Marcantonio Ana Carolina Monachini, de Oliveira Guilherme José Pimentel Lopes, Scardueli Cássio Rocha, Marcantonio Camila Chiérici, Marcantonio Rosemary Adriana Chiérici, Marcantonio Elcio
Department of Diagnosis and Surgery, Univ. Est. Paul. - UNESP, Araraquara 14801-903, Brazil.
Department of Periodontology/Implantology, Dental School, Federal University of Uberlândia-UFU, Uberlândia 38405-266, Brazil.
Case Rep Dent. 2020 Feb 29;2020:7234310. doi: 10.1155/2020/7234310. eCollection 2020.
This case report is aimed at describing a flapless, minimally invasive clinical crown lengthening with an osteotomy performed using a piezoelectric ultrasound. A female patient complained about the amount of gum that was exposed when she smiled, which caused aesthetic discomfort. After a clinical examination, it was confirmed that the patient had excessive gum exposure in the upper arch of the dental region for teeth 14 to 24 when she smiled. The tomographic exam showed that bone tissue was at the level of the enamel-cementum junction, and gingival tissue covered a part of the anatomic crown. Virtual analysis using digital smile design (DSD) demonstrated that enlarging the clinical crowns would provide better aesthetics. The excess gingival tissue was removed from the gingival margin region with the aid of a mockup without interference to the interdental papillae. Then, osteotomy was performed using piezoelectric ultrasound until there was a 2.5 mm distance from the top of the bone crest to the new gingival margin. In the postoperative period, good repositioning of the gingival margin, absence of postoperative complications, and rapid healing of the gingival tissue were verified. After 6 months, a good aesthetic outcome was observed with stability in the level of the periodontal tissues obtained via the crown-lengthening technique. It can be concluded that the minimally invasive clinical crown-lengthening technique was effective in repositioning the gingival margin with no postoperative complications.
本病例报告旨在描述一种使用压电超声进行截骨的无瓣微创临床牙冠延长术。一名女性患者抱怨她微笑时牙龈暴露过多，这导致美观不适。临床检查后，确认患者微笑时在牙齿14至24的牙弓上牙龈暴露过多。断层扫描检查显示骨组织处于釉质-牙骨质界水平，牙龈组织覆盖了解剖牙冠的一部分。使用数字微笑设计（DSD）进行的虚拟分析表明，扩大临床牙冠将提供更好的美观效果。借助模型从牙龈边缘区域去除多余的牙龈组织，而不干扰牙间乳头。然后，使用压电超声进行截骨，直到从牙槽嵴顶部到新牙龈边缘有2.5毫米的距离。术后观察到牙龈边缘良好复位，无术后并发症，牙龈组织快速愈合。6个月后，观察到良好的美观效果，通过牙冠延长技术获得的牙周组织水平稳定。可以得出结论，微创临床牙冠延长技术在重新定位牙龈边缘方面有效，且无术后并发症。
