Why 10,600nm Super-pulsed C02
All dental lasers work on the fundamental principal of “selective photo-thermolysis”, that is selectively converting light into heat. The catalyst for that scientific interaction is the absorption of the wavelength of light (i.e. – 10.600nm) in a target, or what is referred to as a “chromophore”. Simply put, the greater the absorption in the chromophore, the more thermally precise the interaction. In soft issue surgical applications, the two primary objectives of the temperature interaction are; vaporization (incision/excision) and coagulation.
There are several commonly used wavelengths of laser used for soft tissue surgery including C02 (10,600nm), Nd:YAG (1064nm) Erbium (2940nm) and a series of diode (810 – 980nm) lasers. Soft tissue in turn has several potential targets or chromophores including water, hemoglobin, oxyhemoglobin and melanin, with water being the primary target as soft tissue is 90 – 95% comprised of water.
The C02 wavelength (10,600nm) is the wavelength of choice for precise incision/excision, as it is selectively (98%) absorbed by water. The remaining 2% facilitates thermal coagulation. This superior absorption leads to a precise and controlled (0.1mm) depth of penetration. The Erbium laser (2,940nm) has the highest co-efficient of absorption in water of any dental laser, however, there is so much absorption, that there is virtually no residual heat left for coagulation beyond the vaporization site.
Conversely, Nd:YAG (1064nm) and diode (810 – 980nm) lasers are very poorly absorbed in water. Their primary chromophore in biologic soft tissue is melanin and this difference in absorption characteristics leads to a much greater and less predictable penetration depth of 2 – 4 mm. Often referred to as “hot tip” lasers, these lasers require “initiation” of the fiber tip prior to use, which involves carbonization (200ºC+) of the tip, which is then used in contact with the tissue. This process is required to control the depth of penetration and facilitate interaction with soft tissue and actually blocks the laser light from emitting from the fiber tip. Referred to as the “conductive” transfer of thermal energy, this results in less precision and greater presence of inadvertent deep thermal coagulation and potential for tissue char.
​
C02 (10.600nm) lasers have such an affinity for water, there is no requirement to carbonize the tip and block the laser energy from emitting. In this way, 100% of the light is used for therapeutic purposes (incision/excision & coagulation). This process is referred to as the “radiant” transfer of thermal energy resulting in precise control over tissue interaction. Finally, the radiant transfer of thermal energy represents the highest safety profile, as heat is only created as a result of absorption of the light in a chromophore, hence no heat is created if the light if not absorbed. This is a fundamental reason the C02 (10,600nm) wavelength is an ideal choice for disinfection of implants (periimplantitis) as the wavelength is selectively absorbed and vaporizes the diseased soft tissue yet is completely reflected (hence not absorbed) by the implant surface!
​
​