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BNelsonSpectatorHey Glenn
Sorry I missed you.
Best suggestion is to buy a new laser, or send patient to Bob or me to treat(Ha!)
AnonymousSpectatorQUOTEQuote: from Glenn van As on 2:00 am on July 14, 2005In addition I have a patient with a lingual tongue parasthesia from a month ago. No NdYAG available here.
ANy ideas on what I might do for him with a diode or other wavelengths.
Glenn
Glenn, Tuner and Hode have several studies in their book regarding diode and parasthesia. Most used between 6-9 J per spot (length of nerve usually treated in 4 spots). The other parameter used was 6 J/cm. Most biostim studies I’ve read say 4J/cm is ideal.
Almost all the studies were tx pretty close to the time of injury followed by consecutive days, for 7 days. I think Del and some others prefer at least 24 hours between tx. My tx were actually 1 week apart.Hope that helps,
mkatzSpectatorWith respect to the reference of studied treatment being relatively clos to the time of injury, is there evidence ot efficacy for treatment rendered long after injury? Small studies of treatment rendered a short time after injury can appropriately be criticized as not adequately compensating for the recovery that might have occured without treatment. I’m interested in the cases in which a persistant disesthesia/parasthesis/anesthesia is treated with laser irradiation…
By the way, my local neurologist has described laser induced nerve function recovery as being “a lot of hooey”….In spite of his assessment, I’ve got a couple of cases that I am looking forward to treating after I receive my periolase.
By the way, Bob, how long after the course should I receive the laser? I’d like to start scheduling cases.
Robert Gregg DDSSpectatorHey Mark,
With respect to the reference of studied treatment being relatively close to the time of injury, is there evidence ot efficacy for treatment rendered long after injury?
Good point. The answer is a resounding Yes. We have reports of 16 and 20 years post extraction site nerve damage successfully reversed.
Small studies of treatment rendered a short time after injury can appropriately be criticized as not adequately compensating for the recovery that might have occured without treatment.
Yep, well stated. Much appreciated…….
I’m interested in the cases in which a persistant disesthesia/parasthesis/anesthesia is treated with laser irradiation…
I will get you the doctors’ names and the incidents when you come to training. Del has kept better track of those reports than I have.
By the way, my local neurologist has described laser induced nerve function recovery as being “a lot of hooey”….
As would be expected. Does he have anything other than uneducated ignorance and non experience to support his OPINION?
In spite of his assessment, I’ve got a couple of cases that I am looking forward to treating after I receive my periolase.
Have your neurologist do a pre-treatment assessment. I bet he doesn’t have the guts…….
My MD Dad was not too impressed with nerve or pain reduction by laser either. Nor was his neurologist “pain” doctor. Then my Dad suffered from Spinal Stenosis. Repeated epidural injections did little.
One treatment with the FRP Nd:YAG and Dad now has relief–the only durable relief he has obtained. Now Dad has a old FRP Nd:YAG at home for his nurse to use when he is hurting. But his nurse reports improved walking, sitting, movement and posture……Dad report significant pain reduction. Who’s your Daddy’s pain therapist!?
Lack of scientific evidence is not the same as hooey. It’s called anecdotal. Anecdotes are not hooey. They lack controls and other parameters of scientific scrutiny for generalizations. But many accepted therapeutic treatments fisrt began as anecdotal reports.
By the way, Bob, how long after the course should I receive the laser? I’d like to start scheduling cases.
Are you driving to BootCamp? It might be ready Saturday for you to drive it home. But we need to check with Del. Last months course was delayed a day due to one platic part not arrived.
See you soon!
Bob
(Edited by Robert Gregg DDS at 2:37 pm on July 17, 2005)
Herb Yolin DDSSpectatorA number of weeks ago I began a conversation about low level lasers that I somehow accidentally placed in the thread of the ND:Yag. I eventually stopped because of deadlines I had for future speaking engagements. There certainly was a mixed response, but I felt it would only be found by a few people in that thread. My deadlines are over and I will be able to devote a bit more time to this discussion. There was a request for double blinded studies and I will post a list of some that should be significant. There even was an expression that this discussion did not belong in this post. I will never stop bringing to other people what I now know that is making the biggest difference I could ever hope to make in helping humanity through dentistry. You all can pick and choose what is worthwhile for yourselves both from a scientific viewpoint and what can work clinically. I am very new to this forum having joined it very recently. My thinking is that this should be placed under “misc. lasers not talked about” or better yet a new thread called Low Level Lasers. Before I go on, I would like feedback on where to place my post. I said before and will say again that if I only could keep one piece of dental equipment beside the usual drill and fill, it would be my low level laser. Please see my info and see that I am also involved with dental consulting and lecture for and represent a company that sell low level lasers. I do realize profit from sales. I do not want to mislead anyone about that. That is not my purpose here or when I speak about LLL before groups. For starters, I am referring always to low level laser diodes. LEDs are called LLL also, but are far less effective and are not anything I will talk about. There are many differences in LLLs and I do not want to discuss that here in this forum. It would be construed as selling and promoting. I can talk about LLLs many uses in the dental practice. They do not replace the cutting laser (I have one), but can enhance that treatment also. My biggest mission is teaching the concept of Dental Distress Syndrome (DDS) and how it relates to the overall health and well being of almost every immune suppressed person. The LLL is what makes the treatment work so effectively and so quickly. Since I learned about this concept 41.5 months ago, every chronically sick person I have examined in my dental office has DDS. I see a lot of sick patients because I have an amalgam free office since 1993. As someone trained in Prosthetics, I have spent many years (41) grinding on old amalgam and have always felt, that cannot be a healthy thing to do. I made a conscious decision not to be exposed to it anymore then I had to, so I decided to reduce my exposure to mercury vapors by not placing it. My decision was made for myself on a personal level to be away from mercury. Back to the point at hand; they come to me for amalgam removal thinking they will get better if the amalgams are removed. Absolutely every chronic fatigue, arthritic, migraine, TMJ/TMD, chronic neck, compressed vertebrae, I.B.S., and everything else you can think of examines positively for DDS. I do not do even consider amalgam removal until the DDS has been non-invasively temporarily corrected and the symptoms have gone away or greatly reduced. Some stop their treatment at that point and get by with less then the ideal. But they are better, they can return to work etc. Many do want more definitive dentistry and that does occur. It is the laser that facilitates what I do and makes everything happen immediately for most. I cannot ever imagine practicing without one for all of its’ many uses.
. Using LLL in your practice will not diminish one iota the need for hot lasers. You will use your cutting laser more because you will be busier. You will be a more complete healer because you will help patients solve problems beyond the drill, fill and bill concept.
Dental Distress Syndrome (DDS) is also called negative proprioceptive feedback to the brain. It has to do with what the cerebral cortex interprets from how the mandible is in relationship to the skull. That interpretation believe it or not affects the entire body’s functions. This is not a tooth to tooth, but jaw to skull relationship. It sounds complicated and may scare people who want to just keep it simple. I refer you all to ‘The Dental Physician’ by A.E. Fonder. It is out of print, last published in 1982 but available. The laser makes it simple, makes the dentist a hero, allows wellness to take over and creates people who are genuinely happy to see you. It takes a very short time and the internal marketing happens naturally. When a patient has had a long appointment, 30 seconds on the TMJ area makes all the difference. The laser I am using has a face on it the width of tennis ball and contains 12 laser diodes. Again, I want to avoid any accusation of commercialism, but like cutting lasers there are differences and different responses.
I see how time consuming writing posts can be, so please offer comments if and what you might want to read/talk about on this post and again where I should put this. Below is a list of some studies.
List of significant research in LLLs for dentistry.
1.The Efficacy of Laser Therapy in Wound Repair:
A Meta-Analysis of the ‘Literature
Woodruff, L.D., Bounkea, J,M., Brannon, W.,M., Dawes, K.S., Barham, CD., Waddell, D.L.,
Enwemeka, C.S.
Photomedicine and laser surgery 2004 ,
22(3):241-2472. Effectiveness of the GaAIAs (830nm) Diode
Laser for Pain Attenuation in Selected Pain
Groups
Shigeo Toya, Mitsuo Motegi, Kenichiro Inomata, Toshio Ohsiro and Takashi Maeda
Laser Therapy
Volume 6: 1996
Pp. 143-1483. The Effects of GaAIAs Diode Laser on
Extraction Wound Healing
Ali Obeidi and Mohammad Moshref
American Society for Laser Medicine and Surgery Abstracts
Abstract 484. Can Low Reactive-Level Laser ‘Therapy be Used
in the Treatment of Neurogenic Facial Pain? A
Double-Blind, Placebo Controlled Investigation
of Patients with Trigeminal Neuralgia
Arne Eckerdal and J Lehmann Bastian
Laser Therapy
Volume 8: 1996
Pp: 247-2525. Low Level Laser Therapy for Dentinal Tooth
Hypersensitivity
JA Gershman, J, Ruben, J, Gebart-Eaglemont
Australian Dental Journal
1994; 39(6) 353-76. Effect of the Clinical Application of the GaAlAs
Laser in the Treatment of Dentine Hypersensitivity.
Marsillo, A.L, Rodrigues,J.R., Borges, A.B.
Journal of Clincial Laser Medicine and Surgery 2003
.21(5): 291-2967. PLASMA ACTH AND J3-ENDORPHIN LEVELS IN
RESPONSE TO LOW LEVEL LASER THERAPY (LLLT)
FOR MYO-FASCIAL TRIGGER POINTS
E. Liisa Laakso, Tess Cramond, Carolyn Richardson and John Galligan
Laser Therapy
Volume 7: July 1994
Pp: 133-1408. Effect of Low-Power Laser Irradiation on Cell
Growth and Procollagen Synthesis of Cultured
Fibroblasts
Aymann Nassif Pereira, Carlos de Paula Eduardo, Edmir Matson and Marcia Martins Marques
Lasers in Surgery and Medicine
Volume 31: 2002
Pp: 263-267
Glenn van AsSpectatorWas it the plastic part that didnt arrive or the Krispy Kremes in a plastic part?
PS do Krispy Kremes have any role in parasthesia reversals because I know we have those in Canada…….now as for the Periolase………
You know the story.
Glenn
BenchwmerSpectatorPerioLase MVP-7 has multiple pulse widths, but also an increased choice of pulse rates.
A pre-set for Biopsy is 3.6W 100Hz 100usec.
The following 50+ year old male, presents with the following raised lesion on the side of his tongue.Diagnosis is an irritation fibroma.
Treatment will consist of an excisional biopsy using the PerioLase Free pulsed Nd:YAG laser at it’s “Diode” setting of 3.6W 100Hz 100usec.
A couple drops of 4% Citanest Forte was infiltrated into the area.
The lesion was removed as tension was applied to the tissue pulling the fibroma with tissue forceps.Immediately post-lase.
No bleeding, no charring, no sutures.
This “Diode” setting. Makes for a quicker cleaner excision than the 50Hz setting I have traditionally used.Jeff
BenchwmerSpectatorEmergency patient from out of state.
Fell walking his dog. Crowned tooth #9 out. Tooth is vital.Cleaned tooth fragment out of existing crown. Will utilize root canal, post and core build-up retro-fit to existing crown, then re-cementing crown in place.
PerioLase MVP-7, free running, pulsed Nd:YAG will be use for troughing the crown margins and for hemostatis.Before treatmet
RCT therapy was performed. Gingival troughing was accomplished using the PerioLase pre-set of 3.6W 20Hz 250usec. This is a new pulse width setting for me. It is quick, it provides hemostatis with no charring or tissue recession. I now use this setting for all my crown and bridge for tissue retraction and hemostatis with no worry about tissue recession. Six years now, without using packing cord.
A Flexi-post Flange #1 was fitted so the crown could be reseated.Internal surfaces of the crown were cleaned with air abrasion, then coated with Vaseline.
A self-etching DBA was used (Adper-Bond) on the tooth and in the root canal, a self-curing resin cement (3M Rely-X) was used for post cementation,a self-curing core paste was used (Lee Core paste) for the build-up.
The crown was seated, then removed after initial set.
Flashing of core paste was removed with a diamond. Ready for re-cementation.The crown was cleaned and cemented with 3M Uni-cem.
This patient has a boat-load of other dental problems and what should be immediate concerns. This one-visit procedure gave him back his smile, gave him a functioning crowned tooth and building blocks for future restoration of #8 and 9 with crown lengthening, other Perio, new crowns etc. for his dentist back home.Jeff
(Edited by Benchwmer at 5:07 pm on July 19, 2005)
jetsfanSpectatorparasthesia reversal going well. Patient is thrilled and said if there were no more improvement it would still be a great result.
Can anyone explain how this actually works?
Anyone try this for Bell’s Palsey?Robert
dkimmelSpectatorThis week has been an interesting week fo me. I have been learning and playing with my new laser , the Periolase 7. It has lead me to reflect on the last several years of doing laser dentistry. As most of you know I converted my practice over to laser dentistry and am now the Florida Center for Laser Dentistry. Doing this forced me to get not only good with my lasers but productive as well. It is nice to play and have fun but you have to pay the bills. With close to over 赏,000 dollars in lasers you got make some $ to have a ROI.
I have been luck andand have done both. It has not been easy but it has been a great adventure. From the new friends to the ablity to help patients seek dental care that they never would have without the laser.Enough of that. Working with the Periolase has really made it clear to me that dentistry can be done with one type of laser but not well and not efficently. I have worked hard to get my Erbium to do things that some said could not be done and the same with the diode. That is from restorative to perio. I am finding that with the Er, the diode and the Nd:YAG that it is a great mix. Things that I had to struggle with one laser can easly been done with another. ( Yea, a CO2 would be nice but my wife would leave me.) Now don’t get me wrong it really is nuts to buy all the lasers I have. I am a slow learner. The other thought I have had is that even though the process of using the laser is the same for each type of laser– so many things are different. It is like starting over again to get the feel of the Nd:YAG.
I also need bigger ops!!! Man my rooms have gotten smaller. I need to go on a diet.
I think Bob and Del are so right about varable pulse duration. However, the use of the right pulse durations .
Lasers are going to have to get smaller, more user friendly, less expensive and laser companies are going to have to have training before delivery , if Lasers are going to stay strong in dentistry.Ok night. I’ll edit tomorrow
Robert Gregg DDSSpectatorJeff,
Very nice case.
250 usec for “wet” homostasis is a nice option when 650 is a bit too much in the anteriors huh?
Thanks for posting!
Bob
Robert Gregg DDSSpectatorRobert,
Yes, it works just fine for Bell’s Palsey. Of course, the earlier it is treated the easier it is to reverse.
The mechanism is pure speculation:
1. Anti-inflamatory
2. Cell membrane absorption increasing the ion transport capability
3. Mitochondrial absorption = ATP systhesis and increased cell function/respiration.
4. A primitive “TriCorder” device???Bob
Robert Gregg DDSSpectatorHey David,
Did Susan go to bed early and leave you with access to your computer?
If it’s “nuts” to have the number of lasers you have, what would you call it with the number Del and I have?
a. Insane
b. Bizzare
c. Bordering on fetish
d. Museum
e. Two guys without a life
f. Tax deductions
g. All of the aboveEnjoy!
Bob
dkimmelSpectatorAfter learning to know you both the answer is G.
However, C is probably the big one with A close behind
BNelsonSpectatorThe lady I treated with dysesthesia had no feeling for 11 yrs post injury and now has almost complete rehab. I biostim family and friends with plantar fasciititis with consistently good results and one friend had a rotator cuff injury- 6-8 months of meds and pt and couldn’t lift his arm past horizontal. 6 months after biostim, still has full range of motion and on no meds. All anecdotal, but it sure consistently works.
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