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Soft lasers in the implantology

Enhancement of wound healing is the most important benefit of soft laser (SLT) therapy. It is a very efficient additional therapy after implantation or other surgeries. Dentistry and oral surgery are the medical specialties applying this therapy the most frequently.

Post-operational recovery is quicker, sutures can earlier be removed, and there is less post-surgical pain, swelling. All those benefits led to the rapid and wide spreading of lasers in the stomatology.

Soft laser therapy is very versatile in the complex therapy of the epidemic parodontal diseases. Conventional treatments with additional soft laser therapy result in quicker wound healing, start of bone regeneration, rapid sanation of the inflammation. This method has much benefit in conditions as parodontosis, parodontitis, gingivitis, dentition, orthodontic treatment, periodontal pockets.

Gingivitis is a common diagnosis of the dental praxis. More than 90% of the population suffer from more or less severe parodontal diseases. Development of gingivitis and probability of parodontosis depends on the bacterial virulence and the individual’s resistance. The laser itself cannot replace the dental treatments necessary to the improvement of oral hygiene and plaque removal. Every parodontal treatment starts with the restoration of oral hygiene and professional plaque removal. These procedures are completed with laser - before, during and after the treatments.

The soft laser has many benefits in these therapies: Reduces the inflammation of the gum, what causes the swelling and pain. The inflammation inhibiting effect of the laser slows down and inhibits the decomposition of parodontal tissues. Bleeding is reduced during the parodontal surgeries, due to SLT’s anti-inflammatory effect. Reduces bite sensitivity in case of occlusion. Teeth won’t be sensitive after surgical interventions. Wound healing is quicker, post-operative pain is milder consequently less pain killing medication will be applied after parodontal surgeries. Laser may stimulate bone rebuilding on those sites where previously bone resorption occurred - under appropriate conditions and in course therapy. SLT is not only capable of reducing bone resorption but stimulates bone rebuilding as well. Laser therapy considerably stimulates the vertical bone building.

is a very common condition. Mostly appears on the upper lip with swelling and pain. The herpes regularly recurs on every fourth, fifth person; neither general, nor local medication has been developed. This skin lesion spontaneously heals in 8-14 days. The soft laser therapy is most efficient in the hours before the appearance of the skin disorders. That time the patient feels the typical tingling, itching pain preceding the visible outbreak of the herpes. If a daily SLT therapy with visible laser light starts that time the condition generally heals on the third day. Laser therapy reduces not only the time of the discomfort to 2-4 days, but the recurrence by 50% as well.

Aphtha is one the most common lesions of the oral mucosa; occurs in 10-60 % of the patients at any age and often becomes recurrent. It is an auto-immune response of the mucosa that triggers the cross-reaction of a specific streptococcus type. Aphtas are small, painful red lesions that seem to be ulcerous. They can appear as solitary or multiple lesions and they heal in 8-10 days without leaving scar behind. The stomatitis aphthosa recurrens cicatricisans is a special type of the aphtha, it is very painful, heals slowly and leaves scar behind. Daily therapy with continuous wave visible laser heals the lesions in 4-5 days in the two third of the patients, the remaining one third is slightly responsive to the therapy.

Tooth removal is one of the simplest routines of oral surgery. However, most of the complications in the dental praxis are tooth extraction related due to its frequency. Tooth extraction affects both jawbone and soft tissues and inflammatory complications occur rarely even in presence of severely infected adjacent tissues. The post-operative laser treatment has a great importance, because other complications can be related to the extraction. In a couple of minutes after the complication-free extraction the bleeding reduces in the tooth socket. Blood clot forms contraction fissures bacteria may infect The inflammation in the alveolar region induces leukocyte migration upwards; a yellow-grey plaque forms on the clot to prevent infections. Capillaries start to grow from the alveolar walls in three days and they will cover the coagulum in three weeks. In the same time the epithelial cells of the wound edge start to grow. The alveolus surface seals; granulation tissue later woven bone replaces the blood clot and the tooth socket will be remodelled in 1-2 years. No swelling, bleeding or pain occurs during this normal healing process.

Very strict rules are to be observed before placing the implant, the bone graft; during the surgery, immediately after the surgery; in the osseointegration phase and after loading the implant. Strictly defined conditions are to be established for the implants. Soft lasers have an important role in the establishment and maintenance of these conditions. Low number of post-operative complications and success of the implantations indicate the efficiency of the lasers. Laser treatment of the implant site prior to surgery stimulated the bone building process, to produce bone of appropriate density. This treatment shortened the waiting time on extraction sites, surgical bone deficiencies. Instead of half year waiting time it was possible to place the implant after 3-4 months as a result of regular laser therapy (2 times a week). The laser together with medication enhanced the quick sanation of the inflammations and the integration of the bone grafts. As a result of one laser treatment during surgery there was no post-operative pain, swelling at all. As a result of daily laser treatment during 4-7 days after surgery, the sutures could have been removed in 4-5 days, instead of the usual 6-8 days. The drain effect of the sutures was earlier eliminated; so the pathogens had less chance to infect the fresh surgery site. Wound sealing and biologic sealing became stronger and better. Risk of bone graft failures has considerably been reduced. The osseointegration was quicker, the epithelial attachment became stronger, fixed gum appeared more often in laser treated patients. Weekly two laser treatments may prevent the eventual inflammatory complications. In the functional stage laser therapy becomes necessary if there are inflammations in the surroundings of the implant. The intensive 2 week therapy enhanced the sanation of the parodontal inflammation, bone resorption and mucosa inflammation furthermore promoted the restoration of the biologic sealing and the integration of the bone graft.