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Robert Gregg DDSSpectatorAlan–
Thanks!! I’ve never heard of it. I’ll check it out.
Bob
SwpmnSpectatorGlenn:
Thanks for the photo, now I understand. Could tell from your magnified photos that your system was much different than mine but couldn’t quite get the whole image until today.
Al
SwpmnSpectatorRon:
My photos were taken at 1024X768(approx. 300KB file) then resized to 30% for a 307X230(30KB file). This seems to show up well on the forum without having large pics or taking up much space.
On the forum, I’m not sure why sometimes the photos stack on top of one another whereas other times they appear side by side.
Al
SwpmnSpectatorRon:
P.S. I use Ulead Photo Explorer to organize and edit my images. Very simple for dummies like me and I paid a whole ฮ for the program at Office Depot.
Al
2thlaserSpectatorHey everyone, I have done this before, but my friend, Dr. Bob Lowe, who is Ross Nash’s partner, taught me these, just thought I’d share one today. This is another reason why I love our lasers. Normally, send off to the periodontist, wait 8 weeks, get em back, do restoration. Today this patient came in, had sheared off a crown that was on this tooth which was an abutment for her lower partial denture. It had been previously treated endodontically, and the endo was fine. Notice the tissue growing over the tooth. I used a T-4 tip with .5w 11%air and 7%water, troughed around and exposed the root area, then used a hemostat to remove an old stainless post. I enlarged the canal space with a batt cone burr, and took the impression for the post. Here is the preop photo.
Here is the post op photo.Ok, now I removed approximately 1mm of bone circumfrentially, and have a biological width of 2-3 mm. I would like some constructive criticism. What would you others do here? What type of post? Build up? Teach me some new tricks! Please! I love how the laser really gives us such lattitude to do things well. I got an excellent impression, and oh, of course, the patient felt nothing, I used no anesthetic, and she was happy, she said she was on a diet, and was happy to lose the ounce she shed once I removed the tissue, isn’t that hillarious? Thanks everyone.
Mark
AnonymousSpectatorMark,
Nice job on the post removal and laser prep.
I’d go with cast post and core, cutting a keyway in the post prep, so the new post/ core can’t rotate when the RPD is placed back on the new crown. Could it be the rotational forces are what caused the core to fail around the old post?
Seems like with the tapping force of the laser there should be a way to use that to break up cement around a post and vibrate it out. Maybe put an intermediate material on top the post and laser tap it? I don’t know just typing out loud
The biologic width sounds good , how much tooth (ferule?)do you have to place the crown on? I think I remember hearing or reading 2mm minimum or you increase chance of fracture. I can tell you the ones I’ve done with less than that have failed (those times patients and I didn’t want to have the periodontist do crown lengthening,prelaser era).
Its hard to tell from the picture but 1 1/2 -2 mm biologic width plus 2mm minimum ferule and I’d think you’d be good to go.
Glenn van AsSpectatorHere is a case I did today for a young kid with an abscessed
tooth……….darn it all I forgot the radiographs but the adult premolars
are right there. Mom is holistic and wanted no antibiotics…….its xmas
and I only had time for the incision……….all done without anesthetic.Its cool under the scope to see the different appearance of the abscess
which went from pink to white prior to popping because I had the laser in
defocussed mode and then incised it.The Kid felt absolutely ZERO……….I love the pics
Here is the link , note how the abscess went to white.
What I did is put the tip in defocussed mode for about 30 secs about 6-8 mm away and the abscess went from pink with all sorts of vascular nature to white….cool huh.
Then I went close and popped it and look at the three shots I got of it……..NO ANESTHETIC.
Then after it was drained it looked like a popped balloon.
Kid is coming back in the new year to exo the loose baby teeth. Mom didnt want antibiotics……..
Have a look it was really cool..
Glenn
http://www.sendpix.com/albums/021219/194006000000836f2079b3683b2e0f/
Glenn van AsSpectatorThe original pics for the case are in the discussion but for those who forgot ………here are three of them.[img]https://www.laserdentistryforum.com/attachments/upload/Resize of Resize of DSCN3781.JPG[/img][img]https://www.laserdentistryforum.com/attachments/upload/Resize of Resize of DSCN3782.JPG[/img][img]https://www.laserdentistryforum.com/attachments/upload/Resize of Resize of DSCN3786.JPG[/img]
whitertthSpectatorIn these situations I have gone away from cast post and gone to a corepaste buildup with a clear resin post.. I bet with an endo tip or even a t-4 u would get some real nice etching of the canal and a great bond with something like tenure and corpaste..Den Mat also makes a nice resin post…just another suggestion…
PS Great Job on the CL Mark
Glenn van AsSpectatorHere is the healing photos of the case at 72 hours and this is in my mind amazing………
I had to look to find the area I had cut three days before.
Glenn
[img]https://www.laserdentistryforum.com/attachments/upload/Resize of Resize of DSCN3861.JPG[/img][img]https://www.laserdentistryforum.com/attachments/upload/Resize of Resize of DSCN3862.JPG[/img][img]https://www.laserdentistryforum.com/attachments/upload/Resize of Resize of DSCN3864.JPG[/img]
Glenn van AsSpectatorWell done Alan and at a reasonable cost. I shoot at the same and resize to 40% in Acdsee 5.0 which is around 60 dollars usa so you beat me!!
Glenn
Glenn van AsSpectatorGreat stuff……..here is one I did today with the crown in place………
Glenn
These are the photos during the prep……..
I will send the post op shots next and then the radiographs.
Glenn[img]https://www.laserdentistryforum.com/attachments/upload/Resize of DSCN3512.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/Resize of DSCN3528.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/Resize of DSCN3538.JPG[/img]
Glenn van AsSpectatorPart 2 the insert appt………look how nice the tissue looks and the margin is awesome ………
Glenn[img]https://www.laserdentistryforum.com/attachments/upload/Resize of Rotation of DSCN3875.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/Resize of Rotation of DSCN3878.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/Resize of Rotation of DSCN3882.JPG[/img]
Glenn van AsSpectatorHere are the preop and postop radiographs. Not drastic but the result was great.
Glenn
[img]https://www.laserdentistryforum.com/attachments/upload/Resize of DSCN3553.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/Resize of DSCN3887.JPG[/img]
Glenn van AsSpectatorMark……nice stuff. Do you have a radiograph of the case, then we could see how it looks. I think that you need to do either a cast post or a resin post with corebuild up but I am not sure either is gonna hold………
I really love the laser dentistry. CLAP CLAP CLAP and the photos are great………
You are gonna love the scope.
Man what a night for posts huh.
Glenn
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