

water

non-contact

low characteristics (bleeding)

hard tissue

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27
Q

Power per unit area?

A

Power density

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28
Q

Lasers have decreased post op swelling and pain

A

True

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29
Q

Development of Ovoid Pontic form and Gingivectomy:

What laser to design gingival architechture?

A

808 nm Diode Laser

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30
Q

Tissue growing over 2nd Molar…

Use what pre-op? why?

A

Operculectomy

Erbium laser, poor coagulation

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31
Q

What laser to Uncover an Unerupted tooth?

A

Diode

*among others

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32
Q

Fibroma removal with:

A

CO2 laser

*traction, non-contact

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33
Q

Irritation fibroma can be removed with:

A

Diode laser

*char free if work w/in correct parameters

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34
Q

Compared to CO2, Diode laser is a ________ cut

A

chunky, hot tipped

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35
Q

Bluish lesion on lip:

A

Hemangioma

*check pulse

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36
Q

Hemangioma can be Treated with what Lasers of choice:

A

Diode 810-1064

CO2 9.3 or 10.6

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37
Q

If you Tx Hemangioma you need ______, which is why you use Diode or CO2

A

Hemostasis

*max photocoagulation

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38
Q

A Pulsing Hemangioma (found inside cheek), what should you do?

A

Don’t touch

*unless want ER visit for Pt

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39
Q

Super Pulsed CO2 laser releases burst of high peak powers with a short duration of ____ milisecs

*this has great what?

A

10-20

thermal relaxation time

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40
Q

Diode lasers, good for ____ and ____ lesions

Bactericidal

Don’t use with…

A

superficial, interstitial

implants

*absorbs Ti

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41
Q

2 Lasers highly absorbed by water

A

CO2

Er-YAG

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42
Q

Control of _____ thermal damage is paramount when using lasers

A

Lateral

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43
Q

Incision/Excision: Thin, deep cuts with small spot size measuring:

Outline intended ______

Use _____ mode, low fluence, minimum _______

A

0.1-0.5 mm

incision

Gated, depth of penetration

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44
Q

Ablation/Vaporization: use what mode?

A

De-focused

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45
Q

When neoplasms are involved, must have a Diagnosis prior to Ablating

A

True

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46
Q

Uncover implant with what laser?

A

10.6 CO2

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47
Q

Erbium laser will get what?

A

Bleeding

*bad coagulation

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48
Q

Gingival recontouring can be done with…

A

Diode laser

49
Q

CO2 laser can do a Frenectomy

CO2 laser can remove Epulis

50
Q

Exostosis w/ Klinefelter’s

A

Separate muscle fibers

Sub-periosteal sutures

Great result at 4 weeks

51
Q

Ablate, defocus slightly

CO2 laser to expose implant is Ablation

52
Q

Operculectomy with a _______ laser

A

Erbium

*CO2 for complications

53
Q

Lip tie can affect breastfeeding

2 passes, vitamin___ gel and Curaprox brush

54
Q

Lingual Frenectomy with a CO2 laser or the ____ laser

Get rid of thin ______, otherwise will recur

A

Diode

muscle attachments

55
Q

Ortho Gingivectomy with _____ laser

A

CO2

*or diode

56
Q

If there is a lot of gingiva to remove, use electrosurgery followed by lasers

57
Q

Mucocele should be Tx aggressively to seal the lumen of a leaker

58
Q

What must be done when using a Diode Laser?

A

Activate the Tip

59
Q

Fiberotomy with Frenectomy will move incisors into position

60
Q

Only time use Diode Laser in Non-Contact mode:

A

Apthous Ulcer

pulsing - just seal off nerve endings

61
Q

Fibroma on tip of tongue, easy to remove with Diode laser

retraction w/ hemostat

62
Q

Topical Anesthetic used for Laser:

A

Oraqix

*prilocaine + lidocaine

63
Q

Trilogy oral debridement better than CHX b/c fibroblasts

64
Q

Wounds created by a laser heal more slowly and are via _____ intention healing

65
Q

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?

A

Necrotic

thin layer of denatured collagen

w/in 14 days period

21st day

66
Q

Slower healing w/ lasers b/c epithelium has to _____

A

migrate further

67
Q

Lasers heal faster

68
Q

Lasers don’t leave scars

69
Q

Wound healed after Scalpel surgery are stronger

70
Q

4 goals of laser Perio Therapy:

A

photothermal energy affects:

lowers red/orange complex bacteria

biostimulate

enhance mesenchymal activity

71
Q

Red Complex most closely related to Perio and are what 4 bugs?

A

P gingivalis

T denticola

B fosythius

E nodatum

72
Q

Mesophilic bacteria temp range:

*most human pathogens are mesophiles

human body temp =

A

25 - 45 C

37 C

73
Q

Blanching, white gray

Shrinkage

Smoke plume

A

60-80 C

90-100

100-150

74
Q

Genetic component to Perio:

A

IL-1 expression

75
Q

Chromophore is targeted in laser perio Tx

76
Q

Inflammatory tissue has higher levels of what 2 things

A

water

pigment

77
Q

Adverse outcomes to perio Tx

A

temp, dehydration, pain, damage,

78
Q

Why isn’t Diode absorbed efficiently by pigments?

*perio

A

low coefficient of absorption

79
Q

Inside the pocket only use what mode?

A

non-contact

80
Q

Er-YAG is good for Perio

A

we don’t know yet

81
Q

Nd-YAG is a _____ laser fiber optic tip

Contact mode what forms at tip?

This increases lateral thermal conduction, so don’t use where:

A

pulsed

carbonized tissue

bone

82
Q

Nd YAG free running pulse layer used in what perio procedure?

Utilizes what?

A

Laser assisted New Attachment Procedure

Regeneration (instead of resection)

83
Q

laser assisted new attachment procedure used Nd YAG and stimulates what?

A

stem cells

*new root surface of Cementum and new CT

84
Q

Diode laser with ____ micron tip

  • used for perio
  • calibrate each site
85
Q

Perio begins internally and involves weak immune system

86
Q

Biostimulation from low level lasers

A

pain relief

wound healing

87
Q

Calibration:

start at top of pocket, lase to

stop ___ mm short of pocket depth

A

measure pocket

calibrated depth

1mm

88
Q

Topicals, leave max ___ minutes

A

5

*otherwise dehydrate if leave longer

89
Q

Epithelium grows ____/2days

Fibroblasts/osteoblasts ___mm/10days

90
Q

___% reduction in bleeding

___% control group

91
Q

The total amount of energy of the laser is = to that absorbed by tissues

92
Q

Lasers will cure Perio by itself

93
Q

CT regeneration begins on day

maturing process from ____ weeks to 1 year

94
Q

pocket depths greater than 3mm, control

A

junctional epithelium

95
Q

De-epithelialization won’t occur with what 2 lasers

De-epithelialization will occur with what 2 lasers

A

Diode, Nd-YAG

CO2, Erbiums

96
Q

Perio affects 130 million/yr, 60% population

97
Q

Dental hygiene, what laser

A

CO2

*de-epithelialization

98
Q

CO2

Diode

(de-epithelialization?)

99
Q

Why is 10 day critical

A

bacteria re-colonize

epithelial regeneration back into pocket

100
Q

There are no contraindications to CO2 laser

A

True

*except - disconnect Oxygen

101
Q

CO2 10.6

A

laser assisted Tx

perio tip parallel to surface

ceramic tip

102
Q

Laser application of CO2 10.6 (Perio) tip should be ____ mm short of pocket

This does what?

A

1-2 mm short

maximizes thermal air flow

*which minimizes damage

103
Q

CO2 laser removed epithelium w/out damaging underlying CT (in Perio)

104
Q

What tip use on CO2 in Perio?

A

Ceramic

*metal too hot

105
Q

2 places SuperPulsed CO2 lasers have total/complete absorption:

A

hydroxyapatite

water

106
Q

Ultraspeed (superpulsed) will not damage any hard tissue if settings right in Perio

107
Q

CO2 is 100% absorbed in water

108
Q

Use water along with topical for sensitive pts

109
Q

CO2 10.6 can damage deeper tissues

110
Q

Non focused is llike a flashlight and can be effective at only 1-2 mm

A

True

*CO2 laser

111
Q

CO2 laser used in the Defocused Superpulsed mode has ___ watts of power and ___% duty cycle

average power is ___ watts

A

2 watts

20%

.4 watts

112
Q

16 seconds per surface CO2 laser (perio)

113
Q

Older generation of CO2 lasers had too high energy output and did damage

114
Q

SRP isn’t always successful b/c of restricted Access

A

True

*so photons can’t hurt

115
Q

Limited success of SRP b/c diffcult to get to subgingival bacteria

SRP depth is related to success

116
Q

SRP is being improved with lasers

117
Q

SRP changes greatest when?

wound healing continues for how long?

A

1-3 months

3-9 months

118
Q

CO2 laser has what great advantages?

A

absorbed by water in pocket

inflamed tissue has more water

Tim's Cards (140 decks)

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