CBCT assessment for aesthetic crown lengthening

157 Rating(s).


Posted on By Howard Gluckman In Esthetic Therapy (General)

Here is a CBCT which has been marked to show how one can assess the amount of tissue and bone there is present as well as where the bone and the soft tissue is in relation to the CEJ. This makes the assessment of a type 1A or B or type 2 A or B altered passive eruption and will allow one to assess how much bone and soft tissue needs to be removed in order to expose the full crown. It can also be used for aesthetic crown lengthening to assess the biological width as each person is different. This is a critical tool in our planning and can be used with the DSD to assess how much tissue and bone removal can be done and if it is possible to remove enough to get the ideal without exposing the tooth root.


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13 Comments

Very true Howard,

It's such a simple way of assessing each case but still so accurate. This information is invaluable for crown lengthening cases.

Regards


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Howie. Amazing imagines. I would be interested in knowing how you managed this particular case. How old is this patient? It appears there little enamel combined with a large pulp chamber? Thank you sharing such an interesting case with us. Best wishes. Chuck.


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Thanks Chuck
This was managed with both soft and hard tissue removal which in most cases I find the way to go. He was a class 1 case with a lot of attached gingiva so was not difficult. A video of the case is coming to you soon. I also do a very aesthetic incision and suture technique. which the video will show


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Gluckman videos are always great!


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Great assessment tool. Digital planning is the way to go. Looking forward to the video. Naheed


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Howie, always one step further!
Thank you for sharing, I`ll apply it for sure. Radiograms and periodontal probe don`t give 100% information about CEJ relation to the bone.
Usually I do this procedure in two steps, as I learned it from Prof. Hürzeler. 1. Flap elevation and osseous surgery. 2. After 6-8 weeks gingivectomy.
But your method has an advantage. In the time of DSD&Co you exactly know what you can offer to the patient.
Congratulations! (You just wake up with a new idea, they come during jogging or accompanied with a glass of wine?)
Best regards
Snjezana


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Thanks Sjnesana. Im not sure I invented anything here Im sure others have already proposed it. This definitely works well with DSD. I measure what I have and how much I can remove of soft tissue and then the bone to follow and classify my APE as either type A or B and then I see from the DSD how much needs to be removed and see if the space is there. If not then alternatives like Maxillay impaction or lip repositioning need to be looked at.


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Bravo Howie....a clinician and scholar of the literature. Great info here. Thanks Mo


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Thanks Mo. learned form the best


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Hola mi hermano.
Very good application of the tools, I will definitely add it to my protocols.
I have been missing important information and communication with the dental team.
Thanks for sharing


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Thanks Mariano. I agree this is a great tool that really helps us to make a more educated decision about the tissue that needs to be operated on.


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Howie,

Great work my friend very clean very detailed and very to the point and very usable I would not expect anything less from you my friend!! My admiration for this diagram is almost at the fleece level

Cheers,

Richard



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Wow dude fleece level is huge. Respect bro.


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