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…

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

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.

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

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!)

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

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