Monday, 23 May 2016

Biology behind Lasers in Dentistry

Questions: Biology
1. When the laser comes into contact with the biological interface what interactions occur? 

2. How are lasers used to stop and prevent gum disease from occurring?

3. How do lasers strengthen a bond between a tooth and a filling?

4. What biological effects occur when laser photons interact with tissue in gums?

Answers            
1. When a laser beam that is being used for dental purposes engages into physical contact with the biological interface one of these four types of interactions will happen. Reflection, transmission, scattering or absorption.This image depicts the four laser/tissue interactions of Absorption, Transmission, Scattering and Reflection.
Reflection: One of the four interactions that occur when the laser interacts with the biological tissue of the gum is reflection. For this interaction the laser beam reflects off the tissue without penetrating the tissue itself. Although reflection does not occur often it is predominantly used when certain types of lasers (erbium) reflect off of titanium which in turn allows for easy cleaning of the gingiva found usually around implants.
 Transmission: Another interaction which occurs is transmission. In transmission the energy from the lasers pass through the first layers of tissue but doesn't fully penetrate the tissue. This interaction is used to reach areas inside the gum without having to cut the gum open.
Scattering: For this interaction when the laser reaches the tissue it will scatter in many different directions. Not frequently used only used to help biostimulative properties.

Absorption: This is the most important interaction.  When the laser comes into contact with the tissue the molecules in the tissue called chromophores absorb the photons of the laser. From there the energy that was absorbed is now converted into other forms of energy (thermal, mechanical etc.) 

2.  Gum disease is when there is an infection on the supporting tissues of the bone that holds your teeth in place ( gum). The type of laser treatment used to treat this is called periodontal laser therapy. In this type of therapy the dental laser is used to remove the inflamed gum tissue from around the tooth. Once the infected tissue is removed the root of the tooth is exposed. Now a process called root scaling can begin, first they scrape off the calculus and plaque around the root then they smooth out the root and let it heal naturally.

3. Lasers have many different applications but one of the applications it is used frequently for is to cure a filling. To cure a filling the laser is applied to the area where the tooth and the filling meet. When this happens the heat from the laser causes the filling and the tooth to weld together therefore strengthen the bond that they share.

 













4. When laser photons enter the tissue found around a tooth 4 things may occur: fluorescence, photothermal, photodisruptive, and photobiomodulation
 















Fluorescence: fluorescence will occur when the tooth is exposed to 655nm visible wavelength. They use fluorescent to diagnose and manage carious lesions




Photothermal: This happens when chromophores absorb the laser energy and heat is created. The heat generated is used to coagulate blood and incising tissue 


Photodisruptive: This is when short pulsed burst of the laser are used to interact with the water in the tissue causing thermal expansion to occur with the water in the tissue. Because of the thermal expansion in the water molecules small micro explosions occur which aids in the disrupting enamel and bony matrices without causing thermal damage

 

Photobiomodulation: Lasers ability to increase healing rates, circulation, reduce edema and minimize pain. This laser has also increased collagen, synthesis, fibroplast proliferation, increased osteogenesis and enhanced leukocyte phagocytosis. Photobiomodulation is used in dentistry to treat sickness like recurrent herpes and stomatitis.





Chemistry behind Lasers and Dental Bleaching

Questions: Chemistry

1. How is chemistry used in dentistry?

2. How do lasers activate the effects of dental bleaching?

3. How are the different methods of enhancing hydrogen peroxide classified?

4. Compare  the two different chemical formulas for dental bleaching?

Answers

1. One way that chemistry is used in dentistry is in dental bleaching. Dental bleaching are bleaching products which are applied to the teeth in order to remove stains and discolorations therefore increasing whiteness of teeth.




2.When dental bleaching is applied to the teeth, in order to speed up the process of activation of these products laser light is applied to the dental bleach. the laser light enhances the oxidizing effect of the hydrogen peroxide found in the dental bleach.
3. There are 6 different methods of enhancing hydrogen peroxide bleaching. Alkaline pH environment, thermal enhancement, photobleaching, photolysis, fenton reaction and photodynamic effect.
Alkaline pH environment: An alklaine environment is a setting that is considered to be highly basic this type of environment has a ph value always over 7. When hydrogen peroxide is placed in this environment because alkaline is a base it accepts the hydrogen atoms from the hydrogen peroxide which in turn  enhances the hydrogen peroxides bleaching properties.





Photobleaching: Photochemical alteration of a dye by cleaving of covalent bonds. In other words it is the loss of color when illuminated.

Photolysis: Photolysis is a  chemical reaction where a compound is broken down by photons. Interaction of several photons with one molecule




Fenton reaction: Fenton reaction is a mixture of hydrogen peroxide with iron as a catalyst which is used to oxidize waste waters. Fentons reaction can also break down organic compounds                     (





Photodynamic effect: Form of phototherapy that includes light and a photosensitizing substance. Photodynamic therapy has the ability to kill bateria, viruses, and fungi. 






Carbamide Peroxide
4. The two different types of chemicals used in dental bleaching is either carbamide peroxide (  solid composed of equal amounts of hydrogen peroxide and urea CH6N2O3) hydrogen peroxide ( H2O2 colorless liquid used as an aqueous solution it is water with an extra oxygen atom). Studies show that carbamide peroxide is not as efficient as hydrogen peroxide, but carbamide peroxide contains fewer side effects. While hydrogen peroxide frequently causes increased sensitivity of teeth, irritation of gums or develop bleachorexia

Hydrogen Peroxide


Citations

Citations (APA Format)
Statement on Lasers in Dentistry. (2009, April). Retrieved May 20, 2016, from http://www.ada.org/en/about-the-ada/ada-positions-policies-and-statements/statement-on-lasers-in-dentistry
Lasers Use In Dentistry. (2015, November 29). Retrieved May 20, 2016, from http://www.webmd.com/oral-health/guide/laser-use-dentistry?page=2
Lasers in Dentistry: Tissue Interactions and Biological Effects. (n.d.). Retrieved May 20, 2016, from http://www.dentalcare.com/en-US/dental-education/continuing-education/ce394/ce394.aspx?ModuleName=coursecontent&PartID=3&SectionID=-1
Insight in the chemistry of laser-activated dental bleaching. (n.d.). Retrieved May 20, 2016, from http://www.ncbi.nlm.nih.gov/pubmed/25874251
Chemistry of Teeth Whitening. (n.d.). Retrieved May 21, 2016, from http://www.elementsdatabase.com/the_chemistry_of_teeth_whitening.php
Policy on the Use of Lasers for Pediatric Dental Patients. (2013). Retrieved May 21, 2016, from http://www.aapd.org/media/policies_guidelines/p_lasersuse.pdf

Alklaine environment. (n.d.). Retrieved May 22, 2016, from https://www.corrosionpedia.com/definition/1445/alkaline-environment