A case of deep bite, large diastemas and deep pigmentation
After diagnosis we found that the patient has short teeth and excess gingival tissue
Treatment plan
– Digital smile design
– Depigmentation using surgical technique
– Gingivectomy with electrocautery
– Surgical crown lengthening to preserve the biological width
– Suture removal after 10 days and waiting time for 45 days to ensure gingival stabilization and healing
– Laminate veneers (20 units) with butt joint preparation
– Final impressions using addition silicone impression material (one step)
– lithium disilicate (emax press layered) laminate veneers
– Bonding using light cure resin cement (bisco choice II)
– About 6 months follow up
In this case the bite not raised as the VDO is good and the patient did not have decreased VDO
The deep bite was due to the excess bone and gingiva in the maxilla and mandible and short teeth
Lab work by talented Aya Hassan
References:
1. Alhabashneh R, Darawi O, Khader YS, Ashour L. Gingival depigmentation using Er:YAG laser and scalpel technique: A six-month prospective clinical study. Quintessence Int. 2018;49(2):113-122. doi: 10.3290/j.qi.a39267. PMID: 29164181.
2.de Oliveira PS, Chiarelli F, Rodrigues JA, Shibli JA, Zizzari VL, Piattelli A, Iezzi G, Perrotti V. Aesthetic Surgical Crown Lengthening Procedure. Case Rep Dent. 2015;2015:437412. doi: 10.1155/2015/437412. Epub 2015 Nov 2. PMID: 26609452; PMCID: PMC4644817.
3.Silva BPD, Stanley K, Gardee J. Laminate veneers: Preplanning and treatment using digital guided tooth preparation. J Esthet Restor Dent. 2020 Mar;32(2):150-160. doi: 10.1111/jerd.12571. Epub 2020 Feb 7. PMID: 32031329.
Preoperrative smiling view
Preoperative retracted view
The occlusion plane need correction
Surgical depigmentation
Gingivectomy with electrocautary
Butt joint veneer preparation
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