Table of contents Chapter 1. Some basic laser physics... 1

Transcription

1 Table of contents Chapter 1. Some basic laser physics... 1 Introduction... 2 Physics... 2 Energy... 2 Radiation... 3 Electromagnetic radiation... 4 Wavelength and frequency... 5 Photon energy... 6 The electromagnetic spectrum... 6 The optical region... 9 Radiation risks... 9 Can electromagnetic radiation cause cancer?... 9 Protective mechanisms...10 Light The optical spectrum Light sources Various sources of radiation Natural sources of radiation Man-made light sources The light-emitting diode (LED) Flash lamps The laser...18 Laser design Practical lasers The properties of laser light Coherence Interference Laser beam characteristics Polarisation Output power Continuous and pulsed lasers The peak power value Average power output Power density Light distribution Beam divergence Collimation Risk of eye injury Decisive factors in the risk of eye injury The laser instrument Properties of some laser types...42 Description of common surgical laser types The CO2 laser (carbon dioxide laser)... 44

2 Carbon dioxide lasers in surgery Carbon dioxide lasers in dental applications The Nd:YAG laser Nd:YAG lasers in surgery...50 Nd:YAG lasers in dentistry Erbium lasers in dentistry Strong diode lasers in dentistry The KTP laser Q-switching Chapter 2. Therapeutic lasers The first generation The second generation The third generation The fourth generation 2005 and onwards What is a good laser therapy instrument? The basic instrument Sales tricks Sales trick 1: Soliton waves Sales trick 2: Scalar waves Sales trick 3: Treating through clothes Sales trick 4: Class IV laser therapy Sales trick 5: Claimed output vs. actual output Sales trick 6: The 904 nm trick Sales trick 7: False super pulsing Sales trick 8: Pre-programmed machines Sales trick 9a: Home tailored theories Sales tricks 9b: Home tailored theories High power - low power Laser or LED High or low price Penetration of light into tissue A story of a young scientist The wavelength How deep does light penetrate into tissue? Chapter 3. Biostimulation History A few words on mechanisms Photoreceptors What parametres to use Laser parametres Which wavelength? Output power Average output power...95 Power density Energy density The dose... 97

3 Treatment dose Calculation of doses Dose ranges Calculation of treatment time for a desired dose Ready reckoner Dose per point Pulsed or continuous light Pulse repetition rate (PRR) Patient parametres Treatment area Treatment intervals Pre- or postoperative treatment? Treatment method parametres Local treatment Shallow problems Deeper problems Treating inside the body Systemic treatments Acupuncture Trigger points Spinal processes Dermatome Blood irradiation Irradiation of lymph nodes Irradiation of ganglions Combination treatment Interaction with medication Other considerations What about collimation? Depth of penetration, greatest active depth Factors that reduce penetration Tissue compression How deep does the light penetrate? Laser light irradiation through clothes The importance of the tissue and cell condition The importance of ambient light In vitro/in vivo Laser Therapy with high output lasers Laser therapy with carbon dioxide lasers Laser therapy with Nd:YAG lasers Laser therapy with ruby lasers Laser therapy with Er:YAG lasers Laser therapy with surgical diode lasers Risks and side effects The importance of a correct diagnose Cancer

4 Cytogenetic effects? A false picture of health Tiredness Pain reaction Do high doses of laser therapy damage tissue? Is it only an effect of temperature? Protection against radiation injury How to measure effects of laser therapy Thermography Magnetic resonance imaging High resolution digitised ultrasound B-scan Tensile strength Other objective methods Does it have to be a laser? FDA (Food and Drug Administration) How well documented? Confused? The funding of research As time goes by Chapter 4. Medical indications Who and what can be treated? Acne Allergy Antibiotic resistance Arteriosclerosis Arthritis Asthma Blood preservation Blood pressure Bone regeneration Burning mouth syndrome Cancer Cardiac conditions Carpal tunnel syndrome Cerebral palsy Crural and venous ulcers Delayed onset muscular soreness (DOMS) Depression, psychosomatic problems Diabetes Duodenal/gastric ulcer Epicondylitis Erythema multiforme major Fibrositis/fibromyalgia Headache/Migraine Haemorrhoids Hair loss

5 Herpes simplex Immune system modulation Inflammation Inner ear conditions Laryngitis Lichen Low back pain Mastitis Microcirculation Morbus Sluder Mucositis Muscle regeneration Mycosis Nerve conduction Nerve regeneration and function Oedema Ophthalmic problems Pain Periostitis Plantar fasciitis Salivary glands Sinuitis Spinal cord injuries Snake bites Sports injuries Stem cells Stroke, irradiation of the brain Tendinopathies Tinnitus, vertigo, Ménière s disease Tonsillitis Trigeminal neuralgia Thrombophlebitis Tuberculosis Urology Warts Whiplash-associated disorders Vitiligo Womens health Wound healing Zoster Indications in the pipeline Alzheimer s disease Botox failures Cellulites Cholesterol reduction Complex regional pain syndrome (CRPS)

6 Eczema Erectile dysfunction Familiar amyotrophic lateral sclerosis (FALS) Glomerulonephritis Obesity Orofacial granulomatosis Parkinson s disease Post-menstrual stress Pemphigus vulgaris Sleeping disorders Withdrawal periods Wrinkles Consumer lasers Chapter 5. Dental LPT The dental laser literature On which patients can LPT be used? Dental indications Alveolitis Anaesthetics Aphthae Bleeding Bisphosphonate Related Osteonecrosis of the Jaw Caries Dentitio dificilis (pericoronitis) Endodontics Extraction Gingivitis Herpes zoster Hypersensitive dentine Implantology Leukoplakia Lingua geographica (glossitis) Lip wounds Nausea Nerve injury Orthodontics Mild dental pain Paediatric dental treatment Periodontics Prosthetics Root fractures Secondary dentine formation Temperature caveats Temporo-mandibular disorders (TMD) TMD and endodontics Other dental laser applications

7 Dental photo dynamic therapy Composite curing Demineralisation Tooth bleaching Caries detection Lasers as a diagnostic tool Case reports Chapter 6. Non coherent light sources Chapter 7. Veterinary use Case reports Chapter 8. Contra indications Pacemakers Pregnancy Epilepsy Thyroid gland Children Cancer Haemophilia Irradiation of the brain Radiation therapy patients Diabetes Tatoos Light sensitivity Chapter 9. Coherence The role of coherence in laser phototherapy Introduction Summary Numeric references in chapter Chapter 10. The difficult dose and intensity Basics about energy Output power Power density The laser beam The laser probe Pulsed lasers Energy density Treatment dose The dose does not depend on the intensity Dose per point More about treatment technique Chapter 11. The Mechanisms Are the biostimulative effects laser specific? Is it possible to prove that laser therapy doesn't work? Comparisons between coherent and non-coherent light What is the importance of the length of coherence? Hode s hamburger...704

8 Hode s big burger Abrahamson s apple Moonlight How deep does light penetrate into tissue? Bright Light Phototherapy Similarities and differences Possible primary mechanisms Polarisation effects What characterises the light in a laser speckle Porphyrins and polarised light Cell cultures and tissue have different optical properties The effect of heat development in the tissue Macroscopic heating The microscopic heat effect Mechanical forces Excitation effects Primary reactions due to excitation Secondary reactions due to cell signalling Fluorescence luminescence Multi-photon effects Lasing effects in tissue Non-linear optical effects Opto-acoustic waves Secondary mechanisms Effects on pain Effects on blood circulation Stimulatory and regulatory mechanisms Effects on the immune system Other interesting possibilities Summary of mechanisms Diagnostics with therapeutic lasers Photodynamic Therapy PDT Other medical uses of lasers Chapter 12. A guide for scientific work Methodology of a trial Parameters Technical parameters Treatment parameters Medical parameters Closer description of the technical parameters ) Name of instrument (producer) ) Laser type and wavelength ) Laser beam characteristics ) Number of sources ) Beam delivery system ) Pulsed or continuous emission

9 7) Output power ) Power density at probe aperture ) Calibration of the instrument Closer description of the treatment parameters ) Treatment area ) Dose: Energy density ) Dose per treatment and total dose ) Intensity: Power density ) Treatment method ) Treatment distance (spot size), type of movement, scanning ) Sites of treatment ) Number of treatment sessions ) Frequency of treatment sessions Closer description of the medical parameters ) Description of the problem to be treated ) Patients (number, age, sex) ) Exclusion criteria ) Inclusion criteria ) Condition of patient ) Pre-, parallel- or post-medication ) Treated with other methods before ) Drop-out rate ) Follow up ) Outcome measures ) Statistical Analysis ) Economy Gallium-aluminium and all that Recommendations of WALT - The World Association for Laser Therapy Chapter 13. The laser phototherapy literature The importance of reporting all laser parameters - even in the abstract Diclofenac, dexamethasone or laser phototherapy? Another pithole in LPT research Database of Abstracts of Reviews of Effects (DARE) The wound healing contradiction Wikipedia Poor documentation compared to what? LPT equipment and the future English language books on LPT: Books in other languages, with ISBN Laser phototherapy journals Information for your patient Numeric references referred to in the book Abbreviations