Hi Glenn:I look at your case and You know that I am a user of the high fluence technique like Michael Swick has teach me two years ago.I always use the high fluence technique with a LOT of water and I can assure you than we have very good results with that technique.I use the new water handpiece with water in and I can assure you that it’s the easier way to use that technique.
Most of the time I use pulse mode between 8 to 10 watts ,.05on .05off.
You can do a case like that with topical anesthesic only because of the thermorelaxation period you give to surronding tissus.
More you use high power and water less you gonna have post-operative pain.
Very good job Glenn.

I would check occlusion (lateral interferences may be excessive) I saw Robert Barr in Vancouver at the World Congress of Microdentistry last weekend and he showed a case similar to this where he troughed with his waterlase and cleaned root surface and place Emdogain followed by synthetic bone (your choice) and then covered in with Barricade. It looked like a reasonably atruamatic way to treat this area.

I agree with Al in that I dial down the settings to get the best visualization and cutting at a reasonable efficiency. I also turn quickly to the round bur if efficiency and visualization are significantly compromised. I often dial down to 1.5W 11/7 and add h2o if I am getting any charing.

Pat

Dave,

Do you mean that there was no  flap opened ;and that the emdogain was only injected into the pocket ?

I think Bob would have relieved the tooth from occlusion in the LPT as the last stage of LPT is to adjust the problemetic teeth from occlusal trauma. The abutment , however, seems to be carry quite a lot of pontics. Is there only one molar abutment at the other end of the bridge?

Cash may be a problem for the patient but I’d suggest implant bridge to replace the three pontics.( bone quality looks ok ) Sectioning the bridge and polishing the abutment crowns. He may agree.

What about redoing the laser procedure with addition of Atridox ?

Ken

(Edited by Kenneth Luk at 9:16 pm on Aug. 20, 2003)

Wai
Have you had your pk settings checked. You should be able to do .25W 0%air/ 0%water and get colser than 2 mm to your hand w/o it feeling hot. I just had mine reset.Could be things were just too hot.

I’ll be there – look forward to meeting you in person Allen.

Regards,

Janet

Too bad there wasn’t more input on the project. We appreciate your efforts.

---

Error 98 on the DELight means the laser exceeded a certain time limit to reach an energy level selected with the keypad. Usually only takes a few seconds and is dependent upon the amount of change requested. For example, changing the energy setting incrementally is an easy process for the laser. However, making a rapid change from a high enamel setting to a low soft tissue setting may occasionally exceed the time limit and result in Error 98. Usually without consequence.

Error 24 indicates a problem with the energy feedback loop that controls the laser output. May occur in conjunction with Error 98 but indicates a more serious problem within the laser bench assembly. The bench assembly may need to be replaced and this error can only be addressed by a technician.

Al

Hello Wai,

I’ve only heard of “LLLT” in reference to “Low Level Laser Therapy” in using lasers for biostimulation.

Your mention of LLLT here suggests an intended direct effect on the offending tissues (e.g. sulfer producing anaerobes like p. Gingivalis).

What is the source of this protocol and what does LLLT supposed to be an acronym for?

I think the use of air in a pocket could be the source of some ulcerations due to an air embolism.

Let us know how your patients respond.

Good luck.

Bob