When we speak of prep time, are we talking about the time to excavate/prep the lesion OR the total time the patient is in the chair? If we are speaking of prep time, in most instances the rotary high speed will be faster.

In my experience, Class I and II preps are much slower with an erbium laser. These are also the lesions where I have the poorest no anesthesia rate, particulary molars. In my practice it has not been chronologically/production practical to attempt no anesthesia Class I or II preps on molars.

Class III, IV and V(V on anteriors/premolars) prep time is about the same or slower. These are the cavity preps where I have the highest no anesthesia rate. In many cases, we utilize a variable pulse rate erbium at 10 Hz. We find excellent no anesthesia rates for these Classes varying the energy setting from 150-300 mJoules. If one is able to place the composite without local anesthetic, the total chairtime with the erbium may be reduced.

Most of the lesions we prepare with the erbium are moderate in size. I have 34 months experience with erbiums.

As Dr. Allen pointed out, there are other reasons to utilize an erbium laser for cavity preps. The most important reasons we use the erbium is to reduce use of the high speed handpiece and to totally eliminate use of the slow speed handpiece for dentin caries excavation.

Al

Hi Ron,

Overall slower with laser but more pleasant experience for patients and office staff.

1. slower
2. slower/same
3. slower
4. slower/same
5. faster/same
6. faster/same
7. moderate carious lesions
8. 9 months

Also slower as the use of the Dental Operating Microscope makes me more picky with every step of the treatment. The more I see, the more I want to do it better.

Cheers.

Andrew

Until after last week I could answer your questions easly. Now I really can not give you an answer. I have the dentist with the rosecovered sunglasses view of laser dentistry. I was talking with several dentists at the DT meeting in Vegas telling them how long it takes me do a procedure. I told them that after got things down that my time was the same. That is the time the patient was seated and dismissed was no different with or without the laser. Susan overheard me and later informed me that I was wrong. That on average it takes me 10 min longer. OOPs. Now to confuse things, I don’t think it is that simple. Today I just did a quad of fillings. 28 O, 29 O, 30 OB and 31OB . These were on a 22Y/O female. Time pt seated til dismissed was 25 min. (per Susan) This was working with a new assistant and were into dentin. No injections were given for anaesthic.
It is also rare for me to use anaesthesia. Once I start with the laser I have only had to stop and inject once since July 2003. Of course I prescreen the patient as we discussed on another thread. The alloy removal now that I do my wierd thing has been 100% to date. It is a PIA on max molars.
After all that Ron, I don’t know forsure. What I will start doing is timing things again. I have done this before lasers to help with scheduling and have a base line. I’ll try to also include information about anesthesia,tooth #,age of patient, settings,laser type, depth of restoration and anything else I can think of.
There are just so many factors. At the DT meeting guys were talking about having sensitivty and difficult times in cutting. In talking to them they were using 6W . Even with the Delight there is a wide range of setting. Like Allen I use 10Hz and 200mj most of the time. All these factors make a big diffenerce.