Since the early 80’s, the use of laser has been introduced in the daily dental practice and the technological development has also provided over time to optimize its use. Various types of lasers with different wavelengths have been developed for use in a handy, easy and ergonomic manner.
In daily paediatric dentistry, laser could be a very useful medical device which can completely replace the traditional high hand-piece and bur to realize a “micro-invasive” dentistry and a “clean” surgery, without bleeding and sutures. According to the international literature and in the light of recent researches, this work could give an overview on assisted laser therapy in paediatric dentistry, highlighting advantages and disadvantages of this new technology and pointing out the high compliance of the young patient.
The relationship between bioptic technique and tissue preservation has been studied in 18 oral biopsies of young patients obtained by electro surgery or CO2 laser surgery. Biopsies were formalin fixed, paraffin embedded and histologically, histochemically and immunocytochemically treated. All the biopsies show inflammatory cell infiltration, epithelial spongiosis, trichocariosis, supra basal small blisters, and epithelial clefts with lamina detaching from the corium. Histochemistry shows both the presence of edema and acid mucopolysaccharides inside the corium, and variable glycogen content in epithelial cells. Trichocariotic cells show a positive MiB1/Ki67 expression, when they are present. Nevertheless, laser biopsies show a lower amount of basophilic fibrous tissue and of bc12 bodies detection, connected with a higher amount of glycogen, Cytokeratin and MiB1/Ki67 expression in epithelial cells, compared to bovie biopsies. The result show a higher degree of damages in particular at the epithelial level, in electro surgery biopsies rather than laser biopsies. The best epithelial and corium preservation showed by laser biopsies suggest a chance of reversible condition, which can lead to a complete recovery due to its higher capability of restoring tissues.
The effect of Er:YAG laser in debris removing after conventional root preparation was tested by optical system in vivo and scanning electron microscope in vitro. The root canal of fifty permanent molars was cleaned in vivo and Er:YAG laser treated. Flexiscope system was used to evaluate the efficacy of laser cleansing at the different stages of endodontic therapy. Forty permanent teeth, extracted for orthodontic or periodontal purposes, were treated in vitro using the same technique an instruments. The in vitro treated teeth were also examined under the SEM. The result of our investigation show an effective improvement of the cleansing of the endodontic surface from pulpal remaining and a smear layer after laser irradiation in vivo and in vitro. The use of Er:YAG laser in organic debris removing and the consequent optical system analysis of the quality of root preparation in vivo seem to be a reliable technique particularly useful in clinical application.
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