Forums › Erbium Lasers › General Erbium Discussion › New laser owner
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AnonymousGuestQUOTEQuote: from dkimmel on 5:56 pm on Nov. 4, 2004
Don, send me โ in small unmarked bills…
DavidDavid, I thought I taught you better than that…
Disclose all the costs upfront (paperwork ษ, registration ษ, new graphic 񘐜, finders fee 赨) otherwise how are we ever gonna get scopes :biggrin:p.s. Don, check your avatar now, I set up a free preview of what David’s โ gets you !
N8RVSpectatorGEE, THANKS, RON!!
I don’t know what to say … except that under NO circumstances will I exchange name tags with David. I’m not sure what would happen, but from the oblique references, I think I’ll steer clear.
Besides, HE’S not a “Newbie +1”!
Damn, I’m proud.
Tom Daschle is out and I’m a Newbie +1. Could life get any better??
— Don N+1
PBogerSpectatorHey Newbie,
Just to give you a little company, I thought I’d post.
I have absolutely nothing of value to post…I just can’t help myself sometimes.
I just got my waterlase a couple of weeks ago, and I’m mounting the learning curve a little bit at a time until I can get into a course, (still waiting for response from the course administrators)
Anyway, I’m loving it so far, and can’t wait to learn more.I’ve been lurking these and DT forums for a while in order to learn about lasers and prepare myself for my very own. I can’t say enough about the value of being able to evesdrop on these discussions.
KEEP TALKING GUYS!
Regards
Paul
d2thdrSpectatorI’m a new DELight user also, and tried my first restorations today. I think my patient was too young (14 yr old black male), and I had stars in my eyes seeing all these little interproximal lesion that are perfect for tunnel preps (11 of them).
We did get 2 done, ML’s on #8 & 9. Analgesia with 30 and 200mj, for 2 minutes. Actually only used the Dentin setting of 20 @160 for the preps. He rated sensation at a 4/100. Pretty good I thought. Did the miniscule restorations (loved the prep sizes) and moved to the others.
Here’s where I ran into trouble. Tried the same analgesia. Moved in at 20 & 300 and thought I prepared the enamel fairly well. But as I tried to go under the distal marginal ridge, the kid got sensitive, we backed off , moved to dentin setting (20 @ 160), and made little to no progress. This went on for awhile, and I realized I wasn’t really cutting much.
So I bailed out because I didn’t want this to become a situation where I saw how far I could get him to push himself down into the chair. We can do these later, so I really don’t want to use injection and drill.
Tear me a new one, I need help!!
SwpmnSpectatorDennis:
Each of us forms their own opinion based on what they read and see clinically. Personally I rarely use any type of erbium laser “pre-analgesia”. For no chemical anesthesia laser preps I practice patient and lesion selectivity based on what I perceive as the patient’s discomfort threshold.
With the DELight, I think your setting of 20Hz and 300 mJoules is way too high for a posterior tooth on an unanesthetized patient. In most of my similar cases I use an 80 degree tip at 10Hz 210mJoules with the tip placed 1mm from the treatment site and viewed under 2.5 to 4.0X loupe magnification. Placed an occluso-lingual composite on a 14 yo male this afternoon without chemical anesthesia and it appeared that the patient felt nothing.
Al
d2thdrSpectatorAl,
I obviously need more experience and thought on varying the settings. All input is appreciated.
N8RVSpectatorAl, I’d been wondering about the laser analgesia routine as well, having used it routinely and being the impatient sort that I am.
Well, twice now, I’ve had identical lesions on the same patients (occlusals on max first molars, same on mand first molars) and tried both with and without the analgesia prep.
Both times, I used the 90-sec defocused application on the first lesion and none on the second. Both times, the patient told me afterward that the second one “must have been deeper” because they felt it more.
So, while that’s hardly scientific, I’ve chosen to continue using the 90-sec prep before I start removing enamel. All that proves is that some things work for some people, I guess.
File that in the FWIW drawer …
— Don
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