Dental Tribune U.S. Edition No. 5, 2018

A16 INDUSTRY CLINICAL Dental Tribune U.S. Edition | May 2018 Ankylosed tooth extraction Case shows versatility of all-tissue CO2 9.3 µm laser ByEDr.ETimfthyEAndersfn Case summagy A 16-year-old male was referred by his orthodontist for comprehensive care and the extraction of tooth #T. The patient’s mother was very hesitant to have seda- tion done with the local oral surgeon, so she inquired about the possibility of hav- ing the procedure completed in-office. Tgeatment plan The patient’s condition was diagnosed with radiographs (Fig. 1), which showed a clear tooth ankylosis (Fig. 2), loss of the periodontal ligament space and blend- ing/fusion of the tooth to the bone. The ankylosed tooth would need to be removed in order for the orthodontist to proceed with an orthodontic treatment plan for the patient. Our intended surgical plan was to per- form an atraumatic closed ankylosed tooth extraction as quickly and comfort- ably as possible without having to sedate the patient. This was to be accomplished by using my Solea CO2 all-tissue 9.3 µm dental laser. Technique using the Solea all-tissue CO2 9.3 µm laseg This procedure was performed with one carpule of 2 percent lidocaine with 1:100K epinephrine injectable anesthetic and using the Solea laser with software 3.1.5, using the hard- and soft-tissue se- lection and 100 percent mist. My initial approach to the case was to just elevate and luxate the tooth. How- ever, that resulted in movement on only teeth #28 and #30 due to the extent of the ankylosis. The laser was used to trough the tooth and selectively remove bone around the ankylosed tooth (Fig. 3). The tooth was then sectioned with Solea until access depth and water collec- tion slowed down the ablation (Fig. 4). A surgical handpiece was then utilized to complete the section. As shown by the images, the minimal bleeding and the lack of any need for sutures resulted in a very clean and ef- ficient surgery. The total procedure time was less than 30 minutes (Figs. 5, 6). Fig. 1 Fig. 1: Radiograph shows tooth ankylosis, loss of periodontal ligament space and blending/fusion of tooth to bone. Clinical photos/Dr. Timothy Anderson Fig. 2 Fig. 2: Pre-op image of tooth ankylosis. Fig. 3: Laser is used to trough the ankylosed tooth and selectively remove bone around the tooth. Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 4: Tooth sectioned with Solea until access depth and water collection slow the ablation. Figs. 5, 6: The lack of sutures and minimal bleeding results in a clean and efficient surgery. The total procedure takes less than 30 minutes. CDA BOOTH NO. 350 AAPD BOOTH NO. 401 Fig. 7 Fig. 7: Control panel of the Solea CO2 all-tissue 9.3 µm dental laser. This case study uses the hard- and soft-tissue selection and 100 percent mist. Product photos/Provided by Solea Benefits of Solea The use of the Solea CO2 all-tissue 9.3 µm dental laser (Figs. 7, 8) aided significantly in both the psychological and surgical management of this case. The quick and smooth cutting of the laser helped to re- duce both the patient’s and the parents’ anxiety when compared with a tradition- al surgical handpiece. The major surgical benefit was the ex- treme precision and efficiency of the la- ser’s cutting. A large flap was not needed, and there was minimal bleeding from the incision sites. Overall, the laser re- sulted in a less traumatic procedure that significantly enhanced the patient ex- perience, especially con- sidering the nature of the procedure. There was profound healing for the patient in fewer than three days, which enabled the patient to immediately move forward with an orth- odontic treatment plan. Fig. 8: The Solea CO2 all-tissue 9.3 µm dental laser unit.

Dental Tribune U.S. Edition No. 5, 2018

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