The PA Center for Dental Implants and Periodontics provides a broad range of treatment and surgical options for patients with everything from mild periodontal disease to severe periodontal disease that has resulted in tooth and bone loss. The cases presented in this photo gallery provide a glimpse of several of the complex cases that the Center has handled in recent years.
Levine, R.A. “There’s Surgical Hope for the Dreaded ‘Gummy Smile’”, Handout from article in Times Newspapers.
Levine, R.A. “Diagnosis and Treatment of the Gummy Smile”, Compendium of Continuing Education in Dentistry. 1997.
Chief Concern: George had significantly worn teeth due to grinding (bruxing) and wanted to improve his smile.
Treatment Received: In two surgical visits (upper then lower arch), we completed crown lengthening procedures to lengthen George’s teeth. Three months later, George’s case was completed with individual porcelain crowns and the creation of a night guard appliance to protect his new smile.
Chief Concern: Excessive Gummy Smile
Treatment Received: We completed upper gum recontouring /crown lengthening with tooth reshaping of Pam’s central incisors for a beautiful, new smile.
Chief Concern: Sydney was unhappy with the appearance of excessive gum around her upper teeth.
Treatment Received: We completed an upper gum recontouring /crown lengthening with a Maryland Bonded Bridge to replace a missing lateral incisor. When Sydney is older this will be replaced with a single dental implant.
Chief Concern: Shannon was concerned with the looseness of her two, upper primary canines and desired permanent single teeth. In addition, she was unhappy with her asymmetrical, gummy smile.
Treatment Received: In one surgical visit, we removed Shannon’s loose canines and placed immediate implants with bone grafting and correction of her gummy smile. Fixed, screw-retained temporary crowns were placed the following day and final crowns were made a few months later.
Chief Concern: Emily was unhappy with her smile and what she saw as square teeth due to excessive gingival display post-orthodontic therapy.
Treatment Received: In one surgical visit, we completed soft and hard tissue reduction for a beautiful, gummy smile correction.
Chief Concern: Aurora was concerned by the appearance of her upper, seemingly short teeth with dark gingival margins.
Treatment Received: In one surgical visit, we completed osseous crown lengthening with gingival scalloping on teeth #4 through #13. Restorative therapy to replace crowns #5 through #12 was then commenced three months later.
Chief Concern: Liz was troubled by her short-looking teeth and subsequent “gummy” smile.
Treatment Received: We completed gum re-contouring and crown lengthening to give Liz a beautiful, new smile.
Chief Concern: David was unhappy with his smile due to his severely worn dentition from grinding his teeth. He was looking for a total smile makeover.
Treatment Received: Full mouth crown lengthening surgery was completed with transitional fixed temporaries worn during the healing phase and final single crowns completed (upper: first molar to first molar; lower: first molar to first molar). A night guard appliance was made to help control David’s grinding habits.
Chief Concern: Bob was unhappy that he did not show any teeth due to severely worn and damaged teeth from his tooth grinding habit.
Treatment Received: A full mouth, gum-recontouring /crown lengthening was completed with full mouth reconstruction and two single implants to replace Bob’s lower first molar teeth.
Chief Concern: Shea was unhappy with her gummy smile and her maxillary central incisor (#9) with previous root canal and apical surgery. She had discomfort when biting and a root fracture was suspected.
Treatment Received: Prior to surgery, we fabricated a two-tooth, fixed acrylic temporary for teeth #8-9. In one surgical visit, Shea’s gummy smile correction was completed with immediate extraction and an implant in site #9 with hard tissue grafting to preserve her esthetics. A smile makeover was commenced three months later with porcelain veneers on her other seven upper teeth in her smile zone.
Chief Concern: Nick was unhappy with his gummy smile. Ideally orthognathic surgery is indicated to surgically reposition the upper jaw. But Nick elected to treat with a minimally-invasive periodontal plastic surgical procedure called a “lip-repositioning procedure.”
Treatment Received: In one surgical visit, tiny incisions were made in the vestibule under the lip at the junction of the attached and unattached gingiva and a centimeter of loose mucosal tissue was removed from the upper first molar with dissolvable sutures used. The results are that the lip is now repositioned upon smiling in a more downward position, thus showing less gum with the smile without surgically removing any of his gum tissue around his teeth.
