Gingival smile I
The problem
When they smile, some people show too much of their gums and small, square teeth. The aesthetic problem in this case was excessive gum overlapping part of the row of teeth. This occurred because the patient’s teeth did not “erupt” (come out) completely when they should have done and by now she was an adult.
Specifics of the treatment
This treatment consists of periodontal surgery known as crown lengthening. It is a simple type of corrective surgery for outpatients that involves repositioning and re-contouring the gum towards the base of the teeth, thus allowing more enamel surface to show.
Case N. Periodontics
Gingival smile II
Vertical maxillary excess and altered passive eruption
The problem
If the upper lip is too short for the bone and teeth it is supposed to cover or the upper jaw is too long for the lip that covers it, then there is an excessive amount of gum showing when you smile. In this case, we had a gummy smile caused by a combination of: 1) an excess of upper jawbone and 2) an altered passive eruption of the teeth. The resulting look was as if the teeth and the mouth were out of place.
Specifics of the treatment
This treatment requires two very different surgical procedures. The first involves correction and gingival levelling of the gums to uncover some of the surface of the tooth that has “insufficiently erupted” by means of periodontal aesthetic surgery (see case M, too). In the second operation, we lower the upper jaw by performing ostectomies and orthognathic maxillary impaction (or “open bite”) surgery. One-day hospital admission. Operation carried out in collaboration with the maxillofacial surgeon Dr. Joan Birbe.
Case O. Periodontics
Gingival recession and exposed roots
The problem
The problem here is that the teeth are very long and often very sensitive. Gingival recession occurs when the gums and bone covering the teeth begin to shrink or recede. This can be due to aggressive brushing, grinding or crooked teeth.
Specifics of the treatment
We the cover the “naked” roots that reveal teeth that are too long by using grafts of “autologous” gums (i.e. using some of the patient’s own gums). This is a simple outpatient microsurgical correction that involves grafting and moving the gum lower, thus covering a greater area of the tooth’s root.
The solution
We prevent the tooth’s roots from being exposed and remove the sensitivity and pain that we used to feel when eating hot or cold food. In doing so, we also improve the smile’s harmony. From a preventive perspective, we stop the roots from continuing to “lose their gums”.
We would like to thank the patients treated by Dr. Carolina Manresa for kindly allowing us to use the images published in this Dentistry Alphabet, thereby helping to raise awareness of this clinical practice. In accordance with the provisions of Organic Law 15/1999 of 13th December on the Protection of Personal Data.
