Using Lasers for Everyday Dentistry P5

Dec
2013
25

posted by on Gum Disease Prevention

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I want to share with you this case. Many of you may know this guy Lenny LeBlanc. He is a recording artiste and song writer. Back in 1977 Lenya had a fabulous hit ‘falling ‘ and doing the time he has converted over as a Christian arties. One of is some that’s just a mega hit is “above all”. Perhaps you have herd that Lenny is an outstanding arties. We have many song  writers and recording arties that live in  our area because of Fame studio and several of them arte actually my patient  and penny is one of our best  His new CD  has  Fallen on it ,  it’s total of it is Love like no other. Lenny recently did a benefit concert here in the area and we see Lenny, myself, my wife and our staff and this was a fundraiser benefit for underprivileged children in the area but anyway we just finished jay new smile o penny. This what he did  look like and  I notice nan a lot  of his photographs early on  that he just didn’t smile for his  album  so he wanted to do something  about it.

 

We did   one single crown and some veneers and tried to rebuild his smile. We made his teeth a little bit exaggerated because of his stage presence. We checked him on stage to see what it would like and this gave us good results .Now we’re about to get started on a lower on Lenny and he’s just a wonderful guy and based on his song Fallen we ‘eve done all of your marketing on Falling in love with your smile and we use Lenny’s song in a lot of out advertising and promotions.

 

Laser bleaching

One good thing about the easy lays is that it has a belching wand that comes with it and you can bleach a quadrant of teeth at a time. It’s a very short cycle and it does a great job. The system is just wonder foul and the appointment is about a one hour appointment with outstanding results. You see untouched photos of before and an immediate one hour after. very good results for your patients.

 

Let’s talk briefly about Period. Very exciting things are happening in the laser world relative to period and mechanical treatments such as [Inaudible] are not able to remove bacteria .Its just no longer enough. The thing we have to contend with in period is of course bacteria, the bio fame we have to be able to get rid of the snot inside   of the gums. It’s just a horrible collection of  microbial matrix there and we want to get rid  of it , There’s  plaque attached to the tooth , there’s unattached  plaque , there is epithelia plaque . Plaque are bacteria and the connected tissue and bacteria on the bone surface. We are dealing with a lot of bacteria so we will like to get rid of the bacteria in the area around the tooth. The pocket therapy with resulting new attachment thanks to the radula fire peril tips.

 

I know we talked about radial fire tips in indo and this tip is similar but again it is different. The thing that’s different again about that is you will notice that the end of the tip is blunted slightly and the sides are bebble. This allows about 60% of the energy to come out the side so that we can depothilize the lining of the pocket and remove calculus and about 40% comes out the end so that we can reach the bottom of the pocket and we can interact with the bone if necessary.

 

This is a really neat tip and these have been out a little before the first of the years and we are getting great results with them. This is techniques. You see the radio fire tip here in the photograph and we use it first and foremost for trapping to open it up a little bit and to remove the inner epithermal lining. The radio fire tip goes to the side and to the bottom of the pocket towards the tooth and then we can turn the tip slightly towards the tooth and actually remove calculus form the trot surface. When we are doing I’m always seeing little bit of calculus foot up and come to the surface and this is after they have been through root plaguing and scaling. There is always that little bit that you did not get.

 

In here in the photograph you see a piece of calculus that came out right after we used the laser. This is way the tip looks going into the pocket. Once we’ve done the pocket itself we’ll move outside to the outer epithelium to remove it and this is what that would look like. Here’s the reason for that. As we  go down and  we depethalize the lining of the  pocket  and heal it  quad clean the side of the tooth  the healing process begins , the epelthial cells from here will grow much more rapidly than the functional  epithelium down in the bottom of the pocket . Remember err we are trying to establish reattachment.

 

In order to be of service to the functional epithelium don here we take the epethialnn cells here and move them back away from the starting line. We make them run further. They  arte going to grow faster so  we make them go father and so we  remove that outer epetelhelium and then about a week later we go back and  do the same thing and grab those  cells and take them back to the starting line again to give the junction  epithelium more time  for reattachment . After we do that we just apple pressure for about 5 minutes to get a really good broadcloth and then we apply derma bond, a sisal to seal up and this is what it looks like immediately post opposite.

 

A far cry from bridal peril surgery where we would have made the incision, we would have a lot of bleeding and we would have sutures showing and peril dressing. We are really proud of this case. This is one that we just recently worked none. This is the way that the patient present it to our office. A portion of the metal crown on number 9, some obvious periodontal problems and association with that. You see the lingual side. Graphically it looks  like  this. We plan to get the patient in for treatment but before the patient can actually commence she presented with this, an obvious perio abyss. Things are just not going well where. This is the radiograph, you can see the obvious bone loss around the tooth and these were the measurements a collection of 5, 6, 7, and 8s. So not a good situation. We did the procedure that we just described with the laser. Here you see the radio fire perio tip and one week later it definitely looked better. The day what we did the procedure w definitely went in and adjusted the avulsion not the lingual side of those tooth that was in traumatic inclusion. Four weeks later it look  like this and at that point in time we took a whole portion  of the metal cram and we fabricated a  temporary cram to go on it and three months later it looks like this .A huge noticeable improvement and all we’ve  done  here was the laser procedure with the radio fire perio tip and look at our new measurements, I’m not exaggerating  , I use   the same force in making this measurements that we did the first  stage when she came in and we got the 5,6, 7, an and 8s. She was down to 2s and 3s all the way this tooth, just a reachable   improvement over a three month period.

 

 

Three months post operatively radio graphically she looks like this and in my opinion I t think we are beginning to see bone formation in them and so bone growth in that area. If you go back and compare it to April of this year and you look at the same area I think you would have to agree things looks considerable   better in there. We had  plan to  do  dome surgery and a graph  but quite  honestly at this point we were juts allowing  thinks to just go along  because she is doing so well and  if  things continue it  will be a permanent  cram in the near future.

 

Now in the last couple of segments want to talk about profitability with lasers. If you are going tom make an investment like this I think you need to think seriously about hats it’s going to do for my practise and what’s the return on investment. I think that’s a very fair question. First of all we are going to look at the smaller picture procedure by procedure but it really does mouton up fast. Let’s look first of all at additional procedures.  Things that you are currently doing but you can do a few more of those because of laser dentistry.

 

Let’s take the several 750 000 per year dental practise and let’s say that because of the laser faster procedures we can do additional restorative procedures two per day. Well how can you do that? Bomber obey we are working without anaesthesia so we don’t have that wait time .We can work in multiple quadrants instead of limiting ourselves to just one quadrant. There are many times that patients come  in and I fill number 3, 4 , 19 and 30  all in one appointment and I centrally  wouldn’t do that if I had to do that   with anaesthesia. By deign two extra per day we can add $64 400 to this practise.

 

Proteomes and restoration, because we can do proteomes in one step without for more. If we could add one per week, one additional per week we can add $19 750 to this practise. An additional surgical extraction remember we talked about being able to do surgical extraction without having to lay a flap and remove bone. If we could add two of these per week we could add $27 900 to this practise.

 

Additional cosmetic veneer because f of the way we are able to do destroy and that wonderful help that  a laser is in our soft  tissue around our cosmetic work let’s say we can  just  do one , one extra peer week we could  add 74 750 to this  practise . Then by doing biopsies. Remember if you have a solution you see the problem and I told   you we do a lot of biopsies because we are looking or things that need to be checked.  If we can just add one per week we can add $23 350 to this practise.  All  together additional procedures, things that we are currently  doing  but we are  just  going to do a few more of them than we have in the past  because of the laser , we could add $210 150 to this practise.

 

Now let’s look at new procedures. Remember we sort of addressed them in the beginning. Let’s not just send them out the door.  I know that I have to use the specialist too and they are e things that we defiantly need to send to the specialist but they are   many very basic procedures that we send out that we can keep in house. Again the $750 000 practise. If h you are  not currently  doing phrenecotmy  and tongue tie releases  remember I told  you earlier that only  5% of the dentist out there  routinely do these procedures .  If you just add one per week you could add $23 550 to this practise.

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