Fuel Ghoul

Endovenous Laser Removal Compared to IPL Intense Pulse Light Therapy

What's the difference between Laser and Intense Pulse Light or IPL when it comes to laser removal services?

LASER (light amplification by stimulated emission of radiation)  is made up of light beams that are all the same size, a specific wavelength, and are focused together in a narrow channel.

Fuel Ghoul wrote about how lasers are used in dentistry when we profiled the Markham dentist with a powerful Biolase laser.  A laser is a device that emits light through a process of optical amplification based on the stimulated emission of electromagnetic radiation. This pictures shows a very simple schematic outlining the basic concept.

But this is hard to do.. And because its such a complex achievement, there is some dispute about when Lasers were actually invented, but the Laserfest website says Theodore Maiman invented the world's first ruby laser in 1960.

Comprehending the Ruby Laser

Ruby crystal can be grown artificially. The gem is composed of aluminum oxide, where some of the aluminum atoms have been replaced with chromium atoms. So.. if I understand this correctly, regarding the picture on the right, in a ruby laser, the Gain Medium would be a ruby - grown artificially in a cylindrical tube. That cylindrical and hopefully mathematically perfect ruby is then wrapped in a light source which pumps massive amounts of light radiation into the crystal matrix.

Only a fraction of this energy escapes through the Gain Medium to the Output Coupler, which joins the light streams together into a single 'beam'. In early demonstrations of the ruby laser, the output is a single pulse because it takes so much energy to make the light required around the Gain Medium and its hot. Some sophisticated cooling apparatus around the crystal array is required esp for contiguous beam lasers.

Ruby lasers were among the first instruments developed, and publicly tested, and are used today in many applications including healthcare.  Over the years, many thousands of scientists in various advanced nations have been working on improving the technology, and have improved the Gain Mediums. Lasers can now be divided into three categories: gas lasers, solid lasers and molecular lasers.

All three types of Lasers are frequently used in healthcare today.

Modern medical science uses lasers to diagnose disease and make precise incisions in human flesh. Eye surgeons harness lasers to correct vision. Dentists use lasers to do soft tissue oral surgery, and teeth whitening. Many other medical practitioners use some sort of photon scalpel to deliver light energy somewhere in the human body, and by using different wavelengths they can achieve different results. Most medical laser beams are so small, and so precise they allow doctors to safely treat diseased tissue without injuring the surrounding area.

Laser vein removal often uses radio frequency or laser energy to cauterize veins from the inside out..

Endovenous Ablation - Varicose Vein Treatment

Endovenous ablation is a treatment that uses radio frequency or laser energy to cauterize (burn) and close abnormally enlarged veins in the legs, a condition called varicose veins.

Normally, blood circulates from the heart to the legs via arteries and back to the heart through veins. Veins contain one-way valves which allow blood to return from the legs against gravity. If the valves leak, blood pools in leg veins which can become enlarged or varicose.

Endovenous ablation is an image-guided procedure that uses heat generated by radio frequency or laser energy to seal off these faulty vessels, diverting blood flow immediately to nearby healthy veins.

The heat kills the walls of the veins and the body then naturally absorbs the dead tissue and the abnormal veins are destroyed. It can be carried out in a simple treatment room rather than in the operating theatre.

Intense Pulse Light Therapy is not a Laser Therapy

Intense Pulse Light (IPL) systems work on the same principles as lasers in that light energy is absorbed into particular target cells with colour (chromophores) in the skin. The light energy is converted to heat energy, which causes damage to the specific target area. IPL systems are different to lasers in that they deliver many wavelengths (or colours) in each pulse of light instead of just one wavelength. Most IPL systems use filters to refine the energy output for the treatment of certain areas. This enhances penetration without using excessive energy levels and enables targeting of specific chromophores (these are skin components that absorb light).

 

IPL therapy is considered a non-ablative resurfacing technique, which means that it targets the lower layers of skin (dermis) without affecting the top layers of skin (epidermis). The results are not as dramatic as ablative resurfacing where both the dermis and epidermis are injured to produce a much more noticeable overall outcome. The advantage of IPL therapy is its minimal downtime – a patient can often have the procedure done in their lunch break and return to work immediately afterwards.

Lumecca IPL for Skin Rejuvenation

InMode Lumecca uses intense pulsed light to carefully target and treat skin conditions through selective photothermolysis. The Lumecca program improves the appearance of age spots, sun damage, vascular lesions, rosacea, and freckles. An improved skin appearance can be seen after the first session and multiple sessions deliver even better results. A strong sapphire-cooling tip provides a safe and painless procedure for clients. Lumecca can be combined with Fractora for a full-face treatment regime.

Selective photothermolysis is an optical technique used to ablate tissue in targeted regions.  The objective is to heat targeted tissue with a laser and destroy it without damaging surrounding tissue.  Targeted cells are damaged mainly through the absorption of light and the subsequent heating of tissue due to energy transfer.  Heating of the tissue denatures proteins and halts major cell survival processes.  

Skin tightening at Numi spa in Brampton shows the patient lying flat, protected with goggles and numbing gel, getting an IPL treatment at the hands of a skilled technician.

The clinic uses the InMode Lumecca machine which produces a high-output flash to produce a broad wavelength output of non coherent light between 500 to 1200nm. Light pulses generated by this device and others on the market are produced by bursts of electrical current passing through a xenon gas-filled chamber.  Xenon is the new ruby. The lamp output is then directed toward the distal end of the hand piece which releases the energy pulse onto the surface of the skin via a sapphire block. So you see the elements of a laser are still present - a light source connected to a gain medium and then some manner of output synchronicity device. You can read more about Numi Spa Laser Removal in this Brampton magazine. 

IPL is now among the most commonly used treatments for spider and thread veins, and some vascular birthmarks. Light pulses are targeted at the red-pigment (haemoglobin) in the blood which heats and destroys the pigment without affecting the skin or other tissues.

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Markham Dentist Demonstrates BioLase ezlase 940 Diode Laser at Armadale Dentistry

Always interested in how new technology improves people's lives, Fuel Ghoul was quick to accept an invitation from Markham dentist at Armadale Dentistry to watch Dr Gabriala Vidmar demonstrate a diode laser during real life dental surgery. This is a first hand account of how modern dentists now use lasers to do soft tissue surgery, and real laser teeth whitening. The future has arrived at this dental office in Markham.

Gabriala Vidmar has been practicing dentistry in Markham for many years at Armadale Dentistry which is located in building 4A in the shopping plaza complex at 7720 Markham rd. at the heart of the big box store complex that has grown up south of Hwy7, and the old Town of Markham.  

Gabriala is a veteran dentist who graduated with a bachelor's degree in general dentistry in 1997.  Since her graduation, she has continued to pursue extensive training and education in the field of cosmetic dentistry, root canal therapy, oral surgery and Invisalign®.   Gabriala also likes new technology and hopes that someday the dental laser might replace the dentist's drill to offer quieter more comfortable treatments everywhere inside and even outside the mouth.

Ezlase products came to the attention of office administrators at Armadale Dentistry last year, because the 940 model delivers up to seven watts of laser power which most dentists believe makes the impliment more of a surgeon's tool, and not just a teeth whitening pen or gimmicky toy.  Also notable is that this handheld surgical device comes with a powerful battery right inside the pen itself.. so most procedures can be done without the power supply cord attached. The battery holds a good charge, so she can work with the cordless tool all day long, and doesnt have to constantly worry about anything dangling in the patient's face. That also means she has more freedom to maneuver the ezlase dental laser during complicated operations which all adds up to faster, safer, and more efficient surgery.

The device came in a small cardboard box in which there was also included a laminate brochure which reads 'The ezlase offers the most precise control of tissue cutting for different procedures and tissue biotypes. Dentists and clinicians can choose from the widest selection of tip lengths and diameters", and under the heading 'Soft Tissue Surgery', the description continues,  "The ezlase uses better bendable tips for better access to all areas, and offers single-use disposable tips for quick, convenient treatment, and improved cleanliness."

Laser tips are disposable? hmm Fuel Ghoul predicts this will be a big business someday. More research needed to investigate the possiblility of making the largest dental tips inventory warehouse in North America.

Markham Dentist readies Armadale Dentistry clinic's ezlase 940 diode laser for a demonstration.

Specialy trained and now very experienced with lasers, Dr Gabriala Vidmar is also a caring and knowledgeable dentist who devotes herself to patient care. Her vision for the clinic is to offer state-of-the-art comprehensive dental care while achieving her patients’ optimal oral health and esthetics. She wants folks to know that she has the latest high technology devices and can offer a more comfortable experience and get more done in less time

Armadale Dentistry has become a bastion of technology using digital xrays and other advanced machines.  Dr Vidmar hopes the laser will someday replace the dentists' drill for all operations. Already the device is quieter and doesnt terrorize patients with loud whinny noise of an electric motor and spinning drill bit.

Its estimated that less than ten percent of Canadian dentists own and are trained to use lasers for soft-tissue surgery. The highly specialized surgery is perhaps the high art of modern dentistry.

Biolase's proprietary laser products incorporate approximately 300 patented and patent-pending technologies. The common goal of the research is to provide superior performance with less pain and faster recovery times.  The company's innovative products provide cutting-edge technology at competitive prices. 

BIOLASE is acquiring quite a good reputation for offering a diversified array of different dental laser systems that perform a broad range of dental procedures. Their tools are used for both cosmetic and complex surgical applications. In one article I read, the author stated that BIOLASE has sold more than 25,000 laser systems in markets all over the world, and that piece was dated Jan 2014. Other laser products they currently have in development address ophthalmology and other medical and consumer markets.

Benefits of Laser Dentistry

Lasers offer many advantages over the scapel, that cruel knife has been the prinicple cutting tool of surgeons the world. However, procedures that are performed using the new soft tissue dental lasers are less painful, lass damaging, more sterile and they heal faster. In many cases the patient's mouth, skin, gums do not require sutures (stitches) after the operation.  Certain laser dentistry procedures do not require anesthesia.

This is mostly because laser dentistry minimizes bleeding and swelling during soft tissue treatments. Bacterial infections are also minimized because the high-energy beam sterilizes the area being worked on. Damage to surrounding tissue is minimized and that means wounds heal faster, and tissues can be regenerated by the body easier

Top Seven Dental Procedures for which the Ezlase 940 Diode Laser is Commonly Applied

Remove Cold Sores - Low intensity dental lasers reduce pain associated with cold sores and minimize healing time.

Treating Gum Disease - Lasers are used to remove diseased, infected, inflamed and necrosed (dead) soft tissue within the periodontal pocket.

Crown Lengthening - Dental lasers can be used to reshape gum tissue to expose healthier tooth structure.  Referred to as crown lengthening, such reshaping provides a stronger foundation for the placement of restoration.

Gummy Bear Smile - Dental lasers can reshape gum tissue to expose healthy tooth structure and improve the appearance of a gummy smile.

Muscle Attachment (Frenula) - A laser frenectomy is an ideal treatment option for children who are tongue tied (restricted or tight frenulum) and babies unable to breast feed adequately due to limited tongue movement.  A laser frenectomy may also help to eliminate speech impediments.

Soft Tissue Folds (Epulis) - Dental lasers may be used for the painless and suture-free removal of soft tissue folds often caused by ill-fitting dentures.

Removing Benign Tumors - Dental lasers may be used for the painless and suture-free removal of benign tumors from the gums, palate, sides of cheeks and lips.



Biopsy or lesion removal - Lasers can be used to remove a small piece of tissue (called a biopsy) so that it can be examined by specialists for cancer.

The Biolase ezlase 940 Dental Laser

In addition to it's diverse functionality, the administrators at Armadale dentistry were no doubt also influenced by an exclusive ezlase feature called ComfortPulse™ which lets dentists significantly reduce the amount of time the laser is actually cutting flesh, which works to avoid heat that can cause pain at the surgical site. This unique combination of features means that she can perform most ezlase procedures using topical anesthetic only.

The science of using laser for soft tissue dental surgery

Recent research in the field of laser wavelength absorbtion and innovations inspried by this data has positioned BIOLASE Technology as the leader in medical and dental laser systems. They used the research data to develop the ezlase 940, the first dental laser to obtain clearance at the unique 940 nm wavelength.

Biolase ezlase model 940 dental laser operates at 940 nm wavelength which research proves resonates or rather is better absorbed by hemoglobin and oxyhemoglobin than other wavelengths, so the ezlase cuts more efficiently at lower power and with less heat.

The ezlase is FDA cleared for temporary relief of minor pain. The exclusive beam-dispersing handpiece has several therapeutic applications, including providing temporary relief of minor muscle and joint pain and stiffness.

How do lasers work in dentistry?

All lasers work by delivering energy in the form of light. When used for surgical and dental procedures, the laser is most frequently used as a cutting instrumen, and less frequently as a vaporizer of tissue. When used for "curing" a filling, the laser helps to strengthen the bond between the filling and the tooth.  When used in teeth whitening procedures, the laser acts as an activator and enhances the effect of tooth whitening agents.

While all diode lasers cut tissue using heat, many of them can increase tissue temperature excessively, causing patient discomfort. The ezlase keeps patients more comfortable two ways.

Using the ezlase 940 Diode Laser for Teeth Whitening

Diode Dental Laser is designed for a wide variety of procedures, including teeth whitening.  Diode Laser Teeth Whitening is achieved with a proprietary photo-activated whitening gel that is activated by the selective absorption characteristics of a specific true-laser wavelength of light.

Even though its quick, it works. The Diode Laser Whitening procedure is completed in just four short sessions, that each last about thirty seconds each, and which are all performed in the course of one short visit, and the results are truly amazing. The new device has proven itself to be one of the most effective teeth whitening instruments available on the market today.  The technology has already transformed the appearance of thousands of Canadians teeth, and is remarkably effective even on the worst case scenarios, ie teeth that are yellowed or gray in color, Diode Laser Teeth Whitening offers outstanding results. A full-mouth, in-office whitening can be performed in only 20 minutes, which makes it faster than any other in-office whitening system.

Consumers need to be better educated to know that most dental offices and almost all spas and salons that offer “laser teeth whitening” do not, in fact, use an actual diode laser in the procedure.  The term “laser” has been rather loosely applied to every light emitting tool and the lights that most folks use are actually non-laser plasma lights.  There is a significant difference in both the effectiveness and safety of these plasma lights, versus true diode laser activation.
 
The ezlase 940 uses new technology to provide greater patient comfort and superior control of bleeding during dental procedures.  Small and ultralight, the ezlase 940 enables this Markham area dental clinic to proudly and confidently offer better dentistry services, which more proceducres done faster and more comfortably than ever before.  Can your dentist say the same?

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