A visual method of determining marginal placement of crowns: Part I. Marginal placement of anterior crowns.

The cervical margins of crowns are often placed subgingivally to satisfy patients' demands for esthetics, even though subgingival margins can adversely affect gingival health. Photographs of 527 Saudi citizens (285 men and 242 women) with natural and exaggerated smiles were recorded to determine if subgingival margins are always necessary. The photographs indicated that a substantial percentage of the participants did not display the gingival tissue of their anterior teeth during a natural smile. (Percentages ranged from 43.5% to 69.8% of maxillary teeth and from 93.7% to 97.9% of mandibular teeth). The percentage of subjects who did not reveal the gingival tissue of their maxillary anterior teeth during an exaggerated smile ranged from 22.7% to 39.3%; the percentage of mandibular anterior teeth ranged from 54.1% to 72.7%. There was no statistically significant difference between men and women regarding visibility of anterior teeth. Thus, a substantial number of these subjects could receive anterior crowns with supragingival margins without sacrificing esthetics.