Dental Lasers in the 21st Century

Here at 21st Century Dental in Irving Las Colinas, we have always embraced microdentistry, a conservative approach to the surgical and non-surgical treatments for oral maladies and diseases.  We still utilize air abrasion dentistry, a unique non-drill way to remove decay from teeth without pain or anesthesia when the cavity has not advanced too far.  If you were a candidate, many of you have already benefited from that technology and conservative philosophy.

Our dental perio laser is another cutting edge, hi-tech advancement in the world of general and cosmetic dentistry that now allows us to treat soft tissue disease or provide cosmetic or functional surgical intervention with greatly reduced and often almost non-existent post-operative pain or sensitivity (just ask my wife!).  It has proven to regenerate attachment and re-grow lost bone in periodontal diseases.  Our goal when we first purchased the Lares Nd:YAG perio laser was to be a hero in our community and 21st Century Dental practice by treating old problems in new ways!  Could we get better results with less discomfort?  We can!

Why did we first decide to add this technology to our Irving, Las Colinas practice?  After years of research and watching the laser technology evolve and improve, we learned that we could provide many of the services we currently deliver in a better, faster, and more comfortable fashion.  Where indicated, the Lares perio Nd:YAG laser allows us to deliver patient care in a way that few modalities can, and in a way we couldn’t before.

Areas of Use

• Aesthetics (cosmetic gum recontouring where applicable)
• Restorative (to help us gain access and maintain a dry field when bacterial lesions dive below the gums)
• Crown Lengthening and Impressions  (when the tooth is too short and/or to keep things dry while capturing an impression of a crown preparation)
• Periodontal Disease Therapy (the Nd:Yag laser has been able to grow new bone and attachment without flap surgery!)
• Palliative Treatment  of Lesions
• And More: mouth ulcers, benign oral pathology or fibroma removal, viral lip lesions (come running to us at first sensation or tingle!), uncovering implants, removing oral warts or papillomas, treating denture sores, venus varix (blue things), frenectomies (to remove tissue that sometimes causes a space between front teeth), gingivectomy (gum improvements), gingivoplasty, pulpotomies (removing sick, painful nerve tissue), direct and indirect nerve capping (eradicating bacteria touching or almost touching the nerve, tooth exposure to aid painful eruption, and more…)
• Cutting edge procedures being looked at and evaluated:  Biostimulation for the TMJ, parasthesia, sinus infection, desensitization of teeth.
• Treating Heart Disease and Stroke patients who were historically bleeding risks due to taking blood thinners such as:  Aspirin, Heparin, Coumadin.  The laser carefully removes tissues and coagulates!

Our biggest concerns are with periodontal disease and that related treatment.  Why?  Over 100,000,000 American adults have moderate to severe periodontal disease yet less than 3% receive conventional treatment in a given year.  (Michael Newman, DDS, PhD,  7th Annual Conference on Periodontal Surgery, UCLA – November 8-9, 1996)

Professor Ray Yukna at LSU Dental School has said, “Periodontists have long sought methods of achieving pocket elimination by soft tissue new attachment in the suprabony pocket.”

              Journal of Periodontology, Vol. 47, Number 12, December 1976

The Solution

• New Soft Tissue Attachment  (eliminating the space/pocketing due to bacterial toxins)
• 50% Pocket  Depth Improvement  (don’t you love hearing those numbers decrease)
• New Hard Tissue (Bone) Growth 38% increase in bone density (the ultimate goal!)

Laser Perio Treatment Human Histology Study
Professor Ray Yukna, DDS, MS
Louisiana State University

• 6 patients
• 2 teeth per patient
• One LPT (laser perio treated) and one Control tooth
• 3 month tooth removal en bloc
• 6 of 6 showed “New Attachment”

              (new bone, PDL, cementum)

“These cases support the proof of principle that the Laser Assisted New Attachment Procedure using a free running Nd:YAG laser can be associated with periodontal regeneration on a diseased root surface in humans.”

THE ACTUAL PROCEDURE

Laser Periodontal Therapy
Case Selection

• Laser Periodontal Therapy may be used to treat all stages of periodontal disease severity from gingivitis to advanced periodontitis.  The more severe disease processes also require additional clinical intervention such as splint therapy, to stabilize highly mobile teeth.  This procedure would be done in conjunction with ultrasonic scalers.

We would like to thank Doctor Todd McCracken, DDS, MALD, for educational information and input used to compose this article derived from his lecture delivered at the AGD Annual Convention 2005.  We would also like to thank Dr. John Flucke, technology editor and consultant for Dental Practice and Products for his mentorship in perio laser integration as well.