低能雷射在牙科臨床之運用
講員：龍霖
世界牙科雷射學院(WCLI) Mastership
歐洲口腔雷射學(ESOLA)會正式會員
國際牙科植體學會(ICOI)專科醫師
中華民國家庭牙醫學會專科醫師
美國牙髓病學會(AAE)會員
前經國學院牙科助理班講師
前北市牙醫總編輯
鼎友雜誌總編
LOW LEVEL LASER THERPY
Cascade of Events
Laser Biostimulation
↑β endophine release
↑formation of ATP
↑Cell metabolism/proliferation over
150%
↑Immune system function
↓Inflammation and Edema
Drs .Turner and Hodes
(Sweden study)
■LASER DOSAGE for LLLT
Post-Operation
1.SRP 8~16 J
2.RCT 8~14 J
3.Implant(i1 or i2) 16~24 J
4.Flap surgery 8~24 J
5.Post-extraction 8~24 J
6.Pulp hyperemia 24 J
7.ulcer(fail to heal after
conventional treatments) 8~32 J
8.TMD and m. Pain 8~32 J
FDA clearance for Diode LLLT
August 2002
Diode LLLT < 200 mw 60sec
1.effective in highly vasculized tissue
2.effective in cells have diminished function (inflammation ,degeneration…)
LLLT applications in dentistry
(Drs. Turner and Hodes 2000)
■WOUND HEALING and POSTOPERATIVE OUTCOME
■TMD and OCCLUSAL TRAUMA
TMD
82% pain relief in acute stage
66% of chronic cases
Drs. Simonivic. Trobonjaca. Bradley
J. of Laser Med. and Surg
June 1998
■LASERS USED for BIOSTIMULATION and BIOMODULATION
Zimmermann M. The therapeutic effect of the helium neon laser. Dtsch Z Mund Kiefer GesichtsChir 1990：4；313-319.
Because of the deep penetration of wavelengths between 800 and 1064 nm, these lasers are of great advantage.
LLLT Review
1.More power is not better.
2.Acute stage 2~3 sessions per week.
Chronic stage every 7~10days a time.
3. 6 or more applications can last for
more than a month.
4.Limited within 9J per specific site.
5.Slight tissue warmth is alright.
6.No interruption during lasing.(except pulpal diagnosis)
生物刺激的激光典型範圍
是在1〜500mW，一般牙科使用功率不超過50mW。
激光有抗炎、消腫、激活細胞再生、提升免疫力。
急性或術後需要每日或隔日治療。4〜5次治療為一個療程。
治療應進行到症狀結束。在急性病例，通常在激光治療後即刻，一般在5分鐘到2小時之內就可觀察到疼痛緩解等改善情況。
應用於：拔牙術後、口腔炎、牙周病、粘膜水腫、口腔疱疹、牙髓病等方面。
用於生物刺激的激光有He-Ne、CO 、Nd-YAG、Diode。
應用原則：
- 在適當區域
- 與治療點保持相對距離
- 應用準確能量
- 每次治療之間必須保持間隔
- 在症狀發生之前盡快應用激光
其他應用：
- 口腔粘膜病
- 促進骨癒合
- TMD
- 三叉神經病
- Sinusitis