14.The using of infrared, ultraviolet, laser irradiation and BIOPTRON in the periodontal diseases treatment
Bioptron Light. What is Bioptron Light?
The BIOPTRON Light Therapy System is a worldwide patented light therapy. It is a medical device with a specific optical unit emitting polarized light that is similar to the part of the electromagnetic spectrum produced naturally by the sun but with no UV radiation.
It is a medical innovation with natural healing power.
Bioptron Light Therapy can: • Improve microcirculation • Harmonize metabolic processes • Reinforce the human defence system • Stimulate regenerative and reparative processes of the entire organism • Promote wound healing • Relieve pain or decrease its intensity The outstanding characteristics of BIOPTRON Light enable the light to penetrate not only the skin but also the underlying tissues. Thus the positive effect of BIOPTRON Light is not limited to the treated skin area but also has a beneficial effect on the entire organism. When cellular chain reaction is initiated, it triggers secondary responses that can involve the whole body. BIOPTRON Light Therapy stimulates and modulates reparative and regenerative processes as well as the processes of the human defence-system. BIOPTRON Light Therapy acts in a natural way by supporting the regenerative capacity of the body and therefore helps the body to release its own healing potential. The BIOPTRON Light Therapy has become accepted as a new form of treatment in prevention, therapy and rehabilitation worldwide.
Bioptron Light Therapy and Wound Healing
BIOPTRON Light Therapy can be used as monotherapy and/or as complementary therapy for wound healing in the following indications:
• Wounds after a trauma (injuries)
• Burns
• Wounds after operations
• Ulcers
• Decubitus (pressure sores)
Bioptron Light Therapy and Pain Treatment
BIOPTRON Light Therapy can be used as monotherapy and/or as complementary therapy for pain treatment in the following indications:
Rheumatology • Osteoarthritis • Rheumatoid arthritis (chronic) • Arthroses
Physiotherapy • Low back pain • Shoulder and neck pain • Carpal tunnel syndrome • Scar tissue • Musculoskeletal injuries
Sports Medicine Soft tissue injuries of muscles, tendons and ligaments like: • Muscle spasm • Sprains • Strains • Tendonitis • Ligament and muscle tears • Dislocations • Contusions • Tennis elbow
Laser Dentistry
Laser dentistry has been proved especially beneficial for various purposes such as gum reshaping, teeth whitening, cavity removal and to harden the bonding material used in fillings. It is also used for periodontal care such as removing bacteria from the periodontal pockets. Here is some useful information on this field…
All laser devices have the basic following components:
· A laser medium, which can be a solid, liquid, or gas.
· An optical cavity or laser tube having two mirrors, one fully reflective and the other one partially transmissive, which are located at either end of the optical cavity.
An external mechanical, chemical, or optical power source which excites or “pumps” the atoms in the laser medium to higher energy levels
Effects of Lasers on Periodontal Therapy
Pain relief
1. Laser therapy blocks the pain signals transmitted from injured parts of the body to the brain. This decreases nerve sensitivity and significantly reduces the perception of pain.
2. Increases the production and release of endorphins and enkephalins which are natural pain-relieving chemicals within our bodies.
Inflammation reduction
§ Laser therapy causes the smaller arteries and lymph vessels of the body to increase in size – a mechanism called vasodilatation.
§ This increased vasodilatation more effectively allows the following:
o Inflammation, swelling, and edema to be cleared away from injury sites.
o Promotes lymphatic drainage which also aids in this vital healing process.
Accelerated tissue repair and cell growth
• Photons of light emitted by therapeutic lasers penetrate deeply into the tissues of the body to stimulate the production centers of individual cells.
• This stimulation increases the energy available to these cells, causing them to absorb nutrients and expel waste products more rapidly.
Wound healing
Improved blood flow
• Laser therapy significantly increases the formation of new capillaries (tiny blood vessels) within damaged tissues.
Reduced formation of scar tissue
• Laser therapy reduces the formation of scar tissue (fibrous tissue) following tissue damage related to cuts, burns, and surgery.
• Laser therapy is able to reduce this formation by speeding up the healing process, improving the blood flow to the injured area, and more effectively carrying away waste products.
• Faster healing always leads to less scar tissue formation.
Advantages of Laser
• Relatively bloodless surgical and post-surgical course
• The ability to coagulate, vaporize, or cut tissue
• Sterilization of wound tissue
• Minimal swelling and scarring
• No requirement of sutures
• Little mechanical trauma
• Reduced surgical time
• Decreased post-surgical pain
• High patient acceptance
Laser Safety
General safety requirements include laser warning sign outside the clinic, use of barriers within the operatory, and the use of eyewear to protect against reflected laser light or accidental direct exposure. High volume suction must be used to evacuate the plume from tissue ablation. Several authors have studied the thermal effect of lasers on the periodontal ligament and surrounding bone. Hence, periodontal tissues are not damaged if the temperature increase is kept below 5°C. A threshold temperature increase of 7°C is commonly considered as the highest thermal change, which is biologically acceptable to avoid periodontal damage.
Recent Advances
• Waterlase system is a revolutionary dental device that uses laser energized water to cut or ablate soft and hard tissue.
• Periowave™, a photodynamic disinfection system, utilizes nontoxic dye (photosensitizer) in combination with low-intensity lasers enabling singlet oxygen molecules to destroy bacteria (Thomas, 2006).
With conventional mechanical instruments, complete access and disinfection may not be achieved during the treatment of periodontal pockets. Lasers have the potential advantages of bactericidal effect, detoxification effect, and removal of the epithelium lining and granulation tissue, which are desirable properties for the treatment of periodontal pockets. Thus, laser systems, applying the ablation effect of light energy which is completely different from conventional mechanical debridement, may emerge as a new technical modality for periodontal therapy in the near future.
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Benefits
Laser dentistry is useful in different aspects of dental health practice. It is an effective way to perform several dental procedures. This treatment option minimizes pain and recovery time. Those who opt for an extreme comfort and safety prefer a laser dentistry option. The dental procedures performed using lasers may not need sutures. Certain procedures don’t even require anesthesia. As a high-energy laser beam causes coagulation of exposed blood vessels, bleeding during dental procedure is minimized and blood loss is effectively controlled. As this high-energy light beam sterilizes the area to be treated, there are fewer chances of bacterial infections. The surrounding tissue is also less damaged during the laser dentistry procedures. The tissues are regenerated and the wounds heal faster.
Applications
Laser dentistry can be applied to perform a wide variety of dental procedures. Following are some of the dental procedures, where the lasers can be applied: Dental lasers are used for suture-free and painless removal of benign tumors developed at the palate, gums, sides of cheeks and on the lips. The soft tissue dental lasers may be used for early detection of cavities in the tooth. These lasers can detect the by-products produced during tooth decay. Tooth and gum tissues can be safely viewed by using Optical Coherence Tomography. Low dentistry dental lasers can reduce the pain related to cold sores and also minimize the healing time. Dental lasers reshape the gum tissue and bone to ensure healthier tooth structure. Such reshaping is known as crown lengthening and it provides a strong foundation for the restoration. The hard tissue dental lasers minimize the need for local anesthesia and traditional turbine drill. Lasers used in the dental filling procedures can kill the bacteria located in the tooth cavity. This is helpful for a long-term tooth restoration. A laser frenectomy is beneficial for the children who have restricted or tight frenulum (tied tongue) and for the babies who are unable to breast-feed properly because of limited tongue movement. A laser frenectomy is also helpful to minimize speech impediments. Photobiomodulation can be applied to regenerate the damaged blood vessels, nerves and scars. In some cases, sleep apnea may result from a tissue overgrowth in the areas of throat, which may be related to aging. In such cases, a Laser Assisted Uvula Palatoplasty (LAUP) or laser assisted uvuloplasty procedure is performed in order to reshape the throat and relieve the breathing problems related to sleep apnea. Dental lasers are used for suture-free and painless removal of soft tissue folds (Epulis) caused by ill-fitting dentures. The bleaching process associated with teeth whitening can be done effectively with low intensity soft tissue dental lasers. Laser dentistry is useful to reduce inflammation and pain of the temporomandibular jaw joint treatment. The gum tissue can be reshaped with dental lasers. It can help ensure a healthy tooth structure, and thus can improve the appearance of a gummy smile. The tubules located on the root of the tooth can be sealed using the dental lasers. These tubules are responsible for hot and cold sensitivity of a tooth.
Disadvantages/Drawbacks
Dental lasers cannot be used on the teeth that already have the fillings. You cannot apply lasers in many commonly performed dental procedures, e.g. lasers cannot be applied to fill in the cavities located between teeth, around the old fillings and the large cavities prepared for a crown. Besides that, you can’t use lasers to remove silver fillings or defective crowns, or to prepare the teeth for bridges. The traditional dental drills are still required to shape and polish the filling, even though a laser is used. Laser treatment is relatively more expensive. Laser dentistry is a painless and suture-free procedure that can be effectively used to eliminate number of dental problems. That’s why many patients opt for this comfortable and convenient treatment
Application of Laser Dentistry
The application of lasers in dentistry opens the door for dentists to perform a wide variety of dental procedures they otherwise may not be capable of performing. Dentists using lasers in dentistry have become adept at incorporating the state-of-the-art precision technology into a number of common and not-so-common procedures.
Hard Tissue (Tooth) Laser Dentistry Procedures
Cavity Detector: Low intensity soft tissue dental lasers may be used for the early detection of cavities by providing a reading of the by-products produced by tooth decay.
Dental Fillings/Tooth Preparation: Hard tissue dental lasers may eliminate the need for a local anesthetic injection and the traditional turbine dental drill. Lasers used in dental filling procedures are capable of killing bacteria located in a cavity, potentially leading to improved long term tooth restorations. However, dental lasers are not appropriate for the replacement of amalgam fillings, onlays or crowns.
Tooth Sensitivity: Dental lasers may be used to seal tubules (located on the root of the tooth) that are responsible for hot and cold tooth sensitivity.
Soft Tissue (Gum) Laser Dentistry Procedures
Crown Lengthening: Dental lasers can reshape gum tissue (soft tissue laser) and bone (hard tissue laser) to expose healthier tooth structure. Referred to as crown lengthening, such reshaping provides a stronger foundation for the placement of restorations.
Gummy Smile: Dental lasers can reshape gum tissue to expose healthy tooth structure and improve the appearance of a gummy smile.
Muscle Attachment (Frenula): A laser frenectomy is an ideal treatment option for children who are tongue tied (restricted or tight frenulum) and babies unable to breast feed adequately due to limited tongue movement. A laser frenectomy may also help to eliminate speech impediments.
Soft Tissue Folds (Epulis): Dental lasers may be used for the painless and suture-free removal of soft tissue folds often caused by ill-fitting dentures.
Other Laser Dentistry Applications
Viewing Tooth and Gum Tissues: Optical Coherence Tomography is a safer way to see inside tooth and gums in real time.
Benign Tumors: Dental lasers may be used for the painless and suture-free removal of benign tumors from the gums, palate, sides of cheeks and lips.
Cold Sores: Low intensity dental lasers reduce pain associated with cold sores and minimize healing time.
Nerve Regeneration: Photobiomodulation can be used to regenerate damaged nerves, blood vessels and scars.
Sleep Apnea: In cases where sleep apnea is a result of a tissue overgrowth in areas of the throat (which sometimes occurs with age), a laser assisted uvuloplasty or laser assisted uvula palatoplasty (LAUP) procedure can be performed to reshape the throat and relieve the correlating breathing problems associated with sleep apnea.
Teeth Whitening: Low intensity soft tissue dental lasers may be used to speed up the bleaching process associated with teeth whitening.
Temporomandibular Joint Treatment: Dental lasers may be used to quickly reduce pain and inflammation of the temporomandibular jaw joint.
Lasers represent an innovative and more precise technology for specific hard and soft tissue applications. If you choose a laser dentist, you may find that you feel more comfortable and less anxiety during your treatments.
The Future of Dental Lasers
Dental procedures may soon be performed quicker, more effectively and more comfortably thanks to the growing popularity of laser dentistry. Laser (Light Amplification by Stimulated Emission of Radiation) technology has been used in various types of medical procedures for years. An increasing number of dental offices around the world will use dental lasers as the technology continues to improve and its cost decreases.
Dentists may use dental lasers during a professional dental cleaning to remove tartar and as a replacement for the traditional root planing procedure, which is currently performed using a surgical instrument called a curette that can damage surrounding tissue. Eventually, dental lasers could make it possible for dentists to access any part of a tooth, replacing the need for the traditional dental drill. This may help to relieve the fear and anxiety many people experience when they go to the dentist.
Types of Dental Lasers
The Food and Drug Administration (FDA) has approved of a variety of hard and soft tissue lasers for use in the dental treatment of adults and children. Because dental lasers boast unique absorption characteristics, they are used to perform specific dental procedures.
Hard Tissue Lasers: Hard tissue lasers have a wavelength that is highly absorbable by hydroxyapatite (calcium phosphate salt found in bone and teeth) and water, making them more effective for cutting through tooth structure. Hard tissue lasers include the Erbium YAG and the Erbium chromium YSGG. The primary use of hard tissue lasers is to cut into bone and teeth with extreme precision. Hard tissue lasers are often used in the “prepping” or “shaping” of teeth for composite bonding, the removal of small amounts of tooth structure and the repair of certain worn down dental fillings.
Soft Tissue Lasers: Soft tissue lasers boast a wavelength that is highly absorbable by water and hemoglobin (oxygenating protein in red blood cells), making them more effective for soft tissue management. Commonly used soft tissue lasers include Neodymium YAG (Nd:YAG) and diode lasers, which may be used as a component of periodontal treatment and have the ability to kill bacteria and activate the re-growth of tissues. The carbon-dioxide laser minimizes damage to surrounding tissue and removes tissue faster than the fiber optic method. Soft tissue lasers penetrate soft tissue while sealing blood vessels and nerve endings. This is the primary reason why many people experience virtually no postoperative pain following the use of a laser. Also, soft tissue lasers allow tissues to heal faster. It is for this reason that a growing number of cosmetic dental practices are incorporating the use of soft tissue lasers for gingival sculpting procedures.
Some dental laser technology has been developed that can be used to generate both hard and soft tissue laser energy, depending upon the patient’s needs.
In addition to the lasers used for cutting and shaping hard and soft tissues, other laser types are specifically designed for viewing the insides of teeth and cells using Optical Coherence Tomography, a non-invasive imaging technique. Other lasers provide energy and specific proteins that help move messages between cells to match the body’s natural ability to use light spectrums to heal damaged cells.
Low level lasers in dentistry
A wide range of different lasers are used in modern dentistry. The Erbium: YAG laser has a potential of replacing the drill in selected situations; the carbon dioxide laser is a valuable tool in oral surgery; the Argon laser is used in minor surgery and composite curing; the Nd: YAG is used in pocket debridement, tissue retraction and more. This is just to mention a few of the possibilities of the dental laser.
The major drawback so far has been the high cost compared to the conventional therapies and the fast development in the field. The high cost of the investment may not have paid off until the next generation of lasers is on the market. So far the majority of the dentists using lasers are mainly the entrepreneurs and the enthusiasts.
All the above listed lasers are using, or have the possibility of using high powers, ranging from fractions of a watt to 25 watts or more.
Interest from media and patients has been considerable during the last decade, party because of a general interest in “high-tech” and partly because of the eternal dream about an escape from the discomfort experienced in the dental chair.
This article will summarize the physics, science and clinic of a quite different type of dental lasers – the low level laser.
Low level lasers
While the lasers already mentioned can be labeled “High level lasers”, there is a less known type of lasers called “Low level lasers”. These lasers are generally smaller, less expensive and operate in the milliwatt range, 1-500 milliwatts. The therapy performed with such lasers is often called “Low Level Laser Therapy” (LLLT) or just “laser therapy” and the lasers are called “therapeutic lasers”. Several other names have been given to these lasers, such as “soft laser” and “low intensity level laser” whereas the therapy has been referred to as “biostimulation” and “biomodulation”. The latter term is more appropriate, since the therapy caot only stimulate, but also suppress biological processes [1].
Therapeutic lasers generally operate in the visible and the infrared spectrum, 600-900 nm wavelength. However, other wavelengths such as the Nd:YAG at 1064 nm and even the carbon dioxide laser at 10600 nm have been successfully used in laser therapy.
The energy used is indicated in Joule (J), which is the number of milliwatts x the number of seconds of irradiation. Thus, 50 mW x 60 seconds produces an energy of 3000 millijoules, equals 3 J. Suitable therapeutic energies range from 1-10 J per point. The dose is expressed in J/cm2. To calculate the dose, the irradiated area must be known. 1 J over an area of 1 cm2 = 1 J/cm2. 1 J over an area of 0.1 cm2 = 10 J/cm2. There is generally no heat sensation or tissue heating involved in this therapy.
The history
The first laser was demonstrated in 1960. It was a ruby laser, 694 nm wavelength. Interest in the medical implications of laser light was high and already in 1967 some of the first reports appeared on the effects of very low doses of ruby light on biological tissues. In animal studies it was observed that experimental wounds healed better if irradiated and that even the shaved fur of the experimental animals reappeared faster in the irradiated areas. There appeared to be a biological window for the dose. If too low, there was no effect, if too high there was a suppressive effect. Not much later the Helium-Neon laser was introduced in research and the results were similar. Later on diode lasers were introduced and they provided the same results, although some wavelengths appeared to be better for certain indications. In particular, the introduction of infrared lasers improved the optical penetration of the light, reaching deeper lying tissues.
The first commercially available lasers in the early 80ies were extremely low powered, below 1 mW, in spite of the fact that the first scientific reports used 25 mW. This partly explains the initial controversy about LLLT. With the rapid development of laser diodes, the powers of therapeutic lasers have changed dramatically and diode lasers today are typically in the range of 50-500 mW. Increased power has not only shortened the treatment time but also improved the therapeutic results.
Risks and side effects
The only physical risk in laser therapy is the risk of an eye damage. While never reported to have occurred, the risk of an eye damage must be considered, especially when using an invisible and collimated (parallel) beam. Suitable protective goggles should be worn by the patient for extra oral therapy in the face.
Since the therapeutic lasers are well above the ionizing spectrum there is no risk of cancerous changes. Suspected malignancies should of course not be treated by anyone but the specialist.
Among the side effects (rarely) observed are:
– temporary increase of pain in chronic pain conditions. It has been suggested that this is a sign of a transfer of the chronic condition into an acute situation.
– tiredness after the treatment. This is probably a result of the pain relief where the pain previously has prevented a normal relaxation pattern
– redness and a feeling of warmness in the area which is irradiated a result of a increases micro circulation
The science
There are more than 2500 scientific studies in the field of laser therapy, among them more than 100 positive double blind studies. In dentistry alone, the number of studies are some 325, from 82 institutions in 37 countries. The quality of these studies vary but it is interesting to note that more than 90% of the studies report on positive effects of laser therapy.
In total, 30 different dental indications have been reported in the literature. The very variety of indications has been used as an argument against the probability of laser therapy. However, it rather shows the input on general biological systems, such as the immune system, SOD activity, ATP production, cell membrane permeability, release of transmitter substances etc.
Laser therapy science is a complicated matter where a combined knowledge about laser physics, medicine, clinical procedures and scientific rules is essential. Many studies, positive and negative, lack relevant reporting parameters and make a proper evaluation difficult. The existing literature is a sufficient foundation for successful clinical therapy but more research is still needed to find out the optimal parameters.
In two recent US meta analyses there was a high overall significance for wound healing, tissue regeneration and pain.
Treatment
Treatment is often carried out through local irradiation of the site of injury/pain, but it can also be performed on distal points such as regional lymph nodes, ganglia and cervical nerve roots corresponding to the dermatome in question. Pain release can often be achieved in one or two sessions (especially if the reason for the pain still is in a acute stage) whereas many conditions have to be treated during several sessions. When calculating the dosage, parameters such as pigmentation of the skin, condition of the tissue, acute/chronic stage, depth beneath skin/mucosa, transparence of overlying tissue must be considered.
New possibilities
The therapeutic lasers offer improved possibilities in the treatment of pain, wound healing, inflammation and oedema. However, they also offer the dentist a possibility to treat indications previously not within the capability of the general dentist. In the following some examples will be given, each with a selected reference
Dentinal hypersensitivity
With the advent of desensitizing agents, the prevalence of treatment-resistant dentinal hypersensitivity has diminished considerably. On the other hand, the placement of composites and inlays has brought a new reason for the very same. Gershman [8] has shown that dentinal hypersensitivity can be successfully treated with LLLT. Mild pulpitis requires higher doses than the common dentinal hypersensitivity, and repeated treatments. Frequently a sensitive tooth neck can be treated with only one treatment.
Herpes simplex
Oral herpes (HSV1) is a common feature in the dental operatory. Instead of being a contraindication for dental treatment during the acute period, an onset of HSV1 can be a good reason for a visit to the dentist. As with any treatment of HSV1 a treatment in the early prodromal stage is most successful. The pain will be reduced immediately and the blisters will disappear within a few days. Repeated treatment, whenever a blister appears will lower the incidence of recurrence. Unlike Acyclovir tablets, there are no side effects [9]. It has been shown [10] that laser therapy can even be used in the latent period between the attacks to lower the incidence of recurrence.
Mucositis
Patients undergoing radiotherapy [11] and/or chemoradiotherapy [12] suffer gravely from the mucositis induced by the therapy. Nutrition is troublesome and therapy regimen may have to be suboptimal for this reason. LLLT can be used not only to treat the mucositis but even to reduce it by mucosal irradiation prior to radiotherapy/chemotherapy.
Pain
The most frequent complaint among patients is of course pain. LLLT can reduce or eliminate pain of various origins ]6]. Postoperative discomfort after surgery can be substantially reduced by irradiating the operated area postoperatively before the anesthesia wears off.
Paresthesia
After oral surgery paresthesias may occur as a result of the surgery, in particular in the mandibular region. LLLT has been used to eliminate or reduce such complications [13].
Sinuitis
While many cases of sinuitis are “dental”, a great number of patients arrive in the dental office with sinuitis of a viral or bacterial background. LLLT will in most cases lead to a fast reduction of the symptoms [14], making the scheduled treatment easier.
TMD
Problems in the temporo-mandibular joint region are quite suitable for LLLT. For arthritic cases the treatment is concentrated to the joint area, in myogenic cases the muscular insertions and trigger points are treated. Laser therapy should always be used in combination with conventional treatment but will improve the outcome of the treatment. Tinnitus/vertigo
It has been shown [16] that patients suffering from Ménière’s disease (tinnitus/vertigo) have a significantly increased prevalence of problems in the masticatory, neck and trapezius muscles plus problems in the cervical spine, particularly in the transverse processes of the atlas and the axis. Relaxation of the tension in these muscles plus occlusal stabilisation procedures (occlusal adjustment, bite splint) will reduce or eliminate the symptoms of tinnitus and vertigo in this group of patients. Laser therapy can successfully be used to promote muscular relaxation and pain relief in these cases.
Trigeminal neuralgia
Apart from being extremely debilitating, trigeminal neuralgia can sometimes make dental treatment impossible. While no miracle cure, dentists can offer a great deal of comfort to these patients, and with a non-invasive method.
Zoster
Zoster in the trigeminal nerve should be treated in its early phase. The zoster attack in itself is bad enough, but not too infrequently a postherpetic neuralgia will persist for years or even lifelasting. Laser therapy is a cost-effective, non-invasive method without side effects.
Other indications
29 different dental indications are described in the literature, some of them being aphtae, bone regeneration, dentitio dificilis and decubitus.
Acupuncture
If a dentist is trained in acupuncture, the low level laser will be a very convenient way of replacing the needles in many instances, for corporal or auricular acupuncture. Needles are not too popular with the patients, so the laser will be appreciated. Even for a dentist not practicing acupuncture, there are some well defined acupuncture points which can be used, for instance to reduce nausea.
No panacea
The clinical results described above may seem impressive, even to the degree of doubts. However, laser therapy is no panacea and should only be used within the limits of its own merits. Correct diagnosis, proper treatment technique and treatment intervals plus sufficient dosage are all essential to obtain good results.
Non-biomodulating LLLT
A large number of in vitro studies have reported on the enhanced killing of bacteria using various dyes in combination with low level lasers. The most frequently used dye has been toluidine blue (TBO) and some of the microorganisms studied are streptococcus mutans and staphylococcus aureus. The bactericidal effect of TBO is enhanced by low level laser light and the clinical implications of this combination in cariology and periodontology are indeed promising. Low level laser has also been shown to enhance the release of fluoride from lacquers and resin cements.
Soft Tissue Laser (Dental Diode Laser)
Soft Tissue Dental Lasers: Rarely in dentistry does a clinical tool emerge with so many possibilities for treatment. Soft tissue dental lasers are already known for precision cuts with gum tissue, eliminating bleeding at the site and reducing healing time. Dental diode lasers are also being used to help sterilize canals in endodontics, treat periodontal disease, and aid in tooth whitening. Gingival troughing with the diode laser around your preparation also eliminates the need for retraction cord. As these units get smaller and smaller, they can be easily moved into every treatment room of your practice. Discover how soft tissue dental lasers can enhance every part of your practice.
