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ePaper created 2016-12-14, 09:49:38 | version 1.38.0
38 2_2016 laser 38 laser_case report I case report Figs. 1 & 2_A high smile line and the affected outline of the incisal line. Fig. 3_Problems with teeth #13, 12 and 22, occlusal view. Figs. 4a & b_Asymmetrical gingival line with high lip line. _The harmonious and aesthetic appearance of the anterior maxillary region of the mouth has great impact on improving patients’ physical appearance and hence their self-esteem. It is no longer enough to simply reproduce lost tooth structure. Contemporary standardsemphasisetheimportanceofavoidingpro- ceduresthatwillresultinaestheticcompromise,asthe aim is to provide patients with improved aesthetics wheneverpossible. Among the most frequently used methods to achieve predictable, successful aesthetic rehabilita- tionofthesmileiscrownlengthening.Crownlength- eningentailsasurgicalprocedureperformedbyaden- tist to expose a greater amount of tooth structure for thepurposeofsubsequentlyrestoringthetoothpros- thetically.1 Theprocedureexposesmoreofthenatural tooth by reshaping or recontouring the bone and the gingivalline.Thistreatmentcanbeperformedonasin- gle tooth, multiple teeth or the entire gingival line to achieveapleasant,aestheticallypleasingsmile.When performedintheanteriormaxillaryregion,itspurpose istofacilitateanidealgingivalarchitecture,whichin- volves recontouring of the hard and soft tissue in or- dertopreventviolationofthebiologicwidth.2,3 Since the maintenance of a healthy periodontium remainsthesinequanonofasuccessfulaestheticand functional restoration, it is essential not to interfere with the normal arrangement or functioning of the biologic width. Because the biologic width appears to constituteaconstantfeatureinthehumanperiodon- tium, it has been suggested as an inviolate therapeu- tic parameter.4 Clinical observation indicates that im- pingementofthebiologicwidthwillresultinattempts by the gingival tissue to re-establish its original di- mension through bone resorption or, in the presence of a thick alveolar crest, chronic gingival inflamma- tion.5,6 Thepredictabilityofgingivallinelevelsaftercrown lengtheningproceduresandthehealingtimerequired to achieve it are essential factors to consider. The two indications for anterior maxillary crown lengthening proceduresare 1.to increase the amount of labial exposure of the clinicalcrown; 2.toincreasetheamountoftoothexposedsuperiorto thebonetopreventimpingementoftherestoration onthebiologicwidth. _Laser-assisted crown lengthening Critical to the long-term success of any crown lengthening procedure—whether accomplished by conventional means or by laser, and whether involv- ing soft-tissue modification alone or in conjunction with osseous surgery—is preservation of biologic 16 I laser 1_2015 Laser assisted crown lengthening in the anterior maxilla Author_Minovska Ana, Cvetanovska Stojcheva Daniela, Macedonia Fig. 1 Fig. 2 Fig. 3 Fig. 4a