Hi Guys,

This bone removal stuff with the laser is really fun, isn’t it? 

Actually, the ‘papilla flap’ thing that Glenn was mentioning is something I’ve only done once.  I did it that way simply after the fact.  The crown had already been placed.  Foolishly, I thought I’d be able to get away without crown lengthening on this particular case.  Wrong.

So I had no choice but to reflect the facial papilla.  And it worked great.  Had the patient back for post-op on Thursday, and she’s doing very well.

Normally when I do the interproximal crown lengthening, I do no reflection of tissue. And the cool thing is that even though visualization is not the greatest, since the tip is end cutting, if you simply angle the tip appropriately, and run the SIDE of the tip along the side of the root (of both the tooth being prepped and the adjacent tooth), you can pretty much do a great job even with some of the limitations of visualization.

And as I’ve said before, the incredible thing is the rapid reformation of that interproximal papilla — incredible.

Ron —  like you, I don’t bother trying to coagulate with the laser.  I use CutTrol in the Ultradent Infusor syringe, and the bleeding is stopped in two seconds.  Very simple.  I personally agree with Gordon Christensen, and like the CutTrol MUCH better than the similar Ultradent products.

Rod

Hi All–

Great question!

The early hospital protocols develped then later borrowed to develope the Curriculim Guideline for Dental Laser Education in 1992 included this prohibition of using high powered lasers with OXYGEN.

This was because patients who had been intubated with 100% oxygen were killed when a CO2 laser hit the intubation tube.  Hence, no lasers to be used with O2.

When writing the Curriculum Gidelines for dentistry, that provision–it may have been ANSI or the American Hospital Assoc. (AHA), I don’t remember–was left in.

That proscription has no basis in science, the literature or clinical experience when using Nitrous Oxide that is not combustable.  It’s prohibition was overly cautious and misunderstood.  I’m a little surprised that is still being reported.

As I understand it, correct me if I’m wrong, oxygen is combustable, nitrous oxide merely supports a fire, but is not combustable.  

That’s what we teach in our Curriculum Guidelines for the Institute for Advanced Laser Dentistry.

I’ve used N2O2 with lasers for the 12+ years I have been using all sorts of lasers without worry or incident–including “free-beam” carbon dioxide lasers.

Now, when we have our patients on 100% O2, we aren’t using our lasers at that point, right?

In any event, the oxygen in the room is not enclosed as it was when that patient’s intubation tube was lased, ignited the oxygen, exploded and burned their lungs.

Our lasers won’t ingite any extra increase in partial pressure oxygen in the room,  anyway!

So….relax……inhale……and lase away!:biggrin:

Bob

Welcome Rod!!!!!

Knew you’d chime in here eventually!

Al

Glenn,
Good to hear from you. Have you tried your laser on porcelain yet? Just wondering what your results were if you did. Obviously you have the adavantage of the scope, so you can REALLY see more. I am really interested to see what you see.
Mark