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jchanSpectatorTom Schoen had a good one…
jchanSpectatorBob,
I’m in…just waiting for the dollar to get closer to par! I don’t mind it being a smaller and intimate class size…I’ll be happy to treat as many patients as possible.
Mary HartiganSpectatorWas the tissue ever biopsied?
If it is a particular vesicular bullous disease and not diagnosed, over time it could affect other organs including her eyes and eventually cause blindness and other damage.
Has she been tested for HIV? Diabetes? Allergies? RA?
zendentistSpectator@Benchwmer 43355 wrote:
After two years, the tooth is still in the mouth. It has never healed completely (maybe due to the tramatic occlusion) It has been re-evaluated at 3 month recalls, a sinus tract has sometimes reappeared, however much smaller and localized than the start. I have repeated the laser therapy and used antibiotic therapy, it clears up. I’ll see where we are at next month.
JeffIn my opinion and experience, failure to completely heal indicates a failure to completely remove the source of the infection that the patient’s immunes system has to deal with. Untreated lateral/accessory canals, failure to maintain a watertight seal of the endodontica access are all common reasons for failure of root canal therapy.
This treatment seems to be an acceptable alternative to NSER or apical surgery as long as the patient understands that duration of quiescent perieods may be indeterminate. I’d also suggest regular radiographs to monitor the condition of the tooth as well; after all, this approach leaves a potential source of circulating infalmmatory mediators such as C-reactive proteins in thier bodies. Patients with challenged immune systems may have more difficulty keeping these infections contained over time
Don’t get me wrong, I think this is a very nice alternative treatment, but it does not remove the source of the infection, only temporarily lowers the infectious load. Even apical surgery may not remove the infected area of the canal (which has to be assumed to be the entire canal complex), but it does allow closer access and visualization of the root in order that a laser may be used as an enhanced dinsinfection agent.
Arguments can be made as to whether there is truly any treatment to heal a failing endo considering the statistics of NSER, apical surgery/retrofil, or closed laser irradiation of the fistulous tract. Broadly speaking, the more invasive/time consuming procedures offer statistically longer periods of apparent health, while closed laser irradiation is relatively quick, painless, and does show positive results of varying duration. And as such, offering to the patient as an option, I see no reason why you would not charge for the procedure as long as the patient has a realistic understanding of the options. You’re still doing the endodontist a favor; believe me, they don’t want to have to retreat their own cases if there is a viable alternative.
Just my $.02 on a Sunday morning
zendentistSpectatorWhatever laser you use to treat the lesion, consider prescribing Valtrex 2g(500mgX4 with three refills) as well as Denavir ointment, one tube plus three refills. Tell the patient as soon as they feel the prodrome, take four Valtrex and begin applying Denavir to the outbreak area (if extraoral) and get to your office ASAP for laser treatment. Instruct them to continue the Denavir qid after laser treatment for at least 3 days. If the outbreak is intraoral, the Denavir use is moot.
Patients can’t always get into the office during the prime treatment time (prodrome/vesicular stage). Having Valtrex and Denavir on hand gives them gead start on knocking the virus load down ASAP until they can get in to see you. I have also started recommending to some patient that they pony up $239 and purchase a 50mw 532nm green laser (AND SAFETY GLASSES) from laserglow.com; these are very effective at reducing the pain and patients get a kick out treating themselves; however I think having the Valtrex and Denavir is more important.
jchanSpectatorBob, I think you might want to announce that the dates have changed as I was all revved up to go on your original dates set…
etienneSpectatorHi Guys
I am looking for info regarding gingival de-pigmentation using laser. I know that one can use diodes, Nd:YAG or Er:YAG for this procedure.
Any thoughts out there?
Take care
Etienne
Robert Gregg DDSSpectatorSorry guys, still digging through the photo archives to select the material for E-6.
Bob
Robert Gregg DDSSpectator@jchan 55982 wrote:
Bob, I think you might want to announce that the dates have changed as I was all revved up to go on your original dates set…
Jimmy,
No need to announce a change as there has been little interest……we will cancel those dates and shift those interested (who call and committ) to another date or Training Evloution and separate the E-6 attendees to my private practice.
We were originally wondering if we were gonna get 2 or 200 interested. Hard to make lecture space, clinic, hotel accomodations, Course Outlines, patients selections, Weekend dates for 2 additional training days (thus making one month completely booked with training for us) until we know. The number interested is closer to 2 than 20, let alone 200, so now we will adjust the available dates that will work for the most people and patients. If you think training is easy, think again. 😉
Bob
AnonymousInactiveWe have moved the dates to the 14th and 15th of August.
Please call the company as soon as you can to secure your spot.Del
Robert Gregg DDSSpectatorWe tried, we really, really tried. But it looks like the few who were interested are now busy on the previously agreed upon dates.
So for those who would like additional exposure to previous LANAP/Periolase material ( with the usual addition of new material), please check for dates and space availability with training to be considered an “extra” during one of the Evolutions.
There will be a fee(s) for the Evolution(s), the ADA CERP and AGD PACE CE earned, patients treated and follow up, staff support, clinical support, Instructor fees, hotel, transport, eats, etc.
Thanks for playing!:)
Bob
AnonymousInactiveInteresting article
Laser de-epithelialization for enhanced guided tissue regeneration. A paradigm shift?
AnonymousInactive
adminSpectatorDid you check out the ‘Similar Threads’ box below the quick reply box?
BenchwmerSpectatorGot a call from Oral Surgeon today.
Ready to give up on #6, five years later.
Need implant treatment plan.
Jeff -
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