Glenn posted an open crownlengthing (CL)case recently that got me thinking. The use of lasers has pushed the use of a closed technique for CL. This is a great selling point for the use of lasers. There is nothing like doing a CL , prep and impression all in one app. Beats the heck out of waiting 3 months. I am just afraid that sometimes we get short sighted. Two questions come to mind :
1.When should you do a closed CL and when is an open CL procedure indicated?
2. In a closed procedure what are some of things we need to look out for?

When I eval a case for CL it is not just about that tooth but the adjacent teeth. You have to make sure after CL that you have adequate crown to root ratio and not blowing through a furcation area. The adjacent teeth are just as important. You do not want a negative gingival or osseous architecture. This seems to be one key in doing a closed CL. If you can do the CL and not leave a negative osseous or gingival defect then a closed procedure is indicated.

I have noticed in the closed CL it is easy to leave a thin layer of bone around the prep. A scaler seems to remove it easily. There is also a tendency to trough the area and the need to go back and blend the bone to get a smooth transition at the interprox as well as buccal lingual. Tougher in the man. molar areas. At times it seems difficult to angle the handpiece along the long access of the tooth. Biolase needs to work on the tips for this. Rather a pain on long preps. So much so would require doing as an opened CL.

Anyone else have some thoughts on this?
David