Exposure of canine for bracket

[Glenn van As]

PS – check out how even at 10 Hz and 40 mj you can still get some iatrogenic notching on the enamel surface in the last photo at super high mag!!

Cya

Glenn

[dkimmel]

Glenn that is a nice cut at 10Hz and 40mj. A lot smoother then I would have thought and no enamel ablation.
Cool blue color!!

[Glenn van As]

David, my thoughts are that if you are doing work without anesthetic (chemical) that you should try to keep the Hz below 20 (most patients cant tolerate it) and if the soft tissue work is done with anesthetic then 40-50Hz is fine.

Magnification makes all the world of difference.

Glenn

[kapalua]

Beautiful job on that precise clean cut. I assume this could also be done with an Odyssey 810 nm laser? What is the best topical to use and where can I obtain it?

Tom

[Benchwmer]

Don’t try this with a Diode without local anesthetic.
Jeff

[Glenn van As]

You can do this Jeff but you need to use low settings with a very strong topical like
EMLA, DRK liquid, TAC 20 etc.
I use 0.5 -0.6 w CW with this but leave the topical on for a while and use high mag because the tissue will not cut quickly. I have done these with the diode but its not as fast but it is safer to not cut the tooth.

Cya

Glenn

[kapalua]

Thanks Glenn, Where can I obtain those topical anesthetics?

Tom

[Benchwmer]

Glen,
I would use a pulsed, Nd:YAG for such a case.
I like being able to fire at the tissue w/o fear of damage to the tooth.
I’ve used Dr K liquid, now I have my local phamacist make me the potion all kinds of flavors, but for me it never is a replacement for LA during a NdYAG gingival surgery procedure. Works for some small Erbium procedures.
Glad it works so well for you.
Jeff

[Glenn van As]

Hi there Jeff and gang.

EMLA is not available over the counter in the USA as it is in Canada.
I use Topical TAC 20 which is Lido 20%, Tetracaine 4% and Phenlyephrine 2%.

I get this from Professional Arts Pharmacy in Lafayette , LA.
Ph. 888 237 4737

I know Ron Kaminer has a DRK liquid that he helped make because he is fearful of sloughing and sytemic effects due to the lidocaine (hasnt happened to me) and he gets the liquid from

Whites compounding pharmacy 318 631 2005

I have cases I have done with the diode and it can be done, and I can post them but it takes longer and is more sensitive than the erbium. The erbium risks cutting the tooth. The NdYAG I dont have but it is a pulsed laser like the erbium and therefore can be less sensitive and because it is a soft tissue laser wont effect the enamel.

Hope that helps

Glenn

[kapalua]

Hi Glenn,
I found EMLA in the Southern Anesthesia and Surgical catalogue.
Thanks for the info on the other topicals. I appreciate your help.

[Glenn van As]

My pleasure Kapalua……..hope it helps and be judicious with the stronger topicals as they can burn if left too long.

Gotta run……literally a marathon on Sunday so off to bed.

Glenn

[Author]

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