Description
The use of laser meets all the demands for minimally invasive oral surgery:
- Small incisions
- Minimum trauma of treated tissues
- Possibility of treating even very small areas of tissue
- Elimination or reduction of injectable anaesthetics (often replaced by sprays or ointments)
- No bleeding
- Decontamination of the surgical site during treatment
- Very limited operating field involving only the treated tissues (no damage to surrounding tissues)
- Suturing not necessary in most cases
- Considerably shorter operating times.
As a result, there are numerous advantages for patients:
- Fewer post-op infective complications
- Less post-op inflammation
- Less post-op pain
- Better cicatrisation of the tissues
- No tissue shrinkage (predictable results)
- Possibility of eliminating antibiotics
- Shorter healing times
- Minimum post-op discomfort (no time off work).
In view of their specific properties and differences, all the "dental" lasers can be used for oral surgery. CO
2 laser undoubtedly represents the first choice for this type of application. The radiation makes it possible to cut and vaporise the soft tissues without any bleeding, rendering it extremely valid for surgery in highly vascularised areas, such as the soft palate and tongue. Contrary to other wavelengths, it also offers the advantage of exerting a surface action. This overcomes the problem of excessive spreading of heat deeper into the tissues, which could interfere with the vital tooth structures and nerves (CO
2 laser surgery can be defined as "What You See Is What You Get"). Finally, the pulsed emission minimises thermal damage to the treated tissues: in the absence of any necrosis, healing is much faster and painless.
Erbium laser also has a superficial effect with good cutting (focussed beam) and ablation (defocused beam) qualities. Bleeding is relatively limited, although it is not possible to have a completely blood-free operating field as with CO2 laser. Nd:YAG, KTP, and diode lasers interact differently with the tissues. The predominant absorption is carried out by haemoglobin and melanin, and not by water, as in the case of the CO2 and Er:YAG lasers. The resulting coagulation capacity is therefore greater. Conversely, the lower absorption by water gives rise to a greater penetration depth in the tissues, requiring greater accuracy in order to avoid damage to the deeper vital structures. Nevertheless, the indications are comparable with those of the CO2 laser, with operating and clinical differences that make one laser preferable to another but with substantially similar results.