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AnonymousSpectatorQUOTEQuote: from Robert Gregg DDS on 1:00 pm on Oct. 14, 2005
Ron,Don’t know the dosimetry. How long were the implants exposed and in contact? Parallel or perpendicular?
CO2 is fine, nothing wrong with FRP Nd:YAG if used properly.
Bob
Medline is still working on the article so I dropped one of the authors an email with the methods questions.
Glenn van AsSpectatorMickey I dont think that this laser the Clarion is available in North America so I guess it just is important to know where the person is from.
I have ZERO experience with the superpulsed diode but will say that pulse duration for perio is one thing, wavelength (the NdYAG is far better absorbed in black pigmented bacteria and far deeper penetrating than diodes period regardless of pulse duration) is another.
In addition it would seem that in this case the person is asking for a diode to be used not primarily in periodontal pockets (I think that the connective attachment for diodes is Long Junctional epithelium but of course am very amenable to all the published material in Europe on this wavelength that of course I may not have access too).
For cosmetic purposes a lightweight , low cost diode for tissue management is the way to go.
PS could you tell me the cost for the Clarion Elexxion…….
The Ivoclar is around 11,750-12,750 USD and the DIodent 2 is roughly the same cost.
That is the attraction of diodes for those not looking for periodontal treatment in that they are inexpensive and a good alternative to electrosurge where tissue response (ie recession) can be so variable due to high collateral thermal damage that impressions on the same day as tissue managment is not a wise idea.
Hope that helps clarify things and if indeed this person is in UK or Europe then I would consider the diode you mentioned which I have zero experience or knowledge with but do not see it much being sold (is it even available) here in North America.
All the best and have a great weekend.
Glenn
Glenn van AsSpectatorOne of the things to consider is that if you flapped the case that the surface of exposed hydroxyapatite could be easily removed with the erbium lasers. THe hydroxyapatite is readily absorbing the erbium lasers and it will do little to the titanium surface. Water spray keeps everything cool so it might be the way to go in my opinion as the right wavelength for this type of failing implant. The wavelength will strip of the HA and will sterilize and not heat up bone.
The ongoing problem of course is the gap between superstructure and the implant itself.
I think that you will see with time that erbium lasers will become a treatment of choice for failing implants. Lots of research looking at this now.
Glenn
dkimmelSpectatorAs odd as it may seem I am not to concerned about the fit or lack of fit at the implant post interface. It is alomost high and dry at this point and I will probably just seal it as best possible. I don’t even want to think about trying to remove this cemented abutment….
I am more concerned about her occlusion as the doc paid as much attention to the occlusion as he did in seating the crowns and the abutments…..
That said, I still have a wonderful defect..
Several concerns come to mind.
The biggest is removing the tissue that is in the basket.Pretty hard to remove this and keep the Nd:YAG away from the implant. This would be a non issue with an Er. However, this would mean I would have to open the site. Not really what I would want to do if I expect to get the full benifit of the Nd:YAG!!! RAther a CATCH 22.
Which brings me to the real question.
Do I really want to try and get the osseous defect to fill in???
These are not two implants that I would like to maintain for a very long time. As it is now they can be farely easly removed and block grafts placed. If I do get any resolution of the defect I have just made this a harder job…
dkimmelSpectatorToday was the first time I have gotten to play with the Odyssey. Go fiqure I am at a CEREC course and I go play with the lasers….
This little unit rocks..The New Odyssey as Glenn says has the wireless foot pedal. That along with its smaller size, less weight and a retrackable fiber– Makes this a top pick of the diodes…
You really could not go wrong with buying this unit.
Just make sure a diode laser is what you want. Make sure you know what it can and can not do …
Good luck
DAvid
Glenn van AsSpectatorHi David…for some the lack of sterilizability of the fiber is a big issue. For us here in Canada it isnt as much a problem.
I like the size , simplicity and easy handling of the Odyssey 2.4G (new model) and the footpedal is as advertised. I use mine all the day. Today I did a huge frenectomy and decided to use the erbium…..hit a big blood vessel and pressure + Astringident would not stop the oozing.
Finally the diode did the trick. 7 year old girl a little squirmy but I got it done!!
Take care and I want to say that after a long lull on LDF, this board is again becoming quite active. There are lots of new members and lots of new questions…….its a testament to Ron Schalters great website where the issue is wavelengths……..not brands.
Now does this mean it is time to start posting some cases again……..gotta run……its my anniversary.
Off to dinner without a computer!
Grin
Glenn
Glenn van AsSpectatorDavid I will tell you that the distal implant will be a piece of cake, the mesial a real huge headache.
I just tried to remove one on my mom which was exactly the same Corevent HA coated implant. It spun but wouldnt come out.
I finally closed flapped around the implant with the erbium, removed the superstructure and then put a healing cap in.
Will see in 3months and most likely then will flap it to see what can be done. I could spin the implant but no way could I get it up…..
It looked just like your mesial one on the radiograph.
Glenn
Robert Gregg DDSSpectatorQUOTEQuote: from doctorbru on 2:20 pm on Oct. 14, 2005
Bob,Is it correct to assume that a mostly end cutting fiber such as used on the FR:NdYag would be fine if kept parallel to the implant surface ?
Would it be prudent to wipe the tip more frequently to prevent any nonendcutting heat from building up on the fiber tip ?
Bruce
Yes, it is end-firing, but th scatter in the tissue is circumferential around the tip, but making the intensity much less of course (a good thing in this instance).
No need or concern to remove the protein B/U. Just not hot enough.
Thanks Ron.
Bob
mickey franklSpectatorGlenn,hope you enjoyed your aniversery.Hope you left your Scope in the surgery….
I do not know if the Claros diode can be bought in the US.Yhe price in Europe is 20,000 Euros (ศ,000) which does seem much higher than the basic diodes in the US.
I appreciate for basic use a simple diode may be good enough, and know that for advanced perio the Periolase is the best option.
All the best
Mickey
spider24SpectatorThe elexxion claros is not available on the US-market until now. After finishing some studies and the FDA approval it will perhaps be available in 2006.
You should not compare this unit to a classical diode. It´s a diode with cutting performance nearly like a Co2 but excellent hemostasis.
Olaf
cadavisSpectatorOK guys,
I’ve got a patient who has a failing endo on #8. I usually refer out the apicos but she has no insurance and is concerned about cost (single mom, etc….). Since I now have this handy dandy Opus laser, I figure I’ll do my first laser apico probono. If any of you are using the Duo Er/Yag, I would appreciate some info. Actually I’d like a LOT of info. Such as:
– incision using the laser (Er or CO2?),
-is Er or slow speed better to reach root tip.
-After removing 2-3mm from root tip, what is currently viewed as best fill material?
-Does the CO2 have any place in this procedure?
-what do you think about using GelFoam dusted with Tetracycline powder to fill void prior to suturing?Any help would be greatly appreciated.
Thanks,Chris Davis
AnonymousSpectatorHi all,
Thought it might be fun to play a little guessing game regarding parts cost for a certain model erbium laser.Last week my water bottle toggle switch broke. Called the company who quickly sent out the toggle switch and the water bottle and mount. Evidently it all comes together. Now when guessing the cost remember this is including a toggle switch,plastic water bottle, two plastic tubes, and a small metal mounting plate .
Do not include my 5 minutes labor for removing the new toggle switch from the new parts, removing the old toggle switch and placing the new (I would probably faint at that cost, should a company service rep do it).
Closest to the cost gets 1 year free membership in LDF :biggrin:
Robert Gregg DDSSpectator趆?
BenchwmerSpectatorRon,
The plastic bottle alone would be over 赨,
I’ll go 軅 plus shipping, handling and tax.
Repair in my area for my hard tissue laser is 足 an hour, minimun 4 hours, plus 跌 travel time. That would be 񘎸 to install that toggle, plus parts.
That’s why you’re the rich dentist, Ron, you need to keep the economy going.
I ordered a case of plastic bottles for my EMS piezzon unit. Ten plastic bottles were over 񘈨.
Time to raise your laser fees 10% and keep moving ahead.
Jeff
AnonymousSpectatorBob, close but not quite there!
Jeff, or I could just go into the repair business and make some real money
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