Hi Ron–

What was the rationale for treating the pockets a second time after one week?  Who recommended that to you and what are the clinical study references to support such a methodlogy?

I mean, I remember when we started out doing pocket “sterilization” (as it was called back then), we were so uncertain of the effects of our lasers in a “blind” procedure, that we did not want the patients numb so that they could report any discomfort (i.e. heat build-up).  

That was then the thinking 13 years ago, when basic science and clincal studies had not been conducted.   Fast forward a decade:  I hope the laser field has progressed beyond guesswork after all this time.

The research that Del McCarthy and I have been working on since 1989 has been focused on the optimal near-infrared “light dose” per millimeter pocket depth involved in the treatment of inflammatory periodontal disease.  Our clinical investigations–peer reviewed and published–have demonstrated that is 10 to 16 Joules per mm pocket depth (WITH SOME VERY IMPORTANT EXCEPTIONS).  We treat the pocket ONCE with anesthesia and do NOT re-enter the area for at least 6 months, usually 12 months.  That’s how long it takes for bone and ligament to mature (think implants).

We have published our protocol several times.  If you want to access them readily they are at <a href="http://www.millenniumdental.com/research.html

Let” target=”_blank”>http://www.millenniumdental.com/research.html

Let me know.:)

Bob

Dear José —

I don’t like diodes, primarily because they are continuous wave (CW) with a gated pulse (interupted beam) capability.  They don’t give me the control that a free-running pulsed laser can.

But if there were no pulsed Nd:YAGs–for both hard tissue and the best soft tissue effects by far;) –I would prefer the Ceralase over other wavelengths and devices:

–German made
–Joule counter
–Power calibration
–Timer
–980 versus 810nm

The price is good for that device.  You do get what you pay for….There are no cheap erbiums!

Roberto

(How’d I do Mike?)

Ron–

Oh my…..I seem to have offended you.  I’ve been given the RED letter treatment!

My apology if I came across as having “nailed” you for ignorance.  That certainly was not my intent.  I know your experience level, and I wasn’t trying to embarass you.  What would be the point?

I saw and responded to your post about usage.  With 50 members, we are quite a bit more intimate here, and I was trying to get to the essence of your question to better help you out.  I try not to go off “half-cocked” and try to get as much info before I make a statement or recommendation.  Sorry it did not come across more diplomatically.  I thought my smiley face expressed my state-of-mind……..:)

I really wasn’t measured or restrained at all.  It was late and the Vicodin was wearing off after having the wires yanked out of my heal and Achilles tendon earlier that day……But recovering from surgery gives me lots of time, rest and patience that I don’t usually have when I am practicing full time and not flat on my back.  So my post was “unvarnished” and casual.  Oops.

That’s how Del McCarthy and I talk to, ask questions and really challenge each other.  We assume nothing–accept nothing–even from each other, to this day unless there is a good rationale.  I brought you into that state of thinking and problem solving.  It had the wrong effect.  Sorry.

I knew you recently returned from some training.  I was asking questions for an understanding of where you were coming from, who told you what, how, and why you should do certain things, so I could better understand the rationale for the technique you were taught, and what I could recommend.  You know…where you got your information on technique and application and what documentation, references, abstracts, clinical case studies–anything–that was given to you to support it–a Technique Guide, Steps Sequence, Recipe something.  That’s all.  Too bad the written word does not come with intonation and expressions!

It was, I guess a three part question about technique and instruction and written support.  After all, I asked about “clinical study references”, not peer reviewed references, or even published papers.  

Even when we were all first learning in the early 1990’s–and before espousing any technique, we had folks like Marshall Midda, BdS from UK an internationally renowned periodontist (now deceased), Herb Bader, DDS, MS a periodontist at Harvard, John Horton, DDS, MS a world renowned periodontist from Ohio State, and others like periodontists Steve Gold, DDS, MS, Mario Valardi, DDS, MS and Stuart Epstein, DDS, MS as well as Joel White DDS, MS at UCSF that conducted research into the periodontal use of pulsed Nd:YAGs.  

So even in the days when research was sparse, we knew these researchers on a first name basis, they presented their ongoing research and preliminary findings at the early pre-ALD meetings.  So we had a basis for doing what we were doing.  These abstracts and papers are available, as are much more recent papers.  I wanted to know if you had been given them in some form or another?  If not, I’ve got them available and could provide them if you weren’t given them…..

I gain nothing from belittling you or anyone else.  But I come from a perspective on laser periodontal treatment where we have been intensely dedicated to researching and understanding over quite a long period of time.  But aside from our work and publications, it does surprise me that other Educators, Pundits, Mentors, and Gurus who purport to teach laser perio, don’t provide much written support for those claims or written technique guide or a Power Point presentation outline–because I know they do exist.

Etiquettely challenged,

Bob

Guys,

thanks so much for all the information. I am getting my Waterlase Tuesday and I cant wait.

I am reading up as much as possible so that I can jump into this thing with both feet. Already have a couple of crown lengthening procedures lined up for the laser as well as some easy class V’s to get started.

I am sure I will have a ton of questions as I get more and more into this so hopefully you guys wont mind me asking you here.

BTW, Biolase will have several speakers at the Dentaltown meeting. They are even considering doing some sort of proficiency course there as well. If you guys are on the edge, consider coming to the meeting. http://www.towniemeeting.com

thanks.

You bet Mark. I will certainly do that.