Using Lasers in Implant Dentistry: Does it Help?

Dr. T. asks:
Has anybody used the laser to do part of the surgery for dental implant placement? I would think that the laser would be very useful for making the initial incisions through the soft tissue at the implant site. An Erbium or CO2 laser could be used to create an initial channel in the bone for the pilot drill. It would seem to me that the laser could be of significant benefit to the surgeon. I am a general practitioner and I place my own implants. I would do anything I could to minimize the trauma of the surgical placement of implants. Are any of you doing this now? What are your results? Does this decrease post-operative discomfort? Does it heal more quickly?

12 thoughts on “Using Lasers in Implant Dentistry: Does it Help?

  1. I have been using an ND:Yag (periolase) and the Oco biomedical punch through technique. Instead of punching through the Epithelium & Connective tissue I use the periolase to remove the epithelial lining therefore I do not loose any connective tissue. I have also used it on failing implants with remarkable results.

  2. Lasers produce too much thermal insult for the bone to survive. Osteocytes are sensitive to temps over 43-47 Celsius. The waterlase may be an option, but drills and piezo are better choices that certainly a CO2 or Erbium fueled laser.

  3. dear Dr.T,
    I’ve been using Er-Yag and Nd-Yag for many years.Er-Yag is very effective for bone preperations.Because it is very well adsorb both water and hydroxiapatide.Depuration of infected extraction area almost ideal with Er-yag.Post op patient confort is another advantage..But as you know using lasers need some education.you have to understant interaction between wave lenght and biophysical features of periodontal tissues.I really recomment laser for assisting implant surgery…

  4. I have used the ErCrYsGG ( Biolase ) laser for 2 years. Very friendly user on soft tissue No magic effect + no clinical advantages on bone. Laser Benefits on implants are questionable . Too much theoretical issues with unpredictable clinical results.

  5. IMO, there are no advantages to lasers and disadvantages if the bone is over-heated. If there is abundant bone and abundant keratizined tissue, you can easily place flapless with no punch. (Just drill directly throught the tissue.) On the other hand, if either of these is lacking, I’d recommend elevating a flap to expose the bone and preserve what little attached tissue you might have. Either way, the laser is not indicated, imo.

  6. Dr. T–you are absolutely correct! The laser creates the BEST pilot channel going! There is NO CHATTER with a laser-based pilot osteotomy.

    Yes lasers in the infrared spectrum can burn bone. But the zone of necrosis is removed with the next largest osteotomy drill in your prep sequence.

    Yes, lasers offer questionable healing benefits. Bone is bone. You need great primary stability-and often, not a lot of it for success. My favorite implant, hands-down, is the NobelActive for minimizing post-op discomfort–a 4.3mm is placed into a 2.8mm osteotomy! How can you go wrong?

    I have used a Er,Cr:YSGG (Biolase, Waterlase MD) for four years in implant therapy. In the beginning, I used it solely for tissue access to submerged healing abutments/cover screws and for ablation of the inflamed tissues surrounding a “less than clean” healing abutment–PERFECT for isolating the face of the fixture while achieving hemostasis and recontouring of the surrounding soft tissue prior to impression making. Now that I am placing implants, it has been phenomenal when facing an immediate implant into residual interradicular bone. The YSGG creates a perfect osteotomy into the often limited bone–an osteotomy drill will chatter and often destroy the fragile bone–or worse yet, blast out to the path of least resistance into the extaction socket. A NobelActive implant placed into a laser-prepared osteotomy into the radicular bone is a winner every time! Graft the remaining socket with your allograft of choice–the implant needs only 1mm of apical engagement for primary stability. Try that with ANY other system on the market.

  7. There is no real consensus on when and for what purpose we should use lasers around teeth, so to think we could or should use lasers routinely during the placement of implants seems premature at best.

  8. Steve

    You may want to consider research into LANAP for use of lasers around teeth. If you click on my name it will take you to a website it has some information that might be helpful in your quest.

  9. I am working on a case study of an implant done on tooth #9 in a 44 year old female. Good bone, some gum issues. I’m trying to research the price variances found on the market for similar procedure. Dental implant prices vary dramatically from state to state and procedure to procedure but I’m trying to quantify a fair, market price nationwide for like procedures of varying degrees of difficulty. Any feedback on this would be greatly appreciated.

  10. I have always been skeptical about how useful the laser can be in surgeries related to implant placement. However, I have just spent two days with Robert Miller and now have an entirely different appreciation of the extent to which the Er,Cr:YSGG laser can be utilized. This type of laser has a broad and a unique application for both hard and soft tissue surgery and when used appropriately has notable advantages over traditional steel based scalpels and burs and drills.

  11. i making research about low level laser on osseointgration on immediate implant please i want more informations about this subject

Comments are closed.