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Glenn van AsSpectatorAw Mark…thanks for the kind words. I enjoy posting the pics. I know that I can do some things better but I post them to give people a visual clue as to what can be done.
I am gonna post a frenectomy case with the laser (cant remember if I did last night). Not much bleeding and what was really cool is that when I blew a gentle stream of air laterally, I could see exactly where the fibers were still joined. Its been my experience that once you get through the last fibers that the bleeding increases. I like the erbium for cutting these as the post op pain is less, but sometimes there is increased bleeding.
The reason I think postop pain is less is because of the pulsed nature of the laser and the very minimal depth of penetration compared to some of the others.
Just some thoughts…..
PS thanks mark……..I appreciate your kind words. You know what was neat was being at the ADA and having a couple of people come up and tell me that they read some of my posts (either here or dental town) and enjoyed them.
It makes those daggers I take on some of the forums a little less sore!!
Cya
Glenn
AnonymousParticipantSpent the weekend in beautiful California learning much from Bob Barr and Gloria. Course was very informative and practical. Great working with people who love dentistry and are willing to share.
Reinforced some things I was already doing (thank you other forum contributers) and added some things that I will be doing. Amazed at the things that can be done with EMLA! Also got some insight into things like perioscopy and Tech Scan for occlusion.
Using the pig mandibles and having Bob ,do and observe, was invaluable in getting the ‘feel’ for the diode.
Thanks Bob and Gloria, I’ll definitely recommend your course to others.
AnonymousParticipantHi all,
Yesterday tried to tx a herpetic lesion that patient had had for about 7 days .Patient was txing with peroxide.
Used diode 3W ,50/50 ,nonactivated tip out of contact.Started tip 4-5mm away from tissue and circled and cross hatched down to 1mm from tissue. Tx time approx 5 min. At finish tissue no longer showed vesicles and appeared to have shrunk.
Below is image from day after tx.
http://rwebstudio.com/day1.jpg
Expected more resolution, any suggestions?
Thanks
RWATSONSpectatorI don’t have any laser experience yet, but like what I’m hearing about the waterlase particularly. I have been contacted by a broker who as a used Millinium I and a used Millinimum II for sale – presumably from dentists that found they were not that useful. Are these likely to be lemons?? Does anyone have experience with these older laser models – I am told the main difference is the size of machine, not it’s capabilities… What are your thoughts?? Thanks, Bob Watson
SwpmnSpectatorLooks great, Glenn excellent treatment!
Third molars are difficult to profoundly anesthetize for restorative when we use conventional handpiece. If we can place restorations with the laser on an unanesthetized patient it is a great benefit.
Retractor idea is great as it is always difficult to retract buccal tissue when we go to place a facial Class V.
Any ideas on placing a similar restoration on the lingual of mandibular third molars? We have an elderly population in Florida and could spend the rest of our lives battling Class V caries.
Personally I have found that using a wooden tongue depressor works well in these instances. Far better than a dental mirror to retract the tongue.
Thank you for sharing,
Al
SwpmnSpectatorRon:
Interesting case. I’ve treated a few large, intraoral apthous lesions with the Biolase Erbium and there did seem to be some relief of discomfort for the patient. I do not have a diode and also have not attempted to treat a herpetic lesion.
So basically my comments aren’t any help but I found your case interesting.
Al
SwpmnSpectatorGood case, Glenn.
You did a great job and provided an excellent service to the patient.
Al
SwpmnSpectatorBob:
I have followed the development of the Waterlase for 4 years. The early unit was very large and would not fit well in my operatories. Have no input into whether the early unit works as well as the second generation unit.
The new Waterlase is compact and that is what sold me on the unit. Since I purchased my unit, there has been a major advancement in the trunk fiber delivery system. It’s much more flexible and user-friendly.
If the Waterlase is working correctly and you are using the most advanced laser tips, you should be amazed at how quickly the laser will prepare teeth for composites. However, in my practice, we do not market the laser as dental treatment without anesthetic. Some patients can tolerate the procedure without anesthestic – we’ve found it to be about one out of every two.
Be prepared to spend several thousand dollars per year for proper maintenance of the laser.
Al
Glenn van AsSpectatorGreat post Ron
couple of things…….all lasers will work on Apthous ulcers and you did the right thing with your diode. It is deeper penetrating then the erbium but I often will use the erbium as it doesnt hurt as much ( not CW).
If you use the erbium dont use water and it is a more superficial on the outside of the lesion.
Did the lesion hurt the next day or was there less pain.
I can send you some photos of what the erbium lesion looks like after it is done.
Glenn
Glenn van AsSpectatorHere is a link to some photos I just put up on sendpix.
No water and usually 3-10Hz ( not possible with biolase) and 50-80 mj, with no water, just out of contact.
Keep air blowing on tissue to keep it cool. It “numbs up after a while”
Biolase has only 20Hz
so keep it at a low setting for energy.
<a href="http://www.sendpix.com/albums/021029/214811000001620e036e17481406e4/
Cya
Glenn” target=”_blank”>http://www.sendpix.com/albums….p>Glenn
Glenn van AsSpectatorThanks Allen………Please keep in mind , my only hope is not a holier than thou mentality but just to show what lasers can do, stimulate some discussion , improve my presentation skills for lecturing, get some feedback so I know what the audience will ask when I do show the cases and to help some people perhaps in using their lasers.
thanks for the kind words.
Glenn
Glenn van AsSpectatorVery well put…….it has been my experience in talking to users of the Biolase Millenium 1 that it was in many instances more dependable than the earliest versions of version 2. Biolase has worked hard to rectify problems they may have had with the fiber early on.
The first version is HUGE……..
My suggestion is look at the version 2 but make sure that you get an awesome deal and a good warranty.
You will need it, as you can expect some things to go wrong. It may be something small or the fiber, and there is a big difference in cost and inconvenience.
Cya
Glenn
Glenn van AsSpectatorGreat question and one for which I dont have an answer. We typically do 6 handed dentistry on these as I retract with a cotton roll. How do the tongue depressors taste in non anesthetized patients.
” I hated the taste of popsicle sticks as a kid”
Grin
Glenn
AnonymousParticipantQUOTEQuote: from Glenn van As on 12:31 am on Oct. 30, 2002Did the lesion hurt the next day or was there less pain.
No pain, although the patient wasn’t really concerned with pain to begin with. 1 week I’ll have another picture.
I guess my big question is- before tx , lots of vesicles- right after tx the lesion showed no signs of vesicles(sorry ,don’t have a good picture) but yet the next day vesicles are present, was this lesion just ‘blossoming’ again or would I have been better off using EMLA and the diode in contact?
Thanks for your comments,
2thlaserSpectatorHave either of you guys tried a Svedopter? I used to use one in dental school, 20 years ago, when I didn’t have a dental assistant. I just ordered a new one, and it is invaluable to keep the tongue out of the was, as well as suction at the same time. If placed gently and correctly, even if they are not anesthetized, it is comfortable. Just a thought. Glenn, how do you post photos to sendpix?
Al, how has it been going with the Waterlase?
Mark -
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