前牙美学之牙龈生物型要点.pptx

Anterior dental aesthetics:Gingival perspective Thin periodontal biotype Periodontal biotype is classified as thin, normal or thick Thick periodontal biotype 1. Thin periodontium—thickness of attached gingivalless than 1 mm, width—3.5–5 mm, thin marginal bone2. Thick periodontium—thickness of attached gingival to1.3 mm, width 5–6 mm and more, thick marginal bone The thick biotype with its flattened gingival soft tissue form tends to be more frequent with it occurring in 85% of the population than the thinbiotype with its scalloped tissue form (15% of thepopulation). Characteristics of thin biotype (a) Highly scalloped soft tissue and bony architecture(b) Delicate friable soft tissue(c) Minimal amount of attached gingiva(d) Thin underlying bone characterized by bony dehiscence and fenestration(e) Reacts to insults and disease with gingival recession Characteristics of thick biotype (a) Relatively flat soft tissue and bony architecture(b) Dense fibrotic soft tissue(c) Relatively large amount of attached gingiva(d) Thick underlying osseous form(e) Relatively resistant to acute trauma(f) Reacts to disease with pocket formation and infrabony defectformation Firstly, the thin gingival margins allow visibility of a metal substructure.Secondly, due to the fragility of the thin tissue, delicate management is essential for avoiding recession and hence visibility of subgingivally placed crown margins at the restoration/tooth interface a thin biotype the degree of interproximal fill is also dependant on the periodontal biotype A thick periodontal biotype encourages interdentalfill, while a thinner tissue type creates un-aesthetichollow gingival embrasures. For thick biotypes, the papilla may be established to normal dimensions of 5 mm, but for thin biotypes, it is difficult to recreate a papilla longer than 4 mm from the osseous crestThe 5 mm rule is only applicable for adjacent natural teeth or implants bounded by natural dentition.  “5 mm rule