Hi Ken,

Do you not find that the water tends to have trouble flowing out the tip of the canula? Perhaps I haven’t adjusted the flow correctly?

Andrew

You won’t be charged for the fiber or handpiece.

The fiber is sensitive to water left within from previous procedures(could have been left in from practicing on extracted teeth). You must purge water from the fiber after each use. If you aren’t sure how I can give you step by step instructions.

The book by Chris Walinski is quite good.

Al

Sorry man.

How did you know the original set was bad? Did you discover it through the lot number?

Can a defective(from the manufacturer) tip be discerned visually with magnification?

Al

Hi Ken and Everyone,

Sorry for being away for so long. Busy, busy, busy with clinical practice and training, dentists, and hygienists from out of town.

Not to mention the strange, stray Canadian Canucklehead that came by for dinner….None other than Glenn van As! It was GREAT to have him visit. Glenn even offered to pay for EVERYONE’s dinner. Thanks, Glenn! What a great guy……..I’ll send you the receipt right away…..:cheesy:

Ken, you asked, “Bob, the LPT case you posted on soft tissue section was very interesting. Please keep us posted on this case.”

You bet. The patient is out of town and will be back next Wednesday. I’ll post his post op progress.

“I’m sure you’ve heard of perio2000 by Diamond General Development Corp. http://www.perio2000.com
Do you think it may show us the differences in bacterial activities in the pockets before and after LPT, 6 mths post-op?”

Yes, I have heard of them and their probe. The Diamond probe detects levels of sulfide from sulfide producing (H2S) bacteria.

It might help to some degree in detecting levels of bacteria at 6 months LPT, but there are LOTS of other things to attend to that contribute to periodontal disease or health than P. gingivalis, P. intermedia, and B. forsythus.

In fact, these “opportunistic” anaerobes mentioned above are NOT the first to invade the pocket, and probably would not be present at 6 months post LPT if all is going as expected–unless they were not effectively killed in their “priviledged” sites (i.e. endothelial cells, macrophages, calculus, dentinal tubules) during LPT treatment.

So the Diamond probe might not be of much help for the gram positive bugs that first populate a developing pocket.

“What’s your view on perioscope?”

The perioscope is the first generation dental endoscope. I think the idea is great, and the first version is fine, but I think we will see better imaging and scopes in the future.

“In your post on perio treatment with waterlase, you mentioned that: NIR transmitt through water in tissues with NO attenuation of the beam intensity until the beam hits a pigment the wavelength is highly absorbed into– like black pigmented anaerobes embedded out into the tissues.” Correct

“In this post you mentioned when laser hits tissue (that it is absorbed into) :Heat altered protein.” Correct

“Does that mean healthy tissue is also affected as well as bugs?”

Correct, if it is healthy tissue that is absorbing the particular wavelength.

“Lasers penetrate through water to different depths.”

Correct. That’s the “coefficient of absorbtion in water” chart we all have seen so much of.

“How deep do these bugs infiltrate into gum tissues?”

Just like a pimple can expand into a boil, or an abcessed tooth can spread into the cavernous sinus behind the eye, the anaerobes can penetrate many centimeters into tissue.

“Granulation tissue has a higher water content than healthy tissue. Isn’t the higher water content in infected tissue more prone to vaporisation ?

Your statement and follow-on question presumes that granulation tissue is not healthy. To quote Orban’s Perio 1972, “Granulation tissue is found in healing wounds and is composed of fibroblasts and proliferating capillaries, which also give it a granular appearance. With healing, granulation tissue reforms into a normal fibrous connective tissue.”

With NIR lasers, tissue–granulation or otherwise–infiltrated with bacteria that highly absorb the laser’s wavelength would tend to vaporize more quickly, watery tissue or not!;)

Bob

Sure Vince,

Lower settings (<1 watt), pulsing the beam, topical anesthesia (on occasion), air spray opposite high volume evacuation, and you can treat a number of small lesions.

Bob