Aesthetic Considerations in Periodontal Therapy - PDF

Aesthetic considerations in periodontal therapy GDC Learning Outcomes 1.5.2 Obtain valid consent from the patient before starting treatment, explaining all the relevant options and possible costs 1.7.7 Refer to other members of the dental team or other health professionals 1.7.8 Recognise the need...

Aesthetic considerations in periodontal therapy GDC Learning Outcomes 1.5.2 Obtain valid consent from the patient before starting treatment, explaining all the relevant options and possible costs 1.7.7 Refer to other members of the dental team or other health professionals 1.7.8 Recognise the need for and make arrangements for appropriate follow-up care 1.10.5 Assess the results of treatment and provide appropriate aftercare and ongoing preventive advice 1.11.6 Recognise and appropriately manage the complications associated with periodontal therapy 2 Learning Outcomes At the end of the session you will be able to: ▪ Describe the common aesthetic complications of periodontal treatment ▪ Explain the complications of recession ▪ Describe tunnel grafting ▪ Explain black triangle disease and the possible treatments available 3 Aesthetic considerations in periodontal treatment ▪ Recession ▪ Black triangles ▪ “Gummy smile” 4 Recession ▪ All types of periodontal treatment will potentially cause generalised recession which will be much more widespread than that determined by the local anatomy of the gingiva. ▪ Partly dictated by the gingival biotype. ▪ Mainly dictated by the extent of the underlying bone loss from the disease process. ▪ Surgical periodontal treatment will Image credit Beach Denture Clinic usually cause most recession. ▪ Include in consent 5 Complications of recession ▪ Sensitivity ▪ Caries ▪ Appearance, especially in the “aesthetic zone” Image credit Dr Ian Dunn 6 Appearance Localised recession ▪ Gingival grafting can give good results – aesthetically - sensitivity ▪ Manipulation of the patient’s tissues to augment the gingivae and cover the exposed root. Image credits www.periomaine.com 7 Generalised recession Image credits Dr Ian Dunn 8 Tunnel Grafting Image credits www.periodontalimplantok.com 9 Image credits Dr Ian Dunn 10 Black Triangle Disease ▪ Common after periodontal therapy ▪ Needs to be covered in pre treatment consent ▪ Recession in the interdental area ▪ May be treatable restoratively ▪ Not amenable to regenerative surgery ▪ A gingival veneer can give excellent cosmetic results 11 Black triangles – composite closure Image credits Dr Ian Dunn 12 Gingival Veneer ▪ Can be made of acrylic or silicone ▪ Needs a special impression ▪ Worn buccally ▪ Lock into the ID spaces for retention ▪ Needs an experienced lab 13 Gingival Veneer Image credit Dr Ian Dunn 14 Gingival Veneer Image credit Dr Paul Stevenson 15 Gingival Veneer with Implants Image credits Dr Paul Baker, PerioLondon 16 Combination case – uneven smile Image credits Dr Ian Dunn 17 Gummy Smile – crown lengthening Image credits Dr Ian Dunn 18 Additional Resources ▪ (73) EFP Perio Sessions 1 - Anton Sculean's webinar on treatment of gingival recessions – YouTube ▪ (73) Tunnel Technique – YouTube ▪ www.bsperio.org members area case studies ▪ On Moodle Dr Paul Baker video of a tunnel graft case he has kindly shared for you. ▪ Oral status and aesthetics after nonsurgical periodontaltreatment Do patient's perception and dentist's evaluationagree.pdf on Moodle ▪ prosthetic-management-of-pink-aesthetics.pdf on Moodle 19 Thank you. 20