PubMed · 9540484
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D Hoexter. 1995. 'Growing' enamel.. https://pubmed.ncbi.nlm.nih.gov/9540484/
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Lingual forced eruption is a treatment modality that minimizes esthetic impairment during orthodontic treatment. Use of this technique can enhance the acceptance of orthodontic treatment by adult patients and minimize unnecessary compromises in the treatment planning of submerged roots. In this clinical report, a treatment modality for forced eruption therapy is described, clinical considerations for patient selection are identified, and the advantages and limits of the lingual orthodontic technique are discussed.
Treatment of the damaged molar often presents a set of challenges unique to the posterior dentition. Traditional dental treatments continue to be refined to improve the prognosis when treating the posterior dentition. Daily treatment-planning decisions include whether to treat with conventional dental or implant therapeutic approaches, and involve consideration of local host factors as well as limitations in specific therapeutic approaches. This article will review some of the factors to consider in these treatment-planning decisions.
The successful integration of periodontal and restorative dentistry for both natural teeth and implants requires knowledge and application of both mechanical and biological principles. In areas of aesthetic concern, an adequate band of attached gingiva can increase patient comfort, reduce the probability of gingival recession following tooth preparation and simplify restorative procedures. While some restorative margins need to be placed at or below the margin of the free gingiva, this should be considered to be a compromise, and margins should not be placed more than 0.5 mm into a healthy gingival sulcus. Approximately 2-3 mm of healthy, natural supra-alveolar tooth surface is needed for attachment of the gingival tissues to the tooth. This dimension is called the biological width. If adequate biological width does not exist, surgical or orthodontic procedures to expose healthy tooth structure are recommended before final restorations are placed. Retraction of soft tissues for impressions is best accomplished with mechanical methods rather than lasers or electrosurgery because of the potentially harmful effects of these devices to the cementum, bone and soft tissues surrounding the teeth. Implants function best and withstand occlusal forces optimally when loaded in a vertical direction. Therefore, planning implant placement is critical for success. Because of increased proprioception, it is suggested that natural teeth be used to guide the occlusion in partially edentulous patients. Cantilevers should be used with caution and with appropriate attention to occlusal forces. While occlusal trauma does not cause periodontal disease, it may contribute to bone loss around teeth and implants. In the opinion of the authors, provisional restorations are an integral part of dental and periodontal therapy. They can be used to establish aesthetic and physiological contours that can be easily cleaned by patients and they can also be used as a guide for any needed surgical tissue modification.