engleski

Recent concepts of diode lasers usage in dental medicine

Laser devices have gained in importance since the eighties and they are often claimed to be omni-use instruments. Though many applications turned out to be impracticable, an unwaning interest in this technique has remained to date. The broad spectrum of applications for the diode laser means that it is now the most widely used device in laser dentistry. Diode lasers offer an interesting – but not unlimited – field of application in modern dentistry including periodontology, endodontics and soft tissue treatment. LLLT (Low Level Laser Therapy) is the application of red and near infra- red light over injuries or lesions to improve wound and soft tissue healing, reduce inflammation and give relief for both acute and chronic pain. LLLT is used to increase the speed, quality and tensile strength of tissue repair ; resolve inflammation and relieve pain (analgesia). The effects of LLLT are photochemical (like photosynthesis in plants). When the correct intensity and treatment times are used, red and near infrared light reduces oxidative stress and increases ATP. This improves cell metabolism and reduce inflammation. Low level laser therapy effects are biochemical and not thermal and cannot cause heating and thereby damage to living tissue. Four distinct effects are known to occur when using low level laser therapy: A) Growth factor response within cells and tissue as a result of increased ATP and protein synthesis ; improved cell proliferation ; change in cell membrane permeability to calcium up- take. B) Pain relief as a result of increased endorphin release ; increased serotonin ; suppression of nociceptor action. C) Strengthening the immune system response via increasing levels of lymphocyte activity and through a newly researched mechanism termed photomodulation of blood. D) Acupuncture point stimulation. The antimicrobial photodynamic therapy (aPDT) is a non-thermic light-induced inactivation of cells, microorganisms or molecules. "Antimicrobial" photodynamic therapy targets pathogenic microorganisms. Using a dye, the bacteria that cause infections are stained, sensitized and destroyed following exposure with light of a suitable wavelength and energy density. A decisive role plays the „photosensitizer“, a coloring solution (e.g. Toluidin Blue, Methylene Blue etc.). The oxygen atoms in the color molecules are activated by irradiation of appropriate light. They initiate singulet conditions, which have a toxic effect on the cells. The accent is on LaserHF device, the new instrument in the field of soft tissue surgery. Amazing composition of high frequency, diode laser and therapeutic laser in the single instrument is intriguing for the clinician. High frequency technology (HF) has been consequently developed since the seventies, with significant advancements over conventional electro surgery. HF is a unspectacular technology, but well known and accepted in surgical applications by most of the dentists. HF is great supplement for laser technology in the oral soft tissue surgery. The diode laser offers a minimally invansive technique and can make the surgery less extensive, and may reduce the need for general anesthesia or hospital care, and lowers the overall costs. For these reasons, it will become more widely use din the future, particularly in the increasingly elderly population.

dental medicine ; laser ; LLLT ; aPDT ; surgery

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