Simple Frenectomy - Laser Dentistry Forum

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October 8, 2003 at 6:47 am #3388 Reply

Glenn van As
Spectator

Hi folks: Here is a case I did recently with a 810 nm diode which was pretty simple and really was a nice result.

Used some anesthetic and 10 Hz on the Frenum. Hydrogen Peroxide to remove tags.

I will post the healing photos of the case at 5 days, but I used 1.1-1.9 watts.

Hope you like it……..patient had a large diastema before on the two centrals and brackets are coming of soon.

glenn

October 8, 2003 at 6:49 am #10790 Reply

Glenn van As
Spectator

Here are the 5 day healing pictures. Patient had a little pain for the first day or so.

Cya

Glenn

October 8, 2003 at 8:09 pm #10789 Reply

ASI
Spectator

Hi Glenn,

Nice tissue handling and response. How do you like the 810nm as opposed to the 980nm?

Here is an upper labial frenectomy that I did while doing a prep for Empress I crown on #21 and an Empress porcelain laminate on #11. They are temporized for now.

Pre-op
[img]https://www.laserdentistryforum.com/attachments/upload/wkwan1.JPG[/img]

Immediate post-op. Er:YAG soft tissue tip @20Hz 35mj with air coolant followed by Biolitec 600U fibre@5W 0.05on/0.05off with irrigation.
[img]https://www.laserdentistryforum.com/attachments/upload/wkwan2.JPG[/img]

Andrew

October 8, 2003 at 10:25 pm #10785 Reply

Anonymous
Guest

Anyone tried any of the Biofoil Oral Bandage?

Seems like it would be ideal for these frenectomies- maybe cut down on the reattachment. Or how about instead of periopak?

http://bioplanthtr.com/pages/product.html

October 9, 2003 at 10:50 pm #10797 Reply

Swpmn
Spectator

Great case Glenn the absence of char with your use of the diode is notable.

Here is a case where initially there appears to be no indication for maxillary labial frenectomy:

After performing a crown lengthening procedure on the maxillary anterior teeth, felt it might be prudent to also reduce the frenum. Used the Er:YAG 30 Hz 70 mJoules. You will note a “tissue tag” on the labia which in retrospect perhaps I should have removed:

One week post-op:

Two week post-op:

Al

October 10, 2003 at 4:33 am #10791 Reply

Glenn van As
Spectator

Al: GREAT STUFF and beautiful pics man. Al I have had those little areas as well and you can do one of two things. Either grab a hemostat , grasp it and cut it off with either a diode or erbium or shave it off with the erbium.

That is one of the coolest things is how you can shave or plane tissue down with the erbium…..not very easy with a diode.

I often think that tips that were wider and thicker than the chisel tip would be great for planing tissue or doing things like removing more bone.

For dental tooth structure removal its not as crucial to have wide tips but for soft tissue and bone it does help.

I will post a case where I used the erbium for something COOL today.

Cya

glenn

November 5, 2003 at 12:35 pm #10793 Reply

Kenneth Luk
Spectator

Hi all ,
Anybody tried using 980 alone to do frenectomy?
Is it similar to what Glenn showed with 810?
Thanks,
Ken

November 5, 2003 at 1:44 pm #10788 Reply

marc andre gagnon
Spectator

Hi Ken
I do all of my frenectomy only with the 980nm
It take no more than 30 secondes to do it only with the 980.Most of the time ,you can do the frenectomy with water in pulse mode with a fiber of 400um.The indication for using the er:yag before is a fibrous frenumbecause of the nature of the tissue the 980 does’nt cut well.

November 5, 2003 at 5:33 pm #10794 Reply

Kenneth Luk
Spectator

Thanks Marc,
At what power ?
8w 0.05s/0.05s ?

November 6, 2003 at 12:56 am #10796 Reply

Stewart Rosenberg
Spectator

Ron, I’ve tried both methods you suggested for fenectomies. Some folks place a suture to prevent reattachment. Frankly i have not found the need for any of that stuff. I just give the patient a tube of Oxygel and have them apply it several times a day for the first few days to a week and it does the job fine. I do normally extend the incision 4-5 mm higher than I need to end up just in case there is some reattachment but he gel seems to work fine.

Stu

January 26, 2004 at 4:28 am #10786 Reply

jetsfan
Spectator

Here is my first lower frenectomy with diode 810.
I used Ron K’s topical. I started at 1W but wasn”t cutting easily so I bumped it up to 1.2 and it cut very easily without bleeding. After procedure I applied oxyfresh gel to the surgical site. If you notice the margins look white. I am not sure if that was due to the wattage or this is normal look, or perhaps the gel(although the gel is clear). Patient felt very little and was doing just fine when follow up call made that eve and 2 days later. Further gingival procedures to be considered after ortho. Opinions or suggestions please.

Robert.

January 26, 2004 at 2:54 pm #10795 Reply

Robert Gregg DDS
Spectator

Hi Robert–

The white tissue is epithelium separating and lifting off the connective tissue beneath. It is commonly seen with near-IR lasers, and comes from lateral themal heat transfer near to the incision/ablation site. Usually heals w/o problem, but does indicate the surrounding tissue is starting to overheat.

Bob

January 26, 2004 at 3:12 pm #10792 Reply

Glenn van As
Spectator

Often the epithelium can be removed postoperatively with Hydrogen Peroxide in a syringe with a brush tip that ultradent makes.
In addition, I was wondering if the frenum was removed in total on the left hand side of the incision. I might have been inclined to go just a touch more deeper there.

Just my 02 cents worth…….

Canadian at that.

Glenn

January 27, 2004 at 2:04 am #10787 Reply

jetsfan
Spectator

Bob and Glenn,
Thanks so much for your input.

Robert.
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