• Journal of Periodontal and Implant Science
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• v.36 no.4
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• pp.817-827
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• 2006

Purpose : This study was designed 1) to compare the perception of dental professionals and lay people with respect to minor variations in maxillary anterior tooth size and alignment and their relation to the surrounding soft tissues, and 2) to evaluate the normal tooth-gingiva topographical relationships in periodontally healthy young subjects, Materials and methods : Maxillary anterior teeth were intentionally diagrammed in varying degree of deviation with respect to one of three common anterior esthetic discrepancies including variations in crown length, shape of gingival margin, and length of interproximal contact, 17 images were generated to be preferentially selected by 2 groups consisting of dental professionals and lay people (total of 740). Smiling photographs of 120 dental students who had healthy periodontium were taken and the photographic images were analyzed to be classified as 17 kinds of altered image groups. Results : The results demonstrated noticeable difference between the varying levels of discrepancy. Both group preferred gingival margin of lateral incisor to be 0.5mm lower than that of central incisor. Lay people preferred the gingival margin shape that has 2/9 horizontal component of the crown width, while dental professionals preferred the gingival margin shape that has 1/9 horizontal component of the crown width. Lay people preferred longer length of the interproximal contact (two thirds of the crown length), whereas dental professionals preferred shorter length of the interproximal contact (half of the crown length). Photographic analysis of normal esthetic gingival topography revealed 2/9 horizontal component and short length of the interproximal contact which was of the hybrid nature of the preferences shared by lay people and dental professionals. Conclusion: The results of this study show that dental professionals and lay people demonstrated significant difference in their preference of dental esthetic components, which may then influence the decision making process by dental professionals with respect to designing the anterior esthetic gingival line.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.26 no.1
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• pp.4-16
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• 2017

In dental esthetics, soft tissue plays an important part, probably very large portion of it. A clear understanding of the periodontal tissues and its management around teeth and implants help us to develop concepts for a modern dental treatment that addresses the needs of demanding patients in regard of esthetics and durability. When we talk about esthetic, we can say that one of the most important element is a harmonization with gingiva (soft tissue) called 'Pink Esthetic' As for the pink esthetics, gingival line(contour) takes most of the influence on esthetic result; it consists of labial gingival level, interproximal papilla height, and a line that connects them. In the gingival recession, labial gingival level and gingival contour move to the apical portion, and the root area is exposed. It leads to the unesthetic result. Root coverage technique is classically used to treat gingival recession (marginal tissue recession) of natural teeth. It is an essential technique on periodontal plastic surgery part. It is also a very useful technique to recover soft tissue problems in implant dentistry. So, root coverage technique must be mastered for a good implant esthetic result. The general overview of root coverage procedures will be discussed with step by step explanation to get more esthetic result.

• Journal of dental hygiene science
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• v.7 no.3
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• pp.201-205
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• 2007

This study was designed to compare the perception of dental hygiene students and general public with respect to minor variations in maxillary anterior tooth size, alignment and their relation to the surrounding soft tissues. Maxillary anterior teeth were intentionally diagrammed in varying degree of deviation with respect to one of three common anterior esthetic discrepancies including variations in crown length, shape of gingival margin, and length of interproximal contact. Seventeen images were generated to be preferentially selected by 2 groups consisting of dental hygiene students and lay people in Busan(total of 216). The obtained results were as follows; 1. Both group preferred gingival margin of lateral incisor to be 0.5mm lower than that of central incisor. 2. Both group preferred the gingival margin shape of central incisor has 1/9 horizontal component of the crown width. 3. Both group preferred length of the interproximal contact has 1/2 of the crown length. The results of this study may be considered to influence the decision making process by dental professionals with respect to designing the anterior esthetic gingival line.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.11 no.2
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• pp.33-36
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• 2002

As patients have concerned the esthetics of dental restorations, the porcelain fused to metal restorations have gain their popularity due to their strength and esthetic appearance for many years. However, metal collar in subgingival level of porcelain fused to metal restoration often causes black shadows. Inadequately positioned metal collar causes plaque depositions, gingival inflammations, black shadows, and discolorations of margin area. Those problems can be avoided by a clear finishing line, well-fabricated provisional restorations with precise margin and fine polishing, collarless porcelain fused to metal restoration, and all ceramic restoration. In this case report, collarless porcelain fused to metal restoration was used to treat cervical discoloration from old restorations.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.4
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• pp.314-320
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• 2017

In the treatment of esthetically important areas such as maxillary anterior teeth, they should be corresponded with surrounding tissues, and shape of the smile line, soft tissue, and hard tissue, also the anatomical shape and proportion of the teeth should be considered as well. Esthetic analysis includes facial analysis which evaluates the proper parallelism between the occlusal plane and the horizontal reference line, dentolabial analysis which assesses the position of the incisal edge and the coherence between the occlusal plane and the commissural line, tooth analysis which evaluates not only esthetics but also morphology and appearance for proper function, and gingival analysis which forms ideal outline of gingival margins. A maxillary anterior diastema can be esthetically restored through the systematic diagnostic approach and treatment planning, and orthodontic, prosthetic, and conservative treatment can be applied for the treatment.

• The Journal of the Korean dental association
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• v.51 no.11
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• pp.586-594
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• 2013

The critical factors affecting the esthetics of anterior implants can be summarized as following: 1) Correct positioning of implant fixture 2) Enough amount of alveolar bone 3) Optimum volume of soft tissue. The position of implant is probably the most important factor in obtaining esthetic treatment outcome. The 3-dimensional orientation of implant is determined by the position on the alveolar ridge and its direction. Clinicians often try to mimic natural teeth when fabricating restorations. During the course of esthetic diagnosis and treatment, however, one should not forget to consider the correlation between facial pattern, lips, gingiva, alveolar ridge, as well as remaining dentition. Since anterior region is biologically unfavorable when compared with posterior region, one minor discrepancy in positioning of implant can cause esthetically undesirable treatment outcome. If one understands the biological and prosthetic meaning of implant's 3-dimensional position, he or she can achieve superior esthetic outcome in anterior region.

• Journal of Periodontal and Implant Science
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• v.51 no.2
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• pp.88-99
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• 2021

Purpose: Direct intraoral scanning and superimposing methods have recently been applied to measure the dimensions of periodontal tissues. The aim of this study was to analyze various correlations between labial gingival thickness and underlying alveolar bone thickness, as well as clinical parameters among 3 tooth types (central incisors, lateral incisors, and canines) using a digital method. Methods: In 20 periodontally healthy subjects, cone-beam computed tomography images and intraoral scanned files were obtained. Measurements of labial alveolar bone and gingival thickness at the central incisors, lateral incisors, and canines were performed at points 0-5 mm from the alveolar crest on the superimposed images. Clinical parameters including the crown width/crown length ratio, keratinized gingival width, gingival scallop, and transparency of the periodontal probe through the gingival sulcus were examined. Results: Gingival thickness at the alveolar crest level was positively correlated with the thickness of the alveolar bone plate (P<0.05). The central incisors revealed a strong correlation between labial alveolar bone thickness at 1 and 2 mm, respectively, inferior to the alveolar crest and the thickness of the gingiva at the alveolar crest line (G0), whereas G0 and labial bone thickness at every level were positively correlated in the lateral incisors and canines. No significant correlations were found between clinical parameters and hard or soft tissue thickness. Conclusions: Gingival thickness at the alveolar crest level revealed a positive correlation with labial alveolar bone thickness, although this correlation at identical depth levels was not significant. Gingival thickness, at or under the alveolar crest level, was not associated with the clinical parameters of the gingival features, such as the crown form, gingival scallop, or keratinized gingival width.

• Journal of Periodontal and Implant Science
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• v.34 no.1
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• pp.19-28
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• 2004

Tooth is the most important element in esthetic consideration on facial area. Tooth alignment which is in harmony with gingiva, lips, and face is also key element. The purpose of this study was to give a clinical discipline for restoration of gingival contour, which contains a ratio of maxillary 6 anterior teeth, research for gingival contour etc., in case of rehabilitation of maxillary anterior teeth. 300 Dankook university dental school students ,who is their twenties and free from periodontitis, participate in this study. The result was from each 70 males and females who had normal occlusion and tooth alignment. Length, width and length/width ratio of maxillary 6 anterior teeth were 0.74-0.81 in male, 0.81-0.84 in female. There was significant difference between male and female. The most deepest position of gingiva in maxillary central incisor and canine was located in distal part of teeth and maxillary lateral incisor was middle portion. In maxillary central incisors, gingival line of the most deepest point appeared significant difference between male and female (p<0.01) whereas there was no difference in lateral incisors and canines. Distance between interdental papilla apex and the most deepest portion appeared significant difference between male and female. Distance of the deepest position of gingiva is statistically significant except maxillary central incisors and lateral incisors. Standard deviation and mean of the width of labio-lingual were measured in cervical area and there was a significant difference both male and female.(p<0.01) From this result, we could get the mean of maxillary anterior gingival line and these results have great value in clinical guidance in studying maxillary anterior teeth.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.1
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• pp.41-50
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• 2011

The gingival zenith is the most apical point of the gingival outline. This study aimed to quantify the mesio-distal and apico-coronal displacements of gingival zenith in maxillary anterior dentition. 50 healthy patients, who ranged in age from 25 to 36 years were recruited for the study. Alginate impressions of the study group were made and poured with the type III stone. The gingival zenith positions of maxillary anterior teeth were measured in a mesial-lateral direction from the vertical bisected midline. The apico-coronal displacements of the gingival zenith of lateral incisors were measured from a line joining the gingival zeniths of the central incisor and canine. The gingival zeniths were distally displaced in 90%, 53% and 23% of the maxillary cetral incisors, lateral incisors and canines respectively. The mean distal displacements of the gingival zeniths to the vertical bisected midline of central incisors, lateral incisors and canines were 0.90 mm, 0.29 mm and 0.06 mm respectively. The gingival zeniths of lateral incisors were positioned $0.73{\pm}0.43$ mm coronally to the line joining the gingival zenith of central incisors and canines. Consideration of these findings may improve restorative procedures in the anterior maxillary dentition.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.5
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• pp.640-655
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• 2003

Statement of problem : The beauty has a little different meaning according to a time, culture, and nation. Purpose : This study was undertaken to determine the Korean perception of the altered upper anterior dental esthetics including the lack of symmetry, the midline deviation, the gingival exposure, the inclination of incisal plane, the type of incisal plane, and the type of gingival line. Material and Method : 670 subjects were participated in this survey. A questionnaire accompanied by 12 sets of computer-manipulated images using 3D MAX 4.2 software was used to record the ranking of the geometric preference related to the anterior esthetic discrepancies in three or four degrees of alteration. The statistical significance of the differences between the groups was determined by a one-way ANOVA and a t-test. Results : The results obtained were as follows: 1) The Korean perception of the anterior dental esthetics according to the subjects' occupation, sex, and age was most affected by occupation. 2) The masked image emphasizing the dentition and lips appeared stranger than the non-masked image at the same alteration. 3) The lack of symmetry, which was expressed as a unilateral discoloration of the tooth, showed incongruity in any teeth of the anterior dentition. The incongruity was more severe as the degree occurred closer to the midline. 4) The deviation of midline was showed more severe strangeness as the degree of deviation increased. However, more than half of the subjects did not perceive a deviation of 5mm. 5) During smiling, the exposure of the upper gingiva showed more severe incongruity as the degree of gingival exposure increased. 77% of the subjects perceived strangeness at the gingival exposure of 4.5mm. 6) The inclination of the incisal plane appeared stranger as the degree of inclination increased. 62% of subjects perceived strangeness at the $7.5^{\circ}$ inclination of the incisal plane. 7) The type of incisal plane showed increasing strangeness in the order of convex/downward, straight/horizontal, and concave/upward. 80% of subjects perceived strangeness at concave/upward. 8) The type of gingival line was showed increasing incongruity in the order of the same, a little above, and a little under the zenith of the lateral incisor to the line joining the zenith of the central incisor and the canine. However, less than half the subjects did not perceive strangeness at any alteration of the gingival line. Conclusion : The Korean perception of the upper anterior dental esthetics was different to the westerner's perception in the some respects.