Forums › Laser Treatment Tips and Techniques › Hard Tissue Procedures › ROT with waterlase
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Nuno FerreiraSpectatorHello, 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)
Glenn van AsSpectatorHi 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
Nuno FerreiraSpectatorHi 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.
Glenn van AsSpectatorThanks Nuno………cool stuff and well done.
Glenn
greg holmSpectatorNuno. 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
Nuno FerreiraSpectatorGlen. 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.
greg holmSpectatorNuno. 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
Nuno FerreiraSpectatorHi 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?
greg holmSpectatorNuno, 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
Nuno FerreiraSpectatorSorry Greg, im a newbi in this forum
Nuno FerreiraSpectatorSorry Greg, im a newbi in this forum
Glenn van AsSpectatorNuno: 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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