Forums › Nd:YAG lasers › General Nd:YAG Forum › New Smile
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BenchwmerSpectatorA new patient, 25 year old female presents to my office for exam and restorative.
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 LevoPhotos immediately after Tx
No sutures. no packing, only saline rinses and Motrin
Return in 2 weeks
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)
BenchwmerSpectatorPost-op at 4 weeks:
Note: Healing, knife-edge gingival contoursBefore and after photos:
After
BeforeJeff
(Edited by Benchwmer at 12:04 pm on Mar. 7, 2004)
(Edited by Benchwmer at 12:07 pm on Mar. 7, 2004)
kellyjblodgettdmdSpectatorJeff – 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
ASISpectatorHi Jeff,
Good result to bring out the true tooth dimension that was hidden.
Thanks for sharing.
Andrew
Robert Gregg DDSSpectatorJeff–
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
BenchwmerSpectatorBob,
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
kellyjblodgettdmdSpectatorJeff – 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
John EatonSpectatorJeff, it appears that the frenum reattached at a level near were it started. Is that the case?
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