Biologic Width Demystified
Richard Erickson, MS, DDS
Much fuss is justifiably made by many clinician speakers over violating the biologic width in crown margin placement. We've all seen seminar slides of chronically inflamed tissue around a crown in violation of this sacred region. But what exactly is this so-called biologic width? Why when despite your best efforts to esthetically hide a crown margin in the sulcus, it comes peeking back at you at the next prophy visit? John Kois answered these questions recently1 much more clearly than I have ever heard in a presentation and here are the highlights.
Some healthy dimensions of the gingival area are needed in order to compare to what is abnormal. As you can see on the diagram at left, a kind of symmetry exists in normal healthy gingiva: 1mm sulcular depth, 1mm attached epithelium and 1mm connective tissue before the crest of the bone is reached. This is the biologic width. 85% of healthy patients will exhibit this 3mm dimension, while 2% will be less than 3mm and 13% will be greater than 3mm. Also, the distance between the CEJ and the crest of bone is 2mm on average. When this CEJ to crestal bone distance is less than 2mm, the gingiva ride up the clinical crown making the tooth appear submerged and short. If the CEJ to crestal bone distance is greater than 2mm, the CEJ may be exposed and the tooth will appear too long.
To summarize then, the biologic width is equal to 3mm: 1mm sulcular depth, 1mm attachment epithelium and 1mm connective tissue above the crestal bone. This is true on the broad facial surface. In the proximal papillae area, the correct biologic width increases to 4mm. This can be measured on any tooth using the "sounding" technique.
Vertical and Horizontal Dimensions of Implant Dentistry: Numbers Every Dentist Should Know
This article will review the most common vertical and horizontal measurements that the general dentist placing and restoring implants should know, and illustrate how using these parameters will provide more reliable outcomes.
A Multidisciplinary Approach to Single-Tooth Replacement
Over the last several decades, dentistry has focused on more conservative treatment modalities and preventive techniques. This has been possible not only because of improved techniques and materials, but also because of the understanding that tooth preparation, regardless of how conservative it may be, is an irreversible procedure
Restorative Space Management: Treatment Planning & Clinical Considerations for Insufficient Space
In attempting to provide a restorative solution for cases that have been compromised by spatial considerations, clinicians have traditionally opted for an orthodontic approach that did not provide optimal aesthetics due to changes in tooth morphology, specifically tooth size and shape as a result of dental deterioration. With the advent of contemporary aesthetic materials and preparation techniques, clinicians and technicians are now empowered to deliver a penultimate result with minimal compromise to the surrounding dentition. This article presents the clinical and laboratory considerations that must be addressed when providing a prosthetic restoration for crowded teeth.
Estetica e funzione nelle riabilitazioni protesiche complesse: Approccio multidisciplinare alla luce delle nuove tecnologie e dei nuovi materiali - Part 1 of 3
Vedremo quindi come abbiamo sostituito materiali e tecniche tradizionali con altri innovativi che solo attraverso le nuove tecnologie è possibile lavorare, e come i risultati ottenuti con queste sistematiche siano sovrapponibili e a volte migliori di quelli tradizionali.
Restoring Pink & White Esthetics with Implant Restorations
The utilization of artificial gingiva to restore deficient ridge inside the esthetic zone.
The Role of Occlusion and the Articulator in Enhancing Anterior Esthetics - Part 1
T.G. Hornischer Jr., CDT will demonstrate the interplay of occlusal harmony, various anterior tooth form and arrangement, as well as the critical role of model articulation in developing the optimal esthetic outcome.
The Artist Within: How to Create Exceptional Looking Provisionals
In this webinar, Dr. Lerner will demonstrate how smile design, tooth anatomy and the shades of contour, surface texture and colour are all components of a beautiful smile.
Bonding and Cementing Zirconia Restorations: Current Clinical and Scientific Information
Zirconia continues to play a significant role in modern restorative dentistry. From Implants to abutments all the way to frameworks and monolithic crowns. How we manage the process of bonding and cementing these restorations is extremely important to their long term retention and success. This presentation highlights the different approaches available today and specifically defines protocols with clinically relevant research.
Multitasking Digital Dentistry - Part 1 of 2
The "Digital Smile Design" is a technique codified and published in 2011 by Christian Coachman and Marcelo Calamita. This approach has radically changed the way we analyze the aesthetics of our patients and at the same time gave the clinician a great tool of communication with the laboratory and with the patient. In recent years, software's and applications have been introduced on the market in order to simplify the workflow and make more predictable the outcome. The purpose of the lecture is to resume the current concepts about digital aesthetic preview, and to show new trends.
To view this dental publication or article, you must be a registered user of Dental XP. If you are already a member, click here to login.Registration is free and only takes several minutes. Dental XP will never spam you, or sell your information.