Pilot® Laser used in veterinary Dentistry.

1. The Pilot Laser in Veterinary Dentistry

2. Advantages of Lasers
How Lasers Work
Applications in Dentistry

3. Advantages
Advantages/Benefits of Laser Surgery Compared to Steel
Blade Surgery Superior ability to:
• Minimize Hemorrhage
• Minimize Collateral Damage
• Minimize Infection (sterilize surgical site)
• Minimize Pain

4. Thermal Trauma Should NEVER Happen

5. How Lasers Work
Hyperthermia:
• The tissue is elevated above normal temperature but not
destroyed
• The tissue whiten or blanch
• This phenomenon is useful because it will remove diseased
tissue but allow healthy tissue to remain intact

6. How Lasers Work
Coagulation:
• Irreversible damage to tissue
• Causes congealing of liquid into a semi-solid mass (clot)
• Clinician will see a bloodless surgical site contraction of the
vessel wall

7. How Lasers Work
Welding:
• Occurs when there is adherence of layers
• Due to collagen’s helical structure unfolding and intertwining
with adjacent segments

8. How Lasers Work
Vaporization:
• This is also called ablation
• There is a physical change of state; the solid and liquid
components turn into vapor in the form of smoke or steam
• Excision of tissue commences at this temperature

9. How lasers work
Carbonization:
• Tissue is dehydrated and then burned in the presence of air
• Carbon, as the end product, absorbs all wavelengths
• If laser energy continues to be applied, a heat sink will occur
and prevent normal tissue ablation
• The heat that is conducted can cause collateral thermal trauma
to a wide area

11. Periodontal Therapy
• An important use of laser technology is within the
periodontal pocket
• This has become a topic of much interest and is a
promising field in periodontal therapy
• Why would we want to use laser technology for
treatment of the periodontal pocket?

12. Periodontal Therapy
1) The FDA approved the Diode laser for sulcular debridement in 1988.
Due to the diode laser’s wavelength it is safe to use near dental hard
tissue where the CO2 would cause major thermal damage
2) The thin (400 micron = 0.4 mm) diode fiber less traumatic than
conventional instruments
3) Hot-tip fiber action is thought to:
A) Decreases inflammation (biostimulation effects)
B) Vaporize necrotic soft tissue (if can be maintained at hyperthermal
effect)
C) Reduce bacterial populations
… Result is reduced pocket depths over several weeks of healing

13. Periodontal Treatment
PROTOCOL:
For adjunctive
treatment of
scaling,
polishing, and
root planing:
• Pulse Mode
• Power 0.8-1.2 W
• 10-15
sec/pocket

14. Periodontal Therapy
Numerous human dental studies:
One of the first and many to follow:
Moritz A, Schoop U, Goharkhay K, Schauer P, Doertbudak O, Wernisch J,
Sperr W. Treatment of periodontal pockets with a diode laser. Lasers
in Surgery and Medicine 1998;22:302-311.
Findings:
1) Reduction of pocket depth
2) Inhibition of bacteria
3) Preserves healthy tissues

15. Other Applications in Dentistry

16. Soft Tissue
On the bactericidal setting the diode laser can be a powerful tool during
wound management:

17. Important Notes
1) The important principle: light energy strikes the tissue for a
certain length of time, producing a thermal interaction.
2) The targeted tissue needs time to cool before the next pulse of
laser energy is emitted.
3) Of paramount importance to use the least amount of energy or
power to perform the treatment objective.

18. Advantages & Benefits
1) Bio-stimulate tissue
2) Sterilize surgery site
3) Never produce resistant microorganisms
4) Hemostasis
4) Surgical versatility (furcations and distal sites of molars)
5) Reduced intraoperative and postoperative pain/discomfort
Remember: Diode Lasers have FDA clearance for use in the periodontal
pocket

19. Periodontal Therapy
1) In the periodontal pocket, the root surface is contaminated with plaque
and calculus, as well as infiltration of bacteria into cementum
2) Complete removal of these harmful substances is essential for healing
3) Since the periodontium is composed of gingiva, periodontal ligament,
cementum, and alveolar bone, both soft and hard tissues are always
targeted when using lasers for the treatment of periodontal lesions
4) Due to the diode laser’s wavelength it is safe to use near dental hard
tissue were the CO2 would cause major thermal damage

20. Advantages
1) Hemostasis
2) Surgical versatility
3) Reduced intraoperative and postoperative pain/discomfort
4) Reduced need for sutures
5) Sterilization of surgery site

21. Clinical Applications
1) Gingivoplasty / Gingivectomy
2) Biopsy
3) Gingival troughing
4) Crown lengthening
5) Subgingival curettage
6) Operculectomy
7) Frenectomy
8) Open pocket elimination