Gingival contours/levels in the anterior
In this section, I have summarized some of the points from a lecture about the appears of the soft tissue in the maxillary anterior region.
- In regards to gingival contours in the maxillary anterior the 2 centrals are even, the laterals drop down, and the canines rise back up is traditional way of thinking.
- Symmetry is more important that a specific millimeter marking.
- Patients may or may not want to spend the extra time and expense to idealize gingival margins if the margin does not show in a natural smile.
- Study showed that non-dentists don’t particularly have concerns about gingival contour differences between central incisors at up to 1mm. 5mm is where they started to notice a lower quality of esthetics. However, non-dentists did not notice the actual tooth height compared to adjacent teeth until it reached 2mm difference.
- Smile line and patient considerations/expectations play a large role in the decision making process.
- When you want to move the tissue apically or coronally, you can intrude/extrude tooth, add root coverage, or crown lengthen.
- When trying to get tissue to follow tooth during ortho movement, there is a limitation as to how quickly the tooth can be moved. 5mm per month would be safe. However, in certain cases, tissue may not follow tooth.
- It is possible to do periodontal surgery to reposition and plasty tissue in order to reduce, move, and possibly eliminate amalgam tattoos.