LASER
DENTISTRY............
LASER
ENDODONTIC THERAPY
What
is Endodontics?
Endodontics is the
area of dentistry dealing with the prevention, diagnosis,
and treatment of disorders of the dental pulp.
Endodontic therapy (root canal) is a treatment modality
that will save diseased or injured teeth. The alternative
to endodontics is extraction. Typically, a severely decayed
tooth or a tooth with a large filling will begin to ache.
The pain might be intermittent at first and over time progress
to a constant dull throbbing pain or a severe ache that
might be felt on all the teeth on the affected side. Sometimes
there is no pain and an abscess might be discovered on a
routine x-ray.
The pulp is the soft
tissue that is located inside the tooth structure. It contains
nerves, arteries, veins, and lymph tissue. It is contained
in the canals located in thin tube-like spaces in the roots
and in the pulp chamber located within the crown of the
tooth.
This image shows
how the progression of decay, if not treated, will lead
to destruction of the tooth's hard tissue and pulp. If treated
at the beginning of the decay process (first image), a small
filling would resolve the problem. If allowed to continue
as in the last image, root canal therapy would be necessary.
Decay progressing
from a white spot lesion(A), into the enamel(B), into the
dentin(C), towards the pulp(D), into the pulp(E), resulting
in the formation of an abscess in the jaw bone.
When the pulp is
diseased or injured and unable to repair itself, it becomes
infected. Left untreated, the pulp will die and become necrotic.
Pus can build up at the root tip, forming an abscess that
can destroy the bone surrounding the tooth. Endodontic treatment
is the removal of the diseased pulp tissue, which will enable
the body's defense system to repair the damage caused by
the infection.
Endodontic therapy normally takes two or three visits to
complete.
The following steps
are involved in the treatment of the tooth:
- A local anesthetic
is used so the procedure will be pain free. The tooth will
then be isolated by placing a rubber dam over it. This thin
sheet of rubber provides a clean and aseptic working environment.
- An opening is then
made through the top of the tooth into the pulp chamber.
- The pulp is removed
from the pulp chamber and the root canals are cleaned, enlarged,
and shaped to a form that can be filled and sealed latter.
- A temporary filling
is placed in the the opening in the tooth to seal it between
visits. There can be some discomfort in the area of the
tooth for a day or two following the initial visit. Occasionally
the pain can be more severe.
- During the next
stage of treatment, the temporary filling is removed and
the root canals are filled and sealed. This completes the
endodontic treatment.
The dark
area at the end of
the root is a large abscess
before endodontic treatment.
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This shows
the healed abscess
after endodontic treatment.
Following completion the tooth will need to be restored.
Due to the large amount of tooth structure usually lost
from decay and old fillings the preferred restoration is
a crown. A post may be placed into the root to give additional
structural support.
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ROOT CANAL/ENDODONTIC
PROCEDURES
Tooth preparation to obtain access
to root canal
Root canal preparation including enlargement
Root canal debridement & Cleaning - (Surgical
excision of dead, devitalized, or contaminated tissue and
removal of foreign matter from a wound).
Flap preparation incision of soft tissue to prepare
a flap and expose the bone
Cutting bone to prepare a window access to the apex (apices)
of the roots
Apicoectomy - removal of the tip
of the root.
Root end preparation for retrofill
Removal of pathological tissues and hyperplastic tissue
(An abnormal increase in the number
of cells in an organ or a tissue with consequent enlargement).
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LASER ENDONDONTIC
THERAPY
Dentistry has now
been introduced to a new root canal treatment using the
Er,Cr:YSGG (erbium, chromium:yttrium scandium gallium garnet)
laser to provide additional important benefits to our patients.
This new system should help reduce patient fear and improve
their general attitude towards dentistry. The device that
provides such a treatment is the Waterlase Hydrokinetic
Hard and Soft tissue laser (Biolase Technology, Inc), the
only laser system to receive FDA clearance for complete
endodontic therapy involving enamel, dentin, pulp and other
root canal procedures. This laser uses specialized fibers
of various diameters and lengths that provide access to
effectively remove pulpal tissues and tooth structure from
the root canal walls, and prepared the canal for opturation.
From my experience
with the Waterlase Hydrokinetic system on patients, the
most important benefit of this revolutionary technology
for endodontic treatments is the ease of using the system
and the great degree of patient comfort during and after
the procedure. Also, I have found a reduced need-and in
some cases no need to all-for prescription pain medication.
Furthermore, postoperative complications such as inflammation,
swelling, and pain were significantly reduced. In addition,
the possibility exists that more root canal therapy can
be performed without any anesthesia. Also, due to the antibacterial
effect of the YSGG laser, it is my opinion that this will
lead to a reduction in the need for postoperative antibiotics.
All of these factors help to improve patients attitude
towards dentistry.
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The
following are the different types of Laser Dental procedures
that are available:
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LASER ENDODONTICS
What
is Endodontics?
Endodontics is the
area of dentistry dealing with the prevention, diagnosis,
and treatment of disorders of the dental pulp.
Endodontic therapy (root canal) is a treatment modality
that will save diseased or injured teeth. The alternative
to endodontics is extraction. Typically, a severely decayed
tooth or a tooth with a large filling will begin to ache.
READ
MORE............
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LASER PERIODONTICS
What is Periodontics?
Periodontics is that
specialty of dentistry which encompasses the prevention,
diagnosis and treatment of diseases of the supporting and
surrounding tissues of the teeth or their substitutes and
the maintenance of the health, function and esthetics of
these structures and tissues. READ
MORE............
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LASER PEDODONTICS
What
is Pedodontics?
Pedodontics or Pediatric
Dentistry refers to a branch of dentistry that specializes
in dental care for children under the age of 16. Pediatric
dentists require an extra two to three years of dental training
that prepare them in meeting the unique dental needs of
infant, children, and adolescent dental care. This also
includes those with special health care needs.
READ MORE............
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LASER SOFT TISSUE APPLICATIONS 1
SOFT TISSUE
PROCEDURES INCLUDING PULPAL TISSUES
Excisional and incisional biopsies
Exposure of unerupted teeth
Fibroma removal - A benign tumor
that consists of fibrous tissue.
Flap preparation incision of soft
tissue to prepare a flap and expose the bone
READ MORE............
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LASER SOFT TISSUE APPLICATIONS 2
Implant recovery
Incision and drainage of abscesses
Laser soft tissue curettage of the post-extraction tooth
sockets and the periapical are during apical surgery
Leukoplakia - refer below
Operculectomy
READ
MORE............
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LASER SURGERY
Laser surgery for
soft tissue management and tooth whitening to enable cosmetic
dentists tp provice the superior dental care.
For soft tissue and
tooth whitening procedures:
- Gingivectomy Gingivoplasty
- Gingival troughing
- Gingival curettage
- Soft tissue crown
lengthening
- Frenectomy
READ
MORE............
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