Using Lasers for Everyday Dentistry P8

Jan
2014
16

posted by on Gum Disease Prevention

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Matt: Lorne just one other thing the same tips that Rd.  Wilson was speaking about that do not have to be cleave d are also use on the I -Lays. There are disposable, different lengths, different diameters that easily interchange on and off.

 

Lorne: That’s good to know. Don another question about using the laser tips for indo. Is there are risk of those laser tips breaking off in the root canals?

 

Don: They are very flexible Lorne. I’ve never had one that break. We use both the 200 and 400 micron tips.  You never want to force those in the canal. We usually go about too about 2mm  short of the  apex and we’re careful about our  settings but that has not been an issue but you never want to wedge them into the canal  either but they are very flexible and they are designed to be one use.

 

Lorne: Another question you showed a specific case about teeth whitening. Was there any sensitivity on the patient after the whitening and if so how was it treated?

 

Don: We didn’t. If we had we would be treating it with some fluoride butt we didn’t have any post-operative sensitivity at all. I have had the exact same procedures done on myself and I can tell you it was very comfortable. We go through two cycles, the laser will expose abbot a quadrant at a time and we do about j 30 seconds on each quadrant and then we move. It  just take a few outs to activate  the bleaching solution  and then once its activated we  leave it alone for about 5-7  minutes , rinse and the we do it again.

 

Two cycles accomplished  what you saw there and I don’t think I really mentioned it but with the bleaching wand that you saw their on the photograph it can also  be used as  a low  level laser tool and you can set the Boar laser and use  it for  treating TMJ . That’s another nice function of the Easy Lays that you would not be able e to use the bleaching wand on the new I-Lays. It only would allow you to use disposable tips.

 

Lorne: Great we’re down to three questions here. We’re going to finish on time. Have you done any guided tissue regeneration using the laser?

 

Don: I have not personally done that. I have seen Brett Dear present some really nice case on that but in I have not personally done this.

 

Lorne: Another question about the removal of epithelium layer for the peril reattachment.  You might give a quick recap of that and the other question they had was if they could get the slide show. I want to remind everyone that we did record the entire webinar. I’m going to have it on my site, I imagine Schein will have it as well. there’s certifiably will be ways for people l to … When we see you the CE  forms as well as the follow  up  I certainly will let you know when whew available to download and watch the who presentation .  Can you do a quick recap as far as what you recommend there as far as that epithelia layer?

 

Don : I can  run  and I would like to say  to those of you when you purchase the lase and you get a radio fire perio tip Boa Lays u has some really good and concise material   that comes with he tip . It gives you the settings and some diagram sand sort  of the step by step in he procedures so if you need to have that little cheat sheet there as you go along and  do this  for the first few times,

 

The first step is to trap around the tooth, going down in between the tooth and the tissue and because it is a radio filing tip it will shoot energy at an angle towards the tissue which will deapethliaze the lining of the pocket. If you remember form the diagram there is a little blunted in that will allow some energy to go down towards the bottom of pocket.

 

The first thing we’re gapping  to deapethelize the lining of the pocket then after that we will tilt the tip very slightly toward the  tooth  to get a little more favourable  direction on  our radio fire tips , still down inside  the pock and we will use that to go around   using an ear water spray , we will use that to go around an remove calculus that  I down inside  the pocket from the tooth . You will actually see those little bits of calculus coming off.

 

That also property this trot surface for goo reattachment. Then e move outside the pocket and we deapethliase   the outer portion of the pocket, we’re enough inside of the pocket now. So we’re deapethilasing outside the pocket  and we are taking those cells  back away from the top so they have to grow  further before they can turn and go  down in the pocket so we don’t  have the [Inaudible] in the pocket again to   prevent  reattachment . What we are allowing to happen is that the functional epithelium we are giving it a little more time to reattach at the bottom and grow up then once we had done that we use moist tiles and   awe compress very firmly for five minutes to get a blood clot to form underneath there.   That’s a very important step in this I procedure.

 

Then after five  minutes we’ve got  a nice  dry environment and we seal up around the necks of the teeth , the top of the tissue wit  derma bond  and seal that up and then send the patient home .

 

Lorne: When do you bring them back to remove that surface epithelia again or do you?

 

Don: We do , we bring   them back in one week and  if there is any residual derma bond  left on there we would  go ahead an d clean that up . We will deapethlize just the outside of that pocket. That portion doesn’t use anaesthesia   by the way to do that. It’s very comfortable for anybody .We don’t have to sue topical on there. We do not put derma bon on that next time unless it’s in the case of   a smoker that we might but derma bond on it. One more week of we get somebody that smokes.

 

Lorne: When you are deign that RST procedure in your option is that amusing any kind of etching into the trot surface.

 

Don: No, not at the settings that you are using. Another thing with ought getting too technical, the angle of the laser. If we were using a regular 400, 5000, 600 micron tip  , regular tip and wife we were  directly perpendicular  to the roots surface then i would be very  much concerned  about that but because we are going g won into the pocket  parallel  and values we are using radio fire  tips  and we are using the appropriate e  setting s , meaning the wattage  and the pulses per second and air and water because  we are using all of the correct setting as recommended then know that’s not a concern

 

Lorne: Final question. I guesses this is partly for Don, partly for Matt as well. For someone that really just neat to get  more information about laser  is there a good website that they should go to or any video out there, what would either of you recommend for eosin  who is just  thinking about  it and really wants to get a little bit more information  online .

 

Matt: Certainly there are a number of different ways that we would love to help you with him education process. Again I know Don has it on the screen. We would love to come out certainly to youth office and present some different applications and list all the benefits to you and your staff, come in and do a presentation for you ring your lunch.  We have seminars throughout the United States, North America koi that matter.

 

Lorne: re these hands on course matt?

 

Matt: Some  of them are hands on and then some  of them are certainly  just  luncheon presentations  but you  can  go to again the Henry Schein website  and find one  or the  Boa Lays website near  you , a location that’s convenient  and words for tour schedule  and again we would  be more than happy too come into the office ad do an in office demo is that is something that  you also need to get information .

 

Dan: Ladies and gentlemen what is old really recommend to you is to let one of the reps come in and bring a unit in and work with it right there in your office. I think that’s a great way for you to learn. You will get a lot of experience just by having it in your own office and they are happy to do that. There are some wonderful courses, they are designed dos that once you purchase the laser you can come there and take those ads you basic learning but you can also go to those and sit in on them as a learning experience   before you purchase the laser. If you like that so that  you can sort of kick the tires and cleome more  familiar with the  overall technique I  would invite you to go to one of those courses and participate in it .

 

 

Lorne: On more question for you Don, clinical question. If a patient is taking any type of Vida dilators do you see the advantage of using the other lasers such as it relates to equalisation time.

 

Don: There rely isn’t any concrete indication to use in the laser.  That the wonderful things about it, even during pregnancy. Bleeding is not a big problem or us so it is a huge advantage for us being able to do that I recently was in a situation where we did seem crown lengthening on a patient that was 6   month pregnant and owned some blood thinners and did a little own lengthening and even at that time it was just not a problem.  Good question.

 

Lorne: I want to thank bout of you. Don that was an excellent orientation, very informative, we   had a lot goof great k questions here. Matt tanks for being on the call as well. Soon you call all see the phone number bad the website. If you want to get more information, get any office demo, I would highly recommend it. Thanks very much Dr Schein and Boa Lays for helping us with it. Any of you who have ever done a lecture or a webinar know that these things are not easy to put together and it made my life much easier, especially Don it makes my life so much easier when I can just sit here and listen to an expert rather than me having to ring through all these kind of stuff here. Thank again Don. Many of you keno I do these webinars on a regular basis .Thesis is certainly not the last webinar that we are going to do on lasers. When you find out you should have a chance to let us know if you need a little bit more information, some comments. Some of you  would like some more advanced courses, just in soft tissue lasers we can customize anyway you want  but certainly every 3-4  months  I think  I would like to do another laser  webinar.

 

As I said it will be available   on my website. We will let you know about any locations for them. Thank you everyone for being on the call and we will see you’re shortly for the next webinars

 

 

 

 

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