Forums › Erbium Lasers › General Erbium Discussion › Versawave and Upgrading the Delight
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2thlaserSpectatorAl,
Dr. Laurie Walsh in Australia published a study last December that showed at cycles of 15hz, the conduction of the a and c Pain fibers was decreased dramatically. David and I and others have seen the same thing clinically for over a year and a half now. Also, I don’t even use laser anesthesia that much anymore, I just cut at 10hz, per David, and go right at it. I think we are seeing a nice thermal relaxation time inbetween pulses at 10 hz that the pts. really don’t feel much…Hope everything is good in your neck of Florida!
Sincerely,
Mark
AlbodmdSpectatorMark,
I’ve heard of Walsh’s research and was wondering if something that correlated with it was seen clincially. Good to hear it’s working. I wonder if multiples of 15 hz (30,45) would have a similar effect. Us Florida guys have loved 10 hz for awhile. See we actually do talk about laser stuff at our Hooter’s meetings! Would love to have you down as a guess presenter sometime. 😉
Al B
2thlaserSpectatorThanks Al,
I’d love to come down sometime…as long as I get ride on David’s boat! Not sure if you know this, but my next door neighbor here is one of the women who started Hooters! She is still very active in the ownership, and now starting the Hooters Casino in Las Vegas. Funny.Multiples of 15hz is what works, although I find 15 to be the best for laser analgesia. Let me know how it works for you!! I get to see David in 2 weeks as he is helping us teach our course in Atlanta. Should be a fun/educational weekend as David is truly one of the most knowlegeable in lasers don’t you think??
All my best,
Mark
whitertthSpectatorHey Guys,
Hope all is well…
Interesting point here…I have NEVER been able to cut at 10hz without pain…I spoke to a number of people about that and Jim Jesse went ahead and did sampling of 50 patients who were all doing well at 15 hz and couldnt stand anything at 10hz. At the last two training courses we did, we tried going to 10 hz just to see what would happen and both times the patient was uncomfortable,) one time it was the biolase rep)…So i am not so sure that 10 hz is the answer at least not in the hands of myself and some others that have tried i t….. Just some thoughts..,.l
2thlaserSpectatorRon,
I cordially disagree with you here. I use 10hz all day, I start at 2.0 W and work my way up or down from there, with ZERO sensitivity. Not sure what you guys are doing differently, but between Bob, myself, Kimmel, Stu, and others, we seem to be having excellent success?!Respectfully,
Mark
dkimmelSpectator10 HZ rocks. I really like cutting at 10HZ. No sensitivity. Cuts nice…Blows the black stain away…. What more could you ask for.
I also like 50HZ for margins. I’ll have to check but I am sure it is at .75W . Thing is I do it in contact and moving real fast. Has not distroyed a tip yet. Not sure I would recommend this to the faint at heart…..Ron not sure why you and Jessie are not getting the same results.
whitertthSpectatorseems very unusual….we tried in on a biolase rep and the only time he jumped was when we cut at 10hz…there must be a good reason…we were cutting at 2 watts….I am not really sure why,,,anyone want to postulate a reason?
AlbodmdSpectatorMark Colonna wrote: “Should be a fun/educational weekend as David is truly one of the most knowlegeable in lasers don’t you think??”
Are we talking about the same David here?!? David Kimmel from Bayonet Point, Fl of the Florida Center for Laser Dentistry?!!?!? 😉 Dave knows his stuff because of our high pressure laser meetings at Hooter’s! Seriously, Dave knows his stuff and I enjoy messing with him.
10 Hz is basically my default setting now. As Dave said, it cuts great with lower total power and gets the black stuff out.
SwpmnSpectatorI’ve been a 10 Hertz kind of guy for awhile. Average energy setting is 200 mJoules. Works great for me.
Al
2thlaserSpectatorThanks for the reply guys, I thought I wasn’t crazy! Ron, you might be doing something different, or maybe the laser isn’t set up right, who knows. I just know that the 10hz setting is killer! Works great….good luck!
Mark
N8RVSpectatorOK, Mark et.al., now that you have the rest of us lasing away at 10Hz/200mJ, I wonder if the folks at Hoya and Biolase are teaching that? Or, as I suspect, are they still demonstrating blasting enamel away at much higher settings to better sell the lasers? (I know, I know … dumb question)
But seriously, we all know that we can blast teeth to smithereens at the higher settings, but we’ve also learned that we can REALLY do it most of the time with no anesthetic at the lower settings, albeit tediously slowly at times.
So, for those instructors among us, what are you advising these days?
2thlaserSpectatorDon,
Good question…I teach both, but I EMPHASIZE the 10hz. If you use a 400 micron quartz tip at 10 hz, you are pretty garaunteed to have no sensitivity, or little if any. It amazes me everyday. The only time I teach the higher settings, is if the patient needs to be numb anyhow, still use the laser and kick some laser butt with it. I also think that is a great way to really learn what this laser does to tooth structure at higher hz and powers when the patient is numb. Take advantage of it at that time!!!Hope this helps!
Mark
Glenn van AsSpectatorGood reply Mark…….to be honest Don, it all depends on the amount of magnification that you have. The more the merrier and the lower your settings will be for the laser
I teach 10Hz and 200-400 mj because I tell you, if you are using no mag 200 wont cut….you need the slop variable (higher Hz to accomodate for the movement of the tip out of the optimum cutting zone.)
Hope that helps
Glenn
2thlaserSpectatorAnd once again, Glenn is right on.
I had a patient today bring in her mother to watch me do a DO on #12. I brought the scope up to 12x and prepped a slot prep, 10hz 2.0W and she felt nothing. With the higher mag, I had no problem controlling the laser with lower power, and more pinpoint accuracy.
They were amazed…
Mark
Glenn van AsSpectatorI can relate to you a story from last years (2005) ALD where I did a hands on demo with the scope and the laser. I was cutting a tooth and afterwards a lady literally came running up to the front and asked me what laser I was using because it was so much faster than hers.
I of course jokingly asked her if she had a Biolase unit….she did.
Then I told her that the problem wasnt the machine but he magnification that she was using. She told me as a pedodontist that she didnt need mag, and I told her that as a laser user she did!
SHe went and purchased a 2.5X mag loupes from Designs for Vision and came back smiling and said her laser was cutting 2x as fast now.
Its really true, the magnification is essential for the lower settings. Its something I knew a long time ago and when you cut at 12X mag like Mark is doing, you know EXACTLY whether the tip is in the ideal vertical position in non contact mode as you can evaluate the laser tissue interaction ideally.
One other story. I was teaching an evening course with David Hornbrook in San Diego and I got to talking to one doc about his diode. He mentioned that he was finding it so slow to cut unless he got alot of charring.
I asked him for his settings for troughing……..
He told me 2.5 Watts , Continuous Wave…….
YIKES…..
Next question, what mag are you using as a cosmetic dentists?
Answer…….
NONE….my eyes are still 20/20……..
I give up!
Grin
Glenn
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