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I am trying to post some photos(not all got in) on using my erbium laser for crown lenghtening, troughing for impression, and frenectomy on a cosmetic diastema closure i recently did.
this is the before txt smile–note diastema and dark #9
this is beginning to place gingival crest where I want it
This is final gingival placement. note that the crests are moved mesially for symmetry of the final product
checking the bone levels and adjusting accordingly with the erbium for BW
finishing the frenectomy
same day tempsMossman
(Edited by mossman at 10:27 pm on May 26, 2004)
Hey folks
Most of the photos came through (thanks, Ron). For this case, I mocked up using resin on a model so that I knew exactly where I was placing the gingival contours. I also had to remove bone in some areas (crown lenghtening) in order to preserve biologic width. This, as well as the frenectomy, was done with the Er,cr:YSGG laser. I have been doing closed crown lengthening procedures for about 7-8 years, but with the erbium, there is no swelling, the healing is much swifter, and post op pain is very little. The last photo is the same day temps.
retracted view of final case and
final face view
Note that I moved the gingival crest mesially on the centrals and to a lesser degree on the laterals in order for my final product to have symmetry.
(Edited by mossman at 4:15 pm on May 26, 2004)
Sam,
A bunch of questions…(its hard to tell from the pictures), Did the frenum cause a lot of blanching?/ any recession? Was this just to recontour the thickness in the area between the incisors?
When you say you did crown lengthening w/ a bur, were you talking gingivoplasty that happens going subgingival? or actual bone removal?
In this case was bone just removed on the buccal? How did you blend it into the interproximal areas? (I find it hard to see around the head of the Waterlase to do so, any suggestions?)
Have you considered smoothing the root surface (that will pit @ .25W) with a curette?
Good to have another participant. You’ll be a pro at posting images in no time
Nice case and pictures. Very clear presentation.
You can answer Kaveh’s settings question first.
I have just a comment: I use a waterlase too and (when I remember before starting an anterior labial case) I find the straight handpiece very helpful for seeing around a smaller end (I use 6.0 Loupes too).
I would recommend that you try some other tips, like the C and T series. The G-6 is great for wanting to get a lot done with a bigger footprint tip, like bone removal and big areas of soft tissue removal. But the price is ragged soft tissue surface unless the setting is low and the cruising speed is snails paced. For initial incision I like the T-4 that is 6 mm long. The tissue is not as ragged as when I use the G series. As Gramme recently posted, for surface recontouring of gingiva, the C series produced a cooler center effect and is better at smoothing any bulbous tissue. I think we would get better gingival smoothness out of a 30 Hz setting if I had one.
Nice results.