J Korean Acad Prosthodont.  2016 Oct;54(4):438-444. 10.4047/jkap.2016.54.4.438.

The esthetic prosthodontic treatments in maxillary anterior area, considering the gingival margin

• Son D
• Paek J
• Woo YH
• Kim HS

• KMID: 2388224
• DOI: http://doi.org/10.4047/jkap.2016.54.4.438

Abstract

To enhance the esthetic appearance, the maxillary anterior area is important. It is possible to improve the esthetic appearance through the treatment of maxillary anterior area, which includes altering the color, form, and arrangement of teeth. When planning these treatments, clinicians should individualize personal demands, by using the information obtained from facial, dento-labial, dental, and gingival analysis. It is essential to properly prepare the gingival structure, which includes the height of gingival margin, the location of zenith, reconstruction of the interdental papillae, emergence profile, and symmetry. Clinicians often face unfavorable condition of the gingiva and the edentulous ridge, and appropriate management of the gingival structure is needed. In this case report, the patients were treated to improve the gingival conditions surrounding maxillary anterior teeth. By using conservative treatment without surgical intervention, such as application of pink porcelain, subgingival contour modelling and modification of pontic base, satisfactory esthetic results were gained.

Keyword

Dental esthetics; Maxillary anterior; Gingival margin; Modified ovate pontic; Interim dental prosthesis

MeSH Terms

Dental Porcelain
Denture, Partial, Fixed
Denture, Partial, Temporary
Esthetics, Dental
Gingiva
Humans
Tooth
Dental Porcelain

Figure

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  Fig. 1. Initial view. (A) Frontal view - vertical atrophy of ridge and gingival recession of left central incisor and canine, (B) Transverse view - slightly horizontal atrophy of ridge.

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  Fig. 2. (A) Diagnostic wax-up - mimics the gingival architecture, (B) Provisional restoration - transfer of diagnostic wax-up.

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  Fig. 3. (A) Definitive restoration - regain symmetry of gingival margin, (B) Evaluation of smile line.

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  Fig. 4. Initial view. - unesthetic crown form and color, improper location of zeniths and distal space of right central incisor.

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  Fig. 5. Diagnostic wax-up - change of zenith and gingival margin of crowns.

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  Fig. 6. (A) Provisional restoration - improvement of zeniths and closure of distal space of right central incisor, (B) Completion of subgingival contour molding.

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  Fig. 7. Trasfer of gingival morphology. (A) Gingival impression with provisional restoration intraorally, (B) Acrylic resin zig and provisional restoration are seated on master cast, (C) After injection of silicone impression material.

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  Fig. 8. Definitive restoration.

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  Fig. 9. Initial view.

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  Fig. 10. Preparation of the gingiva under pontic base. (A) Shaping of the gingiva under the pontic base using high-speed handpiece, (B) Right after shaping the gingiva.

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  Fig. 11. (A) Preparation of retainer teeth and gingival shape - completely healed soft tissue under the area of pontic base, (B) Completion of provisional restoration - frontal view, (C) Completion of provisional restoration - lateral view. spontaneous emergence profile of pontics.

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  Fig. 12. Definitive restoration. (A) Frontal view, (B) Lateral view.

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