Glenn,
This the nicest, most well documented case I have seen on the board…U did an awesome job!
Great result , you and your patient should be proud of…

Dear Glen
Thankyou for taking the time to document and share such a detailed case.

Keep up the great work.

PS We are looking forward to seeing you in Australia next month!

Kind Regards
Paul

Glenn,

This is much easier to view than on DT. What a great case!! Knowing where you want the teeth in the face and such well thought out planning will give you optimal results. This case of yours has given me pause to reflect on the past cases where I have done crown lengthening closed. On a few, I have had to go back months after the case was put in and numb up the anterior area so that I could probe to bone. Invariably I would find 1 to 2 places where the BW was violated that would make the whole gum area red. Then I would just go in with a scaler, flick off that piece of bone to get to 2.5 mm (margins sunk 0.5 mm sub-g), and everything would be hunky dory.

I know what I do is perio heresy, but I got the idea from John Kois. Again, ignorance is bliss..or not so blissful after Dan Melkers showed his posterior beautiful work and pointed out things in your case that I had never thought of. Also, John NEVER said to do what I do; I apparently mistook his awesome lectures, and began doing closed procedures. He did say that in BW violation cases of the “red-gummed tooth” that he probes to find the offending area and “flicks off” the bony invader. Sorry I went on and on, but you and Dan’s gorgeous work has made me re-think how I am doing things.

I really am interested to see how this turns out cosmetically with balanced gingival architecture and if you ever have to go in to “touch up.”

Thanks, again, Glenn for sharing a remarkably detailed and well thought out case.

Sam

Don’t know how I found this post of yours but I want to thank you for taking the time to do this. Your work is absolutely beautiful and I learned alot just from following your thoughts as you did it. I am new to laser dentistry and can’t wait to see more. I have signed up to attend the ALD meeting in New Orleans and if cases like this are presented then I am in for a treat. I am in the Northeast and don’t really get to hear or see you much. Could you followup with an email to keep me informed of your schedule. Thanks

Glenn,

Very nice case and documentation. I think the results are predictable and will be superb.

I have done some cases like this with the YSGG Erbium and in comparing your great visuals with what I usually see, could we compare notes?

My machine is set at 25 Hz and I notice that you choose 30. Since you have the choice of Hz, has this become your favorite setting and why?

Concerning tissue effects, I do my initial incisions with 0.75 Watts using a 400 micron tip since the 600 micron has to be set at a higher wattage to get the same power density at the tip. I think having a wider incision using the 600 is not important or desirable if suturing. But more to the point, the larger tip seems to leave an obviously ragged edge. Your rate of firing is higher and therefore with a 400 micron tip in motion will leave a smoother edge.

In time I do not think there is a difference in healing results, but the immediate esthetics and predictability of the gingival margin location have to be more easily visualized with or without a scope.

Opps, my rationalizations are showing.

Anyway, great case. I would love your comments on the differences in the Hz and effect on soft tissue raggedness. Is it the Hz or the tip sizeand cruising speed that has greater effect?

I love the patient comfort post-op. I’m sold on Erbium surgery.

Thanks for the time you put in collecting the pictures and posting. I have to find my camera.