The art of gum shaping is a critical part of implant treatment in the aesthetic zone (smile area) of the mouth as well as any area where we use fewer implants to replace multiple teeth – as discussed in my previous blog. There are many ways to provide this treatment and I will briefly describe one of the techniques we use at our clinic.
WHY PROVIDE GUM SHAPING?
In most cases, the healing abutment around implant are a circular shape. Teeth in the anterior aesthetic zone have a more conical and varied anatomy. This anatomical shape determines the shape of the gingival margins and interdental papilla (pink gum triangles between the teeth). If a permanent implant crown is made using a single impression of the gums following removal of the healing abutment then the shape of the future tooth will be determined by the cylindrical shape of both the implant and the healing abutment. In many cases this is not going to enable the provision of an aesthetic tooth replacement to match the adjacent teeth. In the picture below you can see how missing out on the gum shaping process can result in an asymmetrical tooth when compared to the adjacent tooth.
Gum shaping results
For this patient we provided an implant in the UR2 to replace the heavily infected and failing tooth. A bone graft was provided which enabled us to ensure that the gum contours did not collapse following tooth removal. The image shows how well the gum have developed following treatment – the implant crown fits perfectly into the gum contours.
This patient also had 2 implants in the lower right quadrant to provide him with 3 functional teeth to chew with. This was the problem he wanted to address when he came to see me and by providing him with 3 strong functional teeth we can take the high loads away from the other teeth. The forces will be spread more evenly thorughout his dental arch which will provide better long term protection to all of his teeth. The image shows how we also performed gum shaping in the lower right to make 2 implant look like 3 individual teeth with a tight seal between the crowns and the gums. This tight seal will reduce the risk of food accumulation and bacterial contamination under the implants.
SUMMARY
Implant dentistry in the aesthetic zone must take soft tissue management into consideration. The aesthetic appearance of the final tooth is critical when determining the success of the treatment. For predictable and consistent outcomes, we believe it is imperative that implant surgeons provide gum contouring as part of their aesthetic implant treatment.
I hope this blog gives an easy to understand insight into this procedure. Please feel free to contact me for any queries or for information on further training in this field.
Thank you for reading
Mohsin Patel BDS MJDF RCS (Eng)
