Nd:YAG in restorative dentistry - Laser Dentistry Forum

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October 24, 2005 at 7:56 pm #2740 Reply

etienne
Spectator

Hi
This patient presented with a bad fitting bridge which I removed. At the time the tissue was flabby, bleeding and swollen.

I used my Nd:YAG at 40mJ, 80Hz in the sulcus to sterilize the sulcus and stimulate the tissue. Total lase time approximately 30 seconds.

After-

10 Days later I could take an impression to have the final bridge made. Tissue response made the job a lot easier.
Etienne

October 25, 2005 at 12:43 am #5649 Reply

Robert Gregg DDS
Spectator

That’s a nice service Etienne.

Can you use 20 Hz on your machine?

Bob

October 25, 2005 at 2:39 am #5648 Reply

Glenn van As
Spectator

Hey that is beautiful…..tell me something…..what do you think is on the distal of the premolar at the margin. Is it calculus?

What a wonderful service and CLAP CLAP CLAP for the photos……..I LOVE IT!!

Glenn

October 25, 2005 at 4:54 am #5643 Reply

etienne
Spectator

Thanks Bob
I don’t know, I’ll check today and see whether 20Hz is possible. Can you tell me why?
Take care
Etienne

October 25, 2005 at 4:59 am #5646 Reply

etienne
Spectator

Thanks for the compliment Glenn
I would prefer to think that it is something on the lense ;))
Seriously now, I checked the big picture and zoomed in as far as I can, it does seem that it might be calculus. I did not see it at the time, just show you how much one learn on this forum.
Take care
Etienne

October 25, 2005 at 9:52 am #5644 Reply

etienne
Spectator

Hi Bob
I checked the details on my machine:
Frequency from 5 to 200 Hz in 5Hz increments, Max energy per pulse is 250mJ, minimum energy per pulse is 40mJ, maximum power is 10W.
Any feedback on that?
Thanks very much
Etienne

October 25, 2005 at 1:39 pm #5651 Reply

Robert Gregg DDS
Spectator

Etienne,

If you can select 20 Hz and get your mj/p to 200, and SLOW your hand movements down, you would see a much more prfound anti-inflamatory and anti-bacterial effect that at 80Hz and 40mj/p.

That is because the peak powers increase at higher mj/p and that mean deeper penetratin of the Nd:YAG w/o risking peripheral thermal damage…..provided you don’t just pour in energy (Joules). So about 1 minute per tooth is a good goal.

Bob

October 25, 2005 at 1:44 pm #5650 Reply

Robert Gregg DDS
Spectator

Soap Box Warning!

Sorry, I just want to add that this conversation about device parameters is why it is so critical that manufacturers allow there device to completely display actual operating parameteres and not just “Setting 1” for troughing or whatever.

With the abject lack of clinical training by most all manufacturers, knowing the laser’s actual operating parameters: pulse duration, Hz, mj/p, etc at each setting allows us to have a meaningful conversation.

Bob

October 25, 2005 at 2:24 pm #5647 Reply

etienne
Spectator

Hi Bob
Thanks very much!! I really appreciate your teaching on this forum a lot.

OK, 20Hz and 200mJ it is. I assume that would be at a pulse duration of 350usec (my only other option at this stage is 700usec)?
Take care
Etienne

October 25, 2005 at 6:27 pm #5652 Reply

Robert Gregg DDS
Spectator

Yep, and don’t dabble too long either. 350usec is fairly long in PD for tissue–about 50% of thermal tissue coefficient–so be careful.

Are you sure you don’t have a shorter PD like 100 or 150

Bob

October 25, 2005 at 6:42 pm #5645 Reply

etienne
Spectator

I thought I did, I thought it was 50 and 350 but when I checked the details this morning it seems as if I made a mistake previously. Apparently there is new software available that will have shorter PD available. I need ti check that soonest.
Thanks again!!
Take care
Etienne
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