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Glenn van AsSpectatorStill not good, the doc says with pneumonia that the coughing doesnt stop for up to 6 weeks ( I am in week 3) and that the energy levels can be low for up to 3 months.
I am working 5 hours a day this week, trying not to overdue it and have a set back.
Thanks for asking and if I can get through the next 2 weeks then I will have 2 weeks off to get better.
Cya
and thanks for asking.
Glenn
PS interesting stuff about the water bottles makes me want to get an enclosed system and see if it will work better…….with the warm water.
Glenn
Robert Gregg DDSSpectatorMark and Glenn–
Pretty soon you guys will be designing your own erbium lasers with the features you need as clincians–not what the engineers just hand over to you! 😉
You know–heated air and water, closed systems, variable pulse duraions, specially designed tips for specialized uses, new fiber-optics, delivery systems, handpieces, etc.
Oh, and by the way, document your ideas in a journal with date and time. Make rough drawings too. Have a witness sign the page and date it. It’s easy to do. Who knows, you might come up with a really valuable invention–obvious to you, but not others. Then the queston becomes, “Is it unique AND unobvious?” That = patentability.
Don’t expect manufacturers to acknowledge your contributions or inventions, or pay you for your ideas and designs, or give you intellectual property rights. Pretty soon, once the newness and excitment wears off, giving all your ideas and time away will start to become a burden on you, your staffs, and your families.
Manufactuers don’t care.
They are happy to use you up, then replace you with the next generation of “young guns” with lots of energy, enthusiasm and time. I’ve been watching this for the last 12 years. Got caught up into it myself a long time ago. Saw LOTS of laser friends come, get used up, and go. Trying to bring them back is HARD. GREAT guys, GREAT laser clinicians, GREAT laser innovators and laser pioneers like Stoval, O’Grady, Brundrett and Rocklin. Just like you guys now! Names you’ve never heard of, but now lost and gone from the scene (Brundrett was past president of ALD, one of the first HGM argon users, friend of the executives once at HGM–now at Biolase, now doing dentures in a denture clinic–no interest in lasers anymore).:(
But I guarantee you that manufacturers are listening to your ideas. Any company offer travel and free attendence at company sponsored conferences? Think about it…….
But whether THEY see your ideas as valuable or not determines whether or not the ideas get incorporated into the new device refinements.
We spent YEARS trying to get manufactuers to build variable pulse durations into lasers for us to buy. We were told by engineers that pulse width doesn’t matter. CEO’s listened to their engineers.
Now two manufacturers have variable pulse durations in dentistry in addition to our PerioLase MVP-7: Kavo Key 3 erbium & ADT Cavilase.
Choices, not restrictions….options, not limitations are what clincians want in their devices. You guys are finding out how indispensable your lasers are for you. Imagine that a maufactuer decided not to make them any more….or not incorporate your needed refinements……. Scary thoughts, huh?
Glenn–a couple of days of lost revenue recovery, and you can justify a biostim laser and get you back in the pink sooner. Just a thought–hope you get well soon.
Sorry for being so sober. I’ve just seen too many laser dentists (and laser manufacturers) come and go after suffering burn-out, disappointment, lost income. I’d like to see you guys stick around for a long while.:biggrin:
Doesn’t it seem strange that no one else but me posts on the Nd:YAG forum. There were once thousands of us……where’d they go?
Just the ramblings of an old laser man……
Bob
Robert Gregg DDSSpectatorHi Ron–
Welcome to the forum.
I have also been using lasers for over 12 years–erbium, Nd:YAGs, holmium, surgical argon, diodes, carbon dioxide.
I don’t recall your name or having ever met you, though.
Yes, ALD is very political. Every organization that I have ever been involved with is political. I resigned from the ALD board and the organization a couple of years ago for a number of reasons–the main reason was loyalty to customers of MDT that were being discriminated against in their Advanced Proficiency certification exams.
The reason for Category II/Standard proficiency is for new laser users to establish “basic proficiency” in their use of lasers by a recognized body.
The reasons for belonging to a group of like-minded users–which is what the pre-ALD group started out as in 1989–are numerous.
The ALD started out in 1989 as a study club of pulsed Nd:YAG users (dLase 300), and became the North American Academy of Laser Dentistry (NAALD) in 1990, then the ALD in 1992. It was not very political in its early days. Now with around 900 members they are very impressed with themselves. Not very accoutable for their policies, procedures, and ethical oversight, but still impressed with themselves. Sounds like ADA!
What laser did you start out using in 1990? Carbon dioxide if you chose not to hang out with the NAALD would be my guess…..maybe Laser 35?
Again, welcome to the forum.
Bob Gregg
Co-founder
Millennium Dental Technologies
http://www.millenniumdental.com
whitertthSpectatorI started using co2 lasers back then did research in dental school published a bunch of articles and abstracts (see journal of oral +maxillofacial surgery jan 1990) for one..presented at the academy of laser surgery and medicine as a dental student in 89 etc…. so question is ….Should I really take a proficiency exam…Is there a way U get grandfathered into a proficiency by the fact of the research and experience….
Robert Gregg DDSSpectatorThanks Ron–
The reason the Curriculum Guidelines were written was to give the newest laser users some credibility in peer review or in a malpractice lawsuit. But your years of experience would speak to your “proficiency”, so it is probably not necessary.
No, there is no “grandfathering” per se. But the exam is pretty easy to take. Not politicized like the Advanced Proficiency is.
Put it another way. Dr. Terry Myers, the inventor of the first pulsed Nd:YAG dental laser, and arguably the “Father” of laser dentistry–has never taken Standard or Advanced proficiency test, and has never been grandfathered either.
Standard proficiency is also designed to standardize and calibrate the laser user, both new and old like you and me, so we can have a similar basis of understanding and communication.
Are you in a specialty? How much do you use your CO2? Who is the manufacturer? There was quite a variety of CO2 lasers 12 years ago–Crys, Sharplan, Luxar, NIIC, Directed Energy. What do you use it for most commonly? Have you looked at some of the newer laser systems and wavelengths out there now?
Bob
whitertthSpectatorThanks Bob, I have a luxar in the office that I use still for some soft tissue. U may remember that not long ago we spoke as u saw an email that I wrote on the GENX list and we spoke about my troubles with biolase that havesince been resolved. I use the waterlase now for most of my procedures and while i think u have a great product it seems to me that currently the waterlase type lasers seem to be the present catch all of lasers if u will.I just dont see the need at this point for a diode or nd yag if u use the waterlase but I am open to hear opinions….
Glenn van AsSpectatorIt depends on what material you are using. Obviously aluminum shells wont cut, and I wonder about polycarbonate crowns.
There are many plastic temps I am sure that will cut.
What material are you using?
Glenn
Glenn van AsSpectatorBob : that is the great thing about your posts, is that you have seen it all and done almost all and yet you still find the energy and desire to educate us.
I get tired of listening to the naysayers and when I get to that point I just think fine, I will do it and there will come a time when others will want to listen.
I also have found that pictures solve alot of the naysayers. Its easy to disagree with someone til they provide proof, then people get a little quiet. Particularly if the pics are microscope ones.
I have talked to Gary Carr who is in Sandiego and a pioneer of microscopes in endo…….he rarely talks about his travels because he got tired of all the criticism.
In Nov. he gave a little history lesson and a testimonial to all the people he taught microscopes to, the pics were from 94 , 95 etc………even before I even knew about scopes.
He told us that the first lecture he ever did , the future president of the AAE stood up half way through and yelled out………..this scope stuff is utter B.S. and walked out…………..
Can you imagine how he felt, well he realized that S.E.M.s werent gonna mean squat and he started to get GREAT photos from his microscope doing apical retrofills with ultrasonics and when he showed these pics at 10-24X power guess what happened……….
People got awful quiet………..
I find the same thing, but will admit that there is comfort in posting here , yes there are lurkers but no derision .
In closing I have seen a paradigm shift happen at the laser board at Dental Town. Now that some of the leaders have purchased a Waterlase, the rest of t he guys are asking well how much does it cost etc . etc.
The critical mass will move a product when there are enough people using it but then the novelty disappears.
The same thing will happen with scopes or some form of advanced magnification and I do hope to be still praciticing then.
This board is great Ron because it is for sharing and learning and kudos to the “old guard” like you Bob who share not only your incredible knowledge but your history.
As for making a laser……….nah…….no time.
To many other microscope projects on the go.
Take care and all the best………..
Glenn
PS thanks for the great read as usual.
SwpmnSpectatorMark:
That’s a great idea! It can be a real pain in the ass every now and then when the assistant comes to me and says “Doc I can’t get the temp off and the patient is squirming”. Sometimes I have to numb the patient to section the temp.
If we could use the laser to do that without anesthetic that would be great! Like Glenn said, what provisional material are you using? Also what setting did you use to section with the Waterlase?
We use Luxatemp for our single units and I’m sure the Waterlase would cut it like butter. Do to the precision of the laser this would eliminate the problem where you occasionally nick the prep and give the patient a jolt with the high speed.
Al
2thlaserSpectatorAl you are right on! I use turbo temp and luxatemp, also I have cut through polycarbonate, and it works great. Usually I use 1.5-2W with 40%air and 30%water. I keep the air and water down to avoid sensitivity. I then use a Woodson instrument to “wedge” the cut area and the temp will pry right off, one half at a time. Ir really works great. Kind of like cutting through composite, real easy. Glad to see this helps you guys. What else can we do? Let’s keep this up!
Mark
Robert Gregg DDSSpectatorOK. Sure, Ron.
I remember your situation. Glad to hear you got it worked out.
Yep, Waterlase sure seems like the be-all and end-all. Yeah, that was my question–whether you were using any of the newer devices since your early days with CO2.
The “need” for pulsed Nd:YAGs can be summed up in three applications: Hemostasis, hard tissue, selective hard and soft tissue dissection.
You have lots of experience with “total tissue ablaters”. What your lasers see, they absorb into–collagen, water, hydroxyapitite–well that everything in the human tissues, I think.
Pulsed Nd:YAGs are selective in their absorbtion in different tissue, giving a multitude of interactions that can be exploited clinically. Thanks for the kind words about our product.
Bob
Robert Gregg DDSSpectatorGlenn–
Thanks for being so kind with your words to the “old man”!
Don’t let the naysayers get you tired or run down. The trick with this new technologies stuff is to be the tortoise, not the hare. Pace yourself, and stick around. Work on and with the science, not the hype (you don’t) or chasing the novelty applications, and you’ll be around not just to see it, but to participate and enjoy it too.
I certainly can relate to Gary Carr and microscopes. I’ve had my Global for 3-4 years now myself. Never really thought much what others felt about it. But I don’t lecture on it either. Does it make a clinical difference–sure does. I can see and do stuff I never could before. Add that with laser capability and WOW!
And nobody shows that better than you do with your photo skills!
Yeah. I CAN imagine how Gary felt when he was publicly and unfairly ridiculed by an “esteemed” representative of a specialty group.
Del and I unwittingly incited an entire specialty when the AAP wrote an official statement condemning our work with Laser ENAP:
http://www.perio.org/resources-products/enap_laser.htm
Of course they jumped the gun. We aren’t through with our research and we were just introducing Laser ENAP as a concept when the AAP wrote the paper (without any contact or discussion with us of course).
Ha! We wear it as a badge of honor now. One day soon, they will be removing that from their website out of embarrassment…..and they will be awfully quiet.
Thanks again for the kind words.
All the best, and get well soon.
Bob
Robert Gregg DDSSpectatorHi Ron,
I’ve been trying to make the time to say something really smart and informative to your post here, but you pretty much cited everything.
Great post. Nice references.
I have been doing laser irradiation of fluoride with pulsed Nd:YAGs for 12 years or so. It has been long been a part of my “laser power bleaching” after I finish chairside to stablize the bleach and reduce any sensitivity. SHHHHUUUSHHH. Don’t tell anyone, it’s been a bleaching secret of mine all this time.
Not sure what you mean about lasing the Fuji Triage. Heck, I’m not sure what Fuji Triage IS!
Is it a glass ionomer? Are you thinking of lasing the flowable material beforelight curing, then polymerizing the Fugi?
The answer to your question is that I doubt many have thought of doing that. I haven’t. My partner Del probably has (but he’s the Ultimate Playmeister). I’ll ask him tomorrow…..
Would it work and provide a better fluoride uptake at the margin. Sounds good. Should work. Can’t seemto hurt. Sounds like an excellent research project
Bob
Glenn van AsSpectatorHi folks at this time of year people are coming in with root sensitivity by the droves. I always feel at a loss to do much.
Are any of you using the erbium to etch the root surface at a very low level and then add bonding agent to it.
My periodontist has informed me that connective tissue grafts are better for covering the roots and are considered state of the art compared to restorations.
Let me know what you guys are doing with your lasers to treat hypersensitivity to air and water at the cementum.
Thanks………
Glenn
AnonymousSpectatorBob,
Actually, I was curious to see if the laser would cure the Fuji Triage http://www.gcamerica.com/gctriage.html(don’t have any in the office yet), If I could paint the triage in the grooves, paint on topical Fl2 and then lase it could be a quick really effective means of protecting teeth. And if the laser increased the ion exchange with the glass ionomer that would be an added bonus. -
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