seems very unusual….we tried in on a biolase rep and the only time he jumped was when we cut at 10hz…there must be a good reason…we were cutting at 2 watts….I am not really sure why,,,anyone want to postulate a reason?

Dear Ken,

As far as i know Er:YSGG and ErCr:YSGG are the same. But the correct name is ErCr:YSGG.

If you compare them to Er:YAG there are many different aspects that influence the cutting performance like beam guiding system, spot size, beam profile, application tips, contact / non-contact handpiece and so on.

To make a real comparison it would be necessary to use the same beam guiding + application system behind the laser head.

Olaf

Thanks for the reply guys, I thought I wasn’t crazy! Ron, you might be doing something different, or maybe the laser isn’t set up right, who knows. I just know that the 10hz setting is killer! Works great….good luck!

Mark

Hi There

My personal thought is that we probably overuse chemical anaesthesia in traditional dentistry. I suspect there are a lot of procedures we could probably do without anaesthetic, but our patients and ourselves are conditioned to use it. When we get the laser out, it is something they have never seen before and don’t necessarily associate in their minds with pain, and as a result may not feel pain. Sometimes they don’t feel anything, and that is good. Sometimes they feel something but don’t necessarily call it pain. I think this accounts for some of the analgesic effect. Some people will feel something regardless of what you do. These are the “failures” in laser analgesia and probably the same people who you end up giving 4 carpules of anaesthetic to do a simple occlusal on.

I have tried laser analgesia a few times, but to be honest I just don’t have the patience to do it routinely. I have had mixed results. My standard technique is to start about a centimeter away and just slowly close in on the tooth at a moderate energy level. This probably takes 10 seconds. I work away for awhile (read until I get bored) and increase the energy in small increments until I either finish the prep, get into dentin or the patient feels it.

I will be getting a scope in the near future, so it will be interesting to see if that makes a difference.

I think the major problem we have is that all patients experience pain differently. If they would just go through some standardization training it would make things much simpler……

Hey Ken,

Just thinking and typing off the top of my head w/o doing any reading up or research into your question, here’s my understanding:

Along with the erbium rare-earth metal ion, the chromium metal ion is added (“doped”) into the molten mix of Yittrium, Scandium, Gallium, Garnet and allowed to cool into form a crystal rod.

The Chromium ion is add to increase the lasing efficiency of the erbium ion alone when the two are combined.

I don’t remember the efficiency increase or the reason why YSGG is preferred over a YAG crystal. I’m sure it is a selection based on measurements made of the two in comparison or the distribution of the ions in the YSGG vs YAG.

I’m pretty sure there was indeed an erbium:YSGG that was used early on before it was discovered that Cr improved the efficiency of the erbium device.

Olaf is correct.

Er, Cr:YSGG at 2.78microns and Er:YAG at 2.94 microns are close enough to each other that other parameters such as pulse duration, repetition rate, peak power are the parameters that modify the dominant tissue interaction of the wavelengths’ primary absorbance effects to make the additional and substantial differences in performance of the different devices.

For example, an Er,Cr:YSGG and an Er:YAG that both operate at 100 microseconds, 4.00 watts and 20 Hz are more likely to be indistinguishable in effects than the same two wavelengths where one is operating at 150 microseconds and the other at 250 microseconds assuming all other parameters are equal.

I don’t have specific data to support that, but I would be surprised if it were otherwise. But that would be the way to do a head-to-head comparison of wavelengths.

Bob