A grand tour of contour
Featured Products Promotional FeaturesPosted by: Dental Design 6th January 2024
What are the latest gingival contouring techniques?
When Miley Cyrus released her hit song ‘Used to be Young’ earlier this year, fans were quick to notice her new smile. “Has Miley changed her teeth?” they asked. According to Hello Magazine, it wasn’t her teeth but her gum line that had altered.[i]
Gingival contouring, also known as tissue sculpting, involves removing excess gum tissue to improve the appearance of the teeth. While this procedure is becoming increasingly popular, it is not without its challenges. There is a saying in perio surgery: ‘The bone sets the tone.’ Clinicians need to be mindful not to invade the patient’s biologic width, so careful planning of the gingival margin relative to the patient’s osseous crest is vital.[ii]
One of the main challenges is achieving precise results. The goal of this procedure is to create a balanced and symmetrical gum line, harmonising pink and white aesthetics. However, achieving that perfect result can be difficult. The dentist must carefully assess the patient’s gum line and determine the appropriate amount of tissue to remove. If too much tissue is removed, it can expose the tooth’s roots and lead to sensitivity and pain. On the other hand, if too little tissue is removed, the desired aesthetic outcome may not be achieved. Thus, the dentist must have a keen eye for detail and the skill to create a harmonious gum line that enhances the overall appearance of the teeth.[iii]
Another challenge in gingival contouring is managing patient expectations. Patients may come with different ideas of what they want their gum line to look like, and it is important for the dentist to clearly communicate what is achievable. Some patients may have overly high expectations and expect a dramatic transformation, while others may be hesitant about undergoing the procedure due to fear of pain or complications. Dental professionals must address these concerns and educate patients about the benefits and limitations of gingival contouring. Building trust and maintaining open communication play a crucial role in managing patient expectations and ensuring satisfaction with the final results.[iv]
Pain management is another consideration. While the procedure itself is relatively painless, the recovery period can be uncomfortable for some patients. After the excess gum tissue is removed, the patient may experience swelling, soreness, or mild bleeding. Dentists can prescribe pain medications or recommend over-the-counter pain relievers.[v] Proper post-operative care instructions, such as avoiding hard or spicy foods, using a soft-bristled toothbrush,[vi] and maintaining good oral hygiene, also help in minimising pain and promoting healing.
Staying up to date with the latest advances in dental technology is key. Gingival contouring techniques have continued to progress in order to provide patients with more effective and less invasive treatment options. Some of the latest developments include:
- Laser technology: this technique utilises a dental laser to selectively remove excess gum tissue, resulting in a more precise and less invasive procedure. Laser gingival contouring also promotes faster healing and reduces the risk of infection because there is less tissue damage in comparison with traditional treatments.[vii]
- Pinhole Surgical Technique (PST): This is a minimally invasive gingival contouring technique that involves making a tiny hole in the gum tissue near the gumline. Through this small hole, special instruments are used to gently loosen and reposition the gum tissue, creating a more symmetrical and aesthetically pleasing gum line. PST involves minimal pain and swelling and allows for quicker recovery times compared to traditional techniques.[viii]
- Gum Grafting Alternatives: Gum grafting is a traditional method used to treat receding gums, but newer techniques are emerging as alternatives to this surgery. One such technique is the use of dermal fillers or collagen-based materials to augment the gum tissue, restoring its natural contours and improving aesthetics.[ix]
- Digital Smile Design (DSD): DSD combines computer-assisted imaging technology with gingival contouring procedures. By using advanced software, dental professionals can digitally plan and design the ideal gum line and shape, allowing for a precise and customised treatment approach. This technique ensures better aesthetic outcomes, as well as improved communication between the dentist and patient.[x]
- Platelet-Rich Plasma (PRP): PRP is a technique where the patient’s own blood is processed and concentrated to isolate plasma rich in growth factors. This plasma is then applied to the treated area during gum contouring procedures, promoting faster healing, reducing inflammation, and enhancing tissue regeneration.[xi]
Continuing professional education and attending seminars and conferences are essential for dental professionals to stay on top of these latest trends. By continuously learning and improving their skills, professionals can offer the best possible care to their patients. Becoming a member of the British Academy of Cosmetic Dentistry (BACD) gives dental professionals access to networking, educational events and an annual conference, as well as mentoring and career support. It also runs an Accreditation programme that gives members the opportunity to hone and showcase their skills in functional aesthetic dentistry – the optimal way of keeping on top of the latest techniques.
Sometimes, it isn’t a patient’s teeth that are the problem with their smile. With the right expertise, communication, and attention to detail, the challenges of gingival contouring can be overcome, resulting in a successful treatment and a very happy patient.
For further enquiries about the British Academy of Cosmetic Dentistry visit www.bacd.com
[i] Hello Magazine https://www.hellomagazine.com/healthandbeauty/health-and-fitness/501108/miley-cyrus-smile-makeover-teeth/
[ii] Nugala B, Kumar BS, Sahitya S, Krishna PM. Biologic width and its importance in periodontal and restorative dentistry. J Conserv Dent. 2012 Jan;15(1):12-7. doi: 10.4103/0972-0707.92599. PMID: 22368328; PMCID: PMC3284004.[Accessed October 2023]
[iii] Storrer CL, Valverde FK, Santos FR, Deliberador TM. Treatment of gummy smile: Gingival recontouring with the containment of the elevator muscle of the upper lip and wing of nose. A surgery innovation technique. J Indian Soc Periodontol. 2014 Sep;18(5):656-60. doi: 10.4103/0972-124X.142468. PMID: 25425832; PMCID: PMC4239760. [Accessed October 2023]
[iv] Williams M. Do your patients’ expectations match your clinical view? BDJ In Pract. 2022;35(1):22–3. doi: 10.1038/s41404-021-1001-3. Epub 2022 Jan 10. PMCID: PMC8743742. [Accessed October 2023]
[v] Timmerman A, Parashos P. Management of dental pain in primary care. Aust Prescr. 2020 Apr;43(2):39-44. doi: 10.18773/austprescr.2020.010. Epub 2020 Apr 1. PMID: 32346209; PMCID: PMC7186276.[Accessed October 2023]
[vi] Saffarzadeh A, Khodarahmi N, Mohammadi M. Evaluation of the Effect of Ultra-Soft Toothbrushes with Different Commercial Brands on Plaque and Bleeding Indices. J Dent (Shiraz). 2021 Mar;22(1):53-59. doi: 10.30476/DENTJODS.2020.83259.1044. PMID: 33681423; PMCID: PMC7921760. [Accessed October 2023]
[vii] Narayanan M, Laju S, Erali SM, Erali SM, Fathima AZ, Gopinath PV. Gummy Smile Correction with Diode Laser: Two Case Reports. J Int Oral Health. 2015;7(Suppl 2):89-91. PMID: 26668491; PMCID: PMC4672859.[Accessed October 2023]
[viii] Reddy SSP. Pinhole Surgical Technique for treatment of marginal tissue recession: A case series. J Indian Soc Periodontol. 2017 Nov-Dec;21(6):507-511. doi: 10.4103/jisp.jisp_138_17. PMID: 29551873; PMCID: PMC5846251.[Accessed October 2023]
[ix] Reddy SSP. Pinhole Surgical Technique for treatment of marginal tissue recession: A case series. J Indian Soc Periodontol. 2017 Nov-Dec;21(6):507-511. doi: 10.4103/jisp.jisp_138_17. PMID: 29551873; PMCID: PMC5846251.[Accessed October 2023]
[x] Jafri Z, Ahmad N, Sawai M, Sultan N, Bhardwaj A. Digital Smile Design-An innovative tool in aesthetic dentistry. J Oral Biol Craniofac Res. 2020 Apr-Jun;10(2):194-198. doi: 10.1016/j.jobcr.2020.04.010. Epub 2020 Apr 18. PMID: 32373450; PMCID: PMC7193250. [Accessed October 2023]
[xi] Samani MK, Saberi BV, Ali Tabatabaei SM, Moghadam MG. The clinical evaluation of platelet-rich plasma on free gingival graft’s donor site wound healing. Eur J Dent. 2017 Oct-Dec;11(4):447-454. doi: 10.4103/ejd.ejd_76_17. PMID: 29279669; PMCID: PMC5727728. [Accessed October 2023]
