The intraoral use of lasers in oral and maxillofacial surgery has evolved over the last 4 decades as clinical experience along with scientific investigation has increased the body of knowledge. Although the first laser was introduced in 1960 by Theodore Mai-man [1], it was not until 1964, when Patel [2] developed the first continuous-wave carbon-dioxide (CO_2) device, that the laser became a viable intraoral surgical tool. Before the adaptation of CO_2 as a lasing medium, the surgical application of lasers was limited due to their lack of absorption by biologic tissues. With an infrared wavelength of 10,600 nm, the CO_2 laser is highly absorbed by water and, therefore, is highly useful for soft tissue surgery. In 1970, Polanyi [3] wag the first to incise living tissue with a CO_2 laser and subsequently developed handheld instrumentation in the form of a handpiece delivery system that enhanced the ability to use the laser on biologic tissues. Concurrent with the development of the CO_2 laser was the research of Johnson [4] on the Nd:YAG laser, which also found intraoral surgical applications. A wide array of subsequent lasing media with unique radiant-energy wavelengths has been employed successfully for varying indications and types of tissue, including the argon, pulsed dye, copper vapor, holmium:YAG, erbium:YAG, and potassium titanyl phosphate lasers. This article primarily discusses the intraoral use of the CO_2 laser; specific intraoral applications of other lasers also are described.
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