Forums › Laser Treatment Tips and Techniques › Soft Tissue Procedures › 980 nm for deep troughing
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Glenn van AsSpectatorHi folks: this is a kinda cool case which shows the value of high mag with the scope. I have a 980 nm loaner which I am using for a while just to compare to other diodes. You can flood alot of water on the tissue and still have it cut (not easy with the Argon, and not as easy with the 810nm).
Mike Swick uses the high fluency technique with this laser which involves high wattage being pulsed at 20Hz per second (.05 on and off). NOw this isnt a Nd Yag pulsed laser but it does do some cool things.
It does cut with less charring with the water on. I dont often use the 10watts -15 watts that Mike does because you will get charring if the water flow doesnt hit the tissue as you are cutting. I typically will use 4-5 watts pulsed at .05 on and off.
Regardless in this case, the lady had deep interproximal decay on the 2nd molar on the distal. The patient has all her third molars and wouldnt part with them.
I eventually did a DO on the 2nd molar which was ok but had a bit of a resin overhang on it. When it finally went irreversible , I did the endo and suggested a crown when new decay popped up on the mesial of the 2nd molar.
I did the prep (note how the overhang on the distal was so readily visible at 10+ power). I removed interproximal tissue so that I could stop the bleeding (she has a little perio but many do (she is in her 60s)).
The distal was very deep and tough to see if the margin was on solid tooth but eventually I got it done on solid tooth on the distal. Then noticed the decay on the third molar which is so far back I couldnt get a clamp on it. The rubber dam was pulled back and it stayed long enough to get the restoration done on the mesial.
The troughing complete and the impression was taken and worked out very well on the very very deep distal.
THere is still decay on the occlusal but I was running out of time so will treat that at the insert appointment.
Hope it is interesting but this would have been a darn tough case to see the overhang, get crown margin on distal on solid tooth, and restore the third molar in that conservative fashion without the scope.
Cya
Glenn
dkimmelSpectatorGlenn nice case. Which diode laser is this and how is the water delivered?
That scope does make things a bunch easier to see!How are you posting your photos? Everytime I post Ron has to go back and fix them as they are all over the page!!!
DAvid
Glenn van AsSpectatorHi David: this is the Biolitec 980nm diode. The water is delivered through the air/water syringe in my case but they do make a special handpiece which has an irrigation module to it that I dont have.
The scope does help a whole bunch with viewing things.
I put my photos into a collage format with a side program called Fotoslate 3.0 which is part of ACDSee.
I put 8 photos into one collage and when resized down a little comes out at less than 100 kb for the 8 photos with text.
Thats how I get the text photos and everything into one pic, its a collage format.
Glenn
ASISpectatorHi Glenn,
Beautiful stuff again.
Did you use the same setting for the overall troughing as you did for the distal area? How do you like the 980 so far compared to the Diodent?
Andrew
kellyjblodgettdmdSpectatorGlenn – Great pics. I love your approach to #1 – leaving the marginal ridge intact. I’ve got to get a scope!
Just curious – were any diagnodent readings taken on the occlusal of #1? Those grooves look scary.
Keep up the great work. Every time I see one of your picture series with the scope, I know I need to head in that direction.
Thanks for the motivation.
Kelly
Glenn van AsSpectatorHi Kelly……..I could hardly get back there with the scope let alone the diagnodent but the tooth does need an occlusal.
I put the crown in on the molar…nice healing huh……
I will do the occlusal on the molar ( she didnt want it done today) , next month or so.
Hope you like it. As for the scope , it is a marvelous tool.
Glenn
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