DermNet provides Google Translate, a free machine translation service. Maruyama et al.199 compared erbium laser irradiation alone with irradiation followed by chemical and/or mechanical conditioning (using tetracycline, EDTA gel, or minocycline paste). Call to schedule your anti-aging treatment, (203)301-5860. The laser emission occurs at 2940 nm. It has a wavelength of 2940 nm and is effective for precision resurfacing as well as fractional treatments. Tissue studies show that these lasers remove very precise thin layers of skin or tissue with each pass (pulse). Contact us to sponsor a DermNet newsletter. Robert A. Strauss, Kenneth S. Magid, in Esthetic Dentistry (Third Edition), 2015, The Er:YAG laser and the CO2 laser (using a high power, short pulse configuration such as “superpulsing”) can selectively remove the surface epidermis and the papillary dermis of the skin while leaving the underlying reticular dermis and adnexal (epithelial-based) structures. 13.84, 13.85) to decrease intraocular pressure in glaucoma patients, but the procedure was stopped due to the very high risk of intraocular infection (Jelínková et al., 2000). Single pulse durations above 1 μsec often were associated with considerable thermal effects. Author: Anoma Ranaweera B.V.Sc; PhD (Clinical Biochemistry, University of Liverpool, UK); Copy Editor: Clare Morrison; Chief Editor: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, March 2014. An overview of important Er-doped materials is presented in Table 5.11. This result suggests that this laser technique may be of therapeutic benefit for wound healing.197. It has been found that this dopant by itself is not sufficient to form a practical laser. The optimal stimulative energy density was found to be 3.37 J/cm2. INITIA A powerful and versatile diode laser for virtually ‘pain-free’ hair removal on all skin types. The tissue is removed from the epidermis through vaporization, allowing for a … Various kinds of lasers are available; they are differentiated by the medium that produces the laser beam. Both lasers can be pumped by semiconductor lasers. Skin cancers must be treated adequately by other methods before any resurfacing procedure is performed. Er:YAG laser emission on the basis of the absorption of radiation in water. 1.1), which makes it a good laser for cutting bone as well as soft tissue. The char layer can limit the depth of further dermal ablation due to the decreased water content in this layer. There are two groups of very interesting wavelengths corresponding to these active materials: one in the region of 2.7–3 μm (Cr:Tm:Er:YAG, Er:Cr:YSGG, Er:YAG), and the second from 1.5 μm to 1.7 μm (Er:glass, Er:YAP, Er:YLF). Collagen shrinking is reduced with the erbium, resulting in decreased effect on rhytids. Erbium lasers applied to enhance biocompatibility of root surfaces for fibroblast attachment show promising results.157 Feist et al.158 compared adhesion and growth of cultured human gingival fibroblasts on root surfaces either treated by irradiation with Er:YAG laser using two different protocols (groups B and C) or prepared with a curette alone (group A). The erbium laser light works by vaporizing the outer layers of skin to cause skin contraction underneath, and some evidence has indicated it may even stimulate the production of the body’s own collagen. Conditioning of the root surface after SRP has been widely studied. If you have any concerns with your skin or its treatment, see a dermatologist for advice. The units themselves, as well as replacement fibers, handpieces, and attachments, also are more expensive than other dental lasers. The Er: YAG laser is a solid-state laser which is quite similar to the Nd: YAG laser, except that the impurity in the YAG crystal is the rare earth erbium (Er) rather than neodymium (Nd). Erbium Laser Schwarz et al. YAG is abbreviated from: neodymium-doped yttrium aluminum garnet). Care must be taken with the erbium laser because the cellular char that is present after CO2 resurfacing is not present with the erbium. Because the result is rapid healing without scarring, this technique can be used to “resurface” the skin. Topics A–Z Updated by Dr Todd Gunson, Dermatologist, Auckland, New Zealand, July 2014. In extreme cases, it can successfully remove superficial and moderate wrinkles, with results lasting roughly 2 years. Er:YAG laser irradiation used alone or in combination with rhPDGF-BB application may offer a promising periodontal therapy for conditioning root surfaces, with the combined application slightly more effective. The so-called Erbium:YAG laser (synonym: Er:YAG laser), a solid-state laser, is particularly suitable for use in dentistry.It Human gingival fibroblasts adhered to and grew on all treated surfaces. The excellent ablation effect of these lasers for both soft and hard tissue procedures has generated numerous periodontal investigations. Histologically, the amount of newly formed bone was significantly greater in the laser group than in the curette group, although both groups showed similar amounts of cementum formation and CTA. Minimal gingival ablation using an Er: YAG laser directed towards the pigmented area was performed, which exposed metal debris within the connective tissue that was carefully removed. The Erbium: YAG laser with wavelength of 2940 nm (2.94 μm) is unique in its absorption by water, resulting in little tissue debris and minimal thermal injury after skin resurfacing. Erbium-doped yttrium aluminium garnet laser. Medscape Reference pages on lasers including Er:YAG lasers. Oct 2013; 169(3): 91–7. A basic physical characteristic of tissue ablation by laser energy is that as radiant exposure increases, the depth of tissue removal increases.133 Erbium laser wavelengths are highly absorbed by water; therefore effective ablation with a very thin surface interaction occurs on the irradiated tissues, with no major thermal damage to the irradiated and surrounding tissues.134 These laser energies also are highly absorbed by hydroxyapatite,135 so most recent research on laser-induced root surface modification has involved the erbium lasers. Mary Lynn Smith RDH, in Principles and Practice of Laser Dentistry, 2011, Erbium lasers are FDA cleared for both hard and soft tissue applications, and some Er lasers are FDA cleared for sulcular debridement. As a laser material (see Table 5.12 for Er:YAG material parameters summary) it is not very convenient, because the lower level has a much longer lifetime (2 ms) than the upper level (0.1 ms). Scleral laser surgery is rare. An Er:YAG laser is used to make one pair of 4.5 mm incisions in each quadrant, starting 0.5 mm from the limbus with a separation of 2.5 mm and a depth of about 75% of the sclera. Erbium: YAG lasers emit extremely short pulses of infrared energy (2940nm). Both treatment groups showed similar results.195, Recombinant human platelet-derived growth factor BB (rhPDGF-BB) might be a potent stimulator and strong mitogen for human periodontal ligament cells. This thermal effect of the laser beam is based on the absorption of energy by tissue and subsequent transformation of laser energy into heat.174,175 Heat generation during laser irradiation often causes carbonization, melting, and cracking of the tooth structure, with consequent inflammation and necrosis of the pulp.174,176 The application of the CO2 and Nd:YAG lasers for hard tissue treatment tends to result in deleterious effects such as denaturation of proteins,104 with formation of toxic substances, as well as compositional changes in the irradiated tissue.174,175, Compared with the CO2 and Nd:YAG lasers, erbium lasers show satisfactory results, with faster healing after irradiation of bone than seen with use of a CO2 laser or mechanical bur. The erbium laser family has great potential for cutting hard tissues such as bone by ablation, with minimal thermal damage and a positive effect on the healing process.179,180 One drawback, however, is their relatively slow cutting speed. Most patients […] Schwarz et al.61 used an Er:YAG laser to treat lesions in 20 patients who had at least one implant with moderate to advanced periimplantitis, for a total of 40 implants. Again, the selection of settings has an impact on treatment outcome. Fotona uses Er:YAG, a precise superficial laser peel that is able to remove some very thin layers of microns from the epidermis to reduce the appearance of fine lines, some tiny wrinkles, and pigmentation spots. This laser is highly absorbed by the water containing tissues in the skin. 13.84. Radiations with wavelengths in the first group are strongly absorbed by water because of atomic resonances; the active materials from the second group generate wavelengths which belong to (1.5 μm) or are very near (1.66 μm, 1.7 μm) a very useful part of the spectrum called the ‘eye safe’ region, which poses very little hazard to the human eye. This limits hemostasis and coagulation within the pocket. Erbium laser treatments can turn back the clock significantly on skin tone, tightness, and texture. Ablation (removal of tissue) occurs when the target tissue absorbs photons and the resulting temperature increase is sufficient to vaporize tissue within the laser beam’s path. It has been suggested that pulse duration is one of the major factors in generating thermal effects on biologic tissues. The erbium:YAG laser is a 2940-nm ablative laser that targets intracellular water like the CO 2 laser does; however, its affinity for intracellular water is 10 times greater than that of carbon dioxide laser. So, the Er:YAG laser is very useful in dentistry, dermatology, urology, and bone surgery. 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