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Dental Tribune United Kingdom Edition

November 14-20, 2011United Kingdom Edition Our larger, lighter handles set the industry standard for comfort, control and tactile sensitivity, while reducing hand fatigue. PD Light’s Tough super steel tips are individually hand crafed by our employees. Our instruments receive state of the art heat and cryogenic treatment, allowing our instruments to retain their sharp edges longer than other instruments available. We guarantee it! Ergonomic, silicone-handled hand instruments, which combine a comfortable grip, high tactile sensitivity and minimal force requirement. £ 15.53 Special Offer Price Inc. Tax & Shipping FREEPHONE www.dentala2z.co.uk0800 04 39 503 Manufactured in Heidelberg, Germany, our extensive array of products ranges from dental hand instruments through to instruments for dental surgery and implantology. Silicone-handled Hand Instruments Super Steel Instruments Orthodontics TM TM DIE ZUKUNFT DER ZAHNMEDIZIN Exclusively distributed by: Instrument Sets Diagnostics Periodontics RestorationEndodontics * Suitable for steam sterilization 134°C (Autoclave) * Thick non-slip silicone handles * Brightly coloured * Hard wearing working tips * Colour-coded handles for a quicker and clearer orientation Ergonomic, silicone-handled hand instruments £ 13.53 Special Offer Price Inc. Tax & Shipping £ 49.93 Special Offer Price Inc. Tax & Shipping Titanium Coated Periodontal Hand Instruments C M Y CM MY CY CMY K DentalTribuneStripAdvert.pdf 1 7/26/2011 3:02:39 PM scalpel cut, but therefore scar free. After three weeks, at the earliest, the laser cut is com- pletely healed. It is assumed that thermal damage to the external epithelial layer slows the healing process. This undesired result occurs with every thermal laser and therefore with an undesired, related tissue carbonation. Effectively slowing healing The effect described is of use to the experienced laser operator during de-epithelialisation of movable mucomembranes for controlled reproduction of at- tached gingiva. The de-epitheli- alisation area acts as the barrier that slows the healing process. In brief, the area treated with the high-performance laser acts as a natural, resorbable, highly effec- tive membrane with all known and desired effects. The way in which the laser-created autolo- gous membrane can be opti- mally used for ridge preservation will be illustrated later. The sec- ond important factor for optimal bone regeneration is blood, as already conclusively presented and practised by Schulte3 with autologous blood coagulum of cysts. If the vestibular lamella can be retained during tooth re- moval, when compared to a hex- agonal cube, it is about a defect in five of the sides and a missing “lid”. This can be compared to a cyst defect; the sole difference being that no primary wound closure can be achieved without otherwise unnecessary addition- al surgical intervention. Retaining vestibular lamella Accompanying the elap-rp pro- cedure, a whole bleeding of the alveole is absolutely neces- sary postextraction (Fig 1). The bleeding can be achieved con- ventionally via alveole planing or preferably via laser applica- tion. Generally, a claros soft laser (elexxion) in the healing pro- gramme with a pulse of 75mW with 8,000Hz for 120 seconds or with 100mW for 60 seconds, i.e. approx. 6 J per alveole, is suffi- cient in such cases. The T4 soft laser glass rod should be inserted to the base of the alveole and all exposed bone surfaces should be collected on a grid without con- tact (Fig 2). Sometimes, a second or third procedure is necessary, and of course possible, to achieve suffi- cient bleeding. The alveole filled with blood is then membranised (Fig 3) grid-wise with the claros in the haemostasis programme with 30W with 20,000Hz and a pulse duration of 10 seconds with the non-initialised 600 fibre, beginning distally at an unfo- cused distance of one to two mm (Fig 3). This procedure initially re- quires some practice, but is then simple, fast and reproducibly successful. Afterwards, the pa- tient leaves the clinic with in- structions not to brush or rinse too thoroughly (Fig 4). The three-day (Fig 5) and four-week (Fig 6) follow-ups of a different case showed a successful, al- most complete retention of the vestibular lamella. In the follow- ing illustrative examples (Figs 7–10), further results are shown that were also achieved with this new, systematic elap-rp pro- cedure. Please note the almost completely retained vestibular lamella that invites each implant surgeon to a simple and safe im- plantation at a prosthetically sen- sible location. With the elap-rp procedure, ideal conditions for implantation or an ovate pontic can be created quickly and af- fordably without additional ma- terial costs. Use it to offer you pa- tients an optimal and affordable laser treatment. DT Editorial note: A list of references is available from the publisher. page 19DTß About the author Dr Darius Moghtader In den Weingärten 47 55276 Oppenheim Germany dr-moghtader@hotmail.de www.oppenheim-zahnarzt.de www.laser-zahn-arzt.de Fig 1 Condition after extraction Fig 1 Launch of glass rod from laser Fig 3 Membranisation Fig 4 Elap-rp membrane Fig 5 Situation after three days Fig 6 Recall after four weeks Fig 7 Four weeks after elap-rp Fig 8 Six weeks after elap-rp Fig 9 Directly after x and elap-rp Fig 10 Situation after twelve weeks