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  • #3294 Reply

    Anonymous
    Guest

    Recently I thought I’d try placing some Biofoil postop on a frenectomy. [url= [url=”http://www.bioplanthtr.com/pages/product.html]Biofoil[/url]”]http://www.bioplanthtr.com/pages/product.html]Biofoil[/url][/url] is tauted as an oral bandage/ protective covering. I thought this covering may help prevent some of the reattachment you sometimes see , if it could stay in place long enough.

    Preop
    pre.jpg

    Postop
    post.jpg

    Biofoil
    biofoil.jpg

    Day 8
    day8.jpg

    The biofoil was hard to keep in place if there was any moisture. the directions say to slightly wet it but even a dry piece in this case was hard to keep in place. Patients mother said it only stayed 5 minutes. I’ll try it again but my first impression wasn’t favorable.

    Questions on the frenectomy-

    1. On something as heavy as this one, would it be better to remove a ‘wedge’ of tissue?
    2. Should I have been more aggressive in the area just apical to the attached gingiva?
    3. I made a palatal incision (not visible in these pictures) but wondered if I should have abalted a little more right between the teeth?

    Thanks for your input,

    #9929 Reply

    whitertth
    Spectator

    What laser did u use? Local no Local? Nice result…. I am working on a product now to go along with my topical that may solve the problem of the biofoil… I should have a test sample this week and I will let u know…

    #9920 Reply

    Anonymous
    Guest

    Sorry,
    er,cr:YSGG 1.0W 11/7 w/ topical
    Keep us informed on how the new product works.

    #9933 Reply

    Dan Melker
    Spectator

    ok let me start fresh. Very impressive healing! Ron what seems to be so simple can sometimes be a big problem.
    Your handling of the frenum was perfect. I have seen frenectomies where the individual was aggressive into the papilla removing the muscle. Guess what a loss of papilla height.(black triangle)
    A beautiful case and the thought of using topical only- yes I am a believer.
    Thanks,
    I have a hard head but not that hard!
    Danny

    #9921 Reply

    Anonymous
    Guest

    Danny, thanks! From your answer, I’m glad I wasn’t more aggressive interproximally. When using a scalpel do you find it necessary to severe those fibers on the palatal?

    #9935 Reply

    Dan Melker
    Spectator

    Many times the muscle does not attach on the lingual making a frenectomy very simple. Your situation was much more difficult. Usually I move the muscle on the buccal approx. 3mm. and suture it in place. There should be no pull what so ever. Then I stop and re-evaluate a couple of months down the road.
    These type of cases can have a bad outcome if one gets to aggressive initially.
    Ortho plays a part in how aggressive I become. If the muscle is thick and detering ortho then further removal of the muscle may be necessary.
    Being conservative is a great way to start with these types of muscle attachments.
    Thanks,
    Danny
    Honestly, laser has a great advantage over scalpel when doing frenectomy. Quick healing and minimal anesthesia.

    #9928 Reply

    whitertth
    Spectator

    I like this….I like this alot……

    #9937 Reply

    Glenn van As
    Spectator

    Danny well said……..

    Ron this was a nicely handled case.

    Larry Finkbeiner is a periodontist who uses Argon alot from Colorado Springs and he taught me to sever the fibers on the buccal completely (I am quite aggressive here) and then do a palatal wedge or incision right down to the periosteum to get rid of those fibers when they pull through (there will be blanching at high mag on the palate when you pull the lip out) You check with the mirror before starting.

    Larry kotlow goes right through the papilla alot on the facial but I am scared of doing this, its aggressive.

    I think you did a nice job but I might have extended it a little more.

    I look to see if the guitar strings are all cut and sometimes mine extend further. I usually use anesthetic for these particularly on the lower.

    Glenn

    PS Well done…….GREAT HEALING and wonderful pics

    Glenn

    #9922 Reply

    Anonymous
    Guest
    QUOTE
    Quote: from Glenn van As on 12:30 am on April 29, 2004

    I think you did a nice job but I might have extended it a little more.

    Glenn

    Extend how ,Glenn? Apically,deeper?

    Thanks

    #9934 Reply

    Dan Melker
    Spectator

    Ron,
    We very rarely documents cases that are like this one. But the case is very interesting from the standpoint of altered passive or active eruption. The patient obviously is quite young and eventually may be under going ortho. It would be neat if you could follow her development with pictures.
    In my mind I am thinking down the road-will we need some type of procedure to correct possible APE?
    I have never done this myself because usually I do the frenectomy and never see the patient back.
    Just a thought.
    Danny( I am too old to do it myself!)

    #9936 Reply

    ELLIOT ROGOFF
    Spectator

    Hello all and hope you all had nice long week-end. First time reader and first time poster. I am a new owner of an Opus Duo and Opus Diode. I have two frenectomies to do this week and these posts are perfect for me. In the OLDEN days a frenectomy done by scalpel was done by removing a wedge (two incisions) at the frenum. It appears that only one laser incision is done close to the attached gingiva and the rest is left to heal. Also you go down to periosteum to try to remove as many fibers as possible, here how deep does one go? After all my mentors give me the answers I will do the procedure and let you all know if I passed or not. This forum will be alot of fun and sharing in the future – thanks to all of you.
    Elliot

    #9932 Reply

    Benchwmer
    Spectator

    Elliot,
    What laser are you going to use?
    What laser parameters?
    You have decisions to make.
    Jeff

    #9918 Reply

    Anonymous
    Guest

    Elliot, Welcome to the forum.
    A search for ‘Frenectomy’ will give you a few more threads to consider.

    frensearch.jpg

    Like Jeff said, some of the suggestions will depend on what laser, what the soft tissue looks like, and what parameters you plan on using.

    Be sure to get some pictures to post!

    #9925 Reply

    dkimmel
    Spectator

    Elliot
    How did you do?? By the way welcome!!

    Ron,
    Nice case. So much easier to do these with the laser then the blade. If not from the results ,just in patient management. Kids just have a far better experience.
    David

    #9926 Reply

    michael sim
    Spectator

    Do you think we will have as good a result without cutting all the way to the periosteum by dissecting the frenum fibre at BOTH ENDS . Cut one end as we always do , follow the fibres to its other attachment and cut them there also. I have been doing the simple frenectomy for sometime and i have noticed some relapse in ALL of my cases. I noticed the same in cases posted here. Will try this technique tomorrow and will report back the results later.

    michael

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