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Hi folks : Havent posted much lately ( kinda burnt out) but sat down and wanted to post a couple of cases from today. Here is one simple one done without anesthetic.
Patients love not having a numb lip and I was able to use the modified Colonna technique ( modified for Delight) to 6 w with water for 120 secs on each tooth and then use a 600 micron tip at 30 Hz and 140-160 mj for the left canine and a 400 micron tip at similar settings (thats alot of energy) without any problem.
On the first one I did a small amount of soft tissue trimming without anesthetic at 20-30 Hz , and 30 mj non contact to get the tissue back at the gingiva.
I was pleased to get this done without anesthetic……..its possible with some patients and not with others.
Hope you like this one.
Glenn
Here is a 2nd case I did on the little 4 year old I had in last week , other side.
No anesthetic, used the Isolite again for retraction. High energy, with almost a pulp exposure for the bigger decayed tooth.
Used Fuji 9 in the base and flowable over top.
Mom asked me about the material today, dont think dad was too happy with Fl in tooth from last time.
Take care but another biggie without anesthetic.
Glenn
Ok here is the final case I am going to show from today.
Patient came in with bombed out lower right first molar.
I used the laser to section the roots and to trough around the roots to relieve tissue and bone and get solid tooth to apply an elevator to get the roots out.
I was able to avoid a flap and sutures, and elevated the tooth out quite easily. Used a 600 micron tip with water and only a little air at 30 hz and 140 mj and then switched to a 400 micron tip to get deeper into the sectioning and to remove tissue and bone circumferentially to remove the tooth. Patient like the non tactile, non contact manner of bone relief with the laser ( doesnt sound as bad either) and I like that afterwards there isnt alot of bone debris in the socket.
Do you have to use a laser ……..nah.
But if you have an Erbium Yag or Erbium Cr YSGG, you can do these for the patient and the healing seems to be great and also the laser sterilizes in the socket.
I placed a temp bridge for the patient who was not willing to go with an implant.
Glenn
Here is another case I did today……..the two premolars in the lower right quadrant. The first I did a quick core buildup for a crown as there was facial decay and placed in a resin ( wasnt concerned about color as patient going to have crown), and then had to extract 2nd premolar with huge facial decay (first photo).
It broke – so what else is new. With the laser we tried to get enough tooth exposed to use the forceps on it on the mesial and distal………..no luck
More bone later taken away with 400 micron tip and 30 Hz and 140 mj.
Finally got a purchase point on mesial and out it popped.
The papilla between the two premolars was torn so I place one suture (3.0) looks like a tug of war rope. Got my Hartzell microperio instruments and will be getting smaller opthalmic needles and sutures that are 6.0 soon.
Until then this is the best I can do…..placed Gelfoam and let patient go……
Just to show you what is possible.
Glenn
