DIODE LASERS IN CLINICAL PERIODONTICS Tartu , Estonia 19.10.2012

1. DIODE LASERS IN CLINICAL PERIODONTICS Tartu, Estonia 19.10.2012 Saint Petersburg Pavlov's State Medical University Department of therapeutic stomatology LukavenkoAlina DMD, Ph.D Loboda Ekaterina DMD, Ph.D OrekhovaLiudmila DMD, D.Med.Sc., prof., head of therapeutic Dentestry Department of SSMU, Editor-in-Chief of Parodontologiya Journal

2. The LASER– Light Amplification by Stimulated Emission of Radiation;the source of the electromagnetic visible, infra-red and ultra-violet ranges based on compelled radiation of atoms and molecules Lasers in medicine Ophthaolmology Ar, Kr, Excimer, Ho:YAGEr:YAG, Nd:YAG Neurosurgery CO2, Nd:YAG OtolaryngologyNd:YAG, CO2, Er:YAG, StomatologyNd:YAG, Er:YAG, Er, Cr:YSGG, CO2, Ar, Dioden PulmonologyNd:YAG, Cardiology Nd:YAG, GastroenterologyNd:YAG, Ar Urology Nd:YAG, Alexandrit,CO2, Er:YAG OncologyNd:YAG,CO2, Photodynamic OrthopedicsHo:YAG, CO2, Er:YAG, Nd:YAG Gynecology Nd:YAG, CO2, Er:YAG DermatologyAlexandrit, Ar, Er:YAG,Eksymern, Photodynamic, CO2, Kr, Kupfer, Nd:YAG AngioplasticNd:YAG, Er:YAG, Photodynamic

3. Laserdevice mirror of complete reflection reflector partially reflecting mirror or exit mirror resonator or solid mirror laser environment environment pulse lamp reflector

4. Parameters of laser radiation wavelength – distance which the wave passes for one period, λnm energy of radiation– energy transferred by a wave, ЕJ energy density– the quantity of energy falling on unit of area of the irradiated surface, II =Е / SJ/sm2 radiation capacity– quantity of energy given for a unit of time, W = E / tW capacity density– the capacity falling on unit of the irradiated surface, Р = W / SW/sm2 Dose - the quantity of energy absorbed by biological fabricsD = P x tW*s/sm2

5. The laser systems applied in medicine

6. 1/sm Er:YAG Nd:YAG Ar Diod Ho:YAG CO2 105 104 103 102 101 100 10-1 10-2 10-3 980 1064 2080 9600/10600 100 488 514 2940 nm Absorption of laser radiation by various components of biological tissue haemoglobin water Melanin protein factor of absorption hydroxyapatite dispersion length of a wave

7. laser interaction with a tissue: raypath Character of interaction reflection dispersion sorbtion transmission

8. Spectrum of electromagnetic radiation invisible ionizing radiation invisible ionizing radiation visible light 0.001µ 0.400µ 0.750µ 30.0µ 3.0µ Ultra-violetrays Nearinfrared Midinfrared Farinfrared X-rays ArFexcimer 0.01µ Argon0.488µ 0.514µ Nd:YAG 1.06µ Er:YAG 2.94µ CO2 10.6µ XeClexcimer0.308µ Heliumneon 0.632µ Ho:YAG 2.12µ Diode 980µ

9. Application of different types of laser radiation in medicine Laser influence The low-energy 0,5 – 3 mW The midl-energy 200 – 2000 mW The high-energy 20 – 100 W • 1. Intensive therapy • 2. Reflexotherapy • 3. Humoral rehabilitation 1. Physiotherapy 2. Endoscopy 3. Photodynamic therapy 4. Lasergyperthermia 1. Surgery, oncology 2. Cosmetology

10. Application of different lasers in stomatology Cariesandnoncarieslesions Diagnostics Whitening Diseases of oral mucosa Endodontics Conservative periodontics Surgery in periodontics Orthopedics Physiotherapy Orthodontics Surgery

11. DiodLaser Adiodelaserisalaserwhoseactivemediumisasemiconductorsimilartothatfoundinalight-emitting diode. The mostcommontypeoflaserdiodeisformedfromap-n junctionandpoweredbyinjectedelectric current. PACT ALOD LATUS LAZURIT DOCTOR SMILE™ WISER LA3D0001.3 Diod laser Picasso SIROLaser Advance SIROLaser

12. The mostcommontypeoflaserdiodeisformedfromap-n junctionandpoweredbyinjected electric current.

13. Application areaof diod laser radiation capacity 3 W 2W Physiotherapy 1W Photodynamic therapy Surgery

14. Аdvantages of the diode laser • direct transformations of an electromagniticcurrent to the light • high optical factor( near50% ) • big range of radiationfrom400 till 3000 nm • flexible management of radiation • small dimensions of the device • low price

15. Therapy 1. physiotherapeutic rehabilitation 2. Periodontal space processing 3. photodynamic therapy Clinical applications of diod lasersin periodontology Surgery1. correction of short frenulum, shallow vestibulum, lingual frenulum, lateral frenulum2. correction of gingiva3. Periodontal space processing (granulations remuval)4. helen screw installation

16. photochemical- initiate chemical reactions photopolymerization • Chemical bonds in molecules broken directly by laser light • Photodynamic therapy: creates biochemically reactive form of oxygen • biostimulation • Provides relief from pain • Stimulates wound healing • Alter biological process Basic Types of Laser Tissue Interaction Photothermal- Coagulation- warming- denaturing- vaporization- carbonizationphotodistruptive effects- plasma created- disrupts of breaks apart tissue- fluorescence- re-emission of absorbed laser light

17. Depending on parameters of laser radiation, on features of interaction with biological tissues there are: 1. Fluorescence (Luminiscence) – highlighting a biomolecule of quantum of light with bigger length of a wave (smaller energy). Scope– diagnostics with use of special hromoforin biological tissue. 2. Photochemical reaction under the influence of visible and infra-red radiation. Scope– laser therapy(at radiation of a tissue there are chemical and metabolic reactions). 3. Transfer of excitation energy to other molecule leading to subsequent reactions Scope– photodynamic therapy. 4. Photothermalreaction – excitation energy turns into the therma energyl. Scope– laser surgery &intensive thermometry.