Lasers used in dentistry are engineered and designed to perform special functions without changing or damaging the surrounding tissues or materials.
The functioning of a laser goes back to Albert Einstein’s quantum theory of radiation and includes other theories that help explain the local tissue damage. The first laser was demonstrated in 1960. It was ruby laser, 694nm wavelength. Interest in the medical implications of laser light was high and already in 1967 , some of the first reports appeared on the effects of very low doses of ruby light on biological tissues. In animal studies, it was observed that experimental wounds healed better if irradiated and that even the shaved fur of the experimental animals reappeared faster in the irradiated areas. There appeared to be a biological window for the dose. If too low, there was no effect, if too high there was a suprresive effect. Not much later, the Helium-Neon laser was introduced in research and the results were similar. Later on, diode lasers were introduced and they provide the same results, although some wavelengths appeared to be better for certain indications. In particular, the introduction of infrared lasers improved the optical penetration of the ligh, reaching deeper lying tissues. The first commercially available lasers in the early 80’s were extremely low powered, below 1mW was used, in spite of the fact that the first scientific reports used 25 mW. This partly explains the initial contoversy about therapeutic dosage to be used. With the rapid developement of laser diodes, the powers of therapeutic lasers have changed dramastically and diode lasers today are typically in the range of 50-500 mW. Increased power has not only shortened the treatment time but also improved the therapeutic results.
Pulpotomy is defined as the amputation of damaged and inflammed vital pulp from the coronal chamber followed by placement of a medicament over the radicular pulp stumps to stimulate repair, fixation or mummification of the remaining vital radicular pulp.
– Braham & Morris 1985
Pulpotomy is defined as the surgical removal of infected coronal pulp and its objectives are preservation of the radicular pulp vitality and relief of pain.
The removal of impacted mandibular third molars is a complicated surgical procedure involving soft tissue, muscle and the hardest bone in the skeleton. History:
Prior to discovery of x-rays, surgeons removed only those teeth which can readily be examined clinically in the oral cavity.
John Tomes (1849) first to describe method of gaining access through a mucoperiosteal flap.
Oral medicine is defined as that area of special competence concerned with the health of and with diseases involving the oral para oral structures, it includes, principles of medicine that relates to the mouth, as well as research in biological, pathological and clinical spheres, diagnosis and medical management of diseases specific to the orofacial tissues and of oral manifestations of systemic diseases and management of behavioral disorders and the oral and dental treatment of medically compromised patients.
COMMON SITES INVOLVED
Buccal mucosa, faucial pillars ,soft palate, lips and hard palate.
The fibrous bands in the buccal mucosa run in a vertical direction ,sometimes so marked that the cheeks are almost immovable.
In the soft palate the fibrous bands radiate from the pterygomandibular raphe or the faucial pillars and have a sear like appearance
(J.J Pindborg and Sirsat 1966)
It is an insidious chronic disease affecting any part of the oral cavity and sometimes the pharynx. Although occasionally preceded by and /or associated with vesicle formation ,it is always associated with juxta-epithelial inflammatory reaction followed by a fibro-elastic changes of the lamina propria with epithelial atrophy leading to stiffness of the oral mucosa and causing trismus and inability to eat.
First described among five East African women of Indian origin under the term Atrophia idiopathica (tropica) Mucosae Oris by Schwartz 1952
Joshi in 1953 is credited to be the first person who described it and gave the present term “Oral sub-mucous fibrosis”.
In the year 1954, Su. 1. P. from Taiwan described similar condition, which he called “Idiopathic Scleroderma of mouth”