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Lasertechnology + high-frequency technology. The best from 2 worlds. LASER HF. History. High-frequency technology HF (also known as radio-frequency RF).

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slide1

Lasertechnology + high-frequency technology

The best from 2 worlds

LASER HF

high frequency technology hf also known as radio frequency rf

History

High-frequency technology HF(also known as radio-frequency RF)
  • The high-frequency technology (HF) has strictly developed since the 70s, today the devices show clear improvements compared with conventional electric surgery.
  • HF is an unspectacular technology, however, it is known very well and accepted by the dentists in the surgical area.
lasertechnology

History

Lasertechnology
  • Laser devices are often offered as omnipotent instruments and are understood by users, unfortunately, often also as those.
  • Even though some applications turned out as unpracticable, the inquiry is high furthermore.
slide4

Laser in the dentistry

Laser systems and indications

slide5

Bases

37 – 60 °C

65 – 70 °C

Heat

Coagulation

Collagen is converted

into glucose

Hämostasis

Fabric changes colour

grayish / white

Fabric is shrinking

Reversible cell

damage

No visible changes

No mechanical

changes

Temperature

90 – 100 °C

400 °C +

200 °C

Drying

Carbonisation

Vaporisation

Carbonisation of

fabric

(grade IV)

Black colouring

Fabric is

evaporated

Production of

smoke

Intracellular

water evaporates

Further shrinking

of fabric

differences by commercially offered dental laser devices

Marketing

Differences by commercially offered dental laser devices
  • Achievement: 3 – 50 W
  • Moden: cw (continuouswave) / pulsed (µs – ms)
  • Programs: preset / user-defined
  • Design: all kinds
laser marketing strategy

Marketing

Laser marketing strategy
  • „ Better efficiency with higher achievement !“
  • „Special“ pulse-technology, to reduce thermal side effects
  • On the user fitted programs
  • Optimised hand pieces and fibers, tips
  • Great design
  • Price
slide9

Problems

Laser fiber, no kontakt

slide10

Problems

Laser fiber, in kontakt

slide13

Problems

Problem ! – Capillary effects

cuts in a pigs jaw

HF / Laser

Cuts in a pigs‘ jaw

HF: 20 W cut

Needle electrode 200 µm

Laser: 980 nm / 3 W

Fiber 200 µm in kontakt

slide15

HF / Laser

Laser fiber

200 µm

HF– electrode

200 µm

Mechanical strength

Mechanical strength

combination laser hf laser hf

HF / Laser

CombinationLaser + HF = Laser HF

Beginning for the problem solution :

Laser only up to max. 3 - 4 W and mainly HF for surgery

laser hf combination laser hf

Combination

Laser HF = Combination Laser + HF
  • Laser for applications with low achievement
    • LLLT (~ 100 mW)
    • aPDT (< 100 mW)
    • Bleaching (< 2 W)
    • Endodonics (< 2 W)
    • Parodontology (< 3 W)
    • Implantology(< 4 W)
  • HF instead of laser for oral surgery
slide22

Surgery

HF – oral surgery:

Frenektomy

parodontology kill of pathogenic germs

Parodontology

Parodontology: Kill of pathogenic germs
  • Access with the laser fiber like with an instrument, besides, always parallel with longitudinal of the tooth
  • Irradiate of the pocket ground with only approx.

1 W (980 nm) leads to a killing of pathogenic germs.

slide25

Endotonics

Endodonics: Decontamination of the root canal

  • Introducing the laser fiber into the root canal after preparation lege artis
  • Irradiate with 1 W, besides, pull out the laser fiber under rotation of the root canal
  • This procedure is repeated from 2 to 3 times, then the canal is sealed
implantology expose from implants

Implantology

Implantology: Expose from implants
  • The implant was put before a while and now is partial or completely covered from fabric.
  • With a laser achievement of approx. 3 – 4 W the implant is exposed.
slide29

LLLT

LLLT: Low level laser therapySoft laser

  • The light of a soft laser (25 – 100 mW @ 660 nm) is ideal for the treatment of inflammations, aphthes and herpes.
  • The time of treatment amounts between 60 and 240 seconds, besides, a surface of approx. 1 cm ² is irradiated with the laser.
slide30

LLLT

  • ???
slide31

PDT

aPDT:

Anti microbic photo-dynamic therapy

  • The customary methods of the plaque control are not often sufficient – neither mechanical with instruments nor chemical (rinse, antibiotics).
  • To minimise remaining risks, new methods of the selective elimination of pathogenic germs are required, these may not damage the oral flora, nevertheless.
  • With the development of anti microbic, photo-dynamic therapy (aPDT) and new laser technology it is possible to inactivate micro-organisms – also at inaccessible places – without damaging the surrounding fabric.
slide32

PDT

aPDT:

Applications

  • Treatment of oral carcinoms
  • Anti microbic photo-dynamic therapy (aPDT)
    • Management of bio film
    • Parodontitis, Paroimplantitis
    • Caries prophylaxis
    • Caries treatment
slide33

PDT

aPDT:

Photo-dynamic therapy Bacterial reduction about 99%

  • The photo-dynamic therapy is a non-thermal inactivation induced by light of cells, micro-organisms and molecules.
  • So-called “photosensitizer", colouring solutions (e.g., Toluidin blue, Methylen blue, Cyano Green, etc.) play an important role.
  • The oxygen atoms in the colouring solution are activated by the laser light radiotherapy. Besides, oxygen singuletts which have a toxic effect on cells are formed.
slide34

PDT

Fabric

Necrosis, membrane damages

Bakteria

Laser

Photosensitizer

slide35

PDT

  • ???
slide36

Disclaimer

Hager & Werken GmbH & Co. KG, [email protected]

The performed presentation was provided for internal purposes and may not be transmitted without knowledge by Hager & Werken GmbH & Co. KG and their written approval and/or be changed.

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