Page 72 – Laser Dentistry Forum

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March 1, 2003 at 12:54 am in reply to: newbie here, don’t even own a laser… #12394

Swpmn
Spectator

Mike:

I think with your numbers and long term establishment purchase of an Erbium would be a good move. My office is small also 1500 sf, I work two ops with one hygiene, 4th for emergencies. We are established 13 years and practice in a large metro area along with about a million other dentists.

The main reason I got the laser was I wanted to change the way I “touch” patients. You know how patients always say “If they could only come up with something that would get rid of that awful whining sound!”? I starting thinking, there is something and so I got the Erbium laser and electric handpieces at a dental meeting.

Results have been very positive. Patients love the laser and the fact that I have been able to eliminate use of slow speed round burs in almost all cases. I cant say the laser has actually “made” me a ton of money but it probably at least pays for itself. But I do get new patients because of the laser and also surprisingly, I get referrals from other dentists!!!!

Mike, one of the most important things is the Erbium laser makes it fun for me to come to work! I love to use my laser and believe that it enhances my restorative treatment.

Personally, from what I’ve read, learned and tried in my office I would not expect the Erbium laser to also double as a perio treatment laser. If you want to get into perio treatment consider purchase of an Nd: YAG(reading this Bob?) or Diode laser.

Mike, keep in mind that there are not only the initial costs of purchasing the Erbium. After your warranty expires you will need to purchase an extended service contract. Costs of laser tips is a significant factor. Also there will be taxes on the equipment as well as tax deductions.

Good luck! Talk to users, pose a lot of questions to the laser companies, ask about long term maintenance, be informed and get it in writing.

Al

P.S. Feel free to e-mail me at anytime with thoughts/questions. This is a fantastic forum with a great group of girls and guys who constantly help one another learn about laser dentistry.

(Edited by Swpmn at 8:11 pm on Feb. 28, 2003)

March 1, 2003 at 2:13 am in reply to: Role of magnification in laser dentistry #6517

joegarciaar
Spectator

Glenn:
The difference between working with or without magnificacion, is the difference between seeing and not seeing.
Thanks to share your excellent works !
How what do you verify that the decay cavity this free one?
Thanks

March 1, 2003 at 2:14 am in reply to: Trunk Fiber #9251

Swpmn
Spectator

Pat:

My comments on the Erbium laser have two purposes:

1) Main purpose is to inform current Erbium owners and prospective purchasers of long term maintenance issues and costs. I want dentists to ask the laser companies about service contracts beyond the warranty at the time they are considering the purchase.

2) Secondary purpose is to encourage dental laser companies to discuss upfront at the time of sale long term maintenance issues and service contracts with the prospective dental buyer. Folks in the dental laser company community do read this forum and I can tell you I have personally encouraged them to join our forum.

These issues are in the best interest of the dentist and also the dental laser companies. Dental laser companies should seek a long term relationship with the dentist, reduce the short term interest in sales and focus more on a forthright disclosure of long term maintenance issues on a technologically advanced product.

Al

March 1, 2003 at 3:04 am in reply to: Guided Tissue Regeneration #10277

Robert Gregg
Participant

Thanks Pat,

QUOTE

I will reflect on this option as I travel to South America beginning next week.

Ok………now just to tease you a bit more, reflect on this too while you’re gone down South. And if this doesn’t make you say “Uncle”, then I’ll have to post some more!;)

Have a great trip, and enjoy the warm weather!

Pre-Op x-ray of a vertically mobile bridge, that was treated with open flap, osseous surgery twice before presenting for treatment with LPT.

14 month post-op, after only ONE treatment with LPT/LANAP.

Gamma correction of the before and 14 month post-operative x-ray using Emago® software. White areas indicate increased bone density. Bone density increases extend circumferentially and 3-dimentionally into the alveolus.

Talk with you when you get back.

Bob

March 1, 2003 at 3:24 am in reply to: A temporary solution? #10057

Robert Gregg
Participant

PAt,

That may just be the type of situation that responds favorably to laser energy provided you were able to keep in it clean during bonding.

That is worth following!

Bob

March 1, 2003 at 3:28 am in reply to: newbie here, don’t even own a laser… #12393

Robert Gregg
Participant

Allen,

QUOTE

If you want to get into perio treatment consider purchase of an Nd: YAG(reading this Bob?) or Diode laser.

Yes, uh, Huh I’m reading……..thanks!

Hey, did you answer my question about coming to ALD? I didn’t see it.

Bob

(Edited by Robert Gregg at 10:29 pm on Feb. 28, 2003)

March 1, 2003 at 3:32 am in reply to: Hydrokinetics Article #7304

Robert Gregg
Participant

Allen,

QUOTE

Is it possible that my observations could be explained by the presumption that a vital tooth in the mouth would have a higher water content than extracted teeth sitting in a jar of water?

I think you hit the nail on the proverbial head!!

Bob

March 1, 2003 at 3:34 am in reply to: Role of magnification in laser dentistry #6520

Robert Gregg
Participant

Glenn–

Beautious!!

Poetry in photos!

Bob

March 1, 2003 at 6:20 am in reply to: Hydrokinetics Article #7297

Glenn van As
Spectator

Hi Allen , what I see clinically with the scope at high mag, is that the tooth starts to char because if you dont have water to rehydrate the tooth the water gets eliminated after a few pulses and then it stops cutting.

If you keep stopping, put a little water on the tooth and then cut dry it will cut at the rate you are used too.

Glenn

March 1, 2003 at 6:22 am in reply to: Trunk Fiber #9239

Glenn van As
Spectator

Allen I couldnt agree with you more. I do know that I havent had to do much to my laser, change filter packs (yearly maintenance) change tips as the degrade, change one foot pedal, and recently change the arm on my laser that supports the fiber.

ALl minor stuff, no major headaches.

I do know that with time I will need to change the fiber but its still good after 3 years.

Not bad huh.

Glenn

March 1, 2003 at 7:53 am in reply to: General Erbium Discussion #2835

Glenn van As
Spectator

Hi folks: Here is a simple thing to think about. I am finding that it is very rare that I look at a tooth under the scope where I feel that the standard fissure sealant is indicated.

I am writing an article for the ORal health magazine which will be out in the spring on microdentistry and the two most important things for me have been in the introduction of high magnfications to see subtle changes in color of enamel and fissure decalcifications present at magnfications of 10X and above. The second useful tool is the diagnodent which allows me to decide if the decay I spot at high magnfication is progressing into dentin.

I find many times that if I look at high mag that part of the groove is decalcifying and then I dont feel comfortable just covering over it with a sealant. I have been using the laser ( a 400 micron tip) to gently etch the enamel surface at 30 hz adn 100 mj or so (3watts) and then filling with a flowable resin.

This is my glorified resin. Now many years ago I would just fill the small spot that was decaying (in this case the distal pit was 25 on the diagnodent and the buccal was 27), and then leave the rest or FS them. Guess what, when I remove the FS now in alot of cases they arent sealing anything……just the decay is in there and when it gets big enough the FS falls out and you have a stained groove.

At least with the flowables they show you when they are leaking on the external surface.

I dont know if this is right or wrong but just doing fissure sealants on erupted teeth is not something I do routinely now.

How are you handling the following:

1. Fissure sealants
2. Preventative Resin restorations where there is a little bit of decay in one pit.
3. Decay around Fissure sealants.

Here is my case……..hoping to stimulate some discussion.

Glenn

March 1, 2003 at 8:06 am in reply to: Microdental prep #6477

Glenn van As
Spectator

Here is another case where the distal pit was in the 20s with the diagnodent and so I removed the mesial pit FS not knowing if there would be anything under it and in this case there wasnt but in many cases there is.

Other cases similar to this can be found at the following links……..

http://www.rwebstudio.com/cgi-bin/ikonboard/topic.cgi?forum=25&topic=27

http://www.rwebstudio.com/cgi-bin/ikonboard/topic.cgi?forum=25&topic=31<img src="https://www.laserdentistryforum.com/attachments/upload/Resize of Class one microdental prep case 2.jpg

” border=”0″>

March 1, 2003 at 8:14 am in reply to: Microdental prep #6480

Glenn van As
Spectator

Here are the pics from the other case I wanted to show.

Glenn

March 1, 2003 at 8:17 am in reply to: Microdental prep #6478

Glenn van As
Spectator

Here is a tooth that I am going to prepare soon , which shows the same tooth at the 6 steps of magnification under the scope and how the decay becomes more noticeable with high mag.

The patient has decay on the lingual grooves (both of them) and in addition on the diagnodent it was 27 . THe magnification helps me find the spots and then the diagnodent confirms what visually I notice.

(trying to build my case here!!)

Glenn

March 1, 2003 at 8:23 am in reply to: Microdental prep #6481

Glenn van As
Spectator

Am I making anyone else uneasy besides myself from all those darn fissure sealants they told me in dental school to plug in if there was stain and no cavitation?

Another one for the books.

Glenn
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