Restoration of aesthetic zone using ceramic veneers with minimally invasive surgical crown lengthening

Gingivni osmijeh izraz je koji se odnosi na pretjeranu vidljivost gingive prilikom osmijeha te se često javlja u kombinaciji s kratkim kliničkim krunama. Ovaj estetski problem ponekad zahtijeva parodontološko kiruršku i protetsku terapiju. Zahvaljujući napretku tehnologije zahvati na tkivima mogu se provesti minimalno invazivno. Minimalno invazivno kirurško produljenje kruna postupak je kojim se gingiva i koštano tkivo remodeliraju, a klinička kruna zuba izdužuje u apikalnom smjeru bez odizanja režnja. Kako bi rub gingive bio stabilan, resekcijom kosti potrebno je osigurati prostor za epitelni i vezivni pričvrstak. Udaljenost vrha alveolarnog grebena do ruba gingive trebala bi biti 3 mm. Za postizanje harmoničnog odnosa gingive i izradu uspješnog protetskog rada ključan je dobar plan terapije. Iznimno su korisni programi za digitalno dizajniranje osmijeha kao i dijagnostički wax up i mock up koji omogućuju pacijentima vizualizirati ishod terapije. Osim toga, mock up može poslužiti i kao kirurška šablona kod gingivektomije te kao vodič pri brušenju zuba. Kod brušenja za ljuske najvažnije je ostati što više u caklini kako bi se osigurala jača adhezija i veća trajnost nadomjeska. Keramičke ljuskice tanki su nadomjesci s iznimnim optičkim svojstvima koji se svezuju za tvrda zubna tkiva primjenom adhezivne tehnike cementiranja. Pomoću njih moguće je promijeniti oblik, boju, proporcije ili nagib zuba te poboljšati estetiku osmijeha. Budući da zahtijevaju minimalno brušenje zuba, vrlo često su primarni izbor za restauraciju estetske zone.“Gummy smile” is a term that refers to the excessive gingival display when smiling and it often occurs in combination with short clinical crowns. This aesthetic issue sometimes requires periodontal surgical and prosthetic treatment. Thanks to technological advancements, procedures on tissues can be performed with minimal invasiveness. Minimally invasive crown lengthening is a procedure by which the gingiva and the bone are remodeled and by which the clinical crown of the tooth is lengthened apically without flap reflection. For a stable gingival margin through osseous resection, it is necessary to provide space for epithelial and connective tissue attachment. The distance from the top of the alveolar crest to the gingival margin should be 3 mm. Furthermore, an adequate treatment plan is essential to achieve gingival harmony and high quality prosthetic restauration. Different digital smile design software have proved themselves useful, as well as diagnostic wax up and mock up that allow patients to visualise the treatment outcome. In addition, a mock up can be used as a surgical guide for gingivectomy and as a guide for tooth preparation. When preparing teeth for veneers it's essential to preserve as much enamel as possible to ensure stronger adhesion and greater longevity of the restoration. Ceramic veneers are thin shells with exceptional optical properties that are bonded to hard dental tissue using an adhesive cementation technique. With them, it’s possible to change tooth shape, color, proportions, or alignment and improve smile aesthetics. Since they require minimal tooth preparation, they are often the primary choice for restoration of the aesthetic zone