Thanks for the techniques.
I removed two 20 year old occlusal amalgams on a petrified new patient today.
Used the OpusDuoE. 800 micron sapphire tip. I vary Watts and Hz for enamel vs. dentin.
1st Maxillary molars, only the mesial pits were restored.
Removed the caries in the distal occlusal and lingual grooves, used some defocused energy trying to achieve analgesia.
Then removed the amalgams, way into dentin, recurrent caries, black stained dentin. Quartered w/ #330 bur, removed w/ spoon excavator.
Removed the caries, bonded w/ I-Bond, 3M P60/Z250 composite.
Patient said no pain, she was amazed.
It was an amazing demonstration. Thanks for the presentations.
Jeff

Great job guys!

As I read thru several posts lately it seems that many times we do not supply all the info on what we have done or tried (I’m guilty as well ).

How about we try to standardize posts and maybe see if we can narrow down some patterns.

Patient age

Tooth number

Previous restoration (or none)

Type of tip

Power used (watts/mhz)

Focused/defocused

Time

Thanks, keep posting – everytime you do 220 some laser users learn something!

if u dont buy it let me know…i may for 2500 why not take a shot……….

Nice pics Mark and remember if you get a scope the procedure isnt slowed down at all after you learn how to use the scope as the pics are shot WHILE you are working so for instance the osseous recontouring that I do tomorrow a.m. is for one hour with post core buildup and probably crown prep if I have time.

I will post the pics tomorrow or perhaps this is a good one to video and put up on the web site.

WOuld people like to see streaming video of the procedure as Ron has offered to do this. If so I will edit the video from the scope and send it to Ron next week.

WHat say ye?

Glenn

Hi there mossman and welcome to Rons outstanding site.

THis has been going since summer of 2002 when there were about 8 members when I joined early on…….maybe less.

Alot of these issues are still located on this board so dont be afraid to look back and see some of the groundbreaking stuff that Mark has done.

If you want to desensitize there are two ways.

1. Mark Colonnas high energy defocussed settings of
5.5-6w with 90/90 or 90/75 around 10 mm away bathing all sides of the tooth for 1.5-2 mins and then you can find in alot (NOT ALL) patients that they can tolerate the laser for 3-5 mins at high settings. Now not all will make it but the average non squeamish patient will be fine.

2.Bill Chens low to high which starts of with .25w and water and air settings that are lower and builds up. I find the low to high protocol works good for me in Class V lesions but the other protocol works better for Occlusals.

I hope this helps……….I have a Continuum (Hoya Con bio laser ) so the exact settings arent the same for me, so keep this in mind.

Basically one way is high to low and the other is low to high and I have used both, and often they will help.

When I asked my patients to rate the pain between 0-100

80% rated the pain as 0-15
10% rated the pain as 15-50
10% rated the pain as 50+ and those I often had to anesthetize.

Typically those getting the laser for the first time rated the pain as 15 points higher or so then the next time when they werent so worried about feeling something.

Hope that helps and welcome to the board and happy reading as there is a TON of really really great material put up by so many here including

Mark, Rod, the two Ronnies, Al , Pat, Bob Gregg and so many others here that you can literally get a laser education just from this board.

All the best.

Glenn

Ron–

Canker sores/aphthous ulcers often need to have the lesion a”altered”at televel of the basement membrane.

Since the Waterlase is such a shalow penetrator that ought to work the best to do so w/o anesthesia.

Near infrared lases–810 and 980 diodes and 1064 pulsed Nd:YAGs are deeper penetrators and effect the recurrece rates by “bio-modulating” the deper tissues surrounding the clinical appearing lesion.

Bob

Hi Andrew–

Glenn will give us all an earfull in a bit, but let me tell you as a someone with no bias as to either erbium–

I used the DELight on an extracted tooth recently–in fact, right after Stu Rosenberg did at the ALD Hoya ConBio booth in Florida.  It didn’t shut down at all in continuous use by either Stu or me in over 30 minutes of playing around.

Both Stu and I were impressed at how fast the ConBio cut–and Stu has since publically said so on Dental Town.

And as far as coagulation–it is the same.  

Geez!  Tell Tannis to clean up her marketing act.  We don’t need “used car” sales tactics in this field.  We have had too much of that over the last 12 years.

I told Rick Shock the same thing in Florida when he tried to claim the Waterlase can do perio like PerioLase MVP-7.:angry:

Misrepresentations, mischaracterizations, hype, style over substance, claims over science are the sorts of things that hurt the credibility of the ENTIRE laser industry when even one company engages in it, if it is as prolific as some Biolase reps have done it.

I speak to Waterlase owners every week who feel they were under trained and mis-led.:sad:   They still like their Waterlase, but they wish the company reps had been more honest and sincere.  They would still have bought w/o the lies…..

Bob

Speaking as a laser clincian for 12+ years and owner/user of MANY different company lasers (Excel, ADL, ADT, LaserMEd, NIIC, Sharplan/OpusDent, MDT, Sunrise, Biolase);  as well as co-founder of Millennium Dental Technologies.

[url]http://www[/url]. millenniumdental.com

(Edited by Robert Gregg DDS at 6:53 am on April 12, 2003)