Journal List > J Korean Acad Prosthodont > v.54(4) > 1034903

Son, Paek, Woo, and Kim: The esthetic prosthodontic treatments in maxillary anterior area, considering the gingival margin

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. (J Korean Acad Prosthodont 2016;54:438-44)

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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.
jkap-54-438f1.tif
Fig. 2.
(A) Diagnostic wax-up - mimics the gingival architecture, (B) Provisional restoration - transfer of diagnostic wax-up.
jkap-54-438f2.tif
Fig. 3.
(A) Definitive restoration - regain symmetry of gingival margin, (B) Evaluation of smile line.
jkap-54-438f3.tif
Fig. 4.
Initial view. - unesthetic crown form and color, improper location of zeniths and distal space of right central incisor.
jkap-54-438f4.tif
Fig. 5.
Diagnostic wax-up - change of zenith and gingival margin of crowns.
jkap-54-438f5.tif
Fig. 6.
(A) Provisional restoration - improvement of zeniths and closure of distal space of right central incisor, (B) Completion of subgingival contour molding.
jkap-54-438f6.tif
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.
jkap-54-438f7.tif
Fig. 8.
Definitive restoration.
jkap-54-438f8.tif
Fig. 9.
Initial view.
jkap-54-438f9.tif
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.
jkap-54-438f10.tif
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.
jkap-54-438f11.tif
Fig. 12.
Definitive restoration. (A) Frontal view, (B) Lateral view.
jkap-54-438f12.tif
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