Crown Lengthening (Closed) #15

Case Summary:

A 63-year-old female patient presented for an emergency visit with a fractured palatal cusp of tooth #15. She experienced cold sensitivity and discomfort in that area. The patient was very apprehensive about dental treatment because she was undergoing chemotherapy and had a session scheduled for the next day. A preoperative diagnostic radiograph showed no endodontic pathology or periodontal disease. Oral evaluation of the patient indicated that the palatal cusp fractured subgingivally to the level of the alveolar crest. A crown lengthening was required in order to expose sufficient tooth structure for a further restoration and to establish biologic width.

Technique Used:

Due to the patient's medical history and her dental anxiety, as no interproximal bone needed to be removed, a flapless (closed) crown lengthening was performed using Solea. The total appointment time was less than 15 minutes, whereas typically appointments like this last approximately 1 hour. The patient was anesthetized with a minimal amount of anesthetic (1/2 carpule of 4% articaine with epi 1:100,000). Using the 1mm spot size with cutting speed between 30-50% and 20% mist, the dentist ablated the gingival tissue until he could see the planned restorative margin. Then he proceeded to remove bone using the 0.75 mm spot size with 80% cutting speed and 50% mist. The laser was aimed down the long axis of the tooth to remove bone between the tooth and soft tissue. The bone was ablated until the osseous crest was 2mm apical to restorative margins. Both steps were completed with virtually no bleeding. To finish, a Piezo scaler was used to smooth the surgical site and a temporary restoration was placed to prevent gingiva from growing back over the ablated area. Note the excellent healing and tissue appearance at one week post-op when the tooth was prepped for a zirconia crown.

Results:

Solea made this challenging procedure amazingly simple for the dentist. He was able to easily treat the patient that he would have referred to a specialist if all he had were traditional tools. The patient reported no post- operative pain or discomfort and remarkably rapid healing was observed, including the growth of healthy soft tissue around the procedure site. She was grateful that the surgery went smoothly, stress-free and much faster than she expected.

Solea Advantage:

• No flap was needed, incredible precision of Solea made this procedure minimally invasive.
• Clean surgical site with virtually no bleeding.
• Reduced procedure time to less than 15 minutes compared to approximately 1 hour with traditional tools.
• The dentist was able to add this procedure to his repertoire.
• Patient experience was improved compared to using traditional tools, and approach was minimally invasive resulting in faster healing.