Aesthetic Complications of Periodontal Treatment PDF

Aesthetic complications of Periodontal treatment Recession 3 main aesthetic Occurs when there is apical migration of gingival margin....

Aesthetic complications of Periodontal treatment Recession 3 main aesthetic Occurs when there is apical migration of gingival margin. complications: Partly dictated by gingival biotype - more likely if think biotype present. Mainly dictated by extent of underlying bone loss. Recession Result of; Periodontal disease and treatment, toothbrushing trauma and Black triangles orthodontics. Gummy smile Complications: Sensitivity - Give usual sensitivity advice; fluoride mouthwash, apply fluoride varnish and recommend sensitive toothpaste. Caries - More susceptible to root caries, usual advice; high fluoride toothpaste, diet advice. Appearance - Especially within aesthetic zone (3-3), what the patients Localised don’t like about it. ALWAYS include Gingival grafting: complications in consent process Localised: Generalised Connective tissue graft - incisional, usually comes from palate. Helps with localised sensitivity as well as aesthetic concerns. Manipulation of patients tissues to add to the gingivae and cover exposed root. Generalised: Helps with generalised sensitivity as well as aesthetic concerns. Tunnel grafting - non-incisional technique. Root surfaces are cleaned, doxycycline solution is used to detoxify root surface, ‘tunnel’ under gum tissue to create space for graft, interdental papilla remains intact, graft is threaded through tunnelled tissue and secured by single suture (regardless of the number of teeth grafted). Graft is usually from the palate or a donor. Black triangles Recession in the interdental space. Very common after Periodontal therapy. May be treated restoratively - (composite). Gingival veneer can give good results, non invasive, locks into interdental spaced for retention - (acrylic or silicone). Within dental therapist remit to perform black triangle composite closure. Able to take impressions for gingival veneer, but unable to fit. ‘Gummy smile’ Crown lengthening used for aesthetic concerns, crown placement or sub-gingival caries. Gingivectomy used to give patient new gingival margin. In some cases, bone may also need to be removed. Changes shape of tooth. ALWAYS include complications in consent process