ANOTHER LOOK AT ‘DENTAL ECONOMICS’
3. The buccal gingival sulcus was remeasured at 2 mm. A periodontal
probe was used to mark a zenith point 1. 5 mm apical from the current gingival margin, indicating the extent of the desired gingivectomy. Because the extent of the gingivectomy would be limited to
only sulcular tissue (the measured tissue to be removed being less
than the measured sulcular depth), the biologic width would not
be detrimentally affected ( figures 3–5).
5. The enamel was slightly and only superficially abraded with a diamond bur to round and smooth any sharp corners that would become
the future interface between the tooth and the new porcelain restoration. The tooth surface was cleaned prior to impression using
a MicroEtcher (Danville Materials) and 50-micron aluminum oxide
6. A cord (Ultradent Products) size one, presoaked in aluminum chlo-
ride, was then placed to retract the tissue and provide access for
the polyvinyl impression material (figure 10). Although current
chairside CAD/CAM technologies are such that an intraoral digital
scan could have been performed with good accuracy, a polyvinyl
impression technique was chosen to capture more of the subgingival
detail of the tooth.
7. The cord was removed and a full-arch impression was made using
both heavy- and light-body impression material ( figure 11).
4. Using a Radiosurge (Macan Manufacturing), the fine straight cutting
tip was placed at the probe-marked zenith, and a gingivectomy was
performed in two sweeping motions: from zenith to the distal line
angle of the tooth, and then again from zenith to the mesial line
angle of the tooth ( figures 6–9).
Figures 3 and 4: Sulcus measurement Figure 5: Zenith mark
Figures 6 and 7:
Figure 9: Completed
Extent of gingival