Forums Laser Treatment Tips and Techniques Soft Tissue Procedures perio pocket reduction with Waterlase

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  • #3317 Reply

    mickey frankl
    Spectator

    I know the Waterlae is not the best laser for perio,I am still thinking about getting the Periolase . but in the meantime I had a 9mm pocket on an upper molar reduced to 2mm in 8 weeks , by root planing and lasing the pocket 1.5w 30/20 % then 3 more visits of 1w 0/0 one mm inside the pocket.
    Any coments?

    #10136 Reply

    Anonymous
    Guest

    Mickey,
    I think you can be pretty sure that in 8 weeks there is not new attachment so what is really happening in this case? I think time will tell what you really have happening with this treatment.  Do you have any measurements regarding attachment level ? Do you know if you’ve lost any tissue? What was the cause of the pocket (periodontitis vs. perio abcess)? Answers to these may give us all more insight into what has really happened here.

    My big concern is always heat inside a pocket with the erbium. Take your 1W 0/0 and aim it at your finger and see how close you can come w/o discomfort. Feel how deeply the heat penetrates. Now imagine that same thing closed in on each side (bone, soft tissue, etc around the tip in the pocket). Possibly by being only 1 mm in the pocket, the distance to the target was great enough to decrease the power density. Maybe you were able to prevent thermal damage because the treatment time was also short enough. It seems though that, that, is a mighty fine line to walk.

    Glad to hear it seems to be working for your patient,

    #10138 Reply

    mickey frankl
    Spectator

    Ron,thanks for replying.
    I saw this patient for the first time 9 weeks ago and discovered she had an upper second molar crowned with a 9mm buccal pocket,no othe significant pockets.
    The crown margin was subgingival which probably contributed to the defect.
    I did not note any attachment loss but did not measure this.
    The heat element does not sound too good hopefuly not too harmful?
    Thanks
    Mickey

    #10139 Reply

    Glenn van As
    Spectator

    Mickey look for a vertical root fracture or a perf (was endo done on the tooth) in the mid buccal area if this is the only area with a vertical defect.

    Glenn

    #10140 Reply

    Robert Gregg DDS
    Spectator

    Asymetrical defect = occlusion. But you need to rule out perfs and fractures first.

    Bob

    #10137 Reply

    lookin4t
    Spectator

    You got repair by recession and a reduction in inflammation. The laser may have had little to do with it. It may also rebound-you treated it a ton of times in a short period of time, you didn’t regrow anything.

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