| When the tooth, root caries, gingival and alveolar ridge to reach below, make the clinical crown is too short, not conducive to the retention of restoration, it is bound to the margin of the restoration into the gingival sulcus bottom, it will infringe biological width.Crown lengthening surgery using apically repositioned flap operation and removed a small amount of bone and bone forming, make tooth section exposed in the gingival margin, while extending the clinical crown, and create conditions for the restoration of reasonable. Indications include:1.Teeth lengthening of sub-gingival crown fracture, gingival inflammation polyp or interfere with treatment. If the simple excision of gingival, because the principle does not conform to the biological width, periodontal also hyperplasia.2.The root canal perforation or external root resorption in cervical1/3, the tooth still retained value.3.The front teeth crown short, laugh gummy, need to improve the appearance.4.Prosthesis destroy biological width.The contraindications are:1.The section position too deep, so you need to remove too much bone, and the gingival margin position is too low.2.Alveolar fossa root is too short, crown root ratio not coordinator.3.The front teeth to bone more will cause the appearance and the adjacent teeth is not harmonious, available at this time of orthodontic root, the broken end reaches above the gingival margin. The matters needing attention are:1.The wound healing after tooth profile, the exposed length should be able to meet the needs of restorations.2.Height of gingival shape of maxillary anterior teeth of each should be considered with the physiological requirement.3.6weeks to6months after surgery of gingival margin position may be a small amount of adjustment, it is improper to make restoration prematurely. Now the crown lengthening surgery refers to the number of cosmetic operation, generally refers to two kinds, one kind is the crown is too short, poor appearance after the first crown lengthening and repair. There is a smile gingival too much, to extend the operation to use gum on crown. One have to mention, although many doctors tried to dissuade, but take the porcelain teeth to repair the individual teeth irregularly or have many followers. When the crown lengthening surgery often can come in handy, because of uneven teeth must be accompanied by gingival not beautiful arc. Before the first dressing do porcelain teeth gum will undoubtedly bring more satisfactory results. This paper shows the biological basis of the premise, steps and method of periodontal aesthetic crown lengthening. This study adopts a series of new measurement standards, on the basis of known reasonable tooth proportion, clinical crown height measuring tooth ideal location, tired and interproximal gingival papilla at. Crown biological height is defined as the cutting edge to the crest of the ridge distance, crown height was determined from the functional perspective, the ultimate goal is to establish and form tooth structure suitable for repair, placed the edge, establish healthy gingival complex and achieve satisfactory aesthetic effect.Objective To explore the use of proportion gauges and to evaluate the effect of crown lengthening surgery of upper anterior tooth by using innovative proportion gauges.Methods12patients with26upper anterior teeth were treated by crown lengthening surgery with the help of innovative proportion gauges and restored with metal porcelain crown after8to12weeks.The location of the laughing lines, the coordination of gingival margin,the morphology of gums, plaque index (plaque index, PLI), tooth mobility (mobility, MOB) were selected as clinical observation indexes.All evaluation indexes were recorded1W before and after surgery,2M, the immediate postoperative restorations and6M after surgery. The data were analyzed by One-way Analysis of Variance of repeated measures design (SPSS13.0).Results The cervical margin fitted the immediate postoperative restorations very well.The coordination of gingival margin reached91.7%satisfaction. The color of gingival reached95.8%satisfaction.The morphology of gingival reached87.5%satisfaction.The laughing line position in patients with gummy smile changed from high position to median position.The cervical margin fitted the restorations very well6months after operation.There is no significant gingival hyperplasia or retreat.The color of gingival reached100%satisfaction.There is no difference in other indicators.1week after surgery the index of PLI increased significantly compared with the index before surgery(P<0.05).2months after surgery the index of PLI reduced significantly compared with the the index before surgery(P<0.05).The index of MOB increased significantly1week after surgery (P<0.05) compared with the index before surgery.2months after surgery there was no significantly difference of PLI compared with the the index before surgery.Conclusion As long as strictly control the indications,crown lengthening surgery combined with restoration with metal porcelain crown can achieve a good cosmetic restoration purpose by using innovative proportion gauges. |
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