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    How to perform closed crown lengthening with an all-tissue CO2 laser

    A demonstration of how to remove both soft tissue and bone using a Solea® dental laser.

    A 63-year-old female patient presented for an emergency visit having fractured off the palatal cusp of tooth #15. She experienced cold sensitivity and discomfort in that area. The patient was very apprehensive about dental surgery because she was undergoing chemotherapy and had a session scheduled for the next day.

    A pre-operative diagnostic radiograph showed no endodontic pathology. She is in excellent periodontal health (Fig. 1). Oral evaluation of the patient indicated that the palatal cusp of #15 fractured subgingivally to the level of the alveolar crest (Fig. 2).

    Figure 1 RadiographFig. 2 Pre-op
    Fig. 1                                                                                                              Fig. 2

    Case study

    A crown lengthening was required in order to expose sufficient tooth structure for a further restoration and to establish biologic width. As no interproximal bone needed to be removed, a flapless (closed) crown lengthening was to be performed using Solea®

    Figure 3 gingiva removedFig. 3Due to the patient’s medical history and her dental anxiety, crown lengthening via traditional instruments and technique would have been problematic.

    The patient was anesthetized with a minimal amount of anesthetic (¼ carpule of 4 percent articaine with epi 1:100,000) injected to the palatal of tooth #15. This procedure is often performed without injection, but she was too worried about sensation and preferred to receive an injection.

    Using the 1 mm spot size with cutting speed between 30-50 percent and 20 percent mist, the gingival tissue was ablated until the planned restorative margin could be seen (Fig. 3).

    Joshua Weintraub, DDS
    Joshua P. Weintraub, DDS, is a 1996 graduate of the University of Maryland Dental School. He began his dental career in the U.S. Navy ...

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