PDF: Periodontal Plastic Surgery performed in clinically short crowns for prosthetic rehabilitation

Currently, esthetics is paramount in all dental procedures, and patients are encouraged to entertain high expectations.

It has thus become one of the main goals to attain when performing any treatment. Periodontal surgery can help in some cases to achieve this aim by providing a harmonious smile.

Conditions which might affect esthetic harmony are: papillae loss, confined ridge defects, gingival recession, excessive gingival display, delayed passive eruption, lack of keratinized gingiva, gingival tattoo, unsightly gingival texture and aberrant frenum/muscle position.

Analysis of face and smile must be achieved in order to treat excessive gingival exposition or delayed passive eruption cases.

The analysis must encompass height, shape and facial profile of the patient as well as his/her age and gender.

Facial height is divided into three thirds: the upper third is variable according to the hairstyle type of the patient; the middle and lower thirds are more related to oral esthetics.

The middle third spans from the glabella (most prominent point between eyebrows) up to subnasal point (point underneath the nose). 

The lower third is measured from the sub-nasal point up to the soft tissue of the chin (which is underneath the chin). When measured in a resting position, the middle third is equal in length to the lower third.