NEW CASES – LightScalpel lasers in implant dentistry – Jack Hahn, DDS

After incorporating a LightScalpel CO₂ dental laser into his implant dentistry practice, Jack A. Hahn, DDS, has been able to utilize it in everyday procedures to improve patient outcomes. Dr. Hahn has kindly shared a few implant dentistry cases where he utilized his LightScalpel laser.

LightScalpel Lasers and Peri-Implantitis

Unlike other common dental lasers, such as Nd:YAG and diode, LightScalpel 10,600 nm CO₂ lasers can safely be used around dental implants without heating up implant substructures. Compared to conventional peri-implantitis treatment, CO₂ laser treatment results in greater amount of reestablished bone-to-implant contact.^[1] LightScalpel CO₂ lasers, unlike other dental CO₂ lasers, use a flexible fiber delivery system making it easy to reach all areas of the mouth. Other benefits of the LightScalpel laser include: minimized bleeding (which helps to maintain a clear surgical field), less swelling and discomfort for the patient, reduced risk of infection, shortened procedure times, and smoother recoveries.  These clinical benefits make LightScalpel lasers an effective tool for the treatment of peri-implantitis.

CASE #9 Removal of Failed Dental Implant

Jack Hahn, DDS, removed a failed Bicon implant. The labial plate was absent and the surrounding soft tissue was inflamed and suppurating. All remnants of soft and fibrotic tissue were removed using a LightScalpel CO₂ laser. The site was then grafted with Newport Biologics mineralized cancellous cortical particular material and covered with Newport Biologics putty. After 6 months of healing and new bone formation, Dr. Hahn will place a new implant in #8 area.

CASE #8 Extraction and Grafting of an Acute Infected Tooth

Dr. Hahn utilizes his LightScalpel laser at the extraction site of an acutely infected tooth and immediately prior to bone grafting. Tooth # 4 was extracted and all the soft tissue pathology was removed with the LightScalpel laser. The laser was also used to sanitize the site, allowing Dr. Hahn to graft for a future implant in 6 months. Newport Biologics putty was used for the graft material. Dr. Hahn finds that with the consistency of the putty, combined with laser de-epithilzation, no membrane is required.

CASE #7 Uncovering 8 Hahn Implants

Dr. Hahn used his LightScalpel to expose, take impressions, and place Hahn healing abutments on 8 Hahn Tapered Implants. Healed tissue photos are coming soon.

CASE #6 Laser Crown Lengthening

Dr. Hahn performed crown lengthening on old Sterioss implants that he placed over 25 years ago. The photos show the surgical site before the crown lengthening, immediately following the crown lengthening, and 30 days postoperatively. Dr. Hahn notes the excellent healing in the post-op visit.

CASE #5 Laser Implant Exposure After Healing Abutments Come Off

This patient’s healing abutments came off in between appointments. In order to place the prosthesis, Dr. Hahn had to re-expose the implants. The photos were taken immediately before the exposure, immediately after the exposure, and after the placement of the prosthesis.

Implant exposures with LightScalpel dental lasers are quick and easy, saving Dr. Hahn valuable chair time. Some other benefits of performing Dental implant exposures with a LightScalpel laser include: it’s excellent coagulation ability; improved healing; minimized damage to surrounding tissues; diminished inflammation, swelling and pain; reduced risk of infection; and good patient acceptance.

CASE #4 Trauma Case – Central Incisors Internal / External Resorption

Implants, that replace failed endo- or perio-compromised teeth, have a MUCH higher success rate with laser decontamination of the osteotomy site. LightScalpel laser surgical and perio laser tips ensure excellent access to extraction socket for the optimum removal of granulation tissue and socket decontamination (protocol involves manual curettage of the socket with alternating rinsing and lasing).

The patient, a 17-year-old female was involved in a water slide accident 3 years ago. As a result, both central incisors were avulsed and an endodontist replanted them. Both teeth exhibited internal and external resorption. Dr. Hahn extracted both central incisors, removed all the root fragments and sanitized the sites with the LightScalpel laser which also eliminated any granulation tissue. The #8 area was prepared to place a Hahn 4.3×13 Implant and #9 was prepared for a Hahn 3.5×13. 3mm tall Hahn healing abuts were placed slightly below the gingival-tissue level to help develop an emergence profile when at the restoration time in 4 months. Upon seeing the x-ray, Dr. Hahn tightened the healing abutment on #9 to be sure that it was completely seated on the implant. 45nucm. stability was achieved on both implants. He then placed some bone putty to seal any openings. To be on the safe side, he decided to place a temporary partial instead of immediate temporary prosthetics.

CASE #3 Exposing 3 Dental Implants Using a Soft-Tissue CO₂ Laser

In this case, Dr. Hahn used his LightScalpel CO₂ laser to expose 3 implants. Dr. Hahn notes the laser worked great, allowing him to get implant transfer impressions without any bleeding. Better visualization achieved due to the hemostatic effect of the laser saved him time and allowed him to easily seat the abutment, with no cement getting trapped subgingivally.

CASE #2 Using LightScalpel Dental Laser for a Clean Removal of a Blade Implant from a Patient on Blood Thinners

This series of photos illustrates a case where Jack A. Hahn, DDS, used his LightScalpel CO₂ laser to assist in the clean removal of a blade implant from a patient on blood thinners. Dr. Hahn notes very little bleeding due to the CO₂ laser’s excellent hemostatic ability. By using the LightScalpel laser both inflammation and infection were greatly reduced. Nicely healing tissue is seen in the last photo which was taken 7 days postoperatively.

CASE #1 LightScalpel Laser Used to Remove Granulation Tissue After Debridement and Curettage of an Implant Site

After normal manual debridement and curettage of the implant site, the LightScalpel laser was used to remove additional granulation tissue. The ability to reduce bacterial load is due to the CO₂ laser’s affinity for water and very high moisture content in bacteria. Treatment of the recipient bed with a CO₂ laser decreases risk of infection and enables faster bone graft healing.

Dr. Hahn Reviews His LightScalpel Dental Laser

It is by far the best Laser I’ve ever used. Absolutely love how nice the handpiece feels in my hand. I highly recommend anyone looking for a laser to give the LightScalpel a try.

Jack Hahn, DDS

About Jack Hahn, DDS

Jack A. Hahn, DDS of J. A. Hahn Dental Implant Center is the designer of the Replace Implant and the Hahn Implant System, past President and Diplomat of the American Board of Oral Implantology, honored Fellow and Diplomat of the American Academy of Implant Dentistry, and a fellow of the Academy of Osseointegration. To learn more about implant pioneer and implant system designer Dr. Hahn, visit his website at www.dentalimplantcincinnati.com

References

1. Deppe H, Horch HH, Henke J, Donath K. Peri-implant care of ailing implants with the carbon dioxide laser. Int J Oral Maxillofac Implants. 2001;16:659-67.