Sometimes when a cavity progresses or a tooth is fractured past the gum tissue and a filling or crown needs to be placed, revealing more of the tooth structure is necessary. This is done by reflecting the gingival tissue around a tooth and, after temporarily displacing the soft tissue, predictably removing a given height of bone from around the tooth or teeth being treated.
Biomechanical considerations: Biologic Width, Crown-to-root Ratio and Treatment Planning. Biologic width is the distance established by “the junctional epithelium and connective tissue attachment to the root surface” of a tooth. This distance is important to consider when fabricating dental restorations, because they must respect the natural architecture of the gingival attachment if harmful consequences are to be avoided.
This distance is 2.04 mm (on average), of which 1.07 mm is occupied by the connective tissue attachment and another approximate 0.97 mm being occupied by the junctional epithelium. Because it is impossible to perfectly restore a tooth to the precise coronal edge of the junctional epithelium, the roughly 1 mm depth of the sulcus is often included together with the biologic width when leaving a certain amount of tooth structure remaining, thus establishing a margin of safety. When restorations do not take these considerations into account and violate biologic width, three things tend to occur:
If you have ever been told you have a “gummy smile” or that your teeth look too “short”? Our Periodontists can evaluate your smile to determine if cosmetic periodontal surgery can improve the appearance of your smile. Although your teeth appear short, they may actually be longer than what they appear due to being covered with too much gum tissue. We can correct this by performing the periodontal plastic surgery procedure also know as esthetic crown lengthening.
During this procedure, excess gum tissue and bone are reshaped to expose more of the natural tooth. This can be done to more than one tooth to even your gum line, and create a beautiful smile. Our Periodontists have been awarded with the “Excellence in Cosmetic Dentistry” by the American Academy of Cosmetic Dentistry for esthetic crown lengthening.
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