Abstract
Purpose: The gingival line is very important for esthetic appearance. This paper describes a new prosthetic technique, the biological tissue adaptation (BTA) technique, to align the gingival line, without orthodontic treatment or surgical crown lengthening which require flap surgery and ostectomy, and maintains a healthy gingiva without rebounding over the long term.
Technique: The gingivectomy is performed with an electrocautery knife at the position of the gingival line taking into consideration both esthetic appearance and biologic width. In principle, the abutment tooth margin is prepared on the same line as the performed gingival line. In forming the prosthesis, the margin should be perpendicular at the surface of the tooth with the same thickness as the wounded gingival tissue. In other words, the shape of the prosthesis is overhanging the gingival tissue.
Discussion: All 17 cases maintained healthy gingiva without rebounding or other major complications. This appeared to be because the biologic width was reestablished in three dimensions, and plaque accumulation and bacterial invasion can be prevented, because the gingival tissue adapts tightly to the margin of the prosthesis-formed overhang. In addition, the immune system may be superior because the bloodstream is not compromised due to the thick gingival margin, thus the periodontal surroundings biologically seemed to be preserved better.
Conclusion: The BTA technique has many advantages as a prosthetic technique in order to align the gingival line, and can maintain a healthy and esthetic gingiva over the long term.
