Jan Bellows, DVM

    Carbon dioxide (CO2) lasers are used in oral surgery for precisely cutting or vaporizing soft tissue with hemostasis. CO2 lasers intended for dental applications are CW lasers. The CO2 wavelength is absorbed by the water content of oral tissues. Thermal necrosis zones of 100 to 300 lm at cut tissue edges are typical, providing better oral structure safety compared with other lasers (neodymium:yttrium aluminum garnet [Nd:YAG], argon, and diode), which may penetrate up to several millimeters. With the CO2 laser,‘what you see is what you get’ compared with the Nd:YAG laser where no immediately visible change appears in the tissue surrounding the zone of vaporization. With the Nd:YAG laser, it is difficult to estimate the true extend of thermal necrosis. This advantage of replacing traditional excisional techniques with CO2 laser ablation permits removal of the damaged epithelium with as little as 0.1 to 0.2 mm of reversible thermal injury to the submucosa. CO2 lasers are used for oral, soft tissue procedures, such as gingivectomy, gingivoplasty, frenectomy, and biopsy. Tissue vaporization is more efficient with the CO2 laser than with other lasers discussed because of the direct absorption of this wavelength by water..