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Case Reports
. 2021 Sep-Oct;24(5):519-523.
doi: 10.4103/jcd.jcd_441_21. Epub 2022 Mar 7.

Interdisciplinary esthetic approach in clinical dental rehabilitation

Giovane Hisse Gomes  1 , Andrew de Oliveira Corbellini  1 , William Gelain Rotta  1 , Josué Martos  2 , Grégori Franco Boeira  1
Affiliations
Case Reports

Interdisciplinary esthetic approach in clinical dental rehabilitation

Giovane Hisse Gomes et al. J Conserv Dent. 2021 Sep-Oct.

Abstract

During the esthetic evaluation of smile, the presence of diastemas, tooth color, size and shape, and the amount of gingival exposure are important factors to be considered. A 23-year-old female patient was referred to us with a dissatisfaction with her smile. After clinical examination revealed esthetic alterations as generalized tooth yellowish discoloration, a slight diastema in the upper anterior region, and a shortened appearance of maxillary dental crowns, providing a gingival smile. The proposed treatment consisted of an esthetic rehabilitation for resolution of gummy smile and closure of diastema in anterior teeth by the use of digital planning as a guide for the accomplishment of integrated procedures. The result obtained by the multidisciplinary treatment associating periodontal surgical procedure for esthetic crown lengthening with in-office bleaching and direct restorations with composite resin, by digital planning, provided evident harmonization between tooth color and shape and gingival contour, enabling more harmonious smile esthetics.

Keywords: Diastema; esthetic; gummy smile.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Initial smile of the patient. (b) Periodontal probe. (c and d) Clinical insertion of gutta-percha point and radiographic image for periodontal diagnosis. (e) Initial full-thickness flap. The bone margin is <1 mm from the cementoenamel junction. (f) Immediate aspect after osteotomy. (g) Frontal clinical appearance of smile 30 days after surgery
Figure 2
Figure 2
(a) Initial in-office dental bleaching. (b) Digital wax-up and silicone guide on the printed model. (c) Initial composite resin layer on the palatal surface supported by the silicone guide. (d) Aspect of the developmental lobes. (e) Application of the last layer of composite resin. (f) Final clinical aspect
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