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Video Details
Effective Restorative Dentistry Using CO2 Hard Tissue Laser

Description:
The CO2 9.3um hard tissue laser has made restorative dentistry more acceptable to patients mainly due to the lack of local anesthesia required for most all restorations. Procedures will be shown on both virgin teeth as well as replacement of previous restorations. What has been most impressive is how the cutting speed can be varied in both enamel and dentin. Also the efficiency as well as the simplicity of operation will be included. Finally, you will see patient responses after the procedures showing the effectiveness of the laser in anesthetizing the teeth being treated.

Date Added:
2/11/2015

Author(s):

Ronald Goldstein, DDS Ronald Goldstein, DDS
Dr. Ronald Goldstein is currently Clinical Professor of Oral Rehabilitation at Georgia Regents University College of Dental Medicine in Augusta, Georgia, Adjunct Clinic...
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David M. Fantarella, DMD, PC David M. Fantarella, DMD, PC
Dr. David Fantarella has been in practice as a general dentist in Hamden and North Haven, Connecticut for 16 years. He specializes in general, implant, cosmetic and las...
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Questions & Comments
David Fantarella - (2/26/2015 3:00 PM)

I checked with the manufacturer and they settled on 9.3 for a few reasons. While 9.6 is more highly absorbed, it is also more highly reflected which results in a brighter plume of light at the point of cutting. 9.6 is also more likely to melt vs. ablate the enamel. The melted enamel is harder to cut and probably harder to bond to. Lastly 9.3 micron lasers are more readily available in other applications which keeps cost down and reliability up. The laser inside of Solea is water cooled. I typically use the 1 mm pattern in the Enamel setting on Solea with a 10 microsecond pulse duration to achieve analgesia, though I have been using longer pulse durations (around 25 microseconds) in the Enamel setting from start to finish lately and getting great analgesia there as well. The 10,000 pulses per second are delivered in packets or bursts with pauses in between packets of pulses. The average repetition rate is actually around 2,200 with a 4% duty cycle, meaning the laser is off 96% of the time.

Salam Al Akash - (2/20/2015 5:06 PM)

Thank you for presentation, i enjoyed it 1-i know that CO2 laser with 9.6micrometer is the mostly absorbed in hydroxyapatite (Peak absorption) so what is the point of using this 9.3 instead ! any benefit? 2-What is the cooling system which is used inside the machine ? Fan or something else? 3-In desensitisation process which settings did you use ?cause as we know if we use settings below ablation threshold of enamel or dentine then thermal effect will cause heating of the tissue ! 4- we know that the pulsation of erbium lasers with very short pulse duration is the point behind its ability to ablate dental tissue and we know too that we can not pulsate CO2 laser unless we have high cooling ability ,so you used high repetition rate around 10,000Hz ,the question is ..isn't that increase in repetition rate is driving the beam to be just as a continuous beam !! then how is it ablating dental hard tissue? can you kindly discuss that for me Thanks again for sharing new technology , i appreciate

Glenn van As - (2/14/2015 8:43 PM)

Cool stuff Ron and David...nice to see the laser cutting in real time and to see cases that were treated from a restorative standpoint. Thanks for bringing this new wavelength to our attention and continued success with Solea.

David Fantarella - (2/14/2015 12:06 PM)

Paul, Solea is a modified CO2 laser at 9.3um not native CO2 at 10.6. Because of this wavelength change Solea is a hard and soft tissue dental laser. It is highly absorbed in water and hydroxyapatite (chromophores) which enables it to vaporize every tissue in the oral cavity efficiently. Solea is also the first computer controlled dental laser with galvanometers or small mirrors which manipulate the laser beam and a rheostatic foot pedal like the dental drill which enables the practitioner to vary the power on the fly(also revolutionary). ErbYag lasers energize water to chip away enamel without a computer control or rheostatic foot pedal which limit speed and precision. In terms of conservative dentistry it is possible to retain all healthy tooth structure because the analgesic effect is easily obtained without ablation and the amalgam can be broken up from the center. I use Solea to remove any composite or amalgam restoration and some ceramic restorations. The size of the restoration is insignificant. Solea has the capability of ablating amalgam but it is important to control the vapor. I hope this helps. Thank you for you input. David

Maurice Salama - (2/12/2015 8:20 AM)

CONSERVATIVE DENTISTRY...The Laser Approach. Nice job Ron.

Paul Boulos - (2/12/2015 8:11 AM)

Thanks Dr Goldstein and Dr David. is there any advantage of CO2 laser over ERG YAG, as i got one and stopped using it. i wanted to comment on removing the alg filling by evacuating the enamel around the margin,its not conservative approach. laser does collateral damage to healthy tooth structure. how about large metallic restoration or failing ceramic, do you still use the laser. thank you again and your feed back very much appreciated.

Ronald Goldstein - (2/11/2015 3:26 PM)

Thanks, Arshad... What is exciting to me is that kids should never know the feel of a needle since the laser can anesthetize and then remove any decay so that may well be the future of children's dentistry as well.

Arshad Hasan - (2/11/2015 1:12 PM)

Dr Goldstein & Dr David, what a wonderful presentation. Its surprising how lasers have progressed right under our noses to a point where they can actually be used for tooth prep. And the analgesic effect will be a game changer for sure.

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