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Glenn van AsSpectatorRON: CLAP CLAP CLAP……..what camera are you using, its not your IO cam anymore and those are excellent photos.
Nicely done……..gotta go through 1000 emails as I was lecturing on board a cruise ship for a couple of days.
Glenn
AnonymousSpectatorWelcome back, Glenn
1 year ago I took a computer class and a guy in there did digital imaging for a living. He said he was putting together a dental package and I decided to give it a try. The camera is a Fuji finepix s602 zoom with a ring flash. 6.0M recorded pixels,3.1 M effective.4.4 digital zoom, 6.o optical.The ring flash is difused with whiteout (like you use for typing mistakes). It also has a UV filter , external 4 hour battery pack. I’m still learning, but so far I’m happy with it especially since the whole package was under 񘋰. The camera guy said he had a couple docs trade in there S2’s for it because the images were close to the same.
Robert Gregg DDSSpectatorRay–
I LOVE it when you talk blunt like that!!
The managerial ineptitude of Premier and ADT still does not change the basis of my assertion, that is, these companies have had the opportunity to do things in a way that was win-win-win for the company, investor, and customer. They chose….unwisely. Let’s hope those companies today choose more wisely.
QUOTENoticed that they had to hire in scientific talent from overseas. If it weren’t for that, they would have been technically incompetent as well.So tell me Ray, where is the chief scientific talent for Biolase from? Dmitri Boutoussov, PhD? I’m not trying to get you annoyed Ray, but I want to challenge some of the assumptions and assertions you are making. I’m trying to show you examples of things that support my assertion that the more things change in laser dentistry, the more the remain the same as 13 years ago.
I would caution everyone not to be too impressed with the symposium attendance. I remember the early days of excitement and attendance with ADL/ADT. The meetings were large and impressive. Looks can be deceiving, especially when the symposiums are positioned as a means to generate additional sales.
Having given that sober caveat, I hope it went well for all attendees, presenters, and interested parties.
I’m not negative on these meetings, I’m trying to temper the excitement about them from the perspective of someone who was around for the first wave of laser exuberance and saw how it eventually shaped up.
Biolase and ConBio are advancing laser hard tissue technology and clinical applications in 2003 like ADL/ADT was advancing laser soft tissue technology and clinical applications in 1990. The industry for laser soft tissue technology, clinical studies, clinical refinements, and organizations have had 13 years to develop and “mature”. Laser hard tissue technology, science, and clinical usage has a ways to go to be where laser soft tissue technology, science, and clinical usage is today. I plan to be there when it is more fully developed. I’ve had my fill of laying the ground work in basic science, clinical applications, laser technology in the soft tissue arena. I’m gonna let someone else develop the laser hard tissue stuff!
What, you say?! Colette is trying to get back into dental? She had some SEC trouble at the last company in medical she was recently at. Oh well, there are other CEOs out there to be just as weary about……
Bob
lagunabbSpectatorThanks for the call Bob and enjoyed our conversation as usual. I re-emphasize “I am not mad at you” and I love these forums for debating and exchanging viewpoints.
Dmitri Boutoussov is a terrific scientists and engineer. If not for his presence at Biolase, I most probably would not have committed my capital to the company. The dissolution of the USSR has really benefited the laser and material-science industries in terms of technical talent and we are the benefiaries. Best
SwpmnSpectatorNice case Ron and great photos!!!!!
Al
AnonymousSpectatorHi All,
Can all you great dentists give me a little feedback on the following?
About a year ago my chiropractor starts coming to me . Has a history of long time ortho (last 5 years although all hardware off when I see him the 1st time), uncontrolled diabetes and no previous periodontal care- just ‘routine cleanings’.
Referred to periodontist and ortodontist. Ortho and perio come up with a plan to extrude upper anteriors to ‘grow bone’ and the extract and place bridge or implants. Perio also wants to do osseous surgery 4,12, 14. Ortho also wants to realign upper anteriors to get rid of traumatic occlusion- this would be the 3rd go around for braces. Patient alarmed at the บ,000 cost without my restorative plan and no certain outcome ( has 2 daughters in college so $ a concern).I told patient not to do any surgery w/o getting diabetes under control.
Patient went to endocrinologist and is now controlled (1 year later) and would like alternatives to previous treatment plans.
Charting 02/04/03
[img]https://www.laserdentistryforum.com/attachments/upload/rccuspidu.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/rcltbw.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/rcrtbw.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/rcrtbw2.JPG[/img]
[img]https://www.laserdentistryforum.com/attachments/upload/rcmaxant.JPG[/img]
I’m reasonably sure we can get the 4’s , 5’s and 6’s back to where they belong w/ scaling & rootplaning and the diode laser.
What would you do with 6-12 and 14’s bone loss?
Restorative options?Thanks for any insite you might have,
Glenn van AsSpectatorHi folks: I wanted to tell you that I did these small ones today without anesthetic.
I placed silk cord in as a marker and to protect the deeper structures.
No water 30Hz and 30mj (.9 watts)
Then used laser at 1.5watts with water for prep.
Flowable (Tetric Flow B3 used to restore the preps)
Nothing fancy but just something to look at.
Glenn
Glenn van AsSpectatorHere is something I havent seen Mark or anyone else do and I feel like there arent many things that havent been done by these gurus.
I had a patient who vertically fractured the lower right first molar and then on the extraction I had a heck of a time getting the roots out.
Finally got it all but the sequestrum came up on the lingual and in addition there was a sharp bony fragment that was poking through the gingiva so I decided to try and smooth both out without anestethetic.
Placed topical that was it and then used the laser to remove the sequestrum (it actually flew out of there and was maybe the only sore thing) and I smoothed off the bone as well as sterilizing it.
Settings were 30 Hz and 30 mj with lots of water and air in the beginning and afterwards ( a minute or so to get him used to it) I bumped it up to 30 Hz and 70 mj and the patient didnt feel anything at all.
I really was surprised at how nice the loose part flew out, and how easy it was to smooth down the bony fragment………
Mark did I beat you to the punch?
GRIN (probably not) .
I was so tempted to put anesthetic in but now feel impressed that I did it without. Gosh sometimes its hard to let go of the feeling that you have to have anesthetic.
Glenn
SwpmnSpectatorTomorrow I begin with my fourth trunk fiber delivery system since May of 2001 on my Erbium Laser.
Don’t know about you girls and guys, but to me this doesn’t seem reasonable. Personally, I expect a � piece of equipment to run virtually trouble-free for let’s say, 3 years. It’s disturbing to me that after the first year you have to purchase a 񘴘 per year service contract and this is not even mentioned at the time of sale.
When the trunk fiber blows you may be advised that you touched an amalgam or a PFM crown margin or an old metal-containing base or didn’t purge the water out of the system or used powdered gloves or used a damaged tip or you let dust get on your handpiece mirrors until you start to wonder – from a practical standpoint, what can this thing be used for without causing damage to the system?
Signed,
Frustrated in Clearwater
Glenn van AsSpectatorHI Allen………gosh I feel bad for you. I can totally feel your frustration.
I havent had a real problem with my Continuum laser since my foot pedal started acting up (the connection was all frayed) around 6 months ago. I have replaced tips, the foot pedal and filter packs ( as required) and other than that I had one of the fiber holding stands (the fishing pole device) go on me around 2 months ago.
Continuum has been very good to me at replacing things and for limited costs but I know that these companies must also make money. Where is the line?
I have heard that Biolase has had past problems with their fiber. They have had alot of people blowing them. I have not heard of many problems with the ConBio fibers and also I dont worry about all those silly things you mentioned (changing tips with gloves etc…….) Dentistry is hard enough without all those little details to watch on EVERY patient.
Other users from Biolase had problems with their fibers when the Millenium 2 first came out and I thought that many of the issues had been ironed out and resolved but apparently not in all cases.
I have told you and others that I felt that Biolase has marketed themselves fantastically but that the best stable product was Continuums machine in my opinion.
I have taken some grief for my comments but I still stand behind my statements.
I have had very little problem at all with my unit. I also think that Continuum has a great unit but needs to be a little more glitzy in their promotion of their lasers.
I like the fact that I can calibrate my fiber and find out how it is doing on a regular basis and my fiber has lasted a LONG time by Biolase standards.
I dont move my unit much but still move it a little and am a little tough on the fiber but still it has lasted a LONG time. Biolase users have alot of restrictions in order to make their fiber last (minimize movement, no dust, no this and that) and yet some people still blow them.
I know what you mean about rescheduling patients and how frustrating that can be and that patients who have had the laser wont go back to the needle and drill will they.
I have never heard of the trunk fiber in Continuum going but remember that Hoya is a fiberoptic company and it is tough to make the fiber stand up with
all that energy flowing through it and that is why Opus and others have gone with a hollow tube waveguide.I agree with the profit issue but the laser does bring in a ton of patients.
Allen as an aside I am presently trying to change the way and method in which I practice by increasing my fees , differentiating myself from others through the lasers and scopes, improving the service in my office and
eventually perhaps changing locations in a few years.I too am 41 like you and want to start making some great money instead of good money for my retirement and my kids college tuition when they start in
10 years or so it is going to be very very expensive.I think that Dentistry is fun but we all want to be paid well for it too. This has been a hard thing for me to come to grips with especially in Canada where money is almost a taboo topic to talk about.
There seemingly are alot of hidden costs especially with Biolase for their unit and it does seem to need more maintenance than mine. The sapphire tips are
expensive and if they only last a month that isnt very good.Perhaps we both need to keep track of the laser maintenance expenses, the number of procedures and then add some profit and charge the patients an
added laser usage fee so as to make some money and cover the expenses.What do you think, and Bob Gregg should have some ideas on this issue right!!
In closing I would send a nice letter to Keith Bateman and Biolase head office, telling him of your experiences and telling him of your frustrations. Heck mention that you talked to me and that I hadnt had any fibers blow in over three years and have very little maintenance and that you feel that a 45000 dollar machine should be more dependable. What would you say if your Lexus had three engines blow in 1.5 years?
Lets see what they say then………..I dont blame you for your frustration. Let me know if I can be of any help.
Keep your chin up buddy!!!!
Glenn
Robert Gregg DDSSpectatorHi Ron,
Do you REALLY want to know what I would do??:biggrin:
Seriously, what does the patient want to do? What does he want to invest in time and treatment effort and cost?
My orientation would be to try and save each and every tooth by doing endo, LANAP perio, occlusal adjustment, splint therapy and then seeing how he heals…….for the next 2 years! Yes, even the lateral and #14. Touch up as required any perio pockets that partially heal.
But I think you’ll need a variable pulsed Nd:YAG for those deep pockets and considering his diabetic tissues! :cheesy: Much better control over tissue response of the variety of tissue challenges in variable pocket depth and disease overlap.
I wouldn’t subject him to any more ortho though.
Bob
AnonymousSpectator13 yo female with stick on occlusal, no stain or discoloration.Wish I took a photo or used the diagnodent cause I was quite surprised ,see below.
Prior to Seek
After Seek
Final- Er,Cr:YSGG 5.25W 95/85 .Did most of caries removal w/ round burr. Dark area didn’t stain w/ seek, also hard and round burr didn’t remove. GI buildup then tetric flow and ceram
No anesthesia-patient described as being very cold but not painful or needing anesthesia.
(pictures reedited to speed load time)
AnonymousSpectatorNeed some input on diode fibers. Yesterday I managed to roll my chair over the fiber and fracture it.(Second time in 6 months-yes, we moved the machine now!) The break is about 2.5 feet from the adapter that attaches to the laser. It is a relatively new fiber so there is about 4′ of good fiber past the break. Can these be shortened or reattched to the adapter?
2thlaserSpectatorHey guys, welcome back Glenn.
First of all, I have to chime in here in defense of Biolase. I only blew ONE fiber, when I was VERY inexperienced when I FIRST got my laser. Other than that, I have not (knock on wood), had ANY problem since. I use my laser for EVERYTHING, I repeat, EVERYTHING possible, every day all day long 4 days a week! We take pride in caring for our machine, and making sure we follow all protocol. When I lectured this weekend at the WCLI, I did a small section on laser maintenece. Boy did it go over well. If I use my laser as much as I do, and not have a problem, why are others having them I asked? SO, I show them what I am doing, and hope that it helps them not have these problems! Al, call Keith, let him know what you are experiencing. He will help I am sure. I know that Biolase stands behind their products, period. They have proven it over and over by the many dentists I have talked to over the last year. Call them!!!!! (Biolase) I can’t say that enough. Glenn, remember, Continuum is a great product as well. Even though I am a Biolase user, I support ALL lasers, and laser users. What works in your hands, Bob’s hands, my hands, Stu’s hands is what we all personally like to use. You might use a #2round bur, I like spoon excavators. Let’s not get into who’s product is better, or worse. Let’s just support one another here, as we have in the past in this forum. Glenn, I tell many about you, and what you are doing with your Continuum and your scopes. I am proud to be your collegue. Let’s work to further laser dentistry/microdentistry period, and help eachother through our frustrations. I am glad you gave great advice to Al to call Keith. Thank you. I hope to see you soon! To all, keep on doing great dentistry with our GREAT tools!
Sincerely,
Mark
SwpmnSpectatorThat’s one cool case Glenn!
Those bony spicules that are still embedded and you can’t quickly pick out with cotton pliers can be a real pain ’cause the patient always pops in at the worst time! Then you have to anesthetize and try to smooth down with a handpiece.
Would be great to just use the laser without anesthesia to smooth out or dislodge the irritant.
Al
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