Anyone tried this...? - Laser Dentistry Forum

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March 9, 2004 at 2:28 am #3333 Reply

cerecdoc
Spectator

I’ve been wondering if erbium lasers can be used in “stillman’s cleft” areas where there is sufficent underlying bone to not likely slough. Say, on a lower cuspid with inadequate attached gingiva, but adequate bony covering of the root. Removing all the way to the bone, the soft tissue and leaving the bone to scar in and grow some new “attached gingiva” which in reality is a scar. (But who cares?) I have heard that 100 years ago dentists used to create very good “new gums” by removing the gum tissue and allowing the bone to scar in (after weeks of laudinum pain med coverage!)

In other words, removing mucosa to the bone, leaving the thin strip of attached gingiva and “asking” the body to grow scar tissue in its place, thereby broadening the band of attached gingiva. (I wish I had pictures, but I haven’t done this myself!)

Has anyone tried this?

March 9, 2004 at 7:15 am #10308 Reply

kellyjblodgettdmd
Spectator

I can’t say that I have, and I wouldn’t want to be the first to try it either. Maybe I could try it on my cat…..

Just kidding. I would love to know if anyone has tried this, though.

Kelly

March 10, 2004 at 4:28 am #10312 Reply

Andrew Satlin
Spectator

Cerecdoc,

The procedure your referring to is called the “denudation technique” (Ochenbein 1960, Corn 1962, Wilderman1964). Also used was the “split flap ” technique which left the periosteum covering the bone(Staffileno et al 1962).

Both procedures result in significant and permanent alveolar bone loss not to mention severe post operative pain.

I am sure you could accomplish these procedures with a laser but I believe the outcome would be the same as with a blade.

Also, we have really improved on the subepithelial connective tissue graft techniques which predictably increase keratinized gingiva and offer root coverage with much less post op discomfort than even the free gingival grafts.

I hope I have been somewhat informative.

Bye all!!

Andy

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April 24, 2004 at 3:14 am #10311 Reply

Dan Melker
Spectator

Andy really said it all. To add, why avoid doing the 2004 procedure to correct the problem-a subepithelial graft. They are extremely successful and very predictable. Adding connective tissue can only be a benefit to a patient and think of it this way- if you could put back a finger that was lost would you-of course.
If you could put back connective that was lost would you-of course.
Thanks’
Danny

April 24, 2004 at 4:30 pm #10309 Reply

kellyjblodgettdmd
Spectator

Danny – Thanks! I’m gonna use that example with my patients. I’m always learning something great on this site!

Kelly

June 6, 2004 at 4:00 am #10310 Reply

lookin4t
Spectator

If you do this over a Stillman’s cleft, in addition to what andy said, you will make the recession worse.

There is unlikely to be any overlying bone for several mm. In this situation, you will get the opposite of the desired result, and it will happen the majority of the time. That cleft area will not be covered, and you will end up with more recession.

Please don’t
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