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ePaper created 2016-03-29, 15:23:51 | version 1.38.0
shaping the gingival contour case report | 11 cosmetic dentistry 1 2016 canal therapy. The patient had no discomfort and de- sired not only restoration of the defective anterior teeth but also an aesthetic outcome. However, finan- cial limitations meant not all of her dental problems could be addressed. The dental examination revealed that tooth #22 was missing and tooth #23 had shifted mesially. Inaddition,therewerevisibledefectsonteeth#21,11 and12.Therootsofteeth#21and12wereapparently palatally inclined and so were the crowns. Tooth #11 was slightly inclined to the palatal side and so was the crown. During examination of the occlusion, a deep overbite and a large overjet of the anterior teeth became evident. In addition, the contour of the patient’s gingival line was inharmonious. The angle of her mouth was asymmetrical when she smiled (Figs. 1–4). Treatment plan For patients with malocclusion and misalignment of teeth, the restorative procedures should be per- formed once the primary orthodontic treatment has been completed. However, considering the length of treatmentandherfinanciallimitations,thepatientre- fused orthodontic treatment and only accepted the restorative treatment. Since the patient’s inharmo- nious gingival line may have interfered with the final aesthetic outcome, certain methods to improve the gingival contour were considered before tooth preparation. Fig. 10: The gingival contour was marked on the model. Fig. 11: The gingival contour was modified on the model. Fig. 12: The diagnostic wax-up showing the upward-shifted gingival contour. Fig. 13: Occlusal view of the diagnostic model. Fig. 14: The diagnostic wax-up showing the labially shifted restorations. Figs. 15 & 16: The tooth preparation was guided by the silicone index. Fig. 17: The completed tooth preparation. Fig. 18: The provisional restorations replicated from the diagnostic wax-up. Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 Fig. 15 Fig. 16 Fig. 17 Fig. 18 dentistry 12016