A new bone surgical laser technique: technical aspects and applications in dentistry.

Ten patients requiring the extraction of a severely-deteriorated molar or premolar before placement of a dental implant for prosthodontic rehabilitation were selected (6 women; 4 men). The sockets were curetted and decontaminated with an 810 nm wavelength diode laser using a 400 micron fiber at close distance (1 mm) from the target area, power setting 2.5 W, pulsed mode (10 msec t-on, 10 msec t-off for five seconds, three repetitions for each bone wall, 30 seconds pause between each irradiation). The socket filled with beta-TCP plus Tissucol and primary closure was attempted. In addition all patients were treated with a 810 nm GaAlAs laser, in continuous wave mode, defocused hand-piece, 50 J\cm2 ( 1W for 50 seconds) after surgery and on days 3, 5, 7 postoperatively. At 18 months after prosthodontic treatment and loading, the implant was stable. Laser therapy, combined with a graft of biomaterial composed of beta-TCP and tissucol, prevented alveolar crest resorption following tooth extraction. Formation of new bone of acceptable quality and quantity permitted placement of osseointegrated dental implants.