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ASISpectatorHi Ron,
Would you consider a diode laser to coagulate? Along with astringent and even retraction cord as needed to control moisture.
Would you consider an osseos reduction to gain a bit more biologic width?
Andrew
AnonymousSpectatorQUOTEfrom ASI on 5:42 am on July 25, 2003Would you consider a diode laser to coagulate?
Since I did all this w/o anesthetic, I was hesitant to use diode or nd:YAG because I assumed I’d have to numb things up then. If there are parameters to do this w/o anesthesia, I hope someone will post them.
QUOTEAlong with astringent and even retraction cord as needed to control moisture. Would you consider an osseos reduction to gain a bit more biologic width?Was concerned about contamination from astringent and bond of the G.I. I ended up applying pressure to the gingiva w/ 2 cotton tip applicators , flushing with water, having my assistant dry with a 3rd applicator , and then placing the G.I.. Once I let up on the pressure the seepage resumed. Cord would have helped.
Although my crummy photography doesn’t show it (when will I ever remember to dry the preop pics and learn how to get rid of shadows?), there was 2mm between the base of the prep and the attachment.
There were alot of things that I could have done conventionally- cord, astringent, infiltrate anesthetic w/ vasoconstrictor, application of pressure,etc.- My main interest was learning the cause (beam scatter and reflection from the tooth prep, possibly?) and seeing if there were ways to prevent it or control it better with the laser.
Thanks for the comments ,Andrew.
BenchwmerSpectatorRon,
You need to use the wide pulse width on your PerioLase.
Trough before hard tissue caries removal, perform GV w/ Nd:YAG 3.0W 20 Hz 150 usec, Erbium to remove caries, then Nd:YAG if needed at 3.0W 20 Hz 635 usec (or whatever your setting are at wide pulse width) for coagulation)
Use Topical and infiltrate with a couple drops of 4% Citanest before troughing and GV.
The trick is not to let the bleeding start.
This is again where I don’t understand the Hard tissue laser/BioLase mentality where you lose if you need to administer anesthetic, 2 drops of LA and the Nd:YAG would have saved you a half hour of stress w/o any cotton, hemadent, cords, etc.
Still use the Erbium for painless caries removal and tooth prep.
I find that once bleeding starts w/ the Erbium, I’m in trouble w/ hemostatis. The only time I’ve had to use Hemodent and cord in the last 4 years. Previously I’ve always prevented the problem w/ the Nd:YAG technique.
You have too many options now.
Good luck.
Jeff
BNelsonSpectatorRon
Rather than haul out another laser for 2 secs. I just rub a little Ultradent Viscostat on and the bleeding stops in 5-10 secs. Finish everything up with the Er and place your restoration.
ebrodskiSpectatorDear members,
I’m the one who sent Dr. Schalter and Dr. van As the long emails inquiring about dental lasers.
I am trying to quantify the current and incremental of dental lasers (as a % of dentists in US and Europe) over the next few years.
The best data point I’ve found is a March 2002 survey by Dental Products Report that asked dentists whether they were planning on buying a dental laser in the next twelve months. There were 203 respondents.
For soft tissue lasers, 1.1% of dentists plan to buy in the next 12 months and 10.3% are interested in buying one and plan to buy one some point beyond 12 months. 88.6% do not plan to buy one ever.
For hard tissue lasers, .5% will buy in next 12 months and 13.7% plan to buy after 12 months. 85.7% plan to not purchase one.
Would you trust these data points? Do you recommend any other ways of quantifying the incremental penetration over the next 3 years?
Thanks.
Eldar Brodski
Research Analyst
Abacus Capital
whitertthSpectatorAlot of the hemostatics work well but they leave that gelatinous gunk all over…try using superoxol works wonders just let it bubble up and rinse and voila….no bleeding…..see u in Jersey
ASISpectatorHi David,
Good effort on a case considering that you had to wing it solo. Nothing wrong with how it turnd out.
How long did it take for the entire treatment?
Andrew
AnonymousSpectatorEldar,
You might consider going to a World Clinical Laser Institute (Biolase) meeting or the Hoya meeting (think its in Las Vegas if it hasn’t already happened) or an Academy of Laser Dentistry meeting. This would give you a chance to actually talk to purchasers and potential purcahsers who actually are serious enough to spend some money on investigation of lasers.
I think you might find that its one thing to say, in a DPR survey that you’re considering purchase, but when it comes to actually making a 20-50K investment the results may be different.
AlbodmdSpectatorJust received my Delight Er:YAG laser last week. Today I did an amalgam removal on the DL of #6 and placed a composite without any local. Used the preset enamel settings and bathed the tooth for 90 secs from about 10 mm away. Removed amalgam with highspeed and placed composite. Quick and easy. Pt. felt one little twinge once, but other than that. . .nothing. This is too cool. When are they going to come out with laser composite finishing tips? 😉
Regards,
Al B(Edited by Albodmd at 10:21 am on July 28, 2003)
Glenn van AsSpectatorCongrats Albert: I think that alot of the information you have gleaned from the site here will help you in your work. There will be cases that work and some that dont but overall the laser is a great tool and a wonderful marketing device.
Glenn
AlbodmdSpectatorThanks Glenn, this site has been invaluable to me. I’ve learned so much here. Much thanks to Ron for starting it and everyone who’s contributed.
Glenn, which tips do you use the most? Right now I’m using the 80 degree tip mostly. How do you use the endo tips? Looking forward to learning a lot more.
Regards,
Al B
SwpmnSpectatorThat’s great Albert. Enjoy your laser!!! Looking forward to visiting with you in Vegas.
Al
AlbodmdSpectatorInteresting question, for personal sake, I hope laser’s are not accepted to quickly so I can maintain my niche. 😉 Dentists as a whole seem to be slow accepters of new technolgy. I would look at how quickly past technologies like intraoral cameras, air abrasion, and digital x-rays were accepted. I bought my Delight laser not only because I wanted to be able to provide “no shot” dentistry but also because I was the first in my city to have it. Having had my laser for only a short time I can see the tremendous potential in it. I doubt the hard tissue will be accepted quickly because of it’s high cost. If prices drop a lot, then that can change. I thought the intraoral camera was a no brainer to have and I don’t think it’s in a majority of practices yet. The camera is a lot cheaper than the laser. Will be interesting to see what happens.
Regards,
Albert Boholst DMD
AlbodmdSpectatorHey Allen,
Can’t wait for Vegas either, hoping to learn a bunch. My first real day with the laser was great. I did a couple of amalgam removals with high speed after obtaining laser anesthesia and a couple more composites on virgin teeth. The occlusals seemed to take forever even though I tried doing them as has been talked about here, perpendicular to enamel rods. Slowly making my way round the learning curve.
Regards,
Al B
AlbodmdSpectatorI’m looking to use my Delight as an adjunct to my endo procedures also. My rep sent me a copy of an article by Glenn Van As. Here’s some of the main points from the article. Glenn or anyone want to add somemore?
-Use low energy, 30hz, 60mj
-Don’t have NaOCL in the canals
-Instrument with files until you get a size #20 file at apex, and #30 size 2 mm from apex
-Use stopper on laser tip and set at 2mm short of working length
-Move tip continuously, starting 2 mm from apex
-Move coronally at a rate of 2mm per sec
-Move fiber circumferentially for 20-30 secs per canal
That’s a quick summary.
Regards,
Al B -
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