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LASERS IN ORTHODONTICS GUIDE SMT DR CHANDRALEKHA PROFESSOR AND
HEAD OF DEPARTMENTDEPARTMENT OF ORTHODONTICSVYDEHI INSTITUTE OF
DENTAL SCIENCES
PRESENTED BY DR OMAR RIZVI POST GRADUATE STUDENT DEPARTMENT OF
ORTHODONTICS VYDEHI INSTITUTE OF DENTAL SCIENCES
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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
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L light A amplified by S stimulated E emission of R
radiation
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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
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Historical perspectiveEarly 1900s-chinese and egyptians
(phototherapy)1960 Thiodore Maiman1965 Dr Goldman1970s nd-YAG1982-
Pick Frame and Picaro1987 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.
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HISTORY1991 Soft Laser1993 Nd:YAG Laser1993 Kinetic Cavity
Preparation1994 CO2 Laser, Argon Laser1996 Laser welder1997 Nd:YAP
Laser1998 Er:YAG Laser
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FUNDAMENTALS OF LASERS
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Light beam is composed of packets of energy known as photons
Ground state-atoms are normal stateAtoms are excited by energy and
move to higher energyAs it reverts back to its ground state, energy
is emitted-spontaneous emissionResults 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.
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Curing Lights
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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.
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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
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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
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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 lightthrough a medium of
argon gas.+ Fast Tips are usually too small for most restorations
Very expensive Larger than halogen May not cure all materials
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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
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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.
Typicallysynchronized 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 cureall types
of restorations just a little slower than high power.
Step Cure at low power (usually about 150mW/cm2) for 10seconds,
followed by an instant step up to a much higherpower (usually
maximum of light) for the rest of the curinginterval.
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Ramp Start curing at low power (usually about150mW/cm2),
followed by a linear increase to a higherpower (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.
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Nd: YAG laser
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DIAODE LASERSEMICONDUCTOR LASER
Gallium Arsenide chipNo mirror to clean and alignNo gas tube,
flashlamps, laser rod, water coolingPortableNo special powerNo
cooling connectionNo heat QuietAffordableMore powerful, less
traumatic250microsecond-10sec0.05 Hz - 200 HzExpand Practice*
Sulcular debridement* Root canal treatment
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Caries RemovalCavity PreparationHard tissue modificationSoft
tissue modificationPeak absorption of water
andHydroxyapatiteVaporize the water rapidlyAcusto-mechanical
wave
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What is orthodontics???
Branch of dentistry concerned with prevention, interception and
correction of malocclusion and other abnormalities of the dento
facial region.
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Here is why pateints come commonly to a orthodontist.
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The result we achieve by our treatment.
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Future Trends in Dentistry No pain Smile
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WHY ORTHDONTIC TREATEMENT ???
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No pain?Pain
Vibration
Sound
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Smile?Esthetic needsNon invasive
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Incision, Excison, Vaporization, Ablation,
HemostasisDecontamination, Aphtous Ulcer Tx, Drain
AbscessOpeculectomy, Surgical uncovering, Enamel exposure Root
canal treatment
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LASERS..WHY SHOULD I??PRECISIONPOWERPERFORMANCETIME ANTI
CARIOGENIC PREVENTS DECALCIFICATION
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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
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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.
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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 responseThe main
advantage of the laser-etched surface is acid resistance. It yields
more resistant enamel for caries attack
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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
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WHY DID I CHOOSE LASERS??
This is where I want to reach Treatment should be available to
every one irrespective what our economic statusHow do we do this
RESEARCH is the key .
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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
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FrenectomyGingival troughing
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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.
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Application of low level of laser
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Gingival Recontouring
Gingivoplasty
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EXPLORE NEW VISTAS, LET LASER TRANSFER YOUR PRACTICE
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KEEP SMILING. THANK YOU..