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Hi Everyone,
There is NOT enough protective armour that Rod Kurthy could don on me, or flame retardant material that Glenn could loan me, or that I could put on, that would protect me from posting this on any forum but this one……
Here is a usual situation I find myself in, like today–treating an endodontic tooth with a undetermined, yet suspicious plugged canal orafice.
Again, this is NO reason to go and buy a laser, but if you have a pulsed Nd:YAG that you are using for another primary purpose….like perio;)….then this might be a useful adjunctive application for this type of selective laser wavelength.
Patient presented with lost crown and incomplete endo. (Patient has LOTS of issues we are addressing). He’s been living with this tooth partially aopened up, but the MB2 or Mesial palatal(?) canal was not located nor instrumented.
[img]https://www.laserdentistryforum.com/attachments/upload/RandyRCT1a.JPG[/img]
Photo for orientation. Upper right first molar
[img]https://www.laserdentistryforum.com/attachments/upload/RandyRCT1.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/RandyRCT2.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/RandyRCT3.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/RandyRCT4.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/RandyRCT5.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/RandyRCT6.JPG[/img]
X-ray shows file is aligned in the canal properly and apparently reached the apical working distance.
Bob
Well hell, if it looks like a nail, use your hammer on it!!!!!
Rod says that getting crapped on after posting on DentalTown is your Badge of Honor. I’ve a good mind to post my one and only Er,Cr:YSGG crown prep case just for the fun of it. That oughta get ’em going!!!!
So at that particular setting, your 1064 wavelength is selecting what was formerly soft tissue in that canal? Now if you cranked up the setting it would bang up the dentin a lot more, right?
Pardon my dumbness but please explain the term EJECTA? That just the stuff coming out of the calcified orifice?
Nice photography. How’d you get so many pics in one post? I thought we could only get three, has that changed?
Thanks and thanks for help with the question on Glenn’s gingivectomy comparison.
Al
Holy Cow!!! Al, you nearly gave me a heart-attack:o I was having a bit of Deja Vu all over again! Geez….you’d better be LAUGHING, cuz I’m biostimulating my heart to get going again!
Ok, compose myself………
Yes, at the 1064nm wavelength, and with the High Peak powers we can get at 100 microseconds pulse duration, 3.00 watts, 10 Hz = 3000 watts per pulse. Whoo aaah!
At about 2mm defocused, that engery will vaporize organic junk, and etch the pulpal floor dentin, but not vaporize calcified deposits (like pulp stones, for example) or remove dentin unless I decrease the “spot size” and get closer to the hard tissues.
At about 1mm defocused at this setting, the calcified tissue will vaporize before the dentin will. When I TOUCH the dentin, it will THEN vaporize, like in my previous post about Class V dentin prep.
Ejecta would be that material that is vaporized (in a gaseous state–such as carbon=smoke), small bits and pieces of what is being broken down, like calcified crumb bits, and dentin pieces. Really anything that is removed by “recoil” from the forward intense pulse hitting and being absorbed in (thanks Del) the substrate, interacting, and causing that substrate to disasociate into component parts, gas and smaller pieces.
See if this image helps:
Image courtesy of David Harris, PhD, UCSF School of DentistryAs far as the pictures go, you just have to load them three at a time, unless you are MONSTER PHOTO YODA DUDE like Glenn van As who can create a collage and then just load one or two images.
Bob