Pre-prosthetic arrangement for prosthodontic treatment in cases of subgingival hard tissue defects in teeth to receive biologic width and ferrule effect
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Poradnia Protetyki Stomatologicznej, Uniwersytecka Klinika Stomatologiczna w Krakowie
Submission date: 2023-06-27
Final revision date: 2023-08-03
Acceptance date: 2023-09-22
Publication date: 2023-09-22
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Elżbieta Pasławska-Kałuża   

Poradnia Protetyki Stomatologicznej, Uniwersytecka Klinika Stomatologiczna w Krakowie
Prosthodontics 2023;73(3):265–274
Contemporary dental procedures enable the reconstruction of teeth with hard tissue defects that extend below the gum line. Positive treatment outcomes are achieved through the preservation of biological width and restoration of the ferrule effect. The procedures that make these goals possible during pre-prosthetic treatment include surgical crown lengthening, orthodontic extrusion and surgical extrusion. It is important to remember and consider during the diagnostic phase that these procedures also result in a reduction of the length of the remaining root in the bone and a change in the proportion of coronal and radicular parts of the tooth. Additionally, as part of pre-prosthetic treatment, the procedure of Deep Margin Elevation, which serves as an alternative method for preparing the posterior teeth for treatment with indirect restorations, can be performed. However, it is not a technique that replicates the biological width; its implementation requires an intact biological width. When choosing a pre-prosthetic treatment option, various aspects such as the extent and location of the subgingival defect, its cause, the length of the tooth root, the position of the tooth in the dental arch, the patient’s age, future treatment possibilities, and financial considerations should be thoroughly analysed and taken into account. Pre-prosthetic procedures undoubtedly offer a chance to improve prognosis and should be considered accordingly.