Hüseyin TORT, Elif Aybala OKTAY, Serpil KARAOĞLANOĞLU, Fulya TOKSOY TOPÇU

GUMMY SMİLE VE DİASTEMA TEDAVİSİNDE MULTİDİSİPLİNER BİR YAKLAŞIM: VAKA SUNUMU

Amaç: Gülme sırasında diş etinin fazla görünmesi olarak adlandırılan gummy smile hastalar açısından estetik problem yaratmaktadır. Bu vaka paylaşımında güncel ve teknolojik tedaviler ışığında kısa kuron boyu ve diasteması olan hastanın estetik sıkıntılarının multidisipliner bir yaklaşımla giderilmesi anlatılmaktadır. Materyal-Metot: 40 yaşındaki bayan hasta, gülme sırasında diş etlerinin fazla görünmesi ve dişleri arasındaki boşluklardan rahatsız olduğunu belirterek kliniğimize başvurdu. Hastanın yapılan klinik ve radyolojik muayeneleri sonucu sistemik ve periodontal olarak bir hastalık bulgusu saptanmadı. Kuron boyu yükseltme ve porselen laminate yapımı prosedürlerini kabul eden hastanın tedavi planlaması yapıldı. Kuron boylarını ideal yüksekliğe getirmek için apikale pozisyone flap, kemik rezeksiyonu ve frenektomi işlemleri yapıldı. Dişetlerinin iyileşmesini takiben anterior dişler porselen laminate yapımı için minimal girişimsel yaklaşımla hazırlandı. CAD/CAM teknolojisi kullanılarak üretilen laminate venerler dual sertleşen rezin ile simante edilerek hastanın tedavisi bitirildi. Tartışma: Gummy smile tedavisinde apikale pozisyone flap, uzun tedavi süresi gerektiren ortodontik tedaviye ya da daha zor işlem prosedürleri plan ortognatik cerrahiye alternatif olarak tercih edilebilir. Laminate venerler ise uygun endikasyonlarda daha estetik ve minimal preperasyonla daha konservatif tedavi seçeneği sunmaktadır. Sonuç: Gummy smile ve diastema vakalarında farklı tedavi seçenekleri vardır. Hastanın beklentileri de göz önüne alınarak buna göre bir tedavi planı yapılması başarıda önemli rol oynamaktadır. Anahtar kelimeler: Gummy smile, dental laminate, CAD/CAM A MULTI-DISCIPLINARY APPROACH IN GUMMY SMILE AND DIASTEMA TREATMENT: CASE PRESENTATION ABSTRACT Purpose: Gummy smile, which is the name given to the over-visibility of the gums while smiling, causes problems for patients from the aesthetic perspective. This case presentation explains the elimination of the aesthetic problems of a patient, who has short crown length and diastema, using a multi-disciplinary approach in light of the contemporary and technological treatments. Material-Method: A 40-year old female patient has applied at our clinic stating that she was disturbed with the over-visibility of her gums and the gaps between her teeth when she smiled. Any systemic or periodontal disease was not identified as a result of the patient’s clinical and radiological examinations. The patient accepted the crown length extension and porcelain laminate procedures and her treatment was planned. Apically positioned flap, bone resection and frenectomy procedures were carried out in order to bring the crown lengths to the ideal height. Following the recovery of the gums, the anterior teeth were prepared with a minimal invasive approach for porcelain laminate application. The patient’s treatment was completed after the laminate veneers produced using the CAD/CAM technology were cemented using dual-cure resin. Discussion: The apically positioned flap method used in gummy smile treatment may be preferred as an alternative to orthodontic treatment, which requires a long time, or orthognathic surgery, which necessities more difficult treatment procedures. And, laminate veneers offer a more aesthetic and more conservative treatment approach with minimal preparation, in patients with compatible indications. Conclusion: There are different treatment options in gummy smile and diastema cases. Preparing a treatment plan considering the patient’s expectations play a key role in the success of the treatment. Key Words: Gummy smile, dental laminate, CAD/CAM

Anahtar Kelimeler:

Gummy smile, dental laminate

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