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cosmetic dentistry_ beauty & science International Edition

I CE article _ interdisciplinary approach (c) Category 3: more than 8 mm of gingival display, treated with orthognathic surgery with or with- out periodontal and restorative treatment. 6. Hypermobile upper lip—the average mobility of the upper lip is from 6 to 8 mm from the rest position. More than 8 mm represents hypermobility. Con - sidering that the average distance from the lower marginoftheupperlipandthebaseofthenose(sub- nasion)is21mm,onecouldtaketwosuperimposed photographswiththepatientatrestandthepatient smiling fully to calculate the lip mobility very easily usingthe42.2rule.Generallynormaltoothlengthis present and dental labial aesthetics is good to ideal. The treatment regimen could entail a coronally po- sitioned mucosal flap, crown lengthening with os- seousresectionoracombinationofboth(Figs.8&9) Example: Photographs captured at the same mag- nification opened in Adobe Photoshop: Picture10:Fullsmile—lengthofthecentralexposed – measure digitally in pixels distance from incisal edge to the lower margin of the upper lip in full smile. Picture 11: Lips at rest – 2 mm central incisor reveal + 21 mm distance lower lip to base of the nose. Incisal edge to base of the nose 23 mm (incisal edge at the correct position). x = distance from the incisal edge to the lower margin of the upper lip in full smile y = the amount of central incisor exposed at rest Fig.16_Thenewdesignproposalinwax. Fig. 17_Very good communication with the dental laboratory. Fig. 18_The crown-lengthening surgical guide. Figs. 19–24_Crown lengthening with osseous contouring. (Surgery performed by Dr Muriel Krischek, Belgium.) Figs. 25–27_The bis-acrylic prototype. 08 I cosmeticdentistry 1_2014 Fig. 27Fig. 26Fig. 25 Fig. 22 Fig. 23 Fig. 24 Fig. 21Fig. 20Fig. 19 Fig. 18Fig. 17Fig. 16 CDE0114_06-10_Ercus 11.06.14 14:02 Seite 3