LASERS IN

ORTHODONTICS
GUIDE
SMT DR CHANDRALEKHA
PROFESSOR AND HEAD OF DEPARTMENT
DEPARTMENT OF ORTHODONTICS
VYDEHI INSTITUTE OF DENTAL SCIENCES
PRESENTED BY
DR OMAR RIZVI
POST GRADUATE STUDENT
DEPARTMENT OF ORTHODONTICS
VYDEHI INSTITUTE OF DENTAL SCIENCES

 SPECIAL THANKS TO
SHRI DR VENKETESHIAH
PROFESSOR OF DEPARTMENT OF ORTHODONTICS
SMT DR ROOPA
SR LECTURER
DEPARTMENT OF ORTHODONTICS
SHRI DR VINOD
SR LECTURER
DEPARTMENT OF ORTHODONTICS

L light
A amplified by
S stimulated
E emission of
R radiation

LASER is a device that transforms a light of

various frequencies into chromatic
radiation in the visible, infrared and
ultraviolet regions, with all the waves in
phase capable of mobilizing immense
heat and power when focused at a close
range

Historical perspective

Early 1900s-chinese and egyptians (phototherapy)

1960 Thiodore Maiman

1965 Dr Goldman
1970s nd-YAG
1982- Pick Frame and Picaro
1987 Meyers portable laser

Stern and sognnaes(1964) and Goldman et al (1964) were the first

to investigate potential uses of ruby lasers in dentistry

They began their studies on dental hard tissue by investigating the

possible use of a ruby laser to reduce surface dimeralisation

HISTORY

1991 Soft Laser

1993 Nd:YAG Laser
1993 Kinetic Cavity Preparation
1994 CO2 Laser, Argon Laser
1996 Laser welder
1997 Nd:YAP Laser
1998 Er:YAG Laser

FUNDAMENTALS OF LASERS

 Light beam is composed of packets of energy known as

photons
Ground state-atoms are normal state
Atoms are excited by energy and move to higher energy
As it reverts back to its ground state, energy is emittedspontaneous emission
Results without external interference and forms waves
that are in phase.
With all the various types of lights and materials on the
market, it is virtually impossible to come up with one
protocol, especially one featuring reduced curing
times,across the board.

Curing Lights

 Curing lights allow us to polymerize on demand

a vast array of materials.
If you undercure a restoration, for example, you
may not even be aware of the negative sequelae
for years.
Using a light that puts out too much energy also
continues to be a topic for discussion.
Therefore,selecting a curing light and using it
properly can greatly affect the performance and
longevity of your restorations.

Types of Curing Lights

Halogen Use a halogen bulb as the source of light.

+ Most common
+ Least expensive
+ Reliable
+ Long track record
+ Should cure all materials
+ Available in corded and cordless models
+ Wide bandwidth (400nm-510nm)
Somewhat slower than plasma arc and argon lasers

 Plasma Arc Bulb is really an aluminum oxide, high pressure

vessel, which contains highly energized xenon gas (plasma) under

150psi. The inside shape is specific to reflect light arcing between two
electrodes. Arc is only about 1mm long, enabling a very focused beam.
+ Very fast
Expensive
Larger than halogen
Limited track record
May not cure all materials
Tips are usually too small for most restorations
Cords are liquid-filled, may be stiff, and can degenerate over time

 Argon Laser Light generated when energy is

applied to an atom raising an electron to a higher,

unstable energy level. Electron will return to stable level
by releasing light through a medium of argon gas.
+ Fast
Tips are usually too small for most restorations
Very expensive
Larger than halogen
May not cure all materials

 LED (Light Emitting Diode) Special diodes

(an electronic device that restricts current flow chiefly to

one direction) that emit light when connected in a circuit.
+ Available in cordless and corded
+ Light in weight
+ Small
+ Long battery life due to the low power usage
+ Virtually no heat generation at the tip
New, very limited track record
May not cure all materials
Most have poor selection of tips
Power output questionable

Curing Modes

High or Boost Usually the highest power the light will generate.
Achieves this power within five seconds of activation.
Entire curing interval will be at this level power. Typically
synchronized to a timer that has a 10-second curing interval,
which may not be adequate for many restorations.

Regular or Normal Medium power level.Will usually cure

all types of restorations just a little slower than high power.

Step Cure at low power (usually about 150mW/cm2) for 10

seconds, followed by an instant step up to a much higher
power (usually maximum of light) for the rest of the curing
interval.

Ramp Start curing at low power (usually about

150mW/cm2), followed by a linear increase to a higher
power (usually maximum of light) for 10 seconds, and then stay at
that high level for the rest of the curing interval.

Pulse Has different meanings for different lights, but usually means
either the power cycles between high and low every second or so or
the power cycles on and off every second or so from the beginning
of curing.

Nd: YAG laser

DIAODE LASER
SEMICONDUCTOR LASER
Gallium Arsenide chip
No mirror to clean and align
No gas tube, flashlamps,
laser rod, water cooling

Portable
No special power
No cooling connection
No heat
Quiet

Affordable
* Sulcular debridement
* Root canal treatment

More powerful, less traumatic

250microsecond-10sec
0.05 Hz - 200 Hz

Expand Practice

Peak absorption of
water and
Hydroxyapatite
Vaporize the water rapidly
Acusto-mechanical wave

Caries Removal
Cavity Preparation
Hard tissue modification
Soft tissue modification

What is orthodontics???

Branch of dentistry concerned with prevention,

interception and correction of malocclusion and other
abnormalities of the dento facial region.

Here is why pateints come

commonly to a orthodontist.

The result we achieve by our

treatment.

Future Trends in
Dentistry

No pain
Smile

WHY ORTHDONTIC
TREATEMENT ???

No pain?
Pain
Vibration
Sound

Smile?
Esthetic needs
Non invasive

Incision, Excison, Vaporization, Ablation, Hemostasis

Decontamination, Aphtous Ulcer Tx, Drain Abscess
Opeculectomy, Surgical uncovering, Enamel exposure
Root canal treatment

LASERS..WHY SHOULD I??

PRECISION
POWER
PERFORMANCE
TIME
ANTI CARIOGENIC
PREVENTS
DECALCIFICATION

Why Etching in orthodontics???

The primary effect of enamel etching is to increase the surface area

and thereby change the surface from a low energy hydrophobic
surface to high-energy hydrophilic surface ( Reynolds, 1975 ).

Various surface properties may be accomplished but the most

important point is to modify the surface characteristic of the enamel
for adhesive attachment ( Silverstone et al. , 1975 ).

Various preparation methods including orthophosphoric acid,

sandblasting, and laser irradiation have been shown to etch enamel
for orthodontic bonding

 Acid etching decalcifies the inorganic

component of the enamel and the enamel
becomes more susceptible to carious
attack, which is induced by plaque
accumulation around the bonded
orthodontic attachments.

 Laser irradiation removes the smear layer. After laser

etching, some physical changes occur, such as melting
and recrystallization.
Numerous pores and bubble-like inclusions appear Thus,
irregular surfaces are created which permit penetration
of fluid adhesive components.
The main disadvantage was the immediate increase in
temperature, resulting in an inflammatory pulpal
response
The main advantage of the laser-etched surface is acid
resistance. It yields more resistant enamel for caries
attack

Reason ????
The purpose of my thesis work is to
investigate the shear peel bond strength
and adhesive failure location of laser- and
sandblasted-etched enamel compared
with conventional acid-etching techniques,
and to determine the suitability of these
modalities in bonding of brackets

WHY DID I CHOOSE LASERS??

This is where I want to
reach Treatment
should be available to
every one irrespective
what our economic
status
How do we do this
RESEARCH is the
key .

What role do researchers play ???

Well its the researchers contribution that
today numerous dental procedures are
affordable by the masses.
Different studies carried out over the years
have gifted dentistry with introduction of
lasers

Frenectomy

Gingival troughing

Minimal marginal gingival regeneration: A, placement of topical anesthetic on a

previously impacted canine with short clinical crown height;
B, gingivectomy performed with an Er,Cr:YSGG, Waterlase; strict hemostasis
with an erbium laser may be difficult; C, gingivectomy complete and tissue tag
removed (photo taken immediately postoperatively); D, 3-month postsurgical
follow-up with minimal marginal gingival regeneration.

Application of low level of laser

Gingival Recontouring

Gingivoplasty

EXPLORE NEW VISTAS,

LET LASER TRANSFER
YOUR PRACTICE

KEEP SMILING.
THANK YOU..