crown lengthening -ucla ( powerpoint presentation)：牙冠延长术-加州大学洛杉矶分校（简报）

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1、TARRSONFAMILYENDOWEDCHAIRINPERIODONTICSUCLASCHOOLOFDENTISTRYPresentsPresentsDr.E.BarrieKenneyProfessor&ChairmanSectionofPeriodonticsE.BarrieKenneyB.D.Sc.,D.D.S.,M.S.,F.R.A.C.D.S.TarrsonFamilyEndowedChairinPeriodontics.ProfessorandChairmanDivisionofAssociatedClinicalSpecialtiesUCLASchoolofDen

2、tistrySurgicalTechniquesforCrownLengtheningDevelopmentofAdequateCrownPreparationEstheticsIndicationsforCrownLengtheningGingivalMarginsmustnotinvadeBiologicalWidthRequirementsforPeriodontalHealth.DevelopmentofAdequateCrownPreparationTheremustbeaminimumof1mmbetweentheapicalleveloftheJunctionalE

3、pitheliumandthebonecrest.BiologicalWidthRequirementsAninappropriatecrownmarginincreasesplaqueaccumulationincloseproximitytobonecrest.CrownMarginswhichextendapicallybeyondtheJunctionalEpitheliumcanviolatetherequirementsforperiodontalhealth.Deeplyplacedcrownmarginscausinggingivalinflammationand

4、pockets.BothCentralIncisorsandrightlateralincisorhavecrownsviolatingBiologicWidthconcepts.ThisstudymeasureddimensionsoftissuesinvolvedinBiologicalWidthconsiderations.GargiuloA.,WentzF.,OrbanF.DimensionsandRelationsoftheDentogingivalJunctioninHumans.J.Periodontol196132:261Thesearenotclinically

5、accurateduetodistortionwithhistologicprocessing.Usedhistologicsectionstomeasureaveragedimensionsofbiologicwidth.ThisstudysaidwidthofjunctionalepitheliumplusconnectivetissuewidthwasBiologicwidth;i.e.approximately2mm.GingivalsulcusJunctionalepitheliumConnectiontissueattachmentcoronaltobone0.69m

6、m0.97mm1.07mmSulcusdepthBiologicWidthHoweversincethenithasbeenshownthatinprobingthesulcus,theprobeisgenerallyatthedeepestpositionofjunctionalepithelium.Ifasubgingivalcrownmarginisplacedinthemiddleofthegingivalsulcus,thecrestofboneshouldbeaminimumof2mmapicallypositioned.Thenecessaryfor1mmofcon

7、nectivetissuebetweentheepitheliumandboneisaminimalrequirement.Largerdimensionscanbecompatiblewithhealthytissues.Whenasubgingivalcrownmarginistobeplaceditmaybenecessarytosurgicallymovethecrestalbonemarginapicallysothatthereisatleast2mmspacebet