Magical Innovation- Laser Applications in Periodontics

Treatment of peri-implantitis

• Combination of above discussed methods is used. Classical curettes may result in roughening of titanium implant surface and it promotes bacterial adhesion. Laser irradiation not only eliminates bacteria but also removes granulation tissues. Therefore laser irradiation in peri-implantitis is really helpful and innovative application.

Effects of Lasers on Periodontal Therapy

• Pain relief
• Inflammation reduction
• Accelerated tissue repair and cell growth
• Wound healing
• Reduced formation of scar tissue
• It is bactericidal

Advantages of Laser

• Relatively bloodless surgical and post-surgical course.
• Ability to coagulate, vaporize, or cut tissue.
• Sterilization of wound tissue.
• Minimal swelling and scarring.
• No requirement of sutures as many patients fear if we tell about sutures.
• Little mechanical trauma.
• Reduced surgical time.
• Decreased post-surgical pain.
• High patient acceptance.

Disadvantages of Laser

• Caution before and during irradiation
• Use glasses for eye protection for patient, operator as well as assistants.
• Inadvertent irradiation (action in noncontact mode).
• Protect patient’s eyes, throat, and oral tissues outside the target site.
• It reflects from shiny metal surfaces, therefore, it is important to understand laser physics before using it.
• High-speed evacuation requires to capture the laser plumes.

• Direct ablation may cause excessive tissue destruction and thermal side-effects

Destruction attach attached tissues at the bottom of pockets Excess tissue ablation of root surface and gingival tissue within periodontal pockets Thermal injuries to the root surface, gingival tissue, pulp and bone tissue.

• Problems of laser systems

Further development of a new laser system as well as improvement of currently available laser systems Development and improvement of contact probes suitable for periodontal treatment High Cost of the laser system is the major dilemma for its use in clinical practice. Laser functioning depends on wavelength with each different wavelength function get changed. Therefore proper knowledge of laser physics is needed to use lasers confidently. Very few universities provide proper knowledge about lasers and because of this, it is difficult for the users to learn all aspects of the techniques and precautions required for the newer technologies. Conclusion Proper knowledge about laser physics, diagnosis of the case and laser applications in periodontics essential before using it. If we follow all the guide lines, lasers use is really an innovative and magical experience. Laser is just a one weapon with multipurpose uses. References-

1. Ishikawa I, Aoki A, Takasaki A, Mizutani K, Sasaki K & Izumi Y. Application of lasers in periodontics: true innovation or myth? Periodontology 2000, Vol. 50, 2009, 90–126.
2. Aoki A, Sasaki K, Watanabe H & Ishikawa. Lasers in nonsurgical periodontal therapy. Periodontology 2000, Vol. 36, 2004, 59–97.
3. Rakhewar P S, Patil HP, Thorat M. Diode laser treatment of an oral squamous papilloma of soft palate. J Dent Lasers 2015; 9:114-7.

Laser procedures remain adjuncts; treatment planning should begin with evidence-based periodontitis classification and conventional disease control.

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