The ‘pink’ part of restorations can get forgotten whilst the ‘white’ parts get all the attention. The presence of a realistic gingival margin, root contouring, gingival stippling and potential age related gum changes can really add to the ‘aesthetics’ of a denture or bridge.
Patients often request some sort of realism in their prosthesis to distract from noticing that they may have ‘fake’ teeth. This can take many forms and can be generic to different types of restoration, fixed or removable. The presence of black triangles is common problem in patients post treatment for chronic periodontitis. This can be managed with a gingival facade or veneer that recreates the previous gingival profile. Where gingival ‘aesthetics’ have come to the fore is the management of implants with a less than ideal natural soft tissue profile. This potentially becoming an issue due to peri-implantitis or when the presenting bone and soft tissue envelope is not ideal enough for a natural emergence of the prosthesis.
The below paper published in 2011 reviews the different situations where ‘prosthetic’ gingival appearance is needed and ways in which this can be achieved either through a direct restoration or in liaison with dental technician colleagues.
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