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ABSTRACT
The astute clinician strives to create a beautiful smile paying due heed not only to the gleaming white teeth, but also to the
health of the surrounding tissues. A sound periodontium provides a firm foundation for an esthetic and functional prosthesis.
Conversely, when restorations are designed to be self-cleansing and promote gingival health, the tissues present a harmonious
esthetic blend at the restorative -gingival interface. This review paper aims at exploring the potential of an interdisciplinary
approach to achieve this end. This involves incorporating a comprehensive treatment plan, paying close attention to both soft and
hard tissues around teeth and implants before, during, and after restorative procedure. Key aspects of the restoration and partial
denture design that have a direct effect on the periodontium include restoration contour, margin adaptation, margin placement,
prosthetic and restorative materials, design of fixed and removable partial dentures, restorative procedures and occlusal function.
Special emphasis is paid to the consequences of violation of biologic width, that leads to incessant inflammation, possible
recession and unsightly exposure of crown margin. Periodontal considerations include control of periodontal inflammation,
correction of the gingival architecture, and periodontal maintenance. A search of articles from Pubmed and Medline with
the keywords restorative-alveolar interface, methods of gingival retraction and biologic width was conducted. A total of 430
abstracts were collected, of which most relevant articles were included in this paper.
INTRODUCTION
This is an open access article distributed under the terms of the Creative
Commons Attribution-NonCommercial-ShareAlike 3.0 License, which
allows others to remix, tweak, and build upon the work non-commercially,
as long as the author is credited and the new creations are licensed under
the identical terms.
For reprints contact: reprints@medknow.com
DOI:
10.4103/2229-5194.162745
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How to cite this article: John P, Ambooken M, Kuriakose A, Mathew JJ. The
perio-restorative interrelationship-expanding the horizons in esthetic
dentistry. J Interdiscip Dentistry 2015;5:46-53.
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RESTORATIVE CONSIDERATIONS
THAT IMPACT THE PERIODONTIUM
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Gingival retraction
It can be achieved mechanically using retraction cords,
copper bands or cords.
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PERIODONTAL CONSIDERATIONS
Periodontal therapy to resolve inflammation must be
completed before restorative dentistry.
Importance of a healthy periodontium:
A firm foundation for precise and lasting
restorations
Periodontal therapy
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Causerelated therapy
Plaque control, calculus removal, and the removal of any
inadequate dental restorations in the gingival environment,
treatment of food impaction, correction of trauma from
occlusion, and orthodontic tooth movement, motivation
for oral hygiene, as well as extraction of hopeless teeth
can be done.
Surgical therapy
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SUPPORTIVE PERIODONTAL
THERAPY
Maintenance recalls are essential to the longterm success
of fixed and removable prosthesis especially overdenture
abutments. Hygiene adjuncts using endtufted brushes and
daily application of fluoride are beneficial.
CONCLUSION
An interdisciplinary approach requiring coordinated efforts
by the restorative dentist and periodontist is the need
of the hour. Close attention paid to both soft and hard
tissues around teeth and implants before, during, and after
restorative produces a successful outcome. It also gives
the patient the benefit of comprehensive treatment with
precise and lasting and restorations.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
1. YapUJ, OngG. Periodontal considerations in restorative dentistry
1: Operative considerations. Dent Update 1994;21:4138.
2. BeckerCM, KaldahlWB. Current theories of crown contour, margin
placement, and pontic design. JProsthet Dent 1981;45:26877.
3. EissmannHF, RadkeRA, NobleWH. Physiologic design criteria for
fixed dental restorations. Dent Clin North Am 1971;15:54368.
Journal of Interdisciplinary Dentistry / Jan-Apr 2015 / Vol-5 / Issue-1
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