Forums › Laser Resources › Laser Physics Related Literature › Near-Infrared Dental Diode Lasers: Scientific and Photobiolo
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ASISpectatorHi Ron,
Thanks for the post. Great info.
Andrew
AnonymousGuestToo bad the pictures didn’t come thru a little clearer.
Article was posted w/ permission. Thanks Eric and congrats on the article and the newborn!.
lagunabbSpectatorThanks Ron and EB for the article. It is very nice. Just a couple of questions:
In terms of usage, how much work do you do in the activated mode versus optical mode when using these lasers?
I was confused about why BBR was needed to explain the activated mode. How much of the energy from the hot tip is actually transmitted to tissues by far-infrared radiation compared to heat-conduction? I understand the part about convertion of optical energy to heat and infrared rays. However, BBR can exist even for very cold masses (anything above absolute zero). That’s how astronomers detected the newest planet.
Thanks for any comments.
(Edited by lagunabb at 7:46 am on Mar. 19, 2004)
dkimmelSpectatorRon,
Eric does some great articles. It sure would be great if he did some lecturing. It would be worth a plane ride to hear him.David
SwpmnSpectatorQUOTEIn terms of usage, how much work do you do in the activated mode versus optical mode when using these lasers?Thanks for any comments.
Ray:
Personally I use an 810nm diode laser almost exclusively in an activated tip mode Continuous Wave 0.9 to 1.25 Watts for retraction of gingiva/hemostasis around crown/bridge preparations. I have utilized both 300 and 400 micron diameter fibers.
Al
SwpmnSpectatorComparison/Contrast of Electrosurge/Radiosurge with Activated Fiber Tips of 810-830nm Diode Lasers
From my studies and Dr. Bornstein’s paper it appears that an activated(carbonized) diode laser tip vaporizes gingival tissue via heat with minimal input from the specific 810-830 nm wavelengths. In other words the activated diode laser tip acts as a piece of “hot glass” which melts away tissue.
So, what if any difference exists between an activated diode laser fiber tip and the tip of an electrosurge unit?
What’s the difference between electricity vs. a specific wavelength emitted by a laser? For a clinical example, why can a patient get a “shock” from an electrosurge unit yet I’ve never had this happen from my diode laser? Even on thoroughly anesthetized patients this can occur with electrosurge – mandibular molars were often challenging for me in my pre-diode years.
With the diode laser in an activated mode, we commonly retract the gingiva in areas that are not completely anesthetized with no response from the patient. For example, palatal of maxillary crown preps and lingual of mandibular premolars anesthetized via the mental foramen. Perhaps this could be accomplished with electrosurge but guess I was always too scared to try it on a patient.
Now for the big question:
Has anyone else experienced or can anyone explain to me why it seems that I get far greater control of hemorrhage around crown/bridge impressions with an activated diode laser tip(one year) when compared to over ten years usage of electrosurge on coagulation settings? Aren’t they both just two hot wires?
Al
SwpmnSpectatorFor those still interested in this old thread which I either overlooked or lost due to server issues, I was able to obtain some clarification and answers to my questions:
1) The objective when using an activated diode laser tip on dental soft tissues is not my oversimplified term “melting” but immediate tissue vaporization limited to the line of incision. Water and tissue vaporization begin at 100C while an activated diode laser tip operates at several hundred degrees Celsius(perhaps 700-900C).
2)Electricity in electrosurge and the specific 810-830nm wavelength emitted by a diode laser are two completely different forms of electromagnetic energy. Electrons from electrosurge are conducted by water, so the water in human tissue propagates electricity and can give the patient a “shock”. That’s why we use the grounding plate under the patient’s back. The infrared photons emitted by the diode laser are absorbed by hemoglobin in tissue and thus do not travel throughout the patient’s body.
3) With an activated/carbonized diode laser tip, there is a drastically reduced forward power transmission of the specific 810-830nm wavelength. Much of the laser energy is absorbed by the carbonized tip and converted to heat. However, there is still some forward progression of primary photons(810-830nm) coming out of the fiber tip. One obtains a deeper coagulation with the diode tip as there are still some photons absorbed by blood products deeper in the tissue than would account for simple heat conduction from a “hot tip”. This would explain my clinical finding of superior hemorrhage control using a diode laser around fixed prosthetic preparations when compared to electrosurge.
Al
SwpmnSpectatorReference:
The clarification posted in the immediately previous thread is credited to the author of the paper, Eric Bornstein DMD.
Al
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