Forums › Erbium Lasers › General Erbium Discussion › Update on a previous case
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BenchwmerSpectatorGlenn,
WOW!!!
How can you not believe in the strength of composite bonding after seeing the forces you used in moving and alligning this tooth and the bonded bracket?
Jeff
Robert Gregg DDSSpectatorGlenn,
That’s sooooo reeeaaally nice a case and finish. Do you do you own ortho banding and movement? Tooth movement, I mean.;)
Bob
Glenn van AsSpectatorYes Bob….its my ortho case. I do a fair amount. Took some training for 10 years and even tried one year to get into ortho grad school (around 10 years ago) but without success. I think that someone had another plan for me (scopes and lasers) and so it wasnt ortho grad school for me (my marks were pretty average in dental school).
Yes I was a wee bit worried Jeff about whether the bracket would stay on the decalcified tooth so I bonded the bracket on erbium etched enamel.
Thanks for the kind words………maybe I should post it to dental town……..what do you think.
Glenn
AnonymousInactiveGlenn,
NO flame retardant needed for posts like this. You did a tremendous service for your patient – that is the main concern – results. You used the instruments that you have very well.
I would have used other instruments simply because I have other instruments. But there is no way that anyone should argue that you should not have used a particular instrument – or did the work that you did with the instruments you used.
Great work and visibility.
(Edited by Delwin at 11:05 am on June 7, 2003)
ASISpectatorVery nice work, Glenn.
You might consider to bias the bracket on the premolar more to the mesial to encourgare greater derotation distally.
How long for treatment from exposure to now?
Andrew
Andrew SatlinSpectatorGlenn,
Very impressive!!! Really nice case.
I wanted to mention that in these exposure cases you need to be aware of keratinized gingiva and design your flap accordingly.
When you are that far palatal it is not a problem, but when you are dealing with canines impacted toward the buccal it really becomes an issue. Instead of the “punch” technique you might consider reflecting a full thickness flap or sliding a pedicle.
Just thought I would point that out to people that may not have alot of experience with these.
See ya!
Andy
SwpmnSpectatorGlenn:
Cool case.
To make the incision, was the chisel tip placed in contact or out of contact with the palatal tissue?
You mention the incision with the Er:YAG was made “without water” – is the significance because you find that ablation is improved without irrigation?
Al
Glenn van AsSpectatorHi Del ……thanks for the kind words. When I first got my erbium it was drilled in my head that there would be alot of bleeding on soft tissue with the erbium. I had the Argon for soft tissue so why would I want to use the erbium for soft tissue??
Well when I was coerced by Tom Haney to start using the erbium for soft tissue I still remember my dental assistants look that she gave me for using the laser for a Class V….we both looked at eachother as it planed or shaved the tissue away without bleeding. Now the tissue was healthy and a small amount.
It was that moment that made me TRY to use various wavelengths for a variety of procedures to see what would or wouldnt work.
in this case I fully expected to find some bone (hence the flap window design first I wanted to try the chisel tip , which I really like…….
The bleeding was there and I needed to control it with the Argon. If I had used the Nd Yag and no bone was present (there wasnt) it would have been a cleaner cut.
I am glad that you have such an open mind and appreciate your kind words.
Andrew….yes I agree I will rebracket and overdo the rotation the other way to prevent relapse. Good point.
Andy you know what I love……your open mindedness to procedures I and others show here as we try to figure out how best to use the laser for perio procedures. You are to be admired for you positive attitude to much of what I show.
Your point about keratinized tissue on the buccal is very very valid and appreciated. I was aware of the fact that the tooth was in the palate from the occlusal film.
I am in the process of buying one set of surgical instruments to elevate the flaps……I may still use the chisel tip and the laser to cut the flap, but I intend to follow established periodontal guidelines in my flap design.
Allen……the chisel tip is used in contact with the tissue without water at 30 Hz and 80-100 mj.
Water isnt needed because the tissue has water in it.
Air to cool the tissue and in addition if you want to spray sparingly on the tissue it will remove tissue tags building up on the tip…….
Thanks for the kind words.
Glenn
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