Hi Bob,

Can’t remember if I went into the technique here, on the DentalTown message boards, or on the DentalTown case presentation site — guess it’s age-related brain fade, huh?

Anyway, I didn’t use a laser at all to festoon the tissue.  Yes, the gingival margin area I used a diode with an itiated tip. But then to blend it in and do the festooning of the surface I used a wheel diamond in a highspeed.  I use the flat end of the wheel, and tilt it just a little as I ‘paint away’ the tissue.

Then after the festooning (thinning and blending it into the new gingival margin) of the tissue, I used the Waterlase in exactly the same way I’d use it when treating a canker sore.  I simply coated the surface a couple times at a low wattage and no water (such that the surface became white).

And just like a canker sore, it worked like a charm.  The patient (who is a dentist himself, and a recognized Townie) has done great and emails me almost every day.  

After a day he was a little alarmed that the papillas seemed to be rapidly re-growing.  He had always HATED his thick, fat, bulbous papillas, and he was totally flipped out at the thin, knife edge papillas we ened up with.  

So when he saw the tissue growing rapidly after a day, he freaked.  I told him not to worry.  Hypertrophy doesn’t happen that fast.  I told him is was simply a bit of edema and would go back to where we’d put it (although I’d taken it away more than I wanted it, in anticipation of growing a new epithelial covering, which it will do).

Anyway, after about three days the edema did go away and the tissue went right back.

But as far as pain, it’s not been an issue.

I haven’t seen him since the surgery, but he is totally excited about the outcome.  I should be seeing him probably within the next week.  I’ll take photos of the 2-3 week post-op and post them.

And yes, I’d agree.  I’d never want to do that sort of festooning with a laser.  The diamond is great because I can ‘feel’ what I’m doing and can sculpt VERY quickly.  The festooning took me no more than two minutes, and probably less.  

But without the laser to desensitize those cut nerve ends after the festooning, holy moly — PAIN would have been the result — BIG TIME!!

By the way, the post-op photo was taken AFTER desensitizing the surface with the Waterlase.  Even though the Waterlase turns the surface white as you use it, as soon as it gets wet, the white disappears.

Rod

(Edited by Rod at 1:31 am on April 3, 2003)

Al,
I agree but at the same time I am lasering in a more defocused position.  The particles are so small that if they did not flash you would not know they are there.  They spark more than arc.   Many of these amalgam  preps are already over preped from the stand point of tooth integrity and if the laser can be successfully used a more conservative quicker result can be achieved.  

Maybe I’ll get that service contract after all.

Pat