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 Biometric Approach to Predictable Treatment of Clinical Crown Discrepancies
Dental professionals have long been guided by mathematical principles when interpreting aesthetic and tooth proportions for their patients. While many acknowledge that such principles are merely launch points for a smile design or reconstructive procedure, their existence appears to indicate practitioners’ desire for predictable, objective, and reproducible means of achieving success in aesthetic dentistry. This article introduces innovative aesthetic measurement gauges as a means of objectively quantifying tooth size discrepancies and enabling the clinician to perform aesthetic restorative dentistry with success and predictability.
Bonding Lithium Disilicate Ceramic to Feather-Edge Tooth Preparations: A Minimally Invasive Treatment Concept
The purpose of this study is to report short-term clinical outcome of a new minimally invasive prosthetic approach utilizing monolithic lithium-disilicate full crowns bonded to feather-edge tooth preparations. This procedure can be considered a further option for the conservative restorative treatment of single elements where a full crown is required.
Prosthetic Gingival Reconstruction in a Fixed Partial Restoration - Part 1: Introduction to Artificial Gingiva as an Alternative Therapy
Prosthetic gingival restoration of a Class III defect environment.
Dental Diagnosis & Treatment for Obstructive Sleep Apnea - Part 2
Dr. Maurice Salama takes you through his routine for evaluating and testing patients who present with a airway related sleep disorder.
The All-Ceramic Crown Pt 1
A discussion on the basic theory and applications of all-ceramic crowns.
Aesthetics and Functions in the Rehabilitations of Complex Prosthodontics: A Multidisciplinary Approach in the Lights of New Technologies and Materials - Part 1 of 2
We'll see how we have replaced traditional materials and techniques with other innovative new technologies that only you can work, and how the results obtained with these are systematic and overlapping at times better than traditional ones.
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.
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.
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.
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.