Gontijo Isa, Navarro Ricardo S, Haypek Patrícia, Ciamponi Ana Lídia, Haddad Ana Estela
Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.
J Dent Child (Chic). 2005 Jan-Apr;72(1):10-5.
This paper describes a clinical case of labial frenectomy using different high power lasers: diode (810 nm) and Er:YAG (2940 nm). Considerations are made about specific indications, surgery techniques, and advantages of labial frenectomy using these laser wavelengths. The diode laser has high absorbance by pigmented tissues with hemoglobin, melanin, and collagen chromophores. For this reason, this wavelength is well indicated for surgery in soft tissue (vaporization, incision, coagulation, hemostasis). It is not properly absorbed, however, and should never be used in contact with hard tissues (bone). The Er:YAG laser has high absorbance to water and mineral apatite, making this wavelength useful and safe for the ablation of hard tissues. In the labial frenectomy clinical procedure, a combined technique is suggested: using the diode laser in soft tissues and the Er:YAG laser in periosteal bone tissues and for removal of final collagen fibers. It is important for the professional to understand the physical characteristics of the different laser wavelengths and their interaction with biological tissues to assure that they are used in a safe way, and that the benefits of this technology can be provided to infant patients.
本文描述了一例使用不同高功率激光(二极管激光,波长810纳米;铒激光,波长2940纳米)进行唇系带切除术的临床病例。文中讨论了唇系带切除术使用这些激光波长的特定适应症、手术技术及优势。二极管激光对含有血红蛋白、黑色素和胶原蛋白发色团的色素组织具有高吸收率。因此,该波长非常适合软组织手术(汽化、切开、凝固、止血)。然而,它不能被硬组织(骨骼)有效吸收,绝不能用于与硬组织(骨骼)接触的操作。铒激光对水和矿物磷灰石具有高吸收率,使得该波长对于硬组织消融既有效又安全。在唇系带切除术的临床操作中,建议采用联合技术:在软组织中使用二极管激光,在骨膜骨组织及去除最终胶原纤维时使用铒激光。专业人员了解不同激光波长的物理特性及其与生物组织的相互作用非常重要,以确保安全使用这些激光,并能将该技术的益处提供给婴幼儿患者。