Hi All,

Nice discussion.

To take a different perspective–for the analgesic effect to work–some sort of effect is taking pace in the tissues of the pulp.  The question with erbium (which is highly absorbed in water, HA and collagen) is how is the energy of 2.8 or 2.9 getting into the pulp?  Scatter?

Or is the erbium wavelength involved at all.  Maybe a different spectral band that is emitting is involved (no laser is truly monochromatic–even though we repeat that in our basic physics).

Just my early morning musings.  I mean, we’ve been doing this with pulsed Nd:YAG for 14 years (then picking up the high speed or continuing to lase if a Class 5 or composite), but we assumed it was due to the wavelength’s deep penetrating properties.  Maybe not!

Bob

Hi Group,

I find most of the reasons for lasing on the anterior teeth of the older patient have to do with building trust and confidence and getting the patient in the “zone” of relaxation.  I would say it is common for me to laser at 1.50 W and 11%A and 7%H20 for 30 seconds, maybe 45 seconds, if I believe the patient to be more sensitive.  I find this setting to be a comfortable beginning for me and I believe more acceptable for our patient than 5.5/w or so.   Then I test the tooth prep site at 1.50 W if all is well I will increase to 4W and maybe more.  If there is a second or third tooth I rarely lase before I begin and most of the time the patient continues in a comfort mode.  One can certainly use the HS but most patients will tell you they prefer the laser.  The electric seems to be better tolerated than the air turbine.  Success is about what is best for me, my staff and  ultimately, patient enthusiasm for treatment and service received.

Pat

Hi Andrew,

You can try using .25Watt/11% Air/0% water(Waterlase)

Start from a distance of 6mm from the sensitive surface, lase for about 10 second. Advance 1mm and lase for another 10 seconds. Repeat until your tip is 3mm close. Finish off at 2.5mm for another 10 seconds.

Do not advance if patient shows signs of discomfort.

Results are amazing. I figure it is long lasting too. Not enough cases to follow up yet.

Take care,

Wai
drwlam.ca

Glenn,
I am setting at home on the couch after reviewing Ron’s web site and I noticed that no cases have been posted since you’ve taken a time out. I am thinking I really should drive down to the office and see if I have something to post.  Got to give you some break. Well I couldn’t remember if I had anything worth posting so I turned on the tube instead. Ten minutes later I get a call. Fractured off #21 at the gum line and she is in panic mode. So now I have something to post!!!
I want to get the excuses out of the way from the start.
1. This is after-hours and I am working alone. Have not done that in years!
2. I did not take as many photos’ as I would have liked. Again sort of tough to do by your self. Plus she has a 4 mo kid with her.

I did numb the patient as she is blond and 40 Y/O and is always tough to work on.
You have to trust me on the perio probe. I did use it. Just can not hold it, retract and take the photo all at the same time. The pocketing was 1mm all the way around. I took off a tad more then 2mm of gingival all the way around.  2.75 W 55w/65a. This did well on the outer edge of the facial, the distal and the lingual. The mesial and the facial next to the tooth did not work well at all. I dropped back to .5W 7w/11a and this did not work well. The tissue was different in this area, more inflamed and granular. I used the laser smile at 2W continuous and finished the tissue reduction. Then I reduced the bone another 3mm at 2.5W 14w/25a with the G-6 tip..
Now things are becoming fun. The picture I did not get was the bloody mess. Talk about bleed.  She has a problem with clotting and tonight was not the exception. I packed the cord to help. I left it until after cementation. You will see it in the photos. The rest is just simple core, prep and temp.

Ok, now I can go home!
DAvid

Raton.