Dental Publication / Article Details |
Biologic Rationale of Esthetic Crown Lengthening Using Innovative Proportion Gauges
Author(s):
Paul Fletcher, DDS
Date Added:
10/14/2011
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Summary:
Research shows that practitioners tend to underestimate the amount of tooth structure that must be exposed during a crown lengthening procedure. In the anterior portion of the mouth, this can lead to biologic width problems and subsequent cosmetic issues. This paper presents a biologically based, step-by-step approach to periodontal esthetic crown lengthening. Using a series of innovative measuring gauges, the ideal clinical crown length of a tooth as well as the proper occlusogingival placement of the interproximal papilla will be determined based on established, documented tooth proportion relationships. The biologic crown length of the tooth, defined as the distance from the incisal edge to the bone crest, will subsequently be determined as a function of the clinical crown length, with the ultimate goals being adequate tooth structure for the placement of a restorative margin, establishment of a healthy dentogingival complex, and the placement of an esthetically pleasing definitive restoration.
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The Socket Shield technique is a “new” procedure with 10 years of documented successful cases worldwide. Lately we have done some new proposals like the way we extract the lingual slice, the relation of the shield level to the bone, the use of miniflaps, the distance between implant and shield just to mention some.
On the other hand, the only minor “problem” with this technique is the “external shield exposure” and here I propose the method of successful treatment.
We will see the convenience of applying SS to molars also on the light of the paper of Dr. Mataraso from 2009. The molar SS is a viable alternative rather than ridge preservation techniques.
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