DPR

Fig. 01 Pretreatment condition of obvious occlusal decay on Nos. 19 and 30 with fleeting symptoms of sensitivity to sweets and cold drinks.

Fig. 02 The Solea handpiece has excellent ergonomics and a small head that internally contains a mirror to help reflect and guide the laser beam.

Fig. 03 Very precise ablation of enamel and dentin reduces loss of tooth structure, especially the triangular ridges and peripheral rim of enamel that preserves the internal and outer strength of the tooth.

Fig. 04 Final post-operative view using Shofu BeautiFil (a GIOMER) with color and gloss that mimics natural teeth.

Fig. 05 A conservative Class I amalgam shows a halo of underlying breakdown around the older restoration.

Fig. 06 Using CariVu (DEXIS), cracks in the enamel and dentin are evident. They become added biomechanical risk factors to review and plan with the patient and dental team so there are no surprises in care.

Fig. 07 Utilizing laser analgesia techniques and quick/delicate amalgam removal with a 245 bur (Microcopy), the decay and crack cleansing can be completed with the Solea laser.

Fig. 08 Final preparation preserves enamel and dentin so a “bioactive” restoration can be done with GIOMER.

Fig. 09 Research by Senda/Moroiki and Mujdeci have shown particle abrasion (27-micron aluminum oxide powder) done with PrepStart (Danville Materials) that will improve bond strengths after using the laser and for long-term durability.

Fig. 10 Beautibond (Shofu) is a low acidity self-etching primer and has dual monomers to create equal bond strength to dentin and enamel.

Fig. 11 Beautifil II (Shofu) uses GIOMER technology that has various ion release, fluoride recharge and acid neutralization effects that have been documented in a 13-year in vivo study at the University of Florida.

Fig. 12 The post-operative result gives the patient long-term confidence of pulpal protection and tooth strength by being proactive in diagnostic and restorative care.

Fig. 13 Patient has an unnyouthful smile due to wear and decalcification during and after orthodontic care.

Fig. 14 Close-up of teeth shows the details of the defects, as well as the altered proportions of anterior four teeth.

Fig. 15 After remineralization care and occlusal therapy, the restorative care begins with a slight alteration of the gingival frame around the central incisors to create a better width-to-length ratio. This was done with the Solea laser in soft-tissue mode at a 22-μs pulse duration with a light mist and spot size of 0.25 mm for high precision cuts.

Fig. 16 Post laser gum lift with no hemorrhage to complicate restorative care.

Fig. 17 Decay removal is very conservative and precise in areas of decalcification. No anesthesia was used.

Fig. 18 The Solea touch pad control allows a dentist to conveniently and intuitively set the tissue target, beam size, energy levels and mist volume, as well as regulate the power.

Fig. 19 Minimal preparation allows enamel bonding for long-term predictability.

Fig. 20 Microabrasion creates very clean surfaces, adapting all material to tooth surfaces.

Fig. 21 Phosphoric acid etching still remains the standard for cosmetic bonding of enamel. Teeth are isolated with mylar strips.

Fig. 22 ALL-BOND UNIVERSAL adhesive (BISCO) has a long-lasting (durable) bond strength that is hydrophilic (good-wetting) before curing; after curing, it is more hydrophobic (nonpermeable and durable) than other adhesives.

Fig. 23 Adapting Aura composite E1 (SDI) is nonsticky due to less uncured resin used and creamy handling and simulates youthful enamel with a high opalescence and some degree of translucency.

Fig. 24 Aura is easy to polish to a mirror finish with a 16-fluted carbide polishing bur for gross adjustments and polishing discs for refinement.

Fig. 25 Post-treatment photo shows a patient who is much more confident in her appearance.

Fig. 26 Close-up photo demonstrates the beautiful integration of esthetics, biology and function.