Hi Glenn
Concerning your question on Joule, hope this helps:

E=P x t (where E-energy, P-power and t-time)

Where: 1Joule = 1watt/second x 1 second

PRR= 1/ôpd (where PRR-pulse repetition rate, ôpd – pulse delay)

Or PRR= 1 / ôp + ôpp (where PRR-pulse repetition rate,
ôp – pulse duration, ôpp – period between pulses)

And Pavg = Ep x PRR (where Pavg- average power, Ep – pulse energy, PRR – pulse repetition rate)

Take care
Etienne

Just had my first experiences with treating paresthesia. Both were post surgery lip paresthesias. Both about 4 years old. Definitely got some good changes on both. But I didn’t use as much energy as you have been using on this thread – I will bump it up for both 2nd visits. Both patients were amazed – frankly so was I.

** About to admit some guilt here – hope you don’t all think less of me**. I think the reason I that I didn’t use enough energy is that, well, frankly I get bored. Maybe I am the laziest SOB on the planet, or have some untreated ADD, but I have trouble sitting there and waving the wand. Um, so, can my staff do this once I’ve located the spots? Legally, morally, ethically? Anyone having them do this – my hygienists are using the laser during RC appts now and this seems less invasive.

Or am I just a lazy slug…….

Sigh.

Off to pay the bills….Janet

Update on one patient. After his “mini-treatment” (3000 joules) last week, he reports less biting of his lip (he’s not a complainer – I never even knew it was a problem) and he’s happy he can give raspberries again. He said the inside of his lip was fully back. We did 10K joules today on the outside. Needless to say he is thrilled and I feel like a magician.

As an aside, I’d like to take an opportunity to thank Ron for providing this forum as a place to learn, and a place that is safe enough to post even shortcomings without fear. THANKS RON.

My “luck” with paresthesia reversal has not been as sanguine as I would wish. Two cases… treated with 10K joules/ session, multiple sessions ove the course of about 3 months… some improvement in terms of diminished area of anesthesia following mandibular nerve injury (near mental foramen)… significant area remains. I’ve treated the numb areas and the areas distal to the anesthesis tha overly the presumed area of injury. Patients are patient… treatment efforts continuing… all suggestions appreciated.

mkatz,

I’m wondering if you warmed the area sufficiently. The results you describe seem to be similar to LLLTherapy which occasionally produces unpredictable outcomes. Moving too fast over the area can put energy in but may not be as effective or predictable as a smooth slower movement. Try it on your hand and make sure that the motion you are using produces a pleasant warm feeling like a nice hot shower that you are able to stay in and not burn yourself. It has also been my experience that pausing every couple of K Joules and assessing the therapy effectiveness allows the area to relax and/or cool.

with the passage of time I’ve treated two patients… similar situations relating to mental nerve injuries… similar areas of disesthesia… similar number of visits… intra-oral and extraoral treatment… areas well warmed… 10,000 joules/visit… treated about 6 times each at 3 week intervals. The result is improvement, but far from complete recovery. Am I likely to get dramatically greater improvement with a single burst of f visits over the course of a week?

James,

That setting is fine intra-orally.

Lingual parethesias are the toughest. You need to start by mapping the are effected by drawing a picture of the tongue and chart the % of numbness or the amount on a scale of 1 to 10 using an explorer.

Then you need to treat the area that was most likely injured. In this case that would be deep along the lingual nerve pathway from the alveolus, then from the most anterior aspect as well.

The amount of Joules depends on the response the patient gives you. If you start to get tingling after 2000 J, perhaps another 2000 is adequate, before moving to the anterior.

Then extraorally, I might use 6 watts and come under the area of the extraction site and under the angle of the jaw and put in a similar amount as that which was responsive (plus and equal amount for effect).

Good luck and let us know.

Bob