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ePaper created 2016-03-29, 15:23:51 | version 1.38.0
| case report shaping the gingival contour 10 cosmetic dentistry 1 2016 Between BOPT and BTA: A case report on shaping the gingival contour around tooth-supported restorations by means of provisional resin crowns Author: Dr Feng Liu, China Shaping the soft-tissue contour around implants withprovisionalresincrownsafterimplantplacement has become a frequently used technique in implant dentistry.1 For most implant-supported restorations, there is a 3 to 4 mm transmucosal attachment sur- rounding both the implant and the restoration.2 Therefore, adjusting the soft-tissue contour by modi- fyingtheemergenceprofileoftheprovisionalcrowns to optimise the aesthetic outcome has become a reg- ular practice in implant dentistry.3 In consideration of the health of periodontal tissue around natural teeth, the location of the crown mar- gin is preferably placed supragingivally or flush with the gingival margin so that the contour of the resto- ration will not influence the gingival contour.4, 5 How- ever, in the case of covering the original colour of the abutment tooth, forming the ferrule, and/or improv- ing retention and resistance form, the crown margin can be placed subgingivally.6 Because the sulcular deptharoundahealthynaturaltoothisaround1mm, the cervical margin of the crown is usually located 0.5 mm below the free gingival margin.7, 8 Thus, un- like an implant-supported crown, a tooth-supported crown can hardly influence the gingival contour. However, when the sulcular depth of the abutment is sufficiently deep, as with a thick gingival biotype, it is possible to sculpt the gingival contour around the abutment teeth using provisional resin crowns. The treatment process will be demonstrated in this articlethroughatypicalcasewithaseven-yearretro- spective review. Case report A48-year-oldfemalepatientwhosegeneralhealth condition was good, was referred to the Peking Uni- versity Hospital of Stomatology in Beijing in China in 2008. The patient’s main concern was the restoration ofhermaxillaryanteriorteeththathadbeencompro- mised by severe dental caries and treated with root Fig. 1: Frontal view of the patient’s smile before treatment. Fig. 2: Pre-op photograph showing the occlusal relationship of the anterior teeth. Fig. 3: Pre-op photograph of the maxillary anterior teeth. Fig. 4: Pre-op photograph of the maxillary anterior dental arch. Fig. 5: The inclined axis of the tooth would have resulted in an unfavourable aesthetic outcome. Fig. 6: The labial side of the restorations would be shifted labially. Fig. 7: The probing depth of the gingival sulcus around the maxillary left central incisor was 3 mm. Fig. 8: The probing depth of the gingival sulcus around the maxillary right central incisor was 1 mm. Fig. 9: Frontal view of the pre-op model. Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 dentistry 12016