gingival esthetics in periodontics

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PERIODONTAL CONSIDERATIONS

IN

K. PRUDHVI, I STMDS

DEPARTMENT OF PERIODONTICS

GITAM DENTAL COLLEGE

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Introduction

A beautiful smile is an added asset to a

beautiful face.

Esthetic demands of patients are increasing and

esthetics has become an inevitable part of

dentistry.

Key to successful results in esthetic dentistry

lies in a saying by Dawson (1995) “if you know

where you are and you know where you want to

go, getting there is easy”.

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Facial Aspects

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Dentofacial Aspects

Dental Aspects

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Dentogingival components

Goldstein (2000 ) noted a number of dentogingival elements for consideration into general patient esthetic evaluation.

• Dental midline• Occlusal plane• Incisal edge

curvature• Contact points • Incisal embrasures• Axial inclination

DENTAL

• Gingival line • Gingival height of

contour • Gingival

embrasures

GINGIVAL

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Periodontal Parameters For Esthetic Smile

Gingival health

Gingival health is the basic pre-requisite for

an esthetic gingival morphology.

Inflammation produce changes in color and

surface texture of the gingiva. Therefore

proper assessment of gingival esthetics can

only be performed under inflammation free

periodontal conditions.

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Gingival Contours

The contour of the gingival margins of the six

maxillary anterior teeth plays an important role

in smile esthetics and is determined by the

following features

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The contour of the gingival margins must

coincide with the CEJs of the teeth.

The maxillary gingival margin should run

parallel to the incisal edges of the teeth and

parallel to the lower lip line when the

individual is smiling.

The gingival esthetic line:- Ahmad 1998 is

the line connecting zeniths of the central

incisors and canines which intersects the

dental midline This line will be harmonious

with the upper lip which should just cover

1mm of the margin during full smile. This

ranges from 2mm to - 2mm.

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Sylvain and Charruel et al

Chinche and Pinault

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The gingival level of the maxillary left and right lateral incisors are situated below the level of the central incisors and the canines.

The gingival level of the maxillary left and right lateral incisors are at the same level as the central incisors and the canines.

The gingival level of the maxillary left lateral incisors is at a lower level compared to the right lateral incisors.

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The gingival levels of the maxillary lateral incisors are above the level of the central incisors and canines.

The gingival levels of the maxillary canines are at a higher level than the central incisors. However, the lateral incisors are at a much higher level than the gingival margins of the central incisors and canines.

Unequal gingival levels of the maxillary central incisors.

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Gingival Zenith

Defined as the apex of gingival height of contour.

It influence the emergence profile and axial inclination of the teeth by modifying the line angle position of the long axis of the emergence of the crown from the gingiva

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Carolina et al

Stephen et al

1 mm 0.4mm COINCIDED

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Gingiva papilla And Gingival Embrasures

The contact point between the central incisors is in the most incisal position compared with the contact point between other teeth. The interdental spaces appear narrower on the right than on the left causing a difference in the papillary height between the two sides.

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Gingival Display

The degree of gingival exposure ideally should be only 1-3 mm above the cervical area of the tooth (Kokich,1999). An expanse of soft tissue should not be considered to be unaesthetic per se, but the way this soft tissue is arranged relative to the teeth and lips is of an esthetic concern. During an extensive smile, the upper lip should rest at the level of the mid facial gingival margins of the maxillary anterior teeth.

TZANAHAetal

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Gingival Color

The color of the gingiva plays an important

role in overall esthetics.

As seen clinically, it varies from person to

person, in different areas of the mouth and

appears to be correlated with the color of the

skin.

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According to Dummett (1959), color of the

healthy gingiva is variable, ranging from pale

pink to deep bluish purple. Between these

limits of normalcy are a large number of colors,

which depend primarily upon

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Degree of pigmentation of the gingiva and skin is reciprocally related .

The highest rate of gingival pigmentation has been observed in the area of the incisors with a decrease in the posterior areas.

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CONCLUSION

Appearance of the gingival tissues surrounding the teeth and their relation ship with lips plays an important role in the esthetics of the maxillary anterior region of the mouth.

Knowledge of normal is essential pre requisite for diagnosis of abnormal. Therefore, an understanding of the ideal gingival characteristics has critical importance for the multidisciplinary diagnosis and treatment in the anterior dentition.

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