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High-Speed Drilling

Dental turbine

Every medical discipline has its inherent capacity to cause iatrogenic damage, but the dental turbine or rotor, should be considered as a sort of time bomb. Its devastating effects have been completely underestimated by most dentists. As early as 1983, research studies of dental implant surgery demonstrated that, compared with low-speed drilling, using a high-speed drill on bone overheats it and kills or damages cells necessary for healing. The industry has propagated the ergonomic benefits of these high-speed drills, constantly developing more function; and without long-term clinical, histological or pathological monitoring of the effects of turbines in general, the entire dental profession, including universities, has adopted these diabolical machines.

The turbine does not grind down in the manner of slower machines, but rather breaks up the enamel prisms by impact, not only on the edges of cavities and preparations, but also far down into the enamel supposed to remain intact. This has been proven by samples recorded through electron microscope. The cracks thus caused not only allow bacterial toxins, but also the bacteria themselves and macromolecules to pass and penetrate into the dentine, encouraging caries. But the major change is caused in and on the dentine itself.

Many dental practitioners are of the opinion that the pulp receives too much heat due to friction when turbines are used in treatment. Additional abundant cooling would avoid such a burden. Due to the high rotation speed, both a congestion and negative pressure occur on the dentine, and a dry (water-less) zone is formed at the very point of drilling or grinding/milling. After 5-20 seconds of milling or grinding with turbines, there is an increase in pulp temperature by about 22 degrees F., causing irreversible damage in 60% of the pulps examined for this effect. One kind of damage which is not produced thermally, but which equally spells doom to the pulp is damage from negative pressure.

As a result of the high rotation speed, turbulence is produced around the burs, which produces a very high negative pressure over the dentinal tubules. This amounts to as much as a 10 mm water column per 100,000 revolutions. This negative pressure does not increase in linear, but in exponential fashion. As a result of this state, the peritubular dentine linings, the cylindrical odontoblastic processes, are damaged or sometimes torn out. Even odontoblast cores may be partially sucked into the tubules. The metabolic processes in the enamel and dentine regions are disrupted decisively.

Approximately 5 million dentinal tubules per square centimeter (12 million per square inch) are located in the crown area of the pulp. This number decreases down toward the root apex, although it still contains approximately 1.4 million at the cement limit. One single dentinal tubule has a diameter of 1.3 to 4.5 microns. When the drilling or grinding bur is withdrawn, so that the negative pressure ceases, the empty and now open tubules can be filled in a retrograde manner by bacteria and grinding debris, as reported in electron microscope studies. The denatured protein of the destroyed odontoblastic processes and cores can be broken down proteolytically by these bacteria.

Bacterial toxins, capsular antigens and proteolytically broken down protein matter from the dentine tubules act as antigens and result in permanent, auto-aggressive processes and finally in chronic irritation of the pulp. The pulp tissues with damaged odontoblasts then have no chance of survival. They then become the potential focus of infection. Dentists are in no position to differentiate macroscopically whether they are still working in the enamel or are already in the dentine. Even if the bur only contacts the dentine at one single point, the suction effect on the dentinal tubules has then already been produced, causing irreversible damage to the pulp.

The application of conventional methods of pulp testing on teeth treated with turbines in this way merely produces changed sensitivity values. Not until measuring with an electro-acupuncture stimulation current test can the damage be established in an exact manner. Responses to cold or heat stimuli or to electric currents--i.e., via the usual clinical "vitality tests"--provide no evidence for the functionality of the pulp's resistance as an organ. Histological examinations on extracted teeth which had been previously been "treated" with turbines have provided supporting evidence.

When you consider how many dentists apply their turbines day by day without hesitation on millions of patients, you can understand why we consider it a "time-bomb." By means of this machinery, dentists are knowingly or unknowingly damaging the health of their patients, to a criminal degree. When considering the tooth/body connection, it can be surmised that a connection exists between the turbine era and the recent precipitous rise in chronic illness. Turbines have been in use for grinding at least in 99% of dental practices for about 20 years already.

It is a known fact that a chronic disease requires a longer time to develop. If one considers that pulp tissues die at a relatively slow rate and do not always immediately constitute a secondary source to the patient, they must, however, finally result in a breakdown of the local defense mechanism. This fact must at least be given some consideration. It is a belief of many aware ethical biological dentists that the high speed turbines, as presently used in dental practices, must be withdrawn from circulation at least in order to avoid damage, of the kind described, being inflated in the future. Physiological and histological examinations have shown that the upper rotary speed limit is 20,000 rpm.

Hydrokinetic Technology

Hydrokinetic energy is produced by firing laser energy into a spray of atomized water. The water is energized and then is capable of cutting a wide range of human tissue including enamel (the hardest substance in the body), bone, cartilage and soft tissue. Hydrokinetic cutting does not transmit heat to the target tissue whereas other modalities of cutting, such as a high speed dental drill, laser power and electro-cautery, create heat when cutting tissue. As everyone knows, heat causes pain. Hydrokinetic energy can perform numerous dental procedures with little or no pain, virtually eliminating the need for anesthesia in most cases.

With lasers being the dominant instrument of choice in eye surgery, dermatology, surgery and other medical fields, it was only a matter of time before they became the instruments of choice in dentistry. The process is the removal of tissues with YSGG laser-energized water droplets. Hydrokinetic energy is produced by combining a spray of atomized water with laser energy. The resulting Hydrokinetic energy gently and precisely removes a wide range of human tissue including tooth enamel (the hardest substance in the body), and soft tissue (gum tissue) with no heat and no pain in most cases.

The Waterlase works because of its patented Hydrokinetic energy, which is produced by emitting laser energy into a spray of atomized water. The water is energized and is then capable of cutting a wide range of human tissue including enamel (the hardest substance in the human body), bone, cartilage and soft tissue. The Biolase Waterlase uses a unique crystal made from yttrium, scandium, gallium and garnet that is "doped" (laser lingo which means "mixed with") with erbium and chromium to create laser energy of a clinically superior wavelength of 2,780 nanometers. When combined with water, this wavelength produces Hydrokinetic energy with important 21st Century benefits for both the dentist and their patients that include: Most procedures can be done without anesthesia, without needles or patient trauma; Quickly cuts all parts of the tooth including enamel, dentin and caries; Effectively performs numerous soft tissue procedures with little or no bleeding.

The Benefits of the Hydrokinetic Laser

Heat and vibration are the causes of most of the pain associated with the drill. Since Hydrokinetic cutting does not transmit heat or vibration, most dental procedures can be performed with no pain, virtually eliminating the need for anesthesia in most cases.

The laser's pinpoint accuracy is precise enough that your dentist can leave behind as much healthy tooth structure as possible, allowing you to keep your own teeth longer.

Effectively performs numerous soft tissue (gums) procedures with little or no bleeding. The laser gives your dentist a new high-tech tool for many procedures that previously required referral to a specialist. Now you can have them performed during your scheduled appointment.

Avoids many common problems of the high speed drill, including cracks in the teeth from the vibration and rapid turning of the drill burs which can weaken your teeth, creating future problems. The laser sterilizes as it cuts, leaving less chance for bacterial contamination.

The Waterlase prepares your teeth in a way that maximizes the bonding of tooth colored fillings, allowing them to last longer.

Waterlase vs. Drill

The high speed dental drill may cause a smear layer, a layer of dead organic material. The Waterlase creates cuts with no smear layer, providing a better surface for bonding, and allowing your filling to last longer. In October, 1998, the Food and Drug Administration cleared the Waterlase YSGG laser for cutting hard dental tissue including enamel, dentin and caries.

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