Uncovering dental implants using a new thermo-optically powered (TOP) technology with tissue air-cooling.
OBJECTIVE
Uncovering implants with lasers, while bloodless, has been associated with a risk of implant and bone overheating. The present study evaluated the effect of using a new generation of high-power diode lasers on the temperature of a dental implant and the surrounding tissues using an in vitro model.


METHODS
The implant temperature was measured at three locations using micro thermocouples. Collateral thermal damage of uncovered soft tissues was evaluated using NTBC stain. Implant temperature rise during and collateral thermal soft-tissue damage following implant uncovering with and without tissue air-cooling was studied using both the classic operational mode and the new thermo-optically powered (TOP) technology.


RESULTS
For the classic surgical mode using a cork-initiated tip and constant laser power set at 3.4 W, the maximum temperature rise in the coronal and apical parts of the implant was 23.2 ± 4.1°С and 9.5 ± 1.8°С, respectively, while 1.5 ± 0.5 mm of collateral thermal damage of the soft tissue surrounding the implant model occurred. Using the TOP surgical tip with constant laser power reduced implant overheating by 30%; collateral thermal soft-tissue damage was 0.8 ± 0.2 mm. Using the TOP surgical mode with a tip temperature setting of 800°C and air-cooling reduced the implant temperature rise by more than 300%, and only 0.2 ± 0.1 mm of collateral thermal soft-tissue damage occurred, typical for optimized CO2 laser surgery. Furthermore, use of the new generation diode technology (TOP surgical mode) appeared to reduce the time required for implant uncovering by a factor of two, compared to the standard surgical mode.


CONCLUSIONS
Use of the new generation diode technology (TOP surgical mode) may significantly reduce overheating of dental implants during uncovering and seems to be safer for the adjacent soft and hard tissues. Use of such diode lasers with air-cooling can radically reduce the rise in implant temperatures (by more than three times), potentially making this technology safe and effective for implant uncovering.
Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, 11794-8700.|Department of Periodontology, Stony Brook University, School of Dental Medicine, Stony Brook, New York, 11794-8700.
Georgios E
GE
Romanos
Department of Laser Technology and Biomedical Optics, St. Petersburg National Research University of Information Technologies, Mechanics and Optics, Saint Petersburg, Russia.|Dental Photonics, Inc., 1600 Boston-Providence Highway, Walpole, Massachusetts, 02081.
Andrey V
AV
Belikov
Department of Laser Technology and Biomedical Optics, St. Petersburg National Research University of Information Technologies, Mechanics and Optics, Saint Petersburg, Russia.
Alexei V
AV
Skrypnik
Dental Photonics, Inc., 1600 Boston-Providence Highway, Walpole, Massachusetts, 02081.
Felix I
FI
Feldchtein
Department of Laser Technology and Biomedical Optics, St. Petersburg National Research University of Information Technologies, Mechanics and Optics, Saint Petersburg, Russia.
Michael Z
MZ
Smirnov
Dental Photonics, Inc., 1600 Boston-Providence Highway, Walpole, Massachusetts, 02081.
Gregory B
GB
Altshuler
D000818:Animals; D002056:Burns / Q000209:etiology / Q000517:prevention & control*; D002417:Cattle; D015921:Dental Implants; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation*; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D008954:Models, Biological; D003765:Models, Dental; D009061:Mouth Mucosa / Q000293:injuries*; D017695:Soft Tissue Injuries / Q000209:etiology / Q000517:prevention & control; D046509:Tissue Culture Techniques
D015921:Dental Implants
implant; laser; thermo-optically powered (TOP) surgery; uncovering