Large Gap Between Cervical Margin of Bridge and Gingival: How To Close?
Anon. asks:
My treatment plan was to replace the four maxillary incisors with 2 dental implants in the maxillary lateral incisor positions supporting a 4-unit metal ceramic bridge. When I placed the bridge there was a slight gap between the free marginal gingival crest and the cervical margin of the bridge. One year later, the gap between the cervical margin of the bridge and the gingival has grown so that there is now about 1mm gap and it severely compromises the aesthetics. Is there any surgical procedure that I can perform that will close this gap? How can I position the gingival coronally?
5 Comments on Large Gap Between Cervical Margin of Bridge and Gingival: How To Close?
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charles Schlesinger, DDS
7/22/2008
It really depends upon where the crest of the bone is. If you have space under a pontic, sometimes you can perform a CT graft and bulk the tissue up. If it is at the abutment, it depends on where the bone is- in some cases, a coronally positioned flap will work. If you are unsure about things, refer to your periodontist and have the situation evaluated.
Henry J. Ramirez, D.D.S.
7/25/2008
Prep the retainers for labial procelain veneers and have the lab opaque out the gingival so the darkness doesn't show.
Henry J. Ramirez, D.D.S.
7/25/2008
If you can't close the margin and keep the bacteria out, you'll problably have fire-engine red inflamed gingiva which bleeds like a stuck pig until it receeds horribly. Can you retrieve the bridge or is it bonded on?
Dr.Rafael Mosery
7/27/2008
It would be much easier on the patient and on YOU to just remake the restoration.Why would you try surgical procedures that would provide further discomfort to the patient without an assured result? If it was your mother would you put her through a surgical procedure to correct this or do the case over?
Sorry.
Dr SS
7/28/2008
If I understand the problem correctly...
cut off the bridge and remake..this time do a frame try in first
A surgical consideration to repair a poor prosthetic margin should not be a consideration
