Gum reconstruction techniques also known as periodontal plastic surgery, gum plastic surgery, gum contouring surgery and periodontal cosmetic surgery play a big role in creating a proper gum level, restore balance between the gum tooth ratio, and enhance the overall smile. In antiaging dentistry, rejuvenation dentistry and esthetic dentistry, there needs to be a harmony between the relationship of facial features, teeth, gum, and the supporting tissues.
The level of the gums (gum line) with regard to the teeth, lip position and type of smile, play an important role in creating a natural and beautiful smile. Even the gum level of a single tooth may affect the smile drastically.
Gum reconstruction techniques are procedures that are used to idealize the position of the gum with respect to the surrounding tissue and create facial-dental harmony, resulting in a natural and beautiful smile. These procedures fall into two big groups:
- Additive Techniques– procedures that add gum (fake or natural) to replace lost gum and supporting tissues for situations such as: gum recession, B. ridge resorption
- Subtractive Techniques- procedures that remove gum due to excess gum and/or supporting tissues for cases such as: Altered Passive Eruption– B. gummy smile, High lip line, C. gingival hyperplasia, (gum overgrowth) D. uneven gum line.
The key element in deciding which technique to use is highly dependent on the expertise and the diagnostic ability of the dentist and his supporting specialists. There are lots of different techniques that are available for each situation. Each are very technique sensitive and the experience and the know-how of the dentist plays a key role. Particularly when it comes to the gums and supporting tissue, there are no quick fixes. These procedures especially if surgical, need time to heal and allow gums to mature.
Nowadays, there are a lot of quick fixes offered. Same day gum lasering and veneer prepping is common place. Initially these cases look good but if not planned correctly usually within a few months the gums will change. Either get puffy, red, and bleed easily or they will recede.
In our office, we take a different approach. We plan for long term stability and beauty. We first start with a fifty-point full comprehensive exam. A complete smile analysis and full facial assessment are done. If we find out that you can benefit from one of the procedures, we open a discussion and closely listen to your needs. Your input is critical. Then we do something unique. We do a “mock up”. A mock up is a procedure where we place temporary material over gum and/or teeth to help you visualize very quickly how your esthetic can improve and allow you to “see” the end result. It takes a lot of skill and artistic ability to do this step. Dr. Toubia has extensive experience in doing mock ups. He has done thousands of esthetic cases over the past 37 years of practice. He has a great talent and eye. Mock ups are much better technique than virtual designing, digital designing, or computer imaging. It is a beneficial step because it allows us to communicate to you what is possible and it allows you to give us your personal input. The information is captured and recorded which then allows us to communicate with our specialists and our master lab technician and ceramist in great detail. All of this translates to a more custom design and a beautiful, lustrous, and radiant final result.
Next step is to make a surgical sent to help plan gum reconstruction in an accurate way. In simple cases, periodontal surgical stents are made in office. This allows us to do the gum reconstruction predictably and accurately. It gives us a visual reference point from which we can visualize where the final gum level should be. Therefore, no guess work or eyeballing is done. In more advanced cases models are taken and mounting is done. Next the designing is done in the lab, with close oversight by Dr. Toubia, with a wax up technique. This information is transferred into the mouth for you to “see” the design. Once approved, we make surgical guides for our expert specialist and work closely with him/her to get the ideal gum level.
We have developed several techniques such as Esthetic and Conservative Root Coverage (ECRC) and Conservative and Esthetic Gum Reconstruction (CEGR) that address the restorative alternatives in achieving the proper gum tooth ratio and proper Facial Dental Harmony to create a beautiful and natural smile. Our philosophy is to use the most conservative, least invasive, and proven techniques to achieve the best results. Dr. Toubia is extremely knowledgeable, detailed oriented and with his artistic ability he can help you decide the ideal look.
If you have a gum issue please call and make an appointment to see what is possible.