Forums › Laser Treatment Tips and Techniques › Hard Tissue Procedures › Anesthesia
- This topic is empty.
-
AuthorPosts
-
PatricioSpectatorToday I noticed I had progressed up the learning curve. I completed two DO’s on a young adult female who was sensitive to the slightest effort. When I could see my frustration mounting I asked for the ligajet al la Jon Karna after having bathed the tissue at 1.5w and followed his suggestions. This patient felt nothing beyond the slight sensation of a prick and I was able to prep as usual. My confidence in the process felt good and she was very grateful for my interest in her comfort during this process. I noticed today when I come up against some interproximal tissue which was in the way. I just removed it. The removal is becoming second nature. I think there is hope I will master this thing after all. I did look at molar today which I know Mark would have preped but I was not ready for that one yet.
Pat
2thlaserSpectatorPat,
Congrats, good job. Climbing the learning curve is fun actually. Can you tell me what John Karna taught you? I think I get it, but maybe you can describe it for those of us who haven’t done that method yet. Sounds great.
Thanks in advance!
Mark
SwpmnSpectatorThat’s great Pat!
Perhaps your use of the laser anesthetized the area enough so that the patient did not feel the PDL injection?
What teeth needed the DO’s? What needle length, gauge and what specific anesthetic did you use for the PDL injection?
Al
AnonymousGuestQUOTEQuote: from Patricio on 9:36 pm on Nov. 12, 2002
and I was able to prep as usual.http://www.karna-ddscomfordent.com/
With the laser or highspeed?
Ditto Al & Marks questions
PatricioSpectatorMarK, Al, and Ron,
Thanks for your interest and encouragement. Please see Jon Karna’s website http://www.karna-ddscomfordent.com/ He has a slide show and complete details. I preped with the laser #4 and #19 using the same anesthesia method on both teeth. 30 guage needle and lidocaine. If he has taken his instructions down I will post them.
It occurred to me today what you have probably tried. I will begin “anesthetizing” teeth with the laser when I expect to begin by using the high speed to remove the old amalgam. I have long treated many people without anesthetic for routine care. It seems the older they are the easier this is. I can see now this can be a larger group with the addition of the laser to anesthetize.
On the down side. I had one of those large cavities entirely under the gum tissue on the lingual of #2. I dug a deep hole with the laser 1.5w my favorite wave length it seems and was able to see and access the area but could not stop the tissue weeping enough to restore the prep. I placed a seditive filling and rescheduled after healing. Any suggestions beyond another 20K investment. I guess I could have brought out my electrosurg. I did not think of that at the time.
Off to California tomorrow to see what liberals look like. May stop in at the Biolase factory. Anyone thinking about attending the January meeting at Dana Point?
Pat
2thlaserSpectatorPat,
Two things, first, try to use only .50-.75w with 11%air and 7%water to remove tissue. It’ll be a tad slower, but worth it. Also, you will get a little bleeding, you can do a couple of things after tissue reduction, one, do nothing, wait 3-4 min, then go back in, bleeding usually stops. Second, you might try to go back over what you reduced with .25W no water or air, defocused, and “frost” the tissue, that can stop bleeding as well. Don’t give up, you can stop bleeding, just use lower power, and wait sometimes, you might be surprised!
I will be at Dana Point, I am speaking, and I would LOVE to meet you! I love those meetings!
Hope this helps.
Regards,
Mark
gwmilicichSpectatorQUOTEQuote: from Patricio on 9:19 pm on Nov. 13, 2002
MarK, Al, and Ron,I dug a deep hole with the laser 1.5w my favorite wave length it seems and was able to see and access the area but could not stop the tissue weeping enough to restore the prep. I placed a seditive filling and rescheduled after healing. Any suggestions beyond another 20K investment.
I have had the same issues with deep subgingival caries. All I do is run the laser around the gingival crevice to trough it, as per crown troughing, and pack a cord with Ultradent gel on it. Instant haemostasis, plus excellent viusalization and access.
I don’t get hung up on trying to make the laser do everything. It is great for heaps of things, and OK for lots of other stuff as long as you accept you may need other adjuncts to complete Tx. I thought 1cm of retraction cord was a reasonable alternative to a �+ Diode (yep, that is what they cost in NZ)
Cheers
-
AuthorPosts