Anesthesia - Laser Dentistry Forum

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January 7, 2003 at 4:58 am #6049 Reply

jetsfan
Spectator

I have been lurking for a while and enjoying the posts but I do have several questions regarding anesthesia. Hopefully someone can answer them:
1) 5.25 W 90/90 defocused, how close or how far to the tooth is defocused?
2) Is this setting only for posterior teeth or will it work buccal and lingual of anterior teeth?
3) What if the occlusal surface is mostly amalgam or composite for that matter, where do you aim the tip?
4) after you begin the prep, what settings do you use if patient feels pain and you have entered dentin?
5)I have also heard of anesthesia being achieved using 1.5W buccally and lingually. Anyone use this ? with success? and what settings?
6) I primarily use tapered tips, do I need to lower the 5.25W for anesthesia?
7) HOW BOUT DEM JETS!

January 7, 2003 at 2:48 pm #6048 Reply

Anonymous
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Welcome to the forum! I’ll try and answer your questions below.

5.25 W 90/90 defocused, how close or how far to the tooth is defocused?

I stay far enough away that the laser isn’t marking or altering tooth surface.

Is this setting only for posterior teeth or will it work buccal and lingual of anterior teeth?

I use it both ant and posterior but in the anterior I may adjust downward depending on how deep a restoration I’m doing

What if the occlusal surface is mostly amalgam or composite for that matter, where do you aim the tip

I go right thru the composite .amalgam you need to avoid so you don’t fry a tip

after you begin the prep, what settings do you use if patient feels pain and you have entered dentin?

This is where magnification is so important, soon as the enamel is gone I drop down to 2.5 or lower depending on the patient. I think some of the others may drop to about 3.25

I have also heard of anesthesia being achieved using 1.5W buccally and lingually. Anyone use this ? with success? and what settings?

I think Bill Chen is doing this, in my hands I never got enough anesthetic effect to remove amalgams but he evidently is successful with it

I primarily use tapered tips, do I need to lower the 5.25W for anesthesia?

I don’t for the anesthesia part but do for the prepping

HOW BOUT DEM JETS!

didn’t know Winipeg still had a hockey team

January 7, 2003 at 2:50 pm #6075 Reply

Patricio
Spectator

Jetsfan,
Good luck from a DNS Packer backer
1. I am a learner so let the buyer beware! I use a defocus distance which is as close as I can get to the tooth without altering the tooth surface. Approximately 1 to 1 1/2 centimeters. In the anterior I generally use 1.5W preset as a start( workd well for me) just because of the reduced amount of water spray. Same guidelines. I go back and use more watts if there is sensitivity when I begin to remove hard tissue. In most cases when I enter dentin and there is sensitivity I go immediately to the small round bur and clean the deeper areas rarely with any patient discomfort. If I need better access I either reintroduce the laser or use the electirc handpiece, again, with rare patient sensitivity and finally I finish with the laser usually at 1.5w to prep the surface and steilize the prep and remove any remaining stain or possible decay. This works well for me. I intend to try Glenn’s method and use a fissuratomy bur to open the intitial entry on the occlusal of molars. The process works on any tooth though I have had less success with second molars. I routinely numb teeth where I intend to remove an amalgam so amalgam is not a problem. The tip is aimed at the cervical area buccal or lingual primarily but I cover as much of the tooth as possible.
Access dictates.

With some sensitivity I either start over with the defocused laser, continue preping with a round bur(usual), reduce the watts to 3w or 3.5w or just anesthetize the patient with the ligajet or the big one.

I use the tappered tips also.
Pat

January 8, 2003 at 3:35 am #6050 Reply

jetsfan
Spectator

thanks for the quick feedback.
J
E
T
S
JETS, JETS, JETS(USA)

January 8, 2003 at 4:52 am #6060 Reply

Glenn van As
Spectator

Hi Jets fan……….I leave the defocussed stuff to Mark and Ron to tell you from the Biolase standpoint but today I did one with the erbium on an anterior tooth at around 4.8 watts (30 Hz and 160 mj ) at a distance of around 1.5 to 2 inches . (Its tough to tell under the scope) for 60 secs.

Lots of water and lots of air………..then went into the composite and patient felt Zero…….

Check out the erbium section I will post the photos.

Glenn
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