11.1 Restorative/periodontal considerations

Question 1

Define biological width

Answer 1

• “Natural seal” that develops around teeth (and dental implants)
• Essential for preserving periodontal health
• The dimension of the soft tissue attached to the tooth coronal to the alveolar crest (Gargiulo et al. 1961)

Question 2

Describe the importance of the biological width in maintaining periodontal health in the restoration of teeth

Answer 2

if a restoration violates the BM, inflammation occurs with potential loss of attachment and bone

Question 3

Identify methods to correct violation of the biological width

Answer 3

• methods increase the clinical crown length
• surgical crown lengthening
• orthodontic extrusion (forced eruption)

Question 4

Identify periodontal local risk factors associated with restorative dentistry

Answer 4

overhanging restorations, subgingival restoration margins, these can also increase plaque retention.

• lack of interproximal contact
• caries close to the gingival margin (holds biofilm close to gingiva)

Question 5

List treatment options for the correction of these local factors impacting periodontal health

Answer 5

-

Question 6

State the appropriate sequence of treatment options in comprehensive treatment planning

Answer 6

-

Question 7

what is the biological width width when defined as soft tissue attachment alone?

Answer 7

about 2 mm

Question 8

what is biological width when defined as sulcus plus soft tissue attachment

Answer 8

about 3 mm

Question 9

what is the recommended restorative margin placement in relation to the biological width?

Answer 9

supragingival when possible

-subgingival extension to 0.5 mm (NEVINS AND SHUROW)

Question 10

when crown lengthening, how much tooth structure should be made to be between the gingiva and restoration?

Answer 10

about 3 mm