- This topic has 13 replies, 8 voices, and was last updated 2 years, 3 months ago by John Rose.
August 26, 2005 at 2:22 pm #3309
Fifty something male has hemangioma on lip.
Treatment will consist of draining the lesion and destroying the Venus Lake. This will allow for resorption and healing with a minimally invasive treatment.
PerioLase MVP-7 used, 3.6W 20Hz 100usec w/ 360micron fiber.
A couple drops of 4% Citanest was infiltrated.
The lesion was incised using this parameter, drainage occured, the lining of the lesion was re-entered to destroy the interior wall of the Venus Lake to prevent reoccurance. Lase time less than one minute.
No post-tx complications.
Photo at 2 weeks post-lase.
I’ve seen other cases (ESOLA journal from Europe) presented using CO2 where the whole lip is disected, alot of char. months of healing. I’ve only used this technique a half dozen times over the last 3 years, but with no re-occurence. I’ve seen Dr. Rice’s cases in ALD journal using a similar technique w/ a diode.
What’s everyone doing?
The Plastic surgeons want big $$ in my area for a scalpel excision, with no guarantee of re-occurance. It’s nice to have a 10 minute procedure to offer patients as an alternative.
JeffAugust 27, 2005 at 4:03 am #10087
Beautiful result and excellent service to your patient.
Is the tip of the fiber initiated for the procedure or can this type of treatment be carried out with a bare, freshly-cleaved tip?August 28, 2005 at 2:28 am #10083
I didn’t initiate the fiber. I didn’t need a hot tip effect for quick penetration of this type of lesion.
I cleave the fiber, test fire on a power meter, recleave if needed to achieve my desired setting and then proceed.
This PerioLase MVP-7 has the abilty to go to 100Hz with at a lower wattage and narrow pulse width (they call it a diode type setting), if you need a hot tip for fibrous tissue ablation(ie. thick frenums, GVs on smokers, etc.)
Here I’m trying to keep collateral tissue damage at a complete minumum. This case healed faster than my early attempts, less laser is sometimes better.
JeffAugust 28, 2005 at 2:37 pm #10085
Robert Gregg DDSSpectator
Very nice use and result!
BobNovember 27, 2005 at 6:42 am #10077
I was just thinking…you were using 180mJ/pulse through a 360micron fiber. If I wanted to achieve the same result through a 300micron fiber at a pulse length of either 50 or 300 microseconds (in comparison to your 100 microsec). What should my energy per pulse be? Interesting thought. I suspect that it is not as critical as all that but interesting none the same.
Thanks for posting your case!
EtienneDecember 2, 2005 at 2:20 am #10080
Sorry so late with reply, this is the third time I composed this, only to have it lost into cyberspace.
Try #3. I think all is well.
I have never used a 50usec pulse. As long as it will ablate the lining of the Venus Lake it’ll work. The 300usec pulse would produce more thermal damage to the adjacent tissues. The 300micron tip would give you more than a 25% increase in power concentration over my tip,so I would use 3.0W 20Hz 50usec.
Tissue necrosis to adjacent tissue needs to be avoided, enter the lesion, destroy the lake, that’s it. Less is sometimes better.
JeffDecember 2, 2005 at 5:13 am #10078
Thanks very much for your thoughtful reply!!
PS: I’ll send you pics of my case when I am doneDecember 14, 2005 at 11:04 pm #10081
Here is a four month post-op photo
JeffDecember 15, 2005 at 3:25 am #10084
Glenn van AsSpectator
Hey Jeff, it takes a lot to take the time to photograph the follow ups.
CLAP CLAP CLAP…..good for you.
It is neat to see.
Thanks and nice result.
GlennFebruary 10, 2007 at 7:15 pm #10079
I am new to the website and have been in practice ten years. I am just starting out with lasers and was wondering what is a good course to take?February 12, 2007 at 6:07 pm #10082
Are you already own a laser? What type?
You need different types of classes one for liabilty issues another to learn the how to’s.
The end of March there are 2 meetings the same weekend March 28-March 31.
Dental Town Townie Meeting in Las Vegas, also there will be the Millennium Dental Technologies Clinician Meeting. See the list of speakers, mostly soft tissue-NdYAG clinicians. See meeting info on website.
Academy of Laser Dentistry, Nashville, TN, same times they have a Standard Proifiency Test the day before the meeting, then 3 days of speakers, workshops, etc. See their website.
Ask on the forum for more opinions. I’m speaking at the Dental Town Meeting on non-perio uses of the NDYAG.
JeffMarch 30, 2011 at 3:00 pm #10088
What is the code for this procedure?
JoeApril 20, 2011 at 3:12 am #10086
Robert Gregg DDSSpectator
What sort of laser do you have?
BobAugust 8, 2018 at 7:46 am #46406
Has anyone used the Periolase for treatment of a pyogenic granuloma? If so, what were the steps and settings?