Biolase Waterlase MD Case Study: Better Cosmetic Results, Better Patient Experience

If your patients are like a majority of our patients, they are always in a rush and seeking the quickest way to accomplish the dentistry they need or desire. We live in a world of instant gratification and everyone is seeking convenience, speed, cost savings, and a better end result. It's rare to find any product or device that makes our clinical success easier and more predictable, and saves time.

Laser benefits

Laser assisted dentistry offers the clinician all of the above. Today we are performing old procedures in new ways and obtaining equal or better results in a minimally invasive manner. Who would have thought that procedures such as gingival recontouring, frenectomies, and restorative dentistry could even be attempted without local anesthesia? Today, in the hands of a trained and competent dentist these procedures are becoming routine and more and more patients are hearing the shouts of joy from their friends who have experienced the difference of laser dentistry.
Few dentist will pass up any technology that differentiates there practice from all the rest and offers undeniable benefits to their patients. Clinical dental lasers are just that type of technology. I encourage everyone to ask questions and take time to carefully deliberate the investment, but be open-minded enough to recognize the enormous benefits for your patients and your dental office.

Case study

The following is a case I would like to share that illustrates the typical patient seeking cosmetic care in our office. By utilizing laser technology we were able to accomplish complex treatment in a short period of time while obtaining excellent tissue health, as well as a nice cosmetic result that created an advocate for our office and for laser technology.
This 25-year old patient (Fig. 1) wants to obtain a more adult appearance by getting rid of both her "gummy smile" and the bulbous areas of teeth (Figs. 2a, b, and c show the pre-operative natural smile).

Orthodontic correction had been completed 1 year prior to consultation. Patient wants "Rock Star" white color (value) but wants her new smile to harmonize with her facial features and skin tone. Patient specifically requested porcelain veneers.
The options presented were: 1) whitening, 2) add gingival re-contouring and enamelplasty to re-contour existing bulbous cervical areas that were of concern to the patient. 3) Porcelain veneers with gingival recontouring and osseous crown lengthening in areas that biologic width must be violated to obtain correct gingival zenith heights determined during smile design.
Gingival zeniths are marked (Fig 3a) and raised Fig 3b with the Waterlase MD Er, Cr; YSGG laser system. Osseous correction is accomplished over #7-#10 utilizing a closed technique to modify the bone architecture between line angles and not encroaching into the interproximal area.

Temporary restorations are placed (Fig. 4) and gingival tissue is evaluated for desired aesthetic outcome. Once the patient documents that she is satisfied with the corrections, she is released and fabrication of the final porcelain restorations proceeds.

Figs.5a and b show the definitive porcelain restorations prior to try-in and evaluation.

Final restorations bonded and final tissue contours 4 weeks after initial preparation are shown in Figs 6a, b, and c. Note tissue contour stability and health (Fig 6d).

The patient satisfied her aesthetic goals (Before and After images) and was pleasantly surprised that a complete solution was possible in such a short period of time (three weeks).

Conclusion

This case illustrates how our conservative approach to treatment can be reinforced by utilizing minimally invasive tools such as the Waterlase MD. There are many ways to accomplish any given dental task and no one uses the same bur for every preparation or the same hand instrument for every task. With that in mind, consider the Waterlase MD as another tool that can be utilized and added to your clinical "tool box." When presented with daily task such as crown lengthening and gingival re-contouring remember, there may be many ways to accomplish the same task, today they involve minimally invasive techniques that eliminate scalpel and/ or other mechanical methods.
A positive patient experience is a powerful tool that you can utilize to grow and expand your practice. Itfs an exciting time in dentistry and every visit is an opportunity to let our patients know why they should be excited as well.