Laser Assisted Crown Lengthening
Ernesto A. Lee, DMD
Maxillary Anterior Papilla Display During Smiling: A Clinical Study of the Interdental Smile Line
The purpose of this research was to quantify the presence or absence of interdental papillae during maximum smiling in a patient population aged 10 to 89 years. The visual display of interdental papillae during maximum smiling occurred 380 of the 420 patients examined in this study, equivalent to a 91% occurrence rate. Eighty seven percent of all patients categorized as having a low gingival smile line were found to display the interdental papillae upon smiling. Differences were noted for individual age groups according to the decade of life as well as a trend toward decreasing papillary display with increasing age. The importance of interdental papillae display during dynamic smiling should not be left undiagnosed since it is visible in over 91% of older patients and in 87% of patients with a low gingival smile line, representing a common and important esthetic element that needs to be assessed during smile analysis of the patient.
Mucosal Coronally Positioned Flap for the Management of Excessive Gingival Display in the Presence of Hypermobility of the Upper Lip and Vertical Maxillary Excess: A Case Report
Excessive gingival display is a frequent
finding that can occur because of various
intraoral or extraoral etiologies. This report describes
the use of a mucosal coronally positioned flap for the
management of a gummy smile associated with vertical
maxillary excess and hypermobility of the upper
lip. For patients desiring a less invasive
alternative to orthognathic surgery, the mucosal coronally
positioned flap is a viable alternative. We demonstrate
short-term successful use of this technique
for the management of excessive gingival display in
the presence of slight vertical maxillary excess and
hypermobility of the upper lip. Long-term follow-up
studies are needed to determine stability of the results.
Achieving Predictable Connective Tissue Root Coverage
Gingival recession creates esthetic issues. These issues may be corrected from a restorative perspective by the placement of composite resin or ceramic over the exposed root. But this approach often results in a gingival-incisal length that does not blend esthetically with the adjacent teeth. Often accompanying the gingival recession is a decrease in the band of attached gingiva. The wider the band of attached gingiva, the more stable the long-term result. Therefore, surgical correction of the recession…
Papilla Regeneration in Patients with Gummy Smile
A lost interdental papilla is difficult to regenerate. Only a few successful case reports have been published and there are no studies reporting a predictable technique to reconstruct the papilla. In this presentation we talk about the biological determinants of gingival papilla. We show different clinical cases ranging from simple cases, where papilla preservation techniques are applied, to complex cases of patients with gingival smile where we apply papilla regeneration techniques.
The Evolving Role of Soft Tissue Enhancement in Esthetic Reconstructive Dentistry - Part 3 of 3
Soft tissue grafting techniques, new regenerative materials and bioactivators will be highlighted. The expanding role of allograft materials (Perioderm), platelet rich in growth factors (PRGF, PRF), and when to utilize them will be suggested. The ability of these combined protocols to alter the soft tissue profile around natural teeth, implants, and dentulous ridges, will be reviewed as to its critical role in "Complete Esthetics".
Abutment Connection, Micro-Movement and Soft Tissue Wellness
Dr. Paul Weigl discusses the very important relationship that exists between Abutment Connection, micro-movement and Soft tissue Wellness in implant therapy.
A Review of Clinical Applications for Soft Tissue Allografts & Autografts: Solutions for Teeth, Implants, and Dentures
The presentation focuses on the clinical applications for acellular dermal graft (ADG) materials. ADGs have been commonly presented and discussed to provide solutions for treating gingival recession. Compared to autogenous grafts, they have the advantage of minimizing pain, discomfort, and surgery time for patients by avoiding an intraoral donor site such as the palate. In addition to treating gingival recession, ADGs also have uses in bone grafting surgeries such as socket grafting and ridge augmentations (GBR) when they are utilized as a barrier membrane. Finally, ADGs can be combined with bone grafting materials to aid in the augmentation of edentulous ridges to aid denture support. While this last application is less common, it's use is worthy of discussion.
Prosthetic Soft Tissue Development From Single to Full Arch Reconstruction
In addition to surgical intervention is the creation of the specific emergence profile that is essential in the aesthetic zone. The emergence profile composed of 2 parts, the abutment and the subgingival part of the crown. The shape of abutment can be individually shaped so that it gives natural appearance and varies individually (depending on the depth, angulation and diameter of the implant). Sometimes it even dictates the implant position. From a surgical perspective, soft tissue height, position and thickness need to be diagnosed and corrected when needed. From the prosthetic point of view, the emergence profile has to be created to mimic the natural appearance and maintained over time in respect to the biological changes. The course teaches step by step how to be successful with implant prosthetics from single tooth, partially edentulous to full arch reconstruction.
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