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.

Read also: Clinical Advances in Periodontics - PDF

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 sub-nasal 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.

The width of the face is typically the width of ''five eyes''. Looking from a frontal perspective, the four recognized basic facial forms are: square, long, square-long and ovoid. The three facial profiles are straight, concave and convex.

The line of the smile must be assessed in a diversity of situations: at rest, during speaking and when smiling. During a full smile, the upper lip must rest at the level of medium-facial gingival margins of the upper front teeth. The lower lip must rest at the incisive borders of upper anterior teeth. In a full smile instance, the incisive borders of these teeth must run parallel to the curvature of the lower lip.

Related articles