ABSTRACT
OBJECTIVE: To compare the clinical periodontal parameters of teeth restored with a single ceramic crown, with and without crown lengthening procedure. METHODS: This prospective, longitudinal, controlled, and single-blinded clinical trial involved 22 patients with a total of forty-one teeth with ceramic crowns. The teeth were divided into two groups: test (n = 21), comprising teeth rehabilitated post crown-lengthening surgery, and control (n = 20), comprising teeth rehabilitated without crown-lengthening surgery. Plaque index (PI), gingival index (GI), probing depth (PD), bleeding on probing (BoP), and clinical attachment level (CAL) were compared between groups (surgically treated and non-surgically treated) and within each group for each type of site (treated -tt; adjacent - ad; and nonadjacent - nad). Additionally, gingival phenotype (GP), gingival recession (GR), and keratinized tissue width (KTW) were also assessed post- restoration. Statistical analyses used a significance level set at 5 %. RESULTS: PI, GI, and BoP were reduced, but no statistically significant differences were observed within each group or between groups for most follow-up periods. CAL of the TT sites was consistently higher in the test group, and PD was also higher in the test group (p < 0.05), except at T3. adPD, nadPD, adCAL, and nadCAL demonstrated no significant differences between groups and periods. A significant association was identified between GP and the occurrence of GR, with the thick-flat phenotype demonstrating less association with GR, regardless of whether crown lengthening was performed or not. CONCLUSION: Crown-lengthening surgery in rehabilitated teeth does not significantly affect PI and GI after 12 months. Although crown-lengthening surgery affected PD and CAL in TT sites, it did not affect adjacent and non-adjacent sites. CLINICAL RELEVANCE: These findings emphasize the importance of considering individual patient factors and the potential impact on periodontal tissues when planning crown-lengthening surgery. Clinicians must have a comprehensive understanding of the dynamics of the periodontal tissues involved in restorative treatments to optimize the procedure, increase success rates, and minimize potential complications.
Subject(s)
Crown Lengthening , Crowns , Dental Plaque Index , Periodontal Index , Humans , Prospective Studies , Female , Male , Adult , Crown Lengthening/methods , Middle Aged , Single-Blind Method , Gingival Recession/surgery , Ceramics/chemistry , Longitudinal Studies , Gingiva/surgery , Periodontal Attachment Loss/surgery , Dental Porcelain/chemistry , Young Adult , Periodontal Pocket/surgeryABSTRACT
OBJECTIVES: Deep margin elevation (DME) is a restorative approach offering the possibility of performing stepwise elevation of deep proximal cavities to create more favourable margins for direct or indirect restorations. The objectives of this scoping review were to explore what is known or unknown about DME by describing a wide ranging evidence base including peer reviewed literature and non-traditionally published information on the web. DATA: Data were extracted from the included evidence in order to describe the following: the extent and nature of the evidence base; the situations which are appropriate for DME; the materials and techniques which are used; the outcomes which have been measured in empirical studies; the risks which have been reported; and the findings which have been reported in studies which compared DME to surgical crown lengthening. SOURCES: This scoping review included a wide range of published evidence and extensive web searching for grey literature, including CPD, training and multimedia information. STUDY SELECTION: The findings revealed a range of published literature as well as freely available, online information advising practitioners about DME. Most empirical evidence was based on in vitro studies, and there were few clinical studies comparing DME to crown lengthening. Online information included recent, multimedia sources. CONCLUSIONS: DME is a technique that can be used with motivated patients with good oral hygiene if rubber dam isolation is achieved, if there is no invasion of the connective tissue space, and if a strict restorative protocol is adhered to. CLINICAL SIGNIFICANCE: With phasing out of amalgam and adhesive dentistry increasing in popularity, DME addresses multiple clinical problems associated with sub-gingival margins prior to restoration.
Subject(s)
Dental Restoration, Permanent , Humans , Dental Restoration, Permanent/methods , Dental Cavity Preparation/methods , Dental Marginal Adaptation , Crown Lengthening/methods , Dental Materials/chemistry , Dental Caries/therapyABSTRACT
OBJECTIVES: this study aims to compare the clinical outcomes of traditional and digital crown extension guides in the aesthetic restoration of anterior teeth. Additionally, the study will analyze the differences in the results of various digital crown extension guides in anterior aesthetic restorations. METHODS: Sixty-two patients who required aesthetic restoration of their anterior teeth were selected for this study. The patients had a total of 230 anterior teeth and were randomly divided into three groups: a control group of 22 cases who received diagnostic wax-up with pressure film, an experimental group 1 of 20 cases who received 3D printed digital models with pressure film, and an experimental group 2 of 20 patients who received digital dual-positioning guides. The control group had a total of 84 anterior teeth, experimental group 1 had 72 anterior teeth, and experimental group 2 had 74 anterior teeth. The study compared three methods for fabricating crown extension guides: the control group used the diagnostic wax-up plus compression film method, while experimental group 1 used compression film on 3D printed models and experimental group 2 used 3D printed digital dual-positioning crown extension guides. After the crown lengthening surgery, the control group patients wore DMG resin temporary crown material for gingival contouring, while the experimental group patients wore 3D printed resin temporary crowns for the same purpose. The patients were followed up in the outpatient clinic after wearing temporary crowns for 1 month, 3 months, and 6 months, respectively. The clinical results were evaluated in terms of marginal fit, red aesthetic index, and white aesthetic index. RESULTS: Based on the statistical analysis, the experimental group required significantly fewer follow-up visits and less time for guide design and fabrication compared to the control group. Additionally, the surgical time for the experimental group was significantly shorter than that of the control group. During the postoperative period between the 1st and 3rd month, the PES index scores for the marginal gingival level, proximal, and distal mesiodistal gingival papillae of the experimental group showed a trend of superiority over those of the control group. By the 6th month, the marginal gingival level exhibited a significant difference between the experimental and control groups. The experimental group demonstrated superior results to the control group in terms of shape, contour, and volume of the teeth, color, surface texture, and transparency of the restorations, and features during the 1st and 3rd postoperative months. In the 6th month, the comparative results indicated that the experimental group continued to exhibit superior outcomes to the control group in terms of the shape, color, surface texture, and transparency of the restorations, as well as the characteristics of the teeth. Additionally, the experimental group demonstrated significantly fewer gingival alterations than the control group at 1 month, 3 months, and 6 months post-procedure, with this difference being statistically significant. Furthermore, the combination of 3D printing technology and restorative techniques was utilized, resulting in consistent patient satisfaction. CONCLUSION: Digitalisation plays an important role in anterior aesthetic restorations. The use of digital technology to manage the entire process of anterior cosmetic restorations can improve restorative results, reduce the number of follow-up appointments, shorten consultation time, and achieve better patient satisfaction.
Subject(s)
Crowns , Esthetics, Dental , Smiling , Humans , Female , Male , Adult , Incisor , Printing, Three-Dimensional , Digital Technology , Dental Prosthesis Design , Crown Lengthening/methods , Young Adult , Middle Aged , Computer-Aided DesignABSTRACT
OBJECTIVES: The perio-restorative approach to maintaining supracrestal tissue attachment (STA; formerly known as biologic width) is a fundamental goal in modern dentistry. This article aims to review the clinical impact of biologic shaping (BS) as an innovative alternative to traditional crown lengthening procedures, reflecting over two decades of clinical experience. MATERIAL AND METHODS: As a review paper, it is crucial to highlight that BS stands as a unique approach designed to optimize STA while emphasizing minimal to no removal of supporting bone. The review spans over two decades, consistently demonstrating clinical efficacy and predictability. Remarkably, BS focuses on addressing issues such as root concavities, developmental grooves, irregularities, furcation lips, and CEJ offering a remarkable level of clinical precision. RESULTS: The reviewed literature underscores that BS has consistently achieved substantial clinical success in fulfilling its objectives. This method presents a biologically sound alternative to traditional crown lengthening, placing a strong emphasis on the preservation of essential bone tissue and the establishment of durable STA. CONCLUSIONS: The results suggest that BS is a logical and biologically driven approach for maintaining STA, making it a promising alternative to traditional crown lengthening. The method offers a predictable and reproducible way to preserve bone tissue while achieving durable STA. This innovation holds great promise in the field of periodontal and restorative dentistry.
Subject(s)
Biological Products , Tooth , Gingiva , Crown Lengthening/methods , Tooth CrownABSTRACT
OBJECTIVES: The aim of this case series is to present the potential applications of the GingivalStat approach, that is, the use of temporary gingival stabilizers, to favor early gingival margin remodeling and prevent the occurrence of gingival rebound following esthetic clinical crown lengthening. CLINICAL CONSIDERATIONS: Four patients requiring clinical crown lengthening were treated for esthetical and functional reasons. The surgical approach included: (a) gingival margin recontouring; (b) full-thickness flap elevation; (c) osteotomy (to achieve an adequate dimension between the alveolar bone crest and the CEJ) and osteoplasty (to reduce the bone thickness and improve the buccal bone anatomic profile, where indicated); (d) temporary gingival stabilizer placement using a block-out resin or a composite (the GingivalStat approach); and (e) flap repositioning, adaptation, and suture. One- to five-year follow-ups, reported in the different case scenarios, show evidence of clinically stable gingival margins around the treated teeth. CONCLUSIONS: Within the limits of this case series, it can be concluded that the GingivalStat approach appears as a further maneuver to cope with clinical crown lengthening procedures at esthetic sites. GingivalStat seems to favor gingival margin contour remodeling during the early phase of healing as well as prevent the occurrence of gingival rebound. CLINICAL SIGNIFICANCE: GingivalStat approach may guide gingival margin remodeling and prevent gingival rebound after wound healing of sites submitted to esthetic clinical crown lengthening.
Subject(s)
Crown Lengthening , Tooth , Humans , Crown Lengthening/methods , Esthetics, Dental , Gingiva/surgery , GingivectomyABSTRACT
OBJECTIVE: To explore the feasibility of the usage of digital guides in combination with low- and high-power lasers for the treatment of excessive gingival display, also known as "gummy smile". CLINICAL CONSIDERATIONS: Excessive gingival display due to altered passive eruption can affect patient's perception of their own esthetics and consequently have an impact on self-confidence. Therefore, the management of this condition should offer a predictable and stable long-lasting solution. To attain these objectives, digital planning emerges as a tool in optimizing the outcomes of crown lengthening surgery for this condition by enhancing precision through the use of surgical guides. Additionally, the usage of high- and low-powered lasers can provide a safe approach because of their tissue selective removal properties. CONCLUSIONS: The technique described showed satisfactory clinical results in the short- and long-term follow-up, leading to an improvement in patients' self-esteem. This approach integrates digital and laser technologies to deliver a surgical treatment characterized by precision, efficiency, and safety. CLINICAL SIGNIFICANCE: Digital dentistry has contributed to innovative dental procedures, as personalizing surgical guides for patients, assisting and guiding incisions of the gingival margins, as well as the extension of the osteotomy, during the procedures for increasing the clinical crown. Furthermore, smile esthetics are directly related to an individual's improved emotional and social quality of life.
Subject(s)
Gingivectomy , Lasers, Solid-State , Humans , Gingivectomy/methods , Crown Lengthening/methods , Lasers, Solid-State/therapeutic use , Follow-Up Studies , Quality of Life , Esthetics, Dental , CrownsABSTRACT
OBJECTIVES: Aim of this study was to assess the influence of restorative treatment timing on the periodontal, patient and operator-reported outcomes following crown lengthening surgery (CLS). MATERIALS AND METHODS: Eighteen study participants requiring CLS were divided into two groups based on prosthetic rehabilitation timing (6 or 14 weeks postoperatively). Clinical parameters were recorded around treated and neighboring teeth before and after surgery, 6 and 14 weeks postoperatively, at prosthesis delivery, and three and six months after. Soft tissue and radiographic bone changes were evaluated. Patients assessed their perception of the procedure by means of a questionnaire. The final treatment outcome was rated by both patients and prosthodontists. RESULTS: CLS resulted in statistically significant and stable apical displacement of the gingival margin, at both treated and adjacent sites. Plaque and bleeding scores remained low throughout. No statistically significant differences were observed between groups for any clinical or radiographic parameter examined. Healing was uneventful and treatment outcome was satisfying for both patients and prosthodontists, without statistically significant differences between groups. CONCLUSIONS: The present study has been characterized as pilot, because it was not possible to reach the sample size indicated by the a priori power analysis. CLS is an effective pre-prosthetic procedure as long as it is performed under a certain surgical protocol which predicts for at least a 3 mm distance between bone crest and the flap margin at suturing. Within the limitations of this study, six weeks after surgery may be an adequate healing time for the onset of prosthetic restoration. CLINICAL RELEVANCE: Crown lengthening surgery is commonly performed in daily clinical practice with the aim to restore teeth with short clinical crowns. Based on periodontal, patient and operator-reported criteria, 6 weeks after CLS may be adequate healing time before the onset of prosthetic restoration. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03947658, 13/05/2019, retrospectively registered.
Subject(s)
Crown Lengthening , Tooth Crown , Humans , Pilot Projects , Crown Lengthening/methods , Crowns , Treatment OutcomeSubject(s)
Crown Lengthening , Esthetics, Dental , Humans , Crown Lengthening/methods , Follow-Up Studies , Tooth Crown , CrownsABSTRACT
For restoration of extensively damaged teeth preprosthetic treatment measures are necessary. Crown lengthening and extrusion affect the prospective crown-root ratio (CRR). The subject of this in vitro study was to compute CRRs for both treatment approaches. 120 human maxillary central extracted incisors were measured. Measurements were calculated for five treatment groups: C (control), E-2 mm (extrusion of 2 mm), E-4 mm (extrusion of 4 mm), CL-2 mm (crown lengthening of 2 mm), and CL-4 mm (crown lengthening of 4 mm). Tooth (TL), root (RL), and crown lengths (CL) were measured from mesial (m) and facial (f) cemento-enamel junction (CEJ), and respective anatomic (CRR) and effective crown-root ratios (eCRR) were calculated. Following CRR values were computed for C: CRR-m = 0.4 ± 0.1, CRR-f = 0.7 ± 0.1. All crown-root ratios were lower (more favourable) for extrusion compared to crown lengthening (p < 0.001). ECRRs were higher than anatomic CRRs. CRR at mesial CEJ was significantly lower than CRR with facial CEJ as reference (p < 0.001). Mesial measurement-based calculations of CRR typically based on radiographic images should be interpreted with caution as they underestimate the eCRR. CRR can be expected as lower, i.e. more favourable, when teeth are extruded than crown lengthened.
Subject(s)
Crown Lengthening , Crowns , Humans , Crown Lengthening/methods , Prospective Studies , Incisor , Tooth Cervix , Tooth Crown , Tooth RootABSTRACT
Surgical crown lengthening (SCL) is the treatment of choice to ensure healthy tissues when subgingival tooth defects encroach on the biologic width.1 However, restorative techniques employing adhesive dentistry may provide viable alternatives to or complement SCL in select cases without the repercussions of surgical bone removal and open interproximal spaces. One such clinical technique, deep margin elevation (DME), employs a direct restoration to relocate the cervical margin of small subgingival defects of posterior teeth supragingivally. The "elevated" margin simplifies impression-making and bonding of indirect restorations, especially inlays and onlays. Recent scientific systematic literature reviews indicate favorable clinical outcomes and suggest that DME restorations made with scrupulous care have high success rates and are compatible with periodontal health. Optimal working field isolation, meticulous placement of matrices, proper bonding and buildup procedure, as well as regular maintenance and follow-up are essential for success. This article provides an overview of this approach.
Subject(s)
Crown Lengthening , Dental Restoration, Permanent , Dental Restoration, Permanent/methods , Crown Lengthening/methods , Dental Cements , Inlays , CrownsABSTRACT
The presence of subgingival pathology, such as a deep secondary caries lesion, a fracture, an already existing restoration that needs to be replaced or the presence of a resorption defect, can constitute a difficult starting situation for the preservation of a tooth. How to deal with such a situation has been a topic of discussion for years. Surgical crown lengthening is one of the first and classic treatment options that is often chosen in such cases. Crown lengthening is a periodontal surgical technique to obtain extra supra crestal clinical crown length. The question is, what is the long-term prognosis of teeth after surgical crown lengthening. To answer this question, a review of the literature was carried out looking for clinical studies examining survival. Four studies with a follow-up of at least 5 years were included. The factors that adversely affect survival of the tooth after the crown lengthening are an unfavourable crown-root ratio, insufficient plaque control and moderate ability to keep the restoration clean.
Subject(s)
Dental Caries , Tooth Fractures , Humans , Crown Lengthening/methods , Tooth Fractures/surgery , Tooth Crown/surgery , CrownsABSTRACT
Surgical crown lengthening is one of the most common surgical procedures in periodontal practice. It is divided into functional and esthetic surgical crown lengthening. In general, surgical crown lengthening is a predictable periodontal surgical procedure. Its most common complication is excessive regression of the dentoalveolar complex coronally. Esthetic surgical crown lengthening can be performed predictably through prior digital planning, minimizing the risk of potential complications such as excessive regression of the dentoalveolar complex coronally. The present study reported in this article is a clinical case of surgical crown lengthening with digital planning to derive practical recommendations.
Subject(s)
Crown Lengthening , Oral Surgical Procedures , Humans , Crown Lengthening/methods , Crowns , Esthetics, Dental , Tooth CrownABSTRACT
OBJECTIVES: The present study aimed to compare the guided dual technique with the conventional technique in esthetic crown lengthening (ECL). MATERIALS AND METHODS: The trial registration number is NCT04922086. Twenty-four participants diagnosed with altered passive eruption (APE) type I subcategory B were selected and allocated into two groups. In the control group (n = 12), the ECL procedure was planned by clinical examination and transgingival probing; in the test group (n = 12), the ECL procedure was carried out using digital planning and a double guide. Clinical parameters were assessed at baseline, immediately after the intervention (IAI), and at 4, 8, and 12 months of follow-up. RESULTS: The clinical crown length (CCL) mean at baseline was 8.09 mm (± 0.77) and increased significantly to 9.92 mm (± 0.62) IAI, with minimal significant reduction after 12 months (9.47 mm [± 0.60]) in the control group. Similarly, in the test group, the mean CCL at baseline was 8.04 mm (± 0.69) and increased significantly to 9.94 mm (± 0.57) IAI, with minimal reduction after 12 months (9.35 mm [± 0.80]). No differences were found between the mean CCL determined in the digital planning and after 12 months. No correlation was found between gingival thickness and gingival margin stability. High esthetic satisfaction was demonstrated by participants/specialists without differences between groups. CONCLUSIONS: In conclusion, the guided dual technique was as effective as the conventional technique for treatment of APE, with stable results after 12 months of follow-up. CLINICAL RELEVANCE: The guided dual technique aims to transfer both the gingival and bone resection planned position to facilitate the ECL surgical procedure and increase treatment predictability.
Subject(s)
Hominidae , Tooth , Humans , Animals , Crown Lengthening/methods , Esthetics, Dental , CrownsABSTRACT
OBJECTIVE: This article describes a surgical crown lengthening double guide, which was digitally obtained to improve diagnosis, treatment outcome, and follow-up. CLINICAL CONSIDERATIONS: The rehabilitation of anterior dental esthetics should involve interdisciplinary and facially driven planning for achieving pleasant long-term outcomes. Surgical crown lengthening is one of the most common periodontal surgery, which can be assisted by digital tools to improve surgical planning and follow-up. CONCLUSION: The double guide for surgical crown lengthening allows the proper management of hard and soft tissues for achieving a predefined goal based on biological requirements and facially driven planning. In addition, the digital quality control allows the follow-up compared with the pre-operative condition and planned treatment plan. CLINICAL SIGNIFICANCE: The use of digital tools allow the clinician to develop a facially driven planning with proper communication with the team and patient, leading to a shorter, more predictable, and less invasive surgical technique, reducing postoperative inflammation and increasing patient comfort.
Subject(s)
Crown Lengthening , Tooth , Humans , Crown Lengthening/methods , Tooth Crown , Crowns , Treatment Outcome , Esthetics, DentalABSTRACT
The aim of this study was to compare root trunk measurements taken parallel to the tooth axis (TA) to those taken parallel to the root surface (RS) in order to assess the decision-making implications of each method on crown-lengthening surgery. A total of 672 root trunks were measured via CBCT in two planes: TA and RS. The possibility of performing crown lengthening in each clinical situation based on the distance from the cementoenamel junction (CEJ) to the crestal bone (CB) after ostectomy (CEJ-CB) was judged and compared between groups. When RS was used as a reference point, the proportions of cases that judged crown lengthening to be possible were 83.63%, 59.08%, and 39.18% for CEJ-CB values of 4, 5, and 6 mm, respectively. When TA was used instead, those proportions decreased by 3.87% to 7.29%. The lingual root trunk of the lower first molar (LFL) with a CEJ-CB of 4 to 5 mm emerged as the most problematic area; here, the difference between reference planes occurred with one out of every six teeth. Within the limits of this study, utilizing TA for surgical crown-lengthening treatment planning is not ideal because it may lead to extraction of many savable teeth.
Subject(s)
Crown Lengthening , Molar , Humans , Crown Lengthening/methods , Molar/diagnostic imaging , Molar/surgery , Tooth Crown/surgery , Crowns , Tooth Cervix/diagnostic imaging , Tooth Root/diagnostic imaging , Tooth Root/surgeryABSTRACT
AIM: The purpose of the present retrospective case series was to introduce a minimally invasive two-stage flapless crown lengthening procedure where a gingivectomy was avoided or minimized by reducing the bone height through a tunneling technique. MATERIALS AND METHOD: Ten patients (median age 46.6 years, range 26.9 to 71.6 years) were included in the study. The indications for performing a crown lengthening procedure were esthetically short clinical crowns (n = 5), asymmetry of the gingival margin level (n = 2), and both esthetically short clinical crowns and asymmetry of the gingival margin level (n = 3). All the patients presented a thick gingival phenotype, and the mean number of operated teeth per patient was 3.7 (range 2 to 8 teeth). Three patients underwent an additional gingivectomy 6 weeks after the crown lengthening procedure. RESULTS: The esthetic and functional outcome of the treatments fulfilled the patients' and dentist's expectations. CONCLUSION: A minimally invasive two-stage crown lengthening procedure applying a tunneling technique has the potential to achieve predictable esthetic outcomes without an open-flap approach and an additional gingivectomy. However, prospective clinical studies are needed to validate this technique.
Subject(s)
Crown Lengthening , Esthetics, Dental , Crown Lengthening/methods , Prospective Studies , Retrospective Studies , CrownsABSTRACT
Background and Objectives: The report describes a technique using a diagnostic mock-up as a crown-lengthening surgical guide to improve the gingival architecture. Materials and Methods: The patient's primary concern was improving her smile due to her "gummy smile" and short clinical crowns. After clinical evaluation, surgical crown lengthening accompanied by maxillary central full-coverage single-unit prostheses and lateral incisor veneers was recommended. The diagnostic mock-up was placed in the patient's maxillary anterior region and used as a soft tissue reduction guide for the gingivectomy. Once the planned gingival architecture was achieved, a flap was reflected to proceed with ostectomy in order to obtain an appropriate alveolar bone crest level using the overlay. After six months, all-ceramic crowns and porcelain veneers were provided as permanent restorations. Results: A diagnostic mock-up fabricated with a putty guide directly from the diagnostic wax-up can be an adequate surgical guide for crown-lengthening procedures. The diagnostic wax-up was used to fabricate the diagnostic mock-up. These results suggested that it can be used as a crown-lengthening surgical guide to modify the gingival architecture. Several advantages of the overlay used in the aesthetic complex case include: (1) providing a preview of potential restorative outcomes, (2) allowing for the appropriate positioning of gingival margins and the desired alveolar bone crest level for the crown-lengthening procedure, and (3) serving as a provisional restoration after surgery. Conclusions: The use of a diagnostic mock-up, which was based on a diagnostic wax-up, as the surgical guide resulted in successful crown lengthening and provisional restorations. Thus, a diagnostic overlay can be a viable option as a surgical guide for crown lengthening.
Subject(s)
Crown Lengthening , Dental Porcelain , Humans , Female , Crown Lengthening/methods , Gingivectomy/methods , Crowns , IncisorABSTRACT
Digital guides (also known as stents) have become commonly used in daily dental practice. CBCT, digital impressions, and stereolithographic models are considered extremely helpful to create guides for the planning and resolution of surgical cases. In recent years, in periodontal surgery and in particular for the treatment of altered passive eruption (APE), there has been an increasing use of digitally designed guides to improve esthetic outcomes and achieve more predictable results. Digital custom-made guides can be used to improve safety and precision in crown lengthening procedures in patients with APE who have high esthetic expectations. Although most approaches described in the literature show guides used for primary flap or gingivectomy design, the precision of bone recontouring and ostectomy plays a key role in soft tissue rebound and in the final esthetic outcome. The present article describes a new approach using two different guides for soft tissue design in patients with APE.
Subject(s)
Crown Lengthening , Hominidae , Animals , Crown Lengthening/methods , Esthetics, Dental , Gingivectomy/methods , Humans , MotivationABSTRACT
Esthetic crown lengthening (ECL) surgery has been available to our profession for more than 30 years. The objective of this article is to discuss the author's evolution in the techniques associated with ECL surgery. Several technical modifications related to initial incision, ostectomy, and tissue placement will be discussed. In addition, reasons for tissue rebound will be discussed.
Subject(s)
Crown Lengthening , Esthetics, Dental , Crown Lengthening/methods , Esthetics , Retrospective Studies , Tooth CrownABSTRACT
Dental aesthetics are a fundamental treatment goal in dentistry, in which even minute deviations from the ideal may necessitate corrective treatment or constitute a suboptimal clinical outcome. A well-defined protocol that adheres to sound biological and surgical principles is necessary to harmoniously integrate the dental and periodontal components. This article reviews clinical and aesthetic guidelines based on these principles for clinical crown lengthening.