Forums › Laser Treatment Tips and Techniques › Hard Tissue Procedures › Laser veneer
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2thlaserSpectatorHere is a case on #10 I did this morning. Funny thing, this is the first time I couldn’t get the tooth totally “numb” using any technique, only on the disto-buccal near the gingival margin. Everywhere else the patient felt nothing. Thoughts? I would love to learn why this was “spotty” anesthesia. Thanks everyone.
Mark
2thlaserSpectatorI tried to upload photos, but it didn’t work Ron. Here is the site to get to them of the above post.
photos.yahoo.com/toothlaser. Let me know ifyou guys can see them!
Mark
SwpmnSpectatorMark, pics came through great on Yahoo! Looks like a good prep just still looks rough to me but if it’s working great!!!!
Spotty anesthesia happens to me also and is hard to explain. Perhaps some patients have different nerves which innervate different regions of a tooth. I see this fairly often on mandib molars. All the signs show profound anesthesia yet there will be one area of the tooth where you have trouble completing the prep.
Every now and then have trouble with profound anesthesia for preps on max first molars, premolars AND on teeth #7 and #10. When I anesthetize the palate in these situations, no more pain!!!!
What if you tried using the Waterlase with a defocused technique to disrupt or “anesthetize” the nasopalatine or the palate directly gingival to #10 in this case? Might be worth a try. Used the Waterlase this morning to “anesthetize” palate prior to giving greater palatine injection. Worked great!!!!!
Al
P.S. Edit: In the second and third paragraphs of this post I’m referring to “caine” anesthesia, did not want that to get confused with “laser” anesthesia
(Edited by Swpmn at 5:07 pm on Nov. 14, 2002)
(Edited by Swpmn at 5:12 pm on Nov. 14, 2002)
Robert Gregg DDSSpectatorTo All–
I think there are several reasons for the laser anesthetic effect.
But one thing I have noticed–and I’d like your feedback–is that I have found occlusal trauma will cause teeth that I have numbed to not have complete anesthesia. A posterior hit and slide into the anteriors will upset those teeth. Molars, of course, can exceed their physiologic load tolerances.
Just something to think about. See if you notice a correlation as I have.
Al–That’s great to hear about the numbing of the GP nerve!
Bob
2thlaserSpectatorBy Bob, I think you hit on it. If you look at the preop photo, there is a small abfraction area. This tooth takes a little bit of a hit in protrusive. Maybe that is why?! I will definitely make notes of this as I continue.
Al, I like the roughness of the prep, I feel it gives me much more surface area for the bonding of the veneer. Also, I asked Ross Nash about that, being that he really seems to know about veneers, and he agreed with me, BUT I would like to see a study done of how the internal stresses interiorly affect the tooth upon light polymerization of the cement under the veneer. I can only say that in ALL cases I have done, there is absolutely NO post op sensitivity, unlike when I used a high speed and a diamond for the same preps. Thanks everyone!!!
Mark
SwpmnSpectatorMark:
I wasn’t giving you a hard time about the roughness of the prep, we’ve already discussed that and I’m fine with it. My composite and buildup preps with the laser are rough as hell.
Mostly I was interested in your ideas about could the laser have been used to anesthetize any accessory palatal nerves which may have resulted in your inability to numb tooth #10 on the disto facial?
Al
2thlaserSpectatorI agree with you Al. I will try the anesthetic the way you do it. It sounds like a GREAT way to do that!!! You guys always help me out! Thanks.
Mark -
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