Page 449 – Laser Dentistry Forum

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July 28, 2005 at 2:17 am in reply to: Off Topic #3153

jetsfan
Spectator

I know this has little to do with lasers but I do respect the opinions of those who post here.
C factor, the ratio of bonded to unbonded surfaces, is the current explanation of tooth sensitivity after bonding. It has been suggested that composit be placed on one wall at a time, thereby reducing stress on the tooth.
I know this is not scientific but ever since I have been using the YSGG and utilizing Graeme’s technique of filling up the prep ,first with Fuji9 thenflowable anf finally “condesable” composite, I just don’t get the sensitivity. I am able to place the composite in bulk on opposing walls. Never any sensitivity.
What do you think? Anyone else notice this? or have I committed bonding heresy!

Robert

July 28, 2005 at 4:01 am in reply to: tooth sensitivity-c factor #8983

Robert Gregg DDS
Spectator

Robert,

Shhhhhhhhh……………

Bob

July 28, 2005 at 4:46 am in reply to: Deka CO2 #9699

BNelson
Spectator

Bob-
Well said, as usual. Of course I am in your camp, so I guess I may be biased? I seem to be hearing more interest from periodontists for CO2 over mvp-7 for some strange reason. Haven’t figured that one out yet, considering the science doen’t back it.

July 28, 2005 at 6:29 am in reply to: Hard Tissue Procedures #3410

Glenn van As
Spectator

Hi folks: its been painfully quiet in here for a while. Here is a case I did a couple of weeks ago and thought it might be interesting.

This is a yong 13 year old female with alot of crowding. Treatment included extraction of all permanent 1st premolars and the primary tooth on the upper left at the same time.

I have posted some preop radiographs and then when I extracted the primary molar I heard the tell tale “CLICK” which occurs at the same time as the crown is removed. It is typically followed by some short four letter words uttered quietly or thought loudly.

In this case given the orthodontics are being done the primary root had to be visualized (its great to have a scope), and then removed.

The erbium laser was chosen to create the osseous laser trough around the root so that a root tip elevator can be inserted and the root removed. Settings were water on, 40Hz and 110 mj or so. Not much air at all.

I then removed the 9mm root and decided to help the tooth along a little by using the diode to remove the overlying tissue (follicular tissue) and allow this tooth to come in faster and I used the diode to remove the tissue. Settings were 1.0w CW. Light air and water stream. The diode was used in contact as was the erbium.

I like the diode for coagulation in these cases as well. Maybe not quite as nice as Dr. Bobs NdYAG (cant speak from experience though) but it works.

Hope it creates some discussion, we cant have figured it all out in under 3 years can we??

Glenn

July 28, 2005 at 12:53 pm in reply to: Lasers in Dentistry #8693

Benchwmer
Spectator

Recieved my Monthly magazine, Incisal Edge yesterday. Published by Benco Dental (out of Pennsylvania).
They are representing Hoya now.
The article states if I buy a laser and market aggressively my practice should increase 35%-75% in one year. Six new procedure a week will increase production by &#36165,000 per year.
Should be able to add 185 patients per month.
Everyone should be buying 2 or three of these lasers.
Jeff

July 28, 2005 at 4:55 pm in reply to: Lasers for extractions #11018

Benchwmer
Spectator

Hey Glenn,
Nice results, photos and documentation.
With a 550-650usec Nd:YAG pulse width, you could of created hemostatis by setting stable clots in your extraction sites and where the root tip was removed.
Great for third molars and patients on thinning meds.
I had a 50 year old patient leave the practice to save money with a dentist participating in his PPO a couple years ago. I’ve always treated him without taking him off his Coumiden. No problems with hemostatis after surgery and extraction. A couple months ago his new providers took him off his meds prior to a surgical procedure. he died three days later. Maybe it was his time, but his wife is back as a patient and blames his dental care as his cause of death.
I’m glad I never had to take him or my other patients off their meds.
When do you want that Nd:YAG shipped?
Jeff

July 28, 2005 at 6:32 pm in reply to: tooth sensitivity-c factor #8984

Swpmn
Spectator

QUOTE

I know this has little to do with lasers but I do respect the opinions of those who post here.
C factor, the ratio of bonded to unbonded surfaces, is the current explanation of tooth sensitivity after bonding. It has been suggested that composit be placed on one wall at a time, thereby reducing stress on the tooth.
I know this is not scientific but ever since I have been using the YSGG and utilizing Graeme’s technique of filling up the prep ,first with Fuji9 thenflowable anf finally “condesable” composite, I just don’t get the sensitivity. I am able to place the composite in bulk on opposing walls. Never any sensitivity.
What do you think? Anyone else notice this? or have I committed bonding heresy!

Robert

Robert:

Your findings are consistent with those of my own, however, it is my opinion they are unrelated to use of the YSGG which I obtained in 2001. Around 1998 determined I wanted to start shifting away from amalgam and become more proficient in placement of posterior composites. In 1999, found that we could bulk place posteriors without sensitivity by covering dentin with 3M Vitrebond.

July 28, 2005 at 7:08 pm in reply to: Lasers for extractions #11037

Swpmn
Spectator

Nice case Glenn. The erbiums work well for this type of conservative extraction assistance. Sometimes these seemingly simple deciduous tooth extractions can be a real PIA can’t they?

Great job on placing tip and trough on the palatal side and not adjacent to the adult premolar. If we place the erbium tip on the side adjacent to the premolar we could have easily nicked up the adult tooth.

July 28, 2005 at 7:40 pm in reply to: Lasers in Dentistry #8685

lagunabb
Spectator

i will put my 2 cents in from an investor standpoint since I still have a few shares (and I mean that literally) of BLTI.

IMO the business models that worked for the early adopters is not (or will not be) working for wide spread adoption. I think this way because it seems that the interest of companies like Biolase ultimately comes into conflict with the interests of the customers. The models need changing so that the interests of all stakeholders (dentists, companies/ investors) are aligned for the entire duration of the laser from manufacture to obsolecense. It’s up to the smart companies to figure out how to do it. Changing the sales methods by itself will not work. Widespread adoption will not happen until the business models are redone.

July 28, 2005 at 11:51 pm in reply to: Lasers for extractions #11019

Glenn van As
Spectator

Wow Jeff, what a story that is, makes you think about taking them off the coumadin.

I also want to say thanks to Allen, he is one of the brightest laser minds I know and he always takes the time to look in detail at the cases and notice things like the area I took the bone in this case. I didnt even mention it but Allen reads my mind alot of times……scary actually!!

It always feels like home here on LDF because Ron has created an atmosphere of togetherness despite differences in wavelengths or brands.

Its a testament to him and his vision.

Glenn

July 29, 2005 at 12:23 pm in reply to: Deka CO2 #9682

etienne
Spectator

Hi Guys
A friend of mine is interested in obtaing a softissue laser. I personally own a Nd:Yag laser with which I am happy. He was advised to get a CO2 laser. What are your thoughts regarding the all round capabalities of the CO2 vs Nd:yag lasers?
Any ideas appreciated
Take care
Etienne

July 29, 2005 at 7:45 pm in reply to: Deka CO2 #9704

Robert Gregg DDS
Spectator

The difference bewteen a boat and a car.

Both are vehicles and will transport you–just differently.

Where do you want to go? What you you want yo do?

What kind of Nd:YAG do you have–some are “out-of-date” to say the least?

Bob

July 29, 2005 at 7:49 pm in reply to: Lasers in Dentistry #8706

Robert Gregg DDS
Spectator

I was 65 feet down scuba diving off the NaPali Coast so I missed this postn yesterday–sorry!:cheesy:

Ray–I couldn’t agree with you more.

‘nough said. Whew, time to rest……..where’s that Mai Tai?

Aloha,

Bob

July 30, 2005 at 1:32 am in reply to: Lasers in Dentistry #8711

Swpmn
Spectator

QUOTE

IMO the business models that worked for the early adopters is not (or will not be) working for wide spread adoption. I think this way because it seems that the interest of companies like Biolase ultimately comes into conflict with the interests of the customers. The models need changing so that the interests of all stakeholders (dentists, companies/ investors) are aligned for the entire duration of the laser from manufacture to obsolecense. It’s up to the smart companies to figure out how to do it. Changing the sales methods by itself will not work. Widespread adoption will not happen until the business models are redone.

Tang hit the nail on the head here and this has got to rank in my TOP TEN of most profound posts. I made an effort once to express the same opinion to a company and was treated like an arrogant idiot. It’s not the SALE, it’s the VALUE and the LONG TERM relationship with the dentist customer who is the ultimate gatekeeper for investors/shareholders.

And I’ve got ideas on how to rework the business models. Unfortunately, I have nothing to market:(

July 30, 2005 at 4:20 am in reply to: Lasers in Dentistry #8701

Robert Gregg DDS
Spectator

Cool!!
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