# Magnetic Mallet and Laser for a Minimally Invasive Implantology: A Full Arch Case Report
## 1 Introduction
### Lasers in Dentistry  
The laser is light and is characterized by its specific wavelength. The laser (Light Amplification by Stimulated Emission of Radiation) is an electromedical device which, after the input of energy, determines the emission by specific chemical elements of an electromagnetic radiation, light, at a high intensity, with monochromatic characteristics, coherence and unidirectionality.  
There are many lasers used in dentistry [15] and they differ from each other mainly in the active medium that feeds them (erbium, CO\({}_{2}\), diodes...). Each active medium (source) emits its own wave-like radiant energy with its own wavelength. The various wavelengths have different affinities with the various elements of the organism.  
Most medical lasers are in the invisible field. Below 375 nm there is the range of UV rays, above 775 there are infrared rays. Both ultraviolet and infrared are invisible as the human eye perceives light between 375 and 775 nm.  
Depending on the target and wavelength, the laser will have different effects.  
Er: the YAG laser and CO\({}_{2}\) laser are very much absorbed by water and hydroxyapatite and therefore by target tissues (soft and hard tissues); consequently, the penetration into the tissues is very low (2 microns for the Er: YAG laser, 20 microns for the CO\({}_{2}\) laser) and therefore does not cause any effect in depth. On the contrary, diodes and Nd: YAG lasers penetrate very deeply, so in addition to having a visible effect on the surface, they can also have effects that are not visible in depth. It is precisely on these effects that laser therapy in periodonontology and oral surgery are based.  
Based on the concept that the laser transforms light energy into thermal energy, it is evident that the effects of the lasers on tissues are due to the same increase in temperature due to the transfer of thermal energy by the laser sources.  
Precisely because of important and localized increases in temperature, it is possible to obtain, with lasers, the first and most evident effect, as it is visible: tissue ablation.  
In fact, the volatilization of the tissues occurs when the temperature exceeds 100 degrees centigrade.  
If the localized temperature increases significantly, it will be possible to have protein denaturation effects with the dissolution of collagen (between 50 \({}^{\circ}\)C and 75 \({}^{\circ}\)C). This determines coagulation effects, however irreversible the denaturation of the tissues. If, on the other hand, it is possible to keep the localized temperature increase below 50 \({}^{\circ}\)C, there will be only a slight vasodilation, without irreversible changes in the tissues affected by the laser effect.  
The differences in the effects on the target surface of poorly penetrating (erbium, CO\({}_{2}\)) and very penetrating (diodes, Nd: YAG, Helio-Neon) lasers are important:  
* Both laser families have photoablative effects;
* Low penetrating lasers do not go deep, and they have thermal effects but do not have great photodynamic and decontaminating effects. They are ideal for their ablative abilities on hard tissues (Er: YAG) and on soft tissues (CO\({}_{2}\) and Er: YAG);
* Highly penetrating lasers have ablative, thermal (strong, medium, weak), photodynamic (or decontaminating) and biostimulating effects. The deeper we go into the fabric, the more the decontaminating and biostimulating effects increase and the thermal ones are reduced.