Carbon dioxide (CO2) lasers have a wavelength between 9300-10,600 nm. The medium to create the laser beam is a gas that is cooled with either air or water. The laser wavelength is absorbed by water molecules and hydroxyapatite. In vitro studies have demonstrated that continuous CO2 laser use on titanium surfaces may damage the surface topography and/or heat up the titanium metal, but these deleterious effects may not be the case when these lasers are used in a pulsed setting.104
Diode lasers operate in the 800-1064 nm wavelength range. Diode laser mediums are semiconductor crystals and they target pigment in tissues and materials. Diode lasers may have to be “activated” using pigmented materials.16 Diode lasers have been used in combination with phenothiazine chloride dye, sometimes referred to as photodynamic therapy, to treat peri-implant diseases.104
Erbium yttrium aluminum garnet (Er:YAG) lasers operate at 2940 nm and have solid crystal mediums. These lasers are primarily absorbed in water and may be used as both hard and soft tissue lasers. Absorption of the laser beams occurs in hard tissues and titanium, which could lead to increased temperatures and/or surface melting if used at certain settings.104
Neodymium yttrium aluminum garnet (Nd:YAG) lasers use a solid crystal medium and have a wavelength of 1064 nm. Nd:YAG lasers are poorly absorbed by water and penetrate into soft tissues, allowing for their use in the peri-implant soft tissues.104
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