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  • #2759 Reply

    Benchwmer
    Spectator

    A new patient, 25 year old female presents to my office for exam and restorative.

    Ahlq12401a.jpg
    Ahlq12404b.jpg

    Treatment with consist of laser gingivectomies to treat the delayed passive eruption involving teeth #8,9,10,11.
    Only psuedo-pockets 3mm on Facials, will remove less than 2mm per tooth will not affect biologic width.
    Gingivoplasty to gain proper tissue contours and a Maxillary frenectomy to prevent any future recession.
    The PerioLase free running, pulsed  Nd:YAG laser will be used for all procedures.
    Settings of 3.0W 20 Hz 150usec for GV ans plasties
    3.0W 50Hz 150usec for frenectomy
    Done using LA, infiltration of 4%Citanest and 2% Carbocaine w/ 1/20,000 Levo

    Photos immediately after Tx

    Ahlq12404C.jpg
    Alqu12404D.jpg

    No sutures. no packing, only saline rinses and Motrin
    Return in 2 weeks

    Ahlq2404aa.jpg
    Ahlq2404b.jpg

    Will post 4 week follows, next week.
    Simple 1/2 hour procedure to completely change her smile.
    No one had ever suggested the change.
    She is happy. A happy new patient is always a good thing.

    Jeff

    (Edited by Benchwmer at 4:06 pm on Feb. 29, 2004)

    #5772 Reply

    Benchwmer
    Spectator

    Post-op at 4 weeks:
    Note: Healing, knife-edge gingival contours

    Ahlq21804a.jpg

    Before and after photos:

    After
    Ahlq21804b.jpg
    Before

    Ahlq12401aaa.jpg

    Jeff

    (Edited by Benchwmer at 12:04 pm on Mar. 7, 2004)

    (Edited by Benchwmer at 12:07 pm on Mar. 7, 2004)

    #5769 Reply

    Jeff – nice result. Did you take any “natural” smile pictures? I’d love to see how this affected her smile without the cheek retractors.

    She must be very pleased!

    Kelly

    #5771 Reply

    ASI
    Spectator

    Hi Jeff,

    Good result to bring out the true tooth dimension that was hidden.

    Thanks for sharing.

    Andrew

    #5775 Reply

    Robert Gregg DDS
    Spectator

    Jeff–

    Really nice result in maintaining the papilla and not getting any recession or black triangle.

    I noticed that you had some “beveled” tissue. Is that because you aimed your near-IR FRP Nd:YAG towards the tooth to act as a heat sink, instead of the soft tissue?

    Well done and nice photos.

    Bob

    #5773 Reply

    Benchwmer
    Spectator

    Bob,
    This case shows my answer to one of the 10 questions on on BioLase claims. The Erbium is not the ideal laser for gingivectomies. Where I can approach the gingival tissue at a 90 degree angle w/ the Nd:YAG, remove the bulk of tissue under tension from a tissue forcep, then contour w/o any damage to the underlying tooth. With my Erbium I would have approached the tissue with the laser tip parrallel to the tooth, more difficult to visual the amount of tissue to remove, more bloody.
    I have a choice of lasers. It wasn’t a hard choice in this case.
    Jeff

    #5770 Reply

    Jeff – it’s nice having the choice of Er or Diode/Nd:YAG, isn’t it. You make a great point regarding the appropriate uses of each.

    Kelly

    #5774 Reply

    John Eaton
    Spectator

    Jeff, it appears that the frenum reattached at a level near were it started. Is that the case?

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