Hi Allen: I have been using a metal matrix for all my isolation either a cut tofflemire strip like this one I did today, or an interguard from Ultradent which I have shown before. It protects the adjacent tooth and seems to reflect the laser energy and give you faster cuts on the tooth.

In this case I used a 400 micron tip with the Delight laser. A cut tofflemire was used in this case for isolation.
I used a rubber dam with topical (one touch by Hagar) and didnt use any anesthetic except that.

Settings were 30Hz and 100-120 Mj which was quite high for the enamel and then I lowered it to 70 mj for the decay. Used a tiny bur for the last little bit.

Patient rated pain as 0 out of 100. In addition patient has alot of attrition. I used marks nice felt type instrument which is very thin and I like it alot for sculpting the composite.

I finished the case with burs and polishing cups.

Glenn

Hi David,

No need for flaps to de-epithelialize with pulsed Nd:YAGs and diodes.  The perio and CO2 folks need to flap to gain access for their “free beam” lasers.  It is really passe.

Check out the annimation on http://www.millenniumdental.com to see fiber-optically de-epithelialization at work with a pulsed Nd:YAG.

Bob

(Edited by Robert Gregg DDS at 9:48 am on Feb. 26, 2003)

Glenn,

Thanks for the article!

No need to tone down what you are saying, especially when you are right.

I don’t believe for a second that water is doing the cutting with an Er:YAG or Er,Cr:YSGG.

Turn the water and air off an Er,Cr:YSGG, like I did in Phoenix last Friday. SOMETHING sure as hell cut that extracted tooth! And it wasn’t water! Maybe it was……..no I’m not gonna go there, I promised Ray.

My two cents.

Bob