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Forums › Laser Treatment Tips and Techniques › Hard Tissue Procedures › Do lasers really work?

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  • October 28, 2003 at 4:52 pm #3497 Reply

    kellyjblodgettdmd
    Spectator

    Here is a case I show my dentist friends when they ask “Does the laser (erbium) actually remove tooth structure?”

    Pre-op:

    1265D333.jpg

    Post-op:

    126D6059.jpg

    Hope everyone has a great day!

    Kelly

    October 28, 2003 at 11:17 pm #11841 Reply

    Swpmn
    Spectator

    Kelly:

    Looks like what we all see everyday!!!! Keep up the good work.

    Al

    October 29, 2003 at 1:22 am #11836 Reply

    ASI
    Spectator

    Hi Kelly,

    Very nice presentation of laser restorative treatment. A picture is worth a thousand words indeed. You might consider making a postcard out of that for marketing purpose. Good work, Kelly.

    Andrew

    October 29, 2003 at 3:09 am #11837 Reply

    Glenn van As
    Spectator

    Very nice Kelly……….how long to do that, any burs or did you only use the laser.

    What restorative material…….

    Neat case and beautiful post card.

    ANesthetic??

    Glenn

    October 29, 2003 at 4:24 am #11825 Reply

    dkimmel
    Spectator

    Sure you did that with a laser!! We know it was all done with a imaging program. Next thing you know you will want us to believe,we really did put a man on the moon!
    smile.gif
    Nice case.
    David

    October 29, 2003 at 1:28 pm #11832 Reply

    marc andre gagnon
    Spectator

    very nice case
    we see case like that in our office and we know that we can do that treatment without anesthesic.
    What restorative material…….
    A picture is worth a thousand words indeed
    Good work, Kelly.

    October 30, 2003 at 2:08 am #11840 Reply

    Stewart Rosenberg
    Spectator

    Beautiful case Kelly!

    Stu

    October 30, 2003 at 5:52 am #11827 Reply

    kellyjblodgettdmd
    Spectator

    Thanks everybody! To answer some ques: I used ~ 95% laser and 5% #4 slow speed round bur for deep caries next to pulp. I restored using plastic matices inbetween all the teeth and injecting Fuji IX. After the Fuji IX set, I cut it back so as to have 1mm to build up using EsthetX composite for final contour. The appt. took about four hours. She reported no post-op sensitivity.

    I start on the Maxillary arch tomorrow. Whew!

    Kelly

    October 30, 2003 at 5:55 am #11828 Reply

    kellyjblodgettdmd
    Spectator

    Also, here are her CRTbacteria cultures. We have controlled the bacterial levels with a Betadine rinse.

    Lactobacillus:

    AM1Lacto.jpg

    Strep. Mutans:

    AM1Strep.jpg

    November 9, 2003 at 8:18 pm #11826 Reply

    jkline
    Spectator

    Hi Kelly,

    Nice work, and nice pics. As I’m considering the purchase of a laser, most likely a DElight. I have a couple questions: Did you give any anesthetic? The procedure took 4 hours, would the work have been finished sooner with a high speed? Working with a laser seems cool, but to stay profitable I really couldn’t spend more than two hours on this case (assuming you billed &#367-900 total for these six restorations.)

    From a capitalistic standpoint, besides the expense of the laser, I’m worried that it will slow my production down. For instance, I usually do 4 class II composites, 6 class II alloys (yes, I still do them), or two Cerec inlays/hour. If laser prepping drops my speed to 3 fills/hour, then I can see production dropping, which is bad news. Then again, I may actually start doing soft tissue stuff which I either ignore or refer out. How is does the laser effect your bottom line?

    As an aside, I basically taught myself how to use my CEREC. There are several books and manuals and lots of internet resources so it wasn’t much of a problem. It seems besides DT and this site, there really isn’t much out there for do-it-yourself-laser-dentistry. Which is too bad, for it will be 6 months before I can do any traveling for CE, yet the DElight demo unit is coming next month. So if anybody can point me to any type of learning resource, please let me know.

    Thanks,

    Jeff

    November 9, 2003 at 10:13 pm #11839 Reply

    Stewart Rosenberg
    Spectator

    Hi Kelly,

    So glad to see you using GIC and Caries risk tests as well as the betadine rinses. It’s very excitng to me to see that we are reaching dentists around the globe with what I so passionately feel is the best dentistry possible. Keep up the wonderful work and spread the protocols to as many as possible.

    Stu

    November 9, 2003 at 10:40 pm #11829 Reply

    kellyjblodgettdmd
    Spectator

    Thanks, Stu! I learned of the CRTbacteria test and betadine rinses in June when I attended an advanced laser course Kim Kutsch was doing in Seattle. I am fortunate to live so close to Kim and get such great information from him. My brother and I will be attending the Rendevous in January out in Baker. I imagine I’ll see you there.

    In response to Jeff: I did use anesthetic in this case – bilateral mental blocks. I was anticipating that I would probably be doing root canals. However, I have restore posterior teeth on this patient without anesthestic and she did fine.

    With regards to speed – I would not have been any faster with a high speed. The majority of time was spent trying to recreate decent esthetics. I’m kinda picky. I charged roughly &#36400/ tooth for the restorations. Additionally, I charged for the gingivectomies that had to be performed to gain access past the caries (&#36400/arch for “cosmetic” recontouring). So &#363200 in four hours for me (with no lab bill) more than meets my overhead.

    If you are considering incorporating laser technology (especially Erbium) into your practice, you owe it to yourself and your patients to revamp your fee schedule. After I bought my Waterlase (I already had a Nd:YAG and a Diode) I decided it was time to get off the PPO I was participating in. This has been one of the best moves I made this year. I no longer deal with an insurance co. telling me what I can charge. I charge what I feel is fair to the patient and to me to guarantee I do a great job.

    Jeff, I welcome you to call me @ 503-998-3542 if you’d like to talk lasers. I have learned a lot in the last year and a half buying three lasers – many things the hard way. The more you know before you buy, the better.

    Hope to talk to you soon.

    Kelly

    November 10, 2003 at 1:25 pm #11833 Reply

    marc andre gagnon
    Spectator

    If you are considering incorporating laser technology (especially DeLight Erbium) into your practice, speak to dentist than have the same profile of dentistry than you.
    I am a cerec dentist since 4 year and I am also a diode 980 user since 2 years. I use 980 for throughing on all of my cases and it take no more than 30 secondes to prepare the gums for impression without bleeding.I also use the delight for desensibilise the tooth and prepare the site for cimentation of the crown.
    The laser prepping doesn’t drops my speed because I doesn’t use anesthesic most of the time.
    I actually do soft tissue stuff with my 980nm diode for surgery or gingivectomy

    November 11, 2003 at 5:35 am #11830 Reply

    kellyjblodgettdmd
    Spectator

    I wanted to share the completed case with everyone. We finished her caries control today. Used only the YSGG. Patient very comfortable. I feel very confident we won’t be back to the same place again since we are helping her manage her bacterial oral infection.

    Here it is:

    AMfinished.jpg

    November 11, 2003 at 1:05 pm #11835 Reply

    2thlaser
    Spectator

    Kelly,

    Clap, Clap, Clap, great case…and of course, Kim taught you well. (as he did me too). We need to get you to be at the NEXT World Congress of Microdentistry Meeting in SF next August! We can talk Saturday. I look forward to seeing you!
    Sincerely,
    Mark

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