Hi guys: I think that Rons photography is awesome.

Next I would have used a round bur on the buccal as I think that is still decay.

The rest looks awesome.

I hate leaving decay behind and like my continued use of etch in teeth I may be following behind at the ripe ol age of 41.

I am interested to see what others do. i hate leaving decay behind.

Just my .02 cents worth.

Glenn

I will try to upload the image again, Ron, Help? I don’t know why it won’t upload properly, it’s 89K, so it’s small enough! I renamed it, maybe that will help?
Mark

Hi Mark: I think some of your viewpoints may change when you get the scope and see the leathery texture at 10-16X mag of the stain. If you test this stain with caries detector gel it will discolor.

Having said that there is argument as to whether it is necessary to take all the decay out. I hate leaving decay period. If it is a pulp exposure , I want to know.

I also think putting a solid restoration on unsolid foundations (caries) makes the restoration under occlusal forces more prone to leakage.

I think with the laser that it is very easy to leave decay behind because under high mag it is tough to get all the decay out at different angles because the laser is only endcutting.

Mark, keep this post and see if your approach changes (mine did) when you start using the scope routinely. I found often that I would etch a tooth and see that leathery appearance of decay……..shoot. Go back in with a small round bur (when I thought I was done) and then the laser , then re-etch etc.

Glenn

Glenn,

I do something similar but use Hurriseal instead.

At a CE course a few years back they said Gluma, since it is gluteraldehyde based, actually desensitizes by ‘fixing’ some of the pulpal tissue after it makes its way thru the dentinal tubes.

I looked a little for PubMed articles and it seems some say Gluma seals about the same as everything else  and some indicate greater pulpal effect than other desensitizers.

Hi All,
If you can keep you images to 400 pixels in width it will allow the forums to keep their ‘shape’

Thanks

could you be a bit more precise…does very low wattage mean, .25W 0%/0%? Additionally, when it is advised to use wattage in a certain range, how does one decide where to begin. Does it depend on the actual machine and how it is tuned, the patients sensitivity level, the level of “wear” on the tips or all of the above. Tangentially, I was wondering or hoping that Biolase could come up with a device or a meter that will clue us in as to when the tip is in need of replacement.

I tend to agree with Glenn. If the dentin is discolored, I believe caries remains and we should remove the discoloration. Yes, sometimes I get pulps. Most of the time I get lucky with 3M Vitrebond, Clearfil SE Bond and flowable composite.

When I get deep I use a spoon and 95% of the time can still pick away “infected” discolored dentin with a spoon excavator. I don’t use a round bur because I hate the slow speed but go back in with the Erbium until the dentin is either yellow or red. If red, I use the above mentioned capping technique and inform the patient that the tooth may require root canal therapy.

So far, since May 2001, success rate around 90%.

Al