DISGUSTED WITH THE ADA

Today I resigned from the ADA. The ADA working Group on Lasers headed by Charlie cobb published on the ADA website for public consumption.



http://www.ada.org/prof/resources/po...sers_final.asp



I would like to encourage all LANAP dentists to contact the ADA and express your disappointment in their statement.





John S. Findley, D.D.S., president
American Dental Association
211 East Chicago Ave.
Chicago, IL 60611-2678
312-440-2500

1410 East 14th Street
Plano, Texas 75074-6359
972-423-4595
Fax 972-424-6712
findleyj@ada.org

I am writing about the recent ADA Laser Position Statement now published on the ADA website. I find the ADA’s position to be inaccurate and misleading, especially with regards to LANAP. [As an ADA member] I am disappointed in this final statement that was released without review by the clinicians who developed the LANAP protocol,

Specifically is in not accurate to say, “…the therapy included ‘intrasulcular applications’ to remove ‘sulcular epithelium’.” This study reviewed “moderate to advanced” periodontal disease, and as such periodontal pocket applications of the Nd:YAG were investigated.

The second paragraph on the LANAP protocol appears to be conjecture, opinion, and speculation, and is hardly worthy of an official position statement from the ADA. This paragraph and therefore the ADA’s position statement are seriously flawed. Specifically,

1. This study was, at the time, the 4th largest human histology – with a control group – in the prestigious, peer-reviewed periodontal scientific literature. To call it a “pilot validation” or a small sample size is an attempt to minimize the significance of the findings.
2. It is a completely false representation to state that the “study was not blinded”. The study was blinded to the patient (proximate teeth were treated in all but one case), blinded to the calibrated clinical examiner, and blinded to the histologist.
3. It is disingenuous to state the sample size was small. This was a human histological study that involved the block sectioning of the study along with bone. Human Investigation Review Boards (“IRBs) regard human experimentation very seriously. IRBs regard block section removal of teeth even more rigorously. Consequently, (IRBs) bone block sections of human tooth/bone histology is not performed on the same numbers of patients and teeth, as a clinical study comparing established treatment method and that does not involve intention creation of bony defects
4. The placement of the pre-treatment notches were fully explained in the peer-reviewed manuscript in the December 2007 issue of the International Journal of Periodontics and Restorative Dentistry (IJPRD). Yukna, RA; Carr RL; Evans, GH: Histologic Evaluation of an Nd: YAG Laser-Assisted New Attachment Procedure in Humans. Int J Perio Rest Dent 27(6):577-587, 2007
5. It is absolutely baffling what the Council can possibly mean in the statement regarding extrapolation to early and moderate chronic periodontitis, when considering the beneficial outcomes from advanced periodontitis. This statement is more argumentative than enlightening.
6. Similarly argumentative is the Council’s comments on the creation of a stable fibrin clot (referred to as a “seal” by the Council). If the authors do not understand the benefits of creating a stable fibrin (1st connective tissue) clot, then one must question the expertise of the Council and its members in wound healing 101.

ADA American Dental Association

Free Running Pulsed Laser

More laser physics.

The Periolase is a Free Running Pulsed Laser. What that means is that it is pulsed at microseconds.

A microsecond (abbreviated as μs) is one millionth of a second

The Perioslase pulses at 100 microseconds with a repetition rate (Hz) of 20.

When the laser is pulsing at 100us 20hz it stays off for 49,000+us, the equivalent of the pulse being on for 1 second and off for 8 minutes -- plenty of time for the tissues to cool and not cause collateral coagulation and necrosis. The flashlamp gives the ability to have a duty cycle of 0.2% (the time the laser is on, compared to the time it is off). Each pulse at 100ms and 20hz is around 2000 watts which kills any p. gingivalis (pigmented or not) and lots of other species. Most diodes have a functional duty cycle of about 25% due to the low wattage and don't kill the bacteria for the same reason.

This is why a pulsed laser is needed for soft tissue treatment of periodontal disease -- wattages need to be high, duty cycles need to be low.

LASER PERIODONTAL SURGERY

Dental Lasers Depth of Penetration

Nd represents the Periolase the only laser able to do LANAP you can see the depth of penetration can be up to 4 mm. This allows the laser to penetrate into privileged sites deep in the tissue.

Notice the Er being the Erbium (the Syneron, waterlase, Fotana, or Hoya) the CO2 (Deka) have a very shallow depth of penetration.

Laser dentist

Laser Tissue interaction in Periodontal Surgery

This image shows the different dental lasers on the bottom each in their respective wavelength. The Periolase is an ND:Yag with a wavelength of 1064 nm. The lines on the graph show the absorption in each of the different tissues. Notice that Melanin, Hb (Hemoglobin), and HbO2 (Oxigenated hemoglobin) completely disappear at about 1100 nm. This correlates to the increase in absorption in water once the wavelength is absorbed in water the rest of the tissues stop absorbing the energy. Therefore the ND:Yag is highly absorbed in Melanin. Dark pigmented anaerobic bacteria are full of Melanin. Dark pigmented bacteria have been postulated as being the primary bacteria responsible for Periodontitis.

Laser Periodontist

Laser Gum Surgery the Science of LANAP

Why is it that only the Periolase MVP 7 can do LANAP?



Laser phisics 101



L ight

A mplification by

S timulated

E mission of

R adiation



The Electromagnetic spectrum shows the different wavelengths on a graph.













Notice the visible spectrum between 400 and 700 nm the periolase is the ND;Yag that is 1064 nm.


If a laser dentist says that their laser can do LANAP it kind of like saying Blue is Red or Green is Yellow.

Each of these colors has a diferent wavelength and are absorbed diferently in diferent tissues.

LASER DENTAL SURGERY

Show me the laser that Reverses Gum Disease

This is the Periolase MVP 7 it is the only laser that has the FDA clearence to do LANAP.

Don't be fooled by any other laser!

LASER GUM TREATMENT

Alternative to Periodontal Surgery LANAP

Here is a diagram that show the steps of LANAP.

A. = Take measurements of the Periodontal Pocket.

B. = Removal of inner pocket lining with an ND:Yag laser. The laser decontaminates the area.

C. = Scaling an Root Planing is done to remove Tartar and disrupt the Biofilm.

D. = Second pass with the laser allows for a stable Fibrin Clot ones own Tissue Barrier.

E. = Tissue is re adapted to the tooth NO Sutures are used.

F. = Bite is adjusted.

G. = Regeneration.

Periodontal Alternative Treatment