Esthetic Periodontics Flashcards
what are the goals of esthetic periodontics
- describe the esthetic smile
- make a proper diagnosis
- create a periodontal and restorative plan
- cases
what are the essentials of a smile
- the teeth
- the gingiva
- the lips
what are the components of an esthetic smile
- minimal gingival exposure
- display of 75-100% of the crowns and all interproximal tissue
- symmetric display and harmony between the maxillary gingival line and the upper lip
- lower lip parallel to the incisal edges of the maxillary teeth and in close approximation
what is another name for excessive gingival smile and how common is it
- the gummy smile
- descriptive term rather than a dx
- seen in 14% of women and 7% of men
dentists and laypeople did not notice gingival display until central incisors were altered:
1.5-2mm
orthodontists noticed gingival disaplay at:
0.5mm
when measuring face height in repose:
the length of the middle third of the face should equal the length of the lower third
where is the midface measurement
from the glabella (the most prominent point of the forehead between the eyebrows) to the subnasale (the point beneath the nose
where is the lower face measured from
the subnasale to the soft tissue menton (lower border of the chin_
where is lip length measured from
when in repose the lip is measured from the subnasale to the inferior border of the lip
what is the lip length in repose in young females
- 20-22 mm lip length measurement
- 3-4mm display of maxillary central incisors
what is the lip length in repose in young males
-22-24mm lip measurement
- 1-2mm display of maxillary central incisors
what should the lip in full smile be
- the maxillary lip should move to the tooth-gingiva interface on the maxillary central incisors and canines
- if the maxillary lip exposes more than 1.5-2mm of marginal gingiva, this is considered excessive gingival display
if the maxillary lip does not fall in the norms of 20-22mm for women and 22-24mm for men one of the etiologies is:
a short upper lip
what are the treatments for a short maxillary lip
- lip repositioning surgical procedure
- botox therapy
- facial plastic surgery
when is a hyperactive maxillary lip a dx
if the face height, gingival levels, lip length and length of the central incisors are all within acceptable limits and the pt has excessive gingival display
in a full smile the maxillary lip should generally translate ______ from repose
6-8mm
a patient with a hyperactive maxillary lip may translate _______ times that
1.5-2
what is the tx for a hyperactive maxillary lip
- lip repositioning surgical procedure
- botox therapy
- facial plastic surgery
when does dentoalveolar extrusion happen
when one or more maxillary teeth overeruptw
when does dentoalveolar extrusion happen
lack of opposing dentition the maxillary alveolar complex moves down with the overerupting teeth
when cases are dentoalveolar extrusion seen in
class II malocclusion cases
in dentoalveolar extrusion anterior gingival line is:
concave from canine to canine
what is the tx for dentoalveolar extrusion
- movement of the overerupted teeth into their desired positions
- this can be done by surgical treatment with a segmental osteotomy and ortho therapy
- occlusion with stable anterior stops must be restored
when would vertical maxillary excess be the etiology of excess gingival display
if the lower face is longer than the midface
in vertical maxillary excess in a full smile the incisal edges:
of maxillary anterior teeth may be hidden by the lower lip
what can be used to dx vertical maxillary excess
cephalometric radiographs
what is the tx for vertical maxillary excess
- orthognathic surgery is usually required
- a section of bone is removed and the maxilla is then impacted to the desired position
- sometimes a mandibular advancement procedure is also necessary in addition to the maxillary osteotomy to establish a stable occlusion
what is altered passive eruption
when there is a short clinical crown length and the gingiva demonstrates a healthy appearance and there is no incisal edge wear, altered passive eruption is the dx
what is active eruption
eruption of the teeth through the bone and soft tissue into occlusion with the opposing teeth