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.
Prosthetic Gingival Reconstruction in the Fixed Partial Restorations
“Originally published in Inside Dentistry, 2008. Copyright 2008. AEGIS Communications. Reprinted with permission.”
Consideraciones de los materiales disponibles en América Latina para la fabricación de coronas cerámicas libres de metal
El siguiente artículo es una revisión de la literatura odontológica el cual se ha redactado con la intención de llevar al clínico a través de una actualización de los materiales dentales cerámicos libres de metal disponibles en América Latina.
Recommended Shade Matching Protocol
Following much research and clinical evaluation, this chapter outlines the authors’ recommendations for an ideal approach to shade matching: a combination of conventional techniques with new technologies.
Conservative Form and Space Management in Anterior Implants, Veneers and Esthetic Therapy - Part 1 of 2
Dr. Christian Coachman shares conservative methods of overcoming esthetic challenges in anterior restorations involving implant therapy.
Clinical Success Rates of Ceramic vs PFM Restorations
Dr. Christensen reviews in depth studies comparing Zirconia, PFM, and Alumina frameworks.
Provisionals - Anterior, Posterior, Single and Multiple Unit
Provisional restorations have become a vital diagnostic and assessment tool to evaluate function color, shape, contour, occlusion, periodontal response, implant healing, and overall esthetics.
Complete Denture Technique with Prosthodontist Aldo Leopardi
Dr. Aldo Leopardi presents a complete denture case, from initial patient consultation to final try-in and fitting.
Excellence in Cosmetic Dentistry: Replicating Nature, When Nature Has Been Compromised
Drs. Cherilyn Sheets and Jacinthe Paquett discuss the understanding of the art and science of dentistry to create restorations that duplicate nature.
Vertical or Shoulderless Preparations in Contemporary Prosthodontics
From a biological standpoint, preserving a maximum amount of sound tooth structure, as it is done in vertical preparations, might also offer a more conservative alternative to a horizontal margin design in other clinical conditions such as endodontically treated teeth, vital teeth in young individual, teeth affected by caries at the cervical third. Vertical margins on zirconia crowns have been tested in vitro and clinical reports have been published. A re-evaluation of possible advantages and shortcomings of vertical preparation design in contemporary
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.