Diode Laser uses in Skin Tightening

Dr. Mohammad Saleem *¹, Dr. Dheyaa Al-Alkharsa ², Dr. Areej Abdulhamid Farhat ³,
Dr. Ahmad Jamal Bany Younis ⁴, Wayne Selting ⁵, Afnan Mohammed Shawal BDS⁶, Isra Mohammed Shawal  BDS⁷

1.Dentist and Oral Maxillofacial Surgeon, B.D.S, Msc, ABLS.

2.Dentist Germany, USA.

3.Bachelor of dental surgery, Master’s in Public Health Education at USF and Registered Dental Hygienist in Tampa Florida.

4.BDS Cairo University.

5.Department of Surgical Science and integrated Diagnostics, University of Genoa, Largo R. Benzi 10-16132 Genoa Italy.

*Correspondence to: Dr. Mohammad Saleem, Dentist and Oral Maxillofacial Surgeon, B.D.S, Msc, ABLS.

Copyright

© 2024 Dr. Mohammad Saleem. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 11 March 2024

Published: 29 March 2024

Abstract

Diode Laser is a modern non-invasive therapeutic method used for skin tightening. It can be successfully employed in several medical fields including dermatology, urology, ophthalmology, cardiology, dentistry, and immunology. Numerous authors, therefore, have studied this technique in order to improve its efficacy. Significant advancement has been achieved with regard to Diode Laser. Substantial progress was also obtained with respect to Diode for the treatment of skin lesions with emphasis on cutaneous precancerous lesions. This report will explain how Diode laser is used in skin tightening and what is the best technique that will give me the best skin tightening result. Also I will talk about laser biophysics and skin anatomy.

Keyword: Diode,mid infrared, Laser, Skin, Rejuvenation.

Introduction

Light is a form of electromagnetic energy that exists as a particle and that travels in waves at a constant velocity. Unit of this radiant energy is called a photon.

The waves of photons travel at the speed of light and can be defined by two basic properties: amplitude and wavelength.

Amplitude is defined as the vertical height of the wave from the zero axis to its peak as it moves around that axis.

The second property of a wave is wavelength (λ), the horizontal distance between any two corresponding points on the wave.

What is a Laser?

The word laser is an acronym for light amplification by stimulated emission of radiation. Laser is not the same as normal light it has a specific characteristic :

Monochromatic: It is generated as a beam of a single color, which is invisible if its wavelength is outside of the visible part of the spectrum.

Coherent, or identical in physical size and shape. Thus the amplitude and frequency of all of the waves of photons are identical. This coherence results in the production of a specific form of focused electromagnetic energy.

Collimated (produced with all waves parallel to each other) over a long distance, but once the laser beam enters certain delivery systems such as optical fibers or tips.

Amplification

Amplification is the part of this process that occurs inside the laserCavity , this laser cavity composed of

Active medium:Lasers are generically named for the material of the active medium, which can be

1.A container of gas, such as a canister of carbon dioxide (CO2) gas in a CO2 laser;

2.A solid crystal, such as that in an erbium-doped YAG (Er:YAG) laser;

3.A solid-state semiconductor, such as the semiconductors found in diode lasers;

4.A liquid, such as that used in some medical laser devices

Pumping mechanism drives energy into the active medium.

Optical resonator is composed of two mirrors, one at each end of the optical cavity, placed parallel to each other; or in the case of a semiconductor diode laser, two polished surfaces at each end. These mirrors or polished surfaces act as optical resonators, reflecting the waves back and forth, and help to collimate and amplify the developing beam

Laser Delivery Systems

Laser energy should be delivered to the surgical site by a method that is ergonomic and precise.8 Shorter-wavelength instruments.

Flexible fiberoptic systems with bare glass fibers that deliver the laser energy to the target tissue

Semiflexible hollow waveguides

Articulated arms

Some of these systems employ small quartz or sapphire tips that attach to the laser device for contact with target tissue; others employ noncontact tips

Emission Modes

1.Continuous-wave mode, in which the beam is emitted at only one power level for as long as the operator depresses the foot switch.

2.Gated-pulse mode, characterized by periodic alternations of the laser energy, similar to a blinking light. This mode is achieved by the opening and closing of a mechanical shutter in front of the beam path of a continuous-wave emission

3.Free-running pulsed mode

This emission is unique in that large peak energies of laser light are emitted usually for microseconds, followed by a relatively long time in which the laser is off. For example, with a free-running pulsed laser with pulse duration of 100 μsec and pulses delivered at 10 per second (10 Hz), the energy at the surgical site is present for 0.01% of a second and absent for the remaining 99.99% of that second.

Laser Effects on Tissue

• Reflection Simply the beam being redirected off the surface, with no effect on the target tissue.
• Absorption of the laser energy by the intended target tissue usually is the most desirable effect.
• Transmission Of the laser energy directly through the tissue, with no effect on the target tissue

Scattering Of the laser light, which weakens the intended energy

Laser-tissue interaction:

Photothermal, which means the laser energy, is transformed into heat. The three primary photothermal laser-tissue interactions are incision/ excision, ablation/vaporization, and hemostasis/coagulation

1.A laser beam in focus with a small spot size is used for incision/excision procedures

2.A laser beam with a wider spot size will interact with the tissue over a wider area, but more superficially, producing a surface ablation

3.A laser beam out of focus will produce hemostasis/ coagulation

Photochemical effects occur when the laser is used to stimulate chemical reactions, such as the curing of composite resin by an argon laser.

Photobiostimulation: A laser can be used in a nonsurgical mode for more rapid wound healing, pain relief, increased collagen growth, and a general anti-inflammatory effect.

The photoacoustic effect of laser light. This process often is called spallation. The pulse of laser energy on hard dentinal and osseous tissues can produce a shock wave

Tissue Temperature

Most laser actions produce heat for the target tissue

Laser emission modes play an important role in increasing the tissue temperature. The important principle of any laser emission mode is that the light energy strikes the tissue for a certain length of time, producing a thermal interaction.16 If the laser is used in a pulsed mode, the targeted tissue may have time to cool before the next pulse of laser energy is emitted.

Various pulse parameters

Absorption of Laser Energy by Dental Tissues

Different laser wavelengths have different absorption coefficients, with the primary oral tissue components of water pigment, blood constituents, and minerals (Figure 2-27). Laser energy can therefore be reflected, absorbed, transmitted, or scattered, depending on the composition of the target tissue. The primary absorbers of specific laser energy are called chromophores

Each laser wavelength will affect the interrelated components of the target tissue: water content, color of the tissue, vascularity, and chemical composition. The diameter of the laser spot on the tissue, or spot size, whether delivered in contact or noncontact with the tissue, will create a certain amount of energy per square millimeter of tissue. This is called energy density. the smaller the spot size, the greater the fluence For example, a beam diameter of 200 μm, compared with a beam diameter of 300 μm at the same output setting, will have more than twice as much energy density.Also The amount of time during which the beam is allowed to strike the target tissue will affect the rate of tissue. There are many other factors that affect the laser tissue temperature like Using a water or air spray can cool the tissue, which would affect the rate of vaporization  ,Repetition rate of the pulsed-laser emission mode and Hand speed: the speed of moving the laser through the tissue.

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