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Lasers in Dentistry: Minimally Invasive Instruments for the Modern Practice

Course Number: 394

Nd:YAG Lasers

Nd:YAG lasers were the first types of true pulsed lasers to be marketed exclusively for dental use in 1990. They are a near infrared wavelength of 1064 nm. This wavelength is absorbed by pigment in the tissue, primarily hemoglobin and melanin. Photothermal interaction predominates and the laser energy can penetrate deeply into tissues. Contact and non-contact mode are both utilized depending on the procedure being performed. Nd:YAG also have excellent biostimulative properties. Nd:YAG lasers have the unique capacity to safely coagulate blood, a phenomenon used postoperatively with extractions and soft tissue procedures. . This effect is maximized when the pulse duration is set at 650 microseconds.

These lasers are primarily used for periodontal treatments. Their proclivity for pigmented tissue allows for effective debridement and disinfection of periodontal pockets. Bacterial decontamination in tissues treated with Nd:YAG laser energy also contributes to resolution of periodontal infection. As noted earlier they stimulate fibrin formation with longer pulse duration settings and this phenomenon is utilized to biologically seal treated pockets and act as a scaffold for reattachment. The ability to form fibrin is also utilized when forming clots in extraction sites which can help prevent alveolitis and enhance osteogenesis. Nd:YAG lasers can also be used for multiple soft tissue procedures such as gingivectomy, frenectomy, impression troughing, and biopsy. The deep penetration and the near infrared wavelength of these lasers also make them ideal for photobiomodulation procedures.