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AlbodmdSpectatorGlenn,
Was the patient not a good candidate for laser anesthesia? With my limited experience, I’m doing a lot of combination of laser and high speed. As long as patient is numb, they don’t seem to mind. I could do everything in laser, but it would take a lot longer.
Regards,
Al B
Glenn van AsSpectatorHi Albert……..the patient was very nervous and wasnt willing to try the laser without anesthetic. She was one of those patients ………you know the type, so I didnt try it.
The problem is when there is lateral expansion it is tough to do with the laser, time wise it takes alot longer.
Just want to get some advice from others.
glenn
AnonymousSpectatorQUOTEQuote: from Glenn van As on 1:49 pm on Aug. 4, 2003It is very difficult to guess how wide to make your prep with the laser, and even more difficult to go back and widen the access when the decay tracks laterally.
Glenn , I agree .
What I’ve been trying to do lately is prep an outline in enamel where I think the decay extends to laterally and almost have the enamel in the center of the outline collapse in. Seems I’m almost always short of where I need to be and then the prep becomes more difficult and time consuming. I think part of underestimating is due to the magnification. I tend to stay smaller because it looks like I’m opening things pretty wide with the magnification, where in reality (no magnification), often times I’d have a hard time keeping the prep that small if I were using a handpiece.
Now that I’m sitting here thinking about this, I think next time I may try some transilumination with my curing light 1st to see if it might help me estimate where I should be. Could you gain some visibilty transilluminating w/ the Argon? (just thinking out loud)While were on the subject re:class I’s- How do you all handle those black stained fissures that seem to go forever but are too narrow for Mark’s spoons, seems like the 1/4 rounds don’t want to touch them , and if you crank up the laser you get sensitivity (not asking too much, am I)?
ASISpectatorHi Glenn,
Another well documented case. Thanks for sharing.
Do you think the soft tissue tip with the longer taper design will be appropriate to gain better reach for troughing to get the apical half of the distal root out?
I am not surprised that the distal is more of a challenge due to the angulation of the post. I have been guilty of placing post off angled and rendering the root structurally weakened on my fair share of teeth. Just hope this one wasn’t mine.
Andrew
(Edited by ASI at 1:04 am on Aug. 5, 2003)
ASISpectatorHi Guys,
I still use air abrasion selectively with the combined use of laser and handpiece. For those dark stains that are tough to get out and due to being narrow and deep in nature, I find air abrasion is a nice adjunct to the other tools.
Andrew
Glenn van AsSpectatorHi Andrew: no worries about it being your case , it was mine from many years ago. Pt. doesnt have the best OH and had a real tough time with dependency issues a few years ago and his teeth took a beating during those days.
I am not big on the straight tip for these things as the troughing is so small that its tough to get anything in there. In fact I have told Hoya that for bone work a wider bigger tip might be in order.
I like your thinking about the length of the tip but it is so small at the end that the trough would be small.
I have used the 400 micron tip which is longer but again it is difficult to get much of an elevator in there , except a root tip elevator which I find works if the root is loose but otherwise not.
Its neat to see under the scope movement of the root tips, it really is quite obvious when it is ready tocome.
Its also great to be able to visualize the tip at all times.
It makes exos far easier and my assistant is able to see the tip from the monitor the whole time.
Thanks for the post…….
Glenn
AlbodmdSpectatorI’ve learned that the max power settings on the Delight can vary from laser to laser depending on a lot of things. Just something to remember when talking about settings for procedures. Apparently, Allen’s laser is on the statistical high end.
Regards,
Al B
Glenn van AsSpectatorHi Andrew: I think AA is a good tool, but do be careful with the scope and the optics and AA damaging the objective lens. Make sure you keep the plastic cap on the bottom of the scope.
In addition I can tell you that the particles play havoc with the light source as they seem to be attracted to it and will eventually attach to the fan element in there.
Ron as for the dark spots I will often use a 1/8th or 1/16th round bur, a very small diamond or a tip of a fissureotomy bur. I dont use the laser when I see those little dark lines anymore. Takes forever. If you have opened up with a G6, then you could try a G4 to finish but honestly a bur is quicker.
Interesting idea about the opening up of the tooth the way that you are doing it. Neat idea.
I have in the past tried transillumination but mainly on teeth where I have removed the caries and wanted to see if it was all gone with the Argon. It fluoresces under the Argon if it is still left (fluoresces a orange color).
Hope that helps but in all honesty I find these occlusal lesions that I showed you to be difficult to treat without handpieces.
Glenn
Robert Gregg DDSSpectatorVery true statement about the variability of power output between lasers of the identical type.
Then you need to measure at the fiber tip to be sure the energy delivered approximates the energy on the console………..
It’s is then easier to have a meaniful discussion on settings and applications.
Power Max 600 – 迲
http://www.Molectron.comNo financial interest……….just like standardization for safety and efficacy, and comparing apples and oranges.
Bob
PatricioSpectatorHi All,
When I find that my laser outline is not ideal I immediately grab the electic HS. My work is laser assisted as I place more value on patient comfort, speed and staying on schedule. As for the little dark lines which do not respond to the small round bur- God forgive me but I often leave them as being less of a risk than perforation of the pulp chamber or developing a neuritis. I am satisfied that stain and infection are not always synonomous. That’s after 39 years of not having a problem with this approach. Jetsfan don’t take me literally my memory is not that good. Problems if any were certainly few. Evidence based dentistry!Today I had a patient and completed the following with the laser: Removed a large loose composite, desensitized six lower anterior teeth, preped an abfraction, anesthetized a bicuspid and removed an MOD amalgam with a bur finishing with the laser all quickly and without anesthesia. The patient was delighted and informed me she now wants six other restortions, a frenectomy, and two Empress crowns and two veneers.
Pat
ASISpectatorHi All,
Thanks for the advice, Glenn.
Pat, good for you. That’s the internal marketing power of laser dentistry!
Andrew
PatricioSpectatorGlenn,
A great application of the laser. I hope I remember this post when I need to.
Pat
LeostibermanSpectatorFirst of all. Nice to meet you all. I´m Dr. Leo Stiberman from Buenos Aires (Argentina) and the first laser user in my country.
I began my experience in 1997 with the Centauri from Premier Laser Systems and as a pioneer and a lecturer in South America I had the oportunity to know and try every laser machines in the market (Kavo, Fotona, Waterlase, Delight).
I changed to Conbio (Delight) in 2000 and since then I hadn´t had any problem with the unit.
It works very good and the fiber is very friendly. The only limitation that I found is in very small cavities is difficult to go into them because of the width of the tip head. Does somebody had that problem ?
Best regards to everybody, congratulations for this web forum, and finally, sorry for my poor english.
AlbodmdSpectatorGreetings Dr. Stieberman,
Nice to have another longtime Delight user on board. Have you tried the 400 micron tips for the occlusals? They’re smaller and really great for occlusals.
Regards,
Al B
AlbodmdSpectatorWhen I received my new Delight laser, I was getting an Error 24 on the display. Tech checked it out and then it worked fine. This week I’ll sometimes get the Error 24, turn it off and on, change some settings, and then things will work again. The rep and I think something is loose in the laser. Tech will be coming out again to check it out. Anyone else ever get Error 24? Conbio has been really great in trying to get this problem resolved and have promised me a new laser if it isn’t fixed soon.
Regards,
Al B -
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