Reis Isabella Neme Ribeiro, Damin Gabriel Bittencourt, Pereira Camilla Rodrigues, Ichigi Matheus de Alencar, Sant'Anna Luiza Orsi Caminha, Spin-Neto Rubens, Romito Giuseppe Alexandre
Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
Department of Dentistry and Oral Health, Section for Oral Radiology, School of Dentistry, Aarhus University, Aarhus, Denmark.
Eur J Dent. 2024 Jul;18(3):950-956. doi: 10.1055/s-0044-1785535. Epub 2024 May 14.
This case report addresses the treatment of excessive gingival display (EGD) in the context of maxillary asymmetry, zenith irregularities, and occlusal plane inclination. Digital planning was pivotal in formulating a precise treatment strategy by incorporating facial photographs, digital models, and cone-beam computed tomography data. Parameters, including occlusal plane inclination, teeth position, and lip-to-gingival margin relationships, were considered to ensure treatment alignment with the patient's facial characteristics. Notably, during the planning phase, it was evident that the conventional approach using the cementoenamel junction as the apical limit for incisions would result in asymmetry. Consequently, the gingival margin position was defined in accordance with facial and lip features. The chosen treatment, flapless crown lengthening, was tailored to the patient's thin phenotype and guided by measurements derived from digital planning. Postsurgery, the patient experienced a swift and painless recovery. A harmonious smile with a stable gingival margin position was achieved at the 1-year follow-up, seamlessly complementing the patient's facial attributes. This case underscores the importance of personalized EGD treatment and the value of digital planning in enhancing diagnostic accuracy and precise treatment planning, ultimately facilitating optimal treatment strategies.
本病例报告探讨了在上颌不对称、顶点不规则和咬合平面倾斜情况下,对牙龈过度外露(EGD)的治疗。通过纳入面部照片、数字模型和锥形束计算机断层扫描数据,数字规划在制定精确的治疗策略中起着关键作用。考虑了包括咬合平面倾斜、牙齿位置以及唇与牙龈边缘关系等参数,以确保治疗与患者面部特征相匹配。值得注意的是,在规划阶段,很明显使用牙骨质釉质界作为切口的根尖界限的传统方法会导致不对称。因此,根据面部和唇部特征确定牙龈边缘位置。所选择的治疗方法,即无瓣冠延长术,是根据患者的薄型表型定制的,并以数字规划得出的测量结果为指导。术后,患者恢复迅速且无痛。在1年的随访中实现了牙龈边缘位置稳定的和谐微笑,与患者的面部特征完美契合。本病例强调了个性化EGD治疗的重要性以及数字规划在提高诊断准确性和精确治疗规划方面的价值,最终促进了最佳治疗策略的制定。