Soft Tissue Biopsies - Laser Dentistry Forum

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June 1, 2004 at 5:35 am #10651 Reply

kellyjblodgettdmd
Spectator

Jeff – Nice illustration of how there’s more than one way “to skin a cat”. Hopefully, laser users that currently only have one wavelength will start to see the value of having multiple wavelengths. This is a great illustration of using different lasers on the same pathology, but getting slightly different results (obvious less bleeding w/ Nd:YAG).

My guess is that had the Nd:YAG example been treated w/ a diode, there would have been much greater risk to papilla due to decrease in thermal relaxation time.

Good post and nice choices.

Kelly

June 3, 2004 at 4:40 pm #10654 Reply

Samuel Moss
Spectator

Jeff,

Nice post. I wanted to know how the patients felt. Was there more treatment discomfort with one over the other? Post operatively, was one more uncomfortalble during healing than the other. I could see the 2 week results, but did you feel that in the first 4 to 7 days one was healing faster or less traumatically than the other?

Inquiring minds want to know!

Thanks,
Mossman

June 3, 2004 at 7:44 pm #10655 Reply

Benchwmer
Spectator

Hey Sam,
No reports of discomfort from either patient.
I didn’t place them on any pain meds.
I believe using the Erbium w/ a water spray decreases the zone of coagulation(necrosis), therefore healing is more rapid w/ the Erbium. This biopsy using the Nd:YAG was much smaller, so in these cases within 2 weeks healing was faster with the Nd:YAG.
Both work out great.
Jeff

September 9, 2004 at 1:13 am #10658 Reply

Lee Allen
Spectator

Hi,

It has occurred to me that with the edges of the biopsy being so altered even with the Erbium, there is a minimum size that is readable or useful to send.

Any ideas on the minimun size limits of biopsy material with the Erbium, Nd YAG,or Diode? Or to phase it another way: What zone of denatured tissue is created? It must be energy level related.

Should this infuence the extra margin taken in the sample vs excision being the treatment of choice and keepng the margins minimal the goal for minimally invasive surgery?

D Kimmel where are you? I know you know the answers.

September 9, 2004 at 6:11 am #10652 Reply

lookin4t
Spectator

Don’t know a minimum but you’re right. Unless you have a nice piece to send the pathologist will end up playing name that cell.

I’m not sure of the advantage of an erbium over a scalpel here as the bleeding would be the same. A diode would give a larger area of necrosis as Jeff pointed out.

Jeff, can you comment as to why an erbium would be better than a scalpel here? I may not agree, but I’d like to see your reasoning.

September 9, 2004 at 6:53 am #10656 Reply

Glenn van As
Spectator

You can do more without anesthetic with the erbium.

That is one reason.

Less bleeding in non inflamed tissue.

No sutures, which is no big deal for you.

Many Fibromas can be removed without anesthetic, just topical.

Just an idea.

Glenn

September 9, 2004 at 3:28 pm #10653 Reply

lookin4t
Spectator

With this one sutures wouldn’t be useful.

And if it’s small and you’re not sure it’s a fibroma…would you still feel comfy using it?

September 10, 2004 at 3:08 am #10657 Reply

Glenn van As
Spectator

What are you getting at lookin4t

I am obviously missing something but what difference would the scalpel make vs the laser if you were unsure?

Glenn
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