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Jurado CA, Parachuru V, Villalobos Tinoco J, Guzman-Perez G, Tsujimoto A, Javvadi R, Afrashtehfar KI. Diagnostic Mock-Up as a Surgical Reduction Guide for Crown Lengthening: Technique Description and Case Report. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1360. [PMID: 36295521 PMCID: PMC9608665 DOI: 10.3390/medicina58101360] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/22/2022] [Accepted: 09/25/2022] [Indexed: 07/30/2023]
Abstract
Background and Objectives: The report describes a technique using a diagnostic mock-up as a crown-lengthening surgical guide to improve the gingival architecture. Materials and Methods: The patient's primary concern was improving her smile due to her "gummy smile" and short clinical crowns. After clinical evaluation, surgical crown lengthening accompanied by maxillary central full-coverage single-unit prostheses and lateral incisor veneers was recommended. The diagnostic mock-up was placed in the patient's maxillary anterior region and used as a soft tissue reduction guide for the gingivectomy. Once the planned gingival architecture was achieved, a flap was reflected to proceed with ostectomy in order to obtain an appropriate alveolar bone crest level using the overlay. After six months, all-ceramic crowns and porcelain veneers were provided as permanent restorations. Results: A diagnostic mock-up fabricated with a putty guide directly from the diagnostic wax-up can be an adequate surgical guide for crown-lengthening procedures. The diagnostic wax-up was used to fabricate the diagnostic mock-up. These results suggested that it can be used as a crown-lengthening surgical guide to modify the gingival architecture. Several advantages of the overlay used in the aesthetic complex case include: (1) providing a preview of potential restorative outcomes, (2) allowing for the appropriate positioning of gingival margins and the desired alveolar bone crest level for the crown-lengthening procedure, and (3) serving as a provisional restoration after surgery. Conclusions: The use of a diagnostic mock-up, which was based on a diagnostic wax-up, as the surgical guide resulted in successful crown lengthening and provisional restorations. Thus, a diagnostic overlay can be a viable option as a surgical guide for crown lengthening.
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Affiliation(s)
- Carlos A. Jurado
- Woody L Hunt School of Dental Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA
| | - Venkata Parachuru
- Woody L Hunt School of Dental Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA
| | - Jose Villalobos Tinoco
- Graduate Program in Periodontics, School of Dentistry, National University of Rosario, Rosario S2000CGK, Argentina
| | | | - Akimasa Tsujimoto
- Department of Operative Dentistry, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA 52242, USA
- Department of General Dentistry, School of Dentistry, Creighton University, Omaha, NE 68102, USA
| | | | - Kelvin I. Afrashtehfar
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City P.O. Box 346, United Arab Emirates
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, CH-3010 Berne, Switzerland
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