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Gum
Contouring - Improving Your Smile
Correcting a Patient’s ‘Gummy’
Smile With Ease and Predictability
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Photo 1
Patient's chief complaint is that her
teeth are too short. Patient also complains
that she shows too much gum tissue when
she smiles as well. |
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Photo 2
The
X-Rite Shade Vision system is used to
determine the pre-op shade of the teeth.
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Photo 3
Unlike other shade systems, Shade Vision
sends a color image to the laboratory
technician with the shade map so the
technician can see the actual tooth.
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Photo 4
A pre-op measurement of the teeth confirms
that the clinical crown length is inadequate.
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Photo 5
A periodontal probe is used to measure
the depth of the existing pocket. As
a result of the minimal pocket depth,
it will be necessary to remove bone
to establish proper biological width.
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Photo 6
The
proposed gingivectomy is drawn on the
tissue with a marker. A lab fabricated
splint can also be used to assist in
marking the tissue to be removed. |
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Photo 7
Initial gingivectomy incisions being
made with the Biolase diode laser. Note
the absence of bleeding at the surgical
site. |
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Photo 8
The
gingivectomy is complete. If left as
is, this would create a major biologic
width violation, and this tissue would
remain constantly inflamed, and would
most likely attempt to re-grow. The
osseous recoand provisionalization.
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Photo 9
The clinical crown lengths are measured
again to verify the desired lengths
have been reached. The patient is allowed
to view this initial result and give
any input. |
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Photo 10
The
veneer preparations are now accomplished
utilized standard techniques, beginning
with placement of facial depth cuts.
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Photo 11
The veneer preparations have now been
completed. The gingival margins of the
preparations are placed at level of
the new gingival crest. |
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Photo 12
A
hard bite material, Luxabite, is injected
between the teeth. Unlike many polyvinylsiloxane
registration materials, Luxabite exhibits
no flexibility that can lead to errors.
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Photo 13
A
D&D Double Bite Tray (Superior Surgical
& Dental Manufacturing, Inc.) was
used which gives the dentist and the
lab technician the best of both worlds.
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Photo 14
Due to the lack of subgingival margins,
no retraction cord is necessary to produce
this highly accurate impression with
Honigum heavy and light body. |
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Photo 15
Temphase
bisacryl provisionals are “spot-etched”
into place and a thin layer of Luxaglaze
is light cured onto the provisionals
to enhance vitality. |
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Photo 16
With
the provisionals in place the crown
lengthening procedure can now begin.
Intrasulcular incisions are made around
the facial aspects of the teeth in order
to reflect the flap. |
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Photo 17
With
the flap reflected it is readily apparent
there is not the required 3-4 mm of
biological width between the restorative
margin and the osseous crest. |
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Photo 18
The
Waterlase from Biolase is a hard tissue
laser that safely and conservatively
removes and recontours osseous tissue.
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Photo 19
Osseous
recontouring is finished and it is now
apparent that we have the proper vertical
dimension between the osseous crest
and the margin of the restoration. At
this point the margins of the provisionals
should be finished in the mouth to insure
a smooth junction to promote gingival
healing. |
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Photo 20
Sutures
have been placed and the patient will
be reappointed in 5-7 days for suture
removal and a post-op check. |
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Photo 21
It has been 7 weeks since the preparation/surgical
appointment. The excess of gingival
tissue visible on the pre-op portrait
is now gone. A closer look at the smile
shows a dramatic difference when compared
to the pre-op smile close-up seen in
Photo 1. |
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Photo 22
A
close-up facial view of the tissues
show no signs that any surgery took
place. This type of quick, complete
healing is typical of laser surgery.
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Photo 23
Extreme
close-up of central incisors. Note vitality
of restorations. |
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Photo 24
Extreme
close-up of right lateral incisor. Note
the optimum gingival health. |
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Photo 25
Extreme
close-up of left lateral incisor. Recall
that the margins were placed at the
gingival crest, and even after the surgery,
the gingival crest has remained in the
same position as is often the case with
laser surgery. |
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| Smile
Design. Gum recontouring, gummy smiles and
crown lengthening. Perfect Smile. |
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Leeds Cosmetic Dentistry
Cosmetic dentists in Leeds, at Advance Dentist our dentists offer private dental treatment and cosmetic dentistry. Learn more about our cosmetic dentistry treatments including dental implants, teeth whitening, crowns, bridges, porcelain veneers, white fillings, missing teeth or broken tooth. Dr John Haworth and our Leeds dentists provide smile makeovers to improve your confidence, making you look and feel younger with cleaner teeth, whiter teeth and healthier teeth. If you have a dental emergency in Leeds, contact us immediately so we can arrange a dental appointment as soon as possible. Nervous patients, afraid of the dentist or scared of dental treatment, are welcomed and provided with the highest quality of care.
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