Laser: Periodontal Therapy

1.5 W – Pulsed (Repetitive) - Non Initiated Tip
½ mm fiber into sulcus and spray laser energy into the sulcus by sweeping around all B and L

Video says $35 - 5 min painless procedure
Kills the bacteria that cause periodontal disease. Takes numbers from billions to hundreds.
Takes 4-6 weeks for bacteria to reach pre-decontamination levels = created 4-6 week window of opportunity for resolving inflammation and regaining a connective tissue attachment instead of just long junctional epithelium
Reduces or eliminates bacteremias
Reduces or eliminates cross contamination with instrumentation
Kills potential perio before loss of attachment
We don’t need to touch the area with the laser to kill the bacteria
Better than antibiotics – no antibiotic resistances, allergies, no systemic effects, complete spectrum kill, not just broad spectrum, less expensive long term than arestin/perio chip

.6 to 1.0 W – Continuous - with Initiated tip
In sulcus, move back and forth in Z shape, some tissue should stick to laser

Active Quad and any previously treated quads
wipe off with wet 2x2, repeat several times until you can sweep back and forth in pocket and come out with clean tip (like toothpick in cake) or 30 seconds on B 30 seconds on L (max 1 minute per tooth)
If you don’t get anything sticking to fiber turn up power to .7, then if needed .8 etc up to 1.0. Once coagulation happens you have the power setting for that patient.
Don’t worry if you leave a little because you will get another chance at it next time.
selectively targets diseased tissue and removes it while leaving healthy tissue (because of different pigmentation between the two), works in every ethnicity
LBR again quad and any previously treated quads 1.5 W Pulsed 20/20 Non initiated may reach deeper pocket depths after SRP
Lavage with cavitron and non-chlorohexadine medicament in active quad plus any previously treated quads (if possible use betadine/iodophore (don’t use if they are allergic to iodine) at 10/1 in reservoir) chlorohexidine interferes with fibroblastic reattachment
OHI

Biostimulation – Kick starts, rejuvenates unhealthy tissue at bottom of perio pocket by spraying low levels of laser energy in pocket.
Circulation, collagen formation, osteoblastic and fibroblastic activity.
Guided tissue regeneration: wants reattatchment from bottom up and inflammation to decrease from the top down.
Every time you treat new area, you go through previously treated sites and re-treat those areas quickly with the are. Re-killing bacteria, re-biostimulating the bottom of the pocket , mechanically interrupting Lateral attatchment , while encouraging attatchment from bottom up and reduction of inflammation from top down