Dental Publication / Article Details |
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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
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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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