Gingival recontouring by provisional implant restoration for optimal emergence profile: report of two cases

Cone beam computed tomography assessment of maxillary anterior teeth cervix dimensions in healthy adults for optimal anatomic healing abutments

OBJECTIVES

The abutments produced with circular symmetry failed to accurately replicate the natural teeth's cervical shapes. The purpose of this study was to measure cervical cross-sections of maxillary anterior teeth using cone beam computed tomography (CBCT) images to design anatomic healing abutments.

MATERIALS AND METHODS

CBCT data of 61 patients were analyzed using Ez3D Plus software. Measurements were taken at the cemento-enamel junction (CEJ) and 1 mm coronal to CEJ for maxillary central incisors, lateral incisors, and canines. Various parameters, including area, perimeter, and eight line segments in the distal (a), disto-palatal (b), palatal (c), mesio-palatal (d), mesial (e), mesio-labial (f), labial (g), and disto-labial (h) directions, were used to describe dental neck contours. The ratios (f/b and h/d) were analyzed, and differences based on sex and dental arch morphology were explored.

RESULTS

Significant differences were found in area and perimeter between males and females, but not in f/b and h/d ratios. Differences in the f/b ratio were observed among dental arch morphologies for maxillary central incisors, lateral incisors, and canines.

CONCLUSIONS

CBCT measurements of cervical cross-sections provide more accurate data for designing anatomic healing abutments. The fabrication of anatomical healing abutments needs to consider the influence of gender on cervical size and to explore the potential effect of arch shape on cervical morphology.

CLINICAL SIGNIFICANCE

The novel method provides detailed measurements for the description of dental cervical contours for patients with bilateral homonymous teeth missing. The measurements of this study could be utilized to design more accurate anatomic healing abutments to create desired morphology of peri-implant soft tissue.

Digital replication of the peri-implant soft tissue contour of implant-supported crowns: A dental technique

Making an intraoral digital scan of the emergence profile is a clinical challenge. The peri-implant soft tissue collapses after removal of an interim prosthesis, which compromises the correct design of a definitive implant-supported prosthesis. Although techniques are available for digitally reducing such a distortion, achieving a correct alignment of scans to replicate the internal and external characteristics of the peri-implant tissue is still challenging. This article describes an alternative technique for achieving a precise alignment of the peri-implant soft tissue emergence profile generated with an interim prosthesis.

Esthetic enhancement of a traumatized anterior tooth with a combination of forced eruption and tooth alignment: a case report

Exposing sound structure of a subgingivally fractured tooth using orthodontic extrusion is considered to be a conservative way to re-establish biologic width without sacrificing esthetics or jeopardizing periodontal support of neighboring teeth. When a misaligned tooth is traumatically involved, a more comprehensive approach combining tooth extrusion and re-alignment may be necessary for a successful restorative outcome. This case report describes a successful esthetic management of a patient with complicated crown-root fracture on the maxillary right central incisor and pre-existing malocclusion in the maxillary anterior region. Forced eruption along with re-alignment of teeth by orthodontic movement seems to allow re-positioning of the fracture line to a favorable position and correction of crowding, providing a better esthetic result.