Hi Dave and Andrew,

Yes, Andrew, the occlusion was aggresively adjusted at the treatment appointment.  Also, there is only one molar abutment distal to the tooth.

I like your idea Andrew to remove and place single impants, but financial considerations have removed that from consideration.  Sectioning the bridge and making new crowns (perhaps) and a partial is more likely what he can afford…..and that’s even a stretch.

Dave, we have tried Emdogain over the years in a method you describe.  It works fine, but not any better than a stable fibrin clot, and it may not work as well.  

I used to use it a lot, and one has to have patience to leave the area alone for 9 to 12 months before any sign of improvement takes place.  Haven’t used it for some years now.

The stable fibrin clot that is obtained using the correct laser & parameters prevents epithelial migration, bacterial contamination, contains platlet rich plasma (PRP), stem cells, bone morphogenic proteins–in essence all the precursor and nutrient cells needed for regeneration, but without the need for a foreign material injected into the defect.  Plus, it costs less than Emdogain.;)  One also doesn’t need a bone graft material or a tissue barricade, as the patient’s own fibrin does it all….

[img]https://www.laserdentistryforum.com/attachments/upload/Markpoach2B.JPG[/img]

This is the complete thread:

http://www.rwebstudio.com/cgi-bin/ikonboard/topic.cgi?forum=24&topic=54

Andrew, we actually did a laser vs. Atridox comparison.  Atridox was very disappointing compared to using a pulsed Nd:YAG (1.064 nm).  And I think we have tried everything that’s been available (and then some) into the defect at one time or another.  We simply get a much better tissue response with Fr Nd:YAD than when we put something into the defect.  

Thanks for all the ideas and feedback.  This has been great!

Bob

Hi Ron and Bob,

Thank you for your response.

So according to Don, it was the setting “11% Air ” that went wrong. As for heat generation, I really had no idea because the patients I treated didn’t tell me anything like that to me at all.

I think I misused the term “LLLT” for the sulcular debridement procedure I did on my patients.

The two patients I mentioned that came up with the severe ulceration actually had their symptoms subsided in about a week. And for one of them, because by the time she showed up she was still feeling pain, I treated her with the Laser Smile ( Biolase), 1.5 w for 20sec, then 1.7w for another 20sec( 2mm from the ulcerated surface). She immediately had most of the pain relieved.

Question:
Is it a better option to use diode laser ( Laser Smile) for sulcular debridement?

Take care,
Wai