laserissn 2193-4665 Vol. 7 • Issue 1/2015 international magazine of laser dentistry 12015 | research Modification of tooth neck dentin with a diode laser for desensitisation | case report Laser assisted crown lengthening in the anterior maxilla | industry report The TwinLight® approach to periimplantitis LLI-PB87411ENI-PB87411EN AAdvertisementdvertisement 44,, LLiteTouchiteTouch pprint.pdfrint.pdf 1 220.02.150.02.15 110:490:49 editorial I Let’s try again! Dear reader, Prof. Dr Norbert Gutknecht Editor-in-Chief First of all, I would like to wish you a happy, healthy and blessed New Year 2015. The prevalence of antimicrobial resistance is increasing and has been a topic of much debate recently. The re- sults associated with this are not yet known, but are certainly more severe than described in the official media. High concentrations of antibiotic residues are ingested not only via food (meat in particular) but also owing to careless patient prescriptions. As a responsible and future-oriented practitioner, one should seriously consider relevant antibiotic alternatives. With most laser systems used in today’s dentistry, it has become possible to reduce the administration of an- tibiotics or even omit them entirely. This is an option particularly in periodontology, peri-implantitis therapy, en- dodontics and several areas of oral surgery. As scientific studies have demonstrated, bacterial reduction with laser devices is so efficient that post-operative healing is both faster and longer lasting. Based on this knowledge, we should aim for more intensive integration of laser technology in the different fields of dentistry. Numerous congresses organised by our scientific laser society, as well as specialist continuing education events, dealing with the above-mentioned topic offer you opportunities to deepen your knowledge in this area. Announcements of these events will be published in our respective journals. With this in mind, I am looking forward to welcoming you to one of our congresses or continuing education events. Best regards, Prof. Norbert Gutknecht Editor-in-Chief laser 1_2015 I03 I content page 6 page 26 page 32 I editorial I interview 03 Let’s try again! 36 Lasers are becoming increasingly prevalent in dentistry | Prof. Dr Norbert Gutknecht | Dental Tribune International I meetings I research 38 IDS 2015: new exhibitor record and 06 Modification of tooth neck dentin with a diode laser increased exhibition space for desensitisation I | Dr Ute Ulrike Botzenhart news 30 Manufacturer News international I case report 42 News international 16 Laser assisted crown lengthening in the anterior maxilla I | Ana Minovska et al. DGL 45 Auf ein Neues! 20 Gingival plastic with diode laser—A case report | Prof. Dr. Norbert Gutknecht | Ioannis Papadimitriou et al. 46 Manufacturer News germany I industry report 48 News germany 26 The TwinLight® approach to peri- implantitis I about the publisher | Dr Ilay Maden et al. 50 | imprint I practice management 32 Gain power at your laser clinics! Physical evidence and place | Dr Anna Maria Yiannikos 34 Clinical governance—Asystem for better health care Cover image courtesy of Fotona, | Dr Kashif Hafeez www.fotona.com page 36 page 38 page 42 laser 04 I 1_2015 November 27–28, 2015 Berlin, Germany Hotel Palace 24 th Annual Meeting of the DGL LASER START UP 2015 dgl-jahrestagung.de startup-laser.de Fax Reply Name & email address +49 341 48474-290 Practice Stamp I would like to receive further information on the ❏ 24 th Annual Congress of the DGL e.V. ❏ LASER START UP 2015 on November 27 –28, 2015 in Berlin, Germany. laser 1/15 I research Modification of tooth neck dentin with a diode laser for desensitisation Author_Dr Ute Ulrike Botzenhart, Germany Cervical dentin hypersensitivity is a common phenomenon of discomfort, which affects an increasing number of young adults. [PICTURE: ©VLADIMIR GJORGIEV] _Cervical dentin hypersensitivity is a common with erosion as the main factor.3, 4 Other factors, like phenomenon and affects an increasing number of microbiological invasion of exposed dentinal young adults. Today, more than 30 % of the adult tubules with accompanying inflammation of pulpal population in industrialised nations is affected, but tissue, functional overload, traumatic toothbrush- the number of unreported cases is presumably ing and whitening of vital teeth, also appear to be in- much higher and treatment demand is increasing.1 volved.5, 6 Patients who are affected report intense and sharp pain of short duration during eating or dental hy- To date, the commonly accepted theory of pain giene, for example, that cannot be ascribed to any transmission is still Brännström’s hydrodynamic other form of dental defect or disease.2 Dentine hy- theory.7 It states that chemical, mechanical, osmotic persensitivity is associated with exposure of dentine and thermal stimuli induce fluid flow in exposed at the cemento-enamel junction and can be ex- dentinal tubules, activation of mechanoreceptors at plained by the combined effect of several aetiolog- the pulp–dentine border and finally activation of ical factors, such as erosion, abrasion and attrition pain fibres. The structure of the dentinal surface is laser 06 I 1_2015 research I an important factor of this mechanism.8 Examina- tion of tooth necks under a scanning electron mi- croscope (SEM) has shown that affected teeth had eight times as many exposed tubules with a diame- ter twice the size compared with non-sensitive den- tine.8 By demonstrating that the density of sensitive nerve fibres is correlated to pain intensity of a sen- sitive tooth,9 it is also assumed that, in addition to the hydrodynamic theory, other mechanisms, such as nerve stimulation, could be involved. Thus, in- flammation mediators could make nerve endings more sensitive to mild stimuli, which could induce _Material and methods Fig. 1_Samples of (a) Incisor, pain.10 Nevertheless, the precise physiological (b) Canini, (c) Premolar and mechanisms underlying dentine hypersensitivity The samples used were extracted human teeth (d) Molar after quadrangle are not clearly understood yet,11 , 1 2 and despite in- drawn from a pool of extracted teeth collected for preparation in the tooth neck area. tensive research, constant improvement of therapy dental research at the University Bonn, Dental Clinic methods and active substances, reports still show once informed consent had been obtained. Surgical that there is difficulty controlling this painful con- treatment was not linked to research in any way. All dition.11 experiments were in vitro; hence, there were no po- tential risk factors to human health. Laser treatment of dentine hypersensitivity alone or in combination with conventional treat- Immediately after extraction, the teeth were ments is a new promising option for rapid and stored in a sodium chloride solution (0.9 % NaCl, durable pain relief.13 Depending on the laser type Delta-Pharma) with 0.01 ‰ sodium acid added and energy settings used, the actual reported ef- and kept refrigerated at 5 °C to prevent the teeth fects of laser desensitisation are morphological al- drying out and to minimise bacterial and chemical teration of the dentinal structure, for example a decomposition. Teeth without carious lesions at closure of the dentinal tubules by melting and reso- the tooth neck and root surface (n = 60) were di- lidification of the dentinal structure; laser dehy- vided into four groups of 15 teeth by random se- dration with protein deposition or deposition of in- lection. Every test group had the same number of soluble salts in the dentinal tubules; as well as bio - incisors, canines, premolars and molars from the stimulation, for example nerve analgesia, induction maxillae and mandible (four maxillary incisors, one of sclerosis and secondary dentine formation; and maxillary canine, two maxillary premolars, two placebo effects. Recently, great effort has also been maxillary molars, one mandibular canine, three made to integrate tooth structure-like components mandibular molars and two mandibular third mo- into the tooth surface with the help of laser radia- lars). The incisors of the mandibular arch were ex- tion.11, 14–17 changed for third molars because the small root surface did not allow preparation of a quadrangle. However, on account of the high temperature The experimental surface was located at the increase, these methods are not suitable for clinical vestibular, mesial or distal side of the root surface. application11 , 1 6 and too little is known about the Four quadrants were marked in the cervical area long-term morphological and clinical effects of (Fig. 1). laser application to recommend the therapy. Enamel and root cementum were completely The aim of our study was to examine the effects removed with diamond burs under water-cooling of a diode laser with a wavelength of 809 nm in the (INTRAmatic LUX 24, KaVo) by one operator to treatment of dentine hypersensitivity in terms of simulate hypersensitive dentine. With removal of morphological changes. The ability of this type of a 1 mm layer, we assumed that all dentinal tubules laser to close open dentinal tubules, its suitability as had been totally exposed. The sample surface was a method for dentinal sealing, as well as the induc- smoothed with a Gracey curette (#7-8; Thico- tion of recognisable morphological side-effects in dent) and divided into quadrangles with a dia- the dentinal structure using this laser, were tested in mond separating disc (0.5 mm thick) under wa- vitro. Furthermore, the effect of laser–fluoride ap- ter-cooling (INTRAmatic 10 C, KaVo; Fig.1). plication was compared with single treatment op- tions, and the acid resistance of the tested treat- Groups 3 and 4 underwent a pretreatment (acid ment modalities (fluorides, laser, and laser–fluoride etching with 50 % citric acid for 2 minutes, rinsing treatment) was evaluated by the method of pH-cy- with distilled water for 30 seconds) to remove the cling. smear layer created by preparation.