Hi folks: wanted to show the high fluency technique which I am not necessarily a proponent or disaprove of.

Basically it uses higher wattages with a heavy water flow and a pulsed laser. Dr. Michael Swick is the proponent and the person who knows the most about this technique.

It isnt for the faint of heart and YOU MUST have a heavy water stream on the site.

I used the 980 nm diode with 6 watts pulsed at .05 secs on and off for this fibroma removal. TONS OF WATER, and this setting is really a little low.

Now for those of you who want to use you regular diode , Don Coluzzi, whom I admire alot will tell you that 1 w Continuous Wave is safer and gives similar results.

I dont know yet, its the healing I am looking at ………

It definitely isnt faster in my hands but then again I am no expert yet.

This fibroma was on the lateral and ventral surface of the tongue.

Female about 40 and no history every of smoking.

I cut it out with the diode and noted under the scope white part and felt this and it was firm and more fibers…..darn it all , handnt gone deep enough.

Had to do it a second time to get all the fibers.

The little fibroma was quite large underneath huh…….

12mm long and 6 mm wide afterwards.

I like the scope for vision for these sorts of things. I apologize for some of the photos but my assistant was capturing them midstream and the water flow does hinder your view a little.

Just something to ponder.

I wont be able to get anything sooner than 2 weeks healing photos on this as I am leaving for a couple of weeks on vacation.

Gonna meet Mark Colonna tomorrow and am up late tonight posting cases for you all on stuff I have done recently.

Some cool stuff as well as some failures.

Glenn

Hi folks: second last case before I go on holidays.

I did this with anesthetic as a buildup prior to a crown being down.

I removed the tissue on the buccal with a diode because there was plaque and inflammation and the eribum often will increase the bleeding in a case like this.

Diode set at 2 w .02 on and off.

Nice result I think and it allowed me to get the clamp on without inflammation and seepage.

Removed the amalgam and then used the laser to remove the smear layer and in addition to sterilize the prep. Nice etching……..this laser of course was the erbium yag hard tissue laser , unfortunately no hk here but I still managed to get a half decent result , amazing huh.

The tooth is slated for a crown but still wanted to show you the result.

Cya

Glenn

Well folks I have been saving a few of my cases since I got burned out and tonight I posted a few of them for you to view.

I do so not to suggest anything more than here is how one person tries to use his lasers to help patients get a better result. Its not that I know more than anyone else, just one persons perspective.

I did this case last week. Patient is 15 and we have been waiting patiently at moms request to get the tooth in but it wouldnt come in.

I raised a flap on the buccal with the chisel tip and found that I wasnt really far enough to the mesial with my releasing incision……..

Anyways, I couldnt do a window with the laser because I wouldnt have been in attached tissue and then I would for sure need a graft. I am trying to drag the tooth and the attached tissue down with the tooth.

I managed to coagulate and get a bracket on and suture the tissue with two large honking sutures ( I need to get some smaller sutures like 6.0 vicryl so that is my next endeavor) and I show you 5 day healing at the end. I like the healing in this case and will say that it might still need a graft and mom is aware of this but I loosened the tooth ever so slightly on the surgery day with an elevator to make sure it would come down.

I thought the tissue looked pretty good. I didnt like my flap design but hindsight is 20/20.

Have a good weekend and I will be thinking of you in Alaska, and I will shoot some non laser photos for you!!

Cya

Glenn

I usually do Marks deal with higher 5,5 W 90a/60w for 90 sec to prenumb then move in defoucsed and start to remove enamel. Then drop down to 2- 2.5 as I get in to dentin. During lunch with Kim Kutsh(sp) he talked about using much lower settings for enamel reduction.
I just could not see doing it . It would take forever.
Boy was I wrong. I have been doing 1.5W to 2.5W 50a/20w or 60a/30w. Usually it is more like 1.5W and 2W. I am also at about 1mm from the tooth . It is fast. Maybe in some cases faster and by far easier with less water spray. Anyone else using the lower settings?
DAvid