Hi there folks: As I get more comfortable with the erbium for osseous recontouring, I find that I am looking more and more at biologic width issues and making sure I have enough when I didnt before primarily because of the ease of doing this.

In this case this premolar (maxillary) broke and was patched up by my dad who put a couple of pins in.

I had to remove the restorations and pins and then get some more solid tooth structure on the palatal so I used the erbium to remove tissue (30 Hz and 100 mj without water) and then 30 Hz and 130 mj with water for the bone with a 600 micron tip. I think if Hoya Con Bio had a big 1 mm or 1000 micron tip I would use it here so maybe it is something I will talk to them about , a big stubby tip for bone removal.

In addition, we troughed to control hemostasis with the diode that I have in the office at present. I then proceeded to take the impression on the same day.

Now I hear that in the USA that certain dental plans will not pay for the osseous if the crown prep is done the same day. Ridiculous I think but that is something you need to discuss with the patient…….

I took the impression and was pleased with the result and then placed a provisional on the tooth ( my Dental assistant did)

I will post the final shots when I do it for this case and tell you how long the healing took etc and focus in on the palatal to see about recession. I may try and get the patient back in 6 weeks to look at healing as well.

I sent one of my cases to the periodontist here in town for her to look at …….no reply.

I wish people would at least have an open mind to these procedures as I honestly havent had any complications yet but I guess if I will then I will adjust my settings.

One thing I wondered about was the possibility of air emphysemas with the air on cases where you blow out the attachment and bone. I had some bubbles on this case at the gingiva so I think it might be an idea to keep the air low with the bone reduction.

What do you think?

How about taking the impressions on the same day.

Rod taught me the marketing value of this and how you must explain to your patients what a service you are doing to be able to do the reduction of bone at the same time as you take the impression.

What feelings do you have on this and other ideas.

In closing, I am constantly trying to push the envelope on using the erbium as I get more comfortable with simple restorations and other soft tissue procedures with it.

How are you using the erbium lasers in your offices?

Glenn