Dentistry has changed in many ways over the last couple of decades. One of the more recent changes is the growing use of lasers. Some lasers can be used on both hard and soft tissue, and some lasers are designed specifically for soft tissue use. At My Family Dentist, we use soft tissue lasers from Biolase. Specifically, the ezlase and the iLase.
Soft tissue lasers can be used for a large number of conditions. The most common use in our office is reshaping of tissue when doing fillings and crowns. This allows for better access and a better seal for the final restoration. We also use the laser to treat cold sores, remove soft tissue lesions (E.g. elevated bumps on the inner cheek or lip), reshape overgrown tissue, frenectomies, and aid in the treatment of gum disease.
Frenectomies and Z-Plasty
Sometimes tissues do not behave the way we want them to. With the mouth, we can have muscle attachments that do not reshape properly when the teeth come in resulting in high/heavy frenum pulls. These can cause teeth to shift into crooked positions as well as cause the gum tissue to pull away from the teeth exposing the root surface. In other cases, the muscle attachment can be between the floor of the mouth and the tongue causing limited tongue movement. In these cases a soft tissue laser can be used to sever the muscle attachments and free up the tied down tissue, reducing stress and increasing freedom of movement. These types of procedures can also be done the old fashion way using a scalpel and stitches, which can be a lot messier and more painful.
Frenectomy
This patient had a very strong frenum pull on the bottom right. This was causing increased recession of the gum tissue around the adjacent teeth. Over the long term, this can result in bone loss, the decay of the exposed root surface, and tooth movement. To help prevent future damage, the ezlase was used to sever the muscle attachment and reshape the tissue.
Z-Plasty
This patient had an extra short muscle attachment at the base of his tongue causing him to be “tongue-tied”. With this dense, short muscle attachment the tongue had a severely limited movement. The patient also exhibited challenges with swallowing. The process for correcting this is virtually identical to a frenectomy, but due to its location, is called a Z-plasty. After the procedure was done, the patient had increased tongue mobility and noticed an immediate increase in swallowing function. Due to the severity of the condition, it may take two rounds of treatment to fully correct and restore full range of motion.
Tissue Recontouring
In other cases, gum tissue can overgrow and make areas difficult to clean and difficult to fix. In this case, the tissue was severely overgrown and inflamed. As long as this tissue stayed like this, the patient's ability to clean the area was compromised. Reshaping the tissue allowed for easier cleaning and revealed defects in the teeth that could then be properly restored.
