Hi Hubert………it was awesome to meet new friends like yourself and Ken and the ALD and run into long term friends like Ron as well.

I was honoured to receive the Leon Goldman award for 2006 for clinical excellence in the field of Laser dentistry and so it kinda of means that all my hard work to improve my clinical work was noticed by others and that is gratifying.

I appreciate the comments Scott and Hubert, posting the photographs makes me a better dentist ( I learn from the constructive criticisms of others ) and in the end it educates people to the potential of lasers and scopes. Finally, its like a coffee table book that Kramer was putting together in Seinfeld.

Its just an atlas of pictures to look at and say hmmmmmm……..thats interesting , maybe I could do that for Mr. or Mrs… so and so.

If that one thing is my lasting legacy then I can rest in peace.

Thanks to all for your continued friendship, support and kind words. It makes it all worth while.

Glenn

Hi Hubert: thanks man for the nice comments, it really is appreciated. I have been lax on posting cases and my goal in the next couple of months is to start posting more again.

I have used both an 810 and a 980 clinically although at present I just use an 810 (Odyssey and Hoya Con Bio Diodent 1) in my practice. I wasnt sold that the water absorption and streaming water with high energy settings (ala Mike Swick) was quicker, less painful post op and the water hindered by ability to see the tissue laser interaction. Sure I got less charring when I used the water flow on the laser but I didnt see the benefit other than that AND I did seem to get more post op discomfort from the 980 group.

I post for you below something that was posted on DT about the difference between the 810 and 980 written from the 810 bias. Its kinda how I feel about the whole situation.

NOw having said that I think that the nice size of the Sirolaser is great but the glasses from all reports on not great (too dark and big). Size and weight wise the Sirolaser is great but keep an eye out for some of the other companies as there are things in the works with at least two companies that I know for producing some novel concepts. Cant say more but I know that there is stuff on the horizon.

Cya

Glenn

Here is someone from Zap lasers Alex DiSessa

DIODE LASERS – Clearing the air on the [not so new] wavelength confusion

Over the last several months, there has been significant publicity and controversy surrounding the effectiveness of various wavelengths used for dental diode lasers. Although the wavelength concept has been made to sound [overly] complex, there are some simple principles contained herein that should clarify some of the common misconceptions.

Background: Most diode lasers on the market today operate somewhere in the range between 800 and 980 nanometers (nm). There is really no mystique of using a soft tissue laser to remove or cut gum tissue, whether it be a diode from 800-980nm, or even an Nd:YAG which operates at 1064nm. The ultimate clinical objective of each of these devices is to boil the water content within the inter- and intracellular matrix of oral tissues. Once the intra- and intercellular temperature has been raised to 100-150° C, it is simply a matter of boiling or vaporizing the water within these tissues.

800 – 810 nm: Many of today’s popular diode lasers today are set to operate in the wavelength range of 800 – 810nm. This wavelength range was selected because it has extremely favorable absorption of both hemoglobin and melanin (dark pigment), and diseased tissues have more hemoglobin and also pathogenic, pigmented bacteria which live within in the gingival tissues. By initiating the tip, which focuses the photons of light at the tip, thus creating both an end cutting as well as a side-cutting instrument, the 800 – 810nm diode laser raises temperature to boil the water. This has been described as a hot tip effect. However, by initiating the tip, less power output is required, and one can safely and effectively raise the intra- and intercellular water to 100-150° C without any charring. It should be noted that some of the perceived “charring” of the 800 – 810nm diodes is not charring at all, but rather it is the absorption by hemoglobin which upon contact, causes a dark brown/black appearance.

980 nm: The 980nm wavelength is not new to the diode laser scene. In fact, models offering this wavelength have been readily available for many years. This wavelength range was selected because it has extremely favorable absorption of water. When originally introduced, tests were performed using a 980nm diode laser in order to differentiate the attributes of this wavelength from all other diode wavelengths. Such tests included cutting of gingival tissue under an external water stream with very high power output (10-15 Watts). The test results demonstrated that “radiant” energy (i.e., non-initiated tip) could effectively avoid charring given the distinctive attributes of water absorption with the 980nm wavelength. However, “non-charring” radiant energy results were conditional upon the use of high power output (i.e., at least 7 – 10 Watts) and external water irrigation.

Comparisons: Although controversy still exists about “radiant energy” versus using an initiated tip, the maximum power output level for most 800 – 980 nm diode lasers on the market today is far below those used/required in those earlier tests. Additionally, hemoglobin absorption, and consequently, coagulation, is not as effective at the 980nm wavelength as compared to the 800 – 810nm wavelengths, even when cutting in a radiant fashion. Therefore, any perceived advantage of using radiant energy with a 980nm wavelength laser is negated by a lesser control of hemostasis.

One additional factor recently adding to the wavelength controversy has been that of fiber size. It is correct that as the fiber size (diameter) decreases, the energy level emitted from the fiber is effectively increased. Unfortunately, it is also correct that as the fiber size decreases (i.e., below the 300µ range), it becomes more fragile, and thus more impractical and difficult to use for most soft tissue procedures.

Conclusion: The soft tissue diode laser continues to increase in its use as an effective instrument for today’s dentist. Originally starting out as converted overpowered medical lasers with extremely high wattage, today’s soft tissue lasers are specifically designed for dentistry, operating at much lower and efficient power levels. The issue of diode laser wavelength has been a continuing debate, and models in the 980nm range have been available for many years, as have models in the 800 – 810nm range. As stated, the wavelengths have slightly different attributes, but generally all diode lasers in the 800 – 980nm range are designed to function with similar results. In recent years much of the emphasis has been to operate the laser unit at the lowest level of output possible that can effectively perform the function. Such lower output levels provide a safety range for both patient and clinicians, and extend the life of the diode array component.

Alex Di Sessa
Zap Lasers, LLC
http://www.zaplasers.com
888 876 4546

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Alex Di Sessa
Zap Lasers, LLC
888 876 4546
http://www.zaplasers.com
Innovations in Laser Science™