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Viewing 15 posts - 1,051 through 1,065 (of 8,497 total)
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  • in reply to: Hard Tissue Procedures #3555

    OK, I’ll admit upfront that not only am I a newbie, but I don’t even OWN a laser yet!

    Attempting to wade through all the information to see if it would make sense…make that “cents” for me to purchase a hard tissue laser.

    Although I’ve just joined this board, from what I can see you all seem extremely straightforward and honest, so lets see if you can give me some insight…

    Here is my situation, I have a small 3 op office and work out of only one op. The office is only 1000sf so the ops aren’t huge (about 10X12). I’m established 17 years and gross approx 600K with a good net. We are FFS and participate with no plans. I practice in a rural community and am the only DDS with electric handpieces and Digital radiographs. There are approx 20 dentists in the area and one does have a soft tissue laser. That’s about it.

    So, would it make sense for me to purchase a hard tissue laser? Do you think my gross would go up sufficiently to justify the 50K or so to purchase a laser. You probably need more information about me and my practice to answer that…so fire away. Make it honest and dirty. Give me the pros and cons. Let me know what you like best and hate the worst!

    I want it honest and upfront smile.gif Don’t worry, I can take it!

    Thanks for your anticipated replies.

    Appreciatively,
    Mike

    in reply to: Guided Tissue Regeneration #10271

    dkimmel
    Spectator

    Bob, Late getting back. The animation was great. I have referred by hygenist to the site as well.
    David

    in reply to: newbie here, don’t even own a laser… #12381

    dkimmel
    Spectator

    Mike get off the fence. Spend the cash! You don’t need the autohelm.
    David

    in reply to: Tori Removal #11288

    dkimmel
    Spectator

    Allen,
    I know what you mean by the air!!
    Tori can be a pain to grind off. I remember it being much easier with a chisel and mallet– nice and clean. The patients tended to freak. Not good for private practice.
    As far as cutting the bone with the laser. Is it very slow and smooth. Cleaner then grinding? It would seem with a large tori that the depth of the cut would be a problem.
    DAvid

    in reply to: newbie here, don’t even own a laser… #12380

    Anonymous
    Spectator
    QUOTE
    Quote: from mike esposito dds on 9:00 pm on Feb. 27, 2003

    Here is my situation, I have a small 3 op office and work out of only one op. The office is only 1000sf so the ops aren’t huge (about 10X12). I’m established 17 years and gross approx 600K with a good net. We are FFS and participate with no plans. I practice in a rural community and am the only DDS with electric handpieces and Digital radiographs. There are approx 20 dentists in the area and one does have a soft tissue laser.  That’s about it.

    So, would it make sense for me to purchase a hard tissue laser? Do you think my gross would go up sufficiently to justify the 50K or so to purchase a laser.  You probably need more information about me and my practice to answer that…so fire away. Make it honest and dirty. Give me the pros and cons. Let me know what you like best and hate the worst!

    I want it honest and upfront smile.gif Don’t worry, I can take it!

    Thanks for your anticipated replies.

    Appreciatively,
    Mike

    Mike,

    I’m in a town of 2200.1 other full time dentist in town , 1 mostly retired. 4 op’s , just added 5th. Use 1 op for restorative, 1 for C&B ,and laser perio, 2 for hyg. 2 hygienists working ~ 30hours /week each. Numbers probably 12% less than yours, working MWTh 8-5:30,Tue 8-4.

    Since adding the lasers (diode/er,cr:YSGG)our monthly production has set new records each and every month( we did increase fees since we were below what everybody else was charging, now about average). If things continue as they are, I expect to see a 15-20% increase in net  for the year, while planning more time for each procedure and not running around as much, also taking a 5th week of vacation. I do think, however the soft tissue laser has been as important, or more important for us. You might want to seriously consider both, as its great not having to refer very often to the periodontist who is half an hour away.

    You won’t have any problem paying for the lasers!

    Once I saw that even figuring ,very conservatively,  I could pay for the laser, the benefits far outweighed the cost. 4 quads perio a month more than cover it. The frenectomies, fibroma removals, desensitizing, cold sore tx, and being able to work in multiple quads is just gravy.

    Now the benefits for me-
    Starting my 20th year , I’m more excited to go to the office than I’ve ever been.
    I believe the fewer times I have to give injections , the decrease in stress will lenghten my career and possibly my life.
    The appreciation that patients show(especially the parents) is just unbelievable. I did have to numb my second child patient (since August) , not because it hurt but rather because her gag reflex couldn’t handle the water. I never want to have to treat children again w/o it. For that matter, adults either.
    The comraderie with fellow laser dentists is better than anything else I’ve experienced in the dental profession.
    An appointment book that is full 7 weeks out and 30+ new patients a month with absolutely no advertising or internal or external marketing efforts. We did put a small laser ad in for a short period and had days when 10-14 new patients would call each day- we couldn’t handle it and quickly pulled the ad (great problem!)
    Benefits for the patient-
    No shots or numbness after tx (~95% of the time I use the laser)
    Patients are more apt to follow thru on perio tx when they don’t have to travel and can avoid scalpel and suture
    Restorations that are less destructive to sound tooth structure.

    I think your only concern may be space in the operatory. I’m sure you can rearrange things to make it work, though.

    Before you buy though, invest some time and do a standard proficiency class. Make sure to consider both the major players (companies).Keep asking questions. Remember the lasers are not a do all magic wand, but rather another great tool you can use to provide better patient care.

    If I can be of any help, let me know.  517-265-7625 (home)

    in reply to: Guided Tissue Regeneration #10282

    Robert Gregg DDS
    Spectator

    Pat and David,

    Thanks for your comments.

    “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.”

    Yep.  Important to know.  That’s why I usually show our radiographs, bone density studies and human histology, not clinical photos.

    3 series bone density.jpg

    This radiographic series was subjected to bone density analysis using Emago digital comparative software to compare pixel to pixel in the radiographs compared.  Bone density increased from 13% in the pre-op (through the section of film indicated by the green line) to 46% in the 14 month post op image for an increase bone density of 33%.

    3 series clinical.jpg

    These are the clinical photos at 9 months.  No probing was done before this appointment.  Probes depths 2-3mm

    “What sort of pocket depth reduction would one typically expect and what typical final pocket depth vs normal 2-3mm?”

    blinded, multi-centered, retrospective, private practice clinical study

    http://spie.org/scripts/abstract.pl?bibcode=2002SPIE%2e4610%2e%2e%2e49H&page=1&qs=spie

    Study of 65 patients and over 1900 probing sites showed that laser periodontal therapy using a specific modality called “LANAP” for “Laser Ablation New Attachment Procedure” was reproducible in reducing 90% of pockets in ONE treatment by a minimum of 50% regardless of pocket depth as such:

    > 4mm – 2.2mm reduction
    > 6mm – 3.1mm reduction
    > 8mm – 4.5mm reduction

    QUOTE
    What is the long term reinfection potential and what is recomended for maintenance care?

    Great question.  Research over many studies and years shows that periodontal tissues treated using pulsed Nd:YAGs resist reinfection and breakdown longer by as much as 30 to 90 days over what SR/P alone can provide.  But that is nothing you want to rely on with you patients who are ALWAYS suseptable to perio disease once they have it.  So maintenance care is the same, 90 days, though many can be eventually pushed out at the discretion of the RDH.

    QUOTE
    Finally, I would like purchase details for consideration.

    &#3644,995 all inclusive that includes the PerioLase MVP-7 digital pulsed Nd:YAG, 5 days of hands-on clinical training (includes 3 days of Laser BootCamp, extensive literature review), ADA-CERP/AGD-PACE CE’s,  Jeff Mani’s laser reference, license for LPT, patented TrueFlex handpiece (nothing else like it), 6 months money back guarantee on getting clinical results such as those in the study above, hotel and transportation included (not air fare)–and for Laser Dentistry Forum participants–is an EMS Piezon 400 closed system ultrasonic scaler with the tips we use.

    Thanks for asking and for your interest!  Feel free to give me a call.  If you want more info, I can mail you a packet of stuff with lots of before and afters.  Just tell Laurie at MDT I said to send to a packet.

    I’ll be at the Academy of Laser Dentistry Meeting (ALD) all next week–my first meeting travel since my torn Achilles tendon surgery last September….yeah.

    Bob
    MDT:  888-49-LASER
    or 562-860-2908

    (Edited by Robert Gregg DDS at 10:39 am on Feb. 28, 2003)

    in reply to: Laser Supplies #3186

    wiems
    Spectator

    What are people using for ultrasonic scalers in conjunction with laser perio procedures? Lares recommends the EMS Piezon Master 400, but the unit is Basically 3 grand with 1 handpiece and 5 tips.
    Is it worth it?

    in reply to: laser suppliers #9072

    lagunabb
    Spectator

    American Medical Tech Dismisses Auditor Ernst & Young
    Friday February 28, 9:29 am ET

    WASHINGTON (Dow Jones)–American Medical Technologies Inc. has dismissed Ernst & Young LLP as its independent accountant and hired Hein & Associates LLP.
    According to a Form 8-K filed late Thursday with the Securities and Exchange Commission (News – Websites), Ernst & Young’s report for 2001 expressed substantial doubt about the company’s ability to continue as a going concern.

    The report also said that the financial statements didn’t include any adjustments for a possible future effect such doubt might have on the recoverability and classification of assets or the amounts and classification of liabilities.

    The filing didn’t include the reason for Ernst & Young’s dismissal Tuesday.

    There have been no disagreements with Ernst & Young on accounting principles or practices, financial statement disclosure or auditing scope or procedure for the company’s previous two fiscal years, the filing said.

    in reply to: For what it’s worth #12003

    Lee Allen
    Spectator

    Pat,

    Thanks for the tip and the reply. I can hardly wait to try it out. I hate to give anesthetics when seating since it screws up the patient’s ability to occlude normally and increases the number of followup adjustments..

    Bravo!

    in reply to: Guided Tissue Regeneration #10275

    Patricio
    Spectator

    Bob,
    Needless to say this is an outstanding result. I will reflect on this option as I travel to South America beginning next week. We have a thriving and effective non surgical periodontal program and am always looking to improve it. I will call for the packet.
    Pat

    in reply to: newbie here, don’t even own a laser… #12391

    Patricio
    Spectator

    Mike,
    I am with our other very positive friends.  I am also in a small community of 22000.  I am beginning to see some direct charges from the laser as I develop my skills and add procedures but have not thought much about the cost after the first few weeks when I began to realize all the things Ron outlined.  You won’t even notice the &#361000 a month after the first month.  We even began to speed up repayment toward the end of last year. I am busier than I have been in a long time and like Ron I am wondering about how much to advertize tho I have advertized to get the word out and build a laser reputation.  I say market the heck out of it at the beginning.  New patients alone will pay the bill, gladly.
    Pat

    in reply to: Tori Removal #11292

    Swpmn
    Spectator

    David:

    The laser cuts bone fairly quickly and it is possible to obtain smooth services with careful use. Whether our not it would be practical I think would depend on the size of the torus. I only try the small ones with my handpiece so I believe you could use the Erbium in these cases.

    Al

    in reply to: Radio #8598

    Patricio
    Spectator

    Jetsfan,
    See hard tissue laser marketing under Marketing Lasers this forum for some materials which are useful.
    Pat

    in reply to: Trunk Fiber #9244

    Patricio
    Spectator

    Al,
    I agree and also feel a little foolish.  No one ever suggested any long term issues of maintenance and repair.  I bought in at &#361000 per month and now am learning it is more.  My first reaction was denial.  Can’t we avoid this somehow? But Mr. Tell It Like It Is has given me a whole new prospective.  Sad to say.
    Pat

    in reply to: Trunk Fiber #9248

    Patricio
    Spectator

    Al,
    I agree and also feel a little foolish. No one ever suggested any long term issues of maintenance and repair. I bought in at &#361000 per month and now am learning it is more. My first reaction is denial. Can’t we avoid this somehow but Mr. tell it like it is has given me a who new prospective. Sad to say.
    Pat

Viewing 15 posts - 1,051 through 1,065 (of 8,497 total)