Page 137 – Laser Dentistry Forum

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June 2, 2003 at 4:11 am in reply to: perio with warelase #9887

BNelson
Spectator

Glenn,
Fantastic case and I love the quality of the pictures. Do you have your power settings to share with us?

June 2, 2003 at 4:27 am in reply to: Pulsed Nd:YAG for Locating & Opening Calcified Canal #11907

BNelson
Spectator

Bob
Great pictures and educational bit. Del was here this weekend and told me to check this out as it was great, and he was right. Always nice to get the complete skinny on another way to use my Periolase.

June 2, 2003 at 4:42 am in reply to: Waterlase tip replacement #9327

BNelson
Spectator

I was advised to replace the tips if they stopped “working” or “popping” which when checked closely (under magnification) will indicate they have chips on the end. I don’t know how many uses I get per tip as I rotate them. However, I don’t believe I have ever purchased 10 of them for &#36250. Seems like I pay a lot more than that.

June 2, 2003 at 5:34 am in reply to: perio with warelase #9890

Glenn van As
Spectator

HI Bruce….thanks

I use the Argon most times at CW around 1.0 watts.

You can use it higher but then you need to put the laser in pulsed mode 0.2 secs on and off.

For the erbium I use the 600 micron tip most times if it is a big area to lase……maybe gonna start using the chisel tip which has a larger surface area for the bone relief.

I typically will use water on, and use 30Hz and 100 mj or so. You can use more. I wonder whether we should use high settings. As long as the water is on, I dont know if there will be any damage…….

What do you think.

Thanks again Bruce for the kind words.

Its all just me trying things and then posting it for discussion to see how it can be improved. Slowly but surely I am getting a little bit better at using the laser through the magnification, the tips from so many, and trial and error. Its the nature of the beast and I guess why the call it the practice of dentistry, not the perfection of dentistry.

Cya

Glenn

June 2, 2003 at 7:15 am in reply to: General Erbium Discussion #2941

Glenn van As
Spectator

Hi there: here is a case I did last week where the patient was complaining of sensitivity to chewing. No thermal sensation.

HIgh mag view of first premolar showed two cracks.

I thought they would go deeper but they didnt. I usually use the laser at a low setting (30 Hz and 70 mj ) just at the end to create a smear layer free dentin zone and then etch the enamel for a little longer than the dentin.

Just to show you the cracks……its amazing how often we find these.

Glenn

June 2, 2003 at 7:24 am in reply to: General Erbium Discussion #2877

Glenn van As
Spectator

Hi there: gonna get some sleep. In a similar vein to the last post. Removed an old amalgam with anesthetic as per patients request and at end decided to use my standard 30 Hz and 70 mj and guess what I saw….

A little bit of clear serous fluid over the etch. I dried it off and it appeared again. I originally thought it was water in the air/water syringe, but nope, it was a slight laser exposure. I etched it and it stopped and placed bond overtop……nothing else.

I advised the patient and showed her these exact same photos on the TV to warn her of the exposure.

Placed a resin and will wait and see.

Kinda cool to see how much detail the scope shows you yet every once in a while I still get caught with an exposure.

Cya

Sleep………zzzzzzzzzzzzz……….

Glenn

June 2, 2003 at 7:44 am in reply to: General Erbium Discussion #2883

Glenn van As
Spectator

Hi there: I am trying to do more quadrant dentistry for patients and here is a classic case of please get rid of the old tired silver fillings.

I did core buildups with resin (laser assisted) and then noticed a small fibroma forming where I had relatively recently extracted the third molar.

I removed it with the erbium laser, soft tissue tip 30 hz and 80 mj without water. Then to get deeper ( I could feel fibers still in there) I took a 80 degree tip and it was a 400 micron and placed it in the crater to eradicate the remaining fibers with the same settings.

THe post op shows nice healing on the laser troughing for tissue retraction during the prep phase ( Argon) and also the nice healing of the fibroma which the patient was complaining about her tongue playing with it prior to me removing it during the prep phase…

OK OK now I am off to sleep……

Cya

Glenn

June 2, 2003 at 1:40 pm in reply to: perio with warelase #9895

Andrew Satlin
Spectator

Hey Ron,
I realized that I only answered half of your question.
Re: Natural or laser stimulated remodeling. I would say around a restorative margin no. In fact I think if anything, it would lose attachment in the direction of a boney defect due to the proximety of the restorative margin which is difficult or impossible to keep plaque free. Also, the defect we were originally discussing was surgically induced. These behave differently as well.

In regular plaque induced perio defects–we will see. That is regeneration.

The final point is that patients, as you have probably seen, can tolerate a certain degree of negative arch. as well as different biologic widths. It is hard to use these specific rules when each patients tolerance is so different.

talk to you later
Andy

June 2, 2003 at 2:54 pm in reply to: Lasers and cracks #7390

whitertth
Spectator

Glenn, u r giving me the itch to purchase a scope….. nice stuff buddy!

June 2, 2003 at 2:56 pm in reply to: class I and class 2 #12102

whitertth
Spectator

I would schedule 45 minutes depending on the child and if i were doing multiple maybe an hour or hour and fifteen,,,The idea is if u are gonna do these things without anaesthesia as we get deep u will go a bit slower and maybe use alot of hand instruments( look at Mark’s Laser dental tools) so u wont be going all that fast at the end…

June 2, 2003 at 4:00 pm in reply to: Reliability Reports #9306

dilbert
Spectator

As of June 2, 2003. I have a grand total of 1 person reporting his/her experience. I will post charts when there is sufficient info to make pie and bar charts.

June 2, 2003 at 10:52 pm in reply to: Reliability Reports #9320

Swpmn
Spectator

That’s disappointing. Perhaps not many saw these posts(I think most hang out in the ST, HT and Erbium sections) or perhaps just not much interest.

Any chance we could have Ron e-mail all the members of the forum that currently list lasers in use and ask for a response?

Al

June 3, 2003 at 1:22 am in reply to: Reliability Reports #9299

Community User
Spectator

QUOTE

Quote: from Swpmn on 6:52 pm on June 2, 2003
Any chance we could have Ron e-mail all the members of the forum that currently list lasers in use and ask for a response?

Al

Done! All members with valid email addresses should receive an email notification.

June 3, 2003 at 1:54 am in reply to: class I and class 2 #12098

jetsfan
Spectator

I am starting to rethink these deep ones. Yes it would be great to do it with no anesthesia, but if it takes 45 min to do a class 1, perhaps it is time to just give the injection and get it done in half the time( still using the laser).
I have Mark’s instruments, and they are great especially for those small ones. But if the hole in the tooth is huge, then we certainly don’t need microtools.
Today I had an interesting case. I have a patient who has an allergy to vibrations. That’s right vibrations, look it up.
Anyway she was referred to me because the vibration of a high speed drill can cause a severe allergic reaction, so much so that she must carry an epi pen to the dentist. So today we had to do a large class 1 under an old amalgam. I thought that I would attempt the whole thing without anesthesia and of course without a high spped handpiece.
Anesthesia was 5.25W 90/90 for 90 sec. I carefully circuscribed around the amalgam with a g6 tip at 5.25 w. I was able to remove it with a spoon and was quite pleased as no pain was felt. Now came the task of enlarging the prep and removing the decay. It got deeper and deeper and more expansive. I had to remove another amalgam on the mesial again using the same method. As I got deeper and deeper , more and more discomfort was felt. At that point I was at 2,25W 26W36A. To be absolutley certain that all the decay was removed I had to ( reluctantly succumb) and give septocaine. I finished the caries excavtion and place a composite. The procedure took way too long and I sacrificed a tip in the process. Next time I will just give the injection and get it done more quickly. I just don’t know how some of you do it.

June 3, 2003 at 2:07 am in reply to: Reliability Reports #9323

Swpmn
Spectator

Cool!!!!!!!

Al
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