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一次性手术和修复治疗过度牙龈显露的数字化资源。

Digital resources for surgical and restorative treatment of excessive gingival display in one session.

机构信息

Private Practice - Studio Giordani, São Paulo, Brazil.

Private Practice, Blumenau, Santa Catarina, Blumenau, Brazil.

出版信息

J Esthet Restor Dent. 2024 Dec;36(12):1596-1603. doi: 10.1111/jerd.13269. Epub 2024 Jun 4.

Abstract

OBJECTIVE

This article aims to showcase the implementation of a digital workflow in addressing a case of multifactorial excessive gingival display in a patient with high esthetic demands, incorporating both surgical and restorative interventions in a single session.

CLINICAL CONSIDERATIONS

A 28-year-old female patient presented with excessive gingival display, attributed to a combination of short teeth due to altered passive eruption, lip hyperactivity, and a sub-nasal depression that lodged the upper lip during spontaneous smiling. The multidisciplinary treatment strategy encompassed surgical crown lengthening, the placement of a biovolume in the maxillary concavity, and the rehabilitation of the six anterior teeth with direct composite resin, all done in a single session. Smilecloud Biometrics was used to digitally plan the smile, and the final wax-up/mock-up was approved by the patient prior to any irreversible procedure. A digital planning center (GuiderLab) enabled the materialization of the virtual planning and the printing of the periodontal surgical guide, the biovolume, and the resin layering guides for the restorative technique.

CONCLUSIONS

Adopting a digital workflow in multidisciplinary cases with excessive gingival display leads to predictable and more expedited outcomes, ensuring a favorable result between soft and hard tissues.

CLINICAL SIGNIFICANCE

Excessive gingival display is a condition with multifactorial etiologies, including dentoalveolar, periodontal, skeletal, or muscular origins, or a combination of these factors. The diagnoses of altered passive eruption and a hypermobile upper lip are common in daily clinical practice and can be successfully managed through surgical crown lengthening and filling of the maxillary concavity, respectively. To achieve the desired outcome, restorative procedures often complement these surgical interventions.

摘要

目的

本文旨在展示在一位美学要求高的多因素牙龈过度外露患者中实施数字化工作流程的情况,该患者在单次就诊中同时进行了手术和修复干预。

临床考虑因素

一位 28 岁的女性患者因牙齿变短(继发于被动萌出异常)、唇肌活跃和鼻底凹陷导致上唇在自然微笑时嵌入凹陷处而导致牙龈过度外露。多学科治疗策略包括手术牙冠延长术、在上颌凹陷处放置生物体积、以及通过直接复合树脂修复六颗前牙,所有这些都在单次就诊中完成。使用 Smilecloud 生物计量学进行数字化微笑设计,最终蜡型/模型由患者批准,然后再进行任何不可逆程序。数字化规划中心(GuiderLab)使虚拟规划的实现以及牙周手术导板、生物体积和修复技术的树脂分层导板的打印成为可能。

结论

在牙龈过度外露的多学科病例中采用数字化工作流程可实现可预测且更快速的结果,确保软组织和硬组织之间的结果良好。

临床意义

牙龈过度外露是一种多因素病因的病症,包括牙牙槽、牙周、骨骼或肌肉起源,或这些因素的组合。继发于被动萌出异常和上唇多动的诊断在日常临床实践中很常见,可以通过手术牙冠延长术和上颌凹陷处的填充分别成功地进行管理。为了达到预期的结果,修复程序通常补充这些手术干预。

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