Oh I feel so bad that I didnt get there this year. How many people came…….what were the best lectures . What did you like seeing there the most.

I wish I could have come and is it worth while to get the CDrom or DVD or whatever is produced of the whole meeting.

Glenn

After trying to reinvent the wheel with the Pulsemaster, I became a Periolase user.

First, thanks to Bob and Del for being pioneers in the field. The difference in tissue response, effectiveness etc is undescribable.

Much hype is out there on other wavelengths etc. Sound science should be the basis for making a decision for those sitting on the fence. Millennium is the only company that I know of who fully back their product, do the research and provide a standard protocol in order to get consistant results.

Who else out there is putting their money where their mouth is with a 6 month full money back guarantee? Dispite this, I know of NO returns! That should speak for itself.

If a practitioner cannot make money with this machine in his or her office (cause their is a lot of perio out there as well as a long list of other documented uses) he or she needs to find another profession .

The best test beyond the clinical aspect which is extremely significant, is the verbal response from the patients themselves. I am still waiting for my first negative response.

Thanks Bob and Del for making me a hero for my patients and giving me great joy in a profession I love. And thanks to the organizer of this fine forum for productive discussion of the technology available today!

Todd McCracken, D.D.S.,M.A.L.D.

The advice found here is excellent! Do your research, realize the limitations of each wavelength, pulseduration, instrument etc.

I find it misleading though as mentioned earlier, this forum location is for NdYAG lasers. Both the Biolase and Continuum are Er lasers and forum discussion for them is best suited elsewhere.

Todd McCracken, D.D.S.,M.A.L.D.

Hi Ron!

Great question! I have experience with the Diolase ST. The functional capablilities of each of these devices are different. I have tried several similar cases in the past. I did note as Bob and Rod mentioned earlier, occlusion is definately key in good perio therapy as well as splinting and removable occlusal splints

Due to the wavelength and absorption characteristics of the diode lasers, lateral damage is a significant issue. Often the very tissues that could form new bone and attachment, are burned with the intensity of Diode laser hence, the attachment desired is not achievable.

To this date, I have not seen a paper that outlines a logical protocol with repeatable results. Although this would be advantagous to the manufacturers to prove and provide this information, I do not see anyone pursuing this project.

I would be very interested to see the long term results on this case. I have a few myself that I don’t mind sharing. Several of these I later retreated with the periolase after the marginal results achieved with the Diode. I did find that wavelength and pulse duration is extremely significant in the outcome in such cases.

I also noted that while crown lengthing with the diode worked quite well, I did not have control of healing as well and if used in the anterior region, often led to an undesirable margin exposure. The NdYAG allows for much more control in the esthetic zone and I now do all crown lengthing procedures (specifically soft tissue) at the same time of preparation. With proper use, I have yet to have an undesirable result and far superior hemostatis than Diode or Er.

Again, high peak power, with much shorter pulse duration with this specific wavelength lend to greater control of tissues and hemostatis.

Best wishes in your search for more answers!

Todd McCracken, D.D.S.,M.A.L.D. 😉

Bob:

The PD(pulse duration) on my Biolase Waterlase is listed as:

140-150 microseconds.

Frequency is fixed at 20 Hz. Pulse energy up to 300 milliJoules.

Speaking of CDA(California Dental Association) in Anaheim April 24-27, I’m going and would like to personally meet the friends I’ve made on Ron’s Forum.

Who else is going to the Spring CDA Session?

Al

Hi Jeff,

“Bob, Why would’t you use a wider pulse width when coagulating an extraction site?”

That’s the neat thing about having choices in our devices, we can choose the settings that match our comfort zone.

With wider pulse widths, one has to be very careful not to over-warm the bone.  So the “shorter” at 150 usec has sufficient coag capabilities for most extraction sites.

But you are absolutely right about the the long pulse at 635 being a quick coagulator, and one I might also use in a hemophiliac or Coumadin patient.

Remember too, Jeff, you have 4 years experience under your belt, and I want Ron’s learning curve to be a gentle slope, not a “hockey stick”.

Yes, it is also known as:

1.  pulse time
2.  pulse duration
3.  pulse length
4.  pulse shape
5.  pulse profile
6.  waveform

:confused: Sometimes this stuff gets very confusing since there are so many interchangable words to say the same thing.:confused:

250 versus 650 (635) is about 3 x’s shorter in pulse time/duration.  That is the time the pulse is ON before shutting OFF and firing again.  At 20 Hz (50,000 usec in 20 pulses/sec).  Ask Del to do the math! It’s right.

250 usec ON = 49,750 usec OFF (repeats until 20 pulses have fired)

650 usec ON = 49,350 usec OFF

So the refractory tissue cooling OFF time is not changed much at all.

What has changed is EXPOSURE TIME of the tissue during the ON portion of the pulse, that can be varied by a factor of 1.5 x’s to 6.5 x’s for the Periolase MVP-7.  Or from 150 usec to 635 for the Periolase I, by a factor of 4.2 x’s.  Either way 635 or 650 will coagulate quickly without burning or charring.

and the purpose of the increased pulse width-deeper penetration?

Yeah, pretty much.  Deeper, wider, and to envelope large capillaries with the pulse shape.  But now we’re getting in too deep!  It’s a longer exposure time to the tissues like the shutter of a camera controls the “burn” of the film.  Short shutter durations are good for action shots.  Long shutter durations are good for low light conditions.  Too much light and we OVER EXPOSE the film.  We don’t want to do that with patients’ tissue, so we employ long pulse durations when they are called for.

I hope that makes sense.

Bob

Hi Allen: I will be there for the meeting working with Continuum (Hoya Con Bio and Global) make sure you come by and say hi

Bob , what an EXCELLENT synopsis. I can read between the lines. I think that certain laser companies are concerned alot about science and the ALD always has a loyal crew of followers for those lasers. It seems that the Millenium is falling into that fold.

On an aside , I am sorry I missed the ALD , but the buzz that was created by the scopes at the Pacific Dental Meeting here in Vancouver was fun to see.

Dr. Jeff Coil (head of endo at UBC) and myself did a lecture + hands on workshop and it went really well and created alot of interest. 2 years ago I had 4 people for the hands on . This year we had 34 I think.

The lecture had double the number of attendees and John Wests scope + endo course was sold out.

He had a full day lecture and he emphasized the role of the microscope and basically said you can do the things I am doing without one.

Great buzz at the booth and Vancouver being my home town and me working hard to legitimize the usage of the scope for ALL procedures it was heartwarming to see.

I missed meeting everyone but we will have a laugh or two at the CDA in April.

Cya

Thanks for the synopsis.

Glenn