Forums › Laser Treatment Tips and Techniques › Soft Tissue Procedures › Laser incision and drainage
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Glenn van AsSpectatorHi Jerry: I use anesthetic injected around the frenum for two reasons…
1. I hate to have them have pain 1/2 way through…..you can lose their confidence.
2. It helps with hemostasis which is a problem with the erbium (it takes longer to control hemostasis than the actual cutting in most cases).Just my two cents.
Glenn
Robert Gregg DDSSpectatorHi Jerry and Glenn–
It’s raining here in So Cal–so what are YOU guys doing posting on a Saturday!?;)
For frenums I use a topical first (Sultan), then I will infil with 3% Prilocaine (Citanest) plain. pH neutral so less sting.
Since I use the pulsed Nd:YAG (hemostasis effect) at 100 usec (Short Pulse Duration for powerful punch and minimal lateral thermal injury), 4.0 watts (for rapid cutting), 100Hz for a substantial “hot glass” effect, yet this still gives me 400 watts per pulse of “forward penetration” for hemostasis and biostim–I don’t need long anesthetic duration or epi for hemostasis.
I’m not familiar with “TAC Gel”. I’m guessing topical anesthetic?
Glenn, I can’t take a noise-free, white balanced digital picture worth a tinker’s dam, but I can help you speed up your frenum cuts and not need epi!:biggrin:
As such–35mm photos later digitized:
[img]https://www.laserdentistryforum.com/attachments/upload/Slide1 frenum.JPG[/img]
Note injection sites on both sides of central frenum
[img]https://www.laserdentistryforum.com/attachments/upload/Slide2 frenum.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/Slide3 frenum.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/Slide4 frenum.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/Slide5 frenum.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/Slide6 frenum.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/Slide7 frenum.JPG[/img]
It took me about 30 seconds to do this, while Dr. McCarthy was taking pictures at about 1 shot every 5 seconds or so. I then deepened the incision down to the periosteum.
The point of the photo series was the absence of black or brown char, carbon, or extensive epithelial peeling at the tissue margins–indicating a relatively “cool”, clean, and blood free wound using a FR pulse Nd:YAG.
Bob
(Edited by Robert Gregg DDS at 3:18 pm on May 3, 2003)
smileagainSpectatorBob and Glenn
Thank you both for your sage advice- I’ll let you know how the
procedure turns out.Bob- Tac Gel was mentioned of DT forum and praised to the heavens as “awesome and amazing”- so I decided to give it a
try, with what appears as very positive results. It is 20% lidocaine, 4% tetracaine, and 2% something else. I described how surprisingly well it worked to numb nerve tissue on a hot tooth and a scared patient when placed in the pulp chamberThanks again, Jerry
Glenn van AsSpectatorHi Bob……..neat case . The erbium photos are the same but the big difference is that there is bleeding once you get through the last fibers with the erbium whereas with the pulsed Nd Yag there isnt.
Neat stuff and yes it is cool looking on the tissue.
Way to go Bob…….
Keep trying with the photos…..what light source do you have and how old is the fiber optics.
Glenn
dkimmelSpectatorJerry, that would be prilocaine.
Bob, Nice post some more!!David
ASISpectatorNice phots, Bob.
You mentioned that Del took the photos. Was he doing them throught the scope or a SLR camera?
No charring indeed.
Andrew
Happy2thSpectatorGlen, get yourself a WAMKey and make your life easier. You could have removed that crown in less than a minute, and made the endo re-treat MUCH easier. Then you could have just re-cemented the crown. I used the WAMKey for the first time last week and removed a gold crown in about 40 seconds, no joke. I’ll never do endo through a crown again………
(Edited by Happy2th at 8:46 pm on May 26, 2003)
Glenn van AsSpectatorHi Rich……great to see you here. I have seen the WAM key and wondered how it worked. I have the Metalift which also works for Gold crowns but I hate them for porcelain.
I will look at the WAM key….do you have a web site for it.
I love to get the crown off for these as it makes the recementation alot easier but you can destroy the crown core buildup if it is soft I would imagine.
Glenn
Robert Gregg DDSSpectatorThanks for the kind comments everyone.
Andrew, we used a Yashica Dental Eye II 35mm and had digital images made from PhotoWorks. This was a case that preceded my entry into digital.
Yeah, tell us more about he WamKey…..I do a lot of endo, ad that could come in handy.
Bob
AnonymousInactiveHere is the web site:
http://www.wamkey.com/k/gb/accueilgb.htm
I haven’t used it either but it sound great.
Happy2thSpectator<a href="http://www.wamkey.com/k/gb/accueilgb.htm
I” target=”_blank”>http://www.wamkey.com/k/gb/accueilgb.htm
I have used the WAMKey twice now, one for a gold crown, and one for a porcelain crown. Both times I’ve been successful (100% success rate so far!!), and both times it’s taken less than a minute.
I also have a Metalift kit. I am 3 for 10 with the Metalift, and the fastet I’ve been able to remove a crown with the Metalift is 5 minutes (and I’ve wasted up to half an hour on some crowns trying to remove them with the Metalift, finally having to resort to sectioning the crown.) Although I am personal friends with Dr. Robert Westerman, the inventor of the Metalift, I’ve had much better success with the WAMKey. (Please don’t tell Dr. Westerman I said that.)
(Edited by Happy2th at 11:34 pm on May 27, 2003)
ASISpectatorHi All,
Interesting and clever design in crown and bridge removal. If needed, removed crowns and bridges can then be properly repaired by dental lab while area of treatment is provisionalized.
This is such a great forum in sharing info. Keep up the good work everyone!
Andrew
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