Hi David,
I spoke to a user last night. He said that it would take him 15 mins to complete one suggingival scaling with laser alone. The chisel tip is place at an angle towards the calculus, the laser automatically fires away at a pretty low Hz. He would then feel the lack of resisitance and then he would move the tip further down. Asking about the parameters,he could not recall. Hopefully , he would let me know later. After this, he would turn of the water and use it for decontamination and soft tissue ablation of the pocket. He also said the bleeding would also be controlled. I’m not too sure and confused about this.
There are three handpiece, a window, contact tips and non-contact tips.
The selective caries remval will be in the Keylaser 4. So I was told and they basically include the Diagnodent with the laser.
Ken

Using a red laser beam as part of a feedback loop for decay or calculus presence is finicky to be sure. I use a red laser beam in a device called the DetecTar from Ultradent. It “alerts” on calculus alright–and bone and crown margins (below which calculus loves to hide), even root dentin at the right angulation.

Since there are no controlled studies showing the safety as well as efficacy of the KavoKey 3 for combined erbium/red calculus removal, I would be concerned about using it as designed.

Some of us here on the LDF spoke with a rep from Danaher–the parent company of Kavo, who was researching the dental laser market in the US. I know that I told them not to market stuff to dentists with little or no research to support the intended use. I hope they listen. It takes time to conduct proper research, and money for sure, but it is really the only responsible way to introduce new laser applications anymore.

Now I think there may be some value in using an erbium for calculus removal–but we need basic science to show what happens to the calculus and root cementum and dentin at clinically relevant light dose and other operating parameters right Glenn?!

Remember, calculus removal may not be so critical to remove ever speck. It is the plaque and bacteria layer on top of calculus that is most pathologic.

Meta analysis of the perio research (Cobb in Annuals of Perio 1996, Mechanical Instrumentation) shows that pocket resolution takes place even though 50% residual calculus is left behind after closed flap S/RP and 43% is left behind afer open flap S/RP.

So decontamination of the caclulus by S/RP and a “deep penetrating” laser like FRP Nd:YAG might push the balance of bacterial load of the bio-burden in favor of the host.

Bob

Soap Box Warning!

Sorry, I just want to add that this conversation about device parameters is why it is so critical that manufacturers allow there device to completely display actual operating parameteres and not just “Setting 1” for troughing or whatever.

With the abject lack of clinical training by most all manufacturers, knowing the laser’s actual operating parameters: pulse duration, Hz, mj/p, etc at each setting allows us to have a meaningful conversation.

Bob

Yep, and don’t dabble too long either. 350usec is fairly long in PD for tissue–about 50% of thermal tissue coefficient–so be careful.

Are you sure you don’t have a shorter PD like 100 or 150

Bob

Just curious if Dr. Parker could share some of the thought at the ALD meeting about some of the comments madehere on LDF.
Thanks,

Hi David,
Do you mean Er:YAG to remove calculus?
Yes, he meant 15 min per tooth. i asked him a few times! He said the procedure is really slow! I’ll asked him again to confirm this.
Ken