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2thlaserSpectatorAl, You flatter me! When you do more and more, they get faster and easier, and you ought to try, just to “do it” one without the diamond. I really like what you are doing. Great post. No, I wouldn’t laugh at you! I am sitting here smiling, knowing that you are outside the envelope, and should be proud of yourself. My initial crown preps were flukes, patient wanted them, BUT since then, I have developed the technique much further, and quicker. I am developing tips with Biolase, that should help us out too. Hopefully available soon. This is why I published the article, to stimulate, and get others to do neat things, thanks for taking it the through the steps you have with the “modified” technique. Have a GREAT and Happy Thanksgiving!
Mark
2thlaserSpectatorOh, one other comment. You CAN do these without anesthetic, and I would ascertain that you could still use the modified technique, because of the “anesthetic”effect of the laser, for a period of time after the defocusing, and intial enamel and dentin prepping. Let me know if you try it that way. I still have done all my preps without anesthetic, no one has felt anything so far. (I wish there was an icon for crossed fingers!)<—RON! Great job Al, Bravo.
Mark
Glenn van AsSpectatorAl : Many times in various formats I am accused of slandering Biolase, but I want to personally say that I love what you did.
The photos are exceptional, the treatment and dentistry sublime.
I think that a diode, Nd:yag or other dedicated soft tissue laser is a little easier to cut the tissue with for hemostasis but your impression speaks volume for your technique .
The sharing that goes on here is exceptional and the comraderie without equal…………
Congrats to you and your patient has been better served even if you dont look at the microfracture issue and only concentrate on the pulpal temperature rise with diamonds versus the laser. Perhaps long term there will be less endos doing the gross work with the laser and the finishing at low revolutions with an electric handpiece………..
My feelings are………
CLAP CLAP CLAP……..thanks for sharing.
Glenn
Glenn van AsSpectatorFor Continuum I always do the soft tissue without water and with air.
My asssistant will spray the odd drop of water on the tissue but honestly I dont think it matters , perhaps in non anesthetic stuff it will.
MY suggestion is next time you have two class vs……..
Do one with air only and no water for the SOFT TISSUE…….not the hard tissue.
For the other either do both or water only .
Its been my experience under the scope that water on tissue slows the cut down………so much for hydrokinetics.
Glenn
Glenn van AsSpectatorSo it does seem that Biolase has some porcelains it wont cut. I have yet to find a porcelain that Continuum can cut but when you guys do find one, let me know and I will check out whether the Continuum can cut it.
Good research Mark……….
Glennn
Robert Gregg DDSSpectatorAl–
Way to go! Nice post.
When Mark first made his post on crown preps with erbium I did NOT laugh! I’ve been around waaay too long with lasers to know better.:biggrin:
Much of what is new and interesting with lasers is both counter-intuitive and against the main-stream thinking. And even after a decade and a half of laser innovation, this is still an evolving technology. That is why those who refuse to consider the importance of clinical innovations and improvements developed by those doing it everyday–or refuse to continue to learn from others–risk becoming irrelevant themselves as they try to “poo”, “poo” and marginalize the New Guys and Gals and ideas.
I am not referring to anyone that I have seen post here. Those I refer to are too good to be seen posting here!
Glenn–GET BACK IN BED!
I’m kidding.:biggrin: Nice to see you feel good enough to share your comments and insights!
And as far as being accused of slander, I think that ‘s awefully strong language. You have been honest, forthright and honorable in putting forth your concerns and perspectives, with some restraint, I think. You have reflected the opinion of a large constituency that you have come to represent and who respect what you have to say (whether you like it or not).
Get well and get back to posting. Just don’t ever let the “bastards” get you down.;)
Bob
PatricioSpectatorA,
I strongly support the fine word forwarded to you! The wow moment for me was realizing since Mark and you can do it, it is probably possible. Which means I can’t wait for that next crown prep opportunity. Like you guy and gals I am having fun. I noticed this morning I began preping the tooth with a defocused 4W which was a step up for me and it seemed natural.Anyone taking mobile primary teeth out using the laser to “anesthetize” the soft tissue? I thought about it this morning but got cold feet.
Pat
PatricioSpectatorMark,
I have been routinely using 1.5W for “anesthesia” for this type of procedure and in some cases I am preping the gingiva for the ligajet as well. It has felt to me to be a little less intrusive to the patient as to sound and water and I find I do not need to wait for an assistant as the water level is the preset of 7% water and 11%air. The trained patient will probably do well at any setting. I suspect that as I get more comfortable at higher watts the patient will be as well.What is the latest on etching? Are there some laser preps which no longer need the etchant step? I etch routinely cause that is what my grampa told me to do.
Pat
2thlaserSpectatorHi Pat,
You ought to try the 5.5-6.0W anesthesia, it works, and is very profound. I can elaborate if you wish. As far as etching, Glenn has posted a few things about to etch or not to etch on DT, maybe he can post it here too. I use Prime n Bond 2, self etching primer, I don’t acid etch. I have not had a debond at all since using the laser. Your grampa shoulda had a laser! 😉
Have a great Thanksgiving!!! Looking forward to your next posts!
Mark
AnonymousSpectatorHey All,
Looks like everybody is making great progress. I’m jealous because I haven’t used my laser for a week and a half. Been remodeling 2 ops and adding a 5th. When done I’ll post before/after pictures- kinda like Christmas time in the office.The other thing keeping me away from laser stuff was that my wife needed emergency surgery Monday for an infected urachial cyst that ruptured. Anybody that remembers their anatomy and can explain that one gets a prize. She’s improving but a little extra prayer wouldn’t hurt. We’re hoping to get her home Saturday. Meanwhile, my daughters and I are trying to tackle the turkey for tomorrow.Maybe a little prayer there would be a good idea too 😉
As far as the anesthesia goes, I had been using 5.25 90/90 defocused for 45-60 seconds. Non tapered tip. It might also be good in future posts if we include tapered vs. nontapered tip because of the power density difference.
Lots to be thankful for this year-wife getting better, 3 teen daughters, lasers, new ops, and of course, all you guys and your posts which have helped make me a better laser dentist.
Happy Thanksgiving!
Glenn van AsSpectatorCouldnt have said it better myself Ron……….happy thanksgiving to all my friends in the USA.
THink of me when I am hacking and wheezing and coughing tomorrow at work.
Glenn
Robert Gregg DDSSpectatorPat–
Mobile primary teeth should be a piece of cake…
Yes to soft tissue analgesia and low power to break the remaining attachments. Taper tips, a little air and Viola!
Robert Gregg DDSSpectatorRon–
Many thanks to you, best wishes for the holidays to all, and good prayers for your wive.
When she gets home, you can do her a great favor using your diode to biostim for pain relief and wound heal acceleration. May not need to remove any bandage over her naval if you defocus enough…
Let us know how she does…
Bob
gwmilicichSpectatorRe getting a bnad to conform to rootface concavtities, go to this site
Simon MacDonald (a Local dentist) has developed a completely new matrix system. The soft wedge can be purchased separately. They are great to help with the problem you are describing.
Cheers
PatricioSpectatorGraeme,
Thanks for the tip. I find this problem with some frequency with deep cervical margins and have resorted to trimming the flash after placement of the composite so a better way is welcome. Are your materials available from a source in the U. S. the U. S.? Could they be available at the Dana Point meeting in late January? I met some great guys (dentists) from Perth recently. They made it sound like heaven. It seems Australia is on the cutting edge in many ways.
Pat -
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