Diode Laser Workshop. John J. Graeber DMD MALD MAGD FICD. East Hanover,
New Jersey
. Dr. John Graeber ...
Diode Laser Workshop John J. Graeber DMD MALD MAGD FICD East Hanover, New Jersey
[email protected]
Dr. John Graeber
AppreicaDon AMD Lasers Biolase Dental Photonics Helios Lasers IvoclarVivadent Sirona SpectraLase Zila (Discus lasers)
Dr. John Graeber
Disclosure r John Graeber DMD has had the following relations and affiliations: Lecturer, Trainer: HOYA ConBio, American Medical Technologies, BioLase Technology, IvoclarVivadent, Opus, and Air-Techniques. Free Equipment: Dental Photonics Air Techniques, American Medical Technologies, BioLase Technology. Discounted Equipment: HOYA ConBio,
Dr. John Graeber
SoN Tissue Pathology
Clear understanding of pathological lesion
Fully trained with convenDonal approaches
Surgical plan
Laser appropriateness
Use Physical or visual surgical guides
ContaindicaDons: GraN HarvesDng
Post operaDve management
Dr. John Graeber
Surgical Principles
So# Tissue:
Clean Field: Chlorhexidine
WYSIWYG
Tissue Tension
No charring
No Scalpel, Suture, bleeding Don’t mix techniques
Second intenDon healing
Dr. John Graeber
SuggesDons
Carrot simulates fibrous Dssue
Tomato simulates granulaDon Dssue
AYempt each of the procedures on Pig Jaws using different devices
Follow procedure list and power suggesDons.
Fibroma removal on tongue papillae
AddiDonal power required: Cold Jaws and Bloodless specimens
Ask manufacturer’s reps for assistance first/se\ngs/photoiniDaDon
Dr. John Graeber
Stripping/Cleaving Video CommonaliDes
Dr. John Graeber
A well cleaved fiber end Dr. John Graeber
Fiber Maintenance………………………
Dr. John Graeber
A well cleaved fiber end
Cleaving……………………………….
"Micro-‐scalpel" created from an bad cleave and an improper break of the fiber: Cause: Heavy Pressure. (SILENT SCRATCH)
Shard
Dr. John Graeber
Dr. John Graeber
A poorly cleaved fiber
Dr. John Graeber
Poorly cleaved fiber aiming beam
Dr. John Graeber
Burned ?p – needs cleaving
OpDcal Purity Necessary for Photonic Transmission From fiber to Target Tissue
Dr. John Graeber
OpDcally pure Good Cleave
Poor cleave
Leads to Loss of Fluence and PotenDal Physical Tissue Damage
Dr. John Graeber
Incident Angle must be Perpendicular to target Dssue
Figure 4-‐2 Diagram showing anatomic landmarks of the gingiva.
Dr. John Graeber
Downloaded from: Carranza’s Clinical Periodontology (on 30 April 2007 02:33 AM) © 2007 Elsevier
Photo IniDaDon
Low Power devices require “priming the Pump”
Follow each Manufacturer’s recommendaDons
Would occur with Dssue ablaDon
“Wears off” Repeat as ablaDon slows down
One touch technique
Thick arDculaDng Paper has most ink available
Avoid Mylar arDculaDng papers
Dr. John Graeber
Dr. John Graeber
Safety glasses stay with devices
Dr. John Graeber
Use appropriate safety eyewear. Photo-‐iniDate fiber acc. to Mfgr DirecDons Cold animal models may require up to twice the power se\ngs than for live specimens; use the lowest se\ng to achieve treatment objecDve with minimal charring of the Dssue. ____ Cut thru carrot slice across the grain 1.0-‐2.0w cw ____ Pierce the tomato surface mulDply,1.0 W PW ____ make incision into pig tongue 3mm deep 1 inch long-‐ use tension and short strokes (4-‐5mm) 1.0-‐2.0 w cw ____ Excise a piece of tongue using hemostat for tension 1.0-‐2.0 W CW ____ PracDce laser decontaminaDon of any deep pocket 1w pw or cw ____ Ablate interproximal papilla 0.8-‐1.2w cw ____ excise enDre papilla, bevel edges to finish 0.8-‐1.2 w cw
Dr. John Graeber
____ perform full gingivectomy at proper bevel 0.8-‐1.2w cw ____ lase uncovered clean root structure 0.8-‐1.2w ____ create trough for impression where gingival Dssue is thick 0.8-‐ 1.5 w on mulDple teeth ____ create ovate ponDc area on rugae of palate 1.0-‐ 1.5w use All ablaDon and double incision techniques ____ prepare a full thickness flap around one tooth 1.0-‐1.5 W CW ____ frenectomy – use hemostat for tension 1.0-‐1.5 W cw ____ Perform a distal wedge procedure on maxilla 1.0-‐2.0W CW ____ Excise a plug of Dssue for an implant in edentulous area 0.8-‐1.2W cw ____ Degranulate a “defect” under the full thickness flap 1.0-‐2.0w cw ____ lase clean tooth structure 0.8-‐1.2 w ( there should be no absorbDon )
Dr. John Graeber
Dr. John Graeber
Thank You for ParDcipaDng John J. Graeber DMD
[email protected]
Dr. John Graeber
