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Lasers in Dentistry: Minimally Invasive Instruments for the Modern Practice

Course Number: 394

Periodontal Pocket Therapy

All four major dental laser wavelengths have been used for the treatment of periodontal disease. Diodes, Er:YAG, Nd:YAG, and CO2 devices from various manufacturers have received FDA clearance for sulcular debridement, defined as removal of diseased or inflamed soft tissue in the periodontal pocket to improve clinical indices including gingival index, gingival bleeding index, probe depth, attachment level and tooth mobility. In 2004 Millennium Dental received FDA clearance for the Nd:YAG LANAP® Procedure (Laser Assisted New Attachment Procedure – cementum-mediated new periodontal ligament attachment to the root surface in the absence of long junctional epithelium). Nd:YAG and erbium lasers have been the most studied and utilized wavelengths in periodontal therapy. Nd:YAG lasers are useful in periodontal care because of their affinity for pigment allows for selective debridement of diseased sulcular epithelium. The Nd:YAG wavelength is also bactericidal, biostimulative, and has the ability to stimulate fibrin formation with the proper parameters. Erbium lasers have been shown to be effective at scaling and root planning, effective pocket decontamination, and can replace scalpels when incisions are needed. One notable advantage to laser techniques is a predictably more comfortable post-operative experience for patients.