Laser Dentistry for Everyone Webinar Presentation

8/4/2019 Laser Dentistry for Everyone Webinar Presentation

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A presentation by Mark Cronshaw B.Sc,BDS LDS MFHom(Dent)

Fellow World Class Laser Institute

UK Dental Laser Academy

Private Practice Cowes

Laser Assisted Dentistry In TheLaser Assisted Dentistry In The2121stst CenturyCentury

The

Magicof

Lasers


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Pre course Questionnaire:Pre course Questionnaire:

Please answer the followingquestion:

a. I am a laser owner

b. I do not currently own a laser


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There are many types of lasers available indentistry today

Lasers in Dentistry:Lasers in Dentistry:


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Waterlase MD & Waterlase i-PlusWaterlase MD & Waterlase i-Plus

Erbium ChromiumYttrium ScandiumGallium Garnet(ErCr:YSGG)

Wavelength2780nm

Type 1V laser(light amplifiedstimulatedemission of

radiation)


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Ez-lase and i-Lase:Ez-lase and i-Lase:

Both are diodes(semiconductors)

Wavelength 940nm

Type IV lasers


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What is the advantage ofWhat is the advantage ofthe laser overthe laser over

conventional methods?conventional methods?Why not stick to

conventional techniques?


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Laser safetyLaser safety

Isn`t it a bit dangerous?


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Is it safe?Is it safe?

Safety limit set at 5cm for theWaterlase

Effective cutting range within 1-5mmPrecise and clean cuts

Minimal risk of thermal traumaSuperb control of all parameters


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Safety limit set at 3m for theEzlase/Ilase

Safety glasses for 940nm essential!

Effective cutting range in contactonly

Precise and clean cuts

Minimal risk of thermal trauma

Superb control of all parameters


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Hard tissue: class I,II,III,IV,V,VI

Caries removal

Surface roughening and etching

Root canal: all stages of preparationincluding debridement and cleaning

Pulpotomy

Indications for theIndications for theWaterlase:Waterlase:


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Endo surgery: flap preparation,boneremoval,apicectomy. Removal ofcysts and granulation tissue

Bone: cutting,shaving,contouringand resection. Osteoplasty,graftingand osseous crown lengthening,

remove tori, prepare implant sites

Further indications for theFurther indications for theWaterlase:Waterlase:


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Periodontal applications:gingivectomy, laser curettage,decontaminate pockets

Other oral surgery applications:frenectomy, excise polyps, remove

mucocoele etc etc!

...even more applications for the...even more applications for theWaterlase!Waterlase!

Th W t l MD & th W t lT W t MD & t W t


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Less referrals to specialists

Better clinical outcomes: lesspain/quicker healing times

Increased revenue

Happy patients!

The Waterlase MD & the WaterlaseT e Water ase MD & t e Water ase

i-Plus add many additionali-Plus add many additional

procedures:procedures:


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Haemostasis

Crown troughing

Sulcular debridement

Gingivectomy/gingivoplasty Frenectomy/frenotomy

Implant recovery

Excisional/incisional

biopsies

Operculectomy

Crown exposure

Tooth whitening Ulcers

Diode applications:Diode applications:


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Highly versatileInexpensiveEasy to use

Hi-tecExcellent clinical

outcomes

Diodes offer manyclinical benefits ata low cost


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But why bother??But why bother??

What can a laser do for me thatoffers any advantage over mycurrent techniques?


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An introduction toAn introduction to

laser dentistry:laser dentistry:

21st Century solutions to old problems!


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Pretreatment: aestheticrecontouring


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Diodegingivectomy


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One week post

treatment


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The gingival componentis often a management

problem

Elevation of the incisal

planeand crown lengtheningsurgery (closed flap)

Gummy smileGummy smile


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Gummy smileGummy smilereduction:reduction:


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Crown lengthening surgery: before and after


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Same case at two years:


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Crown lengthening surgeryCrown lengthening surgerymay require osseousmay require osseous

recontouring:recontouring:Bone may need to be removed to

prevent gingival regrowth

Hard tissue lasers allows for aflapless minimal approach

Less pain/ faster healing

Increased case acceptance due toreduced trauma


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One week laterOne week later


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Soft tissue reduction only

Can be used together with specialbone chisels for flapless osseousremodelling

Care in case selection!

Not recommended for flap incisions

How useful is a diode for crownHow useful is a diode for crownlengthening?lengthening?


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Why Laser Perio?Why Laser Perio?


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Periodontal care in the UK:Periodontal care in the UK:

Limited availabilityFrequently inadequately diagnosedDated management philosophiesAs a result: treatment frequently

fails

Regarded historically as the poorcousin to restorative and surgicaldentistry


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Systemic effects & healthSystemic effects & healthrisks:risks:

168% increase in risk of heart attack(42% if gingivitis alone!)250% increase in risk of stroke

300% increase in risk of diabetes500% increase in respiratory disease

700% increase in chance ofpremature birthHarvard study: increased cancer

risk?


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The scale of the problem:The scale of the problem:

10% of the population are highlysusceptible to periodontal disease

There are only 300 registeredspecialist periodontists in the UK!Medico-legal settlements of

supervised neglect run to 5 figuresums


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Site Specific PerioSite Specific Perio

Scaling and Root

Planing & LocalChemotherapeuticsDo not disrupt theBiofilm

The need for curettage: Which is more effectiveand kind?


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Diode periodontal treatment


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Laser Induced Gingival ReattachmentIn Periodontal Disease Using

The WaterlaseVersus Conventional Methods

Dr. Solveiga KelbauskieneDr. Solveiga KelbauskieneKaunas Medical UniversityKaunas Medical University

Kaunas, LithuaniaKaunas, Lithuania


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The average pocket reduction of those teethtreated with the laser was at least twice that ofthose treated conventionally.

All pockets treated with the laser were

reduced to normal probing depths at 3,6,9 and12 months post operatively.

Before treatment 74% of the non laser groupand 78% of the laser group had bleeding on

probing.

After 12 months 29% of nonlaser group stillbled and only 8% 0f laser group had bleeding.

ConclusionsConclusions


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Markedreduction inpockets

Non surgicalmanagement

New bone


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What else can the laser do?What else can the laser do?

Frenectomy: an easy procedure withmany clinical indications- speech

difficulties, gingival recession,stabilize implant sites, orthodontics

No sutures/ fast healing/ noscarring/no bleeding


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9 MOS POST OP9 MOS POST OP


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NURIN 2009

12 MOS POST OP12 MOS POST OP


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One week later

Removal of a fibroma:Removal of a fibroma:


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Low Level Laser Therapy:Low Level Laser Therapy:

Low level laserenergy promoteshealing

Activatesmitochondria

Reducesinflammation

Reduces posttreatment pain


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Whitening procedures

WhiteningWhitening

Cli i l R l


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Typical results range from 6 to 12shades of improvement on the Vita

Shade Guide Brightness Scale

Results may vary depending on type ofstain,

enamel thickness, tooth structure, andage

BEFORE LASER WHITENING AFTER LASER WHITENING

Clinical ResultsClinical Results

The very latest laser fromThe very latest laser from


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The very latest laser fromThe very latest laser fromBiolase:Biolase:


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Waterlase iplus:Waterlase iplus:

An emerging new World standard indental laser technology

Able to do hard and soft tissueprocedures quickly and easilyMuch improved user interface to

facilitate new users in applicationsMore power, higher hertz


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Waterlase iplus:Waterlase iplus:

All tissue surgery (diode is softtissue only): excellent for crownlengthening surgery, no flap surgicalextractions as well as the optimum

tool in periodontal diseasemanagement

Enhanced ability to do more andquicker cavity preparation, oftenwithout need of a local anaesthetic

One stop solution to many clinical

dilemmas


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These three pen lasersThese three pen laserslook very similar....look very similar....


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i-Lase features:i-Lase features:

Peak power of 5wUnique Comfortpulse technology:

reduces post operative pain and

discomfort

Easy to use with factory settings forall the common soft tissue

proceduresExcellent ergonomics

Th hTh h


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There are however manyThere are however manypoints of difference!points of difference!

Max power i-Lase 5watts versus 4 Watts Quicklase& 2 watts NV Discus

i-Lase 940nm wavelength vs 810nm for theothers:940nm cuts at much lower energy inavascular tissue cf 810nm

i-Lase has an excellent range of tips: moreoperator choice/easier procedures

Pulse form: i-Lase has unique comfortpulse:reduced heat build up. i-Lase has threedifferent pulse settings vs. one for the Quicklaseand two for the NV Discus

9 0 h S d d i i d


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940 nm The New Standard in Diode940 nm The New Standard in Diode

Lasers from the World Leader in LaserLasers from the World Leader in Laser

DentistryDentistry

Optimumabsorption forhaemoglobin andwater

Less energy required

to cut throughavascular tissue


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Unique ezlaseTM pulsed modeUnique ezlaseTM pulsed modecool cutting - Comfortpulsecool cutting - ComfortpulseTMTM


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Laser clinical advantages:Laser clinical advantages:

Faster healing: excellent tissueresponse

Less trauma: reduced bleeding

Precise control & easy to useHighly adaptable with many clinicalapplications

Excellent revenue return oninvestmentPopular with patients!


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Every dental practice in theEvery dental practice in theUK deserves a laser!UK deserves a laser!

Lasers are being adopted Worldwideas the tool of choice in clinical

dentistry: in the USA 15-20% alreadyown a laser

Within a decade the majority ofdentists will choose to use a laserdue to the excellent clinical results!


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Post course questionnaire:Post course questionnaire:

Please answer the following:a. I would like to introduce laser

treatments in my practiceb. I am happy with my practicewithout introducing new technology


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..thank you for your kind..thank you for your kind

attention!attention!


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Thank you !Thank you !

Any Questions?Any Questions?

Mark [email protected]

Laser EducationLaser Education
mailto:[email protected]:[email protected]


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ProgrammeProgramme

Friday 11th

November 2011

London HS Education Centre18 Stanhope PlaceLondonW2 2HH

Friday 2nd

December 2011London HS Education Centre18 Stanhope PlaceLondonW2 2HH

Friday 28th & 29th October2011Cardiff HS Education CentreCourtney HousePacific Business Park, PacificRoad CardiffCF254 5HJ

Documents

Laser Dentistry for Everyone Webinar Presentation