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  • #3360 Reply

    arrowsmith
    Spectator

    Hey everyone,

    I took a class from John Kois this weekend . . . amazing! While I was there, Dr. Justin(sp?) from DEKA was there and gave me more information about their new CO2 than I was prepared for. He claims to have studies supporting everthing that the Periolase can do and more. In fact, he was very adamant about not using Nd:YAG’s in dentistry at all. Any thoughts? Bob Gregg . . . please help me out on this one!

    aaroN

    #10525 Reply

    drnewitt
    Spectator

    We have a Deka CO2 user in our Vancouver Study Group and we are learning some interesting things about today’s CO2’s. I am not sure if he is on the forum yet but I will encourage him to get on here and add his experiences and cases.

    I think saying Nd:YAG’s shouldn’t be used in dentistry falls into the “my laser is better than your laser” category of sales comments and should probably be taken with a grain of NaCl. Comments like that just begin flame wars and take away from the educational aspect of classes, lectures, and forums, etc.

    #10530 Reply

    Robert Gregg DDS
    Spectator

    Hi aaroN,

    I know Chris Justin from a few personal “exposures” to him in the past two years.

    Paul’s coments are the most appropriate that can be made.  Perhaps he can share what sorts of perio results are being seen in their study group.

    The suggestion that FRP Nd:YAGs should not be used in the pocket is simply not supported with science or 15 years of clinical usage.

    The advocation of CO2 use in the perio pocket is also not supported with science or clinical usage.  If there is any, the advocates should be able to produce the references.  I have asked Chris several times, and he never has provided the requested literature or citations.

    We are very flattered that people and companies are now claiming that they can do all that Millennium and the Periolase has been doing for over 5 years as a company, and that Del and I have been doing for over 10 years in clinical perio bone, cementum, and PDL regrowth.  

    None of us has seen any published anecdotes let alone case studies or peer reviewed research to support the claims that we hear so often from clinicians and manufacturers.  

    No one else has produced, documented and published data on how often (95% of the patients and pockets treated), how much (minimum 50% attachment level gain), or exactly what sort of tissue is created (cementum-mediated new attachment) with claims that “we get what they get” sort of statements.

    Our data is available for the World to see:

    http://www.millenniumdental.com/research.html

    We suggest that you insist they show their data as well.

    I’d like to ask Chris once again to provide the literature citations to support any claims he wants to make where it can be vetted and reviewed by all.

    Bob

    #10533 Reply

    arrowsmith
    Spectator

    Bob,

    Thank you so much for your reply. I must say, I appreciate the professionalism that both you and others here on this forum express. In all honesty, I was shocked at how agressive Chris was. He is a very passionate man and honestly believes in his product, which is great, and I really do respect that. Because I am such a new laser user (I only have the Waterlase) I am very easily persuaded at the moment. I have contacted you myself and am confident that you share as much passion for your product as well . . . obviously it helps to have the years of scientific research to back you up. So, I appreciate the way you, and others approach this situation.
    In terms of the new CO2 laser he is promoting . . . do you, or anyone else, know of the differences between that and the older one? Has Chris spoken with you specifically about this laser?

    aaroN

    #10528 Reply

    lasersmiledr
    Spectator

    Great question Aaron!

    Many companies are making a LOT of claims out there right now. Unfortunately, until they have the science, that is all that they are… CLAIMS. I would love to see their results! Did they have any RESULTS as amazing as Bob’s? I am sure that if they did, they would really want to publish that and let the world know.

    I wonder how many patients this guy has treated himself with an NdYAG? What authority is he speaking from and based upon what clinical research does he claim that the NdYAG should not be used in the perio pocket? I am sure several publications  would indicate that the CO2 would not be a real good choice in the perio pocket!

    Good job in seeing through the smoke and mirrors and laying the question out there for those who have answers!

    Sincerely,

    Todd McCracken, D.D.S., M.A.L.D.

    #10529 Reply

    Glenn van As
    Spectator

    As mentor of the Vancouver Laser Group, I know personally the gentleman who is using the Deka ‘Superpulsed’ CO2 laser for pocket reduction therapy.

    I havent seen any cases yet from this dentist in our group but am excited to be seeing some. He is enthusiastic about the results he is getting and I for one am getting beyond and frankly bored by the my laser is better than your laser stuff which is promoted alot by the reps from the companies and not much from the docs that visit this board.

    Can you believe how professional Bob answered that post, wow!!.

    I know I was yelling inside, but he comes on here and handles it with class , dignity and professionalism.

    That is why I wish all the best for Bob and Del in their pursuits and why I will be getting a Periolase over any of the other lasers for periodontal therapy when the time comes to purchase one.

    He has poured his heart and soul into developing lasers for periodontal therapy, and his efforts and supporting research into his protocol no matter what the results speaks volumes for his ethical approach to his laser.

    I look forward to learning more about the Deka laser , seeing the studies that are I am sure out there about the efficacy and safety of the superpulsed CO2 laser.

    Finally, I have met Chris Justen and laughed a little at your post arrowsmith about Chris. He is a PhD and knows his stuff but his passionate approach to sales sometimes means that you do alot of listening and not alot of talking.

    I wish Deka all the best and look forward to seeing more from their stylish laser systems.

    PS they have an erbium articulated arm system with a low mj setting of 100 Hz and it is not a contact tip design so the doc in question mentioned that he is getting ALOT of sensitivity and also cannot do alot of molar restorations.

    He also mentioned that he is using the CO2 80% of the time and the erbium 20% of the time.

    Take care

    Great thread.

    Glenn

    #10531 Reply

    Robert Gregg DDS
    Spectator

    Thanks Glenn, Todd and aaroN for your kind words and support.

    I understand that the DEKA CO2 has been configured with a 100 microsecond pulse duration. That is new for CO2 lasers in that they have traditionally been continuous wave (CW) or interupted/gated pulse.

    They had the ability to go into a “superpulsed” mode, but that was short burst of high watts (35watts) gated pulses if I remember right.

    That’s why I was a bit confused over the term used by DEKA as “Superpulsed” since that phrase has a prior history in laser devices that meant something else other than microsecond PD.

    Anyway, that sounds very intriguing. I have always wanted to see a short pulse duration in the microseconds in the CO2 wavelength. I think it ought to have some interesting tissue interactions–in both hard and soft tissue. It is still a very superficial wavelength, but the short PD might give peak powers and a greater forward depth of ablation. Don’t know. Need to try one on some lab tissue.

    I wonder what water spray would do to add to the ablation process of enamel and dentin and caries…….

    Bob

    #10526 Reply

    I’m just thinking, but isn’t comparing a CO2 to an Nd:YAG like comparing apples and oranges? The wavelengths are absorbed so differently, which laser you would choose to use would depend entirely on the type of energy/tissue interaction you desired. Many times I will choose to treat gingiva w/ an Er and sometimes with the Nd:YAG – it just depends on what I want the tissue to look like when I’m done.

    Thoughts?

    Kelly

    #10532 Reply

    Robert Gregg DDS
    Spectator
    QUOTE
    Quote: from kellyjblodgettdmd on 12:24 pm on Mar. 31, 2004
    I’m just thinking, but isn’t comparing a CO2 to an Nd:YAG like comparing apples and oranges?   The wavelengths are absorbed so differently, which laser you would choose to use would depend entirely on the type of energy/tissue interaction you desired.  Many times I will choose to treat gingiva w/ an Er and sometimes with the Nd:YAG – it just depends on what I want the tissue to look like when I’m done.

    Thoughts?

    Kelly

    Hi Kelly,

    Yep–apples and oranges.

    CO2 is a shallow penetrator in tissue, Nd:YAG is a deeper penetrator. CO2 is highly absorbed in H20; Nd:YAG is transparent through H20. Nd:YAG is selective for dark pgmented tissue–ideal for infected perio tissues that are loaded with gram negative black pigmented anaerobes, and de-oxygenated hemoglobin.

    That being said, I really love CO2. Been using it since 1991 when I had a NIIC from Japan–others since then. It’s a great wavelength with important uses. I just wouldn’t put in the pocket or near the root surfcace.

    See you soon Kelly!

    Bob

    #10527 Reply

    Thanks, Bob! I’m looking forward to the training in May!

    Kelly

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