美学区牙冠延长术同期应用上皮下结缔组织移植术联合冠修复改善粉白美学效果的初步探索(附1例报告)

Preliminary exploration of simultaneous esthetic crown lengthening and subepithelial connective tissue graft combined with crown restorations for improving pink-white esthetics:a case report

和谐、迷人的微笑是口腔美学治疗追求的目标,发生于上颌前部牙弓美学区的唇齿龈关系不调及粉白美学缺陷都可能影响整体的微笑美学效果。牙齿被动萌出不足导致的露龈笑是常见的微笑美学缺陷之一,美学区牙冠延长术可以行之有效地重建牙龈外形;而上颌美学区牙周表型偏薄,如伴有唇侧软组织轮廓塌陷,不仅损害粉色美学效果,也增加了发生根面透色、牙龈退缩等并发症的风险。如何重建牙龈外形、改善唇齿龈关系,同时恢复协调的软组织轮廓,改善牙周表型,是临床粉色美学治疗的难点。本文展示了1例上前牙美学区露龈笑伴有唇侧软组织轮廓塌陷的美学分析及临床诊治过程,详细介绍了美学区牙冠延长术同期实施上皮下结缔组织移植术的手术过程,联合冠修复重建协调的粉白美学,并采用数字化模型进行多维度的分析评价,最终获得了良好的美学效果。

As the primary goal of modern esthetic dentistry,a harmonious and charming smile may be compromised by the imbalance of lip-gum relationship and pink-white aesthetic defects in the aesthetic area of maxillary anterior arch.The gummy smile,caused by altered passive eruption,is one of the common defects of smile esthetics,which can be effectively treated by esthetic crown lengthening.Besides,the thin periodontal phenotype in maxillary esthetic zone,as well as collapse of labial soft tissue contour,increases the risk of complications such as exposed root color and gingival recession,which compromise pink esthetics.It remains an important and difficult problem to re-establish gingival morphology and contour,improve the labial-gingival relationship,restore the harmonious soft tissue contour,and thicken periodontal phenotype.This article illustrates a case of gummy smile accompanied with collapse of labial soft tissue contour in maxillary esthetic zone,which received esthetic crown lengthening and subepithelial connective tissue graft simultaneously,combined with crown restorations,including esthetic analysis and planning,clinical implementation process and follow-up evaluation of harmonious esthetic outcome using digital model obtained from intraoral scanner.