1 yr. post-op Closed Piezo Lengthening

Nice result Dr. Paul. Can we maintain a change in Biotype when performing these cases? Example, thin scalloped to thick flat?
thanks Sam

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Great result. Where do I find the video of this procedure thanks

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Anterior/Esthetic - vídeos

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Paul,
Very nice improvement. You have done as well as could be expected with a closed approach. Personally, I feel you could have done better with an open approach. It seems to me the interproximal regions are thick,as I prefer to scallop these areas. I don't think that be accomplished with a closed approach. Also, not clear on the advantage of the closed approach. Am I missing something here?
Chuck

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Paul; Yes, why closed approach but great improvement. What are the probing depths one year out? Just curious as I find these cases continue to "rebound" tissue even after 1 year.....and very much appreciate the follow up. That's really great to share these. We often do not see the 1,2, 3 year radiographs or photos of the work presented which is the real information of predictability.
thanks Maurice

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Minimal probing depths.

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Closed approach because pt. would not let me open her gums. As I said I present this as a concept for discussion.
I think I made the teeth too triangular because I took away too much tissue at cervical before ostectomy. The most impressive thing was how comfortable the patient was after the procedure. More study needed.

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Paul,
For the purpose of discussion, why should this approach be encouraged?It seems to me this approach is case selective and there could be significant consequense if used under the wrong conditions.
In addition, how do you propose it can be studied?
Chuck

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Chuck,
I think like a lot of closed procedures (knees, hip, heart)
there may less morbidity. Could be studied on primates.
My question is whether the roots are left rougher and prone to long term problems. Also can we control the healed results of the marginal gingivae as well.

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Paul,
I agree you certainly ask the right questions and point out legitimate concerns with the closed approach.
I question, whether the benefit of less morbidity in this category of surgery is worth the additional risk.
Expectations of current cosmetic procedures are demanding enough with out the additional uncertainty.
Chuck

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True enough.
Maybe better used for posterior restorative crown lengthening.

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