The last step in our series of posts that began with a diagnosis of altered passive eruption is correction of the excess gingival tissue. The correct position for the gingival margins was determined using tooth proportion beginning at the reference of a correct incisal edge location. The information was transferred to a model and a snap on trial smile was created out of Venus Diamond Composite. The corrective procedure begins by trying in the snap on trial smile and letting the patient see what the final result will look like. Today I also took some photographs of the composite in place for the patient to evaluate.
With the green light from the patient to proceed anesthesia was administered. The snap on trial smile serves as the surgical template. I utilize my Deka CO2 Laser for these procedures.
It is efficient, creates incredible clinical results and my patients are amazed by the lack of post-operative discomfort and challenges. With the laser set on repeat I trace around the gingival margins of the composite. Next I remove the composite and using the laser connect the dots and cut almost all the way through the gingival tissue. With a universal scaler the excess tissue can now easily be separated and removed. Holding the laser tip perpendicular I feather out the new gingival margin. The finishing touch once all of the teeth is to evaluate the results, and make any subtle adjustments.
The following video demonstrates the surgical procedure and use of the composite trial smile.
Ann Marie Gorczyca says
Can you do this procedure with simple surgical blade no.12??!!
Lee Ann Brady says
I am sure you can. I am not proficient with a blade and the laser has allowed me to do surgical procedures that otherwise I would shy away from. If you use a blade routinely I am sure you can make this work. i have seen folks make the dots by punching through the tissue around the guide with a perio probe and making bleeding points. then remove the guide and do the rest with a blade.