Dear Friends,
I recently finished lecturing at the Rocky Mountain Society of Orthodontists Annual Meeting in beautiful Salt Lake City, Utah, on the topic of Soft Tissue Lasers in Orthodontics. I thought I may share a few salient points from the lecture.
As an adjunctive procedure, soft-tissue laser surgery enable the orthodontist the enhance our patient's overall orthodontic experience, including cosmetic enhancement, improved oral hygiene, improved stability of tooth movement, and increased treatment efficiency.
The two most popular lasers used in orthodontics are the Diode (semi-conductor) and the Solid-State (Er,Cr: YSGG) laser. Diode lasers use a GaAlAsIn media which releases a 940 nm wavelength which is easily absorbed by melanin and hemoglobin. As such, diode lasers easily ablate (vaborize) soft tissue with little to no risk of damaging teeth or bone. In my office, I use the EzLase Diode laser at 1.5 W with a 400 micrometer tip for nearly all soft-tissue laser surgeries.
There is much debate regarding the use of compound topical anesthetics. Compound anesthetics are custom-made or altered drug products. The two most popular compound topicals are a mixture of 20% lidocaine, 2% phenylepinephrine, 4% tetracaine, referred to as TAC Alternate, and 10% lidocaine, 10% prilocaine, 4% tetracaine, and 2% phenyepinephrine, referred to a Profound PET. Both compound topicals are non-regulated drug products that should be doctor prescribed and doctor applied. They are intended for single patient, single dose usage. The risk of compound anesthetics are they are often improperly labeled, have a low therapeutic index, their MRD is unknown, and their ester component (tetracaine) has a high risk of anaphylaxis. In my office I prefer to use a 1/5 carpule of 4% Septocaine infiltration.
Laser of Choice: Biolase EZLase
Settings: 1.5W
Tip: 400 micrometer
Anesthetic: 4% Septocaine infiltration
I hope this has provided some basic insight on Soft-Tissue Lasers in Orthodontics.
Sincerely,
Neal Kravitz
Neal D Kravitz, DMD, MS is a Diplomat of the American Board of Orthodontics. He is also clinical faculty at the University of Maryland and Washington Hospital Center. Dr. Kravitz received his undergraduate degree from Columbia University and his DMD at the University of Pennsylvania. A prolific writer, Dr. Kravitz currently serves on the editorial review board for seven refereed professional journals. Dr. Kravitz maintains two thriving offices in South Riding, VA and White Plains, MD.
