Orthodontic Tips April 29, 2014
What is the difference between the occlusally positioned gingival margins on the maxillary centrals in these two pictures?
The picture on the left shows tooth 1.1 with a lower than normal gingival margin. The reason for this is because the 1.1 has been worn away from occlusal wear and it has over-erupted.
Treatment for this is to orthodontically intrude the 1.1 to move the gingival margin apically and then restore the incisal edge to create a tooth of ideal length and gingival position.
The picture on the right shows both the 1.1 and 2.1 with a lower than normal gingival margin. The reason for this is thicker than normal alveolar bone on the labial surface of the roots of these teeth. The treatment is periodontal surgery to apically position the gingival margin. This would be accompanied by removal and thinning of some of the alveolar bone. If you just do soft tissue removal without removing bone, the gingiva will grow back to its original position.