LASERS : THE 21ST CENTURY

RACERS IN PROSTHODONTICS

 Light Amplification by Stimulated

Emission of Radiation
Term coined by GORDON GOULD ,
1957
Father of laser: Albert Einstein
Laser light is a man-made single
photon wavelength.

VISIBLE LIGHT

LASER LIGHT

Why Lasers In Prosthodontics

Prosthodontics takes all concepts of
dentistry and integrates effective
comprehensive treatment planning.
It include a wide variety of patients
seeking a diverse range of care:
Fearful
patients

Patients with
complex medical
histories
Patient allergic to
anesthetics

Lasers have become an integral

part of treatment for these
patients

Painless,
Bloodless
& Clean
surgical
field.

Superior
and faster
healing

ADVANTAGESLASER

No
postopera
tive
discomfor
t, and
swelling.

No or
minimal
need for
anesthesi
a.

Laser kills
bacteria,
risk of
infection
is reduced

LASERS ON BASIS OF
APPLICATION IN DENTISTRY
SOFT TISSUE LASERS
HARD TISSUE LASERS

SOFT TISSUE LASERS

No suturing
Little or No
bleeding
Painless
Quicker
A traumatic

HARD TISSUE LASERS

Quicker
More accurate
More
comfortable
Better results

Application in

FIXED PROSTHETICS/ESTHETICS
Soft tissue management around abutments.
Crown lengthening.
Osseous crown lengthening.
Troughing.
Formation of ovate pontic sites.
Modification of soft tissue around laminates

SOFT TISSUE MANAGEMENT

AROUND ABUTMENTS
ARGON laser provide
excellent Hemostasis
and Coagulation
Gingival Retraction
for making impression
during a crown and
bridge procedure
becomes easy

CROWN LENGHTNING
Insufficient clinical crown
length

INDICATIO
Caries
at
gingival
margin
NS
Endodontic perforations near
alveolar crest.
Unaesthetic gingival
architecture.

LASER TROUGHING
A trough is created around a tooth
before impression making using
Nd:YAG laser.
This can entirely replace the need for
retraction cord, electro cautery, and
the use of haemostatic agents.

Gingivaltroughing with the diodelaserexposes finish

FORMATION OF OVATE PONTIC SITES

Two most common causes of unsuitable pontic
site:
Insufficient compression of alveolar plates
after an extraction
Non replacement of a fractured alveolar plate.
Unsuitable pontic site results in un esthetic
and non self cleansing pontic design.
For favorable pontic design laser re-contouring
of soft and bony tissue may be needed

MODIFICATION OF SOFT TISSUE

AROUND LAMINATES

The removal and re-contouring of

gingival tissues around laminates can be
easily accomplished with the Argon laser

REMOVABLE PROSTHETICS
Tuberosity reduction
Torus reduction
Soft tissue lesions
Residual ridge
modification

TUBEROSITY REDUCTION
The most common reason for enlarged
Tuberosity usually is soft tissue hyperplasia

It affects stability of prosthesis

Surplus soft tissue should be excised using soft
tissue lasers

TORUS REDUCTION
Tori and exostoses are formed mainly of compact
bone.
They may cause ulceration of oral mucosa.
They may also interfere with lingual bars or
flanges of mandibular prostheses.

Soft tissue lasers may be use to expose the

exostoses and Erbium lasers may be use for the
osseous reduction.

SOFT TISSUE LESIONS

Epulis fissurata, Denture stomatitis
Persistent trauma from a sharp denture flange
Over compression of the posterior dam area

The lesion can be excised with any of the soft

tissue lasers and the tissue allowed to re
epithelialize.

RESIDUAL RIDGE MODIFICATION

For proper retention, stability and
support for the prosthesis, residual
ridge modification is done with lasers,
in pre prosthetic preparation phase for
Under cuts
Flabby tissue

IMPLANTOLOGY

Second stage uncovering.

Implant site preparation.
Peri-implantitis.

SECOND STAGE UNCOVERING

Following the placement of implant and its Osseo
integration, Er:YAG laser can be used to uncover
implants
ADVANTAGES OVER CONVENTIONAL
SURGERY

Little blood contamination (haemostatic effects)

Minimal tissue shrinkage
Eliminate trauma to the tissues during flap
reflection
Impressions can be obtained at the same
appointment

Two implants are

being uncovered
using a scalpel.

Excess soft tissue

being

Immediately healing caps

are laser exposed and soft
tissue is re contoured

Soft tissue healing within

IMPLANT SITE PREPARTION

Lasers can be used for the placement

of mini implants especially in patients
with potential bleeding problems, to
provide essentially bloodless surgery in
the bone

PERIIMPLANTITIS
Lasers can be used to repair ailing
implants by decontaminating their
surfaces with laser energy.
Lasers can also be used to remove
inflamed granulation tissue around an
already osseointegrated implant.
Diode, CO2 & Er:YAG lasers can be
used for this purpose.

RECENT ADVANCES

MAXILLOFACIAL PROSTHESIS
Topologic data of the patients deformity is
acquired using laser surface digitizing, the
procedure is called Laser Holography
Imaging

Lasers aid in creating a visually realistic

prosthesis that can provide an illusion of
normal appearance.

Laser welding
An attractive alternative
method to join dental casting
alloys such as broken clasp
No need for investment and soldering alloy
Working time is decreased
Easy to operate
Minimal heat damage to denture base
resin

 Ultraviolet (helium-cadmium) laserinitiated polymerization of liquid

resin in a chamber, to create surgical
templates for implant surgery and
major reconstructive oral surgery.

 Laser scanning of casts can be linked

to computerized milling equipment
for fabrication of restorations from
porcelain and other materials.