The laser advantage

In restorative dentistry, close attention must be paid not only to the restoration, but to the area surrounding the restoration as well. This type of thinking should be applied to provide the esthetics and functionality the patient seeks. Therefore, to provide the best in patient comfort and minimally invasive procedures, practitioners must maintain familiarity with the newest instruments and techniques available through innovation and product development.

Of these new instruments, the soft-tissue diode is one that should be added to every restorative and esthetic dental practitioner’s arsenal. Soft-tissue diode laser techniques are proven to be more efficient and gentle when compared with previous procedures. These lasers also are much less traumatic to the surrounding areas and the patient.¹

What they can do for your practice

Soft-tissue diode lasers not only give practitioners the ability to precisely complete routine procedures performed in general practice, but also many procedures they previously would have referred to specialists. They are particularly useful for gingivectomies to facilitate caries removal and enhance a smile’s esthetics in a minimally invasive way. When used to create a trough around prepared teeth, these lasers also can improve the quality of daily impression taking, resulting in impressions that are cleaner and more accurate.

What they can do for your patients

Soft-tissue diode lasers use an energy wavelength of 810 to 980 nm, a level proven to demonstrate a high affinity for soft tissue.¹ Diode lasers also demonstrate photo-thermal effects to ablate, or cut and seal, soft tissue through vaporization.² As a result, patients tend to experience far less post-operative discomfort, as well as significantly less collateral damage to otherwise healthy surrounding tissue areas.

Soft-tissue diode lasers also have the ability to achieve simultaneous cutting and coagulation.² This advancement in laser technology provides an immediate hemostasis with far less tissue-charring and a reduction of bacteria that lessens the incidence of post-procedure bacterial and viral infections.¹ In contrast, conventional methods and instruments, such as scalpels, contribute to patient discomfort because they involve steel, pressure and mechanical friction to cut soft tissue. These methods and instruments often result in excessive bleeding, swelling and discomfort, as well as a need for postsurgical dressings.²

Today’s laser

Previous generations of soft-tissue diode lasers tended to be cumbersome and heavy, with fiber systems that were expensive and difficult to manage. Newer generations, such as Ivoclar Vivadent’s Odyssey 2.4G laser, incorporate innovations that make the laser easier to handle. The Odyssey 2.4G laser features a retractable fiber management system to avoid costly fiber breakage, simplify use and reduce overall cost. The Odyssey Navigator is another soft-tissue diode laser model that features a compact size and disposable fiber tips that fit on the handpiece.

These lasers are routinely used in a variety of surgical soft-tissue procedures. When used adjunctively with CAD/CAM procedures, the Odyssey lasers are proven to provide excellent hemostasis, create bloodless troughs before impressioning and promote a positive post-operative tissue response (Fig. 1).¹ Note that for CAD/CAM procedures, the creation of a bloodless trough, which separates soft tissue from existing tooth structure, helps prevent the formation of a “powder bridge” during digital impressioning (Fig. 2).

They’re portable

The Odyssey soft-tissue diode lasers are lightweight and can be easily transported from operatory to operatory, unlike past models. A docking cradle easily secures to a countertop, providing mobility and a charging base for the rechargeable lithium ion battery.² Units such as these promote freedom of movement throughout the practice, enabling practitioners to use the laser wherever it is needed.

In comparison, earlier soft-tissue laser models were bulky and difficult to use and relocate. Also, whereas previous generations of soft tissue lasers required cleaving and stripping of the fiber optic tip before operation, the Odyssey Navigator uses uni-dose fiber tips that are pre-stripped and cleaved, facilitating efficient, easy operation.²

Using the settings

The Odyssey Navigator soft-tissue diode laser features more than 30 pre-set clinical settings, which are factory-installed in its intuitive software.2 This software also enables dentists to create their own programs and settings.² The technology, design and features of these lasers provide clinicians with greater ease of use and more flexibility than previously available.

Each clinical situation is different, and appropriate power settings are determined primarily by the type of lesion, vascularity of the soft tissue (a more fibrous tissue may require a higher power setting), or the selected mode of operation, which can be continuous or pulsed.²

The cutting speed the dentist prefers also will determine the power intensity necessary. However, dentists should use the lowest power setting that will effectively modify the tissue while not charring the surrounding tissue.²

Troughing for impressions

Soft-tissue diode lasers are useful when treatment planning calls for troughing around subgingival preparations, eliminating the need to purchase and place packing cords.² By using lasers such as the Odyssey, troughing procedures are simple, and bleeding is often stopped or prevented completely. As a result, clinicians can capture an impression without the negative effects of blood, ensuring a predictable restoration every time.² Gingival troughing using a soft-tissue diode laser can be initiated in the “Continuous Wave” mode with contact being made with the fiber optic tip, beginning at 0.8W2. The fiber is then angled against the tooth, with light pressure, during the lasing process.²

Case study

A patient presented with an existing crown on tooth No. 20, which needed replacement because of subgingival marginal caries (Fig. 3). Once the previous crown and caries were removed, the preparation presented subgingivally as expected. The soft tissue surrounding the preparation exhibited a moderate amount of bleeding, which needed to be controlled before powdering and optical impressioning (Fig. 4).

An Odyssey Navigator diode laser was used to achieve hemostasis around the preparation, as well as to create a gingival trough. This was accomplished using a power setting of 1.5W for 30 seconds. The area was then cleansed with chlorhexidine using a cotton pellet, after which a light coating of powder was applied to the preparation. Once these steps were complete, bleeding was under control and an optical impression could be taken of the preparation (Fig. 5).

Following the optical impression, an IPS Empress CAD LT crown in shade A3 was fabricated. The restoration was polished and seated using translucent Multilink adhesive resin cement (Fig. 6). The patient was pleased with the restoration’s esthetics and functionality.

They’ll be your practice’s workhorses

Odyssey lasers provide dentists with a full range of settings and features that make them more user-friendly compared with the bulky laser units of the past. The operator can customize programs and settings, choose between pulse modes and continuous power settings, as well as aim the beam intensity. Because they are lightweight and portable, the easy-to-use units provide greater mobility. These lasers are considered durable workhorses that can be used in a variety of applications, and are backed by Ivoclar Vivadent’s service and support.