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Topic: Dental Lasers
Question:
This may be a little unsual as I am actually a dentist practising in Melbourne. My dilemma is with lasers: I've been given the option of a Biolase Waterlase or the Hoya-Combio - basically I need an honest evaluation on both and which to buy. Hope someone can help! ...Dentist from Melbourne, Australia
Answer:
I have looked at both of these and I bought the Opus... For a number of
reasons. All 3 do the job well.
The Biolase has had more advertising dollars put behind it. The only problem
there is that if you plan to move the laser around the office and the
mirrors get "bumped" some they no longer line up and the laser does not work
properly. They know about the problem but it is a design issue and will not
go away soon.
The Hoya Combio is a good laser. as well. Both it and the Biolase are
non-contact lasers. Which brings me to the Opus.
The Opus has contact and non-contact tips. I can cut much faster with the
Opus than with any other non-contact tip. That is a proprietary deal and I
do not know if anyone else will be able to come up with a contact tip.
I think you really need soft tissue lasers in the office as well as hard
tissue lasers. Here is some information that I think you might find useful
about types of lasers and their functions.
Laser Types - Laser Properties
Diode LASER
The active medium of the diode laser is a semi-conductor P-N junction made
in a GaAlAs crystal. A flexible fiber is used to transmit the laser energy
to the surgical site. It works best on soft tissues and can cut very
precisely with little or no collateral damage depending on the settings used
during the surgery.
The Diode laser many times can be used without anaesthesia doing very
precise anterior aesthetic surgery without causing bleeding or discomfort.
It is the best laser for that purpose.
CO-2 LASER
The active medium of the CO2 LASER is gaseous CO2 a proprietary hollow wave
length technology is used to deliver the LASER energy to the surgical site.
The wave guides are coated to form an internal reflection that allows the
flexible wave guide to be used for the delivery of the LASER energy to the
surgical site.
It is highly absorbed in water and is very good at cutting soft tissue
without causing bleeding depending on the settings used with the LASER. It
is also the best laser to use to control bleeding in an area.
Erbium LASER
The active medium of the Erbium LASER is the solid medium of Erbium. The
Erbium LASER is used in a pulsed mode and is highly absorbed in water at
very low depths. When used on hard tissues the Erbium LASER energy that
touches the hard tissue heats up the water within the hard tissue and causes
that water to be turned into steam. That causes a mini-explosion to occur
and the hard tissue is "ablated" (removed).
The tissue below is not affected in the least since the Laser only works at
very low depths, thereby allowing precise control.This allows the dentist to
cut hard tissue like tooth or bone many times without anaesthesia and be
infinitely more precise than we could with any drill we have ever used in
the past.
The Erbium LASER can also be used to cut soft tissue but it is not as
precise as the Diode Laser and it does not control bleeding. There are times
when this is exactly what is needed and that is when you use the Erbium
LASER to cut soft tissue.
Note that if we are working with a hard tissue like silver fillings, crowns
or porcelain that do not have any water inside then we can not cut that out
with the laser. We therefore need to use a bur to remove that material.
The fact that the Erbium Laser does not affect certain materials enables us
to perform work close or next to a porcelain crown or bridge without the
risk of damage to the existing restoration. The Erbium LASER does work well
if we have to remove composite filling materials however.
James Sanderson, DMD
Alabama Teeth In An Hour
Alabama Sedation Dentist
1633 Montgomery Highway
Birmingham, AL 35216
(205) 979-6005
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