PMC7732405_01
(a) Right lateral incisor in the position of the central incisor and built up with composite resin. (b) Gingival inflammation underneath the overhanging composite restoration. (c) Gingivoplasty with a diode laser. (d) Cemented veneer with excellent postoperative gingival healing.
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She has a congenitally missing upper right central incisor that was replaced with the lateral incisor, moved orthodontically into the place and built up with composite resin to resemble a central incisor (Figure 1(a)). In addition, the overhanging margin of the composite build-up has resulted in inflammation of the gingiva and the interdental papilla (Figure 1(b)). The remnants of the inflamed tissue were removed and conditioned with wet sterile gauze (Figure 1(c)). The lithium disilicate veneer was cemented two weeks later, and the patient expressed immense satisfaction with the outcome (Figure 1(d)).
(a) Overlapping of maxillary central incisors and a peg-shaped lateral incisor built up with composite resin (arrow), (b, c) gingivoplasty on a lateral incisor, and (d) restored maxillary incisors and healed gingiva.
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The maxillary right central and lateral incisors were endodontically treated (Figure 2(a)). Gingivoplasty was then performed with a diode laser on the lateral incisor to gain tooth structure for a ferrule effect (Figures 2(b) and 2(c)). The patient was ecstatic of the final outcome (Figure 2(d)).
(a) Moderately worn down maxillary anterior teeth and missing a right lateral incisor. (b) Gingivectomy performed with the diode laser. (c) Final tooth preparation on healed gingiva. (d) Final prosthesis cemented showing good crown length and gingival harmony.
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Clinical examination revealed several missing teeth and moderately worn down dentition resulting in shortened clinical crown and gingival contour disharmony (Figure 3(a)). The sulcular epithelium was removed under local anaesthesia by using the optic fiber tip at about 30-degree angle and passed along the marginal gingiva (Figure 3(b)). The postoperative event was uneventful, and healing of the gingival tissue was observed after two weeks (Figure 3(c)). The fixed prostheses were delivered a month after surgery, and the patient was satisfied with the final outcome (Figure 3(d)).
PMC7732405_02
(a) Gingival pigmentation and discolored crown margins. (b) Gingivoplasty with a diode laser. (c) Immediate postoperative state of gingival peeling. (d) One-year recall showing minimal redeposition of melanin and minimal gingival recession.
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A 49-year-old female patient complained of dark gingiva and corroded crown margins and requested replacement of the metal ceramic crowns (Figure 4(a)). The preset gingivoplasty mode was selected to remove the melanin pigments on the marginal and attached gingiva at the output power range of 1.0 to 2.0 watts under local anesthesia (Figure 4(b)). A depigmentation procedure was carried out on the marginal and attached gingiva at the output power range of 1.0 to 2.0 watts (Figure 4(c)). She was recalled after a year, and very minimal melanin redeposition was seen on the attached gingiva and the mucogingival junction (Figure 4(d)).