Faster, simpler procedures with greater predictability are just the start
Twenty-five years ago, I decided to limit my practice to implant dentistry. Still today, this encompasses placing and restoring dental implants, as well as restoring adjacent natural teeth. Implants and restorations have been the focus in my practice for all these years.
The following observations on laser treatments in my practice are not intended to be a testimonial, but a simple recognition of outstanding technology as an aid in a very complicated dental field. As it is common, developments in technologies did not stop. As we advanced in the knowledge of implants and all related fields, new laser technologies have opened an even larger opportunity for treatment with absolutely predictable results, minimal trauma, and very low or no post-operative pain levels. I took a very close look at some of these issues and took that very important step three years ago when I added the 10.600 nm UltraSpeed CO2 laser from Deka to my practice. (There are many soft-tissue lasers on the market. Be sure to explore all of the possibilities before choosing the laser that’s right for you.) The benefits of this laser for patients have simply been outstanding, besides being a beneficial convenience to my practice. As I realized later, this was a most important step to improve my implant practice and cope with patient issues a lot better.
Procedures
The following are some of the procedures in which I integrate laser technology. We found that in our practice, we do a high number of immediate extraction replacements, i.e. we remove teeth that can no longer be restored, such as teeth with severe caries, fractured teeth, and those with failed endodontic treatment. Before we had this laser, we would do a delayed extraction placement when there was active pathology (exudates). We removed the tooth, curetted the socket, and then placed the patient on antibiotics. Three weeks later, the patient would return and we place the implant. This resulted in loss of time for me, and the patient was disappointed. The patient desired the implant with an immediate provisional restoration.
Now, by utilizing this laser technology, I can immediately sterilize the socket and remove any pathology without disturbing the osteocytes and osteoblasts in the bone. This convenience helps to facilitate the treatment, and now we have a satisfied patient.
Another use of the laser is the outstanding capability for treating Peri-Implantitis. Patients who have had various types of implants placed over long periods of time may develop some bone loss resulting in Peri-Implantitis. Since the laser does not transmit damaging heat, it can be utilized to vaporize any granulation tissue as well as clean the surface of the implant. I found that this procedure eliminated the acute state of Peri-Implantitis, increasing positive GTR, and thus allowing the patient extended use of the implant.
Improved health and safety
In implant dentistry, we often treat the aging population who have worn their teeth, lost teeth, or can’t wear conventional dentures. Many patients are on anticoagulants. We found that by using the laser for tissue punch directly over the implant, we did not have to take the patient off their medication. The UltraSpeed CO2 laser vaporizes the tissue, seals any of the small capillaries with the result that there is no bleeding. When we do more extensive exposures either to place the implant or perform periodontal treatment, we have the cardiologist control the patient’s anticoagulant medication. Again, the use of the laser in making all incisions during implant surgery will also help to control the bleeding.
Since I also do the prosthetic restorative portion of the treatment in my practice, I find the laser also extremely helpful for tissue retraction around the natural teeth as well as implant abutments. Again, since there is no extreme heat generated, this CO2 laser is safe to use around implants. Today, so many of our patients have high esthetic demands. I have found many new uses for my laser in “smile designs” of the soft tissue gum line. I am able now to always create the desired gingival symmetry in a totally atraumatic fashion.
The actual addition of laser technology to my practice has not only opened many new treatment options in my practice, it has also facilitated patient treatment in allowing optimum results, faster healing, less pain due to quicker healing of the soft tissues. This shortened the treatment time and patients are more apt to refer other patients.
In conclusion, the success in choosing the right laser for your practice is mainly based on (a) The type of practice you own, (b) the main population you treat, for example: are you a Pediatric Dentist, a General Dentist, an Implantologist, or an Oral Surgeon. Understanding the different wavelengths and lasers available in the market will help you choose what is right for you. There is no magic wand in laser technology. No one laser can do it all and not all lasers are created equal. Like computers, technology development dictates how a laser performs. Cutting edge technology equals better performance.