influence of perio on aesthetics

Question 1

What is the aesthetic oral unit?

Answer 1

Teeth
Gingiva (colour, form/shape, position, symmetry, ration to upper lip)
Lipline

Question 2

What is the aesthetic gingival form?

Answer 2

Knife edged margins
Smooth transition from gingiva to tooth
Fill embrasures
Light stippling
Upper canines and central incisors on same plane w laterals +/-1.5mm

Question 3

How does perio affect aesthetics?

Answer 3

Inflammation (erythema/swelling/fibrosis)
Recession (localised/generalised)
Tooth movement (drifting/loss of perio support)

Question 4

How does perio tx affect aesthetics?

Answer 4

Pros
-reduction of erythema/swelling
-improvement of contour

Cons
-recession
-poor contour

Question 5

What is the gingival veneer?

Answer 5

For generalised tissue loss anteriorly
Only if maintenance is good
Contraindicated if high caries risk

Hard and soft type-
Soft- not much choice
Hard- shade guide, tintable

Question 6

What is periodontal plastic surgery?

Answer 6

Treats-
-high frenum
-gingival recession
-delayed gingival maturation
-irregular gingival margin
-subgingival restorative margins
-ridge collapse
-gingival discolouration

Tx options-
Frenectomy
Grafting
Crown lengthening
Excision

Question 7

What is part of the preop assessment?

Answer 7

Initial non surgical management
Radiographic/clinical exam
Patient factors
Consent (purpose/limitations/complications/outcomes)

Question 8

How can you manage excessive gingival height?

Answer 8

Due to delayed gingival maturation/drug induced gingival overgrowth

Gingivectomy

Excisional flap (w/o osseous surgery)

Question 9

What is crown lengthening?

Answer 9

Bone has 1-2cm of tissue above it
Flap is raised, bone is recontoured to prevent relapse (body tries to recreate biological width)
Sutures placed

Can use straight handpiece, appropriate bur and sterile water

Can use this technique with receded crown margins, vertical/horizontal asymmetry and then place better crowns to the new height