A multitude of technology - Laser Dentistry Forum

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May 17, 2003 at 8:38 pm #2826 Reply

Glenn van As
Spectator

Posted on 05/17/2003 by glennvanas Rows | Index

Hi there: Here is a case where were doing some cosmetics for a patient who had a bad fall as a teenager.

Using a Digital SLR camera we took a preop smile (Nikon D1) then moved over to the scope and took some pics of the waxup and study models.

The gingival height of contour was a tiny bit of on the two laterals so we lengthened them after probing (4mm tissue on them) to get them the same height as the centrals. We use the erbium laser to do this.

WHen prepping the lateral it was discovered that the mesial surface of the canine had a small carious lesion. I used the Ultrasonic Sheets SL tips to prep this and these are made by spartan obtura.

The preps were done and then a soft tissue laser was used to trough the tissue for the impressions.

Temps were fabricated and then we noticed that the frenum was quite thick so it was removed with the erbium laser (hence the bleeding).

These are just alternatives to traditional means and arent meant to be a reflection that cords, burs and electrosurges cant be used.

The whole case was done under the dental operating microscopes we use and the photographs taken through them.

I have over the last 4 years tried to install a high tech “difference” to our office while trying to retain a hi touch as well. Its kinda our practice niche and sometimes people will ask if the hi tech are just for show. We use them all day and in a typical case this is how some of the items might be used. Again dont think that it couldnt have been done in any other fashion.

Glenn

May 18, 2003 at 4:35 am #6402 Reply

ASI
Spectator

Hi Glenn,

Very nice documentation. Indeed an illustration of a plethora of high tech applications that not only create a successful outcome, but provide an enjoyable treatment experience for both the patient and the clinician.
The WOW factor must be in the exponential for all involved.

Andrew

May 18, 2003 at 5:06 am #6407 Reply

Glenn van As
Spectator

Hey Andrew………great seeing you yesterday.

I will post another interesting case in a minute, but once you get the laser and the scope you just keep pushing the envelope to see where it will end.

I pushed one too far recently and had some poor healing under a pontic on a bridge we tried to do immediately.

Dealing with that headache these days but all in all it is a fun time in the office.

ALl the best and give me a call when you get the stuff and I will try to come by and spend a couple of hours with you.

Glenn

May 18, 2003 at 11:46 am #6403 Reply

ASI
Spectator

Thanks, Glenn.
I think I speak for all when I express my gratitude for all you share.
I really like the way in which you display your photos. The organized and sequential fashion is so pretty and captivating to look at that I find myself revisitng them over and over again.
Like the line in Bugs Life: I can’t help it! It’s so pretty to look at!
Like Mike Swick said a couple days ago: You da man!

Andrew

May 20, 2003 at 4:18 am #6408 Reply

Glenn van As
Spectator

Hi Andrew: I will say this that when I started using the scope 5+ years ago I was astonished at what I could see and I started trying to take photos (35mm). Man was it hard. I was so thrilled when some of the digital cameras could be mounted to the scope…..it was revolutionary for me.

To be able to photograph what I saw through the scope was unbelievable. Over the years I have read quite a bit on digital photography and learned some more from masters like Gary Carr, Eric Herbranson and some who dont use a scope. The amazing thing about the scope is how easy it is to take the photos and to document procedures……

ACDSee 5.0 is a pretty good archiving program and the ability to make collages from the photos is pretty easy in there so thats how it all came about.

Who knows……maybe one day I will make a book out of them all but that remains to be seen.

I gotta get a DVD burner soon and back up all the images I have on a hard drive or a DVD or two.

Take care and thanks for making my day……

Glenn

May 20, 2003 at 6:01 pm #6415 Reply

Robert Gregg
Participant

CLAP CLAP CLAP

Here Here!!

I concur.

Woo Whoo!

I EXPECT a book one day from you Glenn. Heck, It oughta be on DVD.

Andrew, I forgot how handsome and distinguished you are!! Dang that’s a great picture of you and your next-door neighbors!

Bob

May 21, 2003 at 3:10 am #6409 Reply

Glenn van As
Spectator

Bob I tried to edit the laker girls tshirts to say LASER…..but I got too tired to do it………

Maybe I still will and get a laugh out of it……..

Great pic andrew……..god that suit attracts them doesnt it!!

Grin

Cya

Glenn

May 21, 2003 at 3:26 am #6404 Reply

ASI
Spectator

Hi Bob,

Anyone would look half decent when accompanied with such eye candy support. You know how it is when an ordinary picture looks better in an attractive frame? Good thing those LA Lasers(Lakers) gals had me to bring out the beauty in them.

Seriously, you are too kind in your praise. But certainly not so in your praise for Glenn though. Mind you, you are not too shabby yourself. You are just a walking encyclopedia of laser physics and clinical application.

Best regards,

Andrew

May 31, 2003 at 2:39 pm #6410 Reply

Glenn van As
Spectator

Hi folks: Here is the finish of the case. Please look back at what we accomplished as the photos are at the top of this page.

THese are Empress crowns, custom shaded at the lab, and they were cemented in with Glass Ionomer.

Patient and I were very happy and I think the final result is pretty nice.

The frenectomy healed great and the contouring allowed for the gingival height of contour to be the same throughout the maxillary anterior.

One thing when you have a laser is you really start focussing on the height of contour in these cosmetic cases , especially those with a high smile line……….

I am going to actually post some post op photos when he comes back to show you how the tissue heals after I get my average fitting temps off. Hard to get a smile when they are so numb.

Hope you like it……….

Thanks

Glenn

May 31, 2003 at 8:45 pm #6417 Reply

Andrew Satlin
Spectator

Hi Glenn,
Very nice case. Great tissue healing at two weeks!
Forgive me but I am still a rookie. Erbium recontouring– is that a gingivectomy for esthetics? Then why the troughing? Is that also done with the erbium?
Andy

May 31, 2003 at 10:54 pm #6406 Reply

Glenn van As
Spectator

Hi Andy: I used the erbium to recontour the tissue so the heights of contour (the gingival heights) would be similar.

The troughing is done to back the tissue from the margins for impressions to get a sharp margin.

All the best…..

Glenn

August 28, 2003 at 4:24 am #6411 Reply

Glenn van As
Spectator

I have taken some grief from some on Dental Town over the final results so I thought I would show you some postop pics of the case……..

These are 8 month post op and some preops.

Glenn

August 28, 2003 at 2:56 pm #6416 Reply

Robert Gregg DDS
Spectator

Glenn–

You got GRIEF on Dental Town???:confused:

Since when?

Beautiful result, and nice validation of the need for the frenum release…….

Bob

August 29, 2003 at 4:14 am #6401 Reply

2thlaser
Spectator

Good Grief, what grief? Great stuff Glenn, what a beautiful result, and the patient I am sure is very pleased!

Mark

August 29, 2003 at 6:50 pm #6414 Reply

Kenneth Luk
Spectator

Hi Glenn,
Excellent papilla re-growth between central incisors( 2 wks post-op to 8 mths post-op )
Ken
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