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Hi there: one last case I did this week with the erbium laser…….
THis lady fractured off the premolar and it was decayed and unrestorable (no rads here sorry).
We sent her to the periodontist for a consult re implants but she just couldnt get herself to do it so we opted to do a bridge instead.
I used the laser at 30Hz and 80 mj with water and a 600 micron tip for the core buildup of the posterior abutment which had an endo done through a very old crown.
Then after both preps were done we used the diode to trough and then used the erbium laser with water at 30 Hz and 130 mj to remove bone around the root fragment and then got the root out after the bone relief was done.
A couple of things……I was hoping to get it out in one piece with the forceps but it broke but a little more relief with the laser and I was able to elevate the tooth out of the socket with a small root tip (micro elevator). No flap or sutures required.
I then thought……….well it isnt in a area where it is highly esthetic……lets see if we can get an impression.
It worked so what the heck we went with it.
I then had a custom waxup from the lab (no time for me to do this at night ……) and then we made a suck down template in coping material of a pour of the waxup and used this to make a custom fitting provisional.
I had placed gelfoam in the socket prior to the impression to coagulate and to prevent provisional material and also impression material going down the socket.
Now in this case , it was the first time for me using the diode since I got it back and I couldnt get it working right (my stupidity) so there was some trouble troughing and I did pour more energy into the tissue than needed ( it took longer at 1.0 watts then it should have)……..but we got it sorted out after this case.
I mention this because the patient came back the next day with the temp off and the tissue was inflamed a little and I suspect it may recede a little but time will tell.
It was also a little sore that night but she had never had a tooth removed so this might account for some of the pain and the preps, but I think the laser also didnt help.
I will post the final images when I seat the bridge.
All the best……..just experimenting to see what works and what doesnt……with respect to tissue recession.
I hope that my cases help a little to stimulate you to see what is possible and that my mistakes help you in preventing to make the same ones…….lord knows I make enough of them.
Just ask Bob……..
Glenn
Glenn,
When you get the variable pulse width Ng:YAG like Ron you won’t have to worry about recession or about using Gelfoam to clot.
Same results, but more natural.
Great case, hope your patient appreciates the results.
Enclosed is a similar case done with the PerioLase, photo immediatly after extraction, clot set w/ Nd:YAG 3.0W 20 Hz 635 usec
Jeff
(Edited by Benchwmer at 6:23 pm on April 6, 2003)
(Edited by Benchwmer at 6:29 pm on April 6, 2003)
(Edited by Benchwmer at 6:32 pm on April 6, 2003)
Hi Glenn,
QUOTEI hope that my cases help a little to stimulate you to see what is possible and that my mistakes help you in preventing to make the same ones…….lord knows I make enough of them.Just ask Bob……..
Your case presentation are the best! Your dedication to share your cases so we can all appreciate what is possible in your hands, with technology we now have available to us is superb! Your willingness to listen to what others have to contribute is testimony to your graciousness…..
Thanks for all you do to contribute to the advancement of technology and especially lasers in dentistry!!!
Your “mistakes” are nothing compared to those I have made over the years….
Bob
Thanks Bob……..you know this board, you , Mark , Al, the two Ronnies (hey wasnt there a British comedy abou them) challenged me to become better.
Tom Haney from Continuum forced me to become better using the laser for soft tissue after only using it for restorations in the beginning.
I started using it for frenectomies, biopsies, gingival recontouring around healthy tissue on Class Vs and was very surprised at how it planed tissue away. Totally different than my soft tissue lasers.
Then started looking into bone and by god it works nice and then started thinking out of the box.
Mark does that very well, so do you with Perio.
The scope just is a godsend for video taping and for documentation and I know that the high mags have force me to think about dentistry (and lasers) in a totally different light.
I appreciate all the friendships I have made through my scope indoctrinations and I hope that people out there enjoy the presentations for all they are. Examples of some laser dentistry that can always be improved but at least is graphical (pun intended) and photographic in nature to give a truer sense of what was done.
I do it only one way and you all have shown me other ways of doing things and this is how my education improves.
I do hope that people realize that I dont post because of any holier than thou mentality but just to help improve my work and this photography thing is like a hobby to me…….
I had a patient ask me what I do with all the photos today and I told them…….some I keep some I just look at and delete……some I post………
Its a hobby and a fun one.
ALl the best to you and everyone here.
Thanks for the kind words……..they make it allworth while.
Glenn
PS here are some new pics of me with the scope to show the video camera that we are attaching to the scope that shoots 3 chip digital video and I am getting pretty good color and little vignetting these days.
Makes me very very happy.
Cya
Glenn
