Wow do those lesions ever get big fast huh.

Neat case Andrew, and I too might have been tempted to give anesthetic for those.

Marks spoons are cool and the laser to disinfect is really helpful for reducing the sensitivity afterwards.

I nicknamed the HOP or Hybrid Operative Procedure because I do hop from handpiece to laser to handpiece and back to laser at times.

Mark , I know doesnt like to use the handpiece if at all possible but I find for me at times if the decay really goes lateral like in your case it is very tough to do with the laser by itself. It is also tough to remove all the decay sometimes in nooks or crannies with the laser.

So……..

THe HOP technique will go something like this…

Laser to start to open up grooves and confirm that decay spreads laterally at DEJ using Mark Colonnas technique for opening up grooves.

Highspeed small round or fissuretomy to widen up the enamel and access the decay.

Laser to remove more decay.

Small spoon or slowspeed round bur for removal of all decay confirmation at High mag.

Laser to remove smear layer

Etch , bond and restorations or co-cure with Fuji 9 and then restoration.

Hope that helps……..neat case.

Glenn