periodontics
feature
by James Kohner, DDS
Part I
Have you ever been frustrated when your beautiful aesthetic work is compromised by
an existing display of excessive or uneven gingival tissue in the aesthetic zone? Have you
been tempted by advertisements to remove the excess tissue by gingivectomy using a laser,
electro-surgery unit or blade?
You are not alone. But... stop! Do not proceed until you read further.
Dentistry in the 21st century has changed quite dramatically from the 20th century.
Today, both aesthetics as well as use of technology are higher priorities. Both have revolutionized what we do. From more successes with implants to highly aesthetic veneers and
stronger bonding materials, we now have powerful tools that were not available 10 years
ago. But while utilizing these exciting technologies, it is essential to remember the basics.
Today every complication or restorative challenge does not automatically need to become a
titanium implant or a laser opportunity!
One basic procedure that many clinicians overlook, is crown lengthening. This procedure has remained essentially unchanged for 30 years and remains as useful now as ever.
It has applications in all parts of the mouth. For posterior teeth often there is not enough
tooth structure for retention (Figs 1.1 and 1.2). This can occur as a result of excessive gingiva, caries or fractures. When teeth are prepared in a subgingival fashion, problems can
occur from impingement on the soft tissue. Crown lengthening can help create an abutment tooth that not only has better retention, but allows for a crown margin that will not
impinge on the soft tissues by creating enough mechanical tooth structure for retentiveness
while staying outside of the soft tissue dimension with the restorative margin.
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SEPTEMBER 2014 » dentaltown.com
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Table of Contents for the Digital Edition of Dentaltown September 2014