Closing the diastema (teeth gaps) can be a difficult restorative procedure. Treatment planning and visualization of the intended outcome are critical to success. This “outcome-based” design provides the direction needed to build restorations that are aesthetic, cleanable, and long-lasting.
When a patient wants to fix a tooth gap, it’s crucial to use Facially Generated Treatment Planning (FGTP) principles to guide the restorative process. The tooth shapes can be analyzed using aesthetic templates to determine the correct tooth proportion with the closure of the interproximal space. A diagnostic wax-up can be made using these templates to provide direction for tooth preparation finish lines and margins. The positioning of these lines is crucial to the restorations’ lifespan and maintainability.
The Rule of Thumb
When closing open contact situations, there is a common “rule of thumb” for finish line positions. The contact point between the anterior teeth is usually directly under the peak of the gingival papilla for teeth optimally positioned within the dental arches. This location permits the teeth to have a good face, incisal, and gingival embrasure shape. It is critical for the restorative dentist to appropriately position the restoration’s finishing lines in order to close open contact situations.
If there is one millimeter between the roots of the teeth, the lingual finish line of the veneer should be one millimeter palatal to the papilla, according to the “rule of thumb” (or contact point). If the distance between the roots is two millimeters, the finish line should be two millimeters palatal to the contact. If the distance between the roots is three millimeters, the new contact should be three millimeters to the lingual. In addition, orthodontics should be considered a means for closing contacts.
If the lingual finishing line is placed too far forward, the final veneer ceramic may develop a “wing” of unsupported ceramic, which will create an interproximal “ledge” that will be difficult to floss and clean. This “rule of thumb” can help you get consistent outcomes. It may be simpler to visualize the eventual aim if these notions are applied to a situation.
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