Dentaltown July 2018 - 58
Aesthetic
Crown
Aesthetic crown lengthening is a surgical procedure to correct a
"gummy smile," or to make the teeth appear longer. It is aesthetically
driven and usually requires crown lengthening on the just the buccal
surface of the teeth in question.
It has been reported that 14 percent of all women and 7 percent of all
men have a "gummy smile."1 When dentists and lay people were polled
and shown pictures, most agreed that gingival display up to 2 millimeters
was considered normal and pleasing to the eye, while anything more
than 3mm of gingival display was considered less attractive.2
Sulcus depth varies, depending on which tooth in the mouth
and where on the tooth you're probing. Assuming that you're dealing
with a periodontally healthy situation, 1-3mm would be deemed
within "normal limits" for a sulcus depth. We then will assume the
epithelial attachment to be around 1mm, and the connective tissue
attachment to be around 1mm as well. 2 This usually equates to 3mm
from the free gingival margin to the bone on the direct facial, and
around 4.5mm on the interproximal areas from the tip of the papilla
to the crest of the bone. The only way to know this before surgery
is through bone sounding. I always recommend sounding before
fl apping the tissues, so I can ascertain if I am dealing with a normal,
high or low crest situation.4
Some common causes of a "gummy smile" include:
Hyperactive upper lip
What it means: This patient looks "normal" in repose, but shows an
excessive amount of gingiva when smiling. Tooth size is normal. The average
translation from repose to full smile for women is 7mm; for males, 8mm.
Treatment option: Botox to help immobilize the hyperactive lip.
58
JULY 2018 // dentaltown.com
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Table of Contents for the Digital Edition of Dentaltown July 2018
Dentaltown July 2018 - Intro
Dentaltown July 2018 - Cover1
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