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.

Kavo is a pioneer in Er:YAG application. I think they started 16 years ago with the first Key laser. I also think they had the fist Erbium for dental application.

On their website you find a list with 230 scientific and clinical publications. I think thats a good scientific base.

The unit itself seems not to be one of the fastest and powerfull systems. Newer systems show more performance.

Olaf

First of all: i´m no friend of the KAVO feedback system, because i find it very risky to give a machine the control of switching the laser power on and off. I´m an engineer and i know that every software has bucks.

Absolutly agree. The question is what energy comes realy out of the tip when the diplay shows 160 mJ ? . I think 30-50 mj at the tip are enough.

IMHO bacteria reduction in closed pockets is not effective with an Erbium – the penetration depth is too small. But removal of calculus works pretty good with the right settings.

Thats the reason why Fotona / Lares has developed an Erbium/Nd:YAG combination and i developed an Erbium/Diode combination unit. Erbium for Removal of calculus, diode or Nd:YAG for reduction of bacteria.

I think combined units like Erbium+Nd:YAG or Erbium+diode with standarized treatment protocols have the potential to show this. But with one single wavelength it is impossible. The units i talked about are brand new (production of the elexxion delos started just 6 weeks ago) and studies takes time and money. The future will show.

Olaf

Remember Ron…….1% of nothing is……..

You got it.

glenn

Just wanted to add that I finally got my upgrade last week.

Unfortunately, didn’t get to use it yesterday. Need to learn the newer (different) settings for the increased versatility.

And, I have come to the conclusion that our water is somewhat highly fluoridated, causing the dark char marks frequently. Not seeing them as often, but they’re still there occassionally. I just polish them off with a polishing diamond before finishing.

Sorry to have taken time over the update. The meeting in Chicago was an opportunity to get some progress on the Tucson conference, amongst other things.
I am a little troubled about the lesser regard that Bob appears to give towards science as opposed to clinical experience with lasers. I sense that laser use mirrors in many ways the development of implants in dentistry. Without digressing, a deal of early enthusiasm was eventually polarised through research into the modality of “implant dentistry” that is now generally accepted. I feel that we are progressing in much the same way and, like implants, the universities are doing much of the “catch-up”.
Consequently, I have a fundamental wish to see laser use on all the main programmes, of all the major meetings, because of science and research.
I was invited to attend the recent ALD-Isreal meeting in Tel Aviv. This was a celebratory meeting to acknowledge the melding of the laser chapter with the Hebrew University of Jerusalem and associated academic bodies. This has raised the profile of lasers in Israel from mere existance to a mainstream modality.
For bodies like the ADA to accredit laser use in a more formal way, there needs to be concerted effort to establish scientific protocols and, perhaps more importantly, regulation of laser practitioners. I do not seek to unravel the complex framework of US professional recognition, but I sense the momentum towards Federal protection of patients. Many of the questions that will be asked, by these bodies, need to be addressed by laser organisations that speak with one accord. It appears patently obvious to me that, the impotence, allied to hype and anecdote, in gaining acceptance by academia, will also prevail in our dealings with Federal agencies.
The meeting in Tucson will seek to provide a bias towards clinical aspects of laser use. Amongst others, an unpecedented (for ALD) five invited speakers have been asked to present on various topics, with the sole provisor of “clinically relevant” subjects. Details are on the Academy website. I am aware that over 60 abstracts were submitted and emphasis is being given to a respectful recognition of speakers in presenting at the conference.
With regard to RCP status, I am tempted to suggest that a complete shift of emphasis has occurred from the early days of 1999 when this level of accreditation was launched. Anyone is free to view the application process, or to apply for acknowledgement. The core structure of RCP application is in recognition of the curriculum guidelines – a document which bears testimony to a time when many of today’s diverse opinions sought concord in an objective approach to laser education. I strongly believe that the approach of the Education committee (which oversees applications for RCP) and the Testing sub-committee (which sets SP written exams) is to recognise “obsolete” wavelengths such as Argon, but not to allow disproportionate representation. Nd:YAG, CO2 and the Erbium’s form the major reflection of laser use today and this is recognised in the course content. I would respectfully urge Bob and any other interested person, to look further into the RCP programme offered by the Academy.
Opinion is the privilege of the individual and I sense that, on the one hand, bodies such as ISLD and possibly ESOLA (perhaps to a lesser extent) are ostensibly linked to academia (perhaps suffocatingly so); at the risk of censure, WCLI seeks a more “up beat”, less stifling outlet, but one which may expose the objective observer to a combination of clinical claim and ego, although such is patently very popular.
As members of a wonderful Profession, one which has opened doors for me during 30 years, do we seek the “comfort zones” of a somewhat “lazy” acquiescence with laser use, based on a crescendo of claim and counter-claim as to “which is best”, or should we seek to channel the tremendous enthusiasm that exists, albeit from diverse poles of opinion, towards the education of those that matter – namely our patients and our revered regulatory bodies.
The Academy has done much to try and exorcise the ghosts of the past. With no dis-respect to those who have gone before, our PR is not good; however, there is a concerted move towards making the organisation less rigid, less elitist, more “open”. Perhaps we fall short of a possible “circus” approach by adhering to an evidence-based philosophy. Those who are members of the AAID may identify with such ideology, but the Academy is seeking, rightly or wrongly, to position itself between enthusiasm and pragmatism (or dogma), in its’ dual association with laser dentists (of all wavelengths) and the “Establishment”.
At a time when Prince Charles (and his ghastly wife!) are upholding the ability of the Brits to bore and stupify the USA, I am guilty of similar charges in writing the above. Only time will tell if my understanding of possible future develpments will prevail. What is plainly evident is that, worldwide, laser use is subject to scepticism or dis-regard, a play-thing of idle-rich dentists. That it deserves a better epithet is obvious, but it demands of us that we approach laser use in much the same way as those of us have approached dental implants during the past twenty years.
May I urge every reader of this to come to Tucson next March and speak with me; this serves the Academy well (obviously!) but it might build a platform from which a true representation of the enthusiasm, messianic slavery, or just plain evidence-based “junkery associated with lasers in dentistry, can find a common voice with which we can go forward.
Surely the “mad” group of laser dentists worldwide should suppress past differences and present misunderstandings, to try and work together; let’s plan the future of laser dentistry, not be victims of it. Kind regards, Steven