Please activate JavaScript!
Please install Adobe Flash Player, click here for download
ePaper created 2016-12-07, 11:04:42 | version 1.38.0
21 dentistry 4_2016 cosmetic gingival contour were considered before tooth preparation. Crown lengthening has been widely used for improving the contour of the gingival line.9-11 However, even if the contour of the gin- gival line could be modified through periodontal surgery from the vertical direction, the palatally inclined maxillary anterior teeth would cause the inclination of the teeth’s long axes in the sagittal direction. Therefore, the ideal aesthetic outcome would be difficult to achieve (Fig. 5). In this case, the restoration’s entire labial face needed to be shifted labially so that the height of the gingival contour could be improved (Fig. 6). Therefore, a more suitable treatment option was considered. During further examination, we found that the patient had a thick gingival biotype with a 3 mm deep gingival sulcus around the maxillary right lateral incisor and maxillary left central in- cisor and 1 mm deep around the maxillary right central incisor (Figs. 7 & 8). In implant dentistry, when the soft tissue around the implant is of a thick biotype, modify- ing the contour of the soft tissue by shaping the transmucosal soft tissue with a provisional resin crown of a certain shape has been proved to be an effective method for improving the aesthet- ic outcome.12-15 However, for restoring defective natural teeth, there is insufficient clinical evi- dence to prove whether provisional resin crowns are capable of shaping the gingival contour. Such a treatment protocol was deemed worth attempting in the current case. _Diagnostic wax-up In order to preview the expected outcome and guide the treatment, a diagnostic wax-up was prepared. On the model, the incisal edges Fig. 17_The completed tooth preparation. Fig. 18_The provisional restorations replicated from the diagnostic wax-up. Fig. 19_The provisional restorations placed in the mouth. Figs. 20 & 21_The gingiva was covered by the labial side of the provisional restorations. Fig. 22_The gingiva was covered by the labial side of provisional restorations (diagrammatic sketch). Fig. 23_The provisional restorations appeared just as if they had erupted from the gingival sulcus (diagrammatic sketch). Fig. 17 Fig. 19 Fig. 21 Fig. 22 Fig. 23 Fig. 18 Fig. 20 case report _ shaping the gingival contour