Oral surgery and perioral laser

applications

Seville, March 2008

 Curriculum Vitae
• Geb.: 1963 in Erlangen
• 1982-87: study
• 1988/89: oral surgery Prof.
Weiss
• 1990 : clinic near Nuremberg
• 1991: Nd:YAG Laser
d Lase 300
• 1992 : first laser assisted
implant
• 1993-2002 worldwide
workshops on all wavelengths
• 2001/2 lsds development
• March 2002 diplomate
ICOI
• 2002 Prof. Seville
• 2003 Prof.a.c. Padova
• 2004-06 MSc Lasers in
Dentistry
• 2006/07 Msc
Implantology
• 2008 lcdl transmission
 Why laser in oral surgery?
• Less bleeding
• Better overview
• More safety for patient and surgeon
• Less pain
• Better result
 Advances in oral surgery mean:
• Reaching more value for the patient
• Goal of our doing is:

the goal of the patient

People do not value big surgery

They do not want pain, long treatment time

(Cooper 2001)
Actual laser systems in our clinic
• Nd- YAG- Laser 1064
nm
• CO 2- Laser 10600 nm
• Argon Laser
480/510nm
• Er- YAG Laser 2780
nm
• Diode Laser 980nm
• Diode Laser 810 nm
Implant exposure

Diode laser
980 nm
2w cw
Ball attached lower jaw denture at a 74 year old
heart patient Quick 26 at exposure
 Locating and marking the implants Friday
2:15 pm
 Implant exposure and ball attachment
Friday 2:35 pm
Fixation of the attachment
Friday 3:10 pm
Finished denture after polishment
Friday 3:45 pm
Dalbo attachments
Friday 3:50 pm
Monday 8:00 am
OPG 05/2006
alio loco
 Implant exposure

75 year old female patient

CO 2 Laser
3w cw
OPG 10/2003
Situation, Implant Locator,
UDS forte 0.1ml/ Implantat
 CO2 Laser
mirror beam,
3 w cw, non kontakt
20 sec pro Implantat
Magnetic attachments
4 days after exposure
Situation 3 years later
OPG 05/2006
 Esthetic case

Female patient
27 years old
Insertion 2 Implantats 11/21
(jeweils Hi-Tec 16mm SR 4,2mm) after traumatic
loss of the teeth
 Röntgenausgangsbefund
Fremd OPG vom 14.11.2005
Planning models
Situation
Surgery
After Implant surgery 13.04.2006
Implant exposure, Er-YAG laser 30 hz
100mj pulsewidth 300 µs
Crowns
Try in,18th july 2006
12th October 2006
3rd January 2007
3rd January 2007
Er:YAG 600µs pw 15 hz 300 mj
Er:YAG 1000µs pw 15 hz 300 mj
 Periimplantitis 24,25

55 year female patient

ER:YAG Laser
300µs pulse width
300 µm contact handpiece

I
Extraction24,25, immediate implant,
30 th January,2005
x-ray 23th July 2005
 23 th July 2005
pocket 5mm 26, pocket 4 mm 5, bleeding, tension of
the cheek
 Cut and flap:
ER:YAG 30 hz 100 mj/ Puls

Vaporisation of the infected tissue Cleaning of the implant

surface
 Nano Bone after refreshment of the bone
ER:YAG 25 hz 250 mj

Nano Bone Naht Vicryl rapid 4.0

 Vestibuloplasty
ER:YAG 30 hz 100 mj/Puls

Fixierung Vicryl rapid Naht 4.0

7 days after

Fibrin on the surface

X-ray 29 th of May 2006
29 th of May 2006
Missing attached gingiva

15 year old girl

Vestibuloplasty
Lower front
ER:YAG no spray pw 1000 µs
15 th July 2003
 Vestibuloplasty
Er- YAG 15 Hz 400 mJ 1000µs,
very small bleding,
gain of attachment 10 mm, peri pac
 16th July 2003
ugly photo, but painless
 21st of July
Fibrin covers the wound
28th August 2003
7mm vestibulum
 31st May 2006
5mm attached gingiva
 Mesiodens

8 year old patient

Mesiodens palatinal 11/21
ER:YAG 300 µs
OPG 03/2006
Mesiodens
Oral Situation

Protruded 21
frenulum
Palatinal 11
mesiodens
Soft tissue

ER:YAG Laser 300 µs

30 hz 100 mj/Pulse
Saphir Tip 300 µm
Spray 15ml/min
Luft 3 bar
Bone surgery

Bone surgery
ER:YAG 300µs Saphir
Tip 300 µm
25 hz 300 mJ/Puls
Spray
2 min
Extraction
Mesiodens/ seam 2-0
1 day after
Fibroma under denture

ER:YAG 300 µs
30hz 100 mj/ Pulse
Spray 15 ml/min
Air pressure 4 bar
Clinical Situation(1)
Clinical Situiation(2)
Contact hand piece 300 µm
After removal
Fibroma
1 week after
 Scars

Nd:YAG

VSP
100 hz 5 Watt
OPG 2002
Set of instruments
 Laser applications
• Substitition for Scalpel ?!
- better overview
- higher precision
- less pain and scar
• Excision of benign tumors
• Frenectomy and vestibuloplasty
• Leukoplakia
• Patients with anticoagulant therapy
• Vascular lesions
• Biostimulation
Incision with Nd-YAG laser
Excision of fibroma of the tongue
Adenoma of the palate
Papillomatosis of the hard palate
Large fibroms upper jaw
Epulis granulomatosa
Hydantion caused hyperplasia
Epulis granulomatosa
Mucocele
Ranula
Vestibuloplasty upper jaw
Vestibuloplasty Edlan-Mejchar
Fibroma CO ² laser
Excision of fibroma spray cooled
Steps for excision of fibroma with fiber
Recovery of impacted canine
Cool pro 980 nm
Spray cooled recovery
Frenulum of the tongue
Frenulum of the tongue
Frenulum of the tongue
Frenectomy CO ² laser
Frenectomy diode laser
Vestuloplasty cool pro 980 nm
3 months after
Leukoplakia 1
Leukoplakia 2
Leukoplakia 2
Vascular lesions 1
Vascular lesions 2
Salivary calculus