Module III-Lasers for HAAAHHD Tissue Flashcards
What is the laser of choice for Hard Tissue applications?
Erbium-YAG (Fotona Lightwalker)
What are the secondary choice lasers for Hard Tissue?
Er, Cr YSGG (Bolas)
What ElectroMagnetic Spectrum is associated with Hard Tissue lasers?
MID-IR spectrum (2790nm, 2940nm)
What is the % water found in ENAMEL?
6% water
What is the % water found in DENTIN?
30% water
What is the % water found in CARIES?
65% water
Lasers do not CUT hard tissue, ________ cause micro-removal of hard tissues.
micro-explosions
Lasers remove Hard Tissue by “photo_____” means. The Chromophore is ______
“photoTHERMAL”….water (interstitial)
How long is the typical PULSE duration of the Er-YAG when removing hard tissue?
250-450 us (microseconds)
How deep does the laser typically penetrate the hard tissue?
125 um (micrometers)
Is there contact used for Hard Tissue ablation?
NO, its NON-contact
Do you need water coolant spray when using a laser to remove hard tissue?
YES
Do you need to acid etch when using a laser for hard tissue removal?
YES
For our lasers we CAN adjust _____ and ______, but we cannot adjust _______
CAN-Pulse (Hz) and Energy Density…CANNOT adjust WIDTH
Where do you hold the laser tip in relation to the enamel rods?
PERPENDICULAR
What do you do to the enamel surface before using the laser?
PRE-Etch
MIND BOTTLING: SMALLER DIAMETER TIP = _______ ENERGY DENSITY (fluence)
LARGER
Which part of the laser is cutting the hard tissue?
its END cutting - the end of the laser beam
What do you have to do to cleave loose enamel rods after cutting with the laser?
use a hand instrument (spoon, hatchet)
What is an example (in microns) of a WIDER tip size for getting into softer tissues?
600 microns
Bleaching molecules are ACTIVATED by ______ light and Pulpal Temperatures ______
LASER…RISE
Bleaching: A decrease in DARKLY pigmented ________ structures
carbon ring structures
Bleaching: a decrease in LIGHTLY pigmented ________ structures
UNSATURATED structures
Bleaching: a decrease in hydrophilic _________ structures
NON-pigmented
What is the most essential factor in BLEACHING w lasers?
TIMING
OVER bleaching- breakdown of the ______ and therefore a release of _____, _____, and enamel loss
enamel matrix….CO2, H20
In laser bleaching we are essentially removing stains imbedded in the _______
enamel tubules
In laser bleaching, the ______ is not really bleached so the stains WILL _______
enamel….RE-OCCUR
RCT Tx- Removal of organic remnants and open _____ tubules
Dentin
RCT Tx- what does P.I.P.S. stand for? What type of laser is used?
Photon Induced Photoacoustic Streaming…Erbium-YAG
RCT Tx- Which step can PIPS replace in cleaning the root?
Irrigation with NaOCl
RCT Tx-Which two lasers have FDA clearance for endo? which two DO NOT?
Do: Er-YAG and Er/Cr-YSGG….DO NOT: Diode and NdYAG
Diagodent detects caries by the laser fluorescence of ______
bacteria
What values do you expect to see on the Diagodent with caries into the DENTIN?
values from 20-99
What Diagodent values do you see with caries in the enamel?
5-10
Diagodent when combined with other caries detecting methods had a ___% success rate in diagnosing caries
90%…BOOM GOES THE DYNAMITE
Enamel is transparent to what color light?
RED
What are the molecules that create IR fluorescence during the demineralization process?
PORPHYRINS
When detecting caries with Diagodent- the surfaces of the teeth MUST be _______ before scanning.
CLEAN
What does OCT stand for?
Optical Coherence Tomography
In OCT transmission thru the enamel is in the ______ spectrum range.
NEAR IR (1310-1550)
How many dimensions can OCT produce in an image? How deep can the scan go?
3D…3mm
OCT uses a _______ unit, which splits light and recombines it.
INTER-FER-O-METRY unit
OCT is comparable to an optical ________
ultrasound
OCT has a higher resolution of ___u because it uses ______ rather than sound or radio frequency.
10u…light
Is OCT ionizing or non-ionizing raditaiton
non-ionizing
Which laser can we use to get rid of carbonated hydroxyapatite and replace it with fluroapatite?
9.6um CO2 laser
The 9.6um CO2 laser CONVERTS remaining mineral to a ______ resistant form (fluroapatite)
caries
What is the maximum pulp temp change when using a 9.6um CO2 laser? What are the temps of the walls of the prep?
no more than 4 deg C….80-100 deg C
Normal-Healthy tissue emits a bright ______-_____ fluorescence.
white-green
What is the wavelength used for dysplasia detection?
430nm (blue)
What are the three fluorophores were looking for in the oral mucosa?
NADH, FAD, and Collagen Crosslinks
THINK:::Cancer cells have a ______ metabolism compared to normal cells, so there is a decrease in _____ and an increase in _____
higher…decrease in FAD….increase in NADH
As cancer increases, new blood capillaries are formed. Blood absorbs at ___nm
410nm
Dysplastic tissue- decomposition of ______ matrix, stromal fluorescence is ______
collagen….reduced
