Clinical Application Of Er:YAG Laser In Mini Dental Implant Prosthesis

BackgroundThe use of lasers in implantology has been historically controversial. Whilst there is ageneral acceptance that Er lasers are capable of ablating soft and osseous tissues. It seemsthat there is no evidence-based advocacy as to the use of any laser wavelength in producinga fully-prepared osteotomy site for the placement of mini dental implant placementPurposeThe aim of this study was to investigate and describe the use of the erbium:yttnium-aluminum garnet (Er: YAG) laser) in mini dental implant prosthesis including removal andfixed prosthesis reconstruction.Methods and Materials(1) Patient selection and evaluation:Patients presented at our clinic and selected for laser implant treatment. A full andcomprehensive periodontal examination was performed in detailed including medical anddental history, periodontal charting, and radiograph (periapical x-ray films, panograph,and/or CT scan).(2) Laser Procedures:The laser energy from the Er:YAG laser (Syneron Medical Ltd, Israel) is in the infrared wavespectrum. The laser beam is directed at the target tissue with the lasing medium in the handpiece.In this laser, the photon is amplified by a medium of heterogeneous crystals (YAG). This laseremits photons at the wavelength of2,940-nm, with variable pulse duration of0.5～1.0microseconds and variable repetition rate of10～50Hz. During surgical procedures, the poweroutput is1.0-8.4W, yielding an energy density of100～700mJ. The sapphire tips havelengths of14,17and19mm, and diameters of800,1,000and1,300μm. During the surgicalprocedure, the sapphire end-cutting tip is approximately2mm from the target tissue. The softtissue was removed with a sapphire tip, with initial settings of20Hz and100mJ (2.0W), contactin hard mode. Then the ostectomy surgical sites with settings of20Hz,200～400mJ (4～8W),slight contact would have been used forward/backward motion. Cutting hard/soft tissues involve acomplex interaction of laser energy with water and tissues (hydrophotonics). Thus, the amount oflaser energy needed depends on the tissue involved.(3) The selection and mini implant prostheis reconstructionWith an O-ball abutment the overdenture can be made for the removal or fixed partial denture,wheares with square abutment it can be made of fixed partial denture. The construction of metal-ceramic prosthesis are made with tooth abutments and MDI copings.ResultsThis study shows that Er: YAG laser can be used as a surgical instrument in implanttreatments and to cut soft tissues and bones. This novel Er: YAG laser can use water spraycutting of hard tissue and bone structure to achieve the mini implant osteotomy. The doctormay choose to do laser incision and gradually make the implant cavity in the D1and D2bone, for the corresponding mini threaded implant. This article demonstrated and describedthe use of Er: YAG laser in mini dental implant procedures including complete removal andfixed prosthesis were approached successfully in full mouth reconstruction. ConclusionThe study confirmed that the Er: YAG laser with productive applications in themini-implant placement. It can be controlled using precise laser minimally invasivesurgery for the mini implant in the jawbone. Because of this new progress in laser directdelivery system, it seems that dentists can now use the hard and soft tissue laser on thesafety and predictable in different directions to complete mini-implant reconstruction.