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Lasers: Orthodontic Applications Through Light Amplification Benjamin Lund, Editor, Orthotown Magazine

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When Dr. Theodore H. Maiman developed the first working laser in 1960, he described it as "a solution looking for a problem." Almost 50 years later, lasers are everywhere – even in the orthodontics profession. There are dozens of laser companies offering a throng of lasers on the orthodontic market, and each one is unique – making it difficult for an orthodontist starting to think about purchasing a laser. To ease a little of the burden for you, Orthotown Magazine contacted several leading laser companies to find out what orthodontists ought to know when it comes time to purchase a laser. Lasers aren't looking for a problem anymore – they're looking for orthodontists.

Why should an orthodontist purchase your laser? What are the benefits of using a laser in orthodontics?
AMD: Picasso combines ease of use, plenty of power and a great three-year warranty – all at a third of the price of the competition. Every orthodontist should own a laser. The tissue response is fantastic, it is safe around metal and patients are so much more comfortable post op.

Biolase: The ezlase soft-tissue laser helps improve your orthodontic diagnostics and treatment by giving you control of the soft tissues that frame your patient's smile; allows better bracket placement; improves patient hygiene and makes patient satisfaction soar; improves access to treat partially erupted permanent 6s and 7s; and allows easy exposure of un-erupted teeth.

Hoya ConBio: The DioDent Micro 980 soft-tissue laser enhances tissue healing and reduces post-surgical complications, due to the conservative nature of the treatment accomplished with the laser. The diode laser is utilized in both aesthetic enhancement of the smile, and treatment management of soft tissue issues that impede efficient orthodontic treatment. It can be an effective tool in your practice to reduce treatment times, control oral hygiene, and enhance the final result of your cases. If used properly, it can increase practice efficiency and be a practice builder for you in your community.

Ivoclar Vivadent: Benefits of using an Odyssey laser for the orthodontist include: precise tissue modification; early placement of brackets; fast, effective hemostasis; minimal or no bleeding; reduced treatment time; improved productivity; high patient acceptance and satisfaction; increased revenue; and the ability to expand current services. Benefits for the patient include: maximum comfort, rapid healing time, minimal or no anesthesia, less chair time, and optimal outcomes.

Sirona: Benefits to the orthodontist include: char free ablation – using radiant as well as conductive energy; peak absorption in water; good absorption in hemoglobin and oxyhemoglobin; eight times more absorption in water than an 810nm diode; 0.5 to 7 Watts of power for procedures; in the chopped/pulsed mode there is better thermal control and it keeps tissue cool while ablating; autoclavable tips and disposable tips are available; it weighs less than one lb.; keeps tissue cool and limits thermal damage to surrounding tissue; and 7 CE credit course is included. Benefits to the patient include: virtually no bleeding, minimized thermolateral damage, hemostasis, little to no charring, less swelling, less pain, improved post-operative healing, no need for cord packing, improved post-operative healing, and minimal scar formation.

Zap Lasers: The diode laser can be used to remove tissue such as gingivectomy and gingivoplasty. These procedures provide earlier attachment to teeth and can significantly reduce treatment times. Commonly, cuspids are some of the last teeth bonded due to slow eruption, delayed passive eruption, or impaction, so the diode laser yields simple and predictable tissue exposure prior to bracket placement.

Above photos show before and after a laser procedure by Andy Hayes, DDS, MSD
What procedures can orthodontists do to get the most out of their laser?
Zap Lasers: One of the most commonly used laser procedures is cuspid exposure. This laser technique eliminates the need of waiting the unexposed cuspid to be erupted. Exposing the excess tissue is simple, bloodless and can be performed with topical anesthetic. After applying a topical anesthetic of your choice, employ the use of a laser utilizing 1.2 to 1.4 Watts of power with initiated tip. When tissue is to be removed, the tip is held in light contact with the tissue, and the procedure is performed with light, sweeping brush strokes. The tissue will be removed very easily. There is rarely any bleeding or discomfort, since the blood vessels and nerve endings are sealed while the tissue is removed.

Hoya ConBio: The DioDent Micro 980 creates access for bracket placement, establishes tooth proportionality, oral hygiene, aphthous ulcer, herpetic lesion management, gingival contouring and shaping, and exposure of un-erupted teeth.

AMD: Lots! Obviously cutting and coagulating tissue is the main reason but lots of little procedures like treating aphthous ulcers make using Picasso convenient for the doctor and a great experience for the patient.

Sirona: The following orthodontic procedures ideal for the SIROLaser: uncover partially erupted teeth, hyperplastic tissue, frenectomy, treatment of aphthous ulcers (e.g.: canker sores), herpetic lesions and gingivoplasty.

Ivoclar Vivadent: Crown exposure to aid tooth eruption, operculectomy for faster band placement, treatment of gingival hyperplasia, gingival sculpting, ulcer treatment and frenectomy.

Biolase: The ezlase provides excellent solutions to orthodontic soft tissue challenges: gingivectomy, gingivoplasty/ gingival recontouring, exposure of unerupted teeth, hemostasis, operculectomy, soft tissue crown lengthening, treatment of aphthous ulcers and herpetic lesions, fibroma removal, frenectomy and frenotomy.

What sort of training do you offer for orthodontists on your laser?
Hoya ConBio: We offer an eight-hour continuing education course.

AMD: We are dedicated to ensuring every dentist is properly certified and trained in laser usage. We have three levels of training: step 1 – introductory manual, quick reference guide and DVD training; step 2 – basic certification; and step 3 – a two-day, in-office, hands-on course.

Zap Lasers: A full spectrum of laser training is offered by Zap Lasers including in-office tutorials, DVD, online courses and Webinars.

Ivoclar Vivadent: On-site installation and training is provided by the Ivoclar sales reps. Ivoclar also provides certification training courses.

Sirona: The purchase of the SIROLaser includes a one-day, free product specific training seminar (7 CE credits) to familiarize the user on the safe use of this product. The SIROLaser training seminar focuses on operation, safety and hands-on use of the SIROLaser.

Biolase: The ezlase includes comprehensive training by Orthodontist Robert L. Waugh, DMD, MS, and Intellident Solutions, Inc. Course content includes: Laser physics, science and laser treatment to patients; master controls and fiber treatments used in different laser modalities; case studies and appointment/ treatment sequencing to establish laser-assisted therapies in practice; identifying types of appointments, objectives and what can be accomplished in available time; designing needs-based treatment plans; practice clinical simulation and perform tasks involving various tissue interactions; use of verbal skills for patient involvement and scheduling of laser procedures in low stress day; and comparing diode dental lasers that are available.

Do you offer special pricing at conventions?
Biolase: Yes.

Hoya ConBio: Yes.

Zap Lasers: Zap Lasers is always promoting price incentive at shows and conventions.

Sirona: We are currently offering a $500 rebate on the SIROLaser if purchased before June 30, 2009.

Ivoclar Vivident: Yes, at all conventions, courses, etc. Also, ortho departments at universities receive university rates.

AMD: Our pricing is the same at conventions, online and over the phone. We have made an incredible product that every orthodontist can afford.

Do you offer a trial period with a return option on a new purchase?
Ivoclar Vivadent: Yes, the laser can be returned within 30 days of purchase, no questions asked.

AMD: Absolutely. We offer a try-before-you-buy program.

Biolase: We offer a "Seeing is Believing" in-office demo, which allows orthodontists to try the laser in their office for a day with a Biolase laser specialist.

Zap Lasers: Yes, we offer a 30-day trial period.

What is the appropriate amount of time to obtain the necessary skills to use your laser?
AMD: We recommend our Three Step Training program to ensure confidence and the best return on investment to a first time laser user. Experienced laser dentists can take Picasso out of the box and within five minutes can start using the product.

Hoya ConBio: Immediately. The DioDent Micro 980 is plug and play, and comes with an instructional DVD.

Sirona: After attending our one-day training seminar the dentist should have the necessary skills to use the SIROLaser properly.

Zap Lasers: The typical learning curve using diode lasers is a few weeks. Zap provides clinical training specifically designed for orthodontics to assist the laser implementation and increase the comfort level when using the laser for the first time.

Biolase: After a one-day comprehensive diode laser training course, included in the purchase price of the ezlase, the orthodontist will be able to perform many basic procedures. Application of the laser in daily practice and additional advanced training will allow orthodontists to quickly expand their repertoire of procedures.

Where else do you recommend dentists go to learn more about clinical laser usage?
Biolase: We recommend advanced training through the World Clinical Laser Institute and associated instructors and teaching organizations.

Ivoclar Vivadent: Courses from our instructors, the Academy of Laser Dentistry and Advanced Laser Training.

Sirona: The Academy of Laser Dentistry offers a number of educational opportunities including a laser certification course.

As more and more lasers enter the market, where do you see the cost of purchasing a laser in five years?
Hoya ConBio: Decreasing.

Ivoclar Vivadent: About 30 percent less.

Zap Lasers: As the sales volume increase, economy of scale drives the pricing down. Unfortunately, along with that, you will see companies trying to slash pricing extremely low with the hope low pricing will translate into high sales volumes. The laser market has it is own way to evolve and the industry moves on it's own pace as well. In order to reach that high volume to bring the economy of scale down, a lot of education, dedication and patience is needed, so orthodontists can become more and more comfortable with laser technology.

Sirona: Lasers are technology and as technology continues to improve, the price of existing technology tends to decrease. For instance the cost of LCD and Plasma TVs in the last few years have continued to decrease. You can now purchase a LCD TV for under $1,000 and several years ago they cost several thousands of dollars. However five years from now, our view today of a dental laser might be completely different. As technology advances so do our capabilities.

Thank you to the companies that participated in this survey. To view the comparisons of some of the lasers on the orthodontic market, please Click Here to view our Orthodontic Lasers Chart found on pages 40 and 41.
Respondent List
AMD LASERS (Picasso)
Biolase (ezlase)		 HoyaConBio (DioDent Micro 980)
Ivoclar Vivadent (Odyssey series)		 Sirona (SIROLaser)
Zap Lasers (Styla Ortho Microlaser)
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