ABSTRACT
This report describes a duplication technique of free gingival form from a provisional restoration to a zirconia crown. Three die casts were manufactured from a silicone impression with an acrylic resin ring tray. The first die cast was for the zirconia framework, the second for the provisionalized transfer coping, and the third for relining the provisional restoration. A free gingival impression was taken using a provisionalized transfer coping, and a soft gingival cast was manufactured. The depth of free gingival transparency was measured using a zirconia shade plate. Then, the zirconia framework was customized to allow for subgingival porcelain space. This technique seems to contribute to the clinical-laboratory interface in computer-aided design/computer-assisted manufacture restorations.
Subject(s)
Crowns , Dental Impression Technique , Dental Materials/chemistry , Dental Prosthesis Design , Gingiva/anatomy & histology , Zirconium/chemistry , Computer-Aided Design , Cuspid , Dental Impression Materials/chemistry , Dental Porcelain/chemistry , Dental Restoration, Temporary , Female , Gingival Retraction Techniques , Gingivitis/prevention & control , Humans , Incisor , Middle Aged , Models, Dental , Polyvinyls/chemistry , Prosthesis Coloring , Siloxanes/chemistry , Surface PropertiesABSTRACT
Failure to tend to inadequate crown contours in the crown trial can cause long-term disharmony of the free gingival form. This case report describes a novel technique for free gingival impression from a final provisional restoration to a zirconia crown. Two die casts were manufactured from a silicone impression. The first die cast was for the zirconia crown; the second die cast was for the final provisional restoration and the provisionalized transfer coping. A free gingival impression was taken using a provisionalized transfer coping, and a soft gingival model was manufactured. The proximal contact position was managed using the predicted convex curve of the interdental papillae. One year after zirconia crown placement, no inflammation was observed around the pyramidal interdental papillae, and symmetric interdental papilla heights were evident. A free gingival impression using a two die-cast technique appears to be useful for achieving optimal interdental papilla height.
Subject(s)
Crowns , Dental Impression Technique , Gingiva/anatomy & histology , Tooth Discoloration/therapy , Adult , Dental Porcelain , Dental Restoration, Temporary/methods , Female , Humans , Incisor , MaxillaABSTRACT
The first purpose of this study was to investigate the relationship between the lowest cervical point and the interdental gingival midpoint (IGM) line in the maxillary anterior region. After marking the lowest cervical points and the mesial and distal interdental gingival midpoints on study models of 77 patients, the shortest distances from the IGM lines that connect both interdental gingival midpoints to the lowest cervical points were measured on silicone impressions. The findings showed that the average position of the lowest cervical points in the central incisors coincides with the IGM line. This position is located 0.24 mm palatally in the lateral incisors, and in the canines 0.3 mm facially from the IGM line. The second purpose of the study was to verify the IGM line concept in cervical line management through some clinical cases. In a thick-flat biotype case using a clinical crown lengthening procedure, the lowest cervical points were adjacent to the IGM lines following long-term coronal gingival growth. In a short-term observation of a thin-scalloped biotype case, untouched facial gingiva increased following interdental gingival augmentation. In a case of Miller class 1 gingival recession, a coronally advanced flap combined with the roll technique was performed based on the IGM line concept. According to the results obtained from this study and these cases, it seems that the IGM line could become a diagnostic standard in cervical line management in periodontal plastic surgery.
Subject(s)
Gingiva/anatomy & histology , Gingival Recession/surgery , Gingivoplasty , Adolescent , Adult , Child , Female , Humans , Incisor , Male , Middle Aged , Reference Values , Tooth Cervix , Young AdultABSTRACT
Recently, esthetic implant dentistry has focused on changes in buccal implant mucosal height. The purpose of this article was to investigate the relationship between the height and width of buccal supra-implant mucosa based on the physiologic mucosal form surrounding the implant. Fourteen patients who had buccal supra-implant mucosal heights of more than 1.5 mm and keratinized mucosa 1 year or more after superstructure placement (average period: 3 years 5 months) were studied. Silicone impressions were taken immediately after superstructures and abutments were removed. The study model used for the measurement process was manufactured using improved dental stone. The height and width of the buccal supra-implant mucosa were measured using digital slide calipers, and the ratio of the height and width was investigated. In all cases, the widths were greater than the heights. The average height of the buccal supra-implant mucosa was 2.17 mm, while the average width was 3.44 mm. The average biologic height-width ratio was 1:1.58. The width was larger in the posterior region than in the anterior. There were no differences in the biologic height-width ratio in terms of the diameter of the implant. These findings indicate that peri-implant soft tissue augmentation procedures resulting in an average biologic height-width ratio of 1:1.5 may provide a stable buccal cervical line around the implant superstructure, even for thin periodontal biotypes.
Subject(s)
Dental Implants , Dental Prosthesis Design , Gingiva/pathology , Calcium Sulfate/chemistry , Dental Abutments , Dental Arch/pathology , Dental Impression Materials/chemistry , Dental Impression Technique , Dental Prosthesis, Implant-Supported , Follow-Up Studies , Humans , Keratins , Models, Dental , Mouth Mucosa/pathology , Silicones/chemistry , Surface PropertiesABSTRACT
The following case report describes the buccal and coronal bone augmentation around an irretrievable tooth using forced eruption and buccal root torque for immediate nonsubmerged implant placement. A mandibular left second premolar with degree 2 mobility, severe buccal bone resorption, and interproximal angular bony defects was subjected to forced eruption and buccal root torque. Five months after this process, the tooth was displaced 15 mm coronally and the root apex faced buccally. Buccal and coronal bone augmentation and soft tissue enlargement were evident at reentry surgery. This technique enabled proper implant placement in a situation where the bone was compromised.
Subject(s)
Alveolar Ridge Augmentation/methods , Dental Implantation, Endosseous/methods , Tooth Movement Techniques/methods , Bicuspid , Bone Regeneration , Dental Prosthesis, Implant-Supported , Denture, Partial, Immediate , Female , Humans , Mandible , Middle Aged , Tooth Eruption , TorqueABSTRACT
We describe a case of gingival recession in which root coverage and coronal bone regrowth were achieved after treatment with a connective tissue-bone graft and enamel matrix derivative. The connective tissue-bone graft was harvested from a maxillary edentulous area and then curved to fit the root surfaces of the maxillary left central and lateral incisors. Enamel matrix derivative was applied to the root surfaces, and the connective tissue-bone graft was fixed to the interdental bone by a titanium screw. Six months later, the exposed roots were covered with thick gingiva, and coronal regrowth of thick bone was evident at reentry surgery. This technique is useful for esthetic restoration placement with an intracrevicular margin on teeth with a thin, receding gingiva.
