MY BEST INDIRECT CASE

Vol II 2008

Treatment of Excessive Gingival Display and Anterior Overeruption:

Rehabilitation and Restoration

In order to develop a normal physiologic relationship between the osseous crest and correct the incisal positioning of the gingival margin as related to the CEJ, surgical correction of the patients excessive gingival display was required. Once sufcient crown length was present, the anterior dentition were prepared for porcelain restoration and provisionalized. Aesthetic rehabilitation was performed using a feldspathic veneer system that would provide natural uoresence and light transmission, while neutralizing the underlying tooth shades.

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1. T  he patient presented with excessive gingival display due to active altered eruption. 3. O  cclusal view of the maxillary region demonstrates compromised rotation and preexisting restorations.

2.  Discoloration and alignment were also areas of concern noted during treatment planning. 4.  The diagnostic model was used to determine the desired bone levels following periodontal rehabilitation.

Jay M. Lerner, DDS* Peter Kouvaris, CDT

* Private practice, Palm Beach Gardens, Florida. L  aboratory technician and VP/ Partner, JK Dental Laboratory, Port Washington, New York. 5602 PGA Boulevard, Suite 201 West Palm Beach, FL 33418 Tel.: 561-379-8787 E-mail: lernerlemongello@aol.com 5. Following nal soft tissue healing, the teeth were prepared for all-ceramic restorations.

Jay M. Lerner, DDS, Peter Kouvaris, CDT

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Provisional restorations were placed with the incisal edges brought to proper length.

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A silicone template was fabricated based on the diagnostic waxup of the provisionalized teeth to ensure development of optimal tooth contours.

8. The required porcelain thickness was veried on the model prior to initial layering.

9. The initial porcelain layering was conducted using a feldspathic ceramic (JK Veneer, JK Dental Laboratory, Port Washington, NY).

10. Additional porcelain characterization was added to the cervical third to ensure a natural transition to the gingival tissue.

11. Interproximal cutback and facial characterization were required to provide optimal light transmission.

MY BEST INDIRECT CASE

Vol II 2008

12. Appearance of the denitive restorations following ring. Note the aesthetic light transmission and refraction.

13. Occlusal appearance of the denitive restorations.

14. Note the improved crown visibility and elimination of excessive gingival display during natural smile.

15. Postoperative appearance of the denitive restorations demonstrates aesthetic harmony and a natural emergence prole.