ashley.hoders.dmd

Grateful for the opportunity to share last week with the International Academy of Gnathology in Seattle!! What an absolute treat it was to reunite with so many friends, especially my San Antonio crew (who even got to meet Huddy!) ❤️

How was everyone's first week of 2021?
I am starting with a smile!👄
This 30yr old female came to see me because she wanted to improve her smile esthetics 😁 (short teeth & gummy smile/excessive gingival display).
Management starts with understanding WHY! Etiology is key for treatment planning.
globaldiagnosis systematically walk us through how to determine etiology.
In this situation, etiology includes:

🦷altered (active) pattern of eruption
😁hypermobile lip

The treatment solution includes
🤩Aesthetic crown lengthening ...one of my favorite procedures!
👄If necessary, Botox or lip repositioning can also manage a hypermobile lip etiology.

🤩Papilla Access Technique
published by Pat Allen IJPRD Mar2020
to help us w tunneling in the anterior mandible when faced with shallow recession & thin tissue...have you tried it?

I also like this technique for longer span grafts to facilitate access & when I 🤦🏼‍♀️
inadvertently separate a delicate papilla during a tunnel prep for root coverage & soft tissue augmentation. I find this can happen when the soft tissue is thin, is compromised in quality, & additional factors such as crowding, displacement , prominent roots or undercuts are present.

🛑😱Don’t stress if this happens! This area of papilla separation will actually help you to improve surgical access for both site preparation & graft placement.

Once your graft is in position & secured, reapproximate the papilla (i make sure the graft is BELOW the remaining papilla if using allograft) & coronally advance with sling sutures.

Thank you for letting me help this nice patient & 🙏 always .l_pp for your help!

👉Check out Pat's paper for more! IJPRD Mar 2020

When you are ready for the final impression, making a customized impression coping to capture the subgingival emergence is an extra step that takes LESS THAN 5min & is SO IMPORTANT!
🤷🏼‍♀️WHY?
When you remove the provisional, the soft tissue will almost immediately begin to collapse~ a customized coping prevents this collapse & allows accurate transfer of the soft tissue position…
an important communication tool that defines your restorative goals for your technician & helps optimize the outcome for your patient.
🤷🏼‍♀️WHAT STRUCTURES ARE YOU TRYING TO CAPTURE/SUPPORT?
⭐gingival margin & tips of papilla⭐

I really enjoy helping patients & restorative docs with this “last phase” of surgery.