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2thlaserSpectatorSee Pat, YOU can be above the curve as well. I am still struggling just a bit with the amal removal area you and Ron are having success with. I still get a bit of “antsyness” with these patients, as I remove the amalgam. Maybe I am looking for too much results, as if I am using the laser, where they don’t flinch a bit? Either way, I am still going to proceed with that area of treatment of removing amalgams. We all help eachother learn here, that is what I love about Ron’s forum. I will do my best at Dana Point. I have alot to share. It’s going to be a blast, believe me!
See ya soon!
Mark
Glenn van AsSpectatorHi guys…….i dont have the patience to do alot of amalgam removals unless the patient is firm on no anesthesia.
I do find that alot of my patients “feel” something during the process and sometimes it is a reasonable amount of discomfort but when I ask them I found.
80% rated the discomfort as 0-15/100
10% rated the discomfort as 15-50/100
10% were higher and these I often had to numb up.I was not using the bathing technique Mark and others speak of.
Almost all patients receiving a laser restoration for the 2nd time will rate the discomfort as lower than the first time even if the restoration is larger.
Around 95% would have the laser again, and I do have patients who request anesthetic but the laser because they hate the sound and feel of the drill that much.
Just some food for thought……….for those lurking or thinking about why some patients feel it and others dont.
Glenn
AnonymousSpectatorHi all, thought there might be a need for a forum for sharing sources for supplies and accessories. Dr. Barr had shared a couple with me.
Trinity Technologies http://www.lasersafety.com recently did a custom diode filter for my Sugitel loupes. Trinity had me obtain the filter frame from Surgitel and then made the lenses to fit. These filters are almost clear in color (slight yellow or gold tint) and allow you to see tissue color so much better than the rose color filters that Biolase provides.
The second supplier- Sventech 847-838-lase http://www.sventechlasers.com/
Sventech has ‘laser pencils’ for diode (3 for 趚) that are designed for use with Ultradent disposable tips(Endo EZE ref/up 345 are pliable,White mini ref/up 1247 will not transfer heat according to Sventech). The disposable tip is bendable so you can get a better angle on the fiber for access to the pocket.
Have other good sources? Share them here!
Robert GreggParticipantHi Ron–
Good thread.
One of my favorites for laser protective eyewear is:
Tom Barrows
President & OwnerInnovative Optics, Inc.
US Toll Free: (800) 990-1455
US Phone: (763) 425-6689
US FAX: (763) 425-77896826 Hemlock Lane
Maple Grove, MN 55369
U.S.A.
Electronic mail tom@innovativeoptics.com
<a href="http://www.innovativeoptics.com/clip-in.htmCan’t” target=”_blank”>http://www.innovativeoptics.com/clip-in.htm
Can’t forget about one of the industry standards: UVEX
http://www.bacou-dalloz.com/us/gosite/gosite.lasso?location=http://www.uvex.com/company.html
I have no $$ interestin these companies.
Bob
(Edited by Robert Gregg at 6:45 pm on Dec. 6, 2002)
AnonymousSpectatorHi all,
Was doing some searching for articles on lasers and anesthesia and found nothing. What I did come across were various articles (see below) regarding the increased acid resistance of enamel in teeth that had been lased both with and w/o fluoride. So I was wondering if anyone was doing anything similar in practice? A question to the microdentistry guys (risking showing my ignorance here)- Fuji Triage can be light cured -has there been any thought (in light of studies like those below) about lasing the Fuji Triage to help along the remineralization process?QUOTECalcium solubility of dental enamel following Er, Cr:YSGG laser irradiation
Apel, Christian, Graeber, Hans-Georg, Gutknecht, Norbert, Rheinisch-Westfaelische Technische Hochschule Aachen
Publication: Proc. SPIE Vol. 3910, p. 318-321, Lasers in Dentistry VI, John D. Featherstone; Peter Rechmann; Daniel Fried; Eds.
Publication Date: 3/2000
Abstract:
Ever since the laser was introduced in dental medicine, there has been a constant discussion about its use in caries prevention. Various studies have already illustrated the possible uses of CO2 and argon lasers in this field of dentistry. The aim of the present study was to examine the Er,Cr:YSGG laser with regard to potential in reducing the acid solubility of dental enamel. Thirty freshly extracted bovine incisor teeth were prepared for this purpose. The crowns of the teeth were covered with hard wax, leaving a standardized test area free. The test specimens were then divided into three groups. The test area was uniformly irradiated with 2.7 J/cm2 in the first test group and 6.5 J/cm2 in the second test group. The third test group was left untreated (control group). Demineralization of the teeth was performed over a period of 24 hours in acetate buffer solution (0.1 mol/l) with a pH value of 4.5 and a temperature of 37 degrees Celsius. The calcium content of the solution was subsequently determined by flame photometry. The results confirm a significantly lower calcium content in the test group exposed to radiation of 6.5 J/cm2 (p less than 0.025). Dental enamel seems to have increased acid resistance following irradiation with the Er,Cr:YSGG laser.©2002 SPIE–The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
Comparison of three lasers on demineralization of human enamel
Powell, G. Lynn, Yu, Duncan, Higuchi, William I., Fox, Jeffrey L., Univ. of Utah
Publication: Proc. SPIE Vol. 1880, p. 188-192, Lasers in Orthopedic, Dental, and Veterinary Medicine II, Dov Gal; Stephen J. O’Brien; C. Thomas Vangsness; Joel M. White; Harvey A. Wigdor; Eds.
Publication Date: 7/1993
Abstract:
Previous studies have recorded the reduction of caries-like lesions or demineralization in extracted human teeth that had been irradiated with CO2 laser, Nd:YAG laser, and Argon laser. This study was conducted to evaluate the effects of three different cw lasers on acid resistance and demineralization of dental enamel. Human enamel was laser irradiated with either Argon, CO2, or Nd:YAG energy densities of 60 – 65 J/cm2 or 120 – 130 J/cm2. The amount of demineralization was determined in a rotating disk assembly (0.1 M acetate buffer, pH – 4.5) for 24 hours and the results determined and plotted against the non-lased control using microradiographs and computerized imaging. The amount of dissolution of tooth structure lost to demineralization in 4.5 pH acid bath in a 24 hour period was reduced from approximately 140 microns for the unlased control to approximately 90 microns for the Argon laser and 70 microns for the CO2 laser at 60 – 65 J/cm2. At 120 – 130 J/cm2 the results were: 120 microns for the Nd:YAG, 70 microns for the Argon, and 45 microns for the CO2 laser. This study shows that demineralization is reduced significantly in vitro when human enamel is exposed to Argon and CO2 laser irradiation.
Effect of a new carbon dioxide laser and fluoride on occlusal caries progression in dental enamel
Nobre dos Santos, Marines, Univ. Estadual de Campinas; Fried, Daniel, Rapozo-Hilo, Marcia L., Featherstone, John D., Univ. of California/San Francisco
Publication: Proc. SPIE Vol. 4610, p. 132-139, Lasers in Dentistry VIII, Peter Rechmann; Daniel Fried; Thomas Hennig; Eds.
Publication Date: 6/2002
Abstract:
The purpose of this study was to investigate the effect of a new TEA carbon dioxide (CO2) laser (.9.6 micrometers , 5-8 microsecond(s) pulse duration) combined with fluoride (F), on the inhibition of caries-like progression in occlusal surfaces in sound and demineralized enamel. Of 120 occlusal tooth surfaces (10 per group), 90 were partially demineralized in a 50% HAP/0.1 M Lactic acid/carbopol solution (pH 5.0). Samples were treated with/without the laser (2.0 j/cm2 or 3.0 J/cm2) and/or F (as APF). Caries-like progression was tested by 5 days of pH cycling. Results were assessed by cross-sectional quantitative microradiography. The percent inhibition of caries progression with laser and/or F ranged from 87-170%. This new TEA CO2 laser produced significant protective effect against lesion progression, and in combination with fluoride treatment lesion reversal occurred.
Lee AllenSpectatorHello to All,
I discovered this site with the help of Mark Calonna while visiting his office for “training” which due to licensure only allowed observation. While very invaluable (Thanks again to Mark), it was unnerving that this in the only clinical training that I could find.I had expected as Bob was talking about some hands-on training at a university, a manufacturer’s clinic, or a for-profit group of educators. They abound for other aspects of dentistry: esthetics, C & B, materials, etc.
I will, it seems, do pig jaws and as much reading that I can just to get comfortable with the modality and the feel for distances, pace (thank God for TIG welding school) and clinical judgement for application. For that I will learn with my patients how much is enough or too much. I feel like I am starting my practice all over again with so much to work out: application, patient presentation, techniques, staff training, maintenance, supplies, etc.
This Forum discussion and photos have already been helpful as has the suggested reading from ADL.
This is nervous anticipation of delivery of the Waterlase and just wanted to say,” I’m in”. Hope the water is fine.
Glenn van AsSpectatorLee: I want to congratulate you for coming to this site. I think its great that users of different lasers come here to share information and to help eachother learn.
There are many experienced users at this forum like Bob Gregg whose knowledge makes me feel like he has forgotten more than I will ever know.
Yet , slowly and surely your knowledge will increase.
In a big huge compliment to Ron, I have witnessed a massive leap in his knowledge from when he got his lasers to now. He has tried to read and listened to all and with this in mind his learning curve has been shortened substantially.
Ron , thanks for putting the board together, 66 members already, I never thought I would see that day.
Glenn
Glenn van AsSpectatorHi folks: As I sit at home recuperating over the flu and pneumonia , I started going through some of the thousands of pics I have shot through the scope and since there are so many new members here I thought I would share some of the tips I have uncovered for the laser over the next couple of weeks.
WHen doing kids class 2s in deciduous teeth the beauty of the laser is that it wont cut metal like AA does so you can put a metal matrix on prior to prepping the teeth.
This does 3 things…….
1. It protects the adjacent tooth surface.
2. It helps speed up the prep as there is reflection of the band, I am sure this is the case.
3. If properly placed it can give you the original height of the marginal ridge.I have done this with T-bands and with Ultradents ultraguard. The ultraguard is a little thicker and sometimes I have to remove it and put in a tband to get a tighter contact but it is more rigid and able to get through broad wide contacts.
Here are two cases for you to look at…………
http://www.sendpix.com/albums/021208/132527000008b709185f4c02e94991/
http://www.sendpix.com/albums/021208/133349000008c14cf94e20189a6d4f/
The first case has an ultraguard and the second has two Tbands.
Glenn
2thlaserSpectatorHi everyone,
I had the incredible PLEASURE to meet Lee last week, as he spent a couple of days in my office. I have never met a more personable, professional man, dedicated to our profession. That is why I referred him to this site. He will do awesome things with the laser, in time. He reads, researches, just plain does his homework. He knew so much BEFORE he came to the office. I can’t wait to see what he does when he finally uses his laser. Now, that being said, I still agree with everyone else with education, and training. Dental Schools need this technology. It really needs to get into the didactical and clinical areas, and research as well. WE are doing the research right now, and that isn’t too fair. I just hope that those of us who are users will continue to teach each other, and share our knowlege here, and in other ways to improve and move this technology forward. That’s my 2 cents for now…I am sure I will have more to say at a later time as I need to get to work. Good day to everyone!
Mark
2thlaserSpectatorHi everyone,
I had the incredible PLEASURE to meet Lee last week, as he spent a couple of days in my office. I have never met a more personable, professional man, dedicated to our profession. That is why I referred him to this site. He will do awesome things with the laser, in time. He reads, researches, just plain does his homework. He knew so much BEFORE he came to the office. I can’t wait to see what he does when he finally uses his laser. Now, that being said, I still agree with everyone else with education, and training. Dental Schools need this technology. It really needs to get into the didactical and clinical areas, and research as well. WE are doing the research right now, and that isn’t too fair. I just hope that those of us who are users will continue to teach each other, and share our knowlege here, and in other ways to improve and move this technology forward. That’s my 2 cents for now…I am sure I will have more to say at a later time as I need to get to work. Good day to everyone!
Mark
PS….Welcome Lee!!! You are already an asset to OUR education.
lasersmiledrSpectatorHI all! It’s great to see this site growing! I agree with Mark, much of the research going on in this field is from us. However, I do sincerely want to thank Bob and Del for allowing some of us to follow your tracks in some of the phenomenal procedures. I also find, that the ideas generated by laser technology, as well as the fellowship with top quality docs across the country has made me much more creative ( out of the box thinking) as well as a much better dentist ( and I feel that I am continuing to improve all the time). For that, in the past, present and future, I want to say thanks to all who travel here for I know, you are a different kind of person just to be here in the first place.
With that said, I hope each of you will take the time to share your experiences, techniques etc. here so that we may all learn from each other, and make this an even better site!
Good Day and God Bless to All!
Todd
AnonymousSpectatorLee,
Welcome to the board. Can’t wait til you get that laser going ,as I know how much more fun it has made dentistry for me.Thanks to all for their participation- that’s what makes the board so worthwhile. I know you all have helped me a ton!
Todd,
I was wondering if you could give some background on MALD and the process in obtaining it. I know you need to have standard proficiency, laser 2 years, present cases, but what kind of timetable for the cases?After 2 years or as you go along?When does a mentor become involved? Any advice?
Thanks
2thlaserSpectatorExcellent Glenn, Hope you are feeling better soon.
Great tips, I will try them. Deciduous teeth are so easy to prep, and on top of that, the children are so cooperative. They never feel anything, and usually have zero anticipation of anything starting to hurt, unlike adults, who are just WAITING for some pain! Great stuff, as usual!
Mark
2thlaserSpectatorHey guys, Just one other thing to help reduce sensitivity with the Waterlase, Glenn, I am not sure with the Continuum unit, maybe you can help here. When I was in Phoenix, we were talking anesthesia with the laser, and I remembered to let everyone know that you can warm up the water in a waterbath before attaching to the unit for use. This makes it a bit more comfortable, especially for us in these colder climates. We turn our heat down a bit at night, so the standing distilled water cools down with the room. When we warm it, the patients definitely notice it when using it warm, that it’s more comfortable for them. It would be nice to have a inline water heater, BUT there is already so much in the lasers guts, that the waterbath seems to work real well. (And it’s free!). 😉 Just a tip that I hope helps those who use the Waterlase. Glenn, what type of water connection is in the laser you use?
Mark
Robert GreggParticipantDental Applications of Advanced Lasers
by Jeff ManniThe reference book costs around ๥
Learn without bias or hype about the full range of applications of dental laser technology.
Phone: 781-272-6692
I have no $$ interest in the book. I do hope to keep Jeff interested in updating his reference book, as it is the most useful, single source of any I have ever read about dental lasers. I have purchased 4 of his editions since 1990.
Enjoy!
Bob
(Edited by Robert Gregg at 5:48 pm on Dec. 9, 2002)
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