Printer Friendly

Review: laser soft tissue treatments for paediatric dental patients.


Many benign pathologies or oral anomalies that appear in children's soft tissues can be treated by dentists. Conventional treatment of these pathologies involves the use of the cold knife, electrocautery or cryosurgery (using a gas expansion system or a cotton bud soaked in liquid nitrogen) [Ishida and Ramos-Silva, 1998]. Laser treatment can be added as an alternative or complement to conventional methods [Gontijo et al., 2005]. There is extensive literature on soft tissue management using lasers [Miserendino and Pick, 1995; Bradley, 1997; Strauss, 2000; Stabholz et al., 2003; Kotlow, 2004; Strauss and Fallon, 2004; Brugnera et al., 2006; Kato and Wijeyeweera, 2007; Kotlow, 2011]. Some oral lesions that are susceptible to laser treatment are:

* fraenectomy: maxillary labial [Gontijo et al., 2005], lingual [Verco, 2007],

* vascular lesions: granulomatous hyperplasia [Tamarit et al., 2005], pyogenic granuloma [Boj et al., 2006a], haemangiomas and telangiectatic epulis [Vesnaver and Dovsak, 2006],

* gingival hyperplasia: due to appliances, collateral effects in anti-epileptic drug treatment or bad hygiene [Fornaini et al., 2007],

* periodontics: lasers can be used to disinfect the periodontal pocket (the peak power of a pulsed laser kills resistant subgingival bacteria); periodontal scaling and root planing with Nd:YAG lasers reduces bone and cement loss, improves the epithelial junction and eliminates periodontal pockets [Liu et al., 1999],

* mucositis (in children and adolescents undergoing chemotherapy and/or radiotherapy) [Cruz et al., 2007; Cauwels and Martens, 2011],

* eruption disturbances: eruption cyst or haematoma [Boj et al., 2006b], dentigerous or follicular cyst [Boj et al., 2007b], surgical exposure of unerupted or impacted teeth (operculectomy, fenestration) [Asgari et al., 2007; Boj et al., 2008],

* abscess and cyst drainage [Boj et al., 2007b],

* minor salivary gland lesions: mucoceles and ranulas [Boj et al., 2009],

* lesions caused by papilloma virus: squamous cell papilloma [Boj et al., 2007a], focal epithelial hyperplasia [Akyol et al., 2003], oral condyloma acuminatum and verruca vulgaris [Summersgill et al., 2001]; certain papilloma virus serotypes have been linked to squamous cell carcinomas and therefore, the pathological study of these lesions is important [Tinoco et al., 2004],

* other benign mucosal lesions: fibrous hyperplasia, fibromas, diapneusia, epulis (congenital or not), angular cheilitis, benign migratory glossitis, herpes labialis, intraoral herpes, cankers and traumatic ulcers [White et al., 1998],

* gingival melanin pigmentation [Vesnaver and Dovsak, 2006],

* apexogenesis in permanent teeth [Park et al., 2001] and pulpotomy in primary teeth [Odabas et al., 2007]; disinfection after traumatic pulp exposure [Bradley, 1997],

* premalignant lesions (very important previous incisional biopsy): only remove leukoplakia with no dysplasia because lesions with moderate or severe dysplasia require intervention by a specialist physician. The C[O.sub.2] lasers cause the least dispersal of neoplastic cells into the bloodstream [Roodenburg et al., 1991].

Other dental applications of high power lasers that are beyond the scope of this article include tooth whitening [Jones et al., 1999]; dentinal hypersensitivity [Wan-Hong et al., 2004]; hard tissue management (caries removal, placing crowns or dental veneers and ostectomy) [Hadley et al., 2000; Jacobson et al., 2003; Jacobson et al., 2004; Raucci-Neto et al., 2007]; disinfection of root canals and sealing of canaliculi in endodontics [Kimura et al., 2000; Brugnera et al., 2003]; and cleaning before placement of fissure sealants [Brugnera et al., 2006].

All of the above are indications for the use of high power lasers. In addition, low power lasers have bio-stimulating (tissue regeneration), analgesic and anti-inflammatory effects, which are of great use in oral and dental trauma (lacerations, abrasions and concussions), wound healing, paraesthesia, myalgia and temporomandibular disorder [Pinheiro et al., 1998; Brugnera et al., 2006], root canal disinfection and reducing post-operative pain of endodontic surgery [Kreisler et al., 2003]. Lasers also have been used to reduce pain once fixed appliances have been fitted [Lim et al., 1995; Turhani et al., 2006].

Types of lasers used in soft tissue treatment

The word LASER is an acronym of light amplification by stimulated emission of radiation. This is a type of electromagnetic energy that is directional, collimated, monochromatic and coherent (in time and space). These properties distinguish lasers from disordered, incoherent radiation [Nelson et al., 1988]. There are several types of laser. Each one emits light at a specific wavelength that is determined by the gain medium (solid, liquid or gas) [Pick and Powell, 1993]. The effects of a laser on an irradiated tissue depend on the amount of light energy absorbed, which in turn depends on the laser wavelength and the tissue optical properties. Consequently, each laser has a therapeutic application of choice. Not all lasers produce the same effects. In addition, the effect of one type of laser varies according to the tissue and the emission parameters and can even have different effects on the same tissue. In some cases, a specific treatment can be carried out with more than one type of laser. The output (the amount of energy released per unit of time) can be varied by adjusting the laser unit. Handpieces deliver the energy to the target tissues and contain an optical fibre (tip). Thus, the laser energy can be focused or defocused on a larger or smaller area of application, depending on the distance between the tip and the tissue. A higher output is obtained when the laser is applied to a smaller area [Coluzzi, 2000].

Main types of laser therapy. Low level laser therapy (LLLT) or soft lasers use infrared light at a wavelength near visible light. The average output ranges from 50mW to 1W. The laser beam has no thermal effect. Photo-activation produces cell bio-stimulation (analgesic, anti-inflammatory and accelerates healing), particularly in inflamed and oedematous tissue [Gontijo et al., 2005; Brugnera et al., 2006; Turhani et al., 2006]. Therefore, this kind of therapy is very useful post-trauma, in muscle contractures, paraesthesia and TMJ dysfunctions [Pinheiro et al., 1998; Kulekcioglu et al., 2003].

High power, therapeutic or surgical lasers (high level laser therapy) have a clear thermal effect. They focus a large amount of energy on a small space and produce ablation, incision, carbonisation, vapourisation and coagulation of the tissue. Out of the high power lasers described below, the first four are used for soft tissues and the last two for hard and soft tissues.

The Argon laser is the only high power laser that emits visible light: all of the others emit infrared light. Its use in oral surgery is limited to cutting action on soft tissues. Above all, it is indicated for the surgical treatment of vascular or pigmented lesions. Some argon lasers can be used in polymerisation instead of halogen lamps [Hildebrand et al., 2007]. Wilkerson et al. [1996] performed pulpotomies in primary teeth using this laser. Verco [2007] undertook electrosurgical lingual and maxillary fraenectomies using an Argon laser beam. The combined device they used is called the ExplorAr Argon Plasma Cutting Electrodes (APCE) with Argon Beam Coagulator (ABC)[R]. The APCE makes a fast cut and the ABC coagulates blood.

The Diode laser is a solid-state semiconductor laser associated with aluminium, gallium and arsenic. The output is 3.5-15W. Diode lasers have an 800-980nm wavelength in the range of visible and invisible near infrared light. Beams can be emitted in continuous or pulsed (interrupted) mode [Coluzzi, 2000]. Continuous mode is used for soft tissue procedures. This laser has high absorption in tissues pigmented with haemoglobin, melanin and collagen chromophores and low absorption in dental hard tissues. Consequently, it is indicated for surgery of oral soft tissues close to dental structures that does not involve excessive bleeding [Gontijo et al., 2005]. Diode lasers are small and inexpensive. The optical fibre delivery system touches the soft tissue and can be used for ablation, incision and excision (cutting, vapourisation, curretage, coagulation and haemostasis). This type of laser produces a rapid increase in the temperature of the target tissue [Romanos and Nentwig, 1999; Coluzzi, 2000]. Consequently, it is important to control the time of application and the working power to prevent overheating of adjacent tissues, which can lead to necrosis.

Diode lasers should never be used in contact with hard tissue. In periapical and periodontal surgery it is used for disinfection purposes. In endodontics, a fine optical fibre can be used to improve disinfection of root canals along with biomechanical preparation. Romanos and Nentwig [1999] used this laser to perform fraenectomies. In a preliminary study in an animal model, Silvestri et al. [2007] indicated that the diode laser can arrest the formation of the third molar if the mucosal area of the gum is irradiated when the molar is in its bud stage.

Two other neodymium lasers are of interest. The Nd:YAG (wavelength = 1060nm and output = 0.3-6W) and Nd:YAP (wavelength = 1340nm and output = 5W). The behaviour of neodymium lasers is similar to that of diode lasers. They can operate at high or low output [Bradley, 1997] and have limited use in oral surgery. They can be used as an alternative to C[O.sub.2] lasers, as they produce precision cutting, haemostasis and simultaneous disinfection [Braggett et al., 1999]. However, their cutting efficiency is slightly slower than C[O.sub.2] lasers. They are useful in the treatment of vascular lesions and gingival melanin pigmentation [Matsumoto and Hossain, 2002; Vesnaver and Dovsak, 2006]. In addition, they act as a disinfectant in endodontics and periodontics, as they are an effective bactericide [Brugnera et al., 2003]. An Nd:YAG laser in combination with a diode laser is available on the market. Fornaini et al. [2007] used this laser to perform treatments on orthodontic patients, including fraenectomies, fenestrations of unerupted teeth and gingivectomies, with excellent results.

Carbon dioxide lasers (gas medium; recommended output = 3-10W; wavelength: 10,600nm) have a very high water absorption coefficient, regardless of the colour of the tissue. This laser is well absorbed by all soft tissues that have high water content. The effect on adjacent, non-targeted tissues is minimal. No direct contact with the target tissue is required. The beam can be focused (cutting effect) or defocused (vapourisation). These lasers generate a lot of heat and burn tissue fast. The charred layer should not be removed, as it acts as a biological cover [Tamarit et al., 2005]. In oral surgery, C[O.sub.2] lasers produce excellent intra-operative coagulation of small blood vessels and immediate sterilisation of the surgical field and reduce the inflammatory reaction and scar formation. Consequently, they are widely used in the surgical management of oral soft tissues. An incisional biopsy should be carried out prior to treatment with this laser [Huang et al., 2007]. Carbon dioxide lasers are very safe and effective for soft tissue surgery in developing countries [Kato and Wijeyeweera, 2007]. With this laser, the risk of disseminating cancer cells or producing bacteraemia is virtually nil [Tamarit et al., 2005].

The Er,Cr:YSGG: (erbium, chromium, yttrium, scandium, gallium and garnet laser) type of laser has a 2,780nm wavelength. It cuts calcified tissues (enamel, dentine, cement and bone) safely and effectively, due to a hydrokinetic system of photon liberation in an air-water spray, and can be used instead of a rotary instrument. Ablation of enamel and dentine occurs when the organic components absorb the irradiated energy, which produces vapourisation of the water and of the hydroxyl ions in the apatite mineral. At low output, it desensitises dentine [Jacobson et al., 2003; Raucci-Neto et al., 2007]. Due to its versatility, this type of laser is one of the most commonly used in paediatric dentistry. It can be used on soft and hard tissue and is associated with a reduction in discomfort, oedema, scarring and wound shrinkage. The air-water spray allows histological studies to be carried out on removed lesions, as the tissue is not overheated during the procedure [Boj et al., 2005a, 2005b].

The Er:YAG (Solid state medium of garnet, aluminiumscandium and yttrium stimulated with erbium) is an invisible infrared laser of 2,940nm and is a pulsed laser that uses an optical fibre delivery system. It is effective on hard and soft tissues, similarly to the slightly older Er,Cr:YSGG laser. It is useful for soft tissue surgery that is not extensive [Gontijo et al., 2005]. The fibre-optic delivery system can be used to disinfect root canals along with the conventional biomechanical preparation, with results similar to those of 1% hypochlorite solution [Brugnera et al., 2003].

Argon, diode, neodymium, Er:YAG, Er,Cr:YSGG and C[O.sub.2] lasers have been approved by the USA Food and Drug Administration (FDA) for oral surgery [Keller et al., 1998]. The use of these lasers in various surgical processes has been well documented [Pick and Colvard, 1993; Coluzzi 2000; Martens, 2003; Stabholz et al, 2003; Strauss and Fallon, 2004].

Laser safety

There are several contraindications for laser therapy, of which operators should be aware [Basford, 1995]. In addition, the following safety measures should be taken into account. The eyeball should not be directly or indirectly (through reflection) irradiated when visible or infrared radiation is used at wavelengths of 400-1400nm, due to the risk of retinal damage. Consequently, the dentist, patient and anyone in the vicinity of the treatment area must use safety goggles as indicated by the manufacturer. This measure applies to the use of any type of laser, including soft lasers.

The skin of staff and patients should be protected to ensure that no tissues outside the surgical field are burned. The interaction of the laser with a tissue has a photo-thermal effect. Depending on the absorption, the temperature can produce transient hyperthermia (42-45[degrees]C), coagulation (70-90[degrees]C) or carbonisation (>200[degrees]C). Lasers with the highest absorption in soft tissues (C[O.sub.2] laser) rapidly produce temperatures of 1,700[degrees]C at the point of application. However, less heating occurs in adjacent tissues than with other lasers that have lower absorption coefficients (diode and Nd:YAG lasers). Overheating of adjacent tissues may lead to necrosis. The accumulated thermal effect depends on the time of application (continuous emission or pulsed). Erbium lasers produce less thermal damage, as they are pulsed and use air-water as a cooling system. In addition, they are highly absorbed by intrinsic water [Strauss and Fallon, 2004].

Advantages of the laser over conventional surgery

Analgesia. The use of lasers reduces the amount of local analgesia required and can reduce the perception of pain in some cases [Boj et al., 2005a]. Authors such as Jacobson et al. [2003, 2004] and Boj et al. [2006a, 2006b] using an Er,Cr:YSGG laser and Fornaini et al. [2007] with Nd:YAG and diode lasers performed dental treatments on children without local infiltration analgesia. Other authors did use analgesia [Kopp and St Hilaire, 2004], although doses were lower than normal in some cases [Kato and Wijeyeweera, 2007; Boj et al., 2009].

Haemostatic properties. These properties are significant, due to the high vascularity of the oral cavity [Martens, 2003]. They are extremely useful in vascular lesions and in areas with a rich blood supply, such as the sublingual region, in the case of frenectomies [Matsumoto and Hossain, 2002]. The carbon dioxide laser provides the best intra-operative control of bleeding, which enables precise surgery to be performed, as it is easier to identify anatomical structures when there is no bleeding in the surgical field [Kopp and St Hilaire, 2004; Kato and Wijeyeweera, 2007]. The Er,Cr:YSGG laser also has anticoagulant properties when the percentage of air-water is reduced, which produces a greater thermal effect [Wang et al., 2005]. The argon laser has also been used as a coagulator in areas with a high density of blood vessels, such as the lingual fraenum [Verco, 2007]. Erbium lasers have less of a haemostatic effect than C[O.sub.2] and Nd:YAG lasers [Strauss, 2000; Strauss, 2004].

Sutures. The need for sutures is eliminated, as haemostasis enables wounds to heal by secondary intention. Exceptionally, some authors have used sutures after C[O.sub.2] laser use [Kopp and St Hilaire, 2004].

Lasers are cicatrizants. They improve wound healing, which occurs faster and with less scarring than after conventional treatments. Lasers are good treatment options for ulcers and mucositis [Wong and Wilder-Smith, 2002]. Healing is fastest after the application of erbium lasers, as they have a low thermal effect [Wang et al., 2005]. In addition, the defocused use of a C[O.sub.2] laser at the base of a lesion completes haemostasis and enables immediate contraction of the surgical site, with a 30-40% reduction in wound size. As no mucosal tissue is lost, unaesthetic scar formation caused by wound tension is avoided [Kopp and St Hilaire, 2004; Kato and Wijeyeweera, 2007].

Antibacterial/disinfectant properties. These properties enhance post-operative recovery and reduce the required dose of antibiotics [Turkun et al., 2006]. According to Kato et al. [2007], lasers are very useful in developing countries where patients have high post-operative morbidity and mortality, as infections are prevented.

Anti-inflammatory properties. Treatments that are undertaken with C[O.sub.2] and Er,Cr:YSGG lasers cause less oedema and post-operative pain, which reduces the required doses of analgesics and anti-inflammatory drugs. As the C[O.sub.2] laser cuts soft tissue, it seals nerve endings, blood and lymph vessels, which reduces the inflammatory reaction [Tamarit et al., 2005]. The anti-inflammatory properties of low level lasers can be used to treat muscle contractures and traumas [Turkun et al., 2006].

Operating time. Lasers reduce the operating time needed for soft tissue management. For example, with the C[O.sub.2] laser, the removal of a mucocoele takes 3-5 minutes; a gingivectomy 2 minutes; a maxillary fraenectomy 1.5 minutes; and a lingual fraenectomy 2 minutes [Huang et al., 2007; Kato and Wijeyeweera, 2007].

Vibration. The patient does not feel any vibration, pressure, or the contact of the optical fibre on the tooth, as occurs with a rotary instrument. This increases a patient's collaboration [Keller et al., 1998; Jacobson et al., 2003] and acceptance of the procedure [Genovese and Olivi, 2008].

Post-operative care. Lasers improve post-operative comfort, due to haemostasis, the lack of sutures, and the pain reduction. This is very useful in young patients [Fornaini et al., 2007]. In papers on fraenectomies performed with lasers and with conventional techniques, it was observed that there was less post-operative pain and discomfort, less functional complications and more patient satisfaction after the laser therapy [Haytac and Ozcelik, 2006; Kara, 2008].


As stated in the introduction, laser technology can be used in children for the healing of most oral soft tissue lesions [Brugnera et al., 2006; Martens, 2011; Olivi and Genovese, 2011] instead of conventional methods (cold knife, electrocautery or cryosurgery) [Ishida and Ramos-Silva, 1998].

The lasers of choice for soft tissue management are the Nd:YAG, C[O.sub.2] and diode lasers [Parkins, 2000]. There is extensive literature on soft tissue management with C[O.sub.2] lasers in children, as this procedure is considered safe and has many intra-operative and post-operative advantages [Tamarit et al, 2005; Kato and Wijeyeweera, 2007]. Some authors have used the Nd:YAG laser in children [Braggett et al, 1999], whilst others consider that the combination of Nd:YAG and diodes is more effective [Fornaini et al., 2007].

In recent years, the number of papers on the use of Er,Cr:YSGG lasers in paediatric dentistry has increased as this type of laser is very versatile, commonly used for hard tissue applications but can readily be used for soft tissues [Hadley et al., 2000; Boj et al., 2005b, 2006a, 2008, 2009]. The handpiece is similar to that of a conventional turbine, which facilitates clinical management. The technique is easy, reducing the duration of intervention. Its haemostatic effect enhances visibility of the surgical area, which is a major advantage in children's small mouths. Scarring is minimal (no tissue retraction) and eliminates the need to suture. Lasers reduce post-operative oedema, bleeding, infection and pain, and thus the use of medications [Boj et al., 2007].

For labial fraenectomies, Gontijo et al. [2005] used a combination of a diode laser to manipulate soft tissues and the Er:YAG laser for the periosteum and the final collagen fibres. Erbium lasers allow for fast healing, due to their minimal thermal effect, however surgery is not completely bloodless, as it is with the C[O.sub.2] laser. Therefore, compression is sometimes required to achieve haemostasis. Diode or Nd:YAG lasers are preferable for the management of highly vascular lesions, as they have a major coagulating effect [Tamarit et al., 2005].

The main laser safety measures are as follows. Eye and skin protection is required for the dentist, patient and any staff in the vicinity of the work area, to avoid retinal damage or burns. As a small proportion of the laser energy is not used in the ablation process and causes heat in dental structures, it is important to ensure that the pulp is not damaged with certain lasers (C[O.sub.2] and Nd:YAG), that should only be used for soft tissue ablation [Jacobson et al., 2003; Matsumoto and Hossain, 2002], as a temperature rise of over 5[degrees]C causes irreversible pulp damage. Consequently, erbium lasers, with the correct proportion of air-water, are now used in hard tissue treatments without tissue overheating [Rizoiu et al., 1998; Raucci-Neto et al., 2007].

Certain types of laser (C[O.sub.2] and Nd:YAG) cause vapourisation of the tissue, and if histopathological analysis is required, a biopsy must be performed with a cold knife before laser surgery [Tamarit et al., 2005]. Tran et al. [1999] and Boj et al. [2007a, 2009] indicated that tissues removed with an Er,Cr:YSGG laser can be analysed histopathologically, if they do not receive the impact of the laser on removal, a low power (1.5W) is used and an air-water spray (10% water and 11% air) prevents overheating of the surrounding tissue.

In the past, soft tissue surgical procedures were often rejected in children, as problems with cooperation meant that they could not be performed without general anaesthesia [Kotlow, 2004]. Several authors have stated that the use of lasers causes less discomfort and is well-accepted by young patients and their parents. Thus, lasers can reduce psychological trauma and fear during the dental visit [Matsumoto and Hossain, 2002; Gontijo et al., 2005].

The use of lasers in paediatric dentistry is still not widespread despite their great versatility (some lasers are more versatile than others). This could be due to the high cost of laser units, the lack of education about lasers in undergraduate courses and the fact that training is required. Nevertheless, in some dental treatments, the laser is an irreplaceable tool, rather than the marketing device that some dentists consider it to be. An increasing amount of literature on clinical indications and protocols indicates that the laser is a tool with great future potential in this field [Boj, 2005b].


Although the most commonly used laser for soft tissue management has been the C[O.sub.2] laser, the Er,Cr:YSGG laser represents a therapeutic alternative in most paediatric oral surgery, and produces excellent results. Professionals must know the physical characteristics of the laser and its interactions with biological tissues to be able to use the device safely. It is also essential to know the indications of each type of laser.


Akyol A, Anadolu R, Anadolu Y, et al. Multifocal papillomavirus epithelial hyperplasia: Successful treatment with C[O.sub.2] laser therapy combined with interferon alpha-2b. Int J Dermatol 2003;42:733-734.

Asgari A, Jacobson BL, Mehta M, Pfail JL. Laser exposure of unerupted teeth. NY State Dent J 2007;73:38-41.

Basford JR. Low intensity laser therapy. Still not an established clinical tool. Laser Surg Med 1995;16:331-342.

Boj J, Galofre N, Espana A, Espasa E. Pain perception in pediatric patients undergoing laser treatments. J Oral Laser Appl 2005a;5:85-89.

Boj JR. The future of laser pediatric dentistry. J Oral Laser Appl 2005b;5: 173-177.

Boj JR, Hernandez M, Poirier C, Espasa E. Treatment of pyogenic granuloma with a laser-powered hydrokinetic system: case report. J Oral Laser Appl 2006a;6:301-306.

Boj JR, Poirier C, Espasa E, Hernandez M, Jacobson B. Eruption cyst treated with a laser powered hydrokinetic system. J Clin Pediatr Dent 2006b;30:199-202.

Boj JR, Hernandez M, Espasa E, Poirier C. Laser treatment of an oral papilloma in the pediatric dental office: a case report. Quintessence Int 2007a:38:307-312.

Boj JR, Poirier C, Hernandez M, Espasa E. Laser-assisted treatment of a dentigerous cyst: case report. Pediatr Dent 2007b;29:521-524.

Boj JR, Hernandez M, Espasa E, Poirier C, Espanya A. Erbium laser treatment of an impacted first mandibular premolar: a case report. J Clin Pediatr Dent 2008;33:9-12.

Boj JR, Poirier C, Espasa E, Hernandez M, Espanya A. Lower lip mucocele treated with an erbium laser: a case report. Pediatr Dent 2009;31: 249-252.

Bradley P. A review of the use of Nd: YAG laser in oral and maxillofacial surgery. Br J Oral Maxillofac Surg 1997;35:26-35.

Braggett FJ, Mackie IC, Blinkhorn AS. The clinical use of the Nd: YAG laser in paediatric dentistry for the removal of oral soft tissue. Br Dent J 1999;187:528-530.

Brugnera A, Jr. Zanin F, Barbin EL, Spano JC, Santana R, Pecora JD. Effects of Er:YAG and Nd:YAG laser irradiation on radicular dentine permeability using different irrigating solutions. Lasers Surg Med 2003;33:256-259.

Brugnera A, Garrini AEC, Donnamaria E, Pinheiro. TCCG: Atlas of laser therapy applied to clinical dentistry. Quintessence editora itda. Chicago, 2006.

Cauwels, RGEC, Martens LC. Low level laser therapy in oral mucositis: a pilot study. Europ Archs Paediatr Dent 2011; 12:118-123

Coluzzi DJ. An overview of laser wavelenghts used in dentistry. Dent Clin North Am 2000;44:753-765.

Cruz LB, Ribeiro AS, Rech A, et al. Influence of low-energy laser in the prevention of oral mucositis in children with cancer receiving chemotherapy. Pediatr Blood Cancer 2007;48:435-440.

Fornaini C, Rocca JP, Bertrand MF, et al. Nd:YAG and Diode laser in the surgical management of soft tissues related to orthodontic treatment. Photomed Laser Surg 2007;25:381-392.

Genovese MD, Olivi G. Laser in paediatric dentistry: patient acceptance of hard and soft tissue therapy. Eur J Paediatr Dent 2008;9:13-17.

Gontijo I, Navarro R, Haypek P, Ciamponi AL, Haddad AE. The applications of Diode and Er:YAG lasers in labial frenectomy in infants patients. J Dent Child 2005;72:10-15.

Hadley J, Young D, Eversole L, Gornbein J. A laser-powered hydrokinetic system for caries removal and cavity preparation. J Amer Dent Assoc 2000;131:777-785.

Haytac MC, Ozcelik O. Evaluation of patient perceptions after frenectomy operations: a comparison of carbon dioxide laser and scalpel techniques. J Periodontol, 2006;77:1815-1819.

Hildebrand NKS, Raboud DW, Heo G, Nelson AE, Major PW. Argon laser vs conventional visible light-cured orthodontic bracket bonding: An in-vivo and in-vitro study. Am J Orthod Dentofac Orthop 2007;131: 530-536.

Huang IY, Chen CM, Kao YH, Worthington P. Treatment of mucocele of the lower lip with Carbon Dioxide laser. J Oral Maxillofac Surg 2007;65:855-858.

Ishida CE, Ramos-Silva M. Cryosurgery in oral lesions. Int J Dermatol 1998;37:283.

Jacobson B, Berger J, Kravitz R, Patel P. Laser pediatric crowns performed without anesthesia: a contemporary technique. J Clin Pediatr Dent 2003;28:11-12.

Jacobson B, Berger J, Kravitz R, Patel P. Laser pediatric class II composite utilizing no anesthesia. J Clin Pediatr Dent 2004;28:99-102.

Jones AH, Diaz-Arnold AM, Vargas MA, Cobb DS. Colorimetric assesment of laser and home bleaching techniques. J Esthet Dent 1999;11:11-12.

Kara C. Evaluation of patient perceptions of frenectomy: A comparison of Nd:YAG laser and conventional techniques. Photomed Laser Surg 2008;26:147-152.

Kato J, Moriya K, Jayawardeena JA, Wijeyeweera RL, Awazu K. Prevention of dental caries in partially erupted permanent teeth with a C[O.sub.2] laser. J Clinic Laser Med Surg 2003;21:369-374.

Kato J, Wijeyeweera RL. The effect of C[O.sub.2] laser irradiation on oral soft tissue problems in children in Sri Lanka. Photomed Laser Surg 2007;25:264-268.

Keisler MB, Haj HA, Noroozi N, Willershausen B. Efficacy of low level laser therapy in reducing post-operative pain after endodontic surgery: A randomized double blind clinical study. Int J Oral Maxillofac Surg 2004;33:38-41.

Keller U, Hibst R, Geurtsen W, et al. Erbium:YAG laser application in caries therapy. Evaluation of patient perception and acceptance. J Dent 1998;26:649-656.

Kimura Y, Wilder-Smith P, Matsumoto K. Lasers in endodontics. Int Endod J 2000;33:173-185.

Kopp WK, St Hilaire H. Mucosal preservation in the treatment of mucocele with C[O.sub.2] laser. J Oral Maxillofac Surg 2004;62:1559-1561.

Kotlow LA. Lasers in pediatric dentistry. Dent Clin North Am 2004;48:889-922.

Kreisler M, Kohen W, Beck M y cols. Efficacy of NaOCl/h2O2 irrigation and Ga,Al,As laser in decontamination root canals in vitro. Laser Surg Med 2003;32:189-196.

Kulekcioglu S, Sivrioglu K, Ozcan O, Parlak M. Effectiveness of low-level laser therapy in temporomandibular disorder. Scand J Rheumatol 2003;32:114-118.

Lim HM, Lew KK, Tay DK. A clinical investigation of the efficacy of low level laser therapy in reducing orthodontic postadjustment pain. Am J Orthod Dentofacial Orthop 1995;108:614-622.

Liu CM, Hou LT, Wong MI, La HW. Comparison of Nd:YAG laser versus scaling and root planning in periodontal therapy. J Periodontol 1999;70:1276-1982.

Marsilio AL, Rodrigues JR, Borges AB. Effect of the clinical application of the Ga,Al,As laser in the treatment of dentine hypersensitivity. J Clin Laser Med Surg 2003;21:291-296.

Martens LC. Laser-assisted paediatric dentistry: review and outlook. J Oral Laser Applic 2003;3:203-209.

Martens LC. Laser physics and a review of laser applications in dentistry for children. Europ Archs Paediatr Dent 2011; 12: 61-67

Matsumoto K, Hossain M. Frenectomy with the Nd:YAG laser: A clinical study. J Oral Laser Appl 2002;2:25-30.

Miserendino LJ, Pick RM. Lasers in dentistry. Quintessence books publishing Co, Inc. Chicago, 1995.

Nelson JS, Berns MW. Basic laser physics and tissue interactions. Contemp Dermatol 1988;2:3-15.

Olivi G, Genovese MD. Laser restorative dentistry in children and adolescents. Europ Archs Paediatr Dent 2011;12:68-78

Odabas ME, Bodur H, Baris E, Denir C. linical, radiographic and histopathologic evaluation of Nd:YAG laser pulpotomy on human primary teeth. J Endod 2007;33:415-421.

Park D, Lee H, Yoo H, Oh T. Effect of Nd:YAG laser irradiation on the apical leakage of obturated root canals: An electrochemical study. Int Endod J 2001;34:318-321.

Parkins F. Lasers in pediatric and adolescent dentistry. Dent Clin North Am 2000;44:821-830.

Pick RM, Colvard MD. Current status of lasers in soft tissue dental surgery. J Periodontol 1993;64:589.

Pick RM, Powell GL. Lasers in dentistry: Soft-tissue procedures. Dent Clin North Am 1993;31:281-297.

Pinheiro AL, Cavalcanti ET, Pinheiro Ti, Miranda ER, De Quevedo AS y cols. Low-level laser therapy is an important tool to treat disorders of the maxillofacial region. J Clin Laser Med surg 1998;16:223-226.

Raucci-Neto W, De Castro LMS, Correa AM, Da Silva RS, Pecora JD, Palma RG. Assessment of termal alteration during class V cavity preparation using the Er: YAG laser. Photomed Laser Surg 2007;25:281-286.

Rizoiu I, Kohanghdosh F, Kimmel AI, Eversole LR. Pulpal thermal responses to an erbium, chromium: YSGG pulsed laser hydrokinetic system. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;86:220-223.

Romanos GE, Nentwig GH. Diode laser (980nm) in oral and maxillofacial surgical procedures: clinical observations based on clinical applications. J Clin Laser Med Surg 1999;17:193-197.

Roodenburg JL, Panders AK, Vermey A. Carbon dioxide laser surgery of oral leukoplakia. Oral Surg Oral Med Oral Pathol 1991;71:670-674.

Silvestri AR, Mirkov MG, Connolly RJ. Prevention of third molar development in dog with long pulse diode laser: a preliminary report. Lasers Surg Med 2007;39: 674-677.

Stabholz A, Zeltser R, Sela M, Peretz B, Mashonov J, Zisking D. The use of lasers in dentistry: principles of preparation and clinical applications. Compend Contin Educ dent 2003;24:935-948.

Strauss RA. Laser in oral and maxillofacial surgery. Dent Clin North Am 2000;44:851-873.

Strauss RA, Fallon SD. Lasers in contemporary oral and maxillofacial surgery. Dent Clin North Am 2004;48:861-888.

Summersgill K, Smith E, Levy B, Allen J, Haugen T, Turek L. Human papillomavirus in the oral cavities of children and adolescents. Oral Surg Oral Med Oral Patol Oral Radiol Endod 2001;91:62-69.

Tamarit M, Delgado E, Berini L, Gay C. Removal of hyperplastic lesions of the oral cavity. A retrospective study of 128 cases. Med Oral Patol Oral Cir Bucal 2005;10:151-162. (Spanish).

Tinoco J, Furtado da Silva A, Basilio de Oliveira C, et al. Human papillomavirus (HPV) infection and its relation with squamous cell carcinoma of the mouth and oropharinx. Rev Assoc Med Bras 2004;50:252-256.

Tran TA, Parlette HL. Surgical Pearl: removal of a large labial mucocele. J Am Acad Dermatol 1999;40:760-762.

Turhani D, Scheriau M, Kapral D, et al. Pain relief by single low-level laser irradiation in orthodontic patients undergoing fixed appliance therapy. Am J Orthod Dentofacial Orthop 2006;130:371-377.

Turkun M, Turkun LS, Celik EU, Ates M. Bactericidal effect of Er,Cr:YSGG laser on streptococcus mutans. Dent Mater J 2006;25:81-86.

Twetman S, Isaksson S. Cryosurgical treatment of mucocele in children. Am J Dent 1990;3:175.

Verco PJW. Case report and clinical technique: Argon beam electrosurgery for tongue ties and maxillary frenectomies in infants and children. Eur Arch Paediatr Dent 2007;8(suppl1):15-19.

Vesnaver A, Dovsak DA. Treatment of vascular lesions in the head and neck using Nd: YAG laser. J Cranio-Maxillofac Surg 2006;34:17-24.

Wang X, Zhang C, Matsumoto K. In vivo study of the healing processes that occur in the jaws of rabbits following perforation by an Er,Cr:YSSG laser. Lasers Med Sci 2005;20:21-27.

Wan-Hong L, Bor-Shiunn L, Hsin-cheng L, Chun-Pin L. Morphologic study of Nd:YAG laser usage in treatment of dentinal hypersensitivity. J Endod 2004;30:131-134.

White J, Chaudry S, Kudler J, et al. Nd: YAG and C[O.sub.2] laser therapy of oral mucosal lesions. J Clin Laser Med Surg 1998;16:299-304.

Wilkerson HK, Hill SD, Arcoria CJ. Effects of the argon laser on primary tooth pulpotomies in swine. J Clin Laser Med Surg 1996;14:37-42.

Wong SF, Wilder-Smith P. Pilot study of laser effects on oral mucositis in patients receiving chemotherapy. Cancer J 2002;8:247-254.

J.R. Boj *, C. Poirier *, M. Hernandez *, E. Espasa *, A. Espanya **

Depts of * Paediatric Dentistry, ** Oral Surgery, Dental School, University of Barcelona, Barcelona, Spain.

Postal address: Prox Juax Boj. Dept. of Paediatric Dentistry, Dental School, University of Barcelona, Campus de Bellvitge, c. Feixa Llarga s/n, 08907 Hospitalet de Llobregat, B[degrees]rcelona, Spain.

COPYRIGHT 2011 European Academy of Paediatric Dentistry
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2011 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Author:Boj, J.R.; Poirier, C.; Hernandez, M.; Espasa, E.; Espanya, A.
Publication:European Archives of Paediatric Dentistry
Article Type:Clinical report
Geographic Code:4EUSP
Date:Apr 1, 2011
Previous Article:Case report: laser-assisted rebonding of a central incisor tooth due to a severe trauma--4 years of follow-up.
Next Article:Diagnosis and treatment of ankyloglossia and tied maxillary fraenum in infants using Er:YAG and 1064 diode lasers.

Terms of use | Privacy policy | Copyright © 2020 Farlex, Inc. | Feedback | For webmasters