Forums › Erbium Lasers › General Erbium Discussion › Request to Biolase users
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Glenn van AsSpectatorHi there , I posted this on the Dental Town forum and wanted to post it here.
I am publishing a chapter on erbium lasers and want it to be inclusive rather than exclusive particularly since it is to be an evidence based chapter ( not so much a coffee table book) and in keeping with the theme I need Biolase or users to help me in evaluating their information.
Here is the DT request……
I am making a public appeal to those in the Biolase camp that if you want to “prove” anything about the veracity of the HK claims and if you wish to again “prove” anything about the nature of how HK ONLY affects the Er:Cr:YSGG wavelengths, I will need to see studies (even if they are hiddent secret ones as claimed by some authors ) before November 15th. I will then be writing the textbook chapter and I want it to be an honest , scientific reflection of the state of the art in terms of how erbium lasers work. At present I find it difficult to lay claim to the fact that the mechanism of action for the erbium lasers is different with respect to any one brand or wavelength in how it interacts with hard and soft tissue.
If I am wrong and clear science exists out there to disprove any of my thoughts, I would encourage anyone affiliated with Biolase to come forward and provide me with independent research providing proof to their claims.
I will be attending Kim Kutsch lecture here in Vancouver on October 31st as I received today my personal invitation from Kim to attend. I felt VERY VERY special and immediately cancelled all my patients for this scary day (Halloween) when all the little gremlins and goblins will be trick or treating. I felt special until both my associates giggling with glee showed me their personal invitations…….aw shoot and I thought Biolase had invited lil ol me……..
TOO LATE…….I will be there first hand to hear and take notes on mechanisms of action, science and literature of the waterlase first hand from one of their most experienced laser users.
If there are people from Biolase monitoring this site , I do encourage you to contact me with any university based independent research articles that I may include that lay strength to any uniqueness that this laser has which will necessitate a separate section for the laser biophysics section of the chapter.
I post this in all seriousness here and will do the same to the laserdentistry forum.
I will be at the ADA lecturing on scopes but will return Sunday, and again my deadline is November 15th for these research articles. I want to do a fair job on the chapter and not have people complaining after the fact of a lack of categorization of uniquess for various lasers within the erbium family.
Sincerely awaiting your reply,
Glenn van As
3167 Mountain Highway,
North Van., BC
Canada, V7K 2H4
Ph 604 985 1232Email : glennvanas@shaw.ca
kellyjblodgettdmdSpectatorHello, Glenn. I hate to give you any more work, as I know you are a very busy man, but here is something you may want to look into:
Kimmel AI, Rizoiu IM, Eversole LR. Phase doppler particle analysis of laser energized exploding water droplets (abstract 67). International Laser Congress, Lasers at the dawn of the third millennium, Athens, Greece, Sept. 25-28. Bologna, Italy: Monduzzi editore, International Proceedings Division; 1996.
I’ll keep looking!
Kelly
Glenn van AsSpectatorThanks Kelly…….if I am going to get abstracts for my chapter it will have to be from Biolase users so please send me any articles you can by email to
Thanks again……reading the threads at dentaltown as well.
Glenn
cerecdocSpectatorLet me try to explain biolase’s position as I understand it.
All the erbium lasers use hydrokinetics when set to cut hard tissue. That’s right all of them!
The YSGG wavelength, since it is not as perfectly absorbed by the water molecules, creates a deeper “microexplosion” off the proximal surface of the droplets which propells them to the needed velocity distally toward the tooth requiring less laser energy than the competition’s erbium lasers must use to get the same cutting effect by the water.
The other erbuim lasers must contend with the tendency to merely create a fog of vapor from the surface of the droplets, whereas the YSGG wavelength actually propels microexplosions of water off the surface of the aerosol spray, and thus makes the water do more “work” with less energy (heat) used.
End result, less pain to the patient, theroetically.
Since the number of non-physicist dentists who actually use two brands of lasers in their offices can be counted on a single hand, there is precious little anecdotal data as to how the lasers actually do compare to each other.
It is far more reliable to compare the relative strengths of the companies which make the hydrokinetic lasers.
So, the contention that only the waterlase uses hydrokineics is a straw man argument so far as I have been able to understand. Nobody at biolase is claiming to own the hydrokinetics effect, but rather to be more able to do the hydrokinetics at a power setting which will allow more patients to avoid the SHOT than the competition! Because of the slight difference in the wavelenth of the laser light which biolase uses.
I can’t speak officially for biolase, but having spent about two weeks worth of days in their company over the past year, this above is how I have come to understand their position.
AnonymousGuestOnce again for those who missed it-
Pulsed erbium laser ablation of hard dental tissue: the effects of atomized water spray versus water surface film
Freiberg, Robert J., IMC Associates; Cozean, Colette D., ENO Vision, LLC
Publication: Proc. SPIE Vol. 4610, p. 74-84, Lasers in Dentistry VIII, Peter Rechmann; Daniel Fried; Thomas Hennig; Eds.
Publication Date: 6/2002
Abstract:
It has been established that the ability of erbium lasers to ablate hard dental tissue is due primarily to the laser- initiated subsurface expansion of the interstitial water trapped within the enamel and that by maintaining a thin film of water on the surface of the tooth, the efficiency of the laser ablation is enhanced. It has recently been suggested that a more aggressive ablative mechanism, designated as a hydrokinetic effect, occurs when atomized water droplets, introduced between the erbium laser and the surface of the tooth, are accelerated in the laser’s field and impact the tooth’s surface. It is the objective of this study to determine if the proposed hydrokinetic effect exists and to establish its contribution to the dental hard tissue ablation process. Two commercially available dental laser systems were employed in the hard tissue ablation studies. One system employed a water irrigation system in which the water was applied directly to the tooth, forming a thin film of water on the tooth’s surface. The other system employed pressurized air and water to create an atomized mist of water droplets between the laser hand piece and the tooth. The ablative properties of the two lasers were studied upon hard inorganic materials, which were void of any water content, as well as dental enamel, which contained interstitial water within its crystalline structure. In each case the erbium laser beam was moved across the surface of the target material at a constant velocity. When exposing material void of any water content, no ablation of the surfaces was observed with either laser system. In contrast, when the irrigated dental enamel was exposed to the laser radiation, a linear groove was formed in the enamel surface. The volume of ablated dental tissue associated with each irrigation method was measured and plotted as a function of the energy within the laser pulse. Both dental laser systems exhibited similar enamel ablation rates and comparable ablated surface characteristics. The results of the study suggest that, although the manner in which the water irrigation was introduced differed, the mechanism by which the enamel was removed appeared basically the same for both dental laser systems, namely rapid subsurface expansion of the interstitially trapped water. It is the conclusion of this study that if the proposed hydrokinetic effect exists, it is not effective on hard materials, which are void of water, and it does not contribute in any significant degree in the ablation of dental enamel.
2thlaserSpectatorRon,
What lasers/wavelengths were used in this study? No mention of it. Was it Er, Cr:YSGG, or Er:YSGG, Er:YAG? Just wondering? Is there a more complete detail, rather than the abstract? Just asking for info.
Mark
AnonymousGuestMark, I’ll try and get it.I lost most of my papers in a hard drive crash. There’s only 1 that claims hydrokinetics that I know of — from the study above—
“It has recently been suggested that a more aggressive ablative mechanism, designated as a hydrokinetic effect, occurs when atomized water droplets, introduced between the erbium laser and the surface of the tooth, are accelerated in the laser’s field and impact the tooth’s surface. It is the objective of this study to determine if the proposed hydrokinetic effect exists and to establish its contribution to the dental hard tissue ablation process”BTW- I get the impression that some feel studies of er:YSGG are not applicable to er:cr:YSGG? Can you tell me why? I thought the cr was just a dopant that made the production of photons more efficient.
Thanks, I’ll work on the paper- it is avaiable here http://bookstore.spie.org/index.c….ype=pdf
but I’m gonna be cheap and try to recover it from my old computer.
lagunabbSpectatorRon,
“BTW- I get the impression that some feel studies of er:YSGG are not applicable to er:cr:YSGG? Can you tell me why? I thought the cr was just a dopant that made the production of photons more efficient.”From the one response that I read in reply to a study conducted with Er:YSGG, Biolase stated that droplet size distribution is very important. When a third party Er:YSGG (usually from Schwartz Electro-Optics, sold to OSI Systems this summer), the water spray has to rigged up using “conventional” spray. The Stock-Hibst paper talked about this and ablation rate was much reduced if they weren’t careful. I think the problems could have been avoided if the tip was kept to within 1 mm of the enamel. In essence forcing the resulting water film to always be the distance between enamel and tip. Much of the above assumes that HK works with droplets as propose by Biolase and modeled by Zhigilei, with some assumptions that I don’t necessarily agree with.
SwpmnSpectatorQUOTESince the number of non-physicist dentists who actually use two brands of lasers in their offices can be counted on a single hand, there is precious little anecdotal data as to how the lasers actually do compare to each other.Count me on your hand. Took a physics course in high school and one in college. Made it through both. In light of all the recent controversy, placed a post on Dental Town asking others to join me and let’s end the war over Er:YAG vs. Er,Cr:YSGG.
Reason is I’ve used an Er,Cr:YSGG laser for 2.5 years and an Er:YAG laser for six months. We do not find any clinically significant differences in ablation efficiency, “no local anesthesia” rates or post-operative discomfort between the two erbiums. Both of my erbiums provide me with efficient ablation of dental and osseous structures. Neither of my erbium lasers provides me with the surgical precision and hemostasis control on soft tissue that I experience from my 6 month use of an 810 nm diode laser.
Al
Glenn van AsSpectatorHere here Allen……..its posts like yours that make posts that claim faster cutting or better soft tissue cutting for one brand over another to seem silly.
I think the lasers are more similar than different and that the differences are in areas such as delivery system , noise, water output, marketing, education, # of users, reliability, fiber flexibility and a few others.
This is what we should look at and accept the fact that all of the lasers can cut hard and soft tissue. Which one you prefer is dependent on these other factors.
A voice of reason speaks!!
Cya
Glenn
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