Rufenacht, Claude R.: Fundamentals of Esthetics; Book; 373 pages; 1990; Title-No.: 29311; EUR 240.00. Sep 27, 2013. Read a free sample or buy Fundamentals of Esthetics by Claude R. You can read this book with iBooks on your iPhone, iPad, iPod touch, or Mac. Of Esthetics. View More by This Author. This book can be downloaded and read in iBooks on your Mac or iOS device. CliniCally BasEd diagnostiC Wax-uP for oPtimal EsthEtiCs: thE diagnostiC moCk-uP. Dental publications can download the four-color public service ad. In: Rufenacht. CR, Fundamentals of esthetics. Chicago III: Quintessence, chapter 5, 1990. Lee R, Standardized head position and reference.

Abstract is a universal dental problem that can be especially difficult to treat when it involves the esthetic zone. The purpose of this case report is to demonstrate a multidisciplinary approach to treat a severe gingival recession in the esthetic zone for a patient with a high smile line. A rare complication of post removal during resulted in a severe gingival recession of the maxillary right central incisor.

The gingival asymmetry was highlighted by the patient's high smile line. Mariyan Hd 1080p Video Songs Free Download. A multi-disciplinary approach was used to address the gingival recession including a gingival graft,, and esthetic restoration. This case report highlights how a team of dental professionals can work together to treat a severe gingival asymmetry in the esthetic zone, combining periodontics, orthodontics, and. Keywords Gingival recession; Smile esthetics; Multidisciplinary approach; Orthodontics Introduction Gingival recession (GR) results from the apical migration of and is commonly found in most populations []. Reports on prevalence range from 14 to 90 percent, depending on the population being studied [-]. The etiology of this problem is multifactorial and associated with root anatomy (dehiscence), tooth position in, orthodontic tooth movement, mechanical trauma, width and thickness of keratinized tissues, and chemical []. However, the literature does not associate GR as a potential complication of post removal during endodontic retreatment.

Gingival recession can result in pain from dentin hypersensitivity [], root caries [], abrasion [], fear of tooth loss [], and unfavorable esthetics [], especially when it occurs in the esthetic zone. This is especially true in patients with a high lip line that results in excessive gingival display when smiling and speaking.

While generalized GR results in the appearance of longer teeth, which is associated with aging, asymmetric gingival margins in the anterior region has been shown to be especially undesirable []. When there is a gingival margin discrepancy between the central and lateral, neither laypersons nor dental professionals considered a 2mm discrepancy unesthetic []. However, when the gingival margin discrepancy was between the central incisors, a discrepancy of only 1.5mm was considered unesthetic by laypersons []. This confirms that the presence of symmetry between upper central incisors is a paramount goal for esthetic [,].

Therefore, treatment of GR can be challenging, especially when it involves the esthetic zone []. According to the literature there are several treatment options for GR: control by plaque and calculus debridement [], flap surgery or guided (GTR) to cover the root surface [,], orthodontic extrusion followed by equilibration or restoration [], and orthodontically moving the tooth root into the bony housing to correct dehiscence [,] or a combination thereof. The objective of this case report is to describe a multidisciplinary approach to correct a severe case of asymmetric GR in the maxillary central incisors of an adult patient with a high smile line. This case report also highlights GR as a result of a rare complication of post removal during endodontic retreatment.

Case Report A 45 year old male initially presented to a prosthodontist with the desire to improve the esthetics of his maxillary incisor crowns ( Figure 1A). The upper central incisors had been previously endodontically treated. Initial periapical radiographs reveal failing endodontic treatment with periapical radiolucencies and adequate bone levels in both mesial and distal surfaces ( Figure 1B). The patient was referred to an endodontist for retreatment. During post removal, the endodontist reported that the ultrasonic instrument slipped and hit the facial gingiva of the upper right central incisor. This resulted in necrosis of the facial gingiva and apical migration of the gingival margin beyond the mucogingival junction, without interdental bone loss, classified as a Class II Miller GR ( Figure 2A) [].