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Robert GreggParticipantYeah sure,
Your laser will speed up the absorbtion of just about anything through mucosa. Do what you did on the palatal or incisive area before giving an injection, and you have a kinder, gentler episode.
Same idea with the update of bleach on teeth to whiten, and with fluoride for uptake on enamel or dentin…..
Bob
dkimmelSpectatorI know someone had to have been pretty good with the imaging software to do that.
I have been thinking about this vaporizing. As we know it is not possible. But what if the are cutting the alloy out. Like in removing a post. Ditching the alloy out by removing a thin layer of enamel. Then just disloge it.
David
Robert GreggParticipantGlenn–
Very cool!
What type of 3 chip camera did you get? Should be good for live-streaming video?
I’ve never felt your posts were “holier than thou”, but I have never been “threatened” by what you share or post. Sometimes what you post is simply “better than thou”, and that may make some feel uncomfortable. Those that feel you are preaching versus teaching are those who feel insecure about themselves….and I don’t include anyone here in Ron’s forum.
Your contributions are extremely valuable and appreciated by me and many who are quiet. We are all lucky to have you here on this forum sharing your creativity and skills.
You are a credit to our profession!
Bob
Robert GreggParticipantHi Ron,
Cold sores/fever blisters/HSV-I tend not to return to the same site about 90% of the time.
Canker sore/aphthous ulcers are more like 50%, with the deeper, crater-like ulceration sometimes needing to be surface ablated and with a new wound to cover or seal it. In rare instances, you have to burn it out to the basement membrane. I’ve done that twice in 12 years….once on my wife.
Tongue lesion are much, much better in their resolution and recurrence rates….more like cold sores.
Bob
jetsfanSpectatorMark,
great case!
Was the tooth non vital?
Jetsfan
Glenn van AsSpectatorHi Bob: Thanks…….I just worry that sometimes people get the wrong idea about why I post.
As for the three chip video camera. It is cool. I have waited til now to purchase a camera and this one hooks onto my Xmount adapter on the scope.
It now gives me digital video at 550 lines of resolution and excellent color
i am still learning how to get it perfect as at times it gives me some vignetting at the borders but all in all I am very happy with the Sony TRV 950.
Wait til CDA and you can see some cases I have done.
So far I have done a couple of cool cases with the erbium and one with the diode.
Nothing earth shattering but all in all fun.
Glenn
Glenn van AsSpectatorHi David……….even at high mag it would be impossible to keep the prep small with the scatter from the erbium .
It just wont work taking out an amalgam in my hands…..must have been an april fools joke.
Just like my Biolase shirt.
Grin
Glenn
AnonymousSpectatorHi Mark,
I agree, great case.
How ’bout some more ‘how to’ details on the endo?
Use of files?
How length was established?
How to maintain proper length?
Filled with?
Thanks,
Glenn van AsSpectatorNeat case mark. I noticed the buccal cusp was reduced after the amalgam came out, is there something that you did to reduce it.
The radiographs are great and a very nice result. If you have an editing program place the radiographs is grayscale and the color will look much better. I edited the one radiograph to show you what it looked like after the color alteration. It took one step in ACDSee …….color 256 gray.
I applaud you for cutting back the bone and soft tissue without anesthetic on the palatal……I couldnt do that much I dont think without anesthetic.
The endo shape is nice but what did you fill the canal with. One of the problems is getting a standard shape for a GP cone with the laser. How did you shape the canal…..did you augment with rotary files.
I would love to see a radiograph of the completed case….
Neat stuff.
Glenn
RodSpectatorRon,
Typically, the lesions you discribe are not viral. They’ve been linked to an immunological problem as of late, but nothing definitive.
Often there is a ‘trigger’ for these. Some speculation that there is a food ‘allergy’ or ‘sensitivity’ involved in the ‘trigger’.
And they CAN hurt like a ‘S.O.B.’!!!
One thing that I’d have her do is switch to a non-SLS toothpaste. Sodium Laryl Sulfate is the detergent in toothpaste that causes the foaming that we all love to feel when we brush. But it can denature proteins and also has an effect on the lipids in the oral tissues.
It’s felt that this can, in a high percentage of canker sore sufferers, make them more susceptible. Some patients are not helped whatsoever by using an SLS-free toothpaste, and some are helped tremendously.
She should keep track of foods she eats, and switch to an SLS-free toothpaste. Put it this way — can’t hurt to try.
What laser did you use to treat the lesion.
I usually first treat it with my diode, followed immediately by the Waterlase.
Rod
2thlaserSpectatorThank you gentlemen. First of all, the tooth WAS vital. Fresh fracture. The endo part of it….I opened the pulp chamber using normal laser settings, 3W 80%air, 50%water. Once I opened up the chamber, I power down to 1.25W, 34%air, 24%water, the endo settings, with a Z-2 tip. I find my intial length, as you see in the radiograph, with a #15 K-file. I file usually to a 20 then start with the Z-2 tip 2mm from my working length. You can see a “sharpie marker” mark on the fiber. Activate the tip only AFTER you have placed it in the canal’s, and you are slowly, for 6 seconds, activating the laser on the outstroke. NEVER activate the laser on the instroke, you WILL ledge. Do this about 8 times circumfrentially with the Z-2, then see if the Z-3 will fit to your length. Sometimes, I recheck my working length in between fibers with a 20 file again, this helps to make sure I have the proper canal shape for obturation. No need to use Hypochlorite, the Waterlase disinfects wonderfully, as does Glenn’s Er:Yag too. Then I still fill with GP, and a CaOH sealer. Some like to use EndoRez. I don’t know if I like the formaldehyde that the resins give off during setting at the apex. Most Endodontists, according to the latest surveys, are still using lateral condensation and CaOH sealers. Glenn, the final radiograph is the final fill, just so you know.
I reduced the buccal cusp with the laser, and then prepped the tooth with the laser.
Now, to reduce the bone, I use the T-4 tip with .50W, 14%air, 12%water. Low powers, with the smaller diameter tips allow me to do these procedures without anesthetic. It takes a LITTLE BIT longer, not much, but the patients love the fact they don’t have to get “shot”.
Thanks for the feedback, anything else?
Mark
2thlaserSpectatorWhat are you guys filling your endo with? What results are you getting, and are you using your lasers to remove the smear layer left behind by ALL other means of canal enlarging with files, or any rotary instrumentation, before obturating? Time to learn!
Mark
AnonymousSpectatorHow much time, start to finish?
2thlaserSpectatorThe endo took about 20 minutes if that. The whole case took about 1hr 10min total time with the crown prep, endo, build up, crown lenghtening, and about 񘔂.00 of the patients checkbook. No referal to the periodontist, and I can only imagine how good the tissue is going to look when I seat the permenant crown!
Mark
Robert Gregg DDSSpectatorMark,
That’s a beautiful case, with all the erbium applications! Well done!! Clap! Clap! Clap!
I use Kerr sealer and a vertical condensation technique taught to me by Cliff Ruddle back when he gave hands-on courses in his office.
I would suggest that you re-consider using NaOCL. Studies I have seen show that while lasing alone is bactericidal, lasing to warm the NaOCL in near sterility. Same as to the smear layer.
Bob
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