J Dent Rehabil Appl Sci.  2018 Sep;34(3):208-217. 10.14368/jdras.2018.34.3.208.

Anterior esthetic restoration accompanied by gingivectomy of patient with unesthetic tooth proportion of maxillary anterior teeth: a case report

• Han SY
• Lee J
• Choi SY

• KMID: 2422639
• DOI: http://doi.org/10.14368/jdras.2018.34.3.208

Abstract

The maxillary anterior teeth play an important role in esthetics. The esthetic of maxillary anterior teeth is closely related to tooth morphology and also harmony with gingiva. Precise diagnosis and treatment plan are essential to satisfy patient's demand, and sometimes surrounding soft tissue management is involved to achieve the goal. Gingivectomy can be considered as one method to make esthetic restoration possible. As well as esthetics, function has to be considered in maxillary anterior teeth restoration. Definitive cast of abutment and diagnostic cast waxed up labially were superimposed with model scanner, so can provide former comfortable occlusion. This case report demonstrates functional and esthetic improvements of two patients through gingivectomy and the data of superimposed image of casts.

Keyword

esthetics; gingivectomy; diagnostic wax up; superimposed image of casts

MeSH Terms

Diagnosis
Esthetics
Gingiva
Gingivectomy*
Humans
Methods
Tooth*

Figure

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  Fig. 1 Preoperative extraoral view.

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  Fig. 2 Preoperative intraoral view. (A) Occlusal view of maxilla, (B) Right lateral view, (C) Frontal view, (D) Left lateral view, (E) Occlusal view of mandible.

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  Fig. 3 Zenith of the gingival contour of maxillary anterior teeth.

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  Fig. 4 Analysis of maxillary anterior tooth size and proportion.

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  Fig. 5 Extraoral view of smile line.

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  Fig. 6 Gingivectomy and lip repositioning. (A) Surgical splint for gingivectomy, (B) After gingivectomy and lip repositioning.

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  Fig. 7 Intraoral and extraoral view 1 month after periodontal surgery. (A) Intraoral view, (B) Extraoral view.

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  Fig. 8 Diagnostic model fabrication. (A) Face bow transfer, (B) Frontal view of diagnostic model, (C) Lateral view of diagnostic model, (D) Diagnostic model of maxilla, (E) Diagnostic wax-up model of maxilla.

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  Fig. 9 Intraoral view after tooth preparation and temporary bridge restoration. (A) Tooth preparation, (B) Frontal view of temporary crown, (C) Occlusal view of temporary crown.

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  Fig. 10 Model scan and coping design. (A) Model scanned image, (B) Superimposed image of definitive model and wax-up diagnostic model, (C) Coping design image.

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  Fig. 11 Intraoral view of coping and final restoration try in. (A) Intraoral view of pretreatment state, (B) Coping try in, (C) Final restoration try in, (D) 1 year after treatment.

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  Fig. 12 Analysis of maxillary anterior tooth size and proportion after treatment.

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  Fig. 13 Analysis of overjet and overbite. (A) Before treatment, (B) After treatment.

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  Fig. 14 Analysis of smile line. (A) Before treatment, (B) After treatment.

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  Fig. 15 Intraoral view of occlusion. (A) Occlusion before treatment, (B) Occlusion after treatment.

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  Fig. 16 Intraoral image of frontal view.

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  Fig. 17 Intraoral image of frontal view, 1 month after periodontal treatment and temporary restoration.

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  Fig. 18 CAD image of coping design using scanned and superimposed image.

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  Fig. 19 Intraoral image of frontal view. (A) Before treatment, (B) After treatment.

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  Fig. 20 Intraoral view of occlusion. (A) Before treatment, (B) After treatment view.

Reference

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