Ok here is one case I did today (gosh digital photography is great isnt it).

Lady is awful to work on , she hates coming, sighing , moaning, making all sorts of sounds ( my hygienist thought I had someone challenged in the chair). The beauty is that I only see a tooth (no grimaces , faces etc) when I tune the person out looking at one tooth.

100% of my retina is on the tooth…I LOVE IT.

ANyways I prepare the MO on the 2nd premolar and darn it all see decay on the distal of 1st premolar. I did it and showed the patient afterwards……they never complain for two reasons.

1. with the high mag I can show the where the decay is on the photos on a 20 inch TV and zoom in on it.
2. The amalgam is gone and it is white.

I hope you see the value of the scope in this one.

glenn

Ok last case for a couple of days……..gotta finish a lecture due on Thursday.

Here is the lowdown on the case where magnification and lasers helped me but the scope really helped. Look at this case closely as I think that alot of times these are the little things that the scope helps me with.

Upper first molar needs a crown. No decay noted on radiographs but a large amalgam that the patient wants out and a full coverage restoration.

On interproximal on the distal note the decay that is visible at 16X power.

look how tough it is to see at 2.5X power compared to 16X power.

Next the prep was completed and initially I noticed how deep the mesial amalgam was and got under it and noted decay there as well and so I removed the old amalgam and there was alot of decay there on the mesial.

Removed it with a round bur and was getting very very close to the pulp so I decided to use the erbium laser so that if I got an exposure it is at least sterile. No exposure. I used Mark Colonnas cool spoons for the deep part and it worked great

Then I noticed small decay on the distal surface of the adjacent 2nd premolar, which when prepped was 3mm deep and quite wide but I didnt have to break the marginal ridge and that keeps the tooth much stronger. Its tough to spot the decay without a scope and very tough to use a 1/8th round bur to clean it out.

Flowable was used to fill that proximal preparation.

Next I noticed the marginal tissue below the prep wa oozing so I needed to control the bleeding prior to filling the prep on the premolar and in order to get a good impression.

I then used the Argon laser (green wavelength to cut the tissue and trough around the crown. The microscope gives me great control over this part of the process and allows me to minimalize the trauma to the tissue.

Afterwards I used a diamond bur to refine the preps at 16X power to make sure the margins were equiginigival or slightly subgingival to the laser troughing.

There is no hiding if your impression isnt good enough for the lab. Bubbles , tears, missed margins jump out at you at 10X-16X power and the temp is easier to trim and refine the occlusal with the scope.

I hope this laser + scope case shows you that the microscope isnt just for endo……..oh sure there is a learning curve, heck there is one for the lasers, but its well worth it when little things get spotted like in this case.

Photos will be in two parts…………40 pics in total.

Glenn

PS this case took me 1 hr and 15 minutes from beginning to end including the photos and I had to do the temp and everything myself as my main assistant is on holidays in Mexico.

Cya gotta go sleep.

Glenn

[img]https://www.laserdentistryforum.com/attachments/upload/Resize of Pg 1 of crown pre_p1.JPG[/img]

Glenn, Again, fabulous work. I HAVE been AWOL! I have been in Chicago, and off the net for about a week. I am leaving to lecture in Scandinavia and Germany next week, then off to London in April, SO, that being said, it has been difficult to get online. I took some photos today of a case I did, and will try to get it online when I can. I looked at scopes in Chicago, and will test drive one very soon! USE MAGNIFICATION, it’s awsome! Listen to Glenn everyone, he knows what he is talking about, because HE IS DOING IT! DAILY! Thanks for sharing so much Glenn, you are a credit to dentistry!
Sincerely,
AWOL….Mark

Hi David : I have two scopes (started with one).

You can buy one set of optics and with some of the scopes you can change them from room to room if you purchase an arm and fiberoptic for each room you work in.

If you rooms are narrow you can swing the scope from room to room like an xray and have one scope servicing two rooms.

I bought a scope and mounted it in the ceiling solid in one room and then a few years later bought my second scope.

Mark , I had a long talk with Keith Bateman here in Vancouver today at the Pacific Dental Meeting , had a few laughs , talked alot and your name came up.

Make sure you test drive the different scopes that you are testing, and you know what I use but if you are gonna buy another brand that is ok but make sure you talk to me first privately. I can save you some grief.

I thank you for the kind words on scopes. I am glad to see you travelling so much and enjoying yourself. Make sure they pay you well for it, that your family gets to go sometimes as well. You can get stroked and stoked doing this each and every weekend and guess what……..one day your family isnt there anymore.

Look at all the biggies……it happens to their family life.

Make sure you find balance…….I know the best thing I did was let my wife help me decide where to lecture and where not to go. I have given up the opportunity to lecture in Egypt and Caracas because it just didnt feel right from a safety standpoint. It would have been fun to go but not at the sake of safety.

Thanks for the kind thoughts Mark and it really was funny sitting down with Keith today after all that we both have been through.

You gain a better understanding of the man, I still may not agree with some of the things he believes in but we can agree to disagree on certain items.

Oh ya he grinned about the WCLI and my lecturing there and mentioned that he might like me to come and speak about scopes with lasers (without getting into brand names ) and he might be intersted if certain people (like you , Rod and others ) thought it would be interesting to hear that topic.

ALl the best guys and thanks again.

This is a great group.

Glenn