Posts Under Laser
A patient presented with discomfort on the lower left side due to pulpitis of tooth 3-5. The tooth had been previously restored with a very large and deep composite restoration. The depth of the decay and trauma associated with removing it caused an irreversibe inflammatory response in the tooth known as pulpitis. This tooth required immediate endodontic treatment to remove the inflammed pulp tissue and resolve the discomfort.
Traditionally, this treatment is completed using chemical irrigation of the canal system to ensure the organic tissue and bacteria have been removed from the system. Some chemicals can be dangerous and difficult to use. Also, there is little guarantee that the chemicals introduced into the space can completely reach the apex of the tooth without passing beyond the tooth into the periapical tissues.
At Basinview Dental Centre, Dr. Luke Haslam does not use chemical irrigation to complete root canal disinfection, but rather uses laser energy applied by the Waterlase iPlus. With this system, root canals are cleaned and shaped using traditional instrumentation (hand and rotary endodontic files; stainless steel and/ or nickel titanium). The irrigatant used is simply distilled water - zero complication if any water passes beyond the tooth apex. Once the canal has been shaped as desired, a special laser tip is inserted into the canal space. Once the canal is shaped properly, this tip can be placed into position to allow laser energy to disinfect the tooth apex. Laser energy is applied in a series of passes throughout the canal system until the desired disinfection is achieved - for some teeth, this may merely take 30 seconds!
There is no discomfort or chemical smell. The laser will remove organic debris and bacteria 1000um laterally from the main canal. This means far greater penetration of disinfection than chemical systems into lateral canals, fins, isthmuses and apical deltas. These areas are a common cause of root canal failure - the chemical disinfection simply can not remove was it can not touch.
The root canal completed for this patient clearly shows a complex apical delta - there are at least 5 openings at the apex of this tooth. The laser disinfection allowed for these areas to be easily cleansed prior to obturation which allowed the gutta percha filling to flow into these areas. This will greatly improve the patient's chance of success with this treatment.
The patient noted no post-operative discomfort and has been symptom free since the treatment was completed 4 months ago. The patient has scheduled to have a full coverage crown placed on this tooth to complete the treatment for this tooth.
Conventional periodontal therapy usually involves mechanical scaling and root planing to remove the hardened deposits and rough areas along root surfaces in attempt to allow natural healing. When this treatment is unsuccessful, periodontal surgery is often the next step, which is often very expensive, time consuming and met with post-operative pain. The surgery often results in recession that is not esthetically pleasing.
Laser periodontal therapy is an effective treatment alternative to conventional surgical therapy. In most cases, the treatment can be completed without reflecting a surgical flap of tissue dramatically reducing the risk of recession. The laser energy applied to the pockets and is very effective at removing the infected tissue, disinfecting the pockets and removing the micro-deposits of calculus and infected cementum that can not be removed by mechanical means. In many cases, the entire procedure can be completed with the use of topical anesthetic alone!
There are countless studies that demonstrate the effectiveness of laser periodontal therapies. This simple procedure has been proven to promote reattachment of tissue, bone growth and wound healing. These results can not be achieved by conventional therapies alone.
Keep posted for some treatment results that have been achieved through laser treatments completed by Dr. Luke Haslam and the Waterlase iPlus (ErCr:YSGG 2780nm RFTP).
Basinview Dental Centre is pleased to offer dental treatments using the Waterlase iPlus. With this technology, many cavities can be easily and quickly restored without the application of anesthesia. That means no more needle and no more numbness.
The laser simply applies light energy (photons) to the tooth with a fine mist of water and precisely removes the targeted tooth structure and decay. There is no heat and no vibration and therefore, no discomfort.
Over the coming weeks, we will highlight a variety of specific treatments that can be completed with the Waterlase. With each treatment, we will outline the procedure, the treatment goals, the duration of time required and the expected treatment outcome. We will also offer some basic laser physics so patients can better understand just exactly how the works and why it is so effective at promoting wound healing.
Here is a 30sec video clip of the laser in action. An old composite filling and underlying cavity is removed without any anesthesia. The filling was slightly below the gumline causing some minor bleeding at the margin of the preparation. The tissue is quickly dried with the laser, again without the use of anesthesia. Note the distinct popping sound the laser makes and how the handpiece never actually touches the tooth!