ABSTRACT
Anterior diastemas are common esthetic problems. One of the challenges in clinical esthetic dentistry is closing anterior diastemas without creating “black triangles” between the teeth. The success of a restorative treatment in anterior teeth depends on the esthetic integration between soft tissues and hard tissues. This report describes the successfully accomplished diastema closure case by producing the emergence profile with natural contours at the gingival-tooth interface and then generating of gingival recontouring process.
Subject(s)
Dentistry , Diastema , ToothABSTRACT
A otimização estética de restaurações implantossuportadas é uma combinação da concordância visual entre prótese e arquitetura do tecido mole peri-implantar. A proposta deste artigo consiste na aplicação do método clínico de compressão dinâmica, de condicionamento tecidual ao redor do nível ósseo peri-implantar, utilizando resina flow para reprodução deste condicionamento no processo de moldagem. A técnica tem sido bastante eficaz e difundida em virtude da estabilização do adequado perfil de emergência, a fim de estabelecer a harmonia do contorno gengival com os dentes adjacentes, incluindo altura e largura dos zênites gengivais, tornando o perfil gengival mais triangular e mantendo a estabilidade das áreas de contatos proximais com dentes adjacentes aos implantes.
The esthetic enhancement for implant-supported restorations is a visual combination between prosthesis and its gingival architecture. The aim of this case report is to demonstrate the use of the clinical dynamic compression technique for peri-implant tissues with a flow composite resin during the impression procedures. This technique has proven its efficacy and been well established because it allows for an adequate emergence profile, generating harmony at the gingival contour of the adjacent teeth, including the position of the gingival zeniths, making the gingival profile more tapered while keeping the proximal contact areas between tooth and implants.
Subject(s)
Humans , Female , Adult , Composite Resins/therapeutic use , Computer-Aided Design , Dental Implants , Esthetics, Dental , Gingiva/anatomy & histology , Tissue Conditioning, Dental/methodsABSTRACT
O presente caso clínico relata a perda de um implante devido à peri-implantite, cuja ocorrência foi favorecida pelo mau posicionamento do mesmo. Dessa forma, a coroa e o implante foram removidos, por ausência de possibilidade de outro tratamento mais conservador. Com o auxílio de técnicas cirúrgicas de enxerto ósseo (autógeno e xenógeno), enxerto gengival (conjuntivo subepitelial), tratamento ortodôntico e confecção de novas próteses, a saúde e a estética da paciente foram restabelecidas. Para a substituição, foi utilizado um implante cone-morse, amplamente utilizado em áreas estéticas atualmente. O tratamento durou 18 meses, atingindo as expectativas da paciente. Concluiu-se que a abordagem multidisciplinar e a comunicação entre os profissionais são essenciais para o sucesso do tratamento, uma vez que a instalação de implantes, sem planejamento protético minucioso, pode resultar em uma quantidade inumerável de problemas e complicações, no que diz respeito aos resultados cirúrgicos e protéticos esperados.
This case reports on the loss of a dental implant due to peri-implantitis favored by its malpositioning. In this way, the defi nitive crown and implant were removed because a more conservative treatment was not possible. With the aid of surgical techniques as bone grafting (autogenous and xenogeneic), gingival grafts (subepithelial connective tissue), orthodontic treatment and fabrication of new prostheses, the health and esthetic aspects were retrieved. A new dental implant (Cone Morse type) was inserted as advocated for esthetic regions. After 18 months, patient expectations were achieved. It can be concluded that a multidisciplinary approach and communication among different specialists are fundamental for a successful treatment once incorrect implant placement can generate a myriad of problems and complications regarding the surgical and prosthetic expected outcomes.
Subject(s)
Humans , Female , Adult , Dental Implants , Esthetics, Dental , Peri-ImplantitisABSTRACT
Fixed restoration using implants for patients with posterior partial edentulism is generalized technique. As patient demands increase, the functional and esthetic implant restoration to achieve similar results to lost natural teeth is becoming an important issue. It is inevitable to use customized CAD/CAM abutments rather than ready-made abutments for the creation of implant prosthesis which closely resembles natural teeth. Using CAD/CAM abutment made it possible to obtain natural emergency profiles for posterior implant prostheses, ensuring more comfortable, efficient management of oral hygiene. However, keratinized gingiva with sufficient width and height for a natural emergence profile is required to use a large diameter CAD/CAM abutment which ensures stability and esthetics of hard/soft tissue around the implants. In this case, for esthetical and functional implant zirconia prosthesis, soft tissue graft was performed and customized CAD/CAM abutments were used following ridge augmentation, sinus graft and implantation. Satisfactory results were obtained functionally and esthetically through periodic clinical evaluation, and I hereby report this case.
Subject(s)
Humans , Emergencies , Esthetics , Gingiva , Oral Hygiene , Prostheses and Implants , Regeneration , Tooth , TransplantsABSTRACT
El tratamiento con implantes dentales ha demostrado ser predecible para reemplazar los dientes perdidos o defectuosos. Este caso clínico presenta un paciente con ausencia de las coronas de los incisivos centrales superiores. Luego de una evaluación clínica y radiográfica detallada del tejido blando y óseo, se realizaron las exodoncias de las raíces de los centrales superiores sin levantamiento de un colgajo, seguido de la colocación de 2 implantes, relleno óseo y provisionalización inmediata. Al paciente se le instruyó para que llevara una dieta blanda durante 3 semanas y fue evaluado semanalmente durante un mes y luego mensualmente durante un período de cicatrización de 4 meses. Después de la estabilización del tejido blando y duro, se procedió a la colocación de las coronas definitivas con aditamentos de zirconia. Los resultados que se pueden apreciar luego de la colocación de los implantes y la provisionalización inmediata en el sector estético anterior del maxilar superior nos indican un predecible grado de éxito con esta técnica. Por lo que podemos concluir que esta técnica puede ser aplicada y recomendada siempre y cuando exista un adecuado diagnóstico y protocolo de tratamiento que brinde una correcta selección del caso y asegure una tasa de éxito similar a otras técnicas.
Treatment with dental implants has shown to be a predictable treatment to replace defective or lost teeth. A clinical case is presented on a patient with absence of the crowns of the upper central incisors. After a detailed clinical evaluation of the bone and soft tissue, a root extraction without a flap elevation was performed, followed immediately by the insertion of two implants and provisional crowns and a bone graft. The patient was instructed to follow a soft diet for 3 weeks, and was followed up weekly for a month, and then monthly for a period of 4 months. After the stabilization of the soft and hard tissues, the final crowns using zirconia abutments were inserted. The results shown after placement of the immediate dental implants and provisionalization in the anterior esthetic zone of the maxilla demonstrate a predictable grade of success with this technique. In conclusion, this technique can be applied and recommended when there is an adequate diagnosis and treatment protocol that provides a correct selection of the case in order to ensure a rate of success similar to other techniques.
Subject(s)
Humans , Male , Adult , Tooth Extraction , Dental Implants , Dental Implantation, Endosseous/methods , Dental Restoration, Temporary/methods , Esthetics, Dental , Immediate Dental Implant Loading , Incisor , Maxilla/surgery , Zirconium , Computer-Aided Design , Crowns , Dental Restoration, Temporary , Esthetics, DentalABSTRACT
Esthetics is of prime concern when replacing any anterior tooth. The prosthesis should resemble the adjacent natural tooth closely. Out of many types of pontic designs, ovate pontic may serve the purpose of providing good esthetics and phonetics. It will maintain interdental papilla and help to maintain good gingival health. In addition to it ovate pontic has an advantage of immediately replacing the missing anterior tooth.
ABSTRACT
One of the most challenging task in closing anterior diastema is avoiding "black triangle" between the teeth. This paper reports a case that the closure of diastema in anterior teeth could be successfully accomplished using direct adhesive restorations and gingival recontouring. The traditional technique using Mylar strip was modified to increase the emergence profile with natural contours at the gingival-tooth interface. Mylar strip was extended out of the sulcus by approximately 1 mm high from the gingival margin, and a small cotton pellet was used to provide the emergence contour. This modified approach is acceptable for the clinical situation.
Subject(s)
Adhesives , Diastema , Polyethylene Terephthalates , ToothABSTRACT
In process of fabrication of a fixed partial denture, dies are trimmed to expose margins of the preparations. The need for the soft tissue cast is quite evident as the soft tissue emergence profile that surrounds the prepared tooth is destroyed in the process of fabrication. This article describes a modified technique to fabricate the soft tissue cast for the conventional fixed partial denture. The impression made with the polyvinylsiloxane was first poured to prepare the die cast. After retrieval of the cast, the same impression was poured second time with the resin based resilient material to cover the facial and proximal gingival areas. The remaining portion of the impression was poured with the gypsum material. This technique does not require additional clinical appointment, second impression procedure, technique sensitive manipulations with impression, or cumbersome laboratory procedures. The simplicity of this technique facilitates and justifies its routine use in fabrication of the fixed partial denture.
Subject(s)
Calcium Sulfate , Denture, Partial, Fixed , ToothABSTRACT
The aim of this article is to describe a chairside method for immediate implant provisionalization, which preserves the original natural emergence profile and anatomy of the teeth.
El objetivo de este artículo es describir un método directo en el sillón de provisionalización inmediata del implante, que conserva el perfil de emergencia natural original y la anatomía de los dientes.
Subject(s)
Humans , Female , Aged , Dental Prosthesis, Implant-Supported , Dental Implantation, Endosseous/methods , Dental Restoration, Temporary/methods , Esthetics, Dental , Patient Satisfaction , Time Factors , Tooth Crown , Tooth ExtractionABSTRACT
The purpose of this study were to compare the emergence profiles of crowns with their contralateral tooth, in vitro, and to determine if there is any association between the design of tooth preparations and the resultant emergence profile. 50 working models used for single crown construction were examined. Measurements of the faciolingual width of the crowns and contralateral teeth were taken using digital calipers. Internal line angles and the margin width of dies and the emergence profile of the corresponding crowns were measured from longitudinally sectioned polyvinylsiloxane indices mounted on a flat-bed scanner using image analysis software. Using Students t tests, no statistically significant differences (p>0.05) were found for shoulder width (mean 0.94 ± 0.23mm), internal line angle (mean 105.83 ± 13.57°) or emergence profiles (28.56 ± 12.95°) in the different (anterior, premolar or molar) preparations or crowns. The mean emergence profiles for all crowns was statistically significantly greater (p<0.001) than the contralateral tooth (mean 15.33 ± 7.77°). Using linear regression, there was a weak statistical relationship between emergence profile and margin width (Emergence profile° = 31.352 – 2.973 x margin width (mm)). There was no statistical association between the internal line angle and the resultant emergence profile. In conclusion, the emergence profiles of crowns were higher than the contralateral teeth. Maxillary metalloceramic crown preparations had shoulder widths that did not conform to recommendations in standard texts but line angles were within a satisfactory range. The margin width exerts a weak effect upon the emergence profile of the crown.
ABSTRACT
All contours of the restoration not directly related to occlusion are related to the gingival tissues only. And proper contour of restoration is essential for the health of the periodontal tissues. But there are so many controversies about the contour of the restoration, and there is no uniform agreement in the literature as to which contour of restoration is best for periodontium. In general, the contour of restoration means the supragingival contour only but in the case of the intracrevicular restorative procedure the subgingival contour of restoration must be considered. Because a portion of the restoration is placed in a gingival sulcus which is extremely vulnerable to periodontal disease. In this article the concepts or theories of the supragingival contour, the subgingival contour, and the emergence profile were discussed. The contour of the restoration and the biotype of the periodontium must be considered in intracrevicular restorative procedure. And sufficient tooth preparation is important factor to develop the proper contour of restoration which is kind to periodontium.