Aw Mark…thanks for the kind words. I enjoy posting the pics. I know that I can do some things better but I post them to give people a visual clue as to what can be done.

I am gonna post a frenectomy case with the laser (cant remember if I did last night). Not much bleeding and what was really cool is that when I blew a gentle stream of air laterally, I could see exactly where the fibers were still joined. Its been my experience that once you get through the last fibers that the bleeding increases. I like the erbium for cutting these as the post op pain is less, but sometimes there is increased bleeding.

The reason I think postop pain is less is because of the pulsed nature of the laser and the very minimal depth of penetration compared to some of the others.

Just some thoughts…..

PS thanks mark……..I appreciate your kind words. You know what was neat was being at the ADA and having a couple of people come up and tell me that they read some of my posts (either here or dental town) and enjoyed them.

It makes those daggers I take on some of the forums a little less sore!!

Cya

Glenn

Al,
Great, I am so glad you tried this! Bob Lowe suggested the limited handpiece modification to me awhile ago, yet I never tried it. My goal was to use no rotary instruments at all, BUT, I am glad you did. How did it work? What did the prep look like? Did you smooth the surface with a diamond, or leave it somewhat rough from the ablation of the laser? Obviously, you had to remove amalgam, but what a GREAT case to start on! BTW, when I turn on my Waterlase, it just says Biolase, not millenium on the display, oh well, no big deal.
I am thrilled you tried this, please keep me in the loop if you develop other stratgies. I did another prep yesterday, it took only about 7-8 min. start to finish. I used a G-4 for bulk reduction, then the G-6 for interproximal margination. It was for a Full Gold Crown. The patient loved it…..so did I! I love to use that darn piece of equipment, it has enhanced my life professionally so much.
Again, thanks for sharing Al.
Sincerly,
Mark

Hi Al,
Again, great job. I have talked to many about the “roughness” of the prep, and the consensus seems to be that it really doesn’t matter. In fact, the roughness should increase the surface area for the cement to bond the restoration in place. We are actually going to try and do some studies on this, we are currently lining up the protocol as we speak. I think it would be an interesting study.
I place gold still. Especially in individuals who exhibit bruxism patterns, and who have very heavy occlusion. I graduated in 1983, and I still feel that there is place for 18K gold. I don’t use any non-precious alloys EVER. I DO for the most part practice metal free, other than gold. I haven’t placed an amalgam in over 7 years. With the laser, it really makes me see how amalgam, and GV Black prep design is obsolete for the most part. Funny thing is, I really enjoy the microdentistry more than anything tha the laser allows us to do. I have transitioned my practice to that and have gotten away from the traditional “crown and bridge” practice. BUT that being said, the way the laser prepares tooth structure, with it’s delicateness, exactness, on the tooth, I wanted to apply it’s nature to the macrodentistry of crown/veneer preparations as well. I think that as time moves on, we will find, as the technology gets better and better, and it will, we will be able to do much of everything with the laser over time. Just think back to 1989, and now. In another 10 years, who knows what doors we will be knocking on? I just am honored to be a part of this process now. I thank you again for your posts, and for your initiative in helping to further the processes. Hope your weekend is a great one! GO GATORS!
Sincerely,
Mark

Sameer,
Congrats,and welcome to the Erbium world! I would be happy to help you anytime, just contact me. Sorry I can’t be at the Extravaganza, I am headed to the UK to teach and lecture on those dates. Fill me in though, feed us guys who can’t be there for legitimate reasons what you learn there ok?
Sincerely,
Mark

Sam:

Congratulations on your purchase of the Waterlase! You will find it a useful adjunct to your armamentarium. In my practice, we have eliminated use of the slow speed handpiece for caries removal. My patients love that!

Sam, I want to present a case from today that I believe was successful only due to my communications with Mark Colonna:

70 yo female presented with Class V caries on the facial of tooth #6. Patient expressed to my assistant that the lesion was very sensitive. I explained to the patient that we now have a laser for placement of restorations and asked for her permission to attempt the restoration without anesthesia. At a 10mm distance, “bathed” the facial and incisal edge of the tooth with a G6 tapered tip for one minute at the 4W setting. Reduced the beam setting to 3.25W, moved in slowly and then as the patient felt nothing, rapidly removed enamel and caries. Treatment time from patient seating to polish/dismissal was 15 minutes. We were “swamped” with emergencies today and it helped a lot not to have to use anesthesia. The lady was amazed by the laser.

We’ve only used the Colonna “long-distance defocused” technique for two weeks but I can tell you we already see a difference in our ability to place restorations without anesthesia.

Al

Sam , how ’bout this one-

Pulpal thermal responses to an erbium,chromium: YSGG pulsed laser hydrokinetic system.
Rizoiu I, Kohanghadosh F, Kimmel AI, Eversole LR.
UCLA School of Dentistry, USA.Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998 Aug;86(2):220-3
RESULTS: Pulpal temperatures associated with the hydrokinetic system either showed no change or decreased by up to 2 degrees C. Wet bur preparations resulted in a 3 degrees to 4 degrees C rise. With dry bur preparations, a 14 degrees C rise in temperature was recorded.

Does that mean you can’t fry the pulp,.I’ll bet you can w/o enough h20 or air.

Glad your part of the group-welcome!