Thursday, August 29, 2013

Laser Dentistry - Introduction


What is LASER?

A laser is a device that emits light through a process of optical amplification based on the stimulated emission of electromagnetic radiation. The term "laser" originated as an acronym for Light Amplification by Stimulated Emission of Radiation. Lasers differ from other sources of light because they emit light coherently. Its spatial coherence allows a laser to be focused to a tight spot, and this enables applications like laser cutting and laser lithography. Its spatial coherence also keeps a laser beam collimated over long distances, and this enables laser pointers to work. Laser also have high temporal coherence which allows them to have a very narrow spectrum, i.e., they only emit a single color of light. Their temporal coherence also allows them to emit pulses of light that only last a femtosecond.


Lasers have many important applications. They are used in common consumer devices such as DVD players, laser printers, and barcode scanners. They are used in medicine for laser surgery and various skin treatments, and in industry for cutting and welding materials. They are used in military and law enforcement devices for marking targets and measuring range and speed. Laser lighting displays use laser light as an entertainment medium. Lasers also have many important applications in scientific research. Source: Wikipedia.

Laser Dentistry

By visiting a laser dentist, you’ll have the opportunity to experience a new and exciting technology. Here, you will have some basic information and perhaps reduce any of your concerns.
Diode laser unit

Dental laser is a tools that is used by dentist to do his work. Some lasers are used for surgery, some to cure restorative materials and enhance tooth bleaching, and others to remove tooth structure for elimination of disease and restoration – different lasers for different procedures. All lasers require eye protection. Safety glasses with special lenses will be provided. Family and guests in the dental operatory at the time of your laser treatment may also be asked to wear protective eyeglasses.
protective glass
Lasers do not make whining sounds or other annoying noises. You may experience the sound of a rush of air, since air suction is often used to keep the area cool and cleaner. You should be able to relax and be comfortable while the dental laser is in use.
Laser for gum procedure
Laser is used in gum procedure
Depending on your treatment needs, your dentist may use the laser for a long period of time or possibly only for brief moments. However, even those procedures that require only a short period of laser usage benefit from the advantages of laser therapy. With laser surgery, there is a reduced need for local anesthesia, bleeding is minimized, swelling is controlled, and there is usually little, if any, postoperative discomfort. Laser energy enhances the effect of tooth bleaching agents for a faster and more effective result. Natural looking restorative materials for teeth are more quickly cured to greater hardness. Lasers that remove tooth decay are fast and seldom require anesthesia.
Laser is used in gum procedure
Laser can disinfect the gingival pockets and promote healing
Dental lasers are used for a variety of treatment procedures. Your dentist knows which types of patient care are more patient friendly with a laser than with alternative traditional methods. The dentists using lasers have devoted training time and expense to be able to bring you the many advantages of this exciting new technology.

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Clinical Application of Dental Laser
Who are qualified to handle the laser unit?
Our dental laser unit


Thursday, December 27, 2012

A Case of Orthodontic Treatment


A young lady came to our clinic complaint of her teeth were crooked and her front teeth were jerking out (below).  She wanted to have them corrected.
We suggested to her that braces would be the best treatment option.

She went through orthodontic treatment for 1 years and finally, all her teeth were well aligned (below) and she has the confident to smile again!!

Read more on how we corrected her teeth...

Thursday, August 2, 2012

Dental Implant: A Case of implant on the lower jaw

A young lady had a lower  front tooth exacted a few months ago due to tooth decay and she came to us requesting for a permanent replacement of that missing tooth. She didn't want a denture as it was a removeable appliance. She wanted something fixed in her mouth but wasn't a bridge as she believe a bridge would damage her neighbour teeth.
Therefore, a dental implant was suggested to her.

After a few months a dental implant tooth was completed and she was quite happy about her implant now.
Below are the process of:

A simple case of Dental Implant Treatment

Patient was a24 years old girl, with no medical problem, non-smoker and practicing good oral hygiene.
According to SAC classification by the ITI (International Team of Implantology), the risk of placing implant in her mouth was: LOW

Assessment & Consultation

In October 2010, she came for assessment and consultation where the surgical date were fixed to the following week.
Front view
Top view

Surgery Stage/Day

On 9th October 2010 (surgical day), she came for implant placement. Local anaesthetic was given to numb the surrounding area which followed by raising the gum tissue (flap) to expose the jaw bone. The bone quality was assessed and preparation for implant placement began (lower left pic).
It started with a pilot drill to get the exact position right, then follow with the larger drill until the correct size to fill the fixture implant (lower right pic).
The flap was raised to expose the jawbone
The bone was prepared for implant placement

 Implant fixture measuring 3.7mm diameter x 13mm length (lower left pic) was remove from its container. It was in a sterile condition and the surface is coated with titanium alloy to allowed osteo-integration  when in-contact with bone structure.
The implant was immediately place into the prepared site which was treaded before hand (lower right pic).
Zimmer Implant
The implant was screwed into the prepared bone

 The implant fixture was hand-screwed into the bone at the final stage of the implant insertion. This was to allowed the surgeon to feel the resistance of the implant, and therefore the primary stability was achieved (lower left pic) .
The whole rough surface of the implant body was embedded into the bone until the furnish metal margine (lower right pic). Inspection was made on the front surface of the bone as to make sure there was no perforation!!
Hand-screw of the implant in final stage of insertion
The dept of the implant was checked

 The implant holder (in green) was removed and the implant fixture was carefully check (Bottom).
Implant fixture placed in the jawbone
Another view of implant fixture

 Before stitching back the gum, the top part of the implant fixture was covered with the sulcus former. This was to allow the gum to healed properly and to get a good emergence profile for the fabrication of the crown later (lower left pic).
Sulcus former was placed
The gum was reposition and secured with suture

 The gum (or flap) was reposition so that it wrapped around the sulcus former nicely and was secured with the resorbable suture (upper right pic).
Finally,  a few stitch more to secured the vertical cut (lower pic)
The gum was sutured properly

Prosthetic Stage (Two months later)

18th Dec 2010, patient came back and the gum was nicely healed. The sulcus former (green screw) was firm and intact. The recovery from the implant surgery was uneventful and patient was very keen for the final stage (Bottom pic).
2 month after implant surgery
The gum surround the screw healed nicely

 The sulcus former screw was remove to expose the top part of the implant fixture and the surround gum tissue. There was no sign of redness showed that the wound healed very well (Lower left pic).
Impression coping was used to take the impression of the lower jaw as to make a duplication model of patient's lower jaw (lower right pic).
Top part of the implant fixture and the surrounding healthy gum
Impression coping was used to take the impression of patient's lower jaw

 Then, the colour/shade of the crown was noted to match the neighbour teeth (bottom pic).
The impression record together with the crown colour selection were sent to the lab technician to have the abutment and crown fabricated.

Crown shade/colour selection

Two weeks later, the crown and abutment were ready for fitting (pic below).
Crown fabricated on the model

 Fitting of the crown and abutment

18th Dec 2010 - the abutment (lower left pic) was fitted into the implant fixture in the mouth.
Then, using the torque wrench to tighten the inner screw to fix the abutment to the implant fixture (lower right picture).
Fitting of the abutment
Tightening of the abutment

 The crown was cemented to the abutment with a strong cement and finally, the implant-crown was placed (Pic below).
Cementation of crown over the abutment
End Result!!
The implant in patient's mouth

Orthodontic case

A case of mal-alignment of teeth treated with fix appliance

18 months after orthodontic treatment (below)....



A 25 years-old Chinese female requested for orthodontic treatment. She complained of spacing at her front teeth while her lateral incisors (side teeth) were hiding behind the lower teeth. She also dislike her left canine which erupted high up in the gum area.

Orthodontic treated started in July, 2010...Scaling and dental fillings done prior to braces placement.
Below were the chronology of braces treatment during 19 months

July 2010: After braces analysis done, she only required single tooth extraction. She had clear crystal braces placed on her teeth.

August 2010: The right lateral incisor (side tooth) is coming out

September 2010: Left canine was pull down to its correct position

October 2010: Wire was engaged to the left lateral incisor

November 2010: Both left canine and left lateral incisor were moving into correct position

December 2010

January 2011: Nickle Titanium rectangular wire was used to pull down the left lateral incisor and canine

February 2011

March 2011: Gaps between the teeth on the left side were getting smaller

April 2011

June 2011

July 2011: Stainless steel wire was used to help the teeth to move to each other

August 2011

September 2011: Wire was bend to pull up lower left canine and premolar upwards

October 2011: Upper and lower wire were bend further to close gap

November 2011

December 2011: Treatment finish, all the teeth were in good alignment

Before and After Braces Treatment



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Case 02:  A case of orthodontic treatment with fix appliance