Laser Technology in Implant Dentistry?

Dr. H asks:

Waterlase I’m considering incorporating laser technology into my dental implant practice. From what I’ve read, lasers could aid in the placement of dental implants and also help in decontamination of the implant surface in cases of peri-implantitis. I’d be interested in others thoughts on their experience with surgical lasers during implant treatment? Any other benefits to be aware of? Any drawbacks? Thanks.

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Filed Under Laser Dentistry, What's New, Dental Implants 

Comments

6 Responses to “Laser Technology in Implant Dentistry?”

  1. Brian James on July 12th, 2007 6:20 pm

    I have a perio-implant practice, and I use the KaVo Key 3 Erbium YAG laser. The laser is a very handy tool to have around for a number of reasons. It does not affect titanium surfaces so it is excellent for managmenet of peri-implant infections. Frank Schwarz in Dusselforf has done considerable work with this laser, and has completed a “proof of principle” study where osteotomy sites were prepped with the laser, adn implants integrated. THis is NOT what the laser is designed for, but it proves that it may be used with ease and safety around dental implants. It is good for stage II surgery, where repositioning of tissues are not required. It has a slight coagulation effect (although not as profound as other lasers such as the CO2), which is helpful in patients on anticoagulant medications. IN general, discomfort experienced by patients is a little less than when scalpels are used.

    When you are looking at different lasers, be extremely mindful of the laser physics, as I have seen some extensive damage around integrated implants from lasers other than the Erbiums, in clinicians who were assured the laser was “safe around implants”. Expensive toy, but good fun.

  2. Nikolas Jimenez DMD on July 12th, 2007 10:41 pm

    I have a CO2 laser and have used it for surgery, for vaporizing the gingiva over the implant site and have found that it functions as good as a tissue punch. I wouldn’t suggest buying it to assist in implant placement alone, the laser won’t perform miracles, but it does cut and coagulate. Mine works great with soft tissue excisions.

  3. Brian James on July 12th, 2007 11:04 pm

    Nokolas, my understanding is that CO2 will alter titanium surfaces and should not be used around these components. It has considerable penetration of energy and potentially may result in thermal injury to bone, if extreme care is not taken. I have used CO2 for gingival hyperplasia cases, and it is fantastic for that, but I think there may be better tools for implant related treatment.

  4. John McAllister DDS on July 15th, 2007 12:10 am

    I have owned an Nd:Yag (Periolase) for about a year and a half. Because it reverses perio disease it may not be a good fit for an implant motivated practice because now you would be able to save the patients teeth.

  5. T. Horneman on July 15th, 2007 9:20 am

    It depends on what you like to do with the laser. If you like to do bone-surgery the erbium-yag is the ideal laser like the fotona 3 plus. You can make nice bone-blocks for building up your ridges, you can use them to remove the smearlayer after you drill the wholes and speading up the intergration, you even can do the gingival surgery to expose your implant in the second stage. Don’t use the Nd-YAg, it will meld heat up your implants leading to fealure of your implant. If you just want to do the second stage surgery with the laser of to decontaminate your implant in peri-implantitis you also can use the diode-laser. In peri-implantitis the erbium-yag is usefull to remove the soft granulation-tissue. So it really depends on what you like to do which kind of laser is to be prefered

  6. Robert H. Gregg, DDS on July 16th, 2007 8:35 pm

    CO2 should be okay around implants since it is reflected off the surface and does not heat them up….as are erbium YAGs such as the KaVo Key 3.

    The PerioLase that Dr. McAllister mentions is afree running pulsed (FRP)Nd:YAG that can be successfully used around failing implants when keeping the total fluence to no more than 75 Joules. The results are clinically impressive with stabilization and bone regrowth in the surrounding defect. It is a “deep penetrating” but “selective absorbing” wavelength. Human histology by Prof Ray Yukna demonstrated 100% cementum mediated new attachment following a specific defined laser perio protocol called LANAP (laser assisted new attachment procedure). Manuscript to be published this Fall in the International Journal of Perio and Rest Dentistry (by www.quintpub.com)

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