Abstract
Replacement of missing, damaged, or unaesthetic tooth by dental prostheses helps the patient to rehabilitate the structure and function of the lost tissues. During delivery of the prostheses, the overall health of the oral tissues, including the periodontium, must be considered. The gingival tissues must be healthy and it is of paramount importance to respect the biologic width of the tissues. The biologic width varies among different individuals and at different sites of the same individual. Instead of following a mean value, each patient should be examined to determine the biologic width. In case violation of biologic width is anticipated, appropriate measures should be adopted to maintain the dimensions of the biologic width.
Highlights
Dental prostheses are used for the restoration of damaged, unaesthetic, or dysfunctional tooth, or to replace one or more missing natural teeth.[1]
Tooth and prostheses related factors have been introduced as a separate category in the recent American Academy of Periodontology (AAP) Classification of Periodontal and Peri-implant Diseases and Conditions as other conditions affecting the periodontium under Periodontal Diseases and conditions.[3]
Localised dental-prosthesis-related factors predisposing to periodontitis include:[4] a) Restoration margins placed within the supracrestal attached tissues b) Clinical procedures related to the fabrication of indirect restorations c) Hypersensitivity/toxicity reactions to dental materials
Summary
Dental prostheses are used for the restoration of damaged, unaesthetic, or dysfunctional tooth, or to replace one or more missing natural teeth.[1]. The dimension of the soft tissue, which is attached to the portion of the tooth coronal to the crest of the alveolar bone, termed biologic width[5], should be preserved. Vacek et al[21] reported variations in the dimensions of the supracrestal gingival tissue between teeth and in different sites within the same tooth They evaluated 171 cadaver tooth surfaces and observed mean measurements of 1.34 mm for sulcus depth, 1.14 for epithelial attachment, and 0.77 mm for connective tissue attachment. The components of the biologic width serve for adhesion of the junctional epithelium and insertion of the connective fibers to the dental structure.[5] They create a barrier in the periodontium and prevent microbial penetration If it is impinged, the microorganisms gain access to deeper tisssues and cause destructive inflammation. Localized inflammation that does not respond to adequate measures of plaque control may be a sign of dental material hypersensitivity.[4]
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