Lasers in Periodontics: Dr. Dandu Siva Sai Prasad on Advancing Dental Treatments (Part - 2)

Dr. Dandu Siva Sai Prasad: In the field of periodontics, laser treatment approaches are becoming increasingly common. One of the most frequently used methods is the LANAP (Laser-Assisted New Attachment Procedure), which targets mild to moderate periodontal pockets. We also perform procedures such as gingivectomy for gingival overgrowth and frenectomy for patients with high frenal attachments. Additionally, for those needing a longer clinical crown for better retention of abutments, we offer crown lengthening surgeries. Patients seeking cosmetic enhancements, particularly those with gummy smiles, can benefit from crown lengthening to improve their smiles. For patients with deep gum pigmentation, caused by an excess of melanin resulting in black or dark gums, we provide laser depigmentation treatments. We also utilize lasers to treat peri-implantitis. Based on my experience, all cases treated with lasers have shown successful outcomes. In clinical practice, the most common procedures include crown lengthening, frenectomy, and laser-assisted new attachment procedures for mild to moderate periodontal disease. Other treatments offered include addressing peri-implantitis and cosmetic procedures related to gummy smiles and gum pigmentation. When it comes to choosing between laser and conventional treatments, we guide patients through the benefits of laser options, keeping in mind their financial considerations. A significant advantage of using lasers is reduced tissue bleeding compared to conventional methods. While the costs for laser treatments are generally higher, they may involve less post-operative care since sutures are often not required. Additionally, healing times tend to be faster with laser treatments, which many patients prefer once they understand the benefits and if the costs are manageable.

Dr. Dandu Siva Sai Prasad:The main advantages of using a laser over a conventional procedure include minimal pain, faster healing, and reduced bleeding. Lasers have fewer bleeding areas, while conventional procedures may require more sutures. Additionally, lasers have minimal clinical time and surgical time, with less time spent on surgical procedures. In summary, the main advantages of using a laser over a conventional procedure include reduced pain, faster healing, and reduced surgical time.

From a dental perspective, there are mainly two types of lasers used: those that target soft tissues and those that target hard tissues. Soft tissue lasers are the ones we use most often, with diode lasers being a common choice among them.

Laser dentistry has revolutionized dental care by providing more accurate, safe, and comfortable procedures. It reduces clinical time, treatment time, pain, discomfort, and bleeding levels compared to conventional methods. Laser dentistry also offers minimal bleeding and is most comfortable for patients, reducing treatment time for clinicians.

Dr. Dandu Siva Sai Prasad: The goal of any periodontal therapy is to have better access and visibility of the underlying periodontal tissue. So when you go for a conventional procedure, the access and visibility are masked by the blood fluid but in laser, there will be minimal blood so that we can have easy access and visibility to see the defects, help in easy identification of the defect morphology. This treatment enhances wound healing by sterilizing the area, reducing the microbial load, and preventing post-operative tissue edema and swelling, which in turn minimizes scar formation.

It should be used as a complement to traditional scaling and root planning, meaning that these procedures should be completed before performing the laser surgery.

Dr. Dandu Siva Sai Prasad: Among the lasers available on the market, the most commonly used in periodontics are carbon dioxide lasers, ND:YAG lasers, and diode lasers. These lasers are favored for their excellent ablation properties and hemostatic characteristics. Since the periodontium consists of both hard and soft tissues, these three types of lasers are predominantly utilized in periodontal therapy.

Dr. Dandu Siva Sai Prasad: Laser procedures are generally less painful and require minimal anesthesia. They also promote faster tissue regeneration compared to conventional methods. In periodontics, one of the key advantages of lasers is their ability to remove tissue precisely while causing minimal damage to the surrounding areas. This makes laser treatment less invasive and provides better access to complex areas that are difficult to reach with traditional techniques.

The main principle is called as photothermal effect. When a laser beam is directed into the sulcus, it is absorbed by pigments in the periodontal tissue and by bacteria. This absorption converts light energy into heat energy, resulting in a photothermal effect. The energy absorbed by the pigments and bacteria causes their molecules to vibrate, which generates heat. This unique property makes the laser effective for reducing inflammation and promotes faster healing and tissue regeneration.