laser international No. 4, 2015

Cover / Editorial / Content / Laser phototherapy— an expansion of dental medicine / Denture Stomatitis: Treatment with Diode Laser / A multidisciplinary approach with Er - Cr:YSGG / Manufacturer News / SIROLaser Blue— Three wavelenghts with one single device / Infection control in an era of emerging infectious diseases / Laser treatment of sleep apnoea and snoring / Eleven tips for success in your dental clinic / 24th InternationalAnnual Congress of the DGL / News / The future today - Ultrashort pulsed laser / Die Zukunft in der Gegenwart - Ultrakurzpulslaser / DGL Editorial / 24. JAHRESTAGUNG DER DGL E.V. / News Germany / Imprint

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issn 2193-4665

Vol. 7 • Issue 4/2015

laser
international magazine of

laser dentistry

4

2015

| research
Laser phototherapy—
an expansion of dental medicine

| case report
A multidisciplinary approach with Er,Cr:YSGG

| industry
SIROLaser Blue—Three wavelenghts with one
single device

[2] =>

[3] =>

editorial

Laser on the rise

Prof. Dr Norbert Gutknecht
Editor-in-Chief

Dear colleagues and fellow DGL members,
After years of stagnation, all signs point to a significant revival of the laser market. This became obvious during this year’s DGL Congress, as visitor numbers have doubled compared to last year’s event and scientific contributions covered a broad spectre of topics and various wavelengths. For instance, wavelengths of 450 nm were
rediscovered, which 20 years ago featured argon lasers exclusively and today is represented by modern diodelaser technology. The field of CO2 lasers (1,060 nm), which has been dominating the laser market in the previous
years, was not only revived but it has “mutated”: A new CO2 wavelength of 9,300 nm was introduced, which is
now applied in dentistry for the first time.
This development also had an effect on the diversity of companies present at the congress’ dental exhibition,
leading to an increased presence of visitors at the exhibition between lectures. A simultaneous interpretation of
Friday’s speeches made it possible for attendees of more than ten different nations to partake actively in the congress programme as speakers and passively in the auditorium.
My wish for next year is that this trend will continue, especially at the WFLD World Congress in Nagoya/Japan
and on the 25th Anniversary Congress of the DGL.
The versatility of new wavelengths and wavelength combinations also forms the basis of my manifold good
wishes for you, including luck and success, for 2016.
Looking forward to seeing you again in the new year,

With warm regards,

Prof. Dr Norbert Gutknecht
Editor-in-Chief

laser
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I content

page 6

page 14

I editorial
03

page 22

I events
35

Laser on the rise
| Prof. Dr Norbert Gutknecht

24th International Annual Congress of the DGL—
All on the same wavelength
| Lisa Meißner et al.

I research
06

I special

Laser phototherapy—an expansion of dental medicine
| Jan Tunér

40

I case report

41

10

Die Zukunft in der Gegenwart – Ultrakurzpulslaser
| Dr. Anton Kasenbacher

Denture Stomatitis: Treatment with Diode Laser
| Dr Maziar Mir et al.

14

The future today—Ultrashort pulsed laser
| Dr Anton Kasenbacher

I news

A multidisciplinary approach with Er,Cr:YSGG —
Aesthetic management of hard and soft tissues

20

Manufacturer News international

| Dr Christina Boutsiouki et al.

38

News international

I industry

I DGL

22

SIROLaser Blue—
Three wavelenghts with one single device

43

| Marlene Hartinger

48

Laser im Aufwind
| Prof. Dr. Norbert Gutknecht

News germany

I practice management

I about the publisher

26

50

Infection control in an era of emerging
infectious diseases

| imprint

| Eve Cuny

28

Laser treatment of sleep apnoea and snoring
| Dr Andreas Klug

32

Eleven tips for success in your dental clinic—
Part II: CAPS & CLIMB

Cover image courtesy of Fotona,
www.fotona.com

| Dr Anna Maria Yiannikos

page 32

04 I laser
4_ 2015

page 35

page 40

[5] =>

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[6] =>

I research

Laser phototherapy—
an expansion of
dental medicine
Author_Jan Tunér, Sweden

_Laser phototherapy has been used in dentistry
for several decades. From an initial attitude of incredulity, there is an increasing awareness of the usefulness of this treatment option. Many indications are
now recognised, such as reduction of inflammation,
pain and oedema. Having the known basic mechanisms in the cellular energy transport system in mind,
the wide variation of suggested applications no
longer seems illogical. This article will not linger on
what is already known and accepted, but rather make
an effort to look ahead onto the most recent discoveries. Laser phototherapy (LPT) has been seen as a
Fig. 1_From: Karu T. Ten lectures on
basic science of laser phototherapy.
2007, Prima Books.

Fig. 1

06 I laser
4_ 2015

suitable intervention when some sort of pathology is
present in tissue. A modern approach is to recognise
the ability to pre-condition tissue even before a
trauma such as surgery. This is a bit contrary to what
we have learned in the past. It is well known that the
best cellular response comes from cells in a reduced
environment, i.e. with a low pH. More or less healthy
cells will not react much to LPT. This is shown in the illustration below (Fig. 1).
Indeed, research has confirmed that LPT is not very
useful in studies where healthy animals or human
volunteers have been enrolled. For instance, a model
using genetically diabetic animals has demonstrated
a very positive effect on wound healing, whereas the
same parameters in healthy animals has been modest.1 However, the minimal effect of LPT on fairly
healthy tissues seems to be enough to prepare the target tissues for a surgical intervention, as a way of
“pre-conditioning” the area. In fact, this was one of
the earliest discoveries in the field. McGuff et al. reported already in 1966 that animals exposed to radiation developed less side effects if pre-irradiated with
LPT.2 This effect has later been confirmed in animal
and human studies.3,4 A clinical study by Nesioonpour
used preoperative LPT in patients having surgical fix-

[7] =>

research

ation of distal radius fractures.5 Intravenous regional
anaesthesia was used. The need for painkillers was
less in patients having LPT immediately before surgery. The study by Santos aimed to evaluate the effects of LPT immediately before tetanic contractions
in skeletal muscle fatigue development and possible
tissue damage.6 Optimal doses of LPT significantly delayed the development of skeletal muscle performance and protected skeletal muscle tissue against
damage. Thus, it is suggested that LPT could be used
prior to surgical intervention to reduce postoperative
discomfort.
The fact that LPT can be useful even in healthy tissue was suggested already in 1999 by Schindl.7 The
study showed that patients with recurrent HSV-1 attacks could be successfully treated with LPT even in
the “silent” period in-between outbreaks. Dentists
could therefore, at advantage, treat known HSV-1
prone patients with LPT even if there is no clinical evidence of an outbreak. The importance of this possibility is underlined by two recent studies where patients with recurrent HSV-1 turned out to have a
greater risk of developing Alzheimer’s disease later on
in life.8,9 The connection is unknown, but if patients
with recurrent HSV-1 are treated with LPT at conventional dental sessions, the risks may be reduced.
Alzheimer’s disease is far from dentistry, but certainly there is a connection between the oral cavity
and general medicine. A further example is Burning
Mouth Syndrome [BMS]. This is in the oral cavity but
considered to be a medical problem. LPT has been tried
without success in early studies. However, the origin
of BMS is unknown. Two more recent studies used
high energies and the outcome was successful.10,11
Thus, the effect behind the pain relieving result appears to be inhibition of axonal flow, as demonstrated
by Chow.12 LPT then could not cure these patients, as
with any other therapy, but at least serve as a pain relieving therapy, open for dentists.
Diabetes is another non-dental pathology with a
deep impact in dentistry. The laser dentist cannot do
anything about the pathology itself, but the advantages of treating the side effects of diabetes are obvious. This is among other things demonstrated in the
healing process after surgery and periodontal therapy. An animal study by al-Watban showed that
wounds in the genetically diabetic animals healed just
as fine as for the non-diabetic animals.13 The positive
effect in periodontal therapy is confirmed by
Obradovic.14 We can therefore expect improved heal-

Fig. 3

Fig. 2

ing after scaling, extraction and minor surgery if LPT
as applied in diabetic patients.
Lichen planus is treated by specialists in the dental field and the general dentist often refers these
cases to a specialist or to a medical doctor. A recent
study by Dillenburg showed a better result from LPT
than for the traditional clobetasol.15 Pemphigus vulgaris is yet another autoimmune condition where
steroids can be replaced by LPT.16,17

Figs. 2 & 3_Non-healing wound,
having been unsuccessfully treated
for four months. Initial situation
before LPT on January 5 on the right;
situation on January 16 on the left.
A home care laser device was used.

TMD is indeed a dental indication, but being multifactorial, it borders to psychology and medicine. Each
profession can do its own part. A more holistic attitude is required to cure some of these patients and the
muscular problems are often not only related to the
masticatory system but to neck and shoulders as well.
A laser dentist can make these areas a dental interest
and expand the therapeutic possibilities. From a
strictly scientific point of view, LPT for TMD is not scientifically proven. This is because even with more
than 50 clinical studies, the parameters differ a lot, the
laser parameters as well as the therapeutic approaches. Should the lack of Cochrane-style evidence
be applied to this treatment, we should be aware of
the fact that endodontics is another area where there
is no scientific evidence, according to an evaluation
by SBU—Swedish Council on Health Technology Assessment.18 The lack of evidence stems from the use
of different materials and methods. Thousands of papers cannot rectify this judgement. Of course, we
know that endodontic treatment works well, but we
cannot prove it. The same goes for LPT and TMD,
for the time being. In fact, SBU has a more
positive evaluation of the use of LPT for
neck pain.19

OS]
MM
ETIA
©
:
E
TUR
[PIC

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I research
Dentists on average do not prescribe much NSAIDs
and steroids, yet our patients regularly use these
pharmaceuticals. They work fine for short-term use
but less so for long-term use according to Bjordal.20
The laser dentist can reduce the use by replacing
the pharmaceuticals with LPT to a high degree.21
The only limitation is that the pharmaceuticals can
be taken for a long period at home, whereas the
laser treatment is performed in the clinic. To a certain
extent this limitation can be reduced by the use of
home-care laser units. A consequence of an ageing
European population, taking a lot of medications, is
xerostomia. Dentists can recommend various gels
and sprays to alleviate these problems but with a laser
at hand, a rather long-term improvement of the xerostomia can be achieved. This requires an initial
treatment in the clinic, followed by a period of the use
of a home-care laser.22, 23
Acupuncture is not common in dentistry but is an
option for the laser dentist. Laser acupuncture has
shown similar results as needle acupuncture24 and a
recent meta-analysis provides proof of the efficacy of
laser acupuncture.25 Even the inexperienced dentists
can for instance use the point P6 on the wrist to reduce the gagging reflex. The pain-free and non-invasive quality of laser acupuncture paves the way for a
new kind of dental profession.
Bisphosphonate-associated osteonecrosis of the
jaw (BRONJ) is an emerging dental problem with an
increasing number of patients using bisphosphonates. The healing capacity of these patients is low.
Surgical as well as therapeutic lasers are reported to
be a valuable tool in treating these cases.26, 27

The above is a brief survey of indications which
traditionally are not treated by dentists, but where
the use of a therapeutic laser can expand the scope
of dentistry. Most of the conditions described here
are new for laser applications and have fairly scant
scientific evidence. However, the lack of side effects
of LPT still makes them a reasonable field for dentistry.
Apart from being able to do more for the patients,
the laser dentist also has a possibility of treating himself, staff and family for common problems such as
tennis elbow, carpal tunnel, burns etc. This poses no
legal or ethical problems like treating patients for
these ailments would. The legal situation will differ
from country to country, but still, the side free effect
of LPT opens quite new possibilities for good patient
care. The case below is certainly not dentistry, but indeed a dental patient with a health problem (Figs. 2
and 3)._
References can be obtained by contacting the author at
jan.tuner@swipnet.se

contact
Jan Tunér
Spjutvägen 11
772 32 Grängesberg, Sweden
jan.tuner@swipnet.se
www.tuner.nu

Kurz & bündig
Obwohl die laserunterstützte Phototherapie (LPT) bereits seit mehreren Jahrzehnten angewendet wird, ist die anfängliche
Skepsis der Anwender erst in den letzten Jahren einer wachsenden Anerkennung ihrer Stärken gewichen. Mittlerweile ist sie
bei vielen Indikationen wie Entzündungen, Schmerz oder Ödemen eine anerkannte Behandlungsoption. Betrachtet man die ihr
zugrunde liegenden Mechanismen auf Zellebene, erschließt sich das breite Anwendungsspektrum der Phototherapie. Im vorliegenden Artikel wendet sich der Autor den neuesten Erkenntnissen dieser lasergestützten Behandlung zu.
Eine moderne Herangehensweise macht sich die Eigenschaft der Phototherapie zunutze, Gewebe bereits vor einem möglichen Trauma, wie beispielsweise einem chirurgischen Eingriff, zu präkonditionieren. Gesunde Zellen reagieren schwächer auf
LPT als pathogene Zellen, während die beste Zellreaktion in einer reduzierten Umgebung, also einer Umgebung mit einem niedrigen PH-Wert, stattfindet.
Eine Vielzahl der im Artikel beschriebenen Indikationen sind zwar klassischerweise nicht der Zahnmedizin zuzuordnen, können jedoch unter Verwendung eines therapeutischen Lasers zu einem zahnärztlichen Anliegen gemacht werden. Die meisten
hier beschriebenen Zustände sind neu für die Laseranwendung und haben eine eher spärliche wissenschaftliche Evidenz. Da
die Laser-Phototherapie jedoch keine Nebeneffekte aufweist, kann eine Integration dieser Behandlungsmöglichkeiten in die
Zahnmedizin zu einer sinnvollen Erweiterung des zahnärztlichen Anwendungsspektrums beitragen. Der nebenwirkungsfreie
Effekt einer LPT eröffnet völlig neue Möglichkeiten für eine erfolgreiche Patientenpflege.

08 I laser
4_ 2015

[9] =>

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[10] =>

I case report

Denture Stomatitis:
Treatment with
Diode Laser
Author_Dr Maziar Mir, Prof. Norbert Gutknecht, Dr Masoud Mojahedi, Dr Jan Tunér, Prof. Ramin Mosharraf &
Dr Masoud Shabani, Germany, Sweden, Iran

_Introduction
Denture stomatitis (DS) is one of the most common
oral lesions in patients who wear a complete or partial
removable denture. Very few cases regarding the
treatment of denture stomatitis lesions by laser are reported in the literature. We present a case of treatment
of DS without the use of any pharmaceutical aids.

Fig. 1_Clinical view of type II DS
according to the Newton
classification.
Fig. 2_Immediately after superficial
contaminated layer vaporisation with
diode laser.
Fig. 3_One day after treatment.

The prevalence of DS is 15 % to 70 % among patients using dentures.1, 2 DS is a chronic candida infection. Thus, Candida albicans is the main causative organism. Besides Candida albicans, additional predisposing factors can play a role in the occurrence and
progression of DS, including poor oral and denture hygiene, continual and overnight wearing of removable
dentures, hyposalivation, bacterial and yeast contamination of denture surfaces as well as poor-fitting dentures. All of the mentioned factors are able to increase
the ability of Candida albicans to colonise both the
denture and the oral mucosal surfaces. Additionally,
long-term antibiotic therapy, use of corticosteroids,
diabetes, impaired immunity, malignancy, alcohol
consumption, trauma, and diet may increase the development of DS.3, 7

Fig. 2

Fig. 1

10 I laser
4_ 2015

DS is classified in three types (Nyoton classification): pin-point hyperemic lesions or simple inflammation (type I); diffuse erythema or generalised inflammation (type II) and inflammatory papillary hyperplasia (type III).8,9
Treatment of DS is traditionally started with the introduction of good oral and denture hygiene, correction of ill-fitting denture, discontinuation of nocturnal denture wearing, usage of topical agents such as
nystatin and miconazole and finally relining or replacing of the denture. Systemic antifungal agents such as
amphotericin B and fluconazole are also effective in
cases of recurrence and for patients contraindicated to
surgery. Surgical treatment of the lesion in cases of
type II and type III can be applied in the form of scalpel
surgery, electrosurgery and cryosurgery. Recently,
laser-assisted photodynamic therapy has been reported.10
Vaporisation is ideal for large surface lesions confined to the epithelium,11 whereas cryosurgery is an
option for the removal of superficial, wide lesions in
the oral cavity. Both laser vaporisation and cryosurgery
preclude a histological diagnosis. Therefore, both

Fig. 3

[11] =>

case report

Fig. 4

Fig. 5

techniques only are performed in areas that previously
had biopsy specimens taken or when a clinical diagnosis has been made properly. Cryosurgery disadvantages include unpredictable degree of swelling, lack of
precision for depth and freezing area, and high dependence on the operator’s skill and experience. However, advantages of cryosurgery include absence of
pain, low risk of infection and no need of suture removal.12, 15

_Case report
A 65-year-old female patient with sore mouth sensation, who had worn her dentures for six years continuously without removing it during sleep, was referred for treatment.
Medical history
The anamnesis of the patient revealed no systemic
medical problems, no allergic reactions, no medicament or drugs and no history of past surgical procedures so that the patient had no need for a referral to
a medical consultant.
Dental history
Oral and maxillofacial examination of the patient
revealed no T.M.J. or myofascial disturbances.
Clinical findings
Old and ill-fitting dentures, resorbed alveolar ridge
and a diffuse erythematous lesion of the palate were
observed (Fig. 1).
X-ray examination
X-ray examination showed no abnormal destructive effects.
Clinical diagnosis
The case was clinically diagnosed as denture stomatitis type II according to the Nyoton classification, and
we decided to treat it by diode laser.
Laser parameters
The laser had a wavelength of 980 nm, 400 µm fibre, 1.2 W output power, continues mode and initiated
fibre.

Fig. 6

Treatment delivery sequence
After filling out the consent form, the surgery area
was anaesthetised by infiltration method with 2 % lidocaine with Epi 1:100,000, 1.8 ml. Afterwards, the following treatment steps were executed:
− Defining of the controlled area and the proper placing of the laser warning signs to secure the operating
room.
− Checking of the safety for patient's eye glasses, patient's guardian eye protection and the assistant eye
protection.
− Set up of the laser and test of proper laser operation
(fibre cleaving, control of the laser output, aiming
beam control, spot size estimation, initiation of the fibre with a dark articulation paper and test-fire of the
laser), using minimum power and setting.
− Checking the patient's information (examination
sheet and X-ray, consent form, etc.).

Fig. 4_Five day after treatment.
Fig. 5_One week after treatment.
Fig. 6_Two weeks after treatment.

The lesion vaporization
Removal of the superficial contaminated epithelial
surfaces was performed with contact and scanning
mode in combination and the lesion was vaporized. During the treatment, high volume suction was used to
evacuate the vapor plume and objectionable odors at the
site of operation. During the entire procedure, the lasertissue interaction was respected in order to prevent any
unsuitable reactions in the surrounding tissue. Removal
of carbonized tissue was done by a micro-applicator
brush sucked in 3% hydrogen peroxide solution.
Post procedural education
The patient was advised to keep the area clean and
to avoid food and liquids that may cause pain or irritation to the sensitive tissue, but can use over-thecounter analgesics as needed.
Final result
Excellent laser vaporization of the contaminated
layer was observed with no bleeding, no carbonization
and no char (Fig. 2). The patient did not experience any
discomfort and was satisfied.
Follow-up
The first visit after laser treatment was one day after the procedure (Fig. 3). The patient revisited after five

laser
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[12] =>

I case report
days and one week. As Figs. 3 and 4 show, the healing
process was as expected so that the healing was progressing well and devoid of any pain or discomfort.
Finally after two weeks, the final goal was achieved
(Fig. 5). A new denture was provided after complete
treatment (Fig. 6).

_Discussion
Diode lasers with wavelengths ranging from 810
to 980 nm are used for soft tissue surgery in the oral
cavity. In comparison to conventional DS treatment
(scalpel technique, cryosurgery, topical or systemic
antifungal agents), the laser assisted DS therapy
can be performed fast, with no bleeding, with little or
no pain, no oedema and little or no need to use overthe-counter analgesics. Although antifungal agents,
such as nystatin (100,000 unit per ml) and amphotricin B (lotion 3 %) are effective in alleviating the
clinical signs and symptoms of candida infection,
unpleasant taste, gastrointestinal side effects such
as nausea, vomiting and diarrhoea can be seen in this
model of treatment. Additionally, topical agents
can be diluted through saliva and displaced by oral
movable tissue so that treatment regimens may be
prolonged and lead to unsuccessful treatment of
the infection and also development of resistant
species.16–18 Systemic antifungal agents cannot fully
eradicate the microorganisms that colonize the denture.19 Further side effects such as gastrointestinal
disturbances, hypersensitivity, renal and liver toxicity
and interaction with other medicines can be seen
during usage of systemic antifungal drugs.20 High recurrence rates of denture stomatitis and recoloniza-

tion of candida have been reported after cessation of
the antifungal treatment.19, 21
Use of disinfection agents can also have minor
side effects such as staining and alterations of
taste.22 Photodynamic therapy has been suggested
as a conservative treatment of DS but there is yet little literature to support this kind of treatment.19, 23
Cryosurgery can be used in the field of oral lesion
treatment, but a relatively long period of wound healing is one of its disadvantages and the prevention of
loss of gas attributable to leakage and evaporation,
and a risk of accidents during storage has to be taken
into account.24, 25

_Conclusion
The 980 nm diode laser is a useful tool for the treatment of denture stomatitis._
Editorial note: A list of references is available from the publisher.

contact
Dr Masoud Shabani
Deputy for Research, Ardebil University of Medical
Sciences, Ardebil, Iran
Conservative Dentistry, RWTH Internatıonal Academy,
Aachen, Germany
m.shabani@arums.ac.ir

Kurz & bündig
Prothesenstomatitis ist eine der häufigsten oralen Läsionen bei Patienten, die eine Voll- oder herausnehmbare Teilprothese
tragen. In der Literatur werden nur wenige Fälle zur Laserbehandlung solcher Läsionen erörtert. Im vorliegenden Artikel wird
der Fall präsentiert, bei dem Prothesenstomatitis ohne jegliche pharmazeutischen Mittel erfolgreich mithilfe eines Diodenlasers behandelt wurde.
Eine 65-jährige Patienten stellte sich mit schmerzendem Mund vor. Sie hatte zu diesem Zeitpunkt ihre Prothesen seit sechs
Jahren getragen, ohne diese während des Schlafs herauszunehmen.
Nach klinischer und röntgenologischer Untersuchung wurde der Fall als Prothesenstomatitis Typ II gemäß der Newton-Klassifikation eingestuft und mithilfe des Diodenlasers behandelt. Nach der Behandlung zeigte sich eine sehr gute Laservaporisation der kontaminierten Gewebe, jedoch keine Blutung oder Karbonisierung. Die Patientin blieb während und nach der Behandlung schmerzfrei. Nach zwei Wochen war das Behandlungsziel vollständig erreicht, sodass eine neue Prothese verwendet werden konnte.
Zusammengefasst stellt die laserunterstützte Behandlung der Prothesenstomatitis eine gute Alternative zu konventionellen Behandlungsmethoden dar (Skalpell, Kryochirurgie, topisch applizierte oder systemisch wirkende Antimykotika), denn sie
verläuft schnell und blutungsfrei. Weiterhin ist sie für den Patienten mit keinen oder geringen Schmerzen verbunden, Ödeme
können ausgeschlossen und selbst frei erhältliche Schmerzmittel müssen nicht verwendet werden.

12 I laser
4_ 2015

[13] =>

[14] =>

I case report

A multidisciplinary
approach with
Er,Cr:YSGG
Aesthetic management of hard and soft tissues
Authors_Dr Christina Boutsiouki & Dr. Dimitris Strakas, Germany, Greece

_Introduction
The use of an Er,Cr:YSGG laser system in every day
practice is beyond doubt a very helpful tool in the
hands of a trained practitioner. It can be used safely
both for hard and soft tissue treatments, with minimal or no use of anaesthesia, and complex cases with
many different treatments can be treated in less
time. Therefore patients enjoy the benefit of timesaving and pain-free treatments.

Fig. 1_Initital clinical image after
reference from the orthodontic
department.
Fig. 2_Initial frontal view upper and
lower arch.
Fig. 3_Initial frontal view of the upper
teeth.

The following case report is from a female patient
aged 38, who was referred to the Post-graduate
Dental Clinic of the Operative Dentistry department,
in Aristotle University of Thessaloniki by the Department of Orthodontics. Reason of the reference was
the fact that the patient showed no compliance with
the orthodontic treatment (Fig. 1). Therefore a faster
and conservative aesthetic solution for the front
teeth area was decided. Anterior teeth have a signif-

Fig. 2

Fig. 1

14 I laser
4_ 2015

icant psychological and emotional impact on patients owing to their prominent position within the
dentition and their main role in a smile. The patient’s
chief complaint was the color of her teeth and the
gaps between the upper front teeth (Figs. 2–6). After
obtaining the medical and dental anamnesis, clinical
and radiographic examination was performed in order to address any existing therapeutical problems
(caries, periodontal, endodontic).
The patient mentioned during dental anamnesis
recording that she had performed periodontal therapy one month ago and that she was under observation by the Department of Periodontology. Moreover, it was mentioned that she had worn the brackets for more than five years and that she was reluctant to continue the orthodontic treatment. From
the side of the orthodontists it was recorded that she
was not consistent with the change of the elastic
bands, she omitted a few appointments even when

Fig. 3

[15] =>

case report

Fig. 4

Fig. 5

Fig. 7

Fig. 6

brackets were debonded and that she maintained no
proper hygiene. Additionally, it was made clear that
it is contra-indicated to further continue with the
orthodontic treatment, as the risk of root absorption
was high due to the long-time activation of the
brackets.
Clinical examination revealed poor oral hygiene,
gums hyperplasia, visible discoloration around the
brackets due to smoking, caries on the right upper canine and a PFM crown on the left lateral incisor (Figs.
2–6). Mild demineralisation around the brackets was
also noted after they were removed. It was also observed that the teeth’s central mid-line did not correspond with the facial mid-line (Fig. 1). Clinical and radiographic examination showed no problem at the
posterior teeth.

– Gingivectomy on upper and lower gum line
– Bleaching on upper and lower arch
– Diastema closure between teeth #11–21, #11–12
and #21–22
In order to allow proper soft tissue healing and following the guidelines for adhesive restorations performed after bleaching, a two-week interval was
scheduled between each appointment. The demineralisation around the brackets was decided to be handled with fluoride gel application.

Fig. 8

Fig. 4_Initial frontal view of the lower
teeth.
Fig. 5_Right side initial view.
Fig. 6_Left side initial view.
Fig. 7_The pattern of gingivectomy
was designed on the gingival tissue.
Fig. 8_Periodontal sulcus depth was
checked prior to surgery.

_Gingivectomy

According to our findings, respecting the patient’s
wishes and taking in consideration her financial limitations, the aesthetic rehabilitation should include a
multidisciplinary approach. It was decided to perform the following treatment plan:

Periodontal plastic surgery introduced by Miller in
1993, includes surgical procedures performed to correct or eliminate anatomic, developmental or traumatic deformities of the gingiva or alveolar mucosa.1
It is often combined with aesthetic rehabilitation of
the smile with conservative composite restorations
or with veneers. The goal is to eliminate the periodontal pockets by excision of the excessive soft
tissue.

Tooth Number

Width

Height

7,5

Width: Height Ratio

0,93

1,125

0,87

Table 1_Central and lateral incisors
dimensions.

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[16] =>

I case report

Fig. 9

Fig. 10

Fig. 11

Fig. 12

Fig. 9_Immediate image after
gingivectomy in the upper arch.
Fig. 10_Two-weeks post-operative
image and healing of gingival tissue
in the upper arch.
Fig. 11_Immediate image after
gingivectomy in the lower arch,
following the same procedure.
Fig. 12_Two-weeks post-operative
image and healing of gingival tissue
in the lower arch.

16 I laser
4_ 2015

The gingival architecture in the upper arch was not
even and gum hyperplasia was noted at areas #21–22
and #22–23, owing to chronic insufficient plaque removal and possibly to the PFM crown placement on
tooth #22. Moreover, study of the casts showed that
in order to attain an optimal length-width ratio of
62–80 %, crown lengthening should take place prior
to diastema closure. Normally, the gingival margin is
1 mm coronally to the cemento-enamel junction. The
above-mentioned problems can be solved by removing the excessive gingiva via precisely planned incisions. When crown lengthening is planned to increase the tooth length, the biological width needs to
be considered and not encroached upon, as this may
lead to periodontal breakdown.

Average output power was set to 2,5 W, with a pulse
duration of 700 µsec (S-Mode) and a pulse repetition
rate of 50 Hz using an MZ5 tip under minimal water
spray (Air: 10 %—Water: 10 %). Gum hyperplasia areas were treated first and a scalloped excision pattern was followed (Fig. 9). As a final step, a pleasing
gingival symmetry was created and the gingiva was
allowed to heel for two weeks before the next treatment phase (Fig. 10). The patient reported slight
bleeding at the next day following the gingival treatment, but no pain or soreness. Gingivectomy in
the lower jaw (Fig. 11) was performed at the next
appointment, together with bleaching of the
upper teeth, and was allowed to heal for two
weeks (Fig. 12).

Therefore, periodontal measurements of the sulcus depth were recorded and in accordance with the
preferred tooth dimensions, tooth width, height and
their ratio was recorded prior to surgery (Table 1).
Ideal ratio would be 0,8–0,9. Once the appropriate
proportion was determined, the outlines were
marked on the gingiva with a waterproof marker
(Fig. 7). Since the clinical crown was measured to be
shorter than the anatomical crown, approximately
2 mm of gingiva were calculated to be removed
(Fig. 8). The gingival tissue was of a thick biotype and
had adequate attached gingiva. Gingival recontouring was performed with the following parameters.

_Er,Cr:YSGG assisted teeth bleaching
In order to achieve the best clinical results without
harming dental tissues, it is crucial to follow the procedure carefully and take all safety measures. Before
starting the first session, the patient was also informed that the result of the procedure is not permanent and is dependent on the age of the patient and
the use of tobacco and extrinsic staining by deposition of tannins found in coffee, red wine, tea and cola
beverages. The average duration expectancy is three
to four years for non-smokers. The patient was instructed that if teeth sensitivity or pain was felt dur-

[17] =>

case report

ing teeth bleaching, we should be notified so the
treatment could be paused or stopped.

plied both on upper and lower teeth and was polymerised with a fanning motion for 40 seconds.

Periodontal therapy has been performed in the
Department of Periodontology. Before starting with
the teeth bleaching, it was checked that the teeth
were free of plaque, calculus and extrinsic staining
(Fig. 10). In order to prevent unwanted proteins and
enzymes of saliva’s biofilm to interfere with the
bleaching agent, mild cleaning of the teeth to be
bleached was performed, with the application of a
prophylaxis paste. In the Post-graduate Dental Clinic
of the Department of Operative Dentistry at the Aristotle University of Thessaloniki, we operate an
Er,Cr:YSGG laser (2,780 nm, Waterlase MD, Biolase,
USA) and a yellow-colored bleaching agent used for
in-office bleaching with a concentration of 38 %
H2O2 (Power whitening, WHITEsmile GmbH, Germany). The tip used is a 6 mm long Z-type glass tip
(MZ8) of an 800 µm diameter, used with the gold
handpiece of the laser system. The power settings
that we have used were: output power 1.25 W, pulse
duration 700 µsec (S-mode), while the pulse repetition rate was set to 10 Hz.

The bleaching agent was applied in a 1-2 mm thick
layer on each tooth, except from #22, due to the PFM
crown. With the power settings mentioned above we
activated the bleaching agent for two intervals of ten
seconds on each tooth (Fig. 13), keeping the laser
handpiece on a 2.5 cm distance from the teeth. After
the procedure, the activated bleaching agent was left
for 15 minutes and then carefully removed with
high-power dry suction from the teeth. This procedure was repeated twice at the same appointment.
Upper and lower arch were bleached in separate appointments. Upper teeth’s bleaching was performed
at the same appointment with the gingivectomy of
the lower arch, thereby pointing out the advantage of
the use of laser, in terms of absence of pain and bleeding. No soft tissue irritation was noticed, nor did the
patient report feeling pain or soreness. Final color
evaluation took place from the dentist, the dental assistant and the patient. Two repetitions of the process
at the same appointment were adequate to move the
color of the teeth to B1 according to VITA Classical
Shade Guide (Fig. 14). The patient was satisfied with
the color of her teeth and the next appointment was
arranged in order to close the diastemas.

The dentist, the dental assistant and also the patient evaluated initial tooth color. In our case, the patient’s initial color was evaluated as A3 in the VITA
Classical Shade Guide. Both the patient and the personnel in the laser working area must wear safety
goggles in advance. Lip protection cream was applied
and the working area was isolated with a cheek and
lip retractor. After drying teeth and gums with gentle
air stream, a liquid gingival barrier was carefully ap-

_Diastema Closure
Diastema closure was scheduled after two weeks
in order to achieve high-quality bond strength between the enamel and the composite resin (Ittipuriphat and Leevailoj 2013).2 Casts were studied prior to

Fig. 13_Laser-assisted bleaching of
the upper teeth. Note that tooth #22
has a PFM crown.
Fig. 14_Immediate colour evaluation
after bleaching.
Fig. 15_Evaluation of gold
proportions in casts prior to
diastemas closure.
Fig. 16_Preparation of Class V cavity
on tooth #13.

Fig. 13

Fig. 15a

Fig. 14

Fig. 15b

Fig. 16

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[18] =>

I case report

Fig. 17

Fig. 18

Fig. 20

Fig. 19

Fig. 17_Etching of enamel with laser
at the lateral surfaces of the teeth to
be restored with composite resin and
around a Class V cavity on tooth #13.
Fig. 18_Additional acid etching was
performed on enamel.
Fig. 19_Final frontal view of
restored teeth.
Fig. 20_Final palatinal view of
restored diastemas.
Fig. 21_Final right side view.

restorations; appropriate tooth proportions were calculated and checked with the golden proportions tool,
which can simultaneously define the width of central
incisors in comparison to the lateral incisors, or the
width of the laterals in comparison to the canines
(Fig. 15). This gives an idea of the ideal placement of the
composite resin regarding its placement at the proximal area of two neighboring teeth and how many millimeters of composite resin are required for mesial and
distal closure of a specific diastema. During this planning, the difference in facial and dental mid-line was
also considered (Fig. 1) in order to achieve an even result. Prior to aesthetic rehabilitation, caries on #13 was
removed using an Er,Cr:YSGG laser (2.780nm, Waterlase MD, Biolase, USA, Fig. 16). Average output power
was set to 6 W, with a pulse duration of 140 µsec
(H-Mode) and a pulse repetition rate of 15 Hz using an
MZ6 tip under water spray (Air: 50%–Water: 80%). All
margins and enamel were etched with the same laser
device (Fig. 17). Power settings for bond preparation
were (MZ6 tip, average output power 4,5W, pulse repetition rate 50Hz, H-mode).
Restorative procedure took place free-handedly after placement of a rubber dam. Enamel was additionally etched with 37% phosphoric acid while the mesial
surface of the PFM crown was etched with 9% hydrofluoric acid (Fig. 18). Thus, resin composite bond to
enamel will benefit both from laser etching and from
acid etching. Starting from the central incisors, diastemas were closed using a single composite resin
shade (A3 Shade, Beautifil, SHOFU Inc), first palatinally

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4_ 2015

Fig. 21

and then bucally. It was decided to use a single composite shade, as teeth presented high color saturation
and no prominent translucency or special characteristics. Special attention was given to the proximal transition lines in order to create the illusion of narrower
teeth. Microstructure was created after polishing with
fine and ultra-fine diamond burs, with decreasing
roughness of polishing discs, silicon points and brushes
coated with diamond paste for the final gloss. The incisal plane could not be evened, despite the patient’s
wish, due to occlusional restraints. Final adjustments
were made during polishing at the proximal curvature
and at the incisal plane, to enhance the natural-looking
effect. The final outcome is shown at Fig. 19 bucally and
Fig. 20 palatinally. Side photographs were also taken
(Figs. 21 and 22). Note that, in order to gain in aesthetics, the diastema between #11–12 was decided not to
be fully restored (Fig. 21). Otherwise, we would end up
with very wide central or lateral incisors, which would
compromise the final aesthetic result. At the same appointment, lower jaw bleaching was performed, with
the same procedure described above. Fluoride gel was
then applied at the end of the treatment at the demineralised areas around the brackets, in the buccal surfaces of 11, 12 and 21. Patient recall was at seven days
post-op (Fig. 23).

_Results
The aesthetic rehabilitation of this complex case
was completely performed with the use of an
Er,Cr:YSGG laser. Laser treatment was performed

[19] =>

case report

Fig. 22

with no local anaesthesia. Patient reported no sensitivity at any stage of the procedure. During gingivectomy, no side-effect or comment was reported and
fast healing was exhibited. Regarding diastema closure, it was decided to use a single composite shade
as the teeth presented high colour saturation and no
prominent translucency or special characteristics. No
silicon-key was used and composite was placed free
handed, after an initial evaluation of the interdental
gaps made at the casts, with the golden proportion
tool. Final adjustments were made during polishing
to enhance the natural effect. It is more than evident
that the use of an Er,Cr:YSGG laser system as a multitasking tool allows the scientifically trained clinician
to address the vast majority of dental treatments. By
combining soft and hard tissue aesthetics, a desirable

Fig. 23

gingival architecture and tooth proportion could be
offered to the patient._

Fig. 22_Final left side view.
Fig. 23_The patient smiles in the
seven-days post-operative control.

Editorial note: A list of references is available from the
publisher.

contact
Dr Dimitris Strakas, MSc
PhD cand. Department of Operative Dentistry Aristotle
University of Thessaloniki
Spiridi 28, 38221
Volos, Greece
+30 24210 32525
dimitris.strakas@gmail.com

Kurz & bündig
Der vorliegende Artikel beschreibt einen multidisziplinären Ansatz der Lasertherapie mithilfe eines Er,Cr:YSGG-Lasers anhand
des Fallbeispiels einer 38-jährigen Patientin. Diese wurde an den Autor überwiesen, nachdem eine kieferorthopädische Behandlung aufgrund schlechter Mundhygiene und mangelnder Compliance gescheitert war.
Die Hauptanliegen der Patientin waren die Zahnfarbe und eine Zahnlücke zwischen den oberen Frontzähnen. Die klinische Untersuchung zeigte neben einer schlechten Mundhygiene eine Gingivahyperplasie, eine sichtbare Verfärbung im Bereich der Brackets
durch Rauchen, Karies auf dem rechten oberen Eckzahn und eine Metallkeramikkrone auf dem linken lateralen Schneidezahn. Nach
Entfernung der Brackets wurde zudem eine leichte Demineralisierung der Zähne sichtbar. Weiterhin entsprach die zentrale Mittellinie der Zähne nicht der des Gesichts. Die klinische und röntgenologische Untersuchung zeigten jedoch keine Probleme im Seitenzahnbereich.
Unter Berücksichtigung des Befundes und der Wünschen der Patientin wurde ein multidisziplinärer Behandlungsplan aufgestellt: Gingivektomie des oberen und unteren Zahnfleischrandes, Zahnaufhellung des oberen und unteren Zahnbogens sowie ein
Diasthemaschluss an den Zähnen #11–21, #11–12 und #21–22.
Diese komplexe ästhetische Rehabilitation wurde mithilfe eines Er,Cr:YSGG-Lasers durchgeführt. Obwohl auf lokale Betäubung
verzichtet wurde, berichtete die Patientin, dass sie während der gesamten Behandlung keine Schmerzen verspürt habe. Während
der Gingivektomie gab es keinerlei Nebenwirkungen. Eine schnelle Wundheilung konnte beobachtet werden. Zusammenfassend
kann eine Vielzahl dentaler Behandlungen mithilfe des Er,Cr:YSGG-Lasers durchgeführt werden, was multidisziplinäre Behandlungssätze wie im vorliegenden Fall begünstigt. Durch die Kombination zwischen Hart- und Weichgewebsästhetik wurde der
Patientin eine ansprechende Ästhetik sowohl hinsichtlich der Gingivafläche als auch der Zahnproportionen geboten.

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[20] =>

I manufacturer news_international

Manufacturer News
15 th WFLD Congress 2016

Light to brighten the future
The World Federation for Laser Dentistry (WFLD) is an organisation of academic
societies with the agenda of promoting oral health by innovative developments
in laser dentistry and dental care. It is comprised of 54 member countries
worldwide. In addition to academic activities, the WFLD is also committed to
educational activities in countries around the world. These include training and
lectures, providing safe and appropriate directions for the use of dental lasers,
as well as its international congress.
Every two years, the WFLD holds an international congress at a major city. In
2016, the 15th Congress of the WFLD will take place in Nagoya, Japan, hosted
by honorary presidents Hajime Yamamoto and Isao Ishikawa as well as Kenjy
Yoshida, Chair of Organising Committee. The congress theme is “Light to
brighten the future”, in an effort to move ahead from existing laser dentistry
and dental care, and to look at new developments by incorporating “light” into
all diagnosis and treatment. The congress programme includes: specialist
lectures, symposiums, workshops, oral and poster sessions, seminars and an
extensive dental exhibition. The 15th WFLD Congress will be held from 17 to
19 July 2016, bringing together laser specialists in engineering and medical
fields, including dentistry, from countries around the world. It is hoped that the
congress will also serve as an opportunity for further advancement of academic
research activities and clinical improvement. In addition, it aims at heralding

the beginning of new development of medical devices and new expansion of
the industry in Japan, providing an extensive platform for information on all
aspects of the dental laser industry in its dental exhibition.
WFLD2016 Secretariat
c/o Convention Linkage, Inc.
Asahiseimei Bldg., 3-32-20 Sakae,
Naka-ku, Nagoya, 460-0008 JAPAN
wfld2016@c-linkage.co.jp
www.c-linkage.co.jp/wfld2016

FOTONA

LightWalker with biomodulation
Fotona’s award-winning LightWalker dental laser is
widely recognised as a powerful system that enables
an exceptionally broad range of dental procedures. And now with Fotona’s new Genova
handpiece, LightWalker also offers biomodulation capabilities, which can be
an ideal complement to many surgical
procedures.
The Genova handpiece was specially developed for Fotona’s LightWalker laser system
for inducing highly effective wound healing
and pain reduction. The new handpiece creates a large spotsize with a unique collimated
homogeneous beam profile of Nd:YAG laser
light, which is the optimal infrared wavelength to
penetrate homogeneously into soft tissue. The laser
light is absorbed into the mitochondria and cell membranes of the target cells, leading to an increase in mitotic activity and number of fibroblasts, as well as collagen synthesis, neovascularisation and a decreased

20 I laser
4_ 2015

level of pain. The effect of the Nd:YAG wavelength on
the healing of injuries and lesions through the stimulation of growth factors is substantially higher than
with other wavelengths. The Genova treatment protocol is easy for any dentist to perform. It is clinically proven to stimulate wound healing in
skin, mucosa and bone tissue, and also
provides pain reduction and anti-in-

flammatory effects. And the new Genova handpiece,
with its unique beam profile, treats affected areas
with exceptional precision and control.
About Fotona: Founded in 1964, only four years after
the invention of the very first laser, Fotona is one of the
most experienced developers of high-technology
laser systems, recognized for the design, manufacture, and support of advanced solid-state laser systems for: medicine (aesthetics, surgery, gynecology),
dentistry, industry & defense. Fotona is fully committed to stringent testing of all components and inhouse production of its medical and dental laser systems. This long-term dedication to perfection ensures that the company's laser systems are of the
highest quality, reliability and durability.
Fotona
Stegne 7
1000 Ljubljana, Slovenia
www.fotona.com

[21] =>

Dear authors, thank you for your contributions in 2015.
Looking forward to working with you in 2016!

To publish, please contact:
Georg Isbaner
Editorial manager
g.isbaner@oemus-media.de

%%!

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[22] =>

I industry

SIROLaser Blue—
Three wavelenghts with
one single device
Author_Marlene Hartinger, Germany

Fig. 1

Fig. 1_All participants of the
2nd Sirona Laser Days.

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4_ 2015

_Dental diode lasers

_Three wavelengths—one device

The use of laser in dentistry has steadily grown over
the past decades as lasers have repeatedly proven to be
powerful surgical tools for both hard and soft tissue applications. There is no discipline in dentistry that does
not benefit from the advantages of laser therapy.
Among dental lasers currently available, diode lasers
have become particularly popular due to their compact
size, versatility and relatively affordable pricing. Diode
lasers use a semiconductor stimulated by electricity to
produce laser light and enable practitioners to perform
less invasive procedures with greater patient comfort.
Swelling, scaring and post-operative pain is considerably minimised and wounds and tissue heal faster. In addition, dental diode lasers effectively reduce the level of
oral germs and bacteria. Compared to traditional procedures, diode lasers lessen stress and anxiety in patients
uncomfortable with conventional instruments such as
dental drills and therefore lead to a higher patient satisfaction. Ultimately, as the right instruments are crucial
for the success of a treatment and hence of a practice,
both dentists as well as patients profit greatly from the
predicable outcome of dental laser applications.

At this year’s IDS in Cologne, Sirona introduced
SIROLaser Blue, the first dental diode laser with a blue,
infrared and red diode. By providing three wavelengths
(445 nm, 970 nm, 660 nm) with one single device,
SIROLaser Blue enables a spectrum of 21 indications including frenectomy, fibroma, gingivoplasty, tissue
management and haemostasis. The blue laser light at a
wavelength of 445 nm is used in soft-tissue surgery because it is absorbed more effectively by tissue compared to infrared laser light. Due to its shorter wavelength, it does not penetrate deeply in surgery and has
consequently less effect on surrounding tissue. The
blue laser makes it possible to work in a non-contact
mode, achieving substantially better cutting results at
a lower power than infrared laser light at a higher
power rating. Additionally, the blue laser light interacts
better with haemoglobin, a complex protein found in
the red blood cells of the body, and is therefore ideal for
e.g. the treatment of vascularised tissue. The infrared
light in wavelengths of 970 nm can be utilised for conventional, germ-reducing indications in endodontics
and periodontics, e.g. for the treatment of connective

[23] =>

industry

Fig. 2_During a tour of his practise,
Prof. Guiseppe Iaria explained
various laser applications he and his
son, Dr. Matteo Iaria, offer at their
laser clinic in Brescia.
Fig. 3_Two key members of the
international laser community:
Prof. Giovanni Olivi (Rom) and
Prof. Andreas Braun (Marburg)

Fig. 2

and very dense fibrous tissue. The additional third diode
with wavelengths of 660 nm is used for “soft-laser” applications such as low level laser therapy (LLLT), also
known as therapeutic laser treatment, and biostimulation/tissue regeneration. Laser biostimulation affects
the cellular metabolic processes by providing the body
with a better inflammatory response and helps to
speed up the healing of post-operative wounds.

_2nd Sirona Laser Days in Brescia
To actively promote the advantages of SIROLaser
Blue as one of a kind and to provide the laser community with the opportunity to meet peer-to-peer and to
exchange and share their knowledge and experiences
regarding the new laser device, Sirona invited 28 experienced laser users and leading laser scientists from
13 countries to Villa Fenaroli in Rezzato, Brescia/Italy,
at the beginning of October. The exclusive 2-day programme of the Second Sirona Laser Days included presentations of various clinical cases using diode laser in
everyday working routine, workshops and, as the highlight of the user meeting, a live laser treatment. The
treatment comprised a frenectomy and fibrotic lesion
on the tongue performed by Prof. Giuseppe Iaria, a pioneer and expert in the field of digital/laser dentistry,
and was broadcast via livestream from his practice in
Brescia. Prior to the live treatment, the participants of
the event had the unique opportunity to tour Prof.
Iaria’s impressive, high-tech laser clinic in the heart of
Brescia and to pose questions regarding his many and
varied laser applications. In 1996, Dr Iaria was the first
user in Europe and one of the first users worldwide of a
hydrokinetic laser for dental care. In 2001, he introduced the first diode laser in his practice and now offers 15 medical and surgical lasers, microscopy-based
and CEREC CAD/CAM treatments. When asked about
the “magic” of lasers, Prof. Iaria highlighted three aspects that, in his opinion, must be carefully considered
when utilising lasers as they play a vital role in achieving the best possible treatment results: the correct

Fig. 3

wavelength for the intended treatment, the components of the target tissue and the knowledge and capability of the practitioner.

_The all-rounder: SIROLaser Blue
Prof. Giovanni Olivi from Rome, one of the two patrons of this year’s user meeting and a long-standing expert in the field of laser dentistry, considers the blue
laser's outstanding cutting performance in soft-tissue
surgery as one of its unrivalled advantages. Due to its
coagulation effects, the SIROLaser Blue is an excellent
instrument to cut fast, precisely and in an atraumatic
way; that makes it particularly suitable for laser procedures such as gingivectomies and frenectomies as well
as low-bleeding implant exposure in minimally invasive
surgery. According to Prof. Olivi, the infrared laser light
at 970 nm particularly supports the conventional root
canal treatment by reducing germs and bacteria in areas rinsing solutions cannot reach. In addition, infrared
laser light proves to be very effective in treating aphthae
and recurrent herpes infections. Summing up the two
“Laser days” in Brescia, Prof. Olivi was highly impressed
by the promising results his colleagues presented.
Among the participants in Brescia was also, Prof. Dr
Andreas Braun, Chief Consultant, Department of
Operative Dentistry and Endodontology, PhilippsUniversity Marburg. He presented the highly engaged audience with his latest scientific research
on diode laser applications. His research shows
in particular that, compared to conventional
semiconductor lasers in infrared regions, blue
laser technology marks a genuinely new and
highly promising advancement in laser
dentistry. The scientific data originating
from studies carried out at Marburg’s
Philipps University demonstrate the fast
and reliable elimination of germs and
bacteria during periodontic and enFig. 4
dodontic treatments. Furthermore, results from additional studies regarding its

Fig. 4_SIROLaser BLUE.

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[24] =>

I industry

Fig. 5

Fig. 5_An impressive congress
venue dating back to the
XVIII century: Villa Fenaroli in
Rezzato, Brescia.

potential use in orthodontic treatments strongly imply
future indications of SIROLaser Blue, e.g. the removal
of ceramic brackets. Possible side effects of diode laser
in infrared ranges, such as carbonisation at wound
edges, can largely be avoided. Instead, as various cases
have shown, wounds heal with no any scar formation.
Due to the blue laser’s low penetration depth, unintentional injuries of deeper tissue layers are effectively
minimised while the laser beam can be accurately focused to create a precise coagulation. Ultimately, the
use of blue laser helps not only to reduce local anaesthesia, but may dispense it altogether.

_Summary
All participants of the user meeting in Brescia
agreed on the many benefits of SIROLaser Blue: its cut-

ting performance providing patients with a fast and
atraumatic treatment experience, its effective reduction of bacteria and germs which makes it an excellent
instrument for endodontic and periodontic applications as well as its coagulating effect which enables the
user to cut with as little loss of blood as possible._

contact
Sirona – The Dental Company
Fabrikstraße 31
64625 Bensheim, Germany
Tel.: +49 625 116-0
Fax: +49 625 116-2591
contact@sirona.com
www.sirona.com

Kurz & bündig
Auf der diesjährigen IDS in Köln stellte das Unternehmen Sirona eine richtungsweisende Produktneuheit vor: Der kompakte
SIROLaser Blue ist der erste dentale Diodenlaser mit einer blauen, infraroten und roten Diode. Dadurch ermöglicht er eine Bandbreite von 21 Indikationen und eine Vielzahl von Einsatzmöglichkeiten im Praxisalltag. Im Vergleich zu konventionellen Behandlungsmethoden überzeugen Diodenlaser in der Zahnheilkunde durch eine meist narbenfreie Wundheilung und eine deutlich verbesserte Keimreduktion, vor allem in schwer erreichbaren Bereichen. Darüber hinaus reduziert die Laseranwendung
postoperative Schmerzen und verringert so die Notwendigkeit von schmerzmindernden Medikamenten.
Vom 8. bis 10.Oktober dieses Jahres lud Sirona 28 ausgewählte Laseranwender und führende Wissenschaftler der Laserzahnheilkunde zu den zweiten Sirona Laser Days ins oberitalienische Brescia ein. Das Zwei-Tage-Programm ermöglichte es
der internationalen Laser-Community, sich (weiter) kennenzulernen und sich über ihre bisherigen Erfahrungen mit dem
SIROLaser Blue rege auszutauschen. Ein besonderes Highlight der Veranstaltung war die Live-Behandlung von oralen Fibronen sowie einer Durchtrennung des Lippenbändchens, welche aus der Klinik von Prof. Giuseppe Iaria, einer der Schirmherren
des diesjährigen Anwendertreffens, übertragen und als Livestream über das Internet weltweit ausgestrahlt wurde. Die LiveBehandlung bestätigte die in Brescia wiederholt erörterten Vorteile des SIROLaser Blue: seine koagulierende Wirkung, seine
vorzügliche, präzise Schneidleistung, die ungewollte Auswirkungen auf umliegendes Gewebe deutlich begrenzen, und seinen
keimreduzierenden Effekt. Das Fazit der Veranstaltung ist damit ausgesprochen positiv: mit dem Einsatz des SIROLaser Blue
entscheiden sich Zahnärzte für eine nachweislich sichere wie innovative, den Patientenkomfort deutlich steigernde Behandlungsmethode, die ihr Indikationsspektrum noch lange nicht ausgeschöpft hat.

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Oemus_DGL_LSU2016_A4_image_eng_Layout 1 10.12.15 12:12 Seite 1

25th International Annual
Congress of the DGL
LASER START UP 2016
30 September – 1 October 2016
Munich | The Westin Grand Hotel

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

Fax Reply

Name & email address

+49 341 48474-290

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I would like to receive further information on the

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25th Annual Congress of the DGL e.V.

 LASER START UP 2016

30 September – 1 October 2016 in Munich, Germany.

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Infection control in
an era of emerging
infectious diseases
Author_Eve Cuny, USA
[PICTURE: ©MELODIA PLUS PHOTOS]

_More than three decades have passed since the
emergence of human immunodeficiency virus (HIV) as
a global pandemic. More than any other infection, it is
possible to single out HIV as the primary stimulus for
changing infection control practices in dentistry. Prior
to the mid-1980s, it was uncommon for dentists and
allied professionals to wear gloves during routine dental procedures. Many dental clinics did not use heat
sterilisation, and disinfection of surfaces was limited
to a cursory wipe with an alcohol-soaked gauze
sponge. This was despite our knowledge that hepatitis
B virus (HBV) had been spread in clusters in the offices
and clinics of infected dentists and that dentists were
clearly at occupational risk for acquiring HBV.
Today, many take safe dental care for granted, but
there is still reason to remain vigilant in ensuring an infection-free environment for providers and patients.
HIV has fortunately proven to be easily controlled in a
clinical environment using the same precautions as
those effective for preventing the transmission of HBV
and hepatitis C virus.1 These standard precautions include the use of personal protective attire, such as
gloves, surgical masks, gowns and protective eyewear,
in combination with surface cleaning and disinfection,
instrument sterilisation, hand hygiene, immunisations and other basic infection control precautions.
Sporadic reports of transmission of blood-borne diseases associated with dental care continue, but are
most often linked to breaches in the practice of standard precautions.2
Emerging and re-emerging infectious diseases
present a real challenge to all health care providers.
Three of the more than 50 emerging and re-emerging
infectious diseases identified by the Centers for Disease Control and Prevention and the World Health Or-

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ganization (WHO) include Ebola virus disease (EVD),
pandemic influenza and severe acute respiratory syndrome.3, 4 These previously rare or unidentified infectious diseases burst into the headlines in the past several years when they exhibited novel or uncharacteristic transmission patterns.
Concern about emerging infectious diseases
arises for several reasons. When faced with a particularly deadly infectious disease such as EVD, which
can be spread through contact with an ill patient’s
body fluids, health care workers are naturally concerned about how to protect themselves if an ill patient presents to the dental clinic. With diseases such
as pandemic influenza and severe acute respiratory
syndrome, which may be spread via inhalation of
aerosolised respiratory fluids when a patient coughs
or sneezes, the concern is whether standard precautions will be adequate.
In addition to standard precautions, treating patients with these diseases requires the use of transmission-based precautions. These encompass what
are referred to as contact, droplet and airborne precautions for diseases with those specific routes of
transmission. Transmission-based precautions may
include patient isolation, placing a surgical mask on
the patient when he or she is around other people, additional protective attire for care providers, and in
some cases the use of respirators and negative air pressure in a treatment room. In most cases, patients who
are contagious for infections requiring droplet or airborne precautions should not be treated in a traditional dental clinic setting.
Updating a patient’s medical history at each visit
will assist dental health professionals in identifying

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patients who are symptomatic for infectious diseases.
Patients with respiratory symptoms, including productive cough and fever, should have their dental
treatment delayed until they are no longer symptomatic. Additionally, health care professionals who are
symptomatic should refrain from coming to work until they have been free of fever without taking feverreducing medication for 24 hours.
In most cases, a patient with symptoms as severe as
those experienced with EVD will not present for dental
care and therefore extraordinary screening and protection protocols are not recommended. If a patient is

suspected of having a highly contagious disease, he or
she should be referred to a physician, hospital or public health clinic.
Dental professionals should take action to remain
healthy by being vaccinated according to accepted
public health guidelines, understanding that the recommendations may differ according to country of
residence. Performing hand hygiene procedures at
the beginning of the day, before placing and after removing gloves, changing gloves for each patient,
wearing a clean mask and gown or laboratory coat,
and wearing protective eyewear are all positive actions that help prevent occupational infections. In
addition, cleaning and heat sterilisation of all instruments and disinfection of clinical surfaces ensure a
safe environment for patients. There is solid evidence
that dental care is safe for patients and providers
when standard precautions are followed, but patients and dental health care workers are placed at
risk when precautions are compromised and
breaches occur._
Editorial note: A list of references is available from the publisher.

contact
Eve Cuny
2155 Webster Street
San Francisco, CA
USA
ecuny@pacific.edu
[PICTURE: ©DIMEDROL68]

Kurz & bündig
Seit dem Auftreten des HI-Virus vor dreißig Jahren haben sich Maßnahmen zur Infektionskontrolle in Zahnarztpraxen stark
verändert. War es davor i.d.R. unüblich, bei zahnärztlichen Routineprozeduren Handschuhe zu tragen oder eine Hitzesterilisation
durchzuführen, so werden heutzutage solch einfache Hygienevorkehrungen vorausgesetzt. Mittlerweile lässt sich HIV mit den
Standardvorsichtsmaßnahmen in der Klinik und Praxis gut kontrollieren. Eine Herausforderung stellen dagegen neu auftauchende und wieder auftauchende Infektionskrankheiten dar, wie das Ebola-Virus (EVD), Grippepandemien und das Schwere
Akute Respiratorische Syndrom (SARS). Standardmaßnahmen sind dabei oftmals nicht ausreichend.
Zusätzliche Vorkehrungen hier betreffen Maßnahmen, die eine Übertragung der Erreger durch Kontakt, Tröpfchen oder über
die Luft verhindern. Dies sind Patientenisolation,Aufsetzen einer chirurgischen Maske beim Patient bei Kontakt mit anderen Menschen, zusätzliche schützende Kleidung beim Behandlungspersonal und in manchen Fällen die Verwendung von Atemschutzmasken sowie Luftunterdruck im Behandlungsraum. Patienten mit einer hochgradig ansteckenden Erkrankung wie EVD werden
jedoch selten in Zahnarztpraxen vorstellig und sollten im Fall der Fälle an einen Arzt oder in ein Krankenhaus überwiesen werden.
Generell sollten Zahnärzte darauf achten, gemäß der regional akzeptierten Gesundheitsrichtlinien einen ausreichenden
Impfschutz zu haben, auf eine regelmäßige Handhygiene zu achten, vor jedem neuen Patienten Handschuhe zu wechseln, eine
saubere Maske und Kittel sowie einen Augenschutz zu tragen. Zusätzlich gehört die Reinigung und Hitzesterilisation aller
Instrumente und das Desinfizieren der Behandlungsoberflächen zur Vorsorge. Auf diese Weise kann eine sichere Behandlungsumgebung für das Behandlungsteam sowie den Patienten sichergestellt werden.

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Laser treatment of sleep
apnoea and snoring
Author_Dr Andreas Klug, Germany

_It has become common knowledge that lasers
of different wavelengths can trigger varying reactions in tissues which are only reactive at a distinct
wavelength. In addition, the intensity of those reactions at each special wavelength can be modified by
changing the physical parameters of those monochromatic laser waves.

_Tackling snoring noise
on a cellular level
The typical snoring noise familiar to most of us is
a result of the soft palate vibrating with each breath
after becoming relaxed when one falls asleep. This
phenomenon of the general tissue relaxation during
sleep only becomes a health risk when the tongue
slips back to such an extent that the throat is sealed
completely, thus blocking the respiratory tract.
As a consequence of respiratory arrest due to
sleep apnoea, the body runs its own emergency pro-

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gramme—we wake up with a jolt and gasp for
breath. If episodes of this kind happen frequently,
the oxygen level of the blood drops below a critical
value. This usually leads to the obligatory respiratory
mask during sleep, which many patients resent.
In these cases, a special Er:YAG-laser programme
can help, which tightens relaxed tissues by simply illuminating them. This can be illustrated to the patient by alluding to the image of the cement ceiling
of a building in which the iron reinforcement is
missing.

_Explaining laser therapy
to the patient
The laser forms a standing wave in the tissue,
along which tissue cells are clustering—just as iron
powder would cluster along the magnetic field of a
magnet in a school experiment. Of course, I tell my
patients, cells cannot move like iron filings. For this

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reason, the laser needs more than one treatment
session to become fully effective. In the course of 45
minutes, the cells are furnished with the correct
amount of energy to rebuild the desired fixed “iron
bar” structure. When talking to patients, I like to refer to an image of a chain of people with linked arms.

The typical snoring noise familiar
to most of us is a result of the soft palate
vibrating with each breath after
becoming relaxed when one
falls asleep.

The cellular reaction of the tissue in the
soft-palate and the parapharyngeal space
leads to the desired tightening of the relaxed
tissue. When patients ask me how many sessions will be necessary, I ask them how often
they think they would have to be at a fitness
centre to train their muscles. This is how I tell
them that there is no simple answer to this
question, as many aspects, such as the quality
of the tissue (trained or puffy) or the patient’s
age will influence the treatment outcome.
However, they happily accept my statistical
reply that three to four sessions are sufficient
for 85 to 92 % of all cases. In addition, I always
point out that this means that while one case can be
treated in only three sessions, another might take
five or six appointments to achieve the desired cellular reaction. Many patients agree to give their age
and weight in order to extend my statistical database. Another psychological advantage of this
treatment method is that the patient is in charge of
ending the treatment. He or she (women are less frequently affected by sleep apnoea) is therefore al-

[PICTURE: ©MOTTTIVE]

This image shows that nothing „unnatural“
or painful like burning, etching or scarring will
happen during laser treatment. On
the contrary, the cells determine
what will happen: laser treatment of
the palate is a natural reaction of a
group of tissue cells to a wavelength, just as the inner ear’s celia respond to sound waves.

ways in full control. This includes the financial aspect. Sometimes intense question and answer sessions of the above kind, in combination with the assessment of findings with regard to the anatomical
pharynx classification (I–IV), form the content of the
first appointment. At the end of this session, also the
payment modalities are discussed. Billing specifics
for German dentists can be found below in the section “Kurz & bündig”.

Laser treatment of the palate is a natural reaction of
a group of tissue cells to a wavelength, just as the
inner ear’s celia respond to sound waves.

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I practice management
_Legal aspects
From a legal point of view, I conclude that this
kind of treatment does not constitute a bodily injury,
as the body surface is neither cut nor injured. Since
the legal act of bodily injury is not given, the execution of the treatment is not restricted to speciallytrained personnel, but can be delegated.
So far, the treatment results have confirmed the
effectiveness of this special kind of laser application,
especially when it comes to the final survey of my
patients—“highly recommended” usually is their
verdict. This anti-snoring therapy is one of the few
medical treatment methods without any known
side effects. Even if the therapy should not have any
success, it will not cause any harm either—and that
is one positive aspect I do not want to miss. I therefore think that this new kind of therapy should be
advertised widely, especially since announcing new
types of therapy is explicitly granted to medical professionals in Germany by the Federal Supreme

Court. From a legal point of view, this is not classified as advertisement, a fact that protects us from
any unwanted adverse reactions, such as formal
warnings. Please see paragraph “Kurz & bündig”
below for further information with regard to the
German law.
All in all, laser treatment of sleep apnoea and
snoring is a promising new therapy, and most certainly a last resort for some troubled sleeping
arrangements._

contact
Dr Andreas Klug
Weißhoferstraße 65–67
75015 Bretten
Germany
Tel.: +49 7252 958282
kdrklug@t-online.de
www.drklug-zahn.de

Kurz & bündig
Ausgehend von den Wirkprinzipien unterschiedlicher Laserwellenlängen in verschiedenen Gewebearten beschreibt der
Autor die theoretischen Grundlagen hinter der lasergestützten Therapie von Schnarchen und Schlafapnoe. Dabei geht er besonders darauf ein, wie diese dem Patienten erklärt werden können, ohne in die oft schwer verständlichen Fachtermini zu verfallen. Als Vorteile der lasergestützten Therapie aus Patientensicht wird hervorgehoben, dass der Patient die gesamte Zeit die
Kontrolle über die Vorgänge behält – er bestimmt, wie viele Sitzungen notwendig sind, bis das gewünschte Behandlungsergebnis erreicht ist, und damit hat er volle Kontrolle über die Kosten dieser innovativen Behandlung.
Für deutsche Anwender hat der Autor zudem auch die juristischen Aspekte dieser Laseranwendung erörtert. Er beschreibt,
warum diese aus seiner Sicht den juristischen Akt einer Körperverletzung nicht erfüllt und deshalb auch an geschultes Fachpersonal delegiert werden kann. Auch die Werbung für diese Behandlungsmethode werde nicht durch Mahnungen geahndet,
da der Bundesgerichtshof es Medizinern explizit gestattet, auf neue Behandlungsverfahren hinzuweisen. Weiterhin schreibt
der Autor:
„Während es für die Zuständigkeit u.a. der ZMK auch für den weichen Gaumen keinerlei Probleme geben sollte, könnte
sich juristisch fragwürdig in diesem Zusammenhang ggf. nur die mit dem zurzeit auf dem Markt befindlichen Gerät auch mögliche Anti-Falten-Therapie der Naso-Labial-Falte oder von Falten an der Oberlippe darstellen. Hier befindet sich zwar der mögliche Ausgangspunkt der Bestrahlung innerhalb des Mundes – und damit auch innerhalb der Zuständigkeit eines Zahnmediziners –, das Zielgebiet liegt jedoch eindeutig außerhalb des gerichtlich für uns Zahnmediziner als Behandlungsgrenze definierten Lippenrots. So etwas müsste ggf. gerichtlich geklärt werden.“
Schließlich gibt der Autor deutschen Anwendern die folgenden Abrechnungshinweise, die aufgrund der Anwendbarkeit im
englischen Text nicht berücksichtigt wurden:
„Am Ende der Sitzung muss der Kassenpatient ein vorbereitetes Formular nach §4(5) BMV-Z bzw. §7(7) EKV-Z (= Vereinbarung einer Privatbehandlung) bzw. als Privatversicherter eine Vereinbarung einer Analogleistung nach §6(1) unterzeichnen.
Ihm wird beschieden, er solle zuerst eine Nacht darüber schlafen und dann Termine ausmachen. Damit ist auch den Erfordernissen des Patientenrechteschutzgesetzes Genüge getan. Berechnet wird diese erste Sitzung nach Ä5 und Ä34.
Die eigentliche Laserbehandlung ist analog zu berechnen, muss also vom Behandler selbst herausgesucht werden, je nach
betriebswirtschaftlichem Aufwand. Ich selbst berechne nach Ä2074a mit Einfachsatz zuzüglich der Zuschläge Ä441 und Ä444.
Insofern habe ich immer Luft nach oben, sollten sich irgendwelche Erschwernisse während der Behandlung ergeben.“

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Return address
Deutsche Gesellschaft für Laserzahnheilkunde e.V.
c/o Universitätsklinikum Aachen
Klinik für Zahnerhaltung
Pauwelsstraße 30
52074 Aachen, Germany

Tel.: +49 241 8088164
Fax: +49 241 803388164
Credit institute: Sparkasse Aachen
IBAN: DE56 3905 0000 0042 0339 44
BIC.: AACSDE 33

Membership application form (English)
Name/title:
Surname:
Date of birth:
Approbation:
Status:

self-employed

employed

civil servant

student

dental assistant

Address: Practice/office/institute (delete as applicable)
ZIP/city:

Street:

Phone/fax:

Email:

Private/place:

Street:

Due to an association agreement of DGL and DGZMK, an additional reduced annual fee for DGZMK is charged (85 EUR p.a.
if you are not yet a member of DGZMK). The contribution collection is made by the DGMZK ofﬁce, Liesegangstr. 17a, 40211 Düsseldorf, Germany.
You will be addressed hereby.

With the application for membership I ensure that
I am owing an own practice since

and are working with the laser type
(exact name)

I am employed at the practice
I am employed at the University
I apply for membership in the German Association of Laser Dentistry (Deutsche Gesellschaft für Laserzahnheilkunde e.V.)
Place, date

Signature

Annual fee: for voting members with direct debit € 150
In case of no direct debit authorisation, an administration charge of € 31 p/a. becomes due.
DIRECT DEBIT AUTHORISATION
I agree that the members fee is debited from my bank account
Name:

IBAN:

BIC:

Credit institute:

Signature of account holder

This declaration is valid until written notice of its revocation

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Eleven tips for success
in your dental clinic
Part II: CAPS & CLIMB
Author_Dr Anna Maria Yiannikos, Germany & Cyprus

]
ROST9
RE: ©
[PICTU

_After the last issue of laser
international magazine of laser dentistry, we
have begun a new journey with our
brand new series ‘’Eleven tips to
gain desirable success in our dental
clinics’’. In this publication, we are
going to continue exploring different parameters that can reinforce our
success and professional development
as dental practitioners. Today I will share
with you the knowledge I have gained
within the past 25 years of managing and
evolving my clinic so you can always be one step
ahead and avoid mistakes I have made in the past.

If, for example, we go to the supermarket without our shopping list, what will we end up doing? We
will most probably buy unnecessary things or even
forget the things that we went in the beginning
there for.
My point here is that when we decide that we
need to hire an employee we should know upfront

The third very important tip that I am going to
share with you today in order to be and remain successful at your clinics is how to regain your power.
We learn a lot of things during our studies in the
dental schools. We learn how to make the best fillings with great contours and biocompatible materials; how to treat a tooth that needs a root canal
therapy, but do we really learn anything on how to
find the best employee that will make our life and
daily routine easier?
Firstly we should make a job analysis by listing
the CAPS of the candidate. If we do not take the time
to complete this process, we will not know from the
beginning exactly what we are looking at and by this
we will increase the risk of making the wrong choice.

IT]
HOBB
RE: ©
[PICTU

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what we are looking for, otherwise we might make
mistakes that will cost us money and time!
Let’s have a look now what does CAPS stand for:
– Capacities: The mental and physical abilities required to do the job. How smart and how strong
(physically capable) must the successful applicant
be?
– Attitudes: such as customer service, orientation,
team player, reliability, honesty, willingness to follow rules, problem-solving, loyalty, safety-consciousness, ability to follow through—Imagine
having a receptionist who, although she is doing
the job without a mistake, complains about everything all the time. Is that a person that you would
love to have as part of your team?
– Personality: traits such as competitiveness, assertiveness, attention to detail and sociability—
Also search whether the person will manage his or
her personality to get the job done, since as social
scientists declare about 60 per cent of our personality traits are inherited and most of them are set
by age nine. In other words: personality can’t be
taught and it doesn’t change much over time.
[PICTURE: ©SUNNY STUDIO]

– Skills: Expertise required to do the job—Skills are
the easiest job requirements to identify. We could
do that by asking the candidate to perform certain
tests. For example, if we are trying to find a receptionist we could ask her to translate an article, or
through role playing to check how she responds in
certain scenarios.
Have always in mind the quote ‘we hire them for
the skills but we fire them for their attitudes’!
So finally we found our A-star employees and
now what do we have to do in order to keep them?
The fourth very essential tip of today’s article that
I would love to share with you is the different ways
that we can use to retain our A-star employees.
Apply CLIMB to retain your team!
Now let’s explain a little what does exactly the
acronym CLIMB stands for:
– Challenge: Studies have shown that the main reason that our employees resign is that they are dissatisfied with their tasks. That’s why we should

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give them challenging duties to accomplish. And
what will the result be? They will feel useful and
they will find it difficult to leave from a job that offers them different and unique experiences.
– Loyalty: Be human with your employees and do
not be afraid that you will lose your power. Show
interest in their problems and lay back in times
that they cannot handle any more pressure.
– Investment: Invest time and money to them so
they will feel appreciated. During my lectures I get
regularly the question that we reward them by
giving them bonus and still they are not motivated
enough, what shall we do? My answer here is that
you must renew your reward system regularly.
Sometimes you can give them cash (as bonuses) or
maybe you can offer them other kind of incentives,
like buying them a free trip for vacation on Christmas, for example.Research has proven that the
more powerful and effective incentives are the
ones that that are specific, tangible and noncash.
Also please remember to ‘Reward not the best in
sales but the best’ A major mistake that we usually
do is to only reward the ones that bring money to
our clinics. Instead we should reward the best in
our practices, the ones that are completing their
tasks in excellence unconditionally to what this
task is.
– Measurement: Conduct a fair performance appraisal every six months.

– Building: Demonstrate your commitment to them
by showing them opportunities of career development.
During the next issue we will analyse two new
tips that will reveal new opportunities and potential
of our dental clinics. Till then, remember that not
only are you the dentist in your clinic, but you are
also the manager and the leader.
You can always send me your questions and request for more information and guidance at:
dba@yiannikosdental.com or via our Facebook account. Looking forward to our next trip of business
growth and educational development!_

contact
Dr Anna Maria Yiannikos
Adjunct Faculty Member of AALZ
at RWTH Aachen University
Campus, Germany
DDS, LSO, MSc, MBA
dba@yiannikosdental.com
www.dbamastership.com

Kurz & bündig
Im ersten Teil der Serie “11 Tipps zum wünschenswerten Erfolg in Zahnkliniken“ wurden die ersten beiden Ratschläge dieser Reihe vorgestellt, um Anfängerfehler zu verhindern und langfristigen Erfolg zu erzielen.
Der erste Tipp befasste sich mit der intensiven Auseinandersetzung mit dem Praxisinhaber selbst, seinen Fähigkeiten, Schwächen und Stärken. Der zweite Tipp hatte die Frage zum Ziel, wie man es schafft, nicht nur zufriedene, sondern vor allem loyale
Patienten zu haben.
In der nun vorliegenden Fortsetzung der Artikelserie konzentriert sich die Autorin darauf, wie man den idealen Praxismitarbeiter findet und auch hält. So legt Tipp Nr. 3 ausführlich dar, wie man mithilfe von vier Schlüsselqualifikationen den geeigneten
Mitarbeiter auswählt. Hierbei sollte man neben den geistigen und körperlichen Anforderungen (capacities), der Arbeitseinstellung (attitude) und der Persönlichkeit (personality) des Bewerbers dessen individuelle Fähigkeiten berücksichtigen. Hat man so
einen geeigneten Mitarbeiter ermittelt, kann man sich mithilfe des vierten Tipps der Aufgabe zuwenden, diesen Mitarbeiter zu
halten und zu motivieren.
Dafür gibt die Autorin ihren Lesern fünf einfache Maßnahmen mit auf den Weg: eine berufliche Herausforderung (challenge)
und Interesse am Mitarbeiter als Mensch und nicht als reine Arbeitskraft (loyalty) können neben finanziellen Anreizen (investment) motivieren. Zudem geben eine regelmäßige Evaluierung (measurement) der individuellen Leistungen und Erfolge des Mitarbeiters auf der einen Seite und die Aussicht auf eine stetige berufliche Weiterentwicklung (building) andererseits diesem das
Gefühl, im Unternehmen geschätzt zu werden und dort auch in Zukunft eine Perspektive zu haben.

Nachdem nun aus Mitarbeiter- und Patientensicht alle Weichen für den Praxiserfolg gestellt sind, wird sich die Autorin in der
nächsten Ausgabe von laser international magazine of laser dentistry damit beschäftigen, der Praxis selbst ihr größtmögliches
Erfolgspotenzial zu entlocken.

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events

24 InternationalAnnual
Congress of the DGL
All on the same wavelength
Authors_Lisa Meißner & Claudia Jahn, Germany

Fig. 1

ways to integrate them to the various treatment
methods of their dental practice. In addition, an
overview on all relevant products and companies was
given.

_Main topic wavelengths

Fig. 2

_On 27 and 28 November, experts and members of the DGL (German Society for Laser Dentistry
e.V.) met at the 24th International Annual Congress in
Berlin, the vibrant capital of Germany. In cooperation
with the scientific leaders of the DGL, LASER START UP
was held as a parallel event of the congress. Here, beginners and professionals alike were given opportunities to inform themselves about modern lasers and

For more than 35 years, lasers have been used for
diagnosis and therapy in dentistry. The benefits of
laser therapy, such as the non-contact mode and antiseptic operation, are undisputed. Yet, minimally invasive laser technology still maintains to some extent
the role of an outsider. Recently, however, things have
changed in this regard, as modern dental lasers are
flexible, powerful and ultimately efficient. Therefore,
this year’s congress aim was to illustrate the many
reasons why lasers should form a part of any modern
dental office. The 24th Annual Congress under the
headline “Wavelengths” was led by DGL President
Prof. Dr Norbert Gutknecht, Aachen, Germany. Inter-

Fig. 1_The newly elected DGL
executive board: Dr Thorsten
Kleinert, Dr Detlef Klotz,
DGL President Prof. Dr Norbert
Gutknecht, Dr Gabriele SchindlerHultzsch, Dr Stefan Grümer,
Prof. Dr Siegfried Jänicke (from
left to right). Board member
Prof. Dr Anton Sculean was
not present at the congress.
Fig. 2_In addition to academic
lectures, attendees were given the
opportunity to take part in a number
of practical workshops.

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Fig. 4

Fig. 3

Figs. 3 & 5_Traditionally,
an industrial exhibition is run parallel
to the congress, giving participants
insight to the current trends of the
laser market.
Fig. 4_A display of the latest
OEMUS MEDIA AG publications,
among them the current issue of

nationally renowned, the event attracted many colleagues and speakers from various nations. A major
role in this positive international response to the congress formed the fact that the first congress day was
planned to feature all international speeches. All lectures were interpreted simultaneously into English or
German. A total of 250 visitors took part in the congress.

laser international magazine of
laser dentistry.

Prof. Dr Norbert Gutknecht opened the two-day
event Friday morning and gave a warm welcome
as well as his introductory speech. He was followed
by top-level speakers such as Prof. Dr Jens Malte
Baron, Aachen, Prof. Dr. Andreas Braun, Marburg,
Dr James Caroll, Chesham (GB), Dr Marina Polosky,
Ottawa (CA), Dr Alin Odor, Constanta (RO), Dr Joshua
Weintraub, Stevenson, MD (US), Dr Jaana Sippus,
Vaasa (Fl) and Dr Habib Zarifeh/Beirut (LB). All these
scientific experts gave in insight to their current work,
focusing on laser and its various applications.

_Election of a new executive board
In early afternoon of the first congress day, members of the DGL assembled for the society’s general
meeting. Prof. Dr Norbert Gutknecht, Dr Detlef
Klotz, Dr Stefan Grümer, Dr Thorsten Kleinert, Prof.
Dr Anton Sculean, Prof. Dr Siegfried Jänicke and
Dr Gabriele Schindler-Hultzsch were elected as
the new executive board of the DGL. A series of further interesting speeches by Dr Gottfried Gisler,
Männedorf (CH), Dr Dimitris Strakas (GR), Priv.-Doz.
Dr Jörg Meister, Bonn, Prof. Dr Gerd Volland, Sevilla
(ES), Dr Steffen Stein, Marburg, und Priv.-Doz.
Dr Moritz Kebschull, Bonn, formed the second half
of Friday’s congress programme. Dr Michael Schäfer,
Düsseldorf, concluded the first congress day with his
lecture on opportunities and limitations of (diode-)
laser-supported optimisation. of the so-called “red
aesthetics”.

_LASER START UP 2015
Attendees of LASER START UP 2015, which ran
parallel to the 24th International Annual Congress,
were given comprehensive information on the basics
of laser dentistry. They were welcomed by Dr Jörg
Meister, Bonn, who gave a speech on the physical
principles of laser technology. He was followed by
lectures on laser applications in periodontology, oral
surgery and conservative dentistry.

_Yearbook Laser Dentistry 2016
Another main feature of the congress was an extensive industrial exhibition. Participants of the congress visited the exhibition either between lectures or
during their seminar breaks. Thus, they made use of
this opportunity to contact laser manufacturers directly and to gain background information on specific products.

Fig. 5

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[37] =>

events

Fig.7

Fig. 6

OEMUS MEDIA AG’s publication Yearbook Laser
Dentistry 2016 was distributed to all congress participants free of charge, providing them additionally with concise information on all aspects of laser
dentistry. The compendium features an up-to-date
overview on the German dental-laser market, clinical case reports and introduces dental lasers, photodynamic systems as well as the latest innovations
in laser dentistry on a total of 240 pages.

_Save the Date 2016
Of course, the twin congresses International Annual Congress of the DGL and LASER START UP will
continue their success story of the previous eight
years. In 2016, the 25th International Annual Congress

of the DGL and its counterpart will be held in Munich
from 30 September to 1 October. In addition, the 15th
Congress of the World Federation for Laser Dentistry
will be held from 16 to 19 July in Nagoya, Japan._

contact
OEMUS MEDIA AG
Holbeinstraße 29
04229 Leipzig
Tel.: +49 341 48474-308
Fax: +49 341 48474-290
event@oemus-media.de
www.dgl-jahrestagung.de
www.startup-laser.de

Fig. 6_At the exhibition booth of
this year’s Main Sponsor Sirona.
From left to right: André Förster,
Product Manager Laser Systems,
Ingo Höver, Community Manager,
Sebastian Kiehne, Team Leader
Sales Germany, Instruments and
Special Appliances.
Fig. 7_ An international audience
gathered for a series of speeches
on the first congress day.

Kurz & bündig
Am 27. und 28. November trafen sich die Experten und Mitglieder der Deutschen Gesellschaft für Laserzahnheilkunde e.V.
(DGL) zur 24. Internationalen Jahrestagung in der pulsierenden Hauptstadt Berlin. Parallel zur Tagung fand in Kooperation und
unter wissenschaftlicher Leitung der DGL auch das LASER START UP 2015 statt. Hier konnten sich sowohl Lasereinsteiger als
auch versierte Anwender über die technischen Möglichkeiten der heutigen Laser und deren sinnvolle Integration in die unterschiedlichsten Behandlungsabläufe einer Zahnarztpraxis informieren. Außerdem wurde ein Überblick über die relevanten Produkte und Anbieter gegeben.
Zur 24. Jahrestagung, welche das Hauptthema „Wellenlängen“ hatte und unter der wissenschaftlichen Leitung von
DGL-Präsident Prof. Dr. Norbert Gutknecht, Aachen, stand, erschienen aufgrund großer internationaler Anfragen zahlreiche
ausländische Kollegen und Referenten. Organisatorisch ermöglicht wurde dies durch die Planung des Freitags als internationalen Vortragstag, an welchem alle Beiträge simultan ins Englische oder Deutsche übersetzt wurden. Insgesamt nahmen
ca. 250 Interessenten an den Kongresstagen teil.
Am frühen Nachmittag des ersten Kongresstages traf sich die DGL zur Mitgliederversammlung und wählten mit
Prof. Dr. Norbert Gutknecht, Dr. Detlef Klotz, Dr. Stefan Grümer, Dr. Thorsten Kleinert, Prof. Dr. Anton Sculean, Prof. Dr. Siegfried
Jänicke und Dr. Gabriele Schindler-Hultzsch einen neuen Vorstand.
Auch im kommenden Jahr wird das seit inzwischen 2009 bestehende Doppel wieder gemeinsam ausgetragen. Am
30. September und 1. Oktober 2016 findet die 25. Jahrestagung der DGL und LASER START UP 2016 in München statt.

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NEWS

international

Victims of Pompeii had

Tooth enamel ﬁrst

Excellent teeth

Evolved in the skin

Two thousand years after Pompeii was buried under
the ashes of Mt. Vesuvius, the archaeological site has
still kept most of its secrets. The plaster that was
used in the early 19th century to fill the voids that the
bodies had left in the hardened rock is so dense that
today’s standard imaging technology cannot distinguish between the thick outer cast and the skeletal
pieces inside.

Tooth enamel is the hardest substance produced by the human
body. Since enamel is one of
the four major tissues that
make up the teeth and
gives them their distinctive
shiny white appearance, it
comes as a surprise that a study
has found that enamel most likely
originated from an entirely different part of the body: the skin.

Unlike humans, who only have teeth
in the mouth, certain fish species have
little tooth-like scales on the outer surface of the body. In the study, researchers
from Uppsala University in Sweden and the Institute of Vertebrate Paleontology and Paleoanthropology in Beijing in China analysed Lepisosteus, an
ancient gar fish from North America whose scales
are covered with an enamel-like tissue called

ganoine. Their findings suggest
that enamel in fact first evolved
in the skin. Dr Per Ahlberg, Professor of Evolutionary Organismal Biology at Uppsala University, explained: “Psarolepis
and Andreolepis are among the
earliest bony fishes, so we believe that their lack of tooth
enamel is primitive and not a
specialisation. It seems that
enamel originated in the skin,
where we call it ganoine, and only
colonised the teeth at a later point.”

The study is the first to combine novel
palaeontological and genomic data in a single analysis to explore tissue evolution. The results
have been published online on 23 September in the
Nature journal in an article titled “New genomic and
fossil data illuminate the origin of enamel”.

New pulse laser systems for

A variety of indications
By using a special multi-layer CT scanner that is able
to do just that, the specialists have been able to shed
new light on the life and death of the ancient civilisation. Among other things, the scientific tests, which
also included laser imaging and DNA sampling, revealed that the city’s inhabitants had nearly perfect
teeth.
“We discovered the absence of cavities in the teeth.
This is very interesting and not that surprising, because we all know about the healthy Mediterranean
diet and this has really shown up in the early analyses,” said Massimo Osanna, superintendent at the
archaeological site.
According to the experts, the lack of sugar in the
Pompeian diet and the high levels of fluorine in the air
and water near the volcano are all accountable for
the perfect state of their teeth. In addition to an excellent oral health, the researchers found that most
of the victims still had all their teeth. However, the
scans further showed that the teeth wore away,
because they were used for cutting, orthodontist
Dr Elisa Vanacore said.

38 I laser
4_ 2015

The Lumenis Pulse 100 H, the next generation of the VersaPulse® PowerSuite™ 100 Watt system, is a versatile and enhanced laser solution for the
treatment of a wide array of clinical urologic indications including benign prostatic hyperplasia (BPH), stones, tumors or strictures, along with a range of
other specialties such as general surgery, ENT, gynecology and pulmonary
surgery. As a greatly effective laser system for stones and BPH, the Pulse
100H enables users to perform holmium laser enucleation of the prostate
(HoLEP), the gold standard treatment for BPH, and stone dusting™.
The new system features an improved design to enhance patient safety and
overall user experience. It offers a robust combination of laser parameters
addressing more than 70 types of procedures, an innovative pulse reshape
function for improved safety, dual pedals for improved ease of use, a hands-free
ready and standby mode for minimizing cost per procedure, and a high energy per pulse of up to 3.5 J with a
high repetition rate of up to 50 Hz. In addition to the Pulse 100 H, Lumenis will also be unveiling another key
addition to the Lumenis Pulse laser family, the Pulse 50 H laser system. Designed to efficiently address any
type or size of stone in lithotripsy, the Pulse 50 H system is a superior comprehensive solution that provides
0.2 J of energy per pulse to minimize migration of even the smallest stone. Furthermore, the Pulse 50 H can
be later upgraded to the new Pulse 100 H, allowing physicians to further leverage their investment as they
grow their practice.
“The new Pulse 50 H system provides all features to perform modern intra corporeal Holmium laser lithotripsy
including a wide range of energy levels and frequencies,” said Professor Rassweiler, MD, PhD, Klinikum SLK,
Heilbronn, Germany.

[39] =>

Water pipe smoking can lead to

Dental check-ups

Serious oral
conditions

In order to gain insights into women’s dental visiting patterns and knowledge about the impact of
oral health on their own and their babies’ well-being, Cigna Corp., a global health service company,
conducted an online survey in August among 801
pregnant women and new mothers aged 21–45.
Only 55 per cent of the survey participants rated
their oral health as very good or excellent, and

76 per cent reported oral health problems during
pregnancy, including bleeding gingivae, increased
tooth sensitivity and tooth pain. However, only
43 per cent of pregnant women stated that they
had gone for dental check-ups during pregnancy,
and 36 per cent said that they had not seen a dentist for more than a year. Overall, 33 per cent of
women surveyed said that they had skipped dental checkups during pregnancy because they were
concerned it would be too expensive.
In addition, the survey indicated that targeted interventions by medical professionals could significantly improve the oral health habits of pregnant
women and new mothers. With regard to the daily
oral hygiene habits of new mothers, the investigators found that 36 per cent have brushed and
flossed less frequently since delivery, 67 per cent of
whom stated that they do not have time to keep up
on their hygiene. The full report can be accessed
and downloaded at www.cigna.com.

According to the Centers for Disease Control and
Prevention, 2.3 million Americans smoke tobacco
from pipes, many of whom smoke water pipes, believing it is less harmful than cigarettes. A recent
study, however, has shown that water pipe smoking is also associated with various head and neck
conditions, including periodontal disease and oral
cancer.

Pregnancy: Majority avoids

UMC Utrecht discovers genetic

Cause of disturbed dental development
Researchers at University Medical
Center (UMC) Utrecht have identified a gene that may cause
oligodontia, the agenesis of six or
more teeth. The discovery of the socalled LPR6 gene makes it possible
to diagnose patients more effectively, provide them with better information and develop customized
treatment. The results were published today in The
American Journal of Human Genetics. Oligodontia
greatly impacts quality of life and may lead to eating
and speaking problems, among other things.
Dr Marijn Créton, dentist and maxillofacial prosthetist at the Department of Oral and Maxillofacial
Surgery and Special Dental Care at UMC Utrecht, ensures—in consultation with patients—that ultimately they have a good set of teeth both at a young
and adult age. This requires a treatment of many
years, during which patients are treated by a dentist,
oral surgeon and orthodontist. “Moreover, adolescents with oligodontia often have psychosocial issues,” says Créton. “Missing many teeth is conspic-

uous. Children, teenagers and young adults are
sometimes bullied and regularly experience feelings
of low self-esteem and shame.”

Reference: Massink MPG, Créton MA, Spanevello F,
et al. Loss-of-Function Mutations in the WNT co-receptor LRP6 Cause Autosomal-Dominant Oligodontia, The American Journal of Human Genetics, in
press 2015.

In the study, researchers at Rutgers, The State
University of New Jersey, reviewed 20 published
articles to identify potential health effects of
water pipe smoking on the head and neck region.
According to the World Health Organization,
water pipe smoking sessions may expose the
smoker to more smoke over a longer period than
occurs when smoking a cigarette. Water pipe
smokers may therefore inhale the equivalent of
100 or more cigarettes during one session,
depending on the duration and number of puffs in
a smoking session.
The study, titled “Association between tobacco
waterpipe smoking and head and neck conditions,” was published in the October issue of the
Journal of the American Dental Association.

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I special

The future
today
Ultrashort pulsed laser
Author_Dr Anton Kasenbacher, Germany

As this year’s DGL Annual Congress has just been concluded and with the New Year lying
ahead of us, author Dr Anton Kasenbacher gives another insight in future-oriented laser
dentistry, focusing on the high versatility of ultrashort pulsed lasers.

_Until now, the gold standard in dentistry has
been the subjective mechanical probe and X-ray for diagnosis and the dental drill for therapy. In this vein, it
was agreed that dental lasers could not achieve better
results than conventional methods. However, this view
has changed with the arrival of ultrashort pulsed lasers
and the growing realisation that they open a whole new
field of both diagnosis and therapy.
The patient and all dental tissues, especially the dental pulp structures, need an objective universal method,
which guarantees stress, thermal and radiation confinement. In addition, it has to be ultrafast, precise, hygienic and non-carcinogenic. Only if all these requirements are fulfilled, both diagnosis and therapy are free
of side effects like heat-affected zones, micro cracks,
(pre/post) pain and/or induction of cancer by ionisation
of water molecules.
Today dental lasers (e.g. Er:YAG, CO2), not to mention
the dental drill, still have a long way to go before they
can reach all these goals, as they have still too long
pulse widths. These cause a too long laser-tissue interaction time and the energy used is too high. These are
the reasons why even long microsecond and short
nanosecond pulsed lasers have failed to replace the
dental drill, not the price.
Ultrashort pulsed picosecond lasers avoid these severe disadvantages. Conversely, they generate a number of benefits for the patient and the doctor. They allow therapy and diagnosis (theragnostics) with a sin-

40 I laser
4_ 2015

gle system. The controlled biosafe, non-linear absorption of photons will lead to a paradigm shift in dentistry.
This is also due to the fact that futuristic technologies
like nano-dental medicine and advanced 3-D robotic
procedures have become reality.
The minimally-invasive therapy with picosecond
lasers achieves high ablation rates with a superb quality using high scan speeds and autofocus feedback systems. Hence, possibly this special laser therapy can save
costs by reducing the number of helpers, performing
actually only the necessary protection and intraoral
suction._

[41] =>

special

Die Zukunft in der
Gegenwart
Ultrakurzpulslaser
Autor_Dr. Anton Kasenbacher, Deutschland

Zwischen dem gerade erfolgreich abgeschlossenen Jahreskongress der DGL und dem
Beginn des neuen Jahres gibt Autor Dr. med. dent. Anton Kasenbacher in der letzten Ausgabe der laser dieses Jahres einen kleinen Ausblick in die Laserzahnmedizin der Zukunft,
die bereits heute mit den versatilen Ultrakurzpunktlasern Realität geworden ist.

_Bis heute ist der Goldstandard in der Zahnmedizin die subjektive mechanische Sonde und
das Röntgenverfahren für die
Diagnostik und der Dentalbohrer
im Therapiebereich. In diesem
Sinne stimmte man überein, dass
Dentallaser nichts können, was
nicht auch mit konventionellen
Methoden erreichbar wäre. Diese
Sichtweise hat sich jedoch durch
die Einführung der Ultrakurzpulslaser verändert, welche eine völlig
neue Bandbreite von Indikationen
erschließen.
Der Patient und seine dentalen
Gewebe, speziell die Strukturen
der Zahnpulpa, verlangen eine
objektive und universelle Methode, die stress-, temperatur- und strahlungsarm ist. Zusätzlich sollte dieses Verfahren ultraschnell, präzise, hygienisch und
nicht karzinogen sein. Nur wenn all diese Anforderungen erfüllt sind, können sowohl die Diagnostik als
auch die Therapie ohne Nebenwirkungen wie Wärmeeinflusszonen, Mikrorisse, (pre- oder postoperativer) Schmerz und/oder eine krebsauslösende Wirkung durch Ionisation der Wassermoleküle stattfinden.
Heute sind Dentallaser (zum Beispiel Er:YAG, CO2)
und nicht zu vergessen der Dentalbohrer immer noch

weit davon entfernt, all diese Ziele zu erreichen, denn
sie besitzen immer noch viel zu große Pulsbreiten.
Diese bewirken eine zu lang andauernde Interaktion
zwischen Laser und Gewebe und zudem ist die Menge
der benötigten Energie zu groß. Aus diesen Gründen,
und nicht aufgrund des Preises, konnten langgepulste Laser im Mikrosekundenbereich und kurzgepulste im Nanosekundenbereich den Dentalbohrer
bisher nicht ersetzen.
Ultrakurz gepulste Laser im Picosekundenbereich
können diese schwerwiegenden Nachteile vermeiden. Im Gegenteil, sie bedeuten eine Vielzahl von Vorteilen für Patienten und Anwender. Sie ermöglichen
Therapie und Diagnose (Theragnostik) mit einem einzigen System. Die kontrollierte, biosichere und nicht
lineare Absorption von Photonen wird einen Paradigmenwechsel in der Zahnmedizin einläuten. Dies
ist auch der Tatsache zu verdanken, dass Technologien der Zukunft wie die Nano-Zahnmedizin und
fortgeschrittene, robotergesteuerte 3-D-Verfahren
in die Realität Einzug gehalten haben.
Die minimalinvasive Therapie mit Picosekundenlasern erzielt hohe Ablationsraten mit einer hervorragenden Qualität auf Grundlage von hohen Scangeschwindigkeiten und Autofokus-Feedbacksystemen. Daher könnte diese spezielle Art der Lasertherapie auch kostenreduzierend wirken, indem die
Anzahl von Helfern verringert wird, welche nur noch
für den Arbeitsschutz und das Absaugen verantwortlich zeichnen müssen._

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Oemus_DGL_LSU2016_A4_vorankündigung_Layout 1 10.12.15 12:12 Seite 1

25. JAHRESTAGUNG DER DGL
LASER START UP 2016
30. September bis 1. Oktober 2016
München | The Westin Grand Hotel






Faxantwort
0341 48474-290

Name/E-Mail-Adresse

Praxisstempel

Bitte senden Sie mir das Programm zur/zum

 25. JAHRESTAGUNG DER DGL



LASER START UP 2016

am 30. September und 1. Oktober 2016 in München zu.

laser 4/15

[43] =>

editorial

Laser imAufwind

Prof. Dr. Norbert Gutknecht
DGL-Präsident

Sehr geehrte Frau Kollegin, sehr geehrter Herr Kollege,
liebe DGL Mitglieder!
Nach Jahren der Stagnation stehen die Anzeichen auf eine deutliche Wiederbelebung des Lasermarktes besonders gut. Der gerade abgelaufene DGL-Kongress konnte diese Entwicklung sehr deutlich widerspiegeln. Die Zahl
der Besucher hat sich mehr als verdoppelt und die wissenschaftlichen Beiträge erstrecken sich über ein sehr breites,
schon seit Langem nicht mehr dagewesenes Spektrum an Vorträgen zu den unterschiedlichsten Wellenlängen. So
wurde zum Beispiel nach ca. 20 Jahren erstmals wieder der Wellenlängenbereich um 450 nm entdeckt, der früher
durch die Argonlaser abgedeckt wurde und heute durch eine moderne Diodenlasertechnologie dargestellt wird.
Auch im Bereich der früher sehr dominant vertretenen CO2-Laser (10.600 nm) wurde nicht nur eine Neubelebung,
sondern auch eine „Mutation“ der CO2-Wellenlänge vorgestellt, des erstmals in der Zahnheilkunde eingesetzten
9.300-nm-CO2-Lasers.
Diese Entwicklung spiegelte sich auch in der Vielfalt der Aussteller wieder, was dazu führte, dass unsere Gäste
sich verstärkt während der Pausen in den Ausstellungsbereichen aufhielten. Eine simultane Übersetzung der Vorträge am Freitag ermöglichte es auch Teilnehmern aus mehr als zehn verschiedenen Ländern, aktiv, als Referent, und
passiv, als aktive Zuhörer, am Kongressprogramm teilzunehmen.
Es wäre mein Wunsch, dass sich diese Tendenz im nächsten Jahr speziell auf dem Weltkongress der WFLD in
Nagoya, Japan, und auf dem Jubiläumskongress zum 25-jährigen Bestehen der DGL fortsetzten würde.
Die Vielfältigkeit neuer Wellenlängen und Wellenlängenkombinationen bilden auch die Grundlage für meine
vielfältigen guten Wünsche, kombiniert mit Glück und Erfolg für das neue Jahr 2016.
Ich freue mich auf ein Wiedersehen mit Ihnen!
Ihr

Prof. Dr. Norbert Gutknecht
DGL-Präsident

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24. JAHRESTAGUNG DER DGL E.V.
LASER START UP 2015
Nightlase Anti Schnarch Therapie – Systematik und verbesserte Einteilungen
Dr. Michael Alte, Siegburg, Dr. Thorsten Kuypers, M.Sc., Köln
Seit nunmehr einem Jahr wenden wir das Nightlase Verfahren in unseren Praxen an, um Schnarchen zu therapieren. Es wurden in dieser Zeit
sowohl habituelles Schnarchen als auch obstruktives Schnarchen und
auch Schlafapnoe behandelt.
Es zeigten sich durch unsere Erfahrungen Lücken in der Aufklärung der
Patienten und der Patientenselektion. Aufbauend auf diesen Erfahrungen entwickelten wir eine erste Systematik, die diese Lücken schließen
soll. Wir stellen diese erste Systematik vor, die zur besseren Selektion

der Patienten beiträgt. Des Weiteren wollen wir eine verbesserte Aufklärung präsentieren, die einer entsprechenden Systematik folgt. Diese soll
dazu beitragen, eine Einteilung und Risikoabschätzung des zu erwartenden Behandlungserfolges zu ermöglichen. Eine anschließende Diskussion soll den Vortrag abrunden.
info@dralte.de
info@laserzahnarzt-koeln.de

Photopolymerisation mit einem 445-nm-Diodenlaser im Vergleich zur
LED- und Halogentechnologie
ZA Thomas Drost, Bonn, Dr. Susanne Reimann, Priv.-Doz. Dr. Jörg Meister, Prof. Dr. Matthias Frentzen
In dieser Studie sollte untersucht werden, ob ein Diodenlaser (λ =
445 nm) die gleichen Merkmale wie ein LED- und Halogenpolymerisationsgerät bei der Photopolymerisation von Kompositen aufweist.
Durch Bestrahlung verschiedener, mit Komposit befüllter, Kavitäten
(ISO 4049) wurden die Oberflächen-und Tiefentemperatur (ΔT), die
Polymerisationstiefe (PT) sowie die Lichtdurchlässigkeit untersucht.
Die Oberflächentemperaturmessungen zeigten keine signifikanten
Unterschiede zwischen den drei Strahlungsquellen (ΔT-Laser 1 W =
4,5 °C, SD = ±0,5 °C; ΔT-LED = 4,1 °C, SD = ±0,2 °C; ΔT-HL = 4,3 °C,
SD = ±0,2 °C).
Bei den Temperaturmessungen am Boden einer 6 mm tiefen Kavität
ergaben sich ebenfalls keine signifikanten Unterschiede zwischen dem
Laser 1 W (ΔT = 2,9 °C, SD = ±0,4 °C) und den beiden Lichtpolymerisationsgeräten (ΔT-LED = 2,7 °C, SD = ±0,4 °C; ΔT-HL = 2,6 °C,
SD = ±0,2 °C).

Die Polymerisationstiefenmessungen zeigten keine signifikanten Unterschiede zwischen dem Laser 1 W (PT = 3,3 mm, SD = ±0,1 mm), dem
Laser 0,5 W (PT = 3,0 mm, SD = ±0,1 mm) und den beiden Lichtpolymerisationsgeräten (PT-LED = 3,3 mm, SD = ±0,1 mm; PT-HL =
3,1 mm, SD = ±0,1 mm).
Bei keiner der drei Strahlungsquellen konnte ein Strahlungsaustritt am
Boden einer 6 mm tiefen Kavität während und nach der Polymerisation
nachgewiesen werden. Die vorliegenden Ergebnisse zeigen, dass der
Diodenlaser (445 nm) für die Polymerisation von Komposit geeignet und
mit den im klinischen Bereich eingesetzten Lichtpolymerisationsgeräten
vergleichbar ist. Die Möglichkeit, durch den dünnen und flexiblen Lichtleiter des Lasers eine sichere Bestrahlung von schwer zugänglichen
Kavitäten zu erreichen, erscheint vielversprechend.
ThomasDrost@gmx.de

Diodenlaser – Entwicklungen und klinischer Einsatz
Dr. Michael Hopp, Berlin, Dr. Jörg Meister, Prof. Dr. Rainer Biffar

Die Herstellung von Laserdioden hat sich in den letzten Jahren stark
entwickelt und umfasst heute einen Wellenlängenbereich aus dem ultravioletten bis in den infraroten Bereich. Viele typische Wellenlängenbereiche klassischer Laser auf Festkörper-, Gas-, oder Farbstoffbasis können
mit sehr viel einfacheren Mitteln kostengünstig und volumenminimiert
ersetzt werden.
Durch diese Entwicklung können Wellenlängen optimaler für ihr jeweiliges Einsatzgebiet angewendet und das Gewebe geschont werden.

44 I laser
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Fraglich bleibt, ob die erzeugte Laserstrahlung die der konventionellen
Geräte entspricht und eine geeignete Substitution darstellt.
Die Präsentation stellt eine Übersicht aus Literaturdaten und klinischen
Anwendungen vor und soll eine Orientierungshilfe im Vergleich zu konventionellen Techniken geben.

mdr.hopp@t-online.de

[45] =>

Effektivität der Gewebeinzision mit einem 445-nm-Halbleiterlaser
Michael Berthold, Marburg, Moritz Kettner, Professor Dr. Andreas Braun
Bei Gewebeinzisionen mit einem 445-nm-Halbleiterlaser wird eine effektive Schnittführung mit räumlich begrenzter Hitzewirkung beschrieben. Daher war das Ziel der vorliegenden Studie die histologische Beurteilung von Gewebeproben nach Inzision mit einem 445-nm-Diodenlaser. Vierzig Mukosalappen aus dem Vestibulum von zwanzig Schweinekiefern wurden präpariert, die anschließend auf den Träger einer
mechanischen Lineareinheit gespannt wurden. Das Handstück eines HFChirurgie-Geräts, 970-nm- und 445-nm-Halbleiterlasers wurde auf dem
Verfahrschlitten der Lineareinheit befestigt, sodass alle Gewebeinzisionen mit gleicher Geschwindigkeit und im gleichen Abstand von der Gewebeoberfläche durchgeführt werden konnten. Auf den jeweils zwei Mukosalappen eines Kiefers wurden acht Inzisionen durchgeführt (I–III):
445-nm-Laser ohne konditionierte Spitze, 90°, mit Gewebekontakt bei
1, 2 und 4 W, (IV-V): 445-nm-Laser ohne konditionierte Spitze, 90°, ohne
Kontakt (1 mm) zum Gewebe bei 2 und 4 W cw, (VI): 445-nm-Laser ohne
konditionierte Spitze, 45°, mit Kontakt zum Gewebe bei 2 W cw, (VII):
970-nm-Laser mit konditionierter Spitze, 90°, mit Gewebekontakt bei

3 W cw, (VIII): HF-Chirurgie-Gerät mit gerader Spitze, 90°, mit Gewebekontakt bei 50 W. Die histologische Auswertung erfolgte nach H.E.-Färbung der eingebetteten Präparate bei 35-facher Vergrößerung.
Der Vergleich der Inzisionstiefen zeigte einen signifikanten Unterschied in
Abhängigkeit von der Laserwellenlänge und den gewählten Laserparametern. Dabei konnte die größte Inzisionstiefe mit dem 445-nm-Laser im
direkten Gewebekontakt mit einer Leistungseinstellung von 2 W erreicht
werden (p < 0,05). Die geringste Inzisionstiefe wurde nach Verwendung
des HF-Chirurgie-Geräts gemessen.
Bei Verwendung eines 445-nm-Halbleiterlasers kann im Vergleich zu
einem 970-nm-Diodenlaser und einem Elektrotom mit einer höheren
Schneideffizienz gerechnet werden. Auch eine Anwendung im NichtKontakt-Modus zeigt klinisch akzeptable Inzisionstiefen ohne Anzeichen
ausgedehnter Nekrosezonen.

michaelberthold14@alice.de

Zell- und molekularbiologische Untersuchungen zur Anwendung
von Laserstrahlung im blauen Spektralbereich
ZÄ Dr. Joana Reichelt, Bonn, PD Dr. Jochen Winter, PD Dr. Jörg Meister, Prof. Dr. Matthias Frentzen, Dr. Dominik Kraus
Ziel der Studie war es, ein neues Blaulicht-Lasersystem mit einem
Emissionsbereich von 445 nm im Vergleich zu einem etablierten infraroten Diodenlasersystem (970 nm) auf zellulärer Ebene zu untersuchen. Epitheliale HaCaT- und mesenchymale MG63-Zellen wurden
als Monolayerkulturen auf Glasdeckgläsern ausgesät und mit beiden
Diodenlasern im Dauerstrichbetrieb im Kontakt und Non-Kontaktmodus bei Leistungen von 2 W (445 nm) und 3 W (970 nm) bestrahlt.
Als Simulation einer chirurgischen Schnittführung, erfolgte eine linienförmige Bestrahlung mit einer Faser von 300 µm Durchmesser bei
einer Schnittgeschwindigkeit von 3 mm/s. Als Referenz diente diese
mechanische Wundsetzung mit dem Laserapplikationstip.
Während der Laseranwendung wurde mittels einer Thermografiekamera die Temperaturentwicklung gemessen. Nach Laserinzision
wurde der Wundheilungsverlauf lichtmikroskopisch beurteilt und
morphometrisch vermessen. Mittels Acridinorange/PropidiumiodidFärbung erfolgte eine Lebend-Tot-Diskriminierung. Potenzielle Zytoskelettveränderungen wurden durch Fluoreszenzfärbung der Aktinfilamente mit Phalloidin AF 800, mögliche DNA-Doppelstrangbrüche
durch Immunfluoreszenznachweis von p-H2Ax dargestellt.

Eine charakteristische Zonenbildung konnte nach Bestrahlung mit
beiden Wellenlängen im Kontakt- und Non-Kontaktmodus nachvollzogen werden.
Trotz eines größeren Wundbereiches nach Bestrahlung mit 445 nm,
bedingt durch eine höhere Temperaturentwicklung (493,2 °C im Kontaktmodus), zeigte das neue Lasersystem eine beschleunigte Wundheilung der zentralen zellfreien Zone im Vergleich zum NIR-System. Im
Non-Kontaktmodus konnte durch Vernachlässigung des thermischen
Einflusses weder eine erhöhte Anzahl an devitalen Zellen noch vermehrte DNA-Doppelstrangbrüche oder Zytoskelettveränderungen
detektiert werden.
Unsere Untersuchungen zeigen eine hervorragende thermische Ankopplung des Blaulicht-Lasersystems an die Zellen und unter Einsatz
einer geringeren Leistung eine gute Schneidleistung, verbunden mit
einer günstigen Wundheilung ohne mutagene Nebeneffekte. Daher
stellt das neue Lasersystem eine innovative Alternative zu den etablierten Systemen dar.
joana.reichelt@ukb.uni-bonn.de

laser
4
I 45
_ 2015

[46] =>

24. JAHRESTAGUNG DER DGL E.V.
LASER START UP 2015
Die Anwendung von Dentallasern im zahnärztlichen Praxisalltag
und in der zahnärztlichen Chirurgie; Fallpräsentationen
Ioannis Papadimitriou, ZÄ Venetia Sotiri, ZA Dr Petros Almagout
Die moderne Technologie hat bereits Laser-Anwendung in der Zahnarztpraxis eingeführt. Es gibt verschiedene Arten von Laser, die in der
zahnärztlichen Praxis verwendet werden können. Einige der am
häufigsten verwendeten Laser sind: Erbium Nd:YAG-, CO2- (Kohlendioxid-) und Diodenlaser .
Heutzutage können Laser zur Kavitätenpräparation, Desensibilisierung von freiliegenden Zahnhälsen, Reduktion der bakteriellen Besiedlung von kontaminiertem Dentin, bei chirurgischen Techniken in
der Parodontologie und der präprothetischen Chirurgie verwendet
werden. Weiterhin kann Laser in Bereichen sowohl der Endodontie, Implantologie sowie Mund- und Kieferchirurgie als auch des
Bleaching angewendet werden. Die Lasertherapie hat zunehmende
Bedeutung in das Gesamtbehandlungskonzept in der Zahnmedizin
gewonnen. Dies ist nicht überraschend, dank dem weiten Indikationsspektum, das heutzutage mit Laser effizient behandelt
werden kann, in Kombination mit den traditionellen Behandlungskonzepten.
Das Ziel der Studie ist die Darstellung von Operationen an Weichteilen (Epulis-Exzision, Exzision von traumatischen Fibromen, Frenu-

lektomie, Implantatfreilegung) und die postoperative Wundheilung
der Patienten.
Die Studien wurden in der zahnärztlichen Abteilung des Allgemeinen
Krankenhauses Westattika in Athen und in der Abteilung für Mund-,
Kiefer- und Gesichtschirurgie, der St. Lukas Klinik in Solingen durchgeführt. Die Operationen wurden mit einem 810-nm-Diodenlaser
und einem 10.600-nm-CO2-Laser durchgeführt.
CO2 und Diodenlaser sind 2 Laserarten, die bevorzugt in der Chirurgie eingesetzt werden. Ihr sehr positiver Effekt beim Schneiden und
Abtragen von Gewebe sowie die Möglichkeit der Koagulation von kleinen Blutgefäßen wird heutzutage routinemäßig in der Weichgewebschirurgie angewendet.
Der Einsatz von Laser in der modernen Zahnheilkunde bietet viele Vorteile. Einige von denen werden weiter unten erwähnt: ein blutungsfreies und klares Operationsfeld, keine postoperativen Blutungen,
keine Naht, manchmal ist keine Anästhesie notwendig, kürzere
Termine, beschleunigte Wundheilung.
giannis.papadimitriou_4@hotmail.com

Diodenlaser-Einsatz als Therapieoption in der Weichgewebschirurgie –
Fibromexzision: Fallpräsentationen
Ioannis Papadimitriou
Durch die dauernde Entwicklung und Perfektionierung von Lasern ist
ihre Anwendung in allen Bereichen der Zahnheilkunde geeignet. Früher war Laser als eine komplexe Technologie mit nur limitierendem
Einsatz in der Zahnmedizin angesehen.
Heutzutage ist Laser als zusätzliches einzusetzendes System neben
konventionellen Geräten in einer modernen Praxis integriert. Diodenlaser wurde in den 90er-Jahren in die Zahnmedizin eingeführt und
zeichnet sich vor allem dadurch aus, dass sein Anwendungsbereich
sehr breit gefächert ist. Die Laserstrahlung weist im biologischen Gewebe sehr positive Eigenschaften auf, sie wird reflektiert, transmittiert und absorbiert. Dank der meist ausgezeichneten Absorption der
Wellenlängen von Diodenlasern im durchblutetem Gewebe und der
geringen Absorption in Zahnhartgewebe können chirurgische Eingriffe des Weichgewebes in der näheren Distanz zu Hartgewebe (Knochen; Schmelz; Dentin, Zement) durchgeführt werden, ohne diese
Strukturen zu schädigen, was eine mögliche Alternative zum Skalpell
darstellt.
Ziel der Studie ist die Darstellung von klinischen Fällen von Fibromexzisionen mittels Diodenlaser, die Operationsabläufe und die postoperative Wundheilung der Patienten.

46 I laser
4_ 2015

Die Studie wurde in der zahnärztlichen Abteilung des Allgemeinen
Krankenhauses Westattika in Athen durchgeführt bei Patienten mit
Reiz- und traumatischen Fibromen im Zungen- und Mundschleimhautbereich. Die Operationen wurden mit einem 810-nm-Diodenlaser durchgeführt.
Der Diodenlaser hat eine Wellenlänge von 810 nm. Durch seine hervorragende Absorption in Hämoglobin und Melanin werden Diodenlaser bevorzugt in der zahnärztlichen Chirurgie eingesetzt. Durch ihre
bemerkenswerte koagulierende Wirkung lässt sich mit dieser Laserart Weichgewebe im Mundraum hervorragend schneiden und abtragen.
Der Einsatz von Diodenlaser hat sich in vielen Bereichen der Zahnmedizin bewährt. Ihre Vielfalt der Anwendungsmöglichkeiten sowohl
der konservierenden Zahnheilkunde als auch der zahnärztlichen
Chirurgie, ihr geringes Geräteausmaß sowie moderater Anschaffungspreis, machen den Diodenlaser für eine moderne Praxis sehr
attraktiv.

giannis.papadimitriou_4@hotmail.com

[47] =>

Innovative Wege in der Zahnheilkunde – Der Dioden- und Er: YAG- Laser,
Anwendungsbeispiele
Dr. Dr. (UMF Bukarest) Simona Baur, Zirndorf
Die Lasertechnik hat in der Zahnmedizin inzwischen einen hohen Stellenwert erreicht. Die Bedeutung des Dentallasers als sinnvoll genutzte
Behandlungsalternative in der minimalinvasiven Zahnheilkunde wird in
diesem Beitrag herausgearbeitet. In ausgewählten Falldokumentationen wird zum einen gezeigt, wie der Er: YAG-Laser (2,940 nm) in der
Kavitätenpräparation (Kariesentfernung im Schmelz und Dentin) und
Oralchirurgie effektiv genutzt werden kann. Zum anderen kommt der
Diodenlaser (810 nm) in Beispielen der Parodontalbehandlung, Oralchirurgie und Bleaching zum Einsatz.
Die Fallberichte umfassen verschiedene Therapiemöglichkeiten bei
Patienten, Kinder und Erwachsene, mit diversen Erkrankungen von
Hart- und Weichgewebe im Mundbereich. Pre- und postoperative
klinische Symptome, postoperative Entwicklung und das Wohlbefinden

der Patienten im Zusammenhang mit den angewandten Arbeitsmethoden werden im Detail herausgearbeitet. Besonders in der Kinderzahnheilkunde hat die lasergestützte Therapie (Kariesentfernung, Phrenektomie etc.) signifikante Vorteile gegenüber den konventionellen Therapiemethoden.
Die klinischen Ergebnisse zeigen bei der Verwendung von Er: YAG- und
Dioden-Laser eine optimale Effizienz der Behandlung sowohl im Hartals auch im Weichgewebe. Gerade in Kombination mit dem richtigen
klinischen Prozedere ist die Akzeptanz bei Kindern und Erwachsenen
hoch.

drbaur@zahnarzt-wintersdorf.de

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laser 4/15

[48] =>

NEWS

germany

Internationales Forschungsprojekt

Laserworkshop präsentiert

Lasergestützter Wundverschluss für die
Oralchirurgie

Präzision in Blau

Mit Partnern aus Deutschland, Israel, Lettland und der Toskana
wird im Projekt „Biophotonic Technologies for Tissue Repair
BI-TRE“ der Einsatz biophotonischer Technologien im industriellen, klinischen und medizinischen Bereich konsequent vorangetrieben. Im Rahmen der transnationalen BiophotonicsPlusInitiative startete am 1. September 2015 das deutsche Konsortium mit seinen Aktivitäten. Ziel ist die Bereitstellung eines
lasergestützten Verfahrens für die Mund-, Kiefer-, Gesichts- und
Oralchirurgie zum zuverlässigen Wundverschluss nach einem
operativen Eingriff.

Im Rahmen des Deutschen Zahnärztetages 2015 bot
Sirona den anwesenden Fachjournalisten die Möglichkeit, den neuen SIROLaser Blue nicht nur live in Augenschein zu nehmen, sondern auch eigenhändig anzuwenden. Als erstes Gerät im Dentalbereich nutzt das
System blaues Laserlicht, um chirurgische Eingriffe
schmerzärmer, gewebeschonender und blutungsärmer zu gestalten.
Welche physikalischen Prinzipien den zahnmedizinischen Vorteilen zugrunde liegen, die das kurzwellige
blaue Laserlicht mit sich bringt, erläuterte André

Bisher mussten orale Wunden und Defekte ab einer bestimmten
Größe nach chirurgischen Eingriffen mit Kompressen abgedeckt oder mit einem eigenen Haut- oder
Schleimhauttransplantat mit oft aufwendiger Nahttechnik versorgt werden.
Eine dichte Wundabdeckung, ein zuverlässiger Schutz vor eindringenden Keimen als auch ein haftender
Verband ist im Mund-Rachen-Raum somit auch heutzutage immer noch ein ungelöstes Problem. Durch
den im BI-TRE Projekt erforschten Ansatz zur Wundabdeckung mit Kollagenmembranen, welche
lasergestützt an der Schleimhaut befestigt werden, wird dagegen eine neue Lösung erarbeitet. Ziel ist es,
einen verbesserten Schutz gegen Keime und eine beschleunigte Wundheilung zu erreichen. Zudem können die Behandlungskosten mit dem neuen Verfahren stark gesenkt werden. Die Behandlungszeit lässt
sich erheblich reduzieren, dem Patienten kann eine Transplantation und somit eine weitere Wunde auf
diese Weise erspart werden.

Fotobiomodulation – Neuer Trend für

Schnellere Zahnkorrekturen
Zahnspangen sind heutzutage auch bei Erwachsenen
sehr beliebt. Moderne Verfahren, um kleinere Korrekturen vorzunehmen, verschaffen innerhalb weniger
Monate die gewünschte Zahnstellung. Mittels einer
Lasermethode kann eine Zahnkorrektur noch be-

schleunigt werden. Damit ergibt sich ein weiteres Einsatzgebiet von Lasertechnologie in der Zahnmedizin.
Die neue Methode nennt sich Fotobiomodulation und
nutzt Licht im Bereich zwischen 600 und 1.000 Nanometern Wellenlänge, um den Knochen während der

48 I laser
4_ 2015

Behandlung mit Alignern zu stimulieren. Werden die
Zähne Schritt für Schritt im Kiefer bewegt, muss der
Knochen die entstandene Lücke füllen, um den Zahn
an neuer Position fest im Kiefer zu halten. Durch die Stimulation mittels Laser sollen die Mitochondrien in den
Knochenzellen aktiviert werden. Der Knochenumbau
kann so schneller voranschreiten. Aligner können
dadurch bereits nach wenigen Tagen anstatt von zwei Wochen gewechselt
werden. Fünf Minuten Strahlung pro
Kieferbogen am Tag sollen dafür ausreichen. Laut Dr. Marc Schätzle vom
Zahnmedizinischen Institut der Universität
Zürich berichten Patienten von weniger
Schmerzen beim Adjustieren der Aligner. Insgesamt soll die Methode nebenwirkungsfrei sein. Zur Anwendung ist bereits das Gerät OrthoPulse™ auf dem
Markt. Dieses wurde bei der AAO-Tagung in San Francisco vorgeführt und ist kompatibel mit den gängigen
Alignersystemen.

Quelle: ZWP online

Förster, Produktmanager Lasersysteme bei Sirona.
Demnach hängt die Schneid- und Desinfektionsleistung eines Lasers von der aufgenommenen Energie im
Gewebe ab. Der SIROLaser Blue emittiert ein blaues
Licht mit einer Wellenlänge von 445 Nanometern, wodurch die Lichtenergie von Hämoglobin und Melanin
besonders gut aufgenommen wird. Dadurch erreicht
der blaue Laserstrahl insgesamt eine rund 100 Mal
bessere Absorption als infrarotes Licht. Somit werden
präzise, atraumatische Schnitte in überzeugender Geschwindigkeit ermöglicht.
Zudem verkürzen die sterilen Einmalfaserspitzen die
Vorbereitungszeit bis zur Einsatzbereitschaft des Lasers signifikant, da keine vorherige Sterilisation erfolgen muss. Die hochwertigen Edelstahlhandstücke
sind abnehmbar und können autoklaviert werden.
Nach der theoretischen Einführung konnten sich die
Medienvertreter bei der eigenhändigen Anwendung
des Lasers an einem Tierpräparat selbst von dessen
Leistungsfähigkeit überzeugen.

[49] =>

Antwort:
Deutsche Gesellschaft für Laserzahnheilkunde e.V.
c/o Universitätsklinikum Aachen
Klinik für Zahnerhaltung
Pauwelsstraße 30
52074 Aachen

Tel.: 0241 8088164
Fax: 0241 803388164
E-Mail: sekretariat@dgl-online.de
Bank: Sparkasse Aachen
IBAN: DE56 3905 0000 0042 0339 44
BIC: AACSDE33

Aufnahmeantrag (Deutsch)
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Mit der Stellung dieses Aufnahmeantrages versichere ich, dass ich
seit dem
mit einem Laser des Typs

in der eigenen Praxis
arbeite. (genaue Bezeichnung)

in der Praxis

beschäftigt bin.

in der Abt. der Universität

beschäftigt bin.

Ich beantrage die Aufnahme in die Deutsche Gesellschaft für Laserzahnheilkunde e.V.
Ort, Datum

vollständige Unterschrift

Jahresbeitrag: Für stimmberechtigte Mitglieder bei Bankeinzug 150,00 €.
Sofern keine Einzugsermächtigung gewünscht wird, wird ein Verwaltungsbeitrag von 31,00 € p.a. fällig.
EINZUGSERMÄCHTIGUNG
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Name:

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Diese Erklärung gilt bis auf schriftlichen Widerruf

[50] =>

I about the publisher

laser

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50 I laser
4_ 2015

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) [page_count] => 52 [pdf_ping_data] => Array ( [page_count] => 52 [format] => PDF [width] => 595 [height] => 842 [colorspace] => COLORSPACE_UNDEFINED ) [linked_companies] => Array ( [ids] => Array ( ) ) [cover_url] => [cover_three] =>

[cover] => laser international No. 4, 2015

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Table of contents

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