PMC7927205_01
Alteration of the smile line related to the abundant gingiva of tooth 1.2 (
a,
b); gingival remodelling by erbium-doped yttrium aluminium garnet (erbium:YAG) laser and its immediate clinical appearance (
c,
d).
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f1
She presented an abundant gingiva covering tooth 1.2 which she wished to remove for aesthetical purposes ( Figure 1a,b). A small amount of anesthesia was injected locally (0.9 ml of mepivacaine cloridrate 2%, 1:100,000 epinephrine) after which the gingiva was remodeled by laser (Key Laser 3-Kavo s.r.l.-Italy) in de-focalized modality (not in contact free beam tip, 180 mJ/10 Hz, poor water emission) until the dental crown was sufficiently exposed according to the patient smile line ( Figure 1c,d).
Second step after seven days (
a); flapless (through the gingival sulcus) bone re-contouring by erbium-doped yttrium aluminium garnet (erbium:YAG) laser (
b) and its clinical appearance after 12 days (
c).
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f2
After one week ( Figure 2a), a second procedure was performed to re-contour the marginal bone by the same laser, using a surgical tip (optical prism scalpel-like tip of 01x10mm, 120 mJ/10 Hz, abundant water emission) in contact modality and through the gingival sulcus (flap-less); a light bleeding occurred during the procedure ( Figure 2b). The gingival margin was completely healed, and the smile line appeared significantly improved 12 days after surgery ( Figure 2c).
PMC7927205_02
Severe abrasion of incisors due to bruxism (
a); erbium-doped yttrium aluminium garnet (erbium:YAG) laser-assisted gingivectomy (
b) and contextual flapless bone remodelling (
c); the clinical appearance after 14 days (
d), the teeth preparation as appearing on computer-aided design and the following prosthetic rehabilitation (
e,
f).
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f3
Caucasian housewife who presented in April 2016 with severe abrasion of the anterior teeth related to bruxism over a long duration ( Figure 3a). After local injection of anesthesia, (1,8 ml of mepivacaine cloridrate 2%, 1:100,000 epinephrine), the marginal gingiva was careful recontoured by erbium:YAG laser (Key Laser 3-Kavo s.r.l.-Italy) (not in contact free beam tip, 180 mJ/10 Hz, poor water emission) till an adequate teeth exposure ( Figure 3b,c); subsequently, the cortical bone was-remodeled by a surgical tip (optical prism scalpel-like tip of 01x10mm, 160 mJ/10 Hz, abundant water emission) on both aspects of the maxilla through the gingival sulcus without flap elevation ( Figure 3d). After 14 days, gingival tissues appeared healed and teeth prepared for the following prosthetic restoration by cemented metal-ceramic crowns. ( Figure 3e,f).