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Aesthetic Shaping of The Smile with the OpusDent Opus 10 Diode Laser
In today's world we are continually looking for ways to give our patients what they are looking for. Many people have talked about the golden age of dentistry as if it occurred some time in the past.
I believe that today is actually the best time to be practicing dentistry ever. We have technologies available to us that doctors in the past could only dream of. Interestingly what the mind of man has dreamed of he has achieved. One such technology in our practice today is the family of OpusDent Lasers.
OpusDent, the dental subsidiary of Lumenis, has developed a line of lasers for the dental community that is absolutely impressive. The Erbium:YAG laser is used primarily for cutting and shaping hard tissues in the mouth. The CO2 and the diode lasers are used for cutting soft tissues in the mouth.
Dental Lasers: Sights and Sounds
Watch a short clip demonstrating the use of an Erbium dental laser and the typical sounds generated by lasing procedures. See and hear how modern laser devices are used by a dentist and the dental assistant for comfortable and effortless lasing treatments. A popular technology combined with Sedation Dentistry, to minimize the need for anxiety management medications.
The Opus10 diode laser is the best instrument to use when dealing with aesthetic issues in the anterior of the mouth. It is a solid state diode laser, operating at 830 nm using a 360 micron fiber directly on soft tissue enabling us to ablate the gums and achieve desired proportions. It creates the least amount of collateral damage to the soft tissues of any treatment modality we are aware of and it also provides the most control regarding the final position of the soft tissues after surgery and recovery. The surgical recovery period is virtually non-existent.
In this article we will outline one case where we were able to give an ideal smile to a patient who had undergone many years of Orthodontic therapy yet still did not have the smile of her dreams. From a dental standpoint a fantastic result had been achieved. But aesthetically there was still a problem - the patient still had a unilateral "gummy" smile.
Nitrous oxide sedation was administered to relax the patient. No local anesthetic was necessary and we monitored the patient's discomfort during the procedure. The tissue was sculpted using one to two watts of power in continuous wave mode. The patient indicated if any discomfort occurred and the power was adjusted accordingly.
We removed the appropriate amount of tissue from the teeth and were able to exactly sculpt the tissue to enhance the proportions we wanted. This allowed us to create the correct golden proportions of the teeth themselves as well as the height and width proportions we were looking for. We also placed the zenith of the tooth in exactly the place that we wanted it placed. We were able to broaden the buccal corridors by reshaping the soft tissue above the bicuspids and molars as well. ( Photos 1, 2, 7 & 8)
The Orthodontist had placed the incisal edges exactly where we wanted them to be so that they followed the curvature of her lower lip. The laser allowed us to adjust the gingival portions of the smile to flow with the upper lip. In this instance since we had an asymmetrical smile we used the lips to help us decide how much tissue to remove on each side. Note that we removed less tissue from the right side of the mouth than we did on the left side.
The patient was and has been ecstatic since the procedure was completed. Once we were through with the procedure the patient was able to leave the office and go back to school. Later that night she received an award at her school. If we had done the surgery with conventional techniques she would most likely been at home that night instead of receiving her award.
My experience is that no other method available today provides the results I get with the diode laser.
It is important to let the laser do the cutting for you and try not to push the tissue away with the end of the fiber. It is not a knife and we do not need to try to use it like a knife or blade. If you gently touch the fiber to the tissue it will ablate the tissue for you and in most instances the patient will only feel you touching the tissue.
An AGFA digital camera along with Image Fx software was used to take digital photographs during the surgery to help determine if we had actually accomplished what we had intended. Digital imaging during surgery provides the immediate ability to thoroughly evaluate all of the aesthetic issues without having to wait for film to be developed. It also gives the patient a chance to see and approve the outcome. Then, if any further surgery is needed, it can be done during the same sitting, rather than waiting until the patient recovers and returns at a follow up appointment.
Properly preparing the patient for laser surgery can have an impressive impact on the amount of dentistry we are able to do without using anaesthesia. We place a mirror in the patient's hand and rub the fiber on the gum with the laser is off, while they watch. This allows them to know what they will feel us as we remove the tissue. Many patients elect surgery without sedation, although there will always be some who want sedation with any procedure. Some procedures do require anesthesia but it is surprising how many do not.
The Opus 10 diode laser is the best laser in the OpusDent family of lasers in my hands for exactly shaping the gums in the anterior of the mouth. It can also do many other procedures that you can learn about if you visit Opus on their web site at www.Opusdent.com.
Dr. Sanderson practices Comprehensive Laser Assisted Dentistry in Birmingham Alabama. He uses an Er:YAG laser primarily for cutting and shaping hard tissues in the mouth during procedures such as caries removal, cavity preparation and enamel etching, while a CO2 or a diode laser is used for cutting soft tissues in the mouth during procedures such as gingival re-contouring, and soft tissue crown lengthening.
The inclusion of lasers in his clinic has offered an additional tool to perform a variety of dental procedures with excellent aesthetic results, quick patient recovery and fewer post-operative complications.
His practice is strongly influenced by the time he has spent at the LD Pankey Institute. You can learn more about him and his practice on the web at www.birmingham-laser-dentistry.com
James Sanderson, DMD
Alabama Teeth In An Hour
Alabama Sedation Dentist
1633 Montgomery Highway
Birmingham, AL 35216
(205) 979-6005
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