[...]... technique permits surgery in difficult to reach locations (vocal cords, esophagus, paranasal sinuses) 2 Improved patient benefits: • Minimal postoperative swelling • Very low infection rates • Minimal scar formation • Elimination of the need for skin grafting in floor of mouth surgery • Healed tissue is supple and maintains normal healing capability if repeat surgery is required 19 20 Lasers in M a x i l... credentialed laser clinician at (he hospital in which the surgeon practices for each type of procedure for which privileges are desired In some cases, residency training may substitute for a laser 11 12 Lasers in M a x i l l o f a c i a l Surgery and Dentistry Figure 2 - 1 Nd:YAG-induced relinal burns in a rabbit retina Figure 2 - 1 Nd:YAG-induced retinal burns in a rabbit retina course, but the preceplorship... usage standpoint, skin hazards are regarded as a minor nuisance, they are painful and may be damaging The most common mishap occurs when the laser operator's or assistant's hands pass in front of the working laser beam causing a burn This happens when the laser is either misfired during the course of surgery or when an assistant carelessly places a hand in contact with the laser beam The resulting injury... etc.) Since the late 1970s, lasers have been studied in oral and maxillofacial surgery for the treatment of soft tissue lesions and occasionally for the cutting of bone Light emitted by these surgical lasers is generally in the visible and infrared regions of the electromagnetic spectrum and is nonionizing This radiation must be clearly differentiated from ionizing radiation exemplified by x-rays and. .. several fatalities having been reported since the initiation of the use of lasers in surgery These incidents have occurred as a result of either untrained and/ or unauthorized individuals opening the closed laser cabinet or by technicians who did not follow prescribed electrical safety procedures Contact with the fully charged capacitor located inside the laser cabinet may result in electrical shock or...8 Lasers in M a x i l l o f a c i a l Surgery a n d Dentistry FREE-BEAM LASERS Free-beam (sometimes referred to as noncontact) lasers are devices that permit laser energy alone (without influence by the delivery device) to interact with tissue, causing the final clinical result The interactions between laser light and tissue described above are specific for free-beam lasers They result from interactions... power density (PD) In comparison, nonaqueous tissues like bone, tendon, or fat are poor absorbers that may sustain more heat damage Using a rapid superpulsed (RSP) beam instead of CW will minimize the heat effects In addition, bone will rapidly melt thereby becoming even more anhydrous, resulting in excessive heating even to the point of incandescence followed by actual flaming with continued application... Its target chromophores are pigmented molecules (melanin, hemoglobin, and other proteins) and it is 2 2 28 Lasers in M a x i l l o f a c i a l Surgery and Dentistry surgical instrument to treat these larger lesions, nor is scalpel excision, which may cause aesthetic and functional disabilities The most recent development permitting an increase in the range of applications of the NdrYAG laser has been... is minimal, it may be possible to continue with the proce- 16 Lasers in M a x i l l o f a c i a l Surgery a n d Dentistry dure However, extreme caution is advised in regard to proceeding even in the case of minimal observed damage If the damage is extensive, it may be necessary to control airway ventilation by inserting an endotracheal tube or performing a tracheostomy, ventilation proceeds using humidified... of laser light exiting the tip in comparison to the amount of heat generated by absorption at the tip This means, in essence, that a single laser in combination with different interchangeable tips, can mimic the tissue temperature profile and effect of various lasers 2 Practical Laser Safety in Oral and Maxillofacial Surgery Lawrence M El son A laser is a device thai produces an intense, highly parallel . Lasers in Maxillofacial Surgery and Dentistry Figure 2-1. Nd:YAG-induced retinal burns in a rabbit retina. course, but the preceplorship credentialing. Temperature gradients in tissue. 6 Lasers in Maxillofacia l Surgery and Dentistry OW?3SLT.INC./T.A .r Figure 1-5. Interactions of light and tissue. sorbed