Papilla and pontic area regeneration in patient with gingival smile: A clinical case

Abstract

PurposeConnective tissue grafts are widely documented as a predictable technique for treating Miller Class I and II recessions, as well as procedures in which soft tissue augmentation is required for aesthetic reasons. This article aims to explore the resolution of a clinical case with this type of problema.Clinical caseThis case describes a technique for reconstructing a pontic area and adjacent papilla by means of two consecutive connective tissue grafts. The first graft served to increase the amount of tissue in the horizontal direction, and the second promoted vertical reconstruction of the defect.Results and ConclusionIn cases with aesthetic requirements, restorative intervention may be able to mask tissue loss, but it can hardly achieve optimal aesthetic results. Periodontal plastic surgery techniques can be used to achieve that ideal result. The clinician must diagnose conditions in order to select correct treatment regimen for each individual case. Key words:Papilla, gingival smile, pontic, restorative dentistry.

Integração entre próteses fixas e perfil do biótipo periodontal

“…Ao alcance da desejada estética dentária e gengival, são necessárias correções em tecidos periodontais, visando um contorno gengival adequado e que garanta a harmonia do sorriso do paciente. Neste sentido, as técnicas de enxerto gengival livre permitem a correção de diversas deficiências do tecido gengival, como nos casos em que há necessidade de aumento da faixa de tecido queratinizado vestibular, de forma a favorecer uma adaptação harmoniosa do tecido marginal, de acordo com o perfil de emergências das coroas reabilitadas (Gómez-Meda, et al, 2018).…”

“…Atualmente, é possível encontrar diversas cirurgias plásticas periodontais para o manejo dos tecidos moles, com o objetivo de juntamente com a prótese dentária estabelecer ou restabelecer padrões de estética dento-gengivais. Essas cirurgias também facilitam a técnica de moldagem e consequentemente favorecem ao processo de confecção e adaptação das restaurações cerâmicas (Gómez-Meda, et al, 2018).…”

Multidisciplinary Treatment after Orthodontics: Crown Lengthening and Dental Whitening in the Final Aesthetic Resolution of Smile

“…The absence of the papilla is related to the availability of adjacent bone support, contour of the bone crest, interdental distance and dimension of the inter-proximal space. The interdental distance should be, on average, 3 mm, to give an adequate shape and volume, and the interdental space on natural teeth should be more than 5 mm (GÓMEZ-MEDA et al, 2018). The papillary line is composed of the tips of the gingival papilla.…”

“…In the upper central incisors, when under normal conditions, the papilla should be half of the height of its crown (CÂMARA, 2010). Papilla loss can be divided into three classes: Class I when the tip of the papilla is located between the contact point and the interproximal cement-enamel junction; Class II when the tip of the papilla is present at the level or apically to the interproximal CEJ, however coronal to the vestibular CEJ; and Class III when the papilla is at or below the level of the vestibular CEJ (GÓMEZ-MEDA et al, 2018).…”