Page 102 – Laser Dentistry Forum

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April 15, 2003 at 2:32 am in reply to: Anterior #12130

2thlaser
Spectator

Nice Case David. The laser makes this much easier. Did I miss that you did or did NOT use anesthetic? Also, I have never had that problem with low water settings with my laser, which is good I guess. What tip did you use for recontouring? Also, why did you use 1.75W for tissue? Just wondering what your rationale is. I think the composite on #9 looks great, obviously #10 a tad light, but hey, what a great service in a transitional case. Clap clap as Bob and Glenn would say. You seem to be grasping laser use real well. Sure you want to visit Montana? 😉
Mark

April 15, 2003 at 3:44 am in reply to: waterlase #11230

Glenn van As
Spectator

Hi Bob: thanks for the post. I forgot to welcome Del to the forum.

WELCOME DEL TO THE FORUM AND IT IS GREAT TO HAVE YOUR EXPERIENCES IN ND YAG AND OTHER WAVELENGTHS HERE.

Yelling intended!!

Bob , I agree with your points and they are well taken. I thought this study was full of holes when I looked at it and it was the errors in the methods and materials section that bothered me. I immediately saw why the leakage was what it was, it was obvious but the conclusion many took out of it was that the erbium laser couldnt be used for endo.

Mark………..nice pic and nice tissue.

Do you have a picture of the prep , then we can really see the beautiful healing of the tissue .

Nicely done.

Glenn

April 15, 2003 at 3:50 am in reply to: Anterior #12132

Glenn van As
Spectator

David first off I think you did a wonderful job for the patient and you are to be congratulated for it. Really nice stuff. I have a litany of questions for you just because it is SO exciting to have others post pictures of such nice quality.

1. Anesthetic or not?
2. I typically use around 1-1.5w as I get more sensitivity higher than that but your result is nice.
3. What material did you use for the Class Vs they are very nice.
4. Did you probe before you started ( I get grilled all the time about biologic width)
5. What camera did you use to get the pics.
6. How long did this take.

I think this is wondeful and the centrals are almost the same length now and the result is great.

I dont think there was much enamel left anymore if I look at the pics and suspect this is why it wasnt etched at all.

Great stuff David and welcome to the posting club…..

A standing CLAP CLAP CLAP………cool case.

Glenn

April 15, 2003 at 3:54 am in reply to: Premolar fustration #11900

Glenn van As
Spectator

Well done Ron ……..man I am glad I am not the only one with these kinds of cases……they exhaust you dont they.

I think you did a great service to the patient.

Nice final result……..tired you and her out I bet.

Glenn

April 15, 2003 at 4:06 am in reply to: waterlase #11224

2thlaser
Spectator

Glenn, see previous post in this thread, the whole slew of pictures, including the surgery, minus the buildup are there. Thanks
Mark

April 15, 2003 at 5:36 am in reply to: waterlase #11227

Glenn van As
Spectator

Have you got the healing photos in there?

Thanks Mark

Glenn

April 15, 2003 at 5:55 am in reply to: General Erbium Discussion #2918

Glenn van As
Spectator

Mark Colonna came out with his high energy defocussed mode application to produce desenstization (brilliant I might add).

I have been using this more often and today everyone in the office was smiling on this case.

I use the laser for one minute at 30Hz and 160 mj defocussed to around 10 mm and then up to 25Hz and 240 m which is 6 watts or so of energy for another minute.

I then proceeded to get the resin out without anesthetic at 30Hz and 140 mj -160 mj and the patient never said a word. I finished the whole composite which wasnt that good but considering how difficult the patient was I was pleased . I use the soft tissue at 20Hz and 30-50 mj and she was fine with that as well (no water on it) and placed and finished the resin. Then I noticed a darn spot on the comp that was deeper into the dentin and thought……..shoot , I better reprep that one part.

As soon as I started at 30 Hz and 70 mj (less than 1/2 of what I had used for the whole prep and still only on the enamel …..see pic 8 on the first image) she jumped through the roof……..

It was longer than 3-4 mins since I had used the laser to desensitize and she felt it ALOT.

ANyways, we finished it and I must admit that I was shocked again and so was my staff.

The next case will even blow you away more.

Glenn

April 15, 2003 at 5:56 am in reply to: Mark knows a thing or two #7168

Glenn van As
Spectator

Ps I wasnt very happy with the result but there were some extenuating circumstances……..weird though how she felt it on the small reprep and didnt feel anything at 2X the energy when I had done the desensitization.

Glenn

April 15, 2003 at 6:11 am in reply to: Hard Tissue Procedures #3448

Glenn van As
Spectator

Here is a weird case on a little 9 year old girl.

I originally diagnosed some decay in November of 2002 and the patient showed up finally today (probably the tooth was sore).

I only have preop radiograph not a photograph because I wasnt going to save it until I hit the pulp.

THe decay was big, used the same technique for her with 1 minute at 30 Hz and 160 mj (it doesnt pop so loud at this setting and then 1 min at 25Hz and 240 mj .

Then I went in and the decay was right into the pulp. Bled lots and finally got hemostasis using astringident as I didnt want to rely on Argon .

Etch bond started bleeding again……..back to astringident and then GI used (Fuji 2 ) for the base then used composite over top.

THe whole thing was done with NO anesthetic. I used Marks defocussed technique for 2 minutes and never had pain but she isnt the easiet to treat so I was pleased I got it done.

Hope you like it………I thought it was cool. She rated the pain 3 out of 10.

Glenn

April 15, 2003 at 6:13 am in reply to: Pulpotomy without anesthetic #11413

Glenn van As
Spectator

Will try to get a BW radiograph next time…….told the staff to do it today but they forgot.

Cya

Glenn

April 15, 2003 at 2:46 pm in reply to: Pulpotomy without anesthetic #11407

Anonymous
Spectator

Glenn,

Anything(caoh or other) between the Fuji 2 and the pulp?
Why/why not?

Cool case- I thought these always waited til a weekend to call with pain
😉

April 15, 2003 at 5:11 pm in reply to: Mark knows a thing or two #7166

dkimmel
Spectator

Mark is pretty sharp. Just did his technique this AM on 2 premolars the second was very deep.
Defocused 5.5 W /75w/90a for 90 sec. Then removed the composite and dropped down to 2.75W/55w/65a and finsished everything off. Had to only go back once to defoucus at the high settings.
Scale 1-10. Pt only felt a 2 for a sec. (At the deepest spot).
Sorry no pictures. Running behind!
Nice case Glenn. Great that you can easly take photo’s.
David

April 15, 2003 at 5:35 pm in reply to: Anterior #12128

dkimmel
Spectator

Mark, I used a G4 tip. I did use anaesthetic as the patient was an extereme phobic but does not mind the WAND. Why the 1.75 W? Old habit from using the electro sx. Turn the power up til the tissue carves smoothly. At the lower setting it did not feel like I could control or thin the tissue. Since he was numb I just increased the Watts til the tissue did what I wanted. Still need to work on it though. Still looking forward to Montana ? You bet!!
Glenn
1. Yes anesthetic
2.Often wonder if my Watts and others are really the same form laser to laser!
3. Ultradent Vitlescence A5 with Transmist overlay for #9, #10 was A5 blend to A3.5 with 3M Filtek YT. That is what kiled me on # 10 the Yt was too thick . Just needs to be a very thin layer. Just started using these. Have gotten some nice results . Problem is the look good upside down and the oops!!
4. Probed I did. The guy is going for perio sx. I had 3mm on the facial and maybe took a 1mm.
Used the silk as my guide.
5.Nikon D-1
6.30 min
My hat is off to you guys that post cases with photos as it does take some time!
David

April 15, 2003 at 6:46 pm in reply to: Anterior #12131

2thlaser
Spectator

Very nice David. The reason I asked about the soft tissue wattage, is just that. If he’s numb, go for it, it IS faster. However, if not, 1.75 would be way too much. Again, you are learning fast, it’s cool to watch. Thanks for sharing with us, it’s great!
Mark

April 16, 2003 at 12:21 am in reply to: Anterior #12129

whitertth
Spectator

Great stuff David…..Keep posting
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