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.
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
Long-Term Outcome of Cemented Versus Screw-Retained Implant-Supported Partial Restorations
The present study was designed to compare the long-term outcome and complications of cemented versus screw-retained implant restorations in partially edentulous patients. The long-term outcome of cemented implant-supported restorations was superior to that of screw-retained restorations, both clinically and biologically.
Complex Case Rehabilitation in Light of New Technologies
This case report describes a step-by-step full arch restoration (upper and lower), rehabilitated utilizing new technologies in dentistry. CAD/CAM technology has changed not only the technician's working process, but also the clinician's, offering new benefits to clinical workflow.For example the possibility of using zirconia and its characteristics as a restorative material.
The clinician's and technician's professional backgrounds and relationships are critical to achieving optimal aesthetic and functional results; while prosthetic success depends upon an in-depth knowledge of the materials and their properties and on carefully performed clinical procedures, which are still of utmost importance to obtain satisfactory results.
Occlusion Simplified - Clinical Techniques for Restoring Anterior Guidance and Opening Vertical Dimension - Part 3 of 3
In this video, learn a practical system for restoring worn teeth, rebuilding anterior guidance, and increasing vertical dimension.
Dental Implant Overdenture Clinical Techniques and Tooth Selection - Part 3 of 3
Dr. Aldo Leopardi’s objective for this presentation is to focus on clinical techniques to achieve desired treatment outcomes for stress-broken overdenture designs. A discussion of appropriate tooth/mould selection for function and aesthetics will also be addressed.
Computer-Guided Occlusal Analyses in optimizing Occlusal Function - Part 1 of 3
Dr. Robert Kerstein introduces the principles of utilizing computer-guided occlusal analyses to direct occlusal evaluation and adjustment in the optimization of occlusal function.
Multidisciplinary Crowns & Bridges
A 5 part course worth 1 CEU.
Esthetic Case Design and Minimally Invasive Tooth Preparation: The Role of Magnification
In this webinar, esthetic case planning and a new complete protocol of tooth preparation for full crowns will be highlighted utilizing modified enamel chisels and the dental microscope. Multimedia will be utilized for optimal visual learning using magnification photography and videos to focus on specific details required to improve your dental skills. The important role of magnification in dentistry will be further discussed.
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.
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.