{"id":1041,"date":"2018-02-27T21:51:02","date_gmt":"2018-02-28T02:51:02","guid":{"rendered":"http:\/\/periomontreal.com\/2018\/02\/cas-de-gingivectomie-et-resection-osseuse\/"},"modified":"2018-03-06T22:07:50","modified_gmt":"2018-03-07T03:07:50","slug":"cas-de-gingivectomie-et-resection-osseuse","status":"publish","type":"post","link":"https:\/\/periomontreal.com\/fr\/2018\/02\/cas-de-gingivectomie-et-resection-osseuse\/","title":{"rendered":"Allongement de couronne esth\u00e9tique"},"content":{"rendered":"<h1>Pr\u00e9sentation de la patiente<\/h1>\n<div id=\"attachment_1036\" style=\"width: 310px\" class=\"wp-caption alignleft\"><a href=\"http:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/perio-before.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-1036\" class=\"wp-image-1036 size-medium\" src=\"http:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/perio-before-300x169.png\" alt=\"\" width=\"300\" height=\"169\" srcset=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/perio-before-300x169.png 300w, https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/perio-before.png 560w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-1036\" class=\"wp-caption-text\">AVANT<\/p><\/div>\n<ul>\n<li>Femme de 24 ans d&rsquo;origine hispanique\u2009;<\/li>\n<li>\u00c9tudiante en dentisterie \u00e0 la University of Pennsylvania School of Dental Medicine\u2009;<\/li>\n<li>Aucun m\u00e9dicament, aucune allergie connue aux m\u00e9dicaments\u2009;<\/li>\n<li>Historique m\u00e9dical non contributoire\u2009;<\/li>\n<li>Principale plainte\u00a0: \u00ab\u2009Je n\u2019aime pas mon sourire gingival.\u2009\u00bb<\/li>\n<\/ul>\n<p><!--more--><\/p>\n<p>Cette patiente, \u00ab\u2009S.A.\u2009\u00bb, s\u2019est pr\u00e9sent\u00e9e chez nous en affirmant \u00ab\u2009Je n\u2019aime pas mon sourire gingival.\u2009\u00bb Il existe plusieurs causes d&rsquo;exposition excessive des gencives (commun\u00e9ment appel\u00e9e \u00ab\u2009sourire gingival\u2009\u00bb, notamment l&rsquo;exc\u00e8s vertical maxillaire et l&rsquo;\u00e9ruption passive alt\u00e9r\u00e9e (retard\u00e9e), qui sont les plus communes. Apr\u00e8s une \u00e9valuation approfondie, cette patiente a re\u00e7u un diagnostic d&rsquo;\u00e9ruption passive alt\u00e9r\u00e9e, une condition caus\u00e9e par la r\u00e9cession des gencives et de l&rsquo;os autour des dents et qui ainsi ne permet pas une exposition compl\u00e8te au cours du d\u00e9veloppement.<\/p>\n<h1>Observations cliniques<\/h1>\n<div id=\"attachment_1001\" style=\"width: 310px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/1.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-1001\" class=\"size-medium wp-image-1001\" src=\"http:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/1-300x169.png\" alt=\"\" width=\"300\" height=\"169\" srcset=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/1-300x169.png 300w, https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/1.png 560w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-1001\" class=\"wp-caption-text\">Photo avant d&rsquo;un sourire gingival<\/p><\/div>\n<ul>\n<li>Couronnes cliniques courtes\u2009;<\/li>\n<li>Exposition excessive des gencives\u2009;<\/li>\n<li>Profil osseux plat dans le maxillaire ant\u00e9rieur\u2009;<\/li>\n<li>Diasth\u00e8me entre #11 et 21\u2009;<\/li>\n<li>Ligne de sourire haute.<\/li>\n<\/ul>\n<p>Comme vous pouvez le constater sur la photo ci-dessus, cette patiente affichait une exposition excessive des gencives, des couronnes cliniques courtes\/carr\u00e9es de m\u00eame qu&rsquo;une apparence tr\u00e8s plate des gencives.<\/p>\n<h1>Diagnostic<\/h1>\n<ul>\n<li>Gingivite caus\u00e9e par la plaque\u2009;<\/li>\n<li>\u00c9ruption passive alt\u00e9r\u00e9e (Type 1B).<\/li>\n<\/ul>\n<h1>Plan de traitement<\/h1>\n<ul>\n<li>Traitement initial (d\u00e9tartrage et conseils d&rsquo;hygi\u00e8ne buccodentaire)\u2009;<\/li>\n<li>R\u00e9\u00e9valuation (dans les 3-4 semaines suivantes)\u2009;<\/li>\n<li>Allongement de couronne clinique #16-26\u2009;<\/li>\n<li>Entretien de 3 mois.<\/li>\n<\/ul>\n<p>\u00c9tant donn\u00e9 que cette patiente avait un large sourire allant jusqu&rsquo;aux molaires, nous avons d\u00e9cid\u00e9 de planifier un allongement de couronne clinique des dents #16-26. Comme nous le faisons toujours avant ces types de proc\u00e9dures, une \u00e9valuation dentaire \u00e0 6 points par dent fut effectu\u00e9e afin de d\u00e9terminer la largeur biologique \u00ab\u2009personnalis\u00e9e\u2009\u00bb de tous les sites devant \u00eatre allong\u00e9s. Les valeurs de cette patiente \u00e9taient dans le champ de 5\u00a0mm et non celui de 3\u00a0mm typiques observ\u00e9 chez plusieurs personnes. Cette valeur personnalis\u00e9e nous guidera dans l&rsquo;extraction \u00e0 la fois des tissus durs et mous pour exposer pr\u00e9cis\u00e9ment la quantit\u00e9 de dents ad\u00e9quate.<\/p>\n<h2 style=\"padding-left: 30px; text-align: left;\">Photos pr\u00e9-op &amp; post-op<\/h2>\n\n\t\t<style type=\"text\/css\">\n\t\t\t#gallery-1 {\n\t\t\t\tmargin: auto;\n\t\t\t}\n\t\t\t#gallery-1 .gallery-item {\n\t\t\t\tfloat: left;\n\t\t\t\tmargin-top: 10px;\n\t\t\t\ttext-align: center;\n\t\t\t\twidth: 50%;\n\t\t\t}\n\t\t\t#gallery-1 img {\n\t\t\t\tborder: 2px solid #cfcfcf;\n\t\t\t}\n\t\t\t#gallery-1 .gallery-caption {\n\t\t\t\tmargin-left: 0;\n\t\t\t}\n\t\t\t\/* see gallery_shortcode() in wp-includes\/media.php *\/\n\t\t<\/style>\n\t\t<div id='gallery-1' class='gallery galleryid-1041 gallery-columns-2 gallery-size-full'><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/periomontreal.com\/fr\/2018\/02\/cas-de-gingivectomie-et-resection-osseuse\/pic-1\/'><img loading=\"lazy\" decoding=\"async\" width=\"560\" height=\"315\" src=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/pic-1.png\" class=\"attachment-full size-full\" alt=\"\" aria-describedby=\"gallery-1-1054\" srcset=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/pic-1.png 560w, https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/pic-1-300x169.png 300w\" sizes=\"auto, (max-width: 560px) 100vw, 560px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-1-1054'>\n\t\t\t\tPR\u00c9-OP\u00a0: Marquages de la position de la nouvelle marge gingivale avant les incisions\n\n\t\t\t\t<\/dd><\/dl><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/periomontreal.com\/fr\/2018\/02\/cas-de-gingivectomie-et-resection-osseuse\/pic-2\/'><img loading=\"lazy\" decoding=\"async\" width=\"560\" height=\"315\" src=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/pic-2.png\" class=\"attachment-full size-full\" alt=\"\" aria-describedby=\"gallery-1-1055\" srcset=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/pic-2.png 560w, https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/pic-2-300x169.png 300w\" sizes=\"auto, (max-width: 560px) 100vw, 560px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-1-1055'>\n\t\t\t\tPR\u00c9-OP\u00a0: Marquages de la position de la nouvelle marge gingivale avant les incisions\n\n\t\t\t\t<\/dd><\/dl><br style=\"clear: both\" \/>\n\t\t<\/div>\n\n<h1>R\u00e9sultat final<\/h1>\n<p>R\u00e9sultat final suite \u00e0 la gingivectomie et \u00e0 la r\u00e9section osseuse, 7 semaines post-op. Sourires avant et apr\u00e8s. La patiente \u00e9tait tr\u00e8s satisfaite du r\u00e9sultat\u2009!<\/p>\n\n\t\t<style type=\"text\/css\">\n\t\t\t#gallery-2 {\n\t\t\t\tmargin: auto;\n\t\t\t}\n\t\t\t#gallery-2 .gallery-item {\n\t\t\t\tfloat: left;\n\t\t\t\tmargin-top: 10px;\n\t\t\t\ttext-align: center;\n\t\t\t\twidth: 50%;\n\t\t\t}\n\t\t\t#gallery-2 img {\n\t\t\t\tborder: 2px solid #cfcfcf;\n\t\t\t}\n\t\t\t#gallery-2 .gallery-caption {\n\t\t\t\tmargin-left: 0;\n\t\t\t}\n\t\t\t\/* see gallery_shortcode() in wp-includes\/media.php *\/\n\t\t<\/style>\n\t\t<div id='gallery-2' class='gallery galleryid-1041 gallery-columns-2 gallery-size-full'><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/periomontreal.com\/fr\/2018\/02\/gingivectomy-osseous-resection-case\/perio-before\/'><img loading=\"lazy\" decoding=\"async\" width=\"560\" height=\"315\" src=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/perio-before.png\" class=\"attachment-full size-full\" alt=\"\" aria-describedby=\"gallery-2-1036\" srcset=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/perio-before.png 560w, https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/perio-before-300x169.png 300w\" sizes=\"auto, (max-width: 560px) 100vw, 560px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-2-1036'>\n\t\t\t\tBEFORE\n\t\t\t\t<\/dd><\/dl><dl class='gallery-item'>\n\t\t\t<dt class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/periomontreal.com\/fr\/2018\/02\/gingivectomy-osseous-resection-case\/perio-after\/'><img loading=\"lazy\" decoding=\"async\" width=\"560\" height=\"315\" src=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/perio-after.png\" class=\"attachment-full size-full\" alt=\"\" aria-describedby=\"gallery-2-1038\" srcset=\"https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/perio-after.png 560w, https:\/\/periomontreal.com\/wp-content\/uploads\/2018\/02\/perio-after-300x169.png 300w\" sizes=\"auto, (max-width: 560px) 100vw, 560px\" \/><\/a>\n\t\t\t<\/dt>\n\t\t\t\t<dd class='wp-caption-text gallery-caption' id='gallery-2-1038'>\n\t\t\t\tAFTER: Final result after gingivectomy and osseous resection, \n\t\t\t\t<\/dd><\/dl><br style=\"clear: both\" \/>\n\t\t<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>Pr\u00e9sentation de la patiente Femme de 24 ans d&rsquo;origine hispanique\u2009; \u00c9tudiante en dentisterie \u00e0 la University of Pennsylvania School of Dental Medicine\u2009; Aucun m\u00e9dicament, aucune allergie connue aux m\u00e9dicaments\u2009; Historique m\u00e9dical non contributoire\u2009; Principale plainte\u00a0: \u00ab\u2009Je n\u2019aime pas mon sourire gingival.\u2009\u00bb<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[7],"tags":[],"class_list":{"0":"post-1041","1":"post","2":"type-post","3":"status-publish","4":"format-standard","6":"category-sante","7":"entry"},"_links":{"self":[{"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/posts\/1041","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/comments?post=1041"}],"version-history":[{"count":10,"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/posts\/1041\/revisions"}],"predecessor-version":[{"id":1089,"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/posts\/1041\/revisions\/1089"}],"wp:attachment":[{"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/media?parent=1041"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/categories?post=1041"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/periomontreal.com\/fr\/wp-json\/wp\/v2\/tags?post=1041"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}