by Albert B. Konikoff, DDS
The creation of an esthetic smile is a collaborative process, which at a minimum involves the patient and restorative dentist. Often, however, the participation of other specialists is necessary to fulfill the patient’s expectations. This article explores the periodontist’s role in creating an optimal gingival frame: surgical crown lengthening and a modified subepithelial tissue graft to shorten the clinical crown are the treatments presented. These procedures are part of the periodontal plastic surgical armamentarium as these techniques rise to the highest levels of sophistication.
This article will discuss the two periodontal plastic surgical procedures most commonly used to alter the gingival frame: cosmetic crown lengthening to increase the length of the clinical crown, and gingival augmentation to reduce the clinical crown length. To be predictable, these procedures need to have a sound biologic basis and a reproducible clinical protocol, and be performed in a healthy periodontal environment.
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