What next? - Laser Dentistry Forum

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June 9, 2003 at 12:21 am #3391 Reply

Benchwmer
Spectator

Patient is a seventy something, male. Inflamed and redundant tissue isolated to Mandibular anterior. Tissue condition blamed on poor hygiene, overcrowding and heart meds.

Treatment will consist of laser gingival recontouring, gingivectomy and decontamination of inflamed areas and pockets. FR, pulsed Nd:YAG w/ 340 micron contact fiber. Parameters 3.0W 20 Hz 150 usec to excise, ablate and treat inflamed gingiva.

Immediate post-op photo. Patient now has ability to clean area. Placed on three-month recall.

Redundant tissue is back on #23 at three months.

Retreated area w/ same parameters. Reviewed oral hygiene, maintain on 3-month recall.
After 3-months the tissue is back. The patient doesn’t want to change heart meds (Beta blockers) or improve his hygiene.
I guess you can’t win them all. Will keep on recall schedule.
Jeff

June 9, 2003 at 4:19 am #10819 Reply

Glenn van As
Spectator

Hi Jeff: I find that sometimes I learn more from the failures (regardless of the reason) than the successes.

Thanks for posting……be interesting to see what others suggest.

glenn

June 9, 2003 at 5:55 am #10818 Reply

ASI
Spectator

Hi Jeff,

Suggest to patient to consider more frequent(monthly) visits to reduce inflammation and need to retreat gingival hypertrophy. Otherwise, keep up same recare frequency and retreat as necesssary.

If he doesn’t take suggestion, his position is obvious: he doesn’t want to improve situation.

Andrew
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