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Inside Dentistry
October 2016
Volume 12, Issue 10

The Versatility and Practicality of an All-Tissue Dental Laser

Save time and increase patient satisfaction

Joshua P. Weintraub, DDS

Dental lasers have been available for decades,1 but only now has the technology evolved to the point where lasers can deliver both versatility and practicality to any dental practice. Understanding the different types of dental lasers and their capability is important when considering the needs of a practice. There are a variety of dental lasers with different functionalities and limitations. For example, some lasers cut only soft tissue while others will cut all tissues in the oral cavity.2 With the introduction of these all-tissue lasers, dentists now have the option of using a multi-functional tool that has distinct clinical advantages over traditional instruments, such as the drill and scalpel. Some of these advantages can include:3

• Less need for (injectable) anesthetic
• Ability to complete multi-quadrant dentistry
• Minimal bleeding
• Less need for sutures
• Less postoperative discomfort
• Faster healing times
• Increased preservation of healthy tissue (conservative dentistry)

In addition to clinical advantages, all-tissue dental lasers can also dramatically enhance the patient experience by eliminating the needle, the sound of the drill, and postoperative discomfort—the main contributors to dental phobia. Happy patients are more likely to remain your patient, come in for non-emergency dentistry, and generate referrals. Patient satisfaction is the key to a successful dental practice so it is imperative to consider the patient experience when investing in new technology.

After numerous clinical studies proved its safety,4,5 a 9.3-µm CO2 all-tissue laser (Solea, Convergent Dental, was developed that is cleared for the ablation of soft, hard, and osseous tissue. This is the first and only CO2 all-tissue laser in dentistry. It enables dentists to complete various hard- and soft-tissue procedures quickly with precision and excellent clinical outcomes. The biggest advantage over traditional instruments is this laser’s ability to complete most hard-tissue cases without injectable anesthesia and most soft-tissue cases with minimal bleeding, limited need for suturing, and only topical anesthetic. If injectable anesthetic is not used, this saves time by not injecting the patient, not waiting for them to become numb, and the ability to complete other procedures in different quadrants. With minimal bleeding, visualization of the surgical field is greatly improved. Finally, the patient experience is dramatically enhanced by not using a drill or needle, and reduced postoperative pain.

The following two clinical cases demonstrate this 9.3-µm CO2 all-tissue laser’s ability to complete hard-tissue procedures without anesthesia, and soft-tissue procedures with minimal bleeding, no sutures, and fast healing. Case 1 highlights the versatility of this laser, as the procedure could not be completed with a scalpel. Case 2 focuses more on the everyday procedures that most general dentists will see on a regular basis.

Case 1: Depigmentation and Gingivectomy

A 13-year-old patient presented with puberty/hormone-induced gingival hyperplasia during a consult regarding a gingivectomy. The patient’s mother asked about lightening her daughter’s “dark gums.” A six-tooth gingivectomy and gingival depigmentation was performed. The clinical objective was to remove hypertrophic tissue, expose tooth structure, and remove melanin for a more esthetic smile. Only topical anesthetic was used to complete both the gingivectomy and depigmentation. The total procedure time from start to finish was 20 minutes. The only variables that were adjusted during the procedure were the cutting speed (managed by the variable speed foot pedal), and the spot size (ie, the area of laser ablation). The 1-mm spot size was used to remove the hyperplastic tissue; the 0.25-mm spot size was used to contour the gingiva; and the 1.25-mm spot size was used for depigmentation.

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