Here’s my latest amalgam challenge-

60 yr old Female
Advanced scleraderma and interstitial lung disease, patient can barely get RPD in and out due to limited openning.
On Coumadin
#20 old do amalgam fractured in box (ketac silver temp in box).

Sorry about the poor images, all we could get in was a mouth mirror so they are images in the mouth mirror.

Amalgam removal 4mm tip , bathed 20 seconds , 6 times due to limited ability to keep mouth open. Highspeed removal interspersed with bathing 3x. Slowspeed round burr removal of decay. Observed 2 fractures mesial, etched them well with laser and acid, didn’t remove at this point cause pt was already tired. Figured it would be simple to replace if need be another time.

Relased, etched, bonded.

Pt rated discomfort 3 out of 10.

Ideas/alternatives?

I agree, that was my thought also. I’m sure I’ll have to go back and take care of the ridge sometime, but she couldn’t handle anymore that day. It was a struggle getting that much back together and having the RPD go to place.

Gone back to room temp now that its finally not getting so cold at night in Michigan.Our thermostats automatically set back and during the winter months. We drop the office to about 65 at night. By the time we came in , in the morning, the rooms were warm but the water was not , that’s why we went to warming the water.

David,
I read that article you were mentioned in, they had it on the biolase website. I was trying to figure out who it was. Can’t believe they didn’t mention your name, but at least you can reference being in the paper now.
Regards,
Al B