Page 189 – Laser Dentistry Forum

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August 23, 2003 at 3:36 am in reply to: Perio/Restorative Case and LASERS??? #10546

whitertth
Spectator

Anterior inflamed tissue is most likely due to ill fitting crowns….provisionalize, scale root plane, periostat, and if u need laser therapy( i think here any wavelength will work) …Once u s/rp I think tissue will normalize…I agree with Andrew , the wear is a concern on the lower canine and occlusion, especially good solid posterior contacts as well as anterior guidance must be established.. Looks like u will be opening vertical here… so try and get it close as possible with provisionals…Good luck

August 23, 2003 at 3:54 am in reply to: Perio/Restorative Case and LASERS??? #10544

dkimmel
Spectator

Al, Not wanting to go under the knife is a concern. He is setting limits on his treatment. Do you think it is a matter of trust? That once you get working on him, he would come around.
If you think that this is going to be a big issue I would not place him in full mouth temps. Rather replace the temps that are lost or in poor shape. Deal with the endo and caries. Place him in a splint adjust occlusion as needed. Take him through scalings and use the diode retreating and backing out. [Perioscope use if you got one. ] Then reevaluate his concerns. It looks like you can take care of the biologic width problem without a flap if you place him in temps. #2 can also be CL without a flap. #21 could be more a problem but looks like an occlusial situation. The splint should help. A bit concerned about the span of the bridge that would need to be placed.
Hope that helps
David

August 23, 2003 at 6:11 pm in reply to: Perio/Restorative Case and LASERS??? #10551

Swpmn
Spectator

QUOTE

There’s still room in our September Bootcamp…..:cheesy:

Boy did I know that one was coming!!!!!

Thanks for all the help/suggestions guys!!!! Yes, Andrew, the midline is way off and occlusion is of great concern. As you can see, the crowns on #7 through 10 are all-porcelain – as Ron said I suspect they are poorly fitting or there is a cement problem and also probably biologic width violation. Dave, I feel confident the patient will allow me to reflect a flap should it become necessary.

See midline, sorry shot is not dead on:

[img]https://www.laserdentistryforum.com/attachments/upload/williamsa082303-1.JPG[/img]

Thanks again,

Al

August 23, 2003 at 6:27 pm in reply to: Hoya ConBio meeting at LVI #8403

Swpmn
Spectator

Hey Dave I’ve been on a diet since last November we’re blowin our diets and havin a blast in Vegas!!!!

Al

August 24, 2003 at 4:02 am in reply to: Post LLLT Ulceration #7350

drlam
Spectator

Thanks Bob,

I appreciate your prompt response, though I don’t really know what a free-running pulsed Nd:YAG is.

Take care,
Wai

August 24, 2003 at 1:20 pm in reply to: Post LLLT Ulceration #7348

Anonymous
Spectator

Wai, follow this link for info-
Periolase from Millennium Dental

August 24, 2003 at 8:18 pm in reply to: 980 diode for fibroma removal #9787

Glenn van As
Spectator

Hi Marc and David: just back from a week off and next week I will be in and out of home. I will get some post ops but they will likely be two weeks old.

Thanks for the kind words and thanks Marc Andre for the heads up……I would like to try that handpiece one of these days.

Glenn

August 25, 2003 at 6:15 pm in reply to: Biolase Investment #9384

Albodmd
Spectator

I was just contacted by an analyst from Smith-Barney in New York. So how much is a good hourly rate to charge for my consulting? 😉 Big concern seems to be the growth rate of lasers in dentistry. I don’t seem them being incorporated on a widescale quickly unless the price drops a lot. In which case, I’ll be unhappy cuz I paid so much :-(. But I can always say I was the first to have it in town!
Regards,
Al B

August 25, 2003 at 9:45 pm in reply to: Off Topic #3162

dkimmel
Spectator

What a Monday. I feel like the gunslinger that had to give up his Colt before going into town. Last Friday I did a Apthous ulcer on my wife and it stung. Never had before. Then today it just seemed to cut slower. Then The popping sound became less loud. I changed tips. No change. Changed handpiece and tips , no change then it strated to work. Tried the .25W on wrist and OUCH. The trunk fiber looks fine, the tips look fine, the mirror in the handpieces don’t. They have a whitish to gray cast in a splatter pattern. Soo off they go to be polished. Seems what happened is when they are wipped down prior to sterlization the tips are not being removed and the caps not placed. The liquid is backflowing on to the mirror. Man!!!!!

David

August 25, 2003 at 11:12 pm in reply to: Gunslinger without a gun #9017

Swpmn
Spectator

In other words you sent your handpieces to Biolase? Are they sending you replacement handpieces tomorrow morning?

Al

August 26, 2003 at 1:04 am in reply to: Gunslinger without a gun #9015

Glenn van As
Spectator

Hi folks: I had someone in recently who was a big Biolase user and they were astonished at how little care I use when changing tips. Other things like using it close to amalgam or gold was also a shock.

Perhaps it would be good for Biolase users to post some of the concerns that users should be aware of so that they dont damage tips or mirrors or trunk fibers.

I keep hearing of little things and I know Mark Colonna has an extensive list.

Would it be possible to post this .

I am sure some of it must apply to Delight or Opus users.

Glenn

August 26, 2003 at 2:13 am in reply to: Biolase Investment #9400

Swpmn
Spectator

Well which one did they contact you about the DELight or the Waterlase or was it just erbiums in general???

If you believe all the crap being posted on Dental Town “comparing erbium lasers” you and me are gonna be out of luck!!!! The sky is falling, the sky is falling.

Al

August 26, 2003 at 4:27 am in reply to: Biolase Investment #9385

Albodmd
Spectator

They were actually asking about the Waterlase and why I picked the Delight. They wanted to know how fast I thought the market for hard tissue lasers would grow. Like I said before, not to fast unless there’s a big price drop. I don’t know how fast waterlase is telling them they think it’s going to grow. Can’t wait to see those references from Stu about how much faster the Waterlase is than the Delight. 🙂

August 26, 2003 at 12:45 pm in reply to: Perio/Restorative Case and LASERS??? #10545

marc andre gagnon
Spectator

hi folks
In a case like that, we do curettage with diode 980 at 6 watts pulse mode with a fiber of 400um.
Following that curettage we do irrigation with chlorexidine and fluoride.
For the next week we ask patients to brush with oxyfresh and rince 3 times a day with oxyfresh mouthrinse.
We do post op appointment 2 weeks later and do laser curettage where we have inflammation of the gums and continue with oxyfresh.

August 26, 2003 at 5:53 pm in reply to: Perio/Restorative Case and LASERS??? #10548

Glenn van As
Spectator

Great idea Marc, but if the margins are inflamed due to infringement of biologic width or poor fitting margins (overhangs) the likelihood of resolution of the inflammation is poor in my opinion.

SOmetimes a flap and either/or osseous recontouring and removal of overhangs and replacement with temps provides the best alternative to healing.

If the gingivitis is due to other situations than restorative margins , I think your idea is excellent.

As an alternative you can try this approach and if it doesnt work go to the more comprehensive treatment.

Glenn
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