Andy, very funny!!

Actually, it’s the variable pulsed Nd:YAG laser on display.

It’s one thing to get some decent perio resolution in 4-6mm, non-hemorrhagic clinical situations, but as we all know, our patients come to us “as is”. And we are often surprised by the extent to which a pocket extends and/or someone ends up bleeding–or refuses to clot!

I didn’t think this patient would THIS much of a bleeder!

We struggled clinically with patients like this who would bleed 24-48 hours post-op, for 8 years and many laser devices (including CW diodes, blue/green surgical argon, pulsed Holmium, and lower powered/single, short pulsed Nd:YAGs).

It wasn’t until 1996 when we worked with a prototype medical pulsed Nd:YAG laser that we could select ANY pulse duration from 1 to 1000 usec, that we found the right combination of parameters to “poach” blood proteins.

Those optimal parameters have been configured into the PerioLase MVP-7 that Del and I developed (unabashed product promotion) for the reasons you see here on this post……so we can get the RESULTS we need clinically for us and our perio patients, regardless of case type or medical condition (e.g. coumadin, hemopheliac, etc).

We make this laser configuration–along with the training–available through Millennium Dental Technologies (shamless product and company plug) & the Institute for Advanced Laser Dentistry (an ADA-CERP/AGD-PACE recognized provider) (NOW I’m bragging!) so that other clinicans can enjoy the clinical results we have been so excited about for the last 6 years!

Thanks for indulging my company and product promotion here, but I am very gratified and pleased that I can now help other clinicans get this kind of “mastery” over tissue that we didn’t have for so long.

Bob

Thanks Glenn,

You feeling ocasionally “inadequate” is like Giguere feeling inadequate as a goalie for the “slop” goals Devils got last night! :biggrin:

None of us can be or know all, as me and the rest here simply nod and bow to your clinical, microscopic and photographic skills.

That’s why this forum is so great–we can learn from each other.

As far as wanting to know what’s going on–well–we do.

1. We know from “ancient” histology studies that a “closed system” above a perapical endo lesion will generate new PDL, cementum, and bone.

2. We know from recently finished histology at LSU and Ray Yukna that when we create this same “closed system” as shown here, we also get new PDL, cementum, and bone.

IADR this June:

1735 Laser-assisted Periodontal Regeneration in Humans

R.A. YUKNA, G.H. EVANS, S. VASTARDIS, and R.F. CARR, Louisiana State University, New Orlreans, USA

Objective: The Laser Assisted New Attachment Procedure (LANAP) has been advocated for the sulcular debridement of periodontal pockets with the goal of obtaining new attachment. Clinical case reports have reported favorable clinical results, but there is no human histologic proof of regeneration.

Methods: 3 patients with 2 single-rooted teeth with moderate-advanced chronic periodontitis associated with subgingival calculus deposits were enrolled. Occlusal adjustment and direct bond extracoronal splinting was performed. Under local anesthesia, a 1/4 round bur notch was placed at the apical extent of calculus as carefully as possible. One of each pair of teeth received Nd:YAG laser treatment of the inner pocket wall to remove the pocket epithelium (laser settings were 3 watts, 150 pulses/second, 10 hz). Both teeth were then aggressively scaled/root planed with an ultrasonic scaler. The pocket of the test tooth was lased again to coagulate any blood present and to form a pocket seal. Triple antibiotic ointment and a light cured dressing was placed. Control teeth received all of the above except the laser treatment. The patients were seen every 10 days for the first month, then at 2 and 3 months, at which time the treated teeth were removed en bloc for histologic processing. Decalcified step serial sections were stained with H & E.

Results: 2 of the 3 LANAP treated specimens showed new cementum, new bone, and new periodontal ligament in and coronal to the notch. The control teeth had a long junctional epithelium with no evidence of regeneration. There was no evidence of any adverse pulpal or tooth surface changes in either specimen.

Conclusions: This report supports the proof of principle that LANAP can be associated with periodontal regeneration on a diseased root surface in humans.

Supported by Millennium Dental Technologies and the Louisiana Periodontics Support Fund.

Seq #178 – Therapeutic Intervention – Adjunctive Treatment
11:00 AM-12:15 PM, Friday, 27 June 2003 Svenska Massan Exhibition Hall B
Back to the Periodontal Research – Therapy Program
Back to the 81st General Session of the International Association for Dental Research (June 25-28, 2003)

<a href="http://iadr.confex.com/iadr/2003Goteborg/techprogram/abstract_34208.htm

Have” target=”_blank”>http://iadr.confex.com/iadr….

Have a great day!

Thanks as always for all you contribute!

Bob

Great stuff as usual buddy….. Love to watch u use that scope!!

Mark I think you are exactly right and I do the same thing – lase right into the crack then use my bonding agent and flowable comp prior to my restorative composite.

Al

Nice, Jeff………..and NOW you can pick the color of your laser too……to match your operatory or color scheme.

Bob

Jeff:

Nice case!!!! Nd:YAG troughing looks great with no charring. Was your “goom” sore the next day?

Did Dr. Leigh use the Opus Er:YAG to remove that old composite?

Speaking of sitting on the other side of the chair, guess who this is?

Al 😉