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2thlaserSpectatorGlenn,
Welcome back, we missed you. Thanks for the nice response on the spoons and instruments everyone. David, Glenn is right…remember to defocus more, that’ll reduce the energy, and and sensitivity you might be getting as well. Isn’t this forum great? Glenn, I know we talked about whether you will be in Vancouver in August during the WCM meeting. I can’t remember if you are or not. BUT if so, we really need to get together for dinner. I will call you soon.
Welcome home big brother!
Mark
AlbodmdSpectatorWas just looking at the videos from the ALD listed at http://www.joycomultimedia.com/productCat48705.ctlg and was wondering if anyone has tried them. They seem reasonably priced too. I saw Glenn has a video there.
Regards,
Al B
AlbodmdSpectatorI’ve heard that you can have success billing Perio Surgery through medical. A key point was to state that the procedure was done in your surgical center instead of in your office. Anyone else heard of this?
AnonymousSpectatorHi all,
It was recently suggested that a category for literature and websources would be a good addition to the site. So they have been added. If you come across literature or websites in old posts or have others you think are valuable , please copy and post them in the appropriate category. This should keep things a little handier for quick reference(great idea D.K.!). I also think that if you have comments regarding an article it would be better to copy it and post it in one of the regular forums. This will keep people from having to read a bunch of comments while searching articles.
Lasers in Surgery and Medicine
Volume 31, Issue 3, 2002. Pages: 186-193Published Online: 10 Sep 2002
Copyright © 2002 Wiley-Liss, Inc.
Article
Mechanism of water augmentation during IR laser ablation of dental enamel
Daniel Fried, PhD 1 *, Nahal Ashouri, DDS 2, Thomas Breunig, PhD 1, Ramesh Shori, PhD 3
1Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, California 94143
2Department of Growth and Development, University of California, San Francisco, San Francisco, California 94143
3Department of Electrical Engineering, University of California, Los Angeles, Los Angeles, California 90095email: Daniel Fried (dfried@itsa.ucsf.edu)
*Correspondence to Daniel Fried, Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, 707 Parnassus Ave., San Francisco, CA 94143.
Funded by:
NIH/NIDCR; Grant Number: ROI-DE14554, R29-DE12091, T35-DE07103
DOE; Grant Number: DE-AC03-76SF00098Keywords
erbium laser • CO2 laser • dental enamel • laser ablation • infrared spectromicroscopyAbstract
Background and Objectives
The mechanism of water augmentation during IR laser ablation of dental hard tissues is controversial and poorly understood. The influence of an optically thick applied water layer on the laser ablation of enamel was investigated at wavelengths in which water is a primary absorber and the magnitude of absorption varies markedly.Study Design/Materials and Methods
Q-switched and free running Er: YSGG (2.79 m) and Er:YAG (2.94 m), free running Ho:YAG and 9.6 m TEA CO2 laser systems were used to produce linear incisions in dental enamel with and without water. Synchrotron-radiation IR spectromicroscopy with the Advanced Light Source at Lawrence Berkeley National Laboratory was used to determine the chemical changes across the laser ablation profiles with a spatial resolution of 10-m.Results
The addition of water increased the rate of ablation and produced a more desirable surface morphology during enamel ablation with all the erbium systems. Moreover, ablation was markedly more efficient for Q-switched (0.15 microsecond) versus free-running (150 microsecond) erbium laser pulses with the added water layer. Although the addition of a thick water layer reduced the rate of ablation during CO2 laser ablation, the addition of the water removed undesirable deposits of non-apatite mineral phases from the crater surface. IR spectromicroscopy indicates that the chemical composition of the crater walls deviates markedly from that of hydroxyapatite after Er:YAG and CO2 laser irradiation without added water. New mineral phases were resolved that have not been previously observed using conventional IR spectroscopy. There was extensive peripheral damage after irradiation with the Ho:YAG laser with and without added water without effective ablation of enamel.Conclusions
We postulate that condensed mineral phases from the plume are deposited along the crater walls after repetitive laser pulses and such non-apatitic phases interfere with subsequent laser pulses during IR laser irradiation reducing the rate and efficiency of ablation. The ablative recoil associated with the displacement and vaporization of the applied water layer removes such loosely adherent phases maintaining efficient ablation during multiple pulse irradiation. Lasers Surg. Med. 31:186-193, 2002. © 2002 Wiley-Liss, Inc.
AnonymousSpectatorOf course I couldn’t forget Glenn’s favorite 😉
Pulsed erbium laser ablation of hard dental tissue: the effects of atomized water spray versus water surface film
Freiberg, Robert J., IMC Associates; Cozean, Colette D., ENO Vision, LLC
Publication: Proc. SPIE Vol. 4610, p. 74-84, Lasers in Dentistry VIII, Peter Rechmann; Daniel Fried; Thomas Hennig; Eds.
Publication Date: 6/2002
Abstract:
It has been established that the ability of erbium lasers to ablate hard dental tissue is due primarily to the laser- initiated subsurface expansion of the interstitial water trapped within the enamel and that by maintaining a thin film of water on the surface of the tooth, the efficiency of the laser ablation is enhanced. It has recently been suggested that a more aggressive ablative mechanism, designated as a hydrokinetic effect, occurs when atomized water droplets, introduced between the erbium laser and the surface of the tooth, are accelerated in the laser’s field and impact the tooth’s surface. It is the objective of this study to determine if the proposed hydrokinetic effect exists and to establish its contribution to the dental hard tissue ablation process. Two commercially available dental laser systems were employed in the hard tissue ablation studies. One system employed a water irrigation system in which the water was applied directly to the tooth, forming a thin film of water on the tooth’s surface. The other system employed pressurized air and water to create an atomized mist of water droplets between the laser hand piece and the tooth. The ablative properties of the two lasers were studied upon hard inorganic materials, which were void of any water content, as well as dental enamel, which contained interstitial water within its crystalline structure. In each case the erbium laser beam was moved across the surface of the target material at a constant velocity. When exposing material void of any water content, no ablation of the surfaces was observed with either laser system. In contrast, when the irrigated dental enamel was exposed to the laser radiation, a linear groove was formed in the enamel surface. The volume of ablated dental tissue associated with each irrigation method was measured and plotted as a function of the energy within the laser pulse. Both dental laser systems exhibited similar enamel ablation rates and comparable ablated surface characteristics. The results of the study suggest that, although the manner in which the water irrigation was introduced differed, the mechanism by which the enamel was removed appeared basically the same for both dental laser systems, namely rapid subsurface expansion of the interstitially trapped water. It is the conclusion of this study that if the proposed hydrokinetic effect exists, it is not effective on hard materials, which are void of water, and it does not contribute in any significant degree in the ablation of dental enamel.
Robert GreggParticipantVery nice resource section. Thanks Ron. Nice job as always.
Bob
SwpmnSpectatorQUOTETHe machine isnt as sexy as the Waterlase in looks but it is a hearty stable unit…Glenn
Dave, if you ain’t afraid to get on U.S. 19 just come on down and be the head judge in the world’s first Sexiest Erbium Laser Contest:
[img]https://www.laserdentistryforum.com/attachments/upload/williamsa062603-A.JPG[/img]
Al
P.S. But you gotta bring the Lazer Models since I heard the best ones can be found in Pasco County
AlbodmdSpectatorDavid,
My Delight should be coming in July 10 and my training would be July 11. If you want to come down and watch you’re more than welcome. If not then, some other time. Thanks to Allen for letting me go to his office in Clearwater and check out the lasers side by side. I thought they were both pretty sexy, sort of like choosing between Ana Kournakova and Brittney Spears. . .or Andrew’s Laser Girls and the girls Allen always has in his pics. 😉
Regards,
Al B
dkimmelSpectatorAllen I’ll give you a call. Ah, the Lazer models of Pasco Co.
If your talking about overall tonage– You bet!
Albert, The 11th is the day I take my dad in to find out were is mind is. May have them look for mine while they are at it.
David
David(Edited by dkimmel at 4:37 pm on June 26, 2003)
dkimmelSpectatorI have a Implant patient with recurrent peri-implantitis. The implants are over 11 years old. The osseous contours around three of the implants are not ideal.
[img]https://www.laserdentistryforum.com/attachments/upload/IMG3efb6dd3.JPG[/img]
The bone levels have not changed over the 3 years I have seen this patient. There is subcalculus present and the crown and bridge is not ideal. All of which a feel contribute to the problems of this case.
How would you intergate the use of the Lasersmile in the treatment of this site?
David
dkimmelSpectatorAllen, I was up early this morning and reading your post. I have been putting of using my Lasersmile for doing this troughing around preps. You got me off my butt today. Way cool. I used to use hydrocolloid and electrosurged a ton. I can still hear a lecture by Dr Spears about troughing around preps. He would always get a laugh when he called his elctro sx unit his laser. No sense in spending big bucs if you can do the same thing with electro sx. After using the diode laser today on my C&B cases all I can say is Spears must have never tried it.
Using the diode laser was much nicer. The tissue looked great . I felt I had less tissue tags, better control and better hemostatus.
So thanks for posting.
David
dkimmelSpectatorRon,
I gave your ideal a try. Much better.
However, this is not an ideal Tx. It can be a nightmare if you treated patients with this technique.
There is relief. The outbreak is much smaller.
It is that the lesion is so diffuse and the tongue has a lot of surface area. Relief is 100% for about 6 hours max and then slowly comes back. When it comes back so does the patient!!! The patients deal with the pain but when they find they can get relief ,they don’t want to deal with it. I’ve been down to the office afterhours a bunch of late. Makes the kid smile!!
I sort of expected this result. Since we are only treating symptoms.
David
AnonymousSpectatorThe Science of Low Power Laser Therapy
by Tiina Karu
Gordon and Breach Science Publishers
AnonymousSpectatorQUOTEQuote: from dkimmel on 11:01 pm on June 19, 2003What/Who are you reading on Biostim?
I hate quoting articles! I have a tough time remembering names etc. I remember the important stuff and move on. Looks like this will be something in my past. Starting to get some local flak about using the laser. Wondering if we could start a thread that just list articles that were of relevance. Seems like it could be a good idea. If there is already a spot on the board like this, forgive me a point me in the right direction!
DAvidThere wasn’t a ‘spot’ but there is now (see main page). Great Idea! Thanks for the suggestion.
Just to keep the biostim discussion going, have you thought of using your diode w/ the whitening wand to biostim and cover a greater surface area? Anyone doing this, or have any thoughts/ parameters on this (other than hack2 :biggrin: ) ?
AnonymousSpectatorLasers Surg Med 1998;22(5):302-11 Related Articles, Links
Treatment of periodontal pockets with a diode laser.
Moritz A, Schoop U, Goharkhay K, Schauer P, Doertbudak O, Wernisch J, Sperr W.
Department of Conservative Dentistry, Dental School of the University of Vienna, Austria.
BACKGROUND AND OBJECTIVE: The aim of this study is to examine the long-term effect of diode laser therapy on periodontal pockets with regard to its bactericidal abilities and the improvement of periodontal condition. STUDY DESIGN/MATERIALS AND METHODS: Fifty patients were randomly subdivided into two groups (laser-group and control-group) and microbiologic samples were collected. There have been six appointments for 6 months following an exact treatment scheme. After evaluating periodontal indices (bleeding on probing, Quigley-Hein) including pocket depths and instruction of patients in oral hygiene and scaling therapy of all patients, the deepest pockets of each quadrant of the laser-group’s patients were microbiologically examined. Afterwards, all teeth were treated with the diode laser. The control-group received the same treatment but instead of laser therapy were rinsed with H2O2. Each appointment also included a hygienic check-up. After 6 months the final values of the periodontal indices and further microbiologic samples were measured. The total bacterial count as well as specific bacteria, such as Actinobacillus actinomycetemcomitans, Prevotella intermedia, and Porphyromonas gingivalis, were assessed semiquantitatively. RESULTS: The bacterial reduction with diode laser therapy was significantly better than in the control group. The index of bleeding on probing improved in 96.9% in the laser-group, whereas only 66.7% in the control group. Pocket depths could be more reduced in the laser group than in the control group. CONCLUSION: The diode laser reveals a bactericidal effect and helps to reduce inflammation in the periodontal pockets in addition to scaling. The diode laser therapy, in combination with scaling, supports healing of the periodontal pockets through eliminating bacteria.
Publication Types:
Clinical Trial
Randomized Controlled TrialPMID: 9671997 [PubMed – indexed for MEDLINE]
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