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Hi folks: in using the laser for small occlusals I find the major benefit is that even dental decay can be removed without anesthetic.
In my hybrid technique I am not adverse to using both the laser and burs.
Here is my technique from now on called the Hybrid Occlusal Preparation ( HOP) for short because I am hopping back and forth between the laser and bur to achieve the preparation without anesthetic.
Here is a case I did yesterday using the HOP technique.
I used the Continuum laser first with a 400 micron tip to help anesthetize the tooth and to open up the groove a little bit to see where the decay went laterally. Then I use a bur (in this case a fissureotomy bur) to widen the prep to open up the access to deeper decay. Then use the laser for a minute or two to desenstize the dentin, and then a round bur for final decay removal.
To remove the smear layer I used the laser and then etched ( I know I know) , bonded and a flowable.
This one was over 4 mm deep and I still got it done without anesthetic.
Worst part was drying off the tooth after the etch.
Interesting!
Patient rated pain 8/100.
SHe hates my needle technique!!
Grin
glenn
1week followup- lesion gone , slight cracking from winter dryness but overall good result
Hi Al: Nice prep, I dont like the erbium for crown troughing for a few reasons……..
1. It is slow compared to the diode or argon where you can create a trough around the tooth. The erbium actually causes the tissue to be planed away whereas the dedicated soft tissue lasers create a trough.
2. It bleeds and requires a hemostatic agent.
3. It can nick your margin and cause notches depending on the setting.
I will at times put in Expasyl to laterally expand the tissue.
Check out this diode case………
Glenn
Here is a second case shot with the scope using the Argon laser to retract followed by Expasyl.
There are other less expensive ways to expand the trough but there is no oozing, a better trough and no risk of damage to the margins with the diode , argon or Nd Yag.
I havent had much success with the Erbium troughing, its the way it cuts that makes it difficult in my hands at least.
Glenn
Great Ron………it is amazing how sometimes that Black stuff is under old amalgams…….I often try to lase it just in case it is bacteria of some sort.
Here is an example of what I mean………
A good morning to all.
Glenn
