There are many different wavelengths to choose from, depending on the clinical needs. I want to begin by explaining why Erbium lasers seems to be ideally suited for comprehensive periodontal treatment.
We have all seen the chart showing the absorption coefficient of different wavelengths in water.
This is important for us to understand since water is a main component of dental tissues. The CO2 laser is absorbed very well in water, but there is a tendency to see charring and thermal effects in soft tissue, as well as melting of hard tissues. This does not make it very friendly for periodontal therapy where cementum and roots are involved, although a newer pulsed CO2 laser does improve on this problem.
Diode and Nd:YAG penetrate deep into tissue and may cause unseen thermal effects. Currently, they seem to be positive as adjuncts in periodontal therapy, as long as laser energy applied to the roots is kept minimal and controlled.
Erbium lasers have an excellent ablative potential in soft tissues, do not penetrate deep, and do not show the same thermal damage as the other wavelengths. They seem to be ideally suited for comprehensive soft tissue periodontal treatment, as well as calculus removal and root treatment.
There are 2 different Erbium lasers: Er:YAG and Er, Cr:YSGG. Both have a very similar absorption spectrum. There are few studies that compare their physical properties. As one study shows, it is difficult to analyze different systems because of the different manufacturer parameters.
For all intents and purposes, and to facilitate a meaningful discussion, going forward we will assume that all Erbium laser studies are reasonably interchangeable. Literature reviews will follow very soon.
MS
I initially investigated incorporating a laser into my practice early in 2008. I am a periodontist, and as you may or may not know, there is a general lack of laser awareness in the periodontal community. It is a complex issue that will be addressed separately.
I decided to research lasers independently. I read countless studies, spoke to laser
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I’m still waiting to see the studies that clearly demonstrate this, because I have tried removing calculus with the YSGG on freshly extracted teeth and it doesn’t come off easily. Granted, intra-orally with the presence of saliva it might work, but????
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EXCERPT: BIOLASE Announces FDA 510(k) Clearance of Its Waterlase MDTM Laser for Removing Calculus in Patients With Periodontal Disease Minimally-Invasive Treatment for Condition Impacting Over Half of Americans Over 55
IRVINE, CA–(Marketwire – December 9, 2009) – BIOLASE Technology, Inc. (NASDAQ: BLTI), the world’s leading dental laser company, today announced that it has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) to market its Waterlase MD™ laser system for removal of subgingival calculi to prevent and treat periodontitis, the greatest cause of tooth loss for adults over 35 and a condition impacting more than half of Americans over the age of 55, as reported by the American Academy of Periodontology (AAP).
I just received the Oct-Dec 2009 American Academy of Periodontology’s News Bulletin. In Dr. Samuel B. Low’s President’s message he states the following about lasers and periodontists:
“…As an example, we should have determined the feasability, yes or no, of using lasers. We should have been involved as a profession. We looked the other way, and now we’re down on the food chain.”
No kidding, doc. So what are you going to do about it? Is it just me or does it seem that the AAP is all talk, no action.
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