American Dental Technologies (ADT) pioneered laser use in dentistry and obtained FDA clearance in 1990 for laser-assisted soft tissue procedures. There are different types of lasers based on their operating wavelength. Diode laser is becoming one of the most popular types due to its portability, light weight and versatility. The DioLase ST dental laser system is a portable instrument intended for ablating, incising and coagulating soft tissue using a contact fiber optic delivery system. "Addition of DioLase ST unit to my practice allowed me to perform a variety of cosmetic periodontal procedures in less time and with a more predictable post-operative result", - said Dr. Saldivar, whose focus is on achieving maximum esthetic outcome in dental and periodontal treatment. “Procedures like gingivectomy/gingivoplasty, tissue contouring prior to porcelain veneers and/or crown placement, esthetic crown lengthening, frenectomy, reduction of excessive gingival display or gingival overgrowth, and biopsies constitute a large proportion of contemporary periodontics, and lasers have definitely enhanced the results and simplified the course of treatment”, - further adds Dr. Saldivar. Here is the example of how laser assisted procedure was used to correct gingival color and contour. Brown or dark pigmentation and discoloration of gingival tissue, whether physiological or pathological, can be caused by a variety of local and/or systemic factors. Frequently, the gingival hyperpigmentation is caused by excessive melanin deposition. Melanin hyperpigmented gingiva is an esthetic problem to many individuals, especially those with gummy smiles. People become more conscious of the black or dark patches of pigmentation and request their removal, particularly if the hyperpigmentation is visible during smile and speech. Clinicians have tried to remove melanin hyperpigmentation of the gingiva by various methods. Chemical agents such as phenol and alcohol have been used in combination; however, these chemical agents are quite harmful to oral soft tissues. Free gingival graft surgery has also been used to eliminate the hyperpigmented area; but this requires an additional surgical site and color matching. Abrasion technique, using a large, round diamond bur in a high-speed handpiece with copious irrigation, has also been used, but it is difficult to control the depth of de-epithelialization and to obtain adequate access. Gingivectomy (gum removal) has also been used; however, this is associated with loss of alveolar bone, prolonged healing by secondary intention and excessive pain. Gingevectomy results in non-permanent depigmentation when performed solely for cosmetic reasons. In this case, diode laser was used in eliminating the melanin hyperpigmented gingiva, producing great esthetic result.

If you look closely at your teeth and gums in the mirror, do you see a notable difference in the depth of your gums on each tooth? When you smile, does your grin appear too "gummy"? This can be corrected through the use of a specially design dental laser. Generally, laser gum contouring is done in conjunction with the application of porcelain veneers . However, overly gummy smiles can be contoured to show more teeth than gum.

 

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Appointments :(956) 242 6826
"I used to feel so self-conscious about my smile, but now I smile every chance I get. I feel like I have a 'movie star' smile. Dr. Saldivar and his staff are so nice, they treat you like family." Procedures: 10 porcelain veneers with gum reduction and teeth whitening.
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Laser Dentistry - Gum Shaping

Gingiva Tissue Recontouring

Dr. Saldivar uses one particular laser for providing gum laser treatments that actually gently remove unwanted gum tissue. This treatment has become popularly known as gum shaping, contouring, reshaping, recontouring and in some treatment plans, crown lengthening.

Laser treatment is so precise that Dr. Saldivar is capable of changing the overall appearance of the gumline, from tooth to tooth, producing a great smile.

As can be seen from the photographs to the right, Dr. Saldivar was able to change a nice smile into a luring, almost kiss-able smile. Notice how the symmetry or balance affects the entire smile.

Only laser technologies can offer the precision needed for this type of procedure... and painlessly too.


 

Laser treatments are used in conjunction with the application of porcelain veneers that do wonders for straightening smile lines and producing symmetry in a smile. This technique is popularly known as Instant Orthodontics.

Hand crafted with precision by professional dental labs and applied one by one by Dr. Saldivar,porcelain veneers are fitted and bonded to each tooth. Gaps and other imperfections disappear thereby producing a fuller appearance.

The picture here reveals how Dr.Saldivar skillful application of porcelain veneers and use of Laser technology produces a near orthodontically correct smile.

One laser is used to trim soft tissue in the gum line while yet another laser is used to trim some of the teeth thereby producing a smile line and biting surface that is orthodontically even.

 

The adjacent photos show another example of laser treatments for the gummy smile.

In the top photo the lack of symmetry can be seen, giving the appearance of having smaller teeth. For some patients this can produce an appearance of what seems to be juvenille teeth.

 

Notice how in this second post operative treatment photo the teeth now appear much larger (adult sized) and produces a smile that is fuller, brighter (laser whitening) and more esthetically balanced.

The application of laser gum reshaping and re-contouring can create smiles that produce a better "fit" for a patient's physical features.


 

 

Gum Contouring - Improving Your Smile Correcting a Patient’s ‘Gummy’ Smile With Ease and Predictability     Photo 1 Patient's chief complaint is that her teeth are too short. Patient also complains that she shows too much gum tissue when she smiles as well.     Photo 2 The X-Rite Shade Vision system is used to determine the pre-op shade of the teeth.     Photo 3 Unlike other shade systems, Shade Vision sends a color image to the laboratory technician with the shade map so the technician can see the actual tooth.     Photo 4 A pre-op measurement of the teeth confirms that the clinical crown length is inadequate.     Photo 5 A periodontal probe is used to measure the depth of the existing pocket. As a result of the minimal pocket depth, it will be necessary to remove bone to establish proper biological width.     Photo 6 The proposed gingivectomy is drawn on the tissue with a marker. A lab fabricated splint can also be used to assist in marking the tissue to be removed.     Photo 7 Initial gingivectomy incisions being made with the Biolase diode laser. Note the absence of bleeding at the surgical site.     Photo 8 The gingivectomy is complete. If left as is, this would create a major biologic width violation, and this tissue would remain constantly inflamed, and would most likely attempt to re-grow. The osseous recoand provisionalization.     Photo 9 The clinical crown lengths are measured again to verify the desired lengths have been reached. The patient is allowed to view this initial result and give any input.     Photo 10 The veneer preparations are now accomplished utilized standard techniques, beginning with placement of facial depth cuts.     Photo 11 The veneer preparations have now been completed. The gingival margins of the preparations are placed at level of the new gingival crest.     Photo 12 A hard bite material, Luxabite, is injected between the teeth. Unlike many polyvinylsiloxane registration materials, Luxabite exhibits no flexibility that can lead to errors.     Photo 13 A D&D Double Bite Tray (Superior Surgical & Dental Manufacturing, Inc.) was used which gives the dentist and the lab technician the best of both worlds.     Photo 14 Due to the lack of subgingival margins, no retraction cord is necessary to produce this highly accurate impression with Honigum heavy and light body.     Photo 15 Temphase bisacryl provisionals are “spot-etched” into place and a thin layer of Luxaglaze is light cured onto the provisionals to enhance vitality.     Photo 16 With the provisionals in place the crown lengthening procedure can now begin. Intrasulcular incisions are made around the facial aspects of the teeth in order to reflect the flap.     Photo 17 With the flap reflected it is readily apparent there is not the required 3-4 mm of biological width between the restorative margin and the osseous crest.     Photo 18 The Waterlase from Biolase is a hard tissue laser that safely and conservatively removes and recontours osseous tissue.     Photo 19 Osseous recontouring is finished and it is now apparent that we have the proper vertical dimension between the osseous crest and the margin of the restoration. At this point the margins of the provisionals should be finished in the mouth to insure a smooth junction to promote gingival healing.     Photo 20 Sutures have been placed and the patient will be reappointed in 5-7 days for suture removal and a post-op check.     Photo 21 It has been 7 weeks since the preparation/surgical appointment. The excess of gingival tissue visible on the pre-op portrait is now gone. A closer look at the smile shows a dramatic difference when compared to the pre-op smile close-up seen in Photo 1.     Photo 22 A close-up facial view of the tissues show no signs that any surgery took place. This type of quick, complete healing is typical of laser surgery.     Photo 23 Extreme close-up of central incisors. Note vitality of restorations.     Photo 24 Extreme close-up of right lateral incisor. Note the optimum gingival health.     Photo 25 Extreme close-up of left lateral incisor. Recall that the margins were placed at the gingival crest, and even after the surgery, the gingival crest has remained in the same position as is often the case with laser surgery.

 

Laser-assisted surgery is not a substitute for conventional periodontal procedures. However, when used in appropriate cases, laser offers superior healing potential and more predictable esthetic results achieved in a shorter time. It can also enhance the outcome of ever so demanding restorative procedures, like porcelain veneers and other anterior restorations.If you have any questions or would like to discuss your case, please do not hesitate to contact Dr. Saldivar. We look forward to helping you achieve great health and a beautiful smile!

                       Laser Canker Sore Treatment
Many people needlessly suffer from canker sores or Apthous ulcers. Gentle Laser energy is used in our office to quickly heal these painful and sometimes debilitating mouth ulcers. Not only is the pain reduced immediately, but the ulcers heal in 1 day versus the usual 10-day healing period.Pain relief is immediate and lasts throughout the healing process.Aphthae (or canker sores) are ulcers that are typically round or oval and occur on the inside of the lips or underneath the tongue. They are very common and affect between 30-60% of the population.
The cause of aphthae is still uncertain but hereditary factors are certainly significant with approximately 40% of people who get them having a family history of aphthae.
The main causes of aphthous ulcers include: emotional stress and lack of sleep, local injury by an accidental self-inflicted bite, nutritional/vitamin deficiencies (especially iron and folic acid, vitamins B1, B2, B6, B12 and vitamin C), the menstrual cycle and certain foods (including coffee and chocolate). Aphthae can be divided into three types of ulcers.
Recurrent minor ulcers amount for over 80% of aphthae cases. These are usually between 1-10mm in diameter and heal spontaneously within 7-10 days. Recurrent major ulcers can be in excess of 10mm in diameter and can take months to heal. When they do the usually leave a scar behind. Herpetiform ulcers are multiple, clustered 'pin-prick' ulcers that usually occur on the tongue and can take up to a month to heal. Usually numbering between 2-10 they can number as many as 100.
In all cases, but especially with recurrent major ulcers, the sores can be painful, particularly if irritated by certain foods.
The herpes simplex virus is very common and can cause painful blisters and sores almost anywhere on a persons body. However infections are most common around the mouth and the genitals. Consequently herpes can be divided into two types: type 1 and type 2.
Herpes Simplex Type-1 (Herpes Labials, also known as Cold Sores) : It is estimated that between 60% and as many as 95% of people are infected with HSV-1 although only between 10-30% of these will develop recurrent oral-facial herpes infections. Most people catch the virus during childhood from close contact with family or friends who carry the virus. The virus can be transmitted by kissing, or by using glasses, cups and eating utensils or towels used by an infected person.
The main symptom of HSV-1 infection is the outbreak of blisters filled with fluid around the lips or nose. These can be painful and itchy. Other flu-like symptoms may accompany these outbreaks including fever, headache, muscles aches, and tiredness.
Usually the blisters will disappear by themselves within ten days but the virus will remain dormant in the body among clusters of nerve cells until the next outbreak is triggered. Common triggers include: illness, stress, fatigue and menstruation.
Many people are able to tell when an outbreak is going to occur because they notice a tingling sensation (known as the prodome stage). It is also at this stage when a person is particularly contagious.There is no cure for aphthae. Treatment consists of different medications to reduce the pain and discomfort they cause and to promote/accelerate the healing process. Such medications include: local anaesthetic gels to reduce the pain, antibacterial mouthwashes, protective pastes and in extreme cases sufferers may be prescribed topical corticosteroids.
There is also no cure for herpes simplex. However, traditional treatment involves the use of anti-viral drugs such as Acylovir. Acylovir has been shown to help speed up the infection cycle hastening the end of the outbreak. If used in the prodome stage it can also prevent the development of blisters and it has also been shown to reduce the number of future outbreaks.Studies have shown that patients who have their aphthae treated by laser therapy have immediate pain relief, faster healing and fewer recurrences in the future.
The application of laser energy to a person with HSV-1 equally has significant effects. If applied during the prodormal period nearly all patients will heal within the first 48 hours. In later stages (blistering or crust) over 90% will be cured within 48 hours and all by 4 days. In most cases between 2-4 treatments with laser energy will be required. In addition studies reveal that patients that have laser therapy for the treatment of herpes also see fewer recurrences when compared to conventional treatments.
The diode laser is an ideal choice for the treatment of aphthous ulcers and herpes simplex.