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Large Gap Between Cervical Margin of Bridge and Gingival: How To Close?

posted in Implant Supported Fixed Bridges, advice

« Dental Implant Rehabilitation: Treatment Planning and Techniques with Minis | Evista: A Contraindication for Dental Implants? »

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Anon. asks:
My treatment plan was to replace the four maxillary incisors with 2 dental implants in the maxillary lateral incisor positions supporting a 4-unit metal ceramic bridge. When I placed the bridge there was a slight gap between the free marginal gingival crest and the cervical margin of the bridge. One year later, the gap between the cervical margin of the bridge and the gingival has grown so that there is now about 1mm gap and it severely compromises the aesthetics. Is there any surgical procedure that I can perform that will close this gap? How can I position the gingival coronally?

5 Responses to “ Large Gap Between Cervical Margin of Bridge and Gingival: How To Close? ”

• charles Schlesinger, DDS July 22nd, 2008

  
  

  It really depends upon where the crest of the bone is. If you have space under a pontic, sometimes you can perform a CT graft and bulk the tissue up. If it is at the abutment, it depends on where the bone is- in some cases, a coronally positioned flap will work. If you are unsure about things, refer to your periodontist and have the situation evaluated.

• Henry J. Ramirez, D.D.S. July 25th, 2008

  
  

  Prep the retainers for labial procelain veneers and have the lab opaque out the gingival so the darkness doesn’t show.

• Henry J. Ramirez, D.D.S. July 25th, 2008

  
  

  If you can’t close the margin and keep the bacteria out, you’ll problably have fire-engine red inflamed gingiva which bleeds like a stuck pig until it receeds horribly. Can you retrieve the bridge or is it bonded on?

• Dr.Rafael Mosery July 27th, 2008

  
  

  It would be much easier on the patient and on YOU to just remake the restoration.Why would you try surgical procedures that would provide further discomfort to the patient without an assured result? If it was your mother would you put her through a surgical procedure to correct this or do the case over?
  Sorry.

• Dr SS July 28th, 2008

  
  

  If I understand the problem correctly…
  cut off the bridge and remake..this time do a frame try in first
  A surgical consideration to repair a poor prosthetic margin should not be a consideration

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