Dental News - Interview: “Lasers should form part of every dental clinic’s armamentarium”

Monique Mehler, Dental Tribune International

Tue. 4. February 2020

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After graduating in medicine in 1981, Dr Josep Arnabat-Domínguez attended the University of Barcelona for two more years, completing his specialisation in dentistry. He has now been an associate professor at the university’s dental school for over 25 years, but performs the majority of his work at his private practice, which he opened more than 37 years ago and where he treats patients with dental lasers daily. As a founding member of the Sociedad Española de Láser y Fototerapia en Odontología (Spanish society of laser and phototherapy in dentistry), Arnabat-Domínguez is considered an active advocate in the field, and at AEEDC 2020, he will hold a lecture on laser-assisted oral and dental treatments.

Dr Arnabat-Domínguez, the title of your presentation is “Er,Cr:YSGG laser-assisted oral and dental treatments”. Why did you pick this topic?
The title of my lecture was proposed by the scientific committee, since we have been working with this type of laser for more than 20 years, both at the university and in our private practice in Barcelona. At the University of Barcelona, we have carried out various scientific and clinical studies that support the correct use of this type of wavelength for different dental treatments. That is why I think it may be interesting for congress attendees to be able to see in summary the different applications of this type of laser for their daily practice. We are going to show clinical cases in support of the applications, from various published scientific studies, in order to combine clinical experiences with the scientific evidence that has published in journals of a high scientific standard.

What do you think are the main advantages of the Er,Cr:YSGG laser? What are its limitations?
We have been able to assess the different advantages of this type of laser technology. This type of laser provides us with a wide variety of applications in dentistry, since it is a very versatile one and can be used in both hard and soft tissue in the oral cavity. The reduction in the amount of anaesthetic used and, in some cases, the possibility of performing some types of treatments without anaesthesia are advantages that must be taken into account. Soft-tissue treatments with the Er,Cr:YSGG laser have been shown to produce a decrease in pain and oedema, which is very important in the postoperative period, as it significantly reduces the need for analgesic medication. Also, owing to the laser’s bactericidal property, postoperative infections are usually almost nil and the healing of the surgical wound, which is usually by secondary intention, is very effective. Like any technique, it has its limitations, since it is a laser that is absorbed very superficially and is little absorbed by haemoglobin.

What are the main objectives of your lecture?
The main objective is to give a general overview of the different applications of this type of wavelength in the most common treatments performed by dentists daily. Therefore, its applications in the field of conservative dentistry will be shown, covering the restoration of cavities in enamel and dentine in endodontics, for which we will present clinical cases accompanied by our latest scientific work published on this topic. We will also cover the different applications in periodontics, as well in both soft-tissue surgery and periapical surgery, and finally, we will talk about the possibility of using this type of laser in implantology, both to perform the second surgical stage and to treat peri-implantitis.

Comparing dental lasers from when you started your career to now, what have the greatest developments been?
Since its beginnings in 1992, laser technology has improved a lot. I remember the first Er,Cr:YSGG laser that we were lucky enough to be able to use at the University of Barcelona: it was a laser with very different technical characteristics than today. Technological advances over time have resulted in smaller and much more efficient lasers than in the past; because of that, we have been able to increase the number of procedures that are performed with lasers in the dental field. The fibres through which the beam of laser light is transmitted have been improved, being much more flexible and manoeuvrable than before, as have the different tips and handpieces, which make it possible to reach areas that were previously inaccessible. The new radial and lateral emission tips have significantly increased the treatment results in different fields, such as endodontics, periodontics and implantology.

What kind of training is available for aspirant dentists to learn about lasers from the start?
Currently, Dr Antoni España and I together direct the master in laser dentistry programme at the University of Barcelona. This master’s degree is offered within the framework of the European Union together with five other European universities, the University of Liège (Belgium), University of Parma and Sapienza University of Rome (Italy), Victor Babeş University of Medicine and Pharmacy (Romania) under the name of EMDOLA (European Master Degree in Oral Laser Applications). These six universities offer a coherent, up-to-date European joint study programme with the objective of sharing, increasing, collating and extending competencies in the field of oral laser applications. We have published more than 25 scientific articles in journals indexed in Journal Citation Reports, and we have given lectures and courses in various countries.

Is there anything else you would like to add?
Nowadays, lasers should form part of every dental clinic’s armamentarium. The advantages for our patients mean that, if we want to give the best possible treatment, the use of this technology is essential. Nowadays in modern dentistry, where there are many new technologies, lasers have a very important role. However, it is necessary for dentists who use these technologies to be well trained and have knowledge of what a laser is, how it works and what type of laser to use for each application, since not all lasers produce the same effects on different types of tissue. Furthermore, the same laser can produce different effects depending on the parameters that are used and the user requires knowledge of this. Training is fundamental to make proper use of laser to treat our patients. The industry has understood this demand and currently, together with various scientific associations and universities, different courses and congresses are being held to train all those dentists who want to learn how to use laser technology.

Finally, I would like to express my gratitude to AEEDC for hosting the World Federation for Laser Dentistry world congress at this event, at which the invited speakers will show to the dental community the new advancements, techniques and protocols that are currently being used in laser dentistry.