Hi Robert,

The technique I have used applies to near to not quite mid-infrared lasers (diode, FRP Nd:YAG, FRP Ho:YAG) because these lasers will not interact with bone and or enamel under the primary tooth in question.

I use an ablation setting to extirpate the pulp in the chamber. If it is REALLY infected as in a swollen abcess I will run a small diameter fiber (320) out through the apicies and lase. I will then lase the external sinus track/fistula if there is one and irrigate with Peridex through an endo syringe. Depending on how infected the tooth is, I may put some formocresol on a cotton pellet and let sit for 5 minutes. I will then place IRM.

Settings are 1 watt or less with a diode, activated to remove pulp, then cleaved and unactivated outside the tooth.

For FRP Nd:YAG the settings are 3.00 to 4.00 watts, 20 to 100Hz, 100 to 150 usec PD to extirpate, same settings except 20 Hz to disinfect outside the tooth, 3.00 to 3.60 watts, 20 Hz, 150 to 650 usec for hemostasis is you can adjust the PD.

That’s how I do it, anyway…….

Bob