Forums › Laser Treatment Tips and Techniques › Soft Tissue Procedures › Frenectomy
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BenchwmerSpectatorThis may be East Coast .
A seventy year old woman presents with a longitudinal fracture of #13 (non-restorable), already missing #1,3,14,16. ++ Mobility #2,15.
Treatment plan is for an immediate Virginia Partial denture, with extraction of #13 and Maxillary frenectomy at time of insertion. The partial works as a surgical stint.
Before treatment-
The Virginia Partial is a hard acrylic denture with a metal framework, there are no anterior clasps. A soft acrylic flange provides the retention, fitting above the CEJ. In this case the Maxillary frenum needs to be removed to allow room for this band. Akkers #1 clasps were placed on #2,15.
PerioLase pulsed Nd:YAG was used at 3.6W 50Hz 100usec for tissue ablation.
Immediately post-laseInsertion of the Virginia Partial
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2 months post-op
Lab work by Lab One, Richmond, VA
Laser Perio Therapy (LANAP) will now be performed on all 4 quadrants, now that the occlusion can be relieved off #2, 15.
Jeff
Glenn van AsSpectatorNeat case Jeff, given the discussion of healing on these,do you have any Nd Yag frenectomies with post op pics on day 6 or so. I think that in my hands the erbium wins the healing race over the Continuous wave diode but you have both the erbium and the NdYag, I know there is less bleeding with the soft tissue NdYag but how do you feel the healing short term compares.
For me as I posted in the erbium section the erbium wins everytime whether I use water on or off the diode laser.
Glenn
BenchwmerSpectatorGlenn,
I have a frenectomy case on this string from Sept. 2004 comparing Nd:YAG vs. Erbium. The first post-op photos in those cases were from 7-10 days. The Erbium creates a cleaner wound, that heals quicker.
Here is the ten day healing with Nd:YAG vs. seven days with Erbium.
Nd:YAG 10 days
Erbium-7 days
I find myself having to be more aggresive and having to relieve the tissue more using the Erbium so the frenum doesn’t re-attach. The Nd:YAG wound heals slower, but more predictably. There is no char to heal in either case.
Jeff
Robert Gregg DDSSpectatorJeff–
Very nice results. Expertly done.
Try 4 watts 100Hz and 200-300 Joules per large frenum and I think you will see a cleaner wound that heals more like the erbium photo.
Nice cases though!
Bob
SwpmnSpectatorNice frenectomy Jeff.
Your Virginia partial probably also gave the lady an instant Lip Lift!!!
Glenn van AsSpectatorHey Jeff, great points, I think it is interesting to note the healing from various lasers and I think that the NdYag with its high energy per pulse (like the erbium) will probably heal better than a CW diode given all the same circumstances.
Comparing different brands within a wavelength is for me not the same in terms of amount of differences as it is comparing one wavelength to another.
Neat idea about relapse of erbium. Not sure why that would be , I havent seen that but the operator is the same in your case on each one.
All the best
glenn
BenchwmerSpectatorFor Huong to find Case
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