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Gingival Zenith Positions and Levels of the Maxillary Anterior Dentition Gingival Zenith Positions and Levels of the Maxillary Anterior Dentition

Author(s):

Stephen J. Chu, DMD, MSD, CDT;Dennis P. Tarnow, DDS;Christian F.J. Stappert, DDS, MS, PhD, Priv-Doz;Jocelyn H-P. Tan, DDS

Date Added:

8/18/2009


Summary:

Gingival esthetics has always been an important component of a beautiful smile. Beautiful restorations surrounded by unattractive gingival tissues can negatively impact on a smile (Figure 1). Gingival health is among the first fundamental esthetic objectives during treatment planning; it is also essential to consider gingival morphology and contour.1 The ideal gingival architecture has been described as one that consists of knife-edged gingival margins tightly adapted to the teeth, interdental grooves, and cone-shaped interdental papilla2 (Figure 2). Nordland and Tarnow’s classification of a normal interdental papilla is one that fills the embrasure space to the apical extent of the interdental contact area.3 Deviation from the normal interdental papilla will result in an esthetically undesirable gingival “black triangle,” and gingival asymmetry can lend to visual stress and imbalance (Figure 3).4,5 Adjunctive therapies, including periodontal plastic surgery, are recommended to optimize gingival contours for restorative treatment in the presence of severe gingival deformity (Figure 4).6–8 Understanding the dentogingival interface will allow clinicians to achieve a more satisfactory esthetic outcome during interdisciplinary diagnosis and treatment.

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