Thursday, July 14, 2011

Ooo! Ahh! Lasers

Getting closer to heading out the San Diego. I am looking forward to it. We are going to take some time and go up to Yosemite National Park. If you have never been there, it is one of the grandest and most beautiful places I have ever been. I like it better than the Grand Canyon. My wife is already a nervous wreck; she thinks my two older boys are going to fall off a cliff.

We own an Odyssey soft tissue laser and I love it. It is great for cuspid exposure, gingivoplasty and several other procedures. I use it mainly for crown and bridge impressions. I listened to a doctor that said LVI is teaching to use it on all crown and bridge cases. It is great to make a small trough around the subginigval margins of the prep and supposedly is much kinder to the tissue than electosurgery with better post-operative healing.

The Odyssey is a little cumbersome to set up, so we ordered a new laser from Discus. It is about the size of a curing light and very simple to use. I am very careful about using it in the esthetic zone. I am worried about gingival recession. I still tend to defer to the two cord technique. I know some studies show that cord still can cause periodontal attachment loss, but I have not had many issues with that.

The laser reps will try to sell it as another way to code and bill and make money. I am sure that is true, but I like it just because it makes my job easier and allows me to achieve the quality work that I want. We do not nickel and dime patients at our office (unless we are trying to have the patient fire us!). We do not try to charge more for using the laser during a crown or bridge procedure. It just makes it easier for me and that is worth a lot. However, I have done some esthetic ginigivoplasty that I would not have done without the laser, and we charged the appropriate fee.

I have not invested in a hard tissue laser. I cannot justify the expense with the limited use. I have seen articles and ads about laser endo. My friend has a laser for his perio practice treating periodontal pockets and promoting reattachment. I have not seen any evidence on those uses, so I do not know what to think about it.

Patients definitely seem impressed that we have a laser and utilize current technology. That is a small benefit for patient confidence in our practice.
What are your thoughts on lasers?

Have a great week.



drjudd said...

I too have the Odyssey Laser. I got it with the Cerec seven years ago. I use it to expose margins vs cord packing. I have not packed a cord in seven years.

It has the attached foot pedel so it is a bit of a pain to lug from op to op. I was looking at the smaller ones like the Discus or the i-lase. I was wondering how you like yours.

A friend of mine has an periolase(?) It was very expensive and he charges like over $3000 to treat a whole mouth for periodontal pocket reduction.

Anonymous said...

Hard tissue laser is still too expensive for me. Like you said considering the limited uses it has. I am still waiting for the prices to come down and for them to have it perfected to the point that a new model is still not coming out ever year. I agree with you, I want the laser to do better dentistry or make life easier. Not simply to charge the patient more money.

Anita said...

Does anyone know which of the smaller lasers are good for perio pocket tx as well as for crown and bridge? i recently got a fax from Denmat about the sapphire diode laser which is reasonably priced. What about replacement parts?


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