If any of you are familiar with the name Gus Livaditis – it will bring you back over 20 years ago to the first lecture on the Maryland Bridge. Whatever the success rate you have had personally with the maryland bridge… It is clear that Gus is an innovator.

This time Gus has come up with a very predictable technique called “Vital Pulp therapy”. He has designed a special tip for a bipolar electrosurge unit (his unit with the tips is called the Dentstat – I paid about &#362600 for the unit and 3 tips) Using this Denstat on a vital pulp exposure – no matter how large the exposure- I have been able to get predictable results in 90%+ of the cases with a 1 year post-op so far. Dr Gus Livatidis has been doing the procedure and has documented results for over 5 years. I am really excited about the results. There are two keys parts to this procedure
1. Durable Hemostasis – that’s why you need the bipolar electrosurge. The depth of penetration for the energy is very limited. The advantage of that over the laser energy is that the pulp tissue is not damaged. I have tried this technique with a diode laser and the waterlase… both modalities have too much energy to keep the nerve vital and healthy. With this technique the patient is comfortable right away and stays comfortable. I have used this for molars, and anteriors with excellent results.
2. The right pulp capping material – Dr. Livaditis has been using the meta-4 cement “MetaBond” – Personally I have found that material to be cumbersome to work with and I have been using J Morita’s version “M-Bond” which doesn’t need refrigeration and is very easy to work with.

If you would like to discuss this please call me at 718-339-7982 Jacques Doueck  Brooklyn NY

You can go on the website for Gus Livaditis
 http://www.md-seminars.com/semtop_vitalpulp.php

For complete documentation – go to the Journal of Prosthetic Dentistry and search for articles by Dr. Gus Livatidis.

So, with Delight, you don’t get the black spot?
How much did that little black spot on the mirror in your waterlase hanpiece cost to replace and were you able to do so chairside?
If a Waterlase user, wouldn’t the smart thing be to remove all amalgam with a handpiece first before doing anything to the prep with your laser handpiece?
Greg

Greg, the laser would cleanse also. There are studies that show the laser sterilizes, removes the smear laser,  and etches. There are also studies that indicate increased acid resistance as well.

: J Clin Laser Med Surg 2001 Jun;19(3):159-63 Related Articles, Links  

 
A study on acquired acid resistance of enamel and dentin irradiated by Er,Cr:YSGG laser.

Hossain M, Kimura Y, Nakamura Y, Yamada Y, Kinoshita JI, Matsumoto K.

Department of Endodontics, Showa University School of Dentistry, Tokyo, Japan.

OBJECTIVE: This investigation was performed to evaluate the acid resistance of lased enamel and dentin by Er,Cr:YSGG laser to artificial caries-like lesions by spectrophotometry, and the ultrastructure of lased areas was investigated by scanning electron microscopy (SEM) in vitro. BACKGROUND DATA: In recent years, many studies have been performed to evaluate the effects of Er,Cr:YSGG laser on dental hard tissues. However, there have been only a few studies to determine if this laser is suitable for caries preventive treatments. METHODS: An Er,Cr:YSGG laser was used to irradiate the enamel or dentin samples from 30 extracted human molars at 6 W (67.9 J/cm2) or 5 W (56.6 J/cm2) pulse energy, respectively, with or without water mist. Samples were subjected to 2 microl of 0.1 M lactic acid solution (pH 4.8) for 24 h at 36 degrees C. The parts per million (ppm) of calcium ion (Ca2+) dissolved in each solution was determined by atomic absorption spectrophotometery, and the morphological changes were investigated by SEM. RESULTS: The lowest mean Ca2+ ppm was recorded in the lased samples. SEM observation showed that the lased areas were melted and seemed to be thermally degenerated. After acid demineralization, the thermally degenerated enamel or dentin surfaces were almost unchanged. CONCLUSIONS: The results of this study suggested that Er,Cr:YSGG laser irradiation with and without water mist appears to be effective for increasing acid resistance.

PMID: 11469308 [PubMed – indexed for MEDLINE]

David,
In addition, I would be more than happy if you wanted to come to Whitefish, and learn some from me chairside. I love to teach, and so far, I have seen some great strides in those who I have worked with. Mostly folks from the Pacific Northwest, who take advantage of my location, but the skiing, golf, fishing, Glacier National Park, all just minutes from my office, (as well as a real cool laser in my operatory!). I am always avail by phone too, call, or email me anytime you feel the need to have some questions answered. Bill Chen is a great teacher too, we do differ on the way we deliver our “anesthesia” effect though. Most of the Waterlase users on this board have tried the way I have done it, and seem to be having very good success. I use Bill’s methods sometimes too, but rarely, because I seem to be having success with my own methods. Anyhow, we are here to help, just ask. There are a number of WCLI regional meetings scheduled, just go to http://www.learnlasers.com and you can find them. Also, in late July, there will be another large, East Coast WCLI meeting in NY City at the Waldorf Astoria. I think this will be the biggest meeting yet. I encourage you to attend, you will find so much information there, it’ll be mind boggling. Glenn, You ought to come, I’ll sneak you in, Keith will never know!
Mark

Hi Greg: there are alot of similarities between the two machines, but there are some differences. Many people have mentioned the care they take with their Biolase unit to be careful and avoid blowing the trunk fiber.

I dont worry that much with Continuum and I have been using the same fiber for over 3 years and I am not really very kind sometimes.

I havent had to worry like others about my unit getting damaged but I hate having to replace the black tips as they are 50 bucks US or so.

Glenn

Greg there are several cases where I have done this and posted them here……….

This is one I could find.

http://www.rwebstudio.com/cgi-bin/ikonboard/topic.cgi?forum=29&topic=32

and one more

http://www.rwebstudio.com/cgi-bin/ikonboard/topic.cgi?forum=29&topic=31

glenn

Thanks Nuno………cool stuff and well done.

Glenn