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AnonymousGuestDanny, thanks for the post. Hope you don’t mind I moved it. I have some more questions but am out of time now. I’ll post later.
AnonymousGuestOk, Danny a few questions before the hockey game starts.
In statement 1.you said thicker bone then smaller BW and yet a buccally positioned tooth that has thinner bone would have less BW according to statement 2. Seems contradictory, is there a reason the thinner boned buccally positioned tooth has less BW?
Can I assume to figure out the actual BW you are using the difference between pocket depth and probe depth to bone? If so can you expect the same BW after surgery is done in that area, e.g. say the presurgery BW is 4mm and crown lengthening is done, after the crown lengthening can you expect to get back the same 4mm BW or will it change depending on what changes in shape you make to the bone? What I’m thinking about here is the situation where you have thin kinda pointed bone on the labial and during the lengthening it becomes proportionally less pointed (which I would expect especially w/ a closed laser procedure), tending more to more blunted point, would you then expect less BW than preop ? or is it more a function of thickness as opposed to shape or form?
Hope that makes some kind of sense. Thanks for helping w/ my perio education here 🙂
Dan MelkerSpectatorIn statement 1.you said thicker bone then smaller BW and yet a buccally positioned tooth that has thinner bone would have less BW according to statement 2. Seems contradictory, is there a reason the thinner boned buccally positioned tooth has less BW?
Ron,
Sorry for the confusion
When a tooth is in buccal version the bone is thinner. I have seen BW that encompass from cej to bone a 5mm. distance. At times I see a BW when doing AG procedures of 1mm. The point is to me is that there are factors we can use but many times they do not fall into the categories we would like. Thicker bone usually has thicker tissue. I see excellent growth of BW when dealing with these two factors. Meaning the BW tends to be greater and more stable.(Ron, to me the key is dense connective tissue-great stability)I am a very strong believer of connective tissue and its benefits to stabilization of an area.(long term prevention of recession and bone loss)
As to when I see thin bone buccally(usually thin tissue also) I have seen teeth with dehiscences with huge BW if you can call them BW-7mm. Then I have seen the 1mm. BW with thin tissue and bone.
This my feeling. VISABILITY-that why I am such a big proponent of doing flap surgery(laser or scalpel). You do not guess-you see and deal with the situation. What I am saying is that I am not that good and to help me do the right procedure I need to see.
I will try to answer the next question after I get home.
We try and it is important to give ourselves general information to go by when dealing with our trt. of patients. 1mm. thickness for margins when doing Empress crowns. .3mm when doing Feldspathic rest. etc.
The difference is we are dealing with a dynamic situation the body-BIOLOGY. The whole world is different and by and large every tooth is different. So using a #3mm. for biologic width just just a #. Trying to deal with thw BW is really hard!
Danny -
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