Andrade Nathalia, Moura Guilherme, Maska Bartosz, Kaigler Darnell, Mendonça Gustavo, Wang Hom-Lay
Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA.
Clin Adv Periodontics. 2022 Mar;12(1):26-31. doi: 10.1002/cap.10150. Epub 2021 Mar 3.
A disharmonious smile results from excessive gingival exposure or gingival margin misalignment is a frequent finding in patients. The most common cause is altered passive eruption; however, in the case presented here, the esthetics of the smile is compromised also due to an inadequate implant placement and crown fabrication.
This case presented a combination of altered passive eruption and a buccally as well as deeply placed implant crown (#10) that led to disproportionate dimensions of an upper lateral incisor. Dual digitally guided crown lengthening surgical procedure for teeth #5 to #12 was performed aiming a better harmony of the smile. Treatment also included placement of tooth veneers and re-made of implant crown. A pleasant smile with appropriate colors and proportions was achieved. All esthetic and periodontal health parameters were maintained throughout the follow-up period (1 year).
The use of dual digitally guided crown lengthening help to accomplish precision and stability of esthetic outcome, as it guides for both, bone and soft tissue removal. Particularly, in challenging cases with high esthetic demand and complicated factors present, such as the case presented here, the digital approach provides tools to attain excellent treatment outcome.
牙龈过度暴露或牙龈边缘不齐导致的微笑不协调是患者常见的表现。最常见的原因是被动萌出改变;然而,在本病例中,微笑美观也因种植体植入位置不当和牙冠制作不当而受到影响。
该病例表现为被动萌出改变,以及种植体牙冠(#10)颊侧及深部植入,导致上颌侧切牙尺寸不成比例。对5至12号牙进行了双重数字引导的牙冠延长手术,旨在使微笑更加协调。治疗还包括放置牙齿贴面和重新制作种植体牙冠。实现了具有适当颜色和比例的宜人微笑。在整个随访期(1年)内,所有美学和牙周健康参数均得以维持。
双重数字引导的牙冠延长术有助于实现美学效果的精确性和稳定性,因为它同时指导骨组织和软组织的去除。特别是在美学要求高且存在复杂因素的具有挑战性的病例中,如此处介绍的病例,数字方法提供了实现出色治疗效果的工具。