LASER GUM RESHAPING
- Thursday, 09 January 2014 20:40
Sometimes gums overgrow the crowns of the teeth making them look too short at the end of treatment. We sculpt them to look normal
I am pleased to announce the addition of a new instrument/service in the office called the “Sapphire Diode Soft-tissue laser” and have completed the Advanced Diode online soft tissue laser training course granting an Associate Fellowship Certificate in the WCLI (World Clinical Laser Institute)* See below. This laser instrument will permit my office to offer an array of services to treat conditions that commonly arise at the start of orthodontic treatment or occur during and at the end of orthodontic treatment. One of the most common problems at the start of treatment is to expose the surfaces of teeth that are covered with gums to allow braces to be attached to them, and at the end of treatment is the need to resculpture/reshape the gums of patients whose gums have become bulbous/ overgrown/ uneven or misshapen. The Sapphire can accomplish this in most cases painlessly, without swelling and without surgery/bleeding and without the need for stitches. It has a variety of other useful applications. See Video
Below: list of YouTube videos demonstrating a variety of treatment applications using the soft-tissue diode laser for common problem seen before during and after orthodontic treatment as well as for use in treatment of some common gum diseases
The operations the 810 soft tissue diode laser can perform
- Excision and incision biopsies
- Hemostatic/Hemostasis assistance
- Treatment of apthous ulcers
- Gingival incision and excision
- Gingivoplasty (reshaping)
- Gingival troughing
- Gingival recontouring
- Tissue retractions for impressions
- Oral papillectomy
- Sulcular debridement
- Sulcular tissue removal
- Removal of granulation tissue
- Abscess incision and draining excision
- Removal of fibromas
- Soft tissue crown lengthening
The 810 Diode Soft Tissue Laser
In the CW (continuous wave) mode the power to vaporize gum (soft) tissue varies .1 watts to 3.0 watts. 1.5 watts is typical.
In the P (Pulsed wave) mode the power to vaporize gum (soft) tissue varies .1 watts to 5.0 watts.
Here you see me holding the barrel of the laser which is covered by a protective plastic sac.
Here you see me shining the
Here you see the mock start of the maxillary
Here you can see the laser beam within the aiming beam. The beam is being delivered from a 4mm long quartz/glass tip 400 microns wide.
The assistant, the operator and the patient are required to wear the laser 810nm wave length light-specific glasses.
Case Study: Photos of a gingivectomy on RitaS. 113012 with her critique
Critique: The procedure was very good. At first I was nervous I would feel the entire procedure but I didn’t feel a thing. Dr. Ted & Bryan were so catering. Dr. Ted put a numbing cream on the gum of which needed to be removed , and within 3-5 minutes my mouth starting becoming numb then he put the injection in and I didn’t feel a thing. Once my left side of my mouth was completely numb they went in and removed my gum with a laser. The procedure was calming, quick and painless. Out of a scale from 0-10 the procedure was a 0.
Thanks Dr. Ted & Bryan. RitaS.
The Problem: Overgrown Gum preventing placement of a bracket. Solution: Remove overgrown gum by laser evaporation.
Procedure: Place gum-numb paste on gums above tooth; Give injection of local anethesia. Test that patient's gum is deeply anesthetized. Vaporize excess gum away.
Bond a bracket to the tooth.
Replace the arch wire and add an open coil spring to push teeth apart to help make space for the tooth that is stuck.
Tie the bracketed tooth to the arch wire so that as the space is widening the tooth is being pulled forward
Photo of healed surgical site 7 days later.
Literature References (*Articles Available to Read)
- Am J Orthod Dentofacial Orthop. 2005 Feb;127(2):262-4.
HERE AT AAO
* Principles of cosmetic dentistry in orthodontics: Part 3. Laser treatments for tooth eruption and soft tissue problems.
Sarver DM, Yanosky M.
PMID: 15750548 [PubMed - indexed for MEDLINE]
- Dent Clin North Am. 2007 Apr;51(2):525-45, xi.
HERE AT AAO
* Laser use for esthetic soft tissue modification.
Magid KS, Strauss RA.
Department of Cariology and Comprehensive Care, New York University College of Dentistry, 345 East 24th Street, New York, NY 10010, USA. firstname.lastname@example.org In esthetic dentistry, expanding the evaluation beyond the teeth is necessary to achieve a truly desirable result. The lips, attached and unattached mucosa, free gingival margin, and osseous position and contours must be considered and changed if necessary. Although many treatment modalities are available to accomplish these modifications, the use of lasers of varying wavelengths provides advantages not possible by other means. Lasers are often thought of as generic instruments, but different laser wavelengths function differently, and each has its place in the esthetic continuum. Diode, neodymium:YAG, CO(2) and erbium lasers each have advantages that can be exploited to maximum effect and disadvantages that must be taken into consideration. A thorough understanding of their mechanism of action, their tissue effects, and laser safety is vital to obtaining excellent results.
PMID: 17532926 [PubMed - indexed for MEDLINE]