Forums › Erbium Lasers › General Erbium Discussion › Class 2s in kids
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Glenn van AsSpectatorHi folks: As I sit at home recuperating over the flu and pneumonia , I started going through some of the thousands of pics I have shot through the scope and since there are so many new members here I thought I would share some of the tips I have uncovered for the laser over the next couple of weeks.
WHen doing kids class 2s in deciduous teeth the beauty of the laser is that it wont cut metal like AA does so you can put a metal matrix on prior to prepping the teeth.
This does 3 things…….
1. It protects the adjacent tooth surface.
2. It helps speed up the prep as there is reflection of the band, I am sure this is the case.
3. If properly placed it can give you the original height of the marginal ridge.I have done this with T-bands and with Ultradents ultraguard. The ultraguard is a little thicker and sometimes I have to remove it and put in a tband to get a tighter contact but it is more rigid and able to get through broad wide contacts.
Here are two cases for you to look at…………
http://www.sendpix.com/albums/021208/132527000008b709185f4c02e94991/
http://www.sendpix.com/albums/021208/133349000008c14cf94e20189a6d4f/
The first case has an ultraguard and the second has two Tbands.
Glenn
2thlaserSpectatorExcellent Glenn, Hope you are feeling better soon.
Great tips, I will try them. Deciduous teeth are so easy to prep, and on top of that, the children are so cooperative. They never feel anything, and usually have zero anticipation of anything starting to hurt, unlike adults, who are just WAITING for some pain! Great stuff, as usual!
Mark
Glenn van AsSpectatorThanks Mark……..worked half a day today and am exhausted so its gonna take time.
Kids are much easier to work on , and I use ONE TOUCH topical made by Hagar and distributed by Patterson as it has two active ingredients ( tetracaine hydrochoride ( longer lasting around 30 mins) and benzocaine (shorter acting).
Its cherry flavoured (pink in color) and really numbs up the gums for rubber dam , matrices etc………
That and telling kids ,
“this is the worst part, if you can stand this you wont need a SHOT……”
Both seem to help and most things on kids can get done without anesthetic.
Glenn
PatricioSpectatorGlenn,
Your photos are very useful to me to confirm what I have been doing as to prep shape, decay removal and banding. Your suggestion of preping with band in place moves me one more step forward. For a guy who is not feeling well you sure do good work. Thanks.Pat
SwpmnSpectatorNice cases Glenn!
Thursday I extracted tooth number “I” on a seven year old and used EMLA topical for palatal injection. Kid didn’t even flinch.
We then placed a Class II DO composite on tooth number “B” using the laser with no local anesthetic and no EMLA. Just used an old Mylar strip with a wedge and got a good contact but good ideas regarding the metal matrix.
Al
Glenn van AsSpectatorThanks Allen, just something to try and keep in your mind. The laser users get some idea looking at the photos to see how one person does it and it hopefully gives them confidence that they are doing things along the same line.
This group is good because we talk less about the importance of our machines and more about the nuances of technique.
Its a good group and I for one feel privileged to present ANY ideas to you.
You all are always complimentary and yet you ask good questions which in turn make me a better dentist.
I wonder if EMLA is available in Canada.
Hey as an aside I have started trying to use my endo tips for periodontal abscesses and pericoronitis as the water flushing out and the tiny size of the fibers really has given me good results. I use 30 Hz and 30-50 mj and sometimes I wonder if it is working cuz I only see water but if I put the tip next to tissue I get that tell tale white spot.
ALmost all the patients have improved right away after doing the laser for 30-45 secs.
Any other people doing this…….
PS here is a link to some pics of a pericoronitis case.
Nothing earth shattering but just to give you some thoughts….
http://www.sendpix.com/albums/021209/191130000002e6064a411659683a88/
Glenn
Glenn van AsSpectatorPS Bob I know an Nd:Yag would be idea, without fear of wrecking tooth, cementum or bone.
I like the erbium yag because the combo of the water and the fast pulse rate (like an NdYag) allows me to put this tiny 200-300 micron fiber in the pocket and not very often do I need anesthetic. Patients like that and its not to possible with my Argon or Diode in CW.
Glenn
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