Question:
Just wondering about this. I heard it was a lot less painful, and
equally effective. Don't need one now just curious as i heard about
the procedure 3 yrs ago and haven't heard a peep since.
Answer:
The reason why you have not heard a PEEP is that is is strictly for
CHICKENS.
In fact, hard tissue lasers are becoming increasingly important within
dentistry.
Root canal is stil lbest done by a skilled dentist or endodontist
using rotary instrumentation and not proceeding past the apex (which
is what causes most of the difficulties).
If you follow directions and get the root canal done before you have a
huge abscess and infection root canals are not painful at all.
If you wait until your neck swells up like a ballon hoping the problem
would go away on its own, even a laser would be painful.
As of right now, practitioners prefer the traditional methods since
there are some minor technical difficulties with the laser not being
able to follow the curve of a calcified canal.
I currently do not see any advantage of the laser over the traditional
root canal. In fact due to the expense of the laser, you would be
paying triple for a laser root canal. I single tooth may end up
costing you $5000.00 with the crown, build-up etc whereas now its
about $3000.00. And if you have more than one tooth, you can see it
will get very expensive fast.
Initial hype over a device or technique is often greater than the actual
service offered. I have recently purchased a Waterlase which does have
endo attachments. Some teeth (those *without* amalgam or crowns) could
be opened with less vibration compared to a hand piece which might be
more comfortable.
The other endo use is to use the laser to disinfect the canal spaces
after they have been instrumented and before obturation. If the machine
is sitting in the corner already, the added cost would be minimal.
I don't see it as revolutionary with endo. Maybe SP has more to offer.
The only thing I can add is that I've been using the Millennium (older
model of the Waterlase) since 2001. In that time, I've used it to
advantage for treating teeth, bone, gum tissue, frenums, aphtous ulcers
and the odd herpes lesion. The ONLY place in Endodontics (the practice
of root canal therapy) where I see it as really useful is where there is
chronic pulpitis and pain at or around the apex. I presume that this has
resulted from my inability to get a clean canal, free of debris and
semi-dead nerve tissue, all the way from the pulp chamber to the apex
(tip of the tooth in bone). The way to avoid this, of course, is to have
a good technique with the rotary instruments and to make sure that there
is aggressive cleaning and shaping within the root, and not past it.
I also believe that the Waterlase can soothe teeth that are heating up,
and I think I have saved a few root canals using it in treatment rather
than using ZOE. This, of course, is debatable.
I would also like to see independant studies showing that taking a
non-sterile distilled water-soaked Laser tip into a root canal really is
sterilizing it. Soothing, maybe; sterilizing? Perhaps if the water was
sterile in the first place; but then it goes through this maze of pipes
in the machine and gets squirted out the handpiece. The water that is
atomized in the laser's path will be pulverized, and so that will be
sterile, but the surrounding water will not, IMHO.
It also MAY be useful (using regular hard-tissue tips) in uncovering
hidden canals by carefully lasing the pulpal floor. As W_B or any of you
Endo speed-freaks would observe, if one has good technique in doing
this, one shouldn't need a 50,000$ and plus instrument to accomplish
this task.
The bottom line: To do good Endodontics, on needs FILES and or REAMERS
and such, and a chemiotheraputic agent (NaOCl). The laser is not the
principal instrument, but rather one that MAY aid in soothing teeth as
described above.
I know there's a Laser forum in Dental Town, and maybe someone can ask
them about this, but, as you all can see from the paucity of postings
since I got back from our ODQ dental congress, I have no time. Gawd, I'm
not even finding time to keep up with SMD. Pls don't get down on me
about this, as things will settle down in a few weeks (I hope....).
One last word: for those of you entertaining the notion of buying one of
the older Millennium units: DON'T DO IT! DON'T BE STUPID, as I was. It
ain't worth it, at any price. Get a new model, and profit from the
company support to the max.
