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Robert Gregg DDSSpectatorWell thanks Glenn and Pat. Nice of you to kindly comment and glad you like it.
Glenn, the animation has been up on our website now for about a year.
The animation is something we give to our customers on a CD-ROM to use for patient education, or TV interviews, or lectures, or any personal use like that.
Pat! Have I got a case to show you….I just need to upload the photos for you. Give me a little while and I’ll have it done later today.
Thanks for the kind feedback!
Bob
Robert Gregg DDSSpectatorPat–
[img]https://www.laserdentistryforum.com/attachments/upload/Slide1.JPG[/img]
These pockets were 9-11mm deep on the facial. So greater than the 5mm you asked about.
[img]https://www.laserdentistryforum.com/attachments/upload/Slide2.JPG[/img]
This treatment was accomplished in December of 1997 with a PerioLase prototype FR pulsed Nd:YAG with variable pulse durations to obtain hemostasis and a “soft clot” w/o burning the tissue edges, carbonizing the tissue, creating epithelial peeling on the facial, or deep lateral thermal necrosis.
There is a “window” of optimal therapeutic energy and pulse duration parameters that is required to get this sort of result 4 minutes post-op. Diodes are just too hot and not able to control depth of penetration or surface heating of tissue the way a variable pulsed Nd:YAG can. It’s just he physics of different “waveforms” on and in tissue.
[img]https://www.laserdentistryforum.com/attachments/upload/Slide3.JPG[/img]
As this tissue continues to remodel, we can THEN decide what tissue refinements, recontouring, connective tissue grafting needs to be accomplished.
No probing will be done for 6 months. What reason to do so before then when the literature is clear that healing continues out 9-12 MONTHS post op? There was every expectation the hard and soft tissues would regenerate–and they did. Why wouldn’t they with this sort of 8 day post op result??
[img]https://www.laserdentistryforum.com/attachments/upload/Slide4.JPG[/img]
This patient was only treated once–and she was a heavy smoker
Hope you like it!
Bob
Robert GreggParticipantOkey Dokey Alan, I’ll keep that in mind!
Thanks for the compliment. Glad you like the beard. My wife doesn’t want me to shave it.
Are you going to head up to Destin next week for the ALD?
Bob
SwpmnSpectatorBob:
Unfortunately the Destin ALD meeting conflicted with our local affiliate Winter meeting in Tampa. I need to meet with John Kanca on Friday the 7th and get an update on bonding.
I’m probably going to join the ALD and work towards my Standard Proficiency because I may have gotten the “cart before the horse” by jumping into the clinical applications of lasers first.
Al
SwpmnSpectatorHi neighbor!!!!
I think the Erbium laser would work fine for tori removal although I’ve never tried. I have done a few crown lengthening procedures and the Erbium ablates bone efficiently. However, these were “closed” crown lengthenings where no surgical flap was reflected. Of course, there is no reason we can’t reflect a flap and then use the Erbium to remove osseous.
My thought is that for a tori removal, one would have to reflect a flap to allow proper access to the torus and also to provide an exit route for the dislodged torus. Keep in mind that the Erbium laser is an air discharging device and there might be a slight risk of air embolism underneath the flap. I’m not sure what is the actual rate of air embolism underneath a reflected flap. Although I have surgical handpieces, I have done thousands of surgical procedures over the years with conventional, air-discharging high speed turbines and never had an air embolism.
But I hear if you get one it’s a real pain in the ass. Guess that’s why they call it the Practice of Dentistry, he he he!!!!!!
Al
lagunabbSpectatorBob: You went there. I can’t believe you actually played with a Waterlase ……. How dare you! If Del finds out, he is going to want a divorce and half the biz.
I am with Glenn on this one as most are tired of this non-issue (why bother if erbiums cuts enamel faster with water as advertised and as Fried measured) although I am strictly interested from a technical point of view. Cheers.
SwpmnSpectatorHi Guys:
A couple of weeks ago Glenn and I were discussing the “hydrokinetic” theory. This was prior to Glenn sending me Dr. Hibst’s article.
I ran some tests in my office on extracted teeth using an Er,Cr: YSGG laser. Turned off the water but not the air. I found that the Erbium laser ablated enamel and dentin efficiently without a water spray.
However, I did not feel that the ablation rate was as rapid as what I see in the mouth using a water spray on vital teeth. Is it possible that my observations could be explained by the presumption that a vital tooth in the mouth would have a higher water content than extracted teeth sitting in a jar of water?
Please feel free to rip me apart as you guys are so far ahead of me on basic laser science.
Has a study ever been conducted comparing ablation rate with an Erbium laser on vital vs. endodontically treated teeth?
Al
PatricioSpectatorBob,
This was a great visualization of this laser approach. I accept the visual evidence but would like to be assured that we are not looking at resolved gingivitis retaining the infection in the depths.What sort of pocket depth reduction would one typically expect and what typical final pocket depth vs normal 2-3mm? What is the long term reinfection potential and what is recomended for maintenance care? Finally, I would like purchase details for consideration. Thanks for all your help.
Pat
SwpmnSpectatorPat and anyone else who wants the truth:
Let me give you an example of what can go wrong with an Erbium laser after your one year warranty:
At approximately 18 months of service I was presented with the fact that my flashlamp, pumping chamber and laser rod had failed. I was given two options:
1) Repair the laser for 񙶀.
2) Purchase an extended service contract for 񘴘 which would take care of the repair and also cover any further problems for 12 months.
One of my big “beefs” is there was no discussion of long term maintenance costs on the Erbium at the time of sale. Some of the blame has to be placed on myself for being stupid and not asking about long term maintenance when I purchased the laser. Personally, I think it would be in the best interest of dental laser companies to be forthright and discuss service contracts at the time of sale.
Look at it this way. When you go to Best Buy and purchase one of these fancy HDTV’s for your SuperBowl Party they tell you right up front this is a high-tech device that is going to require maintenance. Laser dental companies could learn a trick or two from retailers – you aren’t buying a toaster.
Al
SwpmnSpectatorMark:
I have heard that the ConBio DeLight Erbium laser has a two year warranty. Whether or not this covers all of the laser components including the “handpieces” I do not know. I have heard through the “grapevine” that most users of the ConBio DeLight do not use a “handpiece” but a different type of delivery system.
Al
PatricioSpectatorJetsfan,
I find the explorer to be effective. I do my best to remove all plaque materials from the groves and pits before using the Diagnodent and I never use any polishing materials. I have adjusted my numbers to provide nearly 100 percent positives when I restore so what I do works for me. Our hygienist may polish first and will often have used the various automatic aids like a prophy jet and if the lesion is not obvious I double check it with my machine.
Pat
PatricioSpectatorJetsfan,
I called the marketing department on three different occassions the last being about that ad. In all three cases they promised to call me back and no one ever did.I have an ad ready to run. The station owner brought his family over to the laser and for the one hour whitening process and we are trading services. This seemed like a nice way to pay for something I hadn’t budgeted.
My sense so far is if your market has no laser competition so to speak it is time to market to the max. for those trout.
Pat
PatricioSpectatorHi gang,
Yesterday I began removing gross decay from a xerostomic. So much decay I could not begin to estimate a treatment plan with out removing the grosss decay. I removed decay from # 6 and wouldn’t you know the pulp began to weep into the void. This will be a future root canal treatment but today was not the time to start so I grabbed my trusty laser and lased the pulp chamber for a millimeter around the weeping site and placed flowable over it as a temporary. I was hoping to stabilize this situation until we can treatment plan and get the patients approval for treatment.I didn’t hear from the patient today so I saw that as positive. I was building on the discusssion about avoiding endo by lasering the exposure which seems to fail eventually in most cases you guys reported but I wonder if it is a process that could be used to buy time painlessly. ??
Pat
jetsfanSpectatorPat,
The marketing dept is extremely busy. My suggestion is to go directly to Keith Bateman and ask him about the radio spot. I’m sure he will help.
I agree, it is time to market the laser… BIG TIME!
If only I knew how. I just finished reading Howie Horrocks and Rodger Kurthy Books. I understand that Rodger is going to have a book specifically on this topic.
It would be nice if posters would share their marketing ideas with those of us who may not have an advertising savy.
Jetsfan
SwpmnSpectatorBob and Jeff:
Welcome to Ron’s Forum Dr. Cranksa!!!!! I enjoyed your article in February 2003 Dental Town. The great thing about this forum is the professionalism and the manner in which colleagues treat one another.
I would like to pose a question and in no way am I trying to be a smartass or critical. In the Dental Town hard copy article, is it possible that Photos 3 and 4 were transposed?
The reason I ask is because in your description of Photo 4 you Note: no shrinkage or recession of gingiva. I think the publisher just transposed the photos.
Thanks for your help and welcome!!!!!
Al
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