Nd:YAG gingivectomy and cosmetics

[dmd92east]

Nice, but I would have been far more aggresive with either the laser or just plain cold steel and sunshine. See articles by Tim Hempton. Good stuff on thid type of treatment.

[etienne]

Nice job!!

I hate these cases, your pictures motivates me to try harder next time 😉

Take care
Etienne

[DinoDMD]

Nice case Matt. And difficult too.
I maybe would have Lanaped it first and then did some tissue re-sculpting for any areas that needed to be touched up later. I have had similar cases ( not as sever as yours however) where Lanap alone let most of the “air” out of the puffy papillas. You just need to be carefull with the  marginal gingiva areas as they have a tendancy of getting over-cooked a bit and later receeding. Nice case. Thanks for sharing.
Nice composites BTW!

Dino

[czeqm8]

Thanks for the compliments.

The reason I treated the gingiva as I did……. This patient is a young girl who has been out of ortho for about 2 weeks. I could not justify lasing more tissue as I feel the tissue will probably take care of itself soon enough. I also could not justify letting her walk around waiting for the tissue to shrink with the cruelty of other children.

Cold steel and sunshine? Really???

Matt

(Edited by czeqm8 at 10:15 pm on July 16, 2006)

[DinoDMD]

Ahhh, makes much more sense now.
As Dr. Evil would say: “I need the info”
Nice Job Matt.

Dino

[dmd92east]

The extra info does help. I thought it was a delayed passive eruption case or medicinally induced hyperplasia. If it just plain old poor OH then great job anyway. Make this patient some custom thicker clear flexible trays and give her some peroxide. 10% carbamide variety.

[czeqm8]

Sorry about the “trick” case guys. You certainly were handicapped with the information I gave.

[JerryD]

Seriously, great job on the composites!
Did you find you had to go back in a few times with the laser as you were prepping or etching to control bleeding?

Great case, Matt!

[Author]

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