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ASISpectatorHey Glenn,
Another great application of Er:YAG.
Too bad a cuspid has to go.
How do you find the valplast clasp in terms of durability?
Almost invisible sitting over the tissue though.Good work again.
How do you find the photo? Should I lose the girls? They are my new assistants as soon as basketball season is over. I wish.
Andrew
ASISpectatorHi Glenn,
What is that crown splitter instrument? Please advise.
I did get a set of Mark’s microdentistry instruments. They are of very high quality. I like the feel of the handle.
Andrew
Glenn van AsSpectatorHi Andrew…….I havent had the valplast partials in for more than about 2-3 years.
Patients like them. They are ok if you use the ValClean cleaner on them.
You can add to them and esthetically they are nice.
I typically will do a combo cast/valplast as in this one.
Hated to lose the canine but it was a toughie to save.
As for the girls…….now that the lakers are toast maybe they are looking for a job…….do you really need both??
Maybe I can borrow one?
I like the pic , it looks good on you……….THE SUIT THAT IS!!
Glenn
Glenn van AsSpectatorHey Andrew: As for the crown splitter , I dont know who makes it but will look tomorrow….had it a while.
I like it as its sturdy and usually breaks the bond. In this case it lifted off easily. Never know though!!
Cya
glenn
SwpmnSpectatorThat’s pretty darn cool. You showed me this on extracted teeth in Anaheim.
How does the 1064nm FR Nd:YAG affect the pulp on vital teeth? Doesn’t the energy penetrate much deeper than my 2780 Er,Cr:YSGG? Did you select a short Pulse Duration in this case to prevent pulpal damage?
Is the fiber in contact with the dentin/caries? Is it possible or would there be any advantages to using a water spray with the FR Nd:YAG?
Al
SwpmnSpectatorThanks, Mark, for the excellent photos demonstrating the most efficient orientation of the Erbium tip to enamel rods.
With the shorter 4mm tip, how far are you away from tooth structure as you ablate? I know you have told me the ablation is faster with the G4 tips as opposed to the longer G6 I use.
Al
SwpmnSpectatorLooks real nice, Ron.
I don’t think any need to go deeper or biopsy.
Al
Robert GreggParticipantThanks Bruce for the kind words. Whew! It was not an enjoyable experience.
Ron, that “dusty” area is actually laser etched enamel. It is not the carbonization. I didn’t take a photo of that. It looks awful! This surface appearance is what shows up after the carbon is removed after water is sprayed on the tooth, and then the (black and gray) carbon is vaporized away.
As you might imagine and maybe see, this is a very thin etched layer. It can be polished off with a brownie point. So, that would leave one to conclude that the Nd:YAG laser etch is weaker than Phos Acid etch right? Yep! Fr Nd:YAG etched enamel alone is a weaker etch than P/A. Bond strength studies and practical clinical applications—like bonding brackets—demonstrated that 11 years ago.
So what’s the value of doing it? None, other than it’s the result of getting stain off. Will it accept a P/A etch and bond? Yes, and look how the P/A etch dissolved some of that already etched enamel surface. So it is a reeeally shallow layer of bond that will brux away during chewing…..
Bob
SwpmnSpectatorSo………here’s my question:
Is the ability to obtain hemostasis more a function of wavelength or of pulse duration? Doesn’t a wider pulse duration invoke a wider band of thermal necrosis and thus achieve the desired hemostasis?
If I could vary and thus increase the pulse duration on my Erbium from say 150 to 550 microseconds would I see an improvement in hemostasis in soft tissue? How come today’s Erbiums don’t come with user adjustable pulse durations? I guess the Cavilase that Jack Miller showed me one time did have a variable PD – anyone know if the PD is “user-selectable” on the Opus Er:YAG?
Al
BenchwmerSpectatorIs this a WaterLase only topic?
If not stated differently I guess we are to assume WaterLase?
I though we were going to give out treatment parameters, tip size, duration, etc.
I never see Hertz posted in WaterLase posts, even if it is fixed, it would be helpful in treatment interpretation.
Ron,
What size tip did you use?
I would place tissue in biopsy bottle, evaluate healing and even then keep to see if insurance will pay w/o biopsy report, never know when you need that tissue.Jeff
AnonymousSpectatorCouple more questions if you don’t mind, Bob.
If there were no pigment present (stain) would you still get etch effect? A recent article in ESOLA journal mentions melting of enamel and dentin surfaces by nd:YAG, is this what would happen w/o the presence of the stain?
If there is some melting and recrystallization, is the tissue more resistant to acid?
Thanks,
BenchwmerSpectatorBob,
I got a blurb in May’s DT Magazine on Should I buy a “Water”laser?, opposite the Opus Ad and before the 2 page BioLase center spread.
At least I got top billing.
Jeff
SwpmnSpectatorExcellent case, Glenn. Nice use of your Er:YAG as a “periotome” to relieve those tough supra-crestal fibers. Conventional treatment might have consisted of troughing around the root with a carbide bur – in your case the patient benefitted by not experiencing the acoustic whine of the high speed. Also treatment with the Erbium may have resulted in less trauma to tissue, bone and possibly less post operative discomfort.
Al
joegarciaarSpectatorMark:
Excellent work. Thanks to share your images. Still I do not make crowns in my patients. Single I am practicing. I hope to gain confidence for it soon.
SwpmnSpectatorNice use of your laser and I’m sure the patient appreciated you not having to fire up a diamond or carbide!!!! Dr. Mark Colonna has taught us this trick also with his Er,Cr:YSGG.
How come Erbiums cut Luxatemp, acrylic and composites? Is it because these materials contain a certain percentage of water? Or do we know if the 2700 to 2900 wavelength is well absorbed by materials in resins?
Anyone ever tried to cut a polycarbonate crown with an Erbium laser?
Al
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