Mark knows a thing or two - Laser Dentistry Forum

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April 15, 2003 at 5:55 am #2918 Reply

Glenn van As
Spectator

Mark Colonna came out with his high energy defocussed mode application to produce desenstization (brilliant I might add).

I have been using this more often and today everyone in the office was smiling on this case.

I use the laser for one minute at 30Hz and 160 mj defocussed to around 10 mm and then up to 25Hz and 240 m which is 6 watts or so of energy for another minute.

I then proceeded to get the resin out without anesthetic at 30Hz and 140 mj -160 mj and the patient never said a word. I finished the whole composite which wasnt that good but considering how difficult the patient was I was pleased . I use the soft tissue at 20Hz and 30-50 mj and she was fine with that as well (no water on it) and placed and finished the resin. Then I noticed a darn spot on the comp that was deeper into the dentin and thought……..shoot , I better reprep that one part.

As soon as I started at 30 Hz and 70 mj (less than 1/2 of what I had used for the whole prep and still only on the enamel …..see pic 8 on the first image) she jumped through the roof……..

It was longer than 3-4 mins since I had used the laser to desensitize and she felt it ALOT.

ANyways, we finished it and I must admit that I was shocked again and so was my staff.

The next case will even blow you away more.

Glenn

April 15, 2003 at 5:56 am #7168 Reply

Glenn van As
Spectator

Ps I wasnt very happy with the result but there were some extenuating circumstances……..weird though how she felt it on the small reprep and didnt feel anything at 2X the energy when I had done the desensitization.

Glenn

April 15, 2003 at 5:11 pm #7166 Reply

dkimmel
Spectator

Mark is pretty sharp. Just did his technique this AM on 2 premolars the second was very deep.
Defocused 5.5 W /75w/90a for 90 sec. Then removed the composite and dropped down to 2.75W/55w/65a and finsished everything off. Had to only go back once to defoucus at the high settings.
Scale 1-10. Pt only felt a 2 for a sec. (At the deepest spot).
Sorry no pictures. Running behind!
Nice case Glenn. Great that you can easly take photo’s.
David

April 16, 2003 at 4:04 am #7169 Reply

Glenn van As
Spectator

Thanks David but believe me the comp was pretty average compared to yours.

Still not happy with the materials. I did like Point 4 flowable that I used recently which was opaque.

Thanks again.

Glenn

April 16, 2003 at 7:25 pm #7171 Reply

Mike Meon
Spectator

Glenn,

Just want to say hello, and tell you how much I have enjoyed this forum. I have had my waterlase about a year and just found all you smart guys. You all have taught me alot.

I have one question, I have tried the defocus mode as you explain on the occlusal, buccal and lingual. I never feel that it makes any difference. Most of my patients feel very little, but I would love to do better. I am from Alabama so it takes us a little longer to get it. Any help would be appreciated.

Keep up the good work, I love it

Mike

April 17, 2003 at 2:03 am #7167 Reply

2thlaser
Spectator

You guys are too much! I am not brilliant, I just try things! You all have taken things to another level and have taught me so much as well!! Amazing. Remember Mike, keep the tip at about 10 mm from the surface of the tooth. I use 5.5 W 80-90%air, and 50-60%water for 90 seconds, and I mean 90 seconds, I time every one of them. Remember too, that the thinnest area of enamel to get penetration of the laser energy is in the occlusal groove, when doing an occlusal. MOVE THE LASER VERY SLOWLY on this area, to get the tooth BATHED in the laser energized water. SLOW is the main word. Let the laser work. Then remember too, you DON”T always have to ablate tissue in a focussed mode. You can get ablation as far away as 6mm with a G-4 tip, at 5.5W. I do most of my procedures with defocessed modes. Only when I am down to 1.5-2W do I go into focussed mode to remove stubborn decay, then I go to my microspoon excavators for final decay removal.

Funny thing, I had a new Biolase rep in today to watch me work, he was amazed, it was fun showing him some incredible things we can do with the laser. I did a real large class III on #23, deep near the pulp, and down the root surface, patient was EXTREMELY phobic, came to us because of the laser. He felt absolutely NOTHING. AND to top it off, the difficult filling came out great, and because of the microspoons, I feel pretty strong, that no endo will be needed. Very nice feeling I must say. I have never had better control of my dentistry than I have now with my laser, and the microspoons. Sorry no pictures today, it was a teaching day, no time. GLENN I WILL GET A SCOPE SOON! I envy you. By the way, I will be doing a lecture in Vancouver on May 23, pretty sure. I will let you know. We have to get in touch.
Thanks again, you make me turn red with the accolades!
Mark

April 17, 2003 at 3:55 am #7170 Reply

Glenn van As
Spectator

Hi Mark………I will be in town that week and maybe I might be able to drop by during the lecture or at the end……who knows.

Its a busy month for me and I do want to spend some time with my family so make sure you email or phone me in advance.

I got my second set of instruments today and am starting to use Marks instruments for most of my composites.

Check them out if you havent already.

Glenn
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