Periodontal Plastic Surgery for Treatment of Gummy Smile with Cosmetic Restoration Treatment
Two of the features first noticed by others are overwhelmingly the eyes and the smile. Through the years teeth have been an indicator of social status and beauty. So, it is not surprising that people are seeking to improve their smiles in many ways including orthodontic treatment, whitening and even in some cases plastic surgery. In a case report published March 2017 in the South Brazilian dentistry journal RSBO the authors detail the process of reducing a gummy smile with plastic surgery and following up with cosmetic restorations.1
A 29-year-old female presented to the clinic complaining of “short teeth with extreme gingival exposure during smiling”. A comprehensive exam was performed, and the treatment plan was presented to the patient with the likely outcome of treatment explained.
The patient was anesthetized, and a surgical guide was placed by periodontists. As described by the author “an inner bevel incision was performed following the gingival margins of the surgical template. The template was removed and a second intrasulcular incision was performed to allow the removal of the gingival tissue”.
Next, an osteotomy and osteoplasty were performed to restore the biological distance between the bone and the future restorations. Irrigation with saline and continuous sutures were placed. Post-operative the patient was prescribed antibiotic (Amoxicillin 500mg), analgesic (ibuprofen 600 mg), and the patient was instructed to use chlorhexidine gluconate 0.12% every 12 hours for 14 days. At four months post-op, the patient was released to start restorations with a restorative dentist.
After cosmetic restorations were completed the patient was followed-up for 1 year, no changes in periodontal and restorative outcome were noted. Oral health and aesthetics can be a delicate balance. In this case report, it was determined “the patient had a gummy smile caused by excessive maxillary growth”. The outcome was successful because care was taken to preserve and maintain a healthy periodontium.
In conclusion, the authors state, “The interaction between Periodontics and Restorative Dentistry demonstrated a potential and advantageous interactivity between the areas”. A multidisciplinary approach was taken to ensure health and aesthetics.
Cosmetic cases are becoming more frequent in dentistry. Would you want to have a multidisciplinary approach taken if this were your case? Do you think this type of cosmetic case will have better longevity and gingival health by using a multidisciplinary approach? Have you seen an increase in the number of patients seeking cosmetic services in your practice?
- Gonçalves, Keith & Agnoletto, Gabrielle & Cunha, Leonardo & Storrer, Carmen & Deliberador, Tatiana. (2017). Periodontal plastic surgery for treatment of gummy smile with cosmetic restoration treatment. RSBO. 1. 50. 10.21726/rsbo.v1i1.386.
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