Biolase WaterLase iPlus Why the First True All-tissue Laser Was Worth the Wait

I f, like most general dentists, you’ve been reluctant to jump on the hardtissue laser bandwagon, this could well be the perfect time to reconsider.

It’s not hard to understand why most general dentists stayed away (in droves) from the soft-tissue lasers of the 1990s, which were huge (both in size and in cost) and limited in potential applications. Over the next 10 to 15 years, soft-tissue lasers got smaller and less expensive, but the improvements needed to make hardor all-tissue lasers practical for clinical use lagged behind; the systems were too slow, too big, and didn’t have enough power to justify the investment.

In 1997, I jumped at the chance to buy Biolase’s first hard-tissue laser and, with the Millennium, was finally able to cut teeth without a drill (and without anesthetic). This was a big step up from air abrasion, but I still didn’t have the speed I’d hoped for. Subsequent incarnations were a bit smaller and better, but speed remained the deal-breaker.

Finally, with the introduction of the WaterLase iPlus just months ago, my wait is over.

The iPlus is a true all-tissue laser system. It cuts everything but amalgam, has double the energy of it predecessor (600 mJ versus 300 mJ), has a shorter (50-microsecond) pulse, and finally gives me the cutting speed I’d always envisioned in an all-tissue laser.

Applications Abound

To date, I’ve used the iPlus for hardand soft-tissue procedures in 200 to 300 patients, and am now able to cut not only soft tissue, but also bone and teeth at a speed that rivals high-speed drills.

The ability to perform single-tooth and whole-mouth preps without anesthetic has opened the door to a range of applications, from cavity prep, to crown lengthening, to work around implants, to perio and endo. With double the energy and half the pulse, I can cut posterior teeth in only a minute or 2 while optimizing patient comfort and reducing anxiety. The soft, flexible fiber is an added plus.

A course is included in the purchase price (currently $65,000 or less than $1000 per month on a finance agreement) and the learning curve is generally a result of the dentist’s hesitation to use sufficient power/water spray. Once you’re comfortable with the system, you can expect to do 90% to 95% of procedures without anesthetic, with the exception of ultra-sensitive patients.

Patient Reaction

As you’d expect, the iPlus is a dream come true for patients who dread the drill and/or injections, and patient satisfaction has been fantastic. They respond well to my explanation of the spray as “energized water” and, while probably just as loud as the drill, the popcorn popper– like sound doesn’t faze them at all.

Patients are relieved that I can do cavity preps in all 4 quadrants without the need for anesthetic. It’s also beneficial for my senior patients, who can be sensitive to the effects of anesthetic. For older patients with gingival decay, I can cut away soft tissue at the gum line without bleeding. A simple setting change then allows me to cut teeth or cut out old interproximal composites with underlying decay.

After 3 months of testing for Biolase, my iPlus has arrived (in Ferrari red). I think this is the company’s crowning achievement. The applications are nearly limitless, and the average dentist will easily use it a dozen times each day.