March 15, 2011
This blog continues to demonstrate what could be possible with the combination of case reports, figure legends, graphics, animations and video in regard to a teaching matrix online. If you have ideas for content or have content to share – please do so.
Crown margins in the Esthetic Zone
In determining where to place a crown margin in the
presence of gingival recession, soft tissue grafting would cover the
root completely and allow crown margin placement at the new gingival
level, thus providing ideal esthetics. However, complete root coverage
is not always possible.
coverage is highly predictable only at sites without loss of interdental
tissue according to the Miller Classification.1 If there is loss of interdental tissue fill, only partial root coverage can be expected.
how can you determine how much root coverage to expect at sites with
loss of papilla fill? The dimensions of the papillae adjacent to the
teeth with recession will predict the amount of root coverage that can
be achieved. The papilla is the triangular gingival tissue between the
teeth. Soft tissue grafting can bring the facial gingival margin to
within 3 mm of the papilla tip, providing that the papilla has a width
of at least 3 mm at its base. The papilla base is located at a point
3 mm apical to the papilla tip (Figure 1).
If the papilla is narrower than 3 mm at its base, it will not support
the graft over the root at this level and less root coverage will be