By Allie Frounfelter, DDS

The digital restorative same-day workflow is only as reliable as the tissue environment it depends on. A bleeding margin, inflamed gingiva crowding a preparation, or subgingival decay extending below the tissue crest will compromise scan accuracy and the fit of the final restoration. Managing that environment predictably is, in my experience, the rate-limiting step in same-day digital dentistry.

Our practice in Evansville, Indiana, runs a fully digital infrastructure: intraoral scanning, chairside milling, CBCT, and 3D printing. Over the past six years, the Solea® All-Tissue Laser has become the instrument that makes the rest of it function reliably and at maximum efficiency. Operating at 9.3 microns, the CO2 wavelength sits near the absorption peak of hydroxyapatite and water, enabling ablation of enamel, dentin, bone, and gingiva with a single instrument. For soft tissue, it produces reliable hemostasis and eliminates sutures in most cases. For hard tissue, it vaporizes enamel and dentin precisely without the thermal spread that limits other CO2 systems.

Integration with the Digital Restorative Workflow

The weak point in same-day restorative dentistry is the gap between preparation and scan. Retraction cord is effective for straightforward displacement but introduces variability in the presence of inflamed, hypertrophic, or actively bleeding tissue. When tissue control fails at that stage, the case converts to a temporary and a second appointment.

With Solea, troughing is performed after preparation and immediately before scanning. The tissue is incised precisely at the margin, hemostasis is achieved in the same pass, and the field is ready to scan without additional retraction steps. Hypertrophic tissue overlying existing restorations or decay is removed cleanly, allowing preparation to proceed in a controlled field. The result: clean, dry, fully visible margins at scan time.

Clinical Case: Full-Mouth Rehabilitation in a Single Sedation Visit

A patient presented with full-mouth failing dentistry: amalgam restorations with overhangs, secondary caries, and crack lines throughout the posterior dentition. The patient consented to complete rehabilitation under sedation in a single visit.

Following removal of existing restorations, tissue was irritated and actively bleeding at multiple sites, consistent with chronic inflammation from years of microleakage and marginal breakdown, the inflection point at which same-day cases most commonly convert to temporization. Using the 9.3-micron Solea laser, we achieved hemostasis at each site, completed composite buildups where indicated, and finalized preparations across the full arch. We scanned immediately, designed and milled restorations chairside, and delivered permanent crowns before the patient left. No provisionals placed; no delivery appointment required (Figure 1).

Figure 1. Pre-op (far left): Full-mouth failing dentistry: amalgam overhangs, secondary decay, and visible crack lines throughout. Intraoperative: Irritated, bleeding tissue after removal of failing restorations — the moment most cases slow down or get temporized. Post-laser tissue management: Clean field, hemostasis achieved, margins accessible. Buildups placed, preps finalized, ready to scan. Same-day final restorations (far right): Permanent crowns delivered in a single sedation visit. No temporaries, no return appointment.