Multiple Uses - Laser Dentistry Forum

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April 30, 2003 at 8:37 pm #2945 Reply

2thlaser
Spectator

Hi everyone,
Here is a case with multiple use for the Erbium Laser. This just happens to be my uncle, visiting from Pennsylvania…he gave me a workout!

Here is the first radiograph, notice decay on #7, and #9. Also the need for retreatment of the endo on #7.

Next is the retreatment of the endo…

Then here is the case AFTER I removed the crowns/bridgework…which is about 20 or so years old…he can’t remember. Alot of decay. #7 is supported by a Removable Partial Denture….7-9 were splinted together…

Here is other photos…occlusal views…

We went in and did closed crown lengthening, no anesthetic….T-4 tip, 12%water, 9%air, and finished preparing teeth for cast posts…..

Then we took impressions….the rest to follow next week as I get the case back from the lab. My uncle said he never felt anything, except my “probe” as I measured the sulcus. Never had any problem as I lasered the soft tissue, and did some boney recontouring creating the ferrule. Unfortunately, I am stuck with his partial, and implants are not an option for him right now, with him living so far away…but in the interim, we will use what he has…maybe next year I can get him to stay for a more extended time to do some implants, and such. I will post more as I get the case back as I said earlier.
Mark

May 1, 2003 at 2:36 am #7477 Reply

Swpmn
Spectator

Looks nice Mark.

What was the wattage setting on the Waterlase for the closed crown lengthening procedure?

Al

May 1, 2003 at 2:44 am #7475 Reply

ASI
Spectator

Hi Mark,

Very nice handling of a case where your hands are kind of tied. Will all 3 teeth again be splinted together for the partial support purpose? If so, you might want him to have custom fluoride trays for home use to increase caries resistance.

Is the last photo after closed crown lengthening and osseous reduction? If so, WOW for the nice tissue appearance.

Good stuff.

Andrew

May 1, 2003 at 4:04 am #7476 Reply

Glenn van As
Spectator

Hi Mark: Nice photos and interesting case.

I dont think I would have been inclined to save the lateral as there isnt much of a ferrule. Even the #9 has in my mind a poor prognosis, as it doesnt have much tooth structure left.

Did you say he has a partial denture or is he chewing just on the bridge?

With the above in mind I still want to mention I was pleased to see the final preps clean of decay and nice posts holes…..no chance for a rubber dam I guess ?

Neatly handled from the laser standpoint, and I will be interested to see the final result after the posts and cores.

You are a braver man than me Gungha Din!

Thanks for posting such an interesting case.

Nice pics again

Glenn

May 1, 2003 at 4:26 pm #7472 Reply

whitertth
Spectator

mark, nice stuff…is there enough bone on the diatal of that lateral…I kinda agree with glenn that the lateral looks like a loser but is finally so what the heck…….

May 1, 2003 at 4:51 pm #7473 Reply

2thlaser
Spectator

Hey guys,
Excellent comments. First let me address Al…The settings were T-4 tip, 13%air, 9%water.

Glenn….I can appreciate what you are thinking…here’s the thing, my uncle lives far away, is 74 so I need to do what I can for him. Actually, there is NO mobility on any of these, and they seem very strong. I have about 2mm of biological width, and my uncle is extremely healthy. He unfortunately, has had a bit of questionable dentistry done over the years, as has my aunt, which you will see in another post soon. I really think this case will be fine. He wears a partial, that (I can’t believe it was made this way), clasps to #7. I will splint 7 and 8, and make #9 a separate crown to help him with the ability to keep the area clean. Believe me, I would rather do a bunch of implants here and then restore it appropriately, but his time here with me is very limited.

Now, Andrew…thanks, yes this is immediate post crown lengthening, and I really did get a nice result here, I agree. Seriously, if we use our Erbiums on LOW powers, it may take a bit more time to acheive our results…but as you see, the tissue responds beautifully.

Thanks everyone, more to come!
Mark

May 1, 2003 at 5:52 pm #7470 Reply

Anonymous
Guest

Mark,

What about placing a cast post (#7)with a ball attachment? Have the ring put in the partial and then add 7 to the partial( can’t think of the name of these now). Gets rid of the lateral forces on 7, no need to splint 7,8 causing a tough area to clean. root tip of 7 maintains bone. no ugly clasp on 7.

Just thinking out loud,

p.s. Mark, instruments arrived and they’re awesome. Would love to buy some more of the spoons to add to other setups.
Thanks for developing these.

May 2, 2003 at 1:07 am #7471 Reply

dkimmel
Spectator

Mark, That tissue looks great. Why do you like the T tips over the Gs in this type of case?
Nice photos, what type of camera?
DAvid

May 2, 2003 at 4:56 am #7478 Reply

Swpmn
Spectator

Hey Mark:

Yeah man I read in your original post where you used a T4 tip at 12% water and 9% air but what was your Power setting on your beam?

You said you used low power – one Watt, two Watts?

Al

May 2, 2003 at 12:43 pm #7474 Reply

2thlaser
Spectator

Right on Al, I goofed!!! Sorry. I use .50W with a T-4, if I change to a G-6 then I use .75W.
Sorry Buddy!
Mark
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