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  • #3533 Reply

    Nuno Ferreira
    Spectator

    Hello, yesterday went to my office a patient with hipersensibility in 4.7 since the bridge was placed, she only went to my office because the bridge was released from the teeth and the gum start to bleading and hipersensibility start to be painfull…She hate needls.
    I start rot with waterlase using turttle protocol (Dr. Chen), when i reach pulp chamber placed some topic about 60 seg.
    She love it, and ask my assistents where we was all this years….

    [img]https://www.laserdentistryforum.com/attachments/upload/wa1.JPG[/img]

    [img]https://www.laserdentistryforum.com/attachments/upload/wa2.JPG[/img]

    [img]https://www.laserdentistryforum.com/attachments/upload/wa3.JPG[/img]

    (Edited by Nuno Ferreira at 7:16 am on Feb. 15, 2003)

    #12175 Reply

    Glenn van As
    Spectator

    Hi Nuno: Nice pics……….couple of questions

    I gather you started a root canal right?

    Do you use rubber dam, are you using Nickel titanium instruments to shape the canals or the laser?

    Nice access and lets discuss endo with the laser more on this thread. Nice stuff.

    Glenn

    #12181 Reply

    Nuno Ferreira
    Spectator

    Hi Glenn
    I use to place rubber dam, but this patient refer some latex reacion, so i decided not to place it.
    When i reach the pulp chamber i use some Nickel titanium instruments to determinate the lenght of the canals with Apex Finder, second step mark endo Pro series Z2 Z3 Z4 tips with 2mm less and start root canal debridement and enlargement. I made pulp extirpation with NiTi instruments.

    #12176 Reply

    Glenn van As
    Spectator

    Thanks Nuno………cool stuff and well done.

    Glenn

    #12172 Reply

    greg holm
    Spectator

    Nuno. You did this without an injection of anesthetic?
    Did the pt feel anything or was the laser able to anes the tooth enough?
    Are you saying you basically did most of the work with niti’s and then did a cleaning of the chamber/canals with the laser?
    Greg

    #12178 Reply

    Nuno Ferreira
    Spectator

    Glen. Since im been using turtle procedures by Dr Chen, i can manage much better my pt confort but everytime they refer some i take some minutes with defocus tips and circle motion in cervical (both V and L) but also near the last tip locacion patient felt something…and Glen the result as been very good. In this case afther all this procedures i reach pulp chamber and we dont need to look to know it because patient NOW as some…so a placed some topics in there for about 60 seg. and then you can do everything , i use NiTi to determinate canals lenght with apex finder.

    I know that some treatments take some time…and this time is more or less with de experience and trainning of all of us. BUT GOD IT FELT SO LOVELY WHEN WE CAN DO IT… AND PATIENT LEAVE HAPPY.

    Sorry about my English, soon i will place some pics and other cases, LOVE u ALL im a lonely Portuguese waterlase user im very glad to have found all of u.

    #12173 Reply

    greg holm
    Spectator

    Nuno. You need not apologize for your English. I wouldn’t even begin to know the first thing about how to post in Portuguese!
    Thanks for the response.
    I don’t know what ‘turtle’ proceedure means or is. Would you describe?
    Greg

    #12179 Reply

    Nuno Ferreira
    Spectator

    Hi Glen,
    As William Chen, DMD, MAGD descrive ‘Turtle’ technique.
    Start desensitizing .25 (15/15) 30 seg., then .25 (0.0) 30 seg defocus mode.
    Increase the power to 1.25 (15w/15a), then
    increase to 2watts(30w/30a), gradually to caries removal setting of 2.5-3.5watts (40w/40a) .
    What setting you use to use Glen?

    #12174 Reply

    greg holm
    Spectator

    Nuno, thank you for the reply. I will keep it as reference. I think you are mistaking me for Glen. I wish I could answer you about technique, but honestly, I don’t have one yet!
    I am, Greg Holm from Wichita, Ks., USA

    #12182 Reply

    Nuno Ferreira
    Spectator

    Sorry Greg, im a newbi in this forum

    #12180 Reply

    Nuno Ferreira
    Spectator

    Sorry Greg, im a newbi in this forum

    #12177 Reply

    Glenn van As
    Spectator

    Nuno: There are two settings for desensitizing teeth.

    Dr. Chen prefers to use the gradually increasing settings method where you have the laser close with water and start at a very low setting and then increase the energy every 20-30 secs.

    Mark Colonna also desensitizes but teaches the defocussed method which is where you have the laser away from the tooth at much higher energy settings and then progressivley get closer after 90 secs to 2 mins of “bathing” the tooth in energy but not cutting you start.

    Both are effective.

    For endo I have not used the laser in a way like you have except in children where I have had accidental exposures and then almost always have had to place a drop or two intrapulpally of anesthetic to help with pain and also to help coagulate .

    I admire what you have done with the Biolase…….clap clap clap.

    Good to see you using rotary NIti for the instrumentation.

    Nice case.

    Cya

    Glenn

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