Tissue response - Laser Dentistry Forum

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October 25, 2003 at 8:48 am #3543 Reply

kellyjblodgettdmd
Spectator

I thought I’d share some pictures of a case that turned out nicely. Patient fractured the L cusp of max premolar to the osseous crest. She was leaving town that day, so I just temporized the tooth with Miricle Mix. Upon her return I prepped the tooth for a crown, placing the margin where I wanted it first, then dropping the tissue and bone 3mm past the margin. I was concerned placing the temp as to how the tissue would heal. At final cementation, however, the tissue looked great, as you can see. Crown was cemented 3 weeks after prep.

October 25, 2003 at 8:56 am #12284 Reply

kellyjblodgettdmd
Spectator

Sorry – I’m having technical difficulties with the pictures. I’ll keep trying.

October 25, 2003 at 8:21 pm #12289 Reply

ASI
Spectator

Hi Kelly,

Nice result and handling of the tissue. Limited osseous reduction such as this is one of the most versatile uses of the erbium laser.

Thanks for sharing.

How are you doing the photos? With an intra-oral camera?

Andrew

October 25, 2003 at 10:24 pm #12293 Reply

Swpmn
Spectator

Great case and result Kelly!!!! Think yours was a good indication for a closed osseous crown lengthening with an erbium.

Al

October 26, 2003 at 4:03 am #12288 Reply

whitertth
Spectator

very nice case….keep up the good work!

October 26, 2003 at 3:06 pm #12283 Reply

jetsfan
Spectator

kelly,
Looks great but I do have a few questions.
From the pictures , it looks like you have created a 3mm trough in bone around the tooth. If so, what are the negative sequalae of that, if any? If not a trough , how do yo smooth out the ledge?
In classical perio surgery, we are taught to blend the bone level toward the adjacent teeth to create smooth contours. If you did that , how did you do it , if not why not?
It doesn’t look as though you extended to direct buccal. If you dropped the bone on the interprox, are you obligated to drop it even lower on direct buccal and lingual, lest you create negative architecture?

October 27, 2003 at 6:43 am #12290 Reply

Glenn van As
Spectator

Kelly: CLAP CLAP CLAP………..

I like the erbium as well for osseous and am also in favor of limited cases where perhaps closed flap can be of benefit. I think that your pics document this accurately and beautifully and the healing is very very nice.

Its a win win for both patient and dentist. You saved the tooth with minimal intervention. I applaud your efforts and really believe that in the next 2 years we will see ALOT of science pointed at when to do closed flap and open flap with the erbium.

A word of caution to the neophytes to make sure to have LOTS of water on the bone, and minimal amounts of air to avoid burning the bone and to eliminate the potential for air emphysemas.

I like your case Kelly ………ALOT.

Thanks for sharing.

glenn

October 28, 2003 at 1:05 am #12285 Reply

kellyjblodgettdmd
Spectator

Thanks to all for the words of encouragement.

Jetsfan – great questions! I be happy to tell you how I approach these situations. Whether I flap or not is case dependant. In this case, I dropped the bone 3mm past the margin, then elevated the tissue slightly to get a perio file on the bone. A couple of minutes later I had a smooth bony contour.

With regards to extending to the buccal, I tried to create a blending as it extended buccally reaching the original bone level @ midroot (bucco-lingually).

Sometimes I just lay a flap as in this case I did today.

I spoke with the patient 10 minutes ago, and she is comfortable taking 600mg ibuprofen q8h.

October 28, 2003 at 11:22 pm #12294 Reply

Swpmn
Spectator

Kelly:

Nice to see a flapped crown lengthening procedure which is probably the best technique. Gotta be cognizant of the air embolism risks however. Your case should heal nicely.

Al

October 29, 2003 at 4:26 am #12282 Reply

dkimmel
Spectator

Kelly are using a scope?
David

November 4, 2003 at 5:56 am #12286 Reply

kellyjblodgettdmd
Spectator

Dave: Thanks for asking. No, I’m not using a scope, but my new Zeiss Pico is getting installed in about 2.5 weeks. I can’t wait! I’m taking these pictures with a Nikon Coolpix 5000 with a non-flashing ring light. It’s not the best camera, but it does pretty well, especially for the price.

November 4, 2003 at 6:05 am #12291 Reply

Glenn van As
Spectator

Hey Kelly…….dont tell David he is going to have scope envy.

COngrats there Kelly, after you have played with it a while and if you are getting frustrated email me as I am just releasing a DVD on scope positioning which will be available next week.

Take care and congrats.

Glenn

November 4, 2003 at 5:37 pm #12287 Reply

kellyjblodgettdmd
Spectator

Thanks, Glenn. I’m sure I’ll be contacting you as questions arise.

Have a great day!

Kelly

November 4, 2003 at 7:54 pm #12292 Reply

Stewart Rosenberg
Spectator

I must add my kudos Kelly. Beautiful case!

Stu
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Viewing 14 posts - 1 through 14 (of 14 total)