2. * female
* medical condition: none
* patient’s request
- get rid of her pain in the her
upper anterior teeth and she
wants to get her “old” smile
back (referred patient)
* 30 years
Patient 1
12. Diagnosis
* iatrogenic damage to soft tissue and teeth (13-23):
violation of biologic width resulting in crown
lengthening
* leakage ceramic restorations
(bacteria) causing soft tissue
inflammation
* gummy smile
* long anterior teeth upper jaw
* To much tooth exposure with lips in repose /
dynamic interference anterior teeth with lower
lip during smiling
* buccal corridor in conflict with anterior region
13. primary concerns
* how to eliminate the pain in her teeth
* How to “heal” the affected soft tissue
* How to re-establish correct tooth proportions
* How to restore her teeth long term
* How to meet her aesthetic wishes (want “old smile” back)
14. treatment objectives
* re-create healthy soft tissue around the restorations
* improve length-width ratio’s of her upper anterior teeth
* improve the aesthetics of her smile
* eliminate pain
* improve soft tissue positions (facially) of tooth 13-23
15. treatment plan
* remove old ceramic restorations
* cement provisionals (13-23) with the correct l/w ratio
* re-create a new CEJ position restoratively
* soft tissue healing phase
* root coverage with Allograft (alloderm) using the tunnel
technique
* healing and maturation phase soft tissue (6 months)
* ceramic restorations 13-23
