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Nd:Yag

Nd:YAG a.k.a. “1064” “YAG”


Overview

An expensive soft-tissue option do to the internal mechanism of this laser. However, that mechanism allows this laser to micro pulse which allows for higher peak power and low average power which cuts more efficiently and has less trauma. Very good coagulation properties and bactericidal properties for perio procedures. These lasers cost anywhere from $12,000 – $90,000 depending on features, fiber quality, internal mechanism and training and support.

Pros

  • Micro Pulsing for better tissue interaction
  • Very good surgical & Coagulation properties
  • Proven protocols for Perio

Cons

  • Typically larger in size, but some newer models are dramatically reducing in size
  • Cost can be high
  • This wave length is used to weld various metals.  Must be extremely careful around implants or any other metal in the mouth

Success Keys

  • Because this laser micro pulses, it gives you many more setting options and parameters.  Thus, manufacturer training for this unit will be critical to adequately learn how to make all the settings adjustments (pulse duration, power and cycles per second).  There are many different combinations and you must learn how each permutation is optimal for a specific target tissue.
  • You must be VERY close to the target tissue for these lasers to work.  Imagine you were righting using an old feather and ink well.  You would have to be as close to the tissue to draw the ink.  However, if you apply pressure, the fiber will cut NOT the laser energy and will cause bleeding.
  • Your char should be light brown, not black.  If it is black your power settings are too high and thermal necrosis will cause scaring and post-operative pain.  If it is light brown you will have neither of these problems.
  • Try to use the least amount of power to attain your clinical objective. 

Target Tissue Keys

  • The key target tissue is melanin and some absorption with water.  So the darker the tissue is, the more efficient and effective this laser is.  However, in fibotic and/or less colored tissue this laser is more effective than its sister diode wavelengths due to the additional absorption of water and the additional peak power settings.