Dual Digitally Guided Crown Lengthening in Esthetic Area Compromised by Disharmonic Implant Crown

Author(s):  
Nathalia Andrade ◽  
Guilherme Moura ◽  
Bartosz Maska ◽  
Darnell Kaigler ◽  
Gustavo Mendonça ◽  
...  
2020 ◽  
Vol 23 (2) ◽  
pp. 28-33
Author(s):  
Indira Apriantika ◽  
Agung Krismariono

A healthy and beautiful smile can affect appearance and confidence. One of the aesthetic problems in dentistry that is often complained of by patients is excessive gingival display (gummy smile). The excessive gingival display can be caused by several factors, one of which is altered passive eruption (APE). One of the treatments to correct gummy smile related to APE is crown lengthening. Crown lengthening can be with bone reduction (gingivectomy with bone reduction) or without bone reduction (gingivectomy). Crown Lengthening with bone reduction is a surgical procedure that aims to maintain the dentogingival complex and to improve smile aesthetics. The purpose of this case report is to determine the crown lengthening with bone reduction (gingivectomy with bone reduction) procedure as a gummy smile treatment related to APE .A23-year-old female patient, came to Dental Hospital of Universitas Airlangga with complaints of her upper gum which not in the same length and the teeth looked short, she considered her smile was less aesthetic. After conducting analyses relating to aesthetics and periodontal tissue, crown lengthening with bone reduction was chosen for this patient treatment. The treatment results are quite good, visible gingival margins that matched the gingival zenith and improved patient's smile profile. APE as the etiology of patient's gummy smile can be corrected. There are no post-surgical complications such as excessive pain and infection. A proper diagnosis, treatment plan, and good techniques can produce a harmonious smile on the patient.


Author(s):  
Dennis Flanagan ◽  
Alessandro Fisher BS ◽  
Carmen Ciardiello ◽  
Vito Moreno ◽  
Alen Uvalic ◽  
...  

When planning an implant supported restoration the dentist is faced with the surgical and prosthetic technical issues as well as the patient’s expectations. Many patients wish an immediate solution to an edentulous condition. This is especially may be true in the esthetic zone. The extent of the zone is determined by the patient. The dentist may consider when it is feasible to load the supporting implants with definitive or provisional prosthetics. For the work herein, consideration of many parameters were theoretically assessed for inclusion: bone density, cortical thickness, seating torque, parafunction, bite load capacity, number of implants under load, implant/crown ratio, implant diameter and length. After assessment, the most influential parameters were selected. An iteration, using patient age, implant diameter, bite load capacity and cortical thickness, is now presented to aid the implant dentist in determining the feasibility for immediate functional loading of a just placed dental implant in a healed site. Extensive testing is required to develop this concept. According to this iteration, most immediate functional loaded implants would fail. A future refined and definitive formula may enable the clinician to safely immediately functional load an implant with a definitive prosthesis.


2020 ◽  
Vol 12 (45) ◽  
pp. 34-39
Author(s):  
Flavia Sukekava ◽  
Julia Helena Luiz ◽  
Paloma Palma ◽  
Jaques Luiz

Gummy smile is a characteristic in which the patient exposes more than 2 mm of keratinized gingiva in forced smile. With a multifactorial cause, its correct planning depends directly on the correct diagnosis. Usually, the procedures that involve manipulation and the enlargement of the aesthetical crown lengthening are surgical. The objective of this case series was to show the advantages of surgical crown augmentation surgery in aesthetic areas with minimally invasive techniques. Three cases of gummy smile were presented, with different treatment plans and techniques for execution. In the 3 cases, bone removal was performed with piezoelectric ultrasound, which made the postoperative more comfortable for patients. These cases illustrate the use of technology to reduce morbidity in patients who need to undergo bone removal to treat gingival smile.


BDJ ◽  
1999 ◽  
Vol 187 (1) ◽  
pp. 21-24
Author(s):  
V. Ward
Keyword(s):  

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