Comparison of Diode Lasers in Soft Tissue Surgery using CW and Superpulsed Mode: An in vivo Study

Abstract

Dental soft tissue surgery by diode lasers in CW mode often causes carbonization of the tissues with following necrosis and a delay of wound healing. In vitro studies have already shown that superpulsed diode laser surgery has much less disadvantages for the tissues in histological approach. Purpose of this study was to investigate in vivo, if superpulsed mode of operation can realize an improvement for surgeon and patient in soft tissue surgery. A total of 26 patients were treated by diode lasers in different modes of operation for soft tissue surgery. Around 12 patients were treated by superpulsed Elexxion Claros diode laser: 810 nm; 10-50 W P peak ; 10-20 µs pulse duration; 12000-20000 Hz; 400 µm fiber. 14 patients were treated by Vision MDL-10 diode laser: 980 nm; 2.5 W; CW mode and also 400 µm fiber. Clinical treatment was documented by photos and questionnaires for patients and surgeons. Questions concerned: Carbonization, coagulation, cutting speed, pain, swelling, bleeding, need for drugs, functional reduction and fibrine layer on wounds-during treatment, directly after treatment, after 1 day, after 3 days and after 1 week. The clinical observations and the questionnaires showed in most cases signicant differences between CW mode and superpulsed diode laser treatment in surgery. It could be shown that superpulsed diode laser surgery is superior to continuous wave done treatment. Carbonization and thermal damage of the tissues can be reduced to a minimum, therefore healing is faster as in CW mode surgery. Generation of a soft tissue cut is faster and more precise. Patients have less pain in amount and time period. The need of drugs is reduced. There are less functional restrictions and there is less swelling. The advantages of superpulsed mode of operation for soft tissue diode laser surgery are evident. Continuous wave mode should no longer be implemented in diode laser surgery.

Lasers in Orthodontics

“…12 Soft tissue surgery done by super pulsed diode laser is more reasonable as compared to performing the same with continuous mode. 13 For all the cases depicted here, PP mode of operation was selected. It is advisable to prime or condition the fiber before the procedure.…”

Comparison of diode laser in soft tissue surgery using continuous wave and pulsed modes in vitro

“…Numerous investigations on the interaction between diode lasers and soft biologic tissues are available [12][13][14][15][16][17][18]26,34]. However, these studies focus on the effectiveness of direct laser surgery, which is difficult to compare with hot-tip surgery.…”

“…Diode laser radiation with a wavelength of (980 AE 10) nm is one of the most widely used lasers in dentistry and dermatology [14][15][16][17][18]. The average power of these lasers for medical application does not exceed 10-15 W [12][13][14][15][16][17][18], with rare exceptions [20,21].…”

“…In recent years, the use of radiation from diode [1,7,[11][12][13][14][15][16][17][18][19] and fiber [1,19] lasers for soft tissue surgery has attracted considerable interest. Diode laser radiation with a wavelength of (980 AE 10) nm is one of the most widely used lasers in dentistry and dermatology [14][15][16][17][18].…”

“…Lasers are widely used for soft tissue surgery [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19], because they effectively cut soft tissues with good hemostasis [1][2][3]. CO 2 lasers (l = 10.6 μm) are considered the most popular gas lasers [1,[4][5][6][7].…”