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SwpmnSpectatorI have used a HOYA ConBio DELight erbium and HOYA DioDent diode for three years and have been extremely pleased with HOYA products and service. My first dental laser was a Biolase Waterlase and I was not pleased with machine reliability or service from the company.
A properly used diode laser is an affordable, EXCELLENT tool for crown and bridge impressions. Mine does not collect dust as I use it every day. In my opinion, a diode laser(800nm range) provides no benefit in the treatment of periodontitis(STM).
Best wishes with your decision,
Al
AnonymousSpectatorDavid, forget Mexico and the diode (unless you just don’t want to move the periolase for C&B).
Use the discount toward training courses. IMO, getting good with the erbium is much more difficult than the Periolase. the extra training with quickly advance your learning curve.
Andrew SatlinSpectatorHi Guys,
I was curious. Does the diode mode on the periolase really work as well as the diode lasers?
If so, which laser would you recommend for soft tissue “cutting” ? Not for treating perio disease but for soft tissue crown lenghtening etc.?
Andy
BNelsonSpectatorRon,
I have to agree with Glenn. It looks to me like two roots, maybe one root wasn’t even filled. Making success more questionable.
Nice case and will be interesting to follow.Bruce
Glenn van AsSpectatorHi Andy: If you are going to use a diode, and I use mine every day then I would suggest either Hoya Con Bios Diodent 2, Ivoclars Odyssey 2.4 or even the inexpensive Zap lasers.
I know of at least 2 companies that are working on new diode products and probably they will be looking at releases at around Greater New York or Chicago Midwinter.
I am not at privvy to discuss what the companies are or what they are planning on doing but the emphasis is not on the wavelengths now but on size , portability and there are some pretty cool things coming down the pipeline.
You heard it hear first.
Glenn
Nick LuizziSpectatorAndy:
When you ask which laser is best for ‘soft tissue crown lengthing’ do you mean just tissue reduction or boney reduction around the tooth closed flap? I have used both periolase and erbium to do CL. I like the efficiency and look of the area as I’m doing it with the erbium. After I cement the temp and remove cement I use the periolase on hemostasis to clot. It’s not the same as diode-dry type clotting. You just must be aware that the erbium tip is not going to descriminate between tooth, cementum or bone. I think I like the water pulse to wash and I can keep tract where I am in the proceedure. As far a diode mode to compare soft tissue for periolase vs diode, that would be a good thing to do at the ALD or similar show side by side.
Do the diligence yourself them make your own decision. That is the only way to go, get your own data. Hope it helps. Nick
Robert Gregg DDSSpectatorI’ve treated some cavitations, I guess, that bubbled up through the gum tissue from the area of a previous 3rd molar alveolus, with the rootbone form intact, but a mess inside. I cleaned it out with curets, Periodex and lased it…. but not before I biopsied it and sent the garbage in the persistent socket to the lab.
It was comprised of osteogenic, hemopoetic cells and amorphous cellular structures. The microbiology came back with some gram negative criters if I remember right.
I’d have to pull her chart to see exactly.
The thing was, that lower left area where #17 once was, was pulled due to an infection, and the patient reports it never felt right. RCTs on 18 and 19 later did not resolve her “nagging” pain that sometimes would keep her up at night.
Once i cleaned up the area as described, she has had complete relief now for several years.
Cavitation? I don’t know what that means….I have a Hx of an infected extraction site that was not curetted (or lased) at the time of extraction, which likely trapped bacteria in the site and there was an attempt by the body to heal. The wound site closed over but the infection was walled off, not resolved.
Bob
Andrew SatlinSpectatorThanks Glenn!
Hi Nick,
By soft tissue crown lengthening I meant removal of soft tissue like a gingivectomy. I ‘m a periodontist so I don’t do closed flap crown lengthening. I own a periolase so I am familiar with the diode mode (which I use on many occasions) and the difference between wet and dry hemostasis.
I guess I was under the impression that the diode lasers removed tissue very quickly like an electrosurge, without its negative effects. The diode mode on the periolase can be a bit slow on cases with very thick fibrotic tissue. Medication associated gingival overgrowth for example.
Thanks for the input!!
Andy
Andrew SatlinSpectatorWow Glenn,
Somehow I missed this case. Great job. Interesting how the slight mesial inclination of certain teeth can make these cases challenging.
I have started incorporating some more root reshaping on cases like this–thanks to Danny. Have you tried it yet?
I love the way you ramped the osseous from the furcation without opening it up. Thats textbook. You know what else works well, is if you “flute” the buccal and lingual interproximal areas. Like the old denture wax ups? That little bit of osteoplasty helps the interprox tissue tuck in really nicely.
Anyway, these cases are probably old news to you by now!
Really nice work as always!
Andy
Glenn van AsSpectatorHi Andy: I still manage to do some closed flap and some open flap cases. I did a closed flap the other day on the lingual of a lower 2nd molar which needed one -2mm of reduction of bone and there wasnt much hope with this patient (not easy to work on) of reflecting a flap and getting access there, so I did a closed flap.
I will post it if I have a chance. I still dont find my surgical skills to be above average. I wish I had the energy and time to spend on courses to improve on that , and to be honest , I firmly believe that is one reason why I dont do more open flap cases is because I lack the surgical skills to be above average at them.
I have never done a root reshaping case but I think Danny knows or thing or two on how to handle some of these tough cases.
WEll gotta run, next patient is here and thanks so much Andy for the kind words. Even the older cases are fun to revisit every once in a while to see what I did then and how I would handle it now.
See ya
Glenn
Andrew SatlinSpectatorGlenn,
Lower 2nd molar areas can be intimidating. Unfortunately they often require considerable osseous recontouring on people with thick biotype. They are also very challenging on uncooperative patients becasue of the obvious access problem and the strength of the tongue.
You really should pursue the root reshaping treatment (with all that free time on your hands!). Because of your restorative experience I bet you would find it easier than I did. Tissue ends up healing fast and really nicely!! Less ostectomy required also. The fancy periosteal sutures and the CT grafts that Danny does in conjuction with crown length is a separate issue.
You are too hard on yourself. Your surgery looks great!
Keep in touch
Andy
cadavisSpectatorI used the Sirolase 980nm diode laser on an apthous ulcer this morning. Patient apparently gets these ulcers after almost any major dental tx. We had done endo and crown earlier this week. She started having pain from area and came in for followup. Noted small ulcer on mucosa adjacent to the endo tooth. Used laser set on 0.5W CW out of contact about 2cm, hi-vac, for 90 seconds or so in swirling motion. Afterward she said she could barely tell it was there anymore.
Dang, I guess these contraptions actually work.
Glenn van AsSpectatorGood for you Chris……couple of things.
1. You got them on the right day. Make sure that you are treating these as early as possible. Ideally in the vesicular stage. Once they start to heal, using the laser will delay healing (you actually burn the healing tissue!).
2. Dont overdo the time on them. If you do too much then you will cook the tissue as well and it hurts.
3. Dont initiate the tip. You want the energy to transfer into the area and not be blocked by the initiated tip.
4. Look for desication of the area and it drying up. The diode penetrates deeper than say an erbium so you have to be careful to not go to close and too deep.
5. You can use the high volume for the plume and to cool tissue. Sometimes air or a short burst from the 3 way syringe can cool the tissue if the patient is sensitive to the diode.These are a few things that I have learned over the years and I tell you that it is amazing to see how often the lesions donot reappear in the same areas again.!!
Cya and neat stuff.
Glenn
whitertthSpectatorWho’s that good lookinfg dude on the cover of Dentaltown?( NOTICE ONE MUST PICK BETWEEN THE 2 HERE)..
Nice write up guys……
SharazSpectatorExtract from BIOLASE News Page:
No Material Impact on Operating Results Anticipated
IRVINE, CA, Sep 11, 2006 (MARKET WIRE via COMTEX News Network) — BIOLASE Technology, Inc. (NASDAQ: BLTI), a medical technology company that develops, manufactures and markets lasers and related products focused on technologies for improved applications and procedures in dentistry and medicine, announced today that on September 7, 2006, it received a Warning Letter from the Los Angeles District Office of the United States Food and Drug Administration (“FDA”) following an inspection of the Company’s Irvine, California facility in August 2006.
The Warning Letter indicates that certain aspects of the manufacture, packing, storage or installation of the Company’s devices are not in conformance with the FDA’s current Good Manufacturing Practice requirements for medical devices. A substantial portion of the identified issues relate to actions or inactions that occurred prior to 2006, some of which continue to date. The Warning Letter instructs the Company to take prompt action to address the concerns and states that failure to do so may result in regulatory action being initiated by the FDA. Until the Company resolves this matter to the satisfaction of the FDA, certain government requests will not be granted or approved.
Jeffrey W. Jones, president and chief executive officer, commented on the development, “Compliance with FDA guidelines is taken very seriously at BIOLASE and we have given this matter the highest priority within the organization. We are working very cooperatively with FDA representatives to take any necessary action to expeditiously resolve all of the cited matters to their satisfaction. We do not anticipate that this matter or its resolution will have any material impact on our operating results.”
……………..ooooops!
(Edited by Sharaz at 3:12 am on Sep. 19, 2006)
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