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dkimmelSpectatorPat, I have 2 more weeks before I get my laser. I am like a kid X-mas eve. Trying to numb with the temp on will be one of my first things to do. (That is after I fiqure out how to turn it on.) Seems like it would be a great service to our patients.
David
SwpmnSpectatorPat:
Although I seem to have a much lower “no-anesthesia” success rate than Dr. Mark Colonna and others, I do see an improvement using Colonna’s Defocused Technique. Presently, I am running at about 58-67% without local anesthetic and this is an improvement over my previous 50% success rate based on information/training from the company.
Case in point:
Today I placed two large inciso-lingual composites on an elderly patient from the incisal all the way down to the lingual gingival. These were really “reverse” composite veneers on teeth numbers 24 and 25. I hate these because you have to decide whether to block both inferior alveolar nerves or mental nerves. Ideally these teeth should have been restored with crowns.
I educated the patient on the laser and asked for permission to place the restorations without local anesthetic. Used Colonna’s technique of bathing the teeth for 90 seconds at high power(6W or 300 mJ times 20 Hz). Patient felt nothing and was amazed at the technology.
Whether or not these restorations could have been placed with a bur I don’t know but I am starting to see improvement in no local anesthesia cases using the Defocused technique.
Al
AnonymousSpectatorPat,
Did you desensitize the tooth with the laser at the crown prep appointment? Was this needed in addition to that?
When you did lase the prep at the seat , was this a focused application ,or defocused?
Thanks,
Glenn van AsSpectatorHi Mark…….missed the post that made you 150 . Congrats.
I would be happy to help you out with the scopes.
I will be in Atlanta at the Hinman and California at the CDA in Anaheim.
You going to any of these.
If you ever want to come North for a lecture it might be fun for you as well to come by and see the office.
Gonna go post some cases from today.
nothing to fancy, had to anesthetize most all day…..whiny kids, and whiny adults.
Glenn
Glenn van AsSpectatorHi Ray……..I am trying to tone down my remarks regarding water accleration and other assorted issues with various mechanisms of action. The water definitley seems to wash the debris away, cool the pulp and apparently it also is needed to rehydrate the tooth.
I am glad you enjoyed the article and it was a fun read for me as well.
All the best and I will keep my eye out for anything like this in the future.
Glenn
Glenn van AsSpectatorHi Jeff. I just take a cup of one of these flat polishing discs and buff the end very slowly with a slowspeed under high mag to try and take the shards off.
My guess is that you get a 50% improvement over the old tip, but I will ask that you check with Opus dent if this is ok as I know it is fine with the Conbio but might not be fine with the Opus.
Glenn
2thlaserSpectatorThat Post put a smile on my face. Only because I HAD THE SAME TYPE OF DAY! Wow, a real Monday all over the Pacific Northwest!
I would love to come see the office. I want to show my wife how cool it all is. She was not a real happy camper when I got the laser, the tune is much sweeter now! Now I need the scope, BUT, I do want it to be a “joined” decision. That being said, she is up your way quite often for her work, we will try to make it sometime soon. Thanks again for the invite!
Mark
Glenn van AsSpectatorHi Mark: Its an open invitation and I will be choked if you dont come soon.
Thanks again…….and dont be worried about the cost. I guarantee the scope will become a money maker for you.
Glenn
PatricioSpectatorAl,
This is great news that the numbers are going up for you. When I think about the total package of laser care whether or not the teeth could have been done without anesthetic or whether the guy or gal next door is doing it that way we LD’s provide a definite advantage in patient care. When you can numb a tooth, prep it microdentally using multiple instruments, adjust the tissue or reduce the bone level, while minimizing patient discomfort and doing it faster than a speading bullet(well you get the idea) I believe patients will want this because it is a better way . I predict that within 10 years most dentists will have a laser because their patients will demand it. Those patients who know about this exceptional care are already looking for dentists who provide this service. I suppose with Glenn’s pictureswe will all be getting scopes too.
Pat
PatricioSpectatorRon,
I did not desensitize for the crown prep. I am going to try that right after I remove an impacted third molar. Actually, why not try this. It might take a a couple of renumbs depending upon how long it would take to prep the crown but with fresh burs etc. not long and of course Mark would be proud if all or part was preped with the laser.I always use the same defocused/ focused process moving in and out as the tooth tolerates without damaging the tooth though in this situation I intentional left a 1.5w frost on the prep for retention before I was done.
Pat
PatricioSpectatorMike,
Due to circumstances and problems I received a new machine after 7 months and in the process I ended up with the extra trunk. I still have four months to go before my first year is up so I am not uncovered. Wouldn’t be nice to know what the typical problems are during the second year and on and the various estimated cost of repairs and calibration. Does the company explain this in some detail when it is time to talk about service contracts? Your opinion and Al’s are useful in helping me decide what is best. Thanks.
Pat
SwpmnSpectator[img]https://www.laserdentistryforum.com/attachments/upload/williamsamatrix(2).JPG[/img][img]https://www.laserdentistryforum.com/attachments/upload/williamsamatrix(1).JPG[/img]
In an earlier thread “Air abrasion vs. laser” the question was posed by Dr. Greg Holm regarding placement of a metal matrix against the adjacent tooth to prevent damage. Dr. Glenn van As stated that he has done this many times and found no sparking or flashback from the matrix. He proposed that it is not metal in itself but specific metals which cause flashback.
As Bob Gregg suggested I took a chance today and irradiated a Danville sectional composite matrix with my Erbium. There was absolutely no sparking or flashback. Dr. van As’ observation was confirmed.
I believe this is a significant finding and can help us determine why some metals appear to cause damage to our tips, mirrors and trunk fibers whereas other metals produce no flashback. I have contacted Danville for the exact metal content of the matrices.
Al
(Edited by Swpmn at 7:38 pm on Feb. 25, 2003)
Glenn van AsSpectatorHi Pat: I have said many times, the reason I look every day on this forum is that I want to learn from you all.
I discovered that a microscope would allow me to see things at incredible magnfications and it allowed me to be precise and really changed the way that I did my dentistry. I was always a “watch” kind of guy but when I got the scope I realized that I was really missing the boat.
I wanted to do better work for my patients and that is why I bought the scope. From this initial desire I went to the desire to show patients and I bought video hookup for my staff and for my patients to see what I was doing.
Then I wanted to document and so the digital camera (after some terrible problems with 35mm photos) was hooked up.
ALong the way I discovered how much more comfortable I was with practicing dentistry and this was due to sitting upright .
Today I had a horrible fractured maxillary canine to take out…….piece by piece and it was on my assistants mom and I felt terrible but even though it was way way up there I could always follow the root tip at 10-16X mag and that helped with the stress of not getting it our for 45 mins.
I started showing my cases because people thought I was lying and I suddenly realized that very few people were using the combination of lasers and scopes and I do hope that with time more people will look at the combination.
I have learned an awful lot from you , Al, Ron , Mark of course, Rod and many others.
Today Rod Kurthy was teasing me on Dental town about laser assisted periodontal therapy and you know what , I am terrible at perio in my practice and something I have to do better.
My Argon is not mobile and I use it in my restorative op so I need to get a diode soon and I hope to get Continuums soon.
Until then, I will continue to post whenever possible and I want to thank you and so many others for your kind words. Its the reason I post, I never have a course to sell, or a CD , or a DVD……its just my love to teach and my hobby I guess to take photos………
Thanks Pat…….your post sure made my tough day better.
Glenn
AnonymousSpectatorAl ,
Thanks for doing the test. I had a feeling Bob wouldn’t send us on a mission to see how many would fry their laser tips. I guess I need to try one of my Garrison Gold matrices.
Lee AllenSpectatorPat,
Great idea ! I have thought about doing this before but worried about the water and air on a sensitive prep. So more questions arise. How far away was the tip when you waved the magic wand? A G-4 or T-6 tip? (Bob Gregg says there are different power densities with each) Did the patient respond to the air/water and just tolerate initally? Do you think there is a difference between the reponses for molars and bi’s & anteriors?
One answer always seems to bring up more questions.
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