I hope everyone enjoyed our recent meeting at Mount Hope plantation.
My major take home point was that outstanding final outcomes, especially in the esthetic zone, are dictated by exceptional provisionalization techniques.
I especially liked his direct customization of impression copings with provisionalized implants. This is something I plan on utilizing in my office.
I especially liked his direct customization of impression copings with provisionalized implants. This is something I plan on utilizing in my office.
Sincerely,
Rick
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Couple of questions regarding interproximal papilla height:
ReplyDelete1. If crowding is corrected orthodontically in a teenager, the papilla always fill the interproximal space. In older people, this rarely happens...is that because the crestal bone fails to rebound in older ortho patients?
2. We all understand the significance of vertical height (crestal bone to proximal contact) in predicting the papilla height. Does anyone know of a formula that correlates the horizontal dimension (root proximity and shape of clinical crown). Seems like this horizontal component would be just as important as the vertical since both are related to papillary volume. I would assume the third dimension, facio-lingual, is not as variable.
Steve
ReplyDeleteQ 1. I want to forward this to Jim and Mike for comments.
Q 2. There is no rule that I am aware of with regards to MD positioning of teeth and how this relates to papilla fill. In my opinion, it seems that any significant increase or violation of the mesio-distal distance of the embrasure form will impact the papilla negatively.
The malaligned teeth in adults have been that way for 20,30,40 or more years. The papillae have been obliterated for a long time. Combine that fact with the likelihood of adult perio and bone loss and gingival recession and it is clear why adult papillae do not regenerate after orthodontic straightening. IMHO
ReplyDelete