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  • August 2, 2005 at 9:25 pm in reply to: Deka CO2 #9706

    Robert Gregg DDS
    Spectator
    QUOTE
    Quote: from etienne on 5:41 am on Aug. 1, 2005
    Dear Bob
    Thanks very much for your time. I really appreciate the fact that you are willing to advice me on this even though there is nothing in it for you.

    OK, that sorts out the CO2 vs Nd:YAG. Can you also tell me what the difference between the Diode (810nm as well as 980nm) and the Nd:YAG is for practical purposes as far as softtissue is concerned?
    Take care
    Etienne

    Dear E,

    Probably we should have this discussion in the diode section.

    What sort of soft tissue applications are you interested in?

    Are you registered on Dental Town? I think there is quite a lot of diode FRP NdYAG discussions there, and some here as well.

    http://www.rwebstudio.com/cgi-bin/ikonboard//topic.cgi?forum=30&topic=21

    http://www.rwebstudio.com/cgi-bin/ikonboard//topic.cgi?forum=30&topic=20

    Bob

    August 3, 2005 at 7:00 pm in reply to: General Nd:YAG Forum #2722

    Klye Reeves
    Spectator

    Has anyone tried LLLT/Biostim for idiopatic burning tongue syndrome? Forty-something white male. Have gone through all the usual stuff like diet, toothpastes, blood studies with MD, etc. No cause determined, no relief. If it is neural in origin, it seems like some of the same principles of parasthesia reversal would apply. Any thoughts???

    August 5, 2005 at 2:58 pm in reply to: Deka CO2 #9684

    etienne
    Spectator

    Hi Bob!
    Thanks very much for your note. I had a look at the LINKS and learned a lot. Please let me know when (if?)you plan to market the Periolase in South Africa.
    Take care
    Etienne

    August 6, 2005 at 1:01 am in reply to: Lasers in Dentistry #8686

    lagunabb
    Spectator

    Al – thanks for the compliment. It is easy for us to muse about adoption but it is a complex problem for any vendor of sophisticated equipment in the dental market. The thing that really strikes me about the dental device market is the fragmentation of having to deal with essentially 150,000 small individual businesses. Each with their own patient sets, spending budgets/priorities and technology support needs. If it was just 50 customers as in the semiconductor chip business, it would be done already — actually it has been done (here I am referring to the Cymer business model).

    Bob – Stop, you are making me Maui and Honolua sick.

    August 6, 2005 at 3:51 am in reply to: Burning tongue #5530

    Robert Gregg DDS
    Spectator

    I can’t remember……..

    Give it a try, can’t hurt. It should work.

    Keep us posted.

    Bob

    August 6, 2005 at 3:54 am in reply to: Deka CO2 #9702

    Robert Gregg DDS
    Spectator
    QUOTE
    Quote: from etienne on 10:58 am on Aug. 5, 2005
    Hi Bob!
    Thanks very much for your note. I had a look at the LINKS and learned a lot. Please let me know when (if?)you plan to market the Periolase in South Africa.
    Take care
    Etienne

    You’re welcome E,

    Give us a year or two–gotta get into Canada and the UK first or Glenn will kill me.

    Bob

    August 6, 2005 at 12:46 pm in reply to: Off Topic #3121

    dkimmel
    Spectator

    Katie (Dr.Miller) has now been in my practice a bit over 3 weeks. I have started her training by pretty much putting her feet to the fire. She has a little background as to how the laser works but we have not really dug into it very deeply. I decided to do this later and get her started clinically.

    We started out with her doing one of our patients that needed a helping hand. She did 4 Incisals right off using the Delight. I talked her through some basic settings and when and how to change them by watching the laser tissue interaction. She was using 2.5 loops and we have bumped her up to X6 loops.
    Then she used the laser and the highspeed at the same time to remove a DO alloy on #29.
    I then moved her over to the Waterlase and soon to the MD. I am holding out on the Periolase for now. ( I got to have some fun.)
    She has been knocking out some pretty advanced hardtissue stuff with the ER lasers. Like all of us she has had a few that gave her problems. She has had to pickup the highspeed and has has to numb a few patients.
    I am very proud of her. In 3 weeks she has gotten past some of the stumbling blocks that discourage others .

    Can you see me smiling?rock.gif

    August 6, 2005 at 3:14 pm in reply to: Training Katie #8823

    2thlaser
    Spectator

    How lucky she is to have a mentor like you David. That…..comes from my heart!

    Mark

    August 9, 2005 at 7:14 am in reply to: Laser Bleaching #7910

    etienne
    Spectator

    Hi All
    The Smartbleach system referred to seems to be the Deka KTP technology.

    I saw before and after SEM pictures recently of cases where various bleaching methods were used. The pictures were done by the Univerity of Vienna and were presented as part of the ESOLA course. In some instances there were clearly changes in the surface texture of the teeth. Is anybody concerned about this kind of changes (damage?) to the enamel? Should I be?
    Thanks for any thoughts about this.
    Take care
    Etienne

    (Edited by etienne at 2:41 am on Aug. 14, 2005)

    August 10, 2005 at 12:44 pm in reply to: Hard Tissue Procedures #3441

    whitertth
    Spectator

    Here is a topic that hasnt been discussed in a while….Many of us teach and profess, and have learned about laser analgesia or anesthesia….But recently it has come under scrutiny by some ( including myself)…Is it reality or nonsense? Have there been any concrete studies or even concrete anecdotal studies to show it exists. I was a big believer till the last 6 months, when I stopped at the insistence of Dr. Jim Jesse only to prove to myself yes or no. Jim has never used laser anesthesia and beleives that patients that feel it, feel it, patients that dont dont. He has had as good clinical success as anyone not using local, andmy results have been similar the last 6 months. I think the question is have u tried doing multiple fillings of the same size on the same person and on multiple people and seen diffent results with and without laser anesthesia…
    Guys? Anyone?

    August 10, 2005 at 5:37 pm in reply to: Laser anesthesia/analgesia #11360

    Anonymous
    Spectator

    Interesting question and I’ve been thinking about this alot since you first mentioned it to me.

    Since I’ve had the scope, and when I’m using it with the laser, I never do the laser analgesia thing and just get right to it. Maybe its because I can see that much better and thus control the energy, but I don’t see any difference in success. Maybe its the ability to ablate at lower powers. Without the scope (in the posterior) I still tend to do the 90 second thing, but in all honesty I’m numbing up more and more in the posterior areas just because the anesthesia time allows me a few minutes to go do other things (sacrilege, I know). Without the scope in the anterior, I just use low power(1-1.25W) and start defocused, slowly moving in. I’m usually doing max. second molars w/ anesthesia and a handpiece just because its easier and faster. I guess I’ve got to the point of asking is this going to be easier and faster on both the patient and myself ? This may just be my own adjustment in deciding there are some things I am able to do with the laser, but since I’m not trying to prove I can do it anymore, (with the laser) why not do what isn’t going to have me guessing yet at one more thing whether or not the patient is going to feel it.

    I know there was one guy that used to post on DT that he never did laser analgesia and was successful but I also had a hard time swallowing that in his first six months the laser didn’t bother any of his patients.

    So I’d also like to hear what others experiences have been. Good topic, Ron

    August 11, 2005 at 1:07 am in reply to: Fibroma removal from tongue #5744

    Benchwmer
    Spectator

    Bob,
    Here is a post-op at 21 days.

    Before

    Tate63005aba.jpg

    After:

    Tate72105A.jpg

    Jeff

    August 13, 2005 at 9:41 am in reply to: Laser anesthesia/analgesia #11367

    Glenn van As
    Spectator

    Hi Rons…….I agree with both of you in that laser analgesia is ok for some patients and for others it doesnt make a bit of difference.

    I will tell you a couple of things. First off my erbium laser is used for so many things but restorative in adults is not the leading procedure for me. As Dr. Schalter mentioned , sometimes there is a reason to use anaesthesia and I dont often use it for incisals, Class 4s, class 5s, all cavity preps in kids, small Class 1s (less than 40 on the diagnodent) but for bigger class 2s, large class 1s , wimpy patients and other things, I just dont have the patience to try and do it without anesthetic like I did when I first got the laser.

    In addition I will also relay one thing to you, and that is I had a patient very sensitive to cold air and water for a class V restoration.

    I did the restoration with laser analgesia eventually getting to a high level of 30hz and 140 mj.

    I finished the whole procedure and noticed on small dark spot on the cavosurface ENAMEL border after the whole thing was done and took the laser back in there at 30Hz and 70 mj and she jumped and looked at me saying…….owwwww…..what the heck are you doing.

    Remember the restoration was done, the energy was on enamel, and it was half of what I had used in dentin 10 mins earlier or so.

    I know for her it worked but in any individual case the results may vary.

    For me its a nice trick to have in your toolbox for those antsy patients who just have to try without anesthetic.

    Great post

    Glenn

    August 14, 2005 at 7:31 pm in reply to: Laser anesthesia/analgesia #11370

    Swpmn
    Spectator

    Since the topic was brought up:

    Not intending to p1&#36&#36 off any of my colleagues but it is my opinion that “laser pre-analgesia/anesthesia” with respect to use of the 2780-2940nm erbium generated wavelengths is BS/non-sense/hocus pocus/voodoo which can only be attributed to a “placebo” effect.

    Here in Clearwater we did try the most commonly recommended technique for awhile and found no significant difference from what we were already doing.  If we think about this from a physics standpoint, a defocused erbium wavelength will be immediately absorbed to the tune of a few microns when applied to the exterior of a tooth.  How can it possibly have a several millimeter affect which will disrupt pain impulse in the pulp?

    Enamel rod lightwave theory?  Erbium will be immediately absorbed as soon as it strikes hydroxyapatite.  Acoustic theory?  Perhaps something here but I propose results would be similar to banging on the tooth for 90 seconds with a mirror handle.

    The commonly observed clinical finding where we are able to prepare non-chemically anesthetized teeth with an erbium laser can only be explained as a local phenomenon.  A high speed handpiece could be viewed as a “Continuous Wave” instrument which applies a constant, deeply penetrating heat effect to the pulp.  The pulsed, short duration, almost-never-on, long thermal relaxation time, micrometer absorbed erbium allows us to prepare many(but not all) teeth without chemical anesthesia due to this localized phenomena.

    We currently have our highest ever success rates using the erbium laser to prepare composite restorations on non-chemically anesthetized patients. We carefully select the patient and the lesion. Recently, we have been pulling two patients per day out of hygiene and immediately placing composites without chemical anesthesia. Our patients are thrilled and it adds &#36300-400 per day to our gross income. We are also receiving referrals for pediatric patients where we are able to place composites on deciduous teeth without chemical anesthesia.

    August 15, 2005 at 1:50 pm in reply to: Laser anesthesia/analgesia #11361

    Anonymous
    Spectator
    QUOTE
    Quote: from Swpmn on 3:31 pm on Aug. 14, 2005
     Perhaps something here but I propose results would be similar to banging on the tooth for 90 seconds with a mirror handle.

    Al,
    I really want to see video of the 15 or 20hz mirror handle tapping smile.gif

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