It highlights esthetic crown lengthening procedure creating symmetrical gingival margins in the maxillary anterior region around dental implants and natural teeth. A multidisciplinary approach for the treatment of anterior. This esthetic crown lengthening technique affords many benefits. In a tooth with a crown, the walls of the crown form figure 1. Prepping too far under the gingiva and not getting predictable impressions. Crown lengthening is a surgical procedure which aims to increase the clinical crown height. Jan 01, 2019 esthetic crown lengthening ecl procedure indicated to decrease the gingival tissue display that improves the smiling beauty when the clinical crowns are short assaf, 2014.
Based on an analysis of the possible clinical scenarios, a new classification system is introduced in an effort to organize the diagnostic process. Indications and surgical techniques abstract periodontal surgery has a major role in todays esthetic dentistry. The crown lengthening procedure clp is commonly used to achieve an esthetic smile, this procedure is also used to expose dental structure when an inadequate clinical crown is available for the placement of a restoration 3. Its indications include subgingival caries, crown or root fractures, altered passive eruption, cervical root resorption and short clinical abutment, and its aim is to reestablish the biologic width in a more ap. Esthetic crown lengthening for upper anterior teeth. Faced with a cusp fractured below the gingiva prepping too far under the gingiva and not getting predictable impressions planning esthetic restorations in the anterior and facing uneven tissue or a gummy smile crown extension is one of the most commonly required. The periodontal status of the involved teeth is first assessed. This article discusses the esthetic parameters of ideal gingival labial positions and presents a classification of crown lengthening procedures and the procedure for a twostage crown lengthening technique. Esthetic crown lengthening in anterior teeth 43 sibility is the occurrence of bone loss of unpredictable nature, leading to gingival recession. You also prepared for the surgery by performing a virt. The relationship between the periodontium and the restoration is critical if gingival health and esthetics are to be achieved. Crown lengthening in the maxillary anterior region.
Crown lengthening is a viable procedure that enables to restore teeth having a short clinical crown, extensive subgingival caries, and subgingival tooth fractures at dentogingival junction. Esthetic crown lengthening involving dental implants and natural. The gingival margins of the central incisors should be symmetrical and either at the same level or within 1 mm apically of the margins of the lateral incisors. Excessive gingival display or gummy smile may adversely impact patients appearance leading to esthetic concerns. Excess gingival display can occur when passive eruption. Often, the discussion of crown lengthening in the anterior sextants is presented in the context of esthetic surgery. This article will discuss biological parameters for aesthetic crown lengthening. Multidisciplinary approach with predictable esthetics. In the maxillary anterior region, the gingival labial margin position is an important parameter in the achievement of an ideal smile. Comparison of three different crown lengthening procedures in the maxillary anterior esthetic regions. Anterior esthetic gingival depigmentation and crown.
Planning esthetic restorations in the anterior and facing uneven tissue or a gummy smile. Esthetic crown lengthening for maxillary anterior teeth. Among various indications for crown lengthening are esthetic periodontal surgeries. Moreover, patients have stated that their teeth have the greatest impact on improving their physical appearance, and hence how the era of cosmetics and dentistry. Not every scenario necessitates the removal of soft tissue. The patient was referred to a periodontist for evaluation of the subgingival fractures of teeth 8 and 9, and for esthetic crown lengthening of the other maxillary teeth. The appearance of the gingival tissues surrounding the teeth plays an important role in the esthetics of the anterior maxillary region of the mouth. Esthetic crown lengthening crown lengthening for esthetic reasons aims to correct either a gummy smile or gingival overgrowth fig. During surgical crown lengthening, the bone level was lowered for placement of the prosthetic margin and reestablishment of the biological width. Crown lengthening gauge the crown lengthening gauge, a doubleended instrument, has the biologic periogauge blpg tip on one end, and the papilla tip on the opposite end. Surgical crown lengthening for function and esthetics pubmed. A new innovative approach rm norman tri kusumo indro and leonard c nelwan division of dentistry, prof.
It highlights esthetic crown lengthening procedure creating symmetrical gingival margins in the maxillary anterior region around dental implants and natural. The blpg tip is designed to replace existing aesthetic crown lengthening techniques, employing the use of polymerbased surgical guides or templates. To begin an esthetic crownlengthening procedure, the clinician may want to fabricate a surgical guide or stent to assist in determining the apical extent of the gingival margin, using the principles of ideal width and height of respective tooth types figure 414. Excessive gingival display or gummy smile may adversely impact patients appearance leading to esthetic. Coronal gingival proliferation following esthetic crown lengthening may be. Crown lengthening is a surgical procedure designed to increase the extent of supragingival tooth structure for restorative or esthetic purposes by apically positioning the gingival margin, removing supporting bone or both. Periodontal plastic surgery combining gingival depigmentation and esthetic crown lengthening was performed in a single appointment using scalpel. Pdf esthetic crown lengthening for upper anterior teeth. Different indications are illustrated with cases to show the surgical treatment approach to improve the esthetic appearance for each condition.
The dotted line represents the preoperative gingival margin. Anterior surgical crown lengthening may be undertaken to avoid restorative margin impingement on the biologic width. Its indications include subgingival caries, crown or root fractures, altered passive eruption, cervical root resorption and short clinical abutment, and its aim is to re. Stability of the gingival margin after an aesthetic crown lengthening.
The surgical procedure was initiated with gingival demarcation on the mid. Oct 12, 2017 thus, performing aesthetic crown lengthening starts with an understanding of the aesthetic zone, that is the maxillary anterior dentition. Moestopo beragama university, south jakarta, iowa, indonesia. Twostage esthetic crown lengthening fairfield county implants. The patient and restoring dentist were concerned with the healing time that should. Anterior esthetic crown lengthening two types of crown lengthening. After signing a written informed consent, the patient underwent an esthetic crown lengthening procedure to correct this mucogingival deformity, followed by prosthodontic rehabilitation. Esthetic rehabilitation through crown lengthening surgery and. First, it places the control of positioning the gingival margins in the hands of the restorative dentist, while still allowing for any finetuning of the tissue levels by the surgeon at a later date. Case report scalpel depigmentation and surgical crown.
The treatment protocol suggested for this case included complete oral prophylaxis along aesthetic crown lengthening and gingival depigmentation in relation to maxillary the left premolar to the right premolar region. Crown lengthening is also used to alter the gingival labial profiles. A wide area of gum attached on the buccal surface, distance from the edge of the fracture clinical crown lengthening a case report. An ideal anterior appearance necessitates healthy and inflammationfree.
Esthetic periodontal plastic surgery is especially rewarding in such individuals with compromised esthetics. Dec 03, 2017 esthetic crown lengthening a highly gratifying but often undiagnosed esthetic issue the relationship between a persons physical appearance and his or her selfesteem is well documented in the literature, and some of those studies suggest an individuals face is the prime source of determining physical attractiveness. In the presence of a good crown to root ratio, esthetic crown lengthening can provide an appropriate proportions of the anterior teeth, along with pleasing gingival symmetry 9. The patient and restoring dentist were concerned with the healing time that should elapse before the teeth were permanently restored. Nandakumar, journalthe journal of contemporary dental practice, year2005, volume6 3, pages 947. D2934 prefabricated esthetic coated stainless steel crown primary tooth. Periodontal surgery has a major role in todays esthetic dentistry. Healing time for final restorative therapy after surgical. A case is reported here on the cosmetic correction of black gums and gummy smile. Nissaf daouahi 1 dalenda hadyaoui 2 zohra nouira 2 belhassen harzalah 2 mounir cherif 2. Periodontal therapy is a necessary and useful adjunct when any anterior restoration is undertaken. Treating the gummy smile with aesthetic crown lengthening.
Extraoral examination revealed no significant findings. A male patient reported with chief complaint of difficulty in mastication. Figure 6appliance used for esthetic diagnosis will assist in determining appropriate incisal edge position, clinical crown. Esthetic crown lengthening with flapless osseous reduction using abrasive bur. Paolantoni g, marenzi g, mignogna j, wang hl, blasi a, sammartino g. Crown lengthening can be limited to the soft tissues when there is enough gingiva coronal to the alveolar bone, allowing for surgical modification of the gingival margins without the need for osseous recontouring i. When performed in ideal clinical conditions, crown lengthening gives satisfactory results both from a functional as well as esthetic point of view.
This short video adds some smart tips for performance surgical crown lengthening. A comprehensive clinical examination must assess clinical crown length, anatomical crown length, keratinized gingiva height and the location of the alveolar crest. Once the clinician selects periodontal resection as his or her treatmentofchoice, the coslet system allows the dentist to determine the most suitable crown lengthening approach for each patient. Modified lip repositioning with esthetic crown lengthening. How to improve the smile with esthetic crown lengthening. A total of 10 patients in need of crown lengthening have been treated with this procedure, and 1to 7year followups have shown good esthetic results and stable tissue levels. Its indications include subgingival caries, crown or root fractures, altered passive eruption, cervical root resorption and short clinical abutment, and its aim is to reestablish the. You should check other videos on the channel for further tips. Comparison of three different crownlengthening procedures in. Crown lengthening and restorative procedures in the esthetic. Crown lengthening is a surgical procedure designed to increase the extent of supragingival tooth structure for restorative or esthetic purposes by.
Esthetic crown lengthening corrected the gingival line. To evaluate the desired gingival level and the proportion of restoration to be made using the recurring esthetic dental red proportion method, a diagnostic waxup model was fabricated. After completion of reendodontic treatment the lengthening of clinical crown procedure was performed fig. Excessive gingival display, as well as inadequate widthtolength ratios and proportions, result in anterior teeth that exhibit a square appearance with excessive lateral incisor dominance.
Perawatan crown lengthening pada gigi anterior pasca. Crown lengthening and restorative procedures in the esthetic zone. Pdf esthetic crown lengthening for maxillary anterior. This case report describes a successful multidisciplinary approach used to improve the smile esthetics of a patient presenting with excessive gingival display, asymmetric gingival margins, and small upper anterior teeth and lower anterior teeth. Esthetic periodontal plastic surgery is especially rewarding. Careful rehabilitation plan and knowledge of morphological features of maxillary anterior teeth crowns, as influential factors for esthetic performance of the anterior dentition, are also necessary.
Contribution of crown lengthening to optimize aesthetics. Esthetic crown lengthening and frenectomy surgery local anesthesia was induced using a 4% articaine solution with epinephrine 1. The term functional relates to exposure of subgingival caries, exposure of a fracture or both. A papilla preservation crown lengthening procedure ppcl was proposed for treatment of the maxillary anterior teeth canine to canine and compared to two. Procedure prior to commencement of the surgical procedure, the patient consent was obtained. In addition, during an esthetic crown lengthening procedure, bone removal. Restoring esthetics and function with crown lengthening. Stomatologija, baltic dental and maxillofacial journal, 8. The clinical crowns appear short and demonstrate attrition. It is also useful for enhancing maxillary anterior esthetics.
An asymmetrical gingival line was visible when the patient smiled. A representative case of maxillary anterior crown lengthening in a patient. Perawatan crown lengthening pada gigi anterior pasca terjadi. Indications for crown lengthening include teeth with subgingival caries or extensive caries that shortens the tooth, fractures, and short clinical crowns caused by. Pdf esthetic crown lengthening for maxillary anterior teeth. Esthetic rehabilitation through crown lengthening surgery. Treatment considerations include the shape and the shade matching of the crown, interdental spacing, and esthetic desires which should be fulfilled. The biological width, at treated sites, was reestablished to its original vertical dimension by 6 months. The relationship between a persons physical appearance and his or her selfesteem is well documented in the literature, and some of those studies suggest an individuals face is the prime source of determining physical attractiveness. Crown lengthening and restorative procedures in the. Apr 03, 2019 the patient elected anterior crown lengthening of 4 along with a combination of crowns and laminate veneers for teeth 4 and 2227. You met your patient, understood his or her concerns and also provided a diagnosis and treatment plan. Surgical crown lengthening with flap surgery and bone. Comparison of three different crownlengthening procedures.
Crown lengthening procedure is an effective management strategy for gummy smile and kois has stated that 3 mm of. Closeup view of the anterior maxillary teeth before the surgery. Introduction and aimcrown lengthening surgery cls stems from the need to adequately access and isolate the healthy margins of a damaged crown and from the consequences of an improperly placed restoration margin padbury et al. Contemporary crownlengthening therapy the journal of the. Laserassisted crown lengthening procedures in the esthetic zone. Crown lengthening an overview sciencedirect topics. A manual periodontal probe pcpunc 15, hufriedy, chicago, il. After discussing the exact sequence of the therapy and the possible complications, informed consent was signed. Crown lengthening is one of the most common surgical procedures in periodontal practice. Esthetic crown lengthening involving dental implants and. Mohamed hany ahmad abd elghany1, alduraibi mohammed sulaiman2, ghydaa abdulah. Clinical crown lengthening is a useful procedure to provide tooth length for proper restoration of a tooth. A case report medical history was noncontributory, and he denied a history of smoking or alcohol consumption.
Multidisciplinary dentistry is a team approach of different specialties on diagnosis and treatment planning and treatment of oral health conditions. The other consequence may be persistent gingival inflammation without any bone loss 10. Crown lengthening surgery has been categorized as esthetic or functional. An external or internal bevel gingivectomy gingivoplasty is the procedure.
It is a relatively simple procedure where excess gum tissue, and sometimes bone, is removed and. In addition, a consistent 3 mm gain of coronal tooth structure was. Clinical crown lengthening a case report weronika lipska1, marcin lipski2, malgorzata lisiewicz3, andrzej gala3, krzysztof gronkiewicz3, dagmara darczuk 1, maria chomyszyngajewska 1department of periodontology and oral medicine, dental institute, jagiellonian university medical college ul. The blpg tip is used to achieve the proper mf clinical crown and biologic crown osseous crest to incisal edge position lengths during surgical crown lengthening.
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