Hi Andy……I have come a long ways from my first stuff. To be honest, David Kimmel and others like Matt Brink have a far better understanding of the elements of periodontal surgery than I do. I am weak still in osseous and its details. I know that in some cases for me closed flap is easier to do than open flap because as mentioned I am not as good in handling the flap and tissue as Danny or others.

I know I will never get as good as Danny as even with my scope and being able to see details, he is a surgery god.

I appreciate the patience that some here have shown me. I must admit that I at present am not to excited to show closed flap cases despite the fact that I am doing them for various reasons. I am trying to gather 100 different cases and also get followup on osseous done with the laser. When I get cases that are 2-3 years old , (they are starting to come) then I feel more comfortable.

Oh I will post the final photos of the vertical root amp that Danny showed me how to do. It worked out AWESOME.

The crown is not perfect in contour but the tooth looks great…….

Look for that one…..I am off to find the photos and put them in a collage.

cya and thanks for the nice words, I tell you though, this osseous is a whole other thing.

PS Danny sent me another case, I am off to look at that now, I do learn lots of things, so many details to study and understand about biology and then also to see where things fit in.

I might send him a case of anterior closed flap I did recently in private if he promises to look at it and see what he thinks with an open mind…..it was done because the girl who was 17 wouldnt have ortho, and wouldnt have a surgical flap. I talked to her for a huge amount of time and she finally succumbed to the laser but not to the open flap.

In any event there were some interesting results so far after only 1 month mind you.

Gotta run……

Glenn

Let me first say that I think the result is good. Perfect? No. So the question comes what do I see that is not perfect? How could have the outcome have been different?

First the photos.

before

immediately after surgery

Note on this photo, the gingiva at 9 is the same height and contour as 8.

the most recent follow up.

I think that there is a bit of relapse due to bone that resides sub gingival. The tissue on tooth 9 is still coronal to the tissue on 8. Also the mesial aspect of 9 has rebounded some from the immediate post op.

How could this have been changed? I think that a flap with bone removal would actually have given a bit better result. With that said, would I have wanted to have had surgery with bone removal if I was the patient? Probably not. This result is quite nice, the smile is not a gummy smile, and the surgery would be a lot of extra stuff for very little improvement?

Overall a very nice result that you should be quite happy. I am sure the patient is.

(Edited by czeqm8 at 12:30 pm on May 29, 2006)

(Edited by czeqm8 at 12:31 pm on May 29, 2006)