Suppose that the patient shown in the first photo presents with a chief complaint “I don’t like how long my teeth are getting and their dark staining.” What treatment would you recommend?
In our opinion, there is a best approach: subepithelial connective tissue grafting (SECTG). This is the only approach that can restore the teeth and tissue to their pristine condition, will not require replacement in the future, and reverse the lengthening of the teeth due to recession. Merely placing composite restorations, veneers, or crowns will not achieve any of these three goals.
In this case, the SECTG could have been placed in a single visit, which would have required using both sides of the palate as donors. Our patient chose to treat one side at a time (#6-8 and 9-11 separately) so that he could chew normally on the untreated side. Fortunately, due to the predictability of the procedure, the end result for each side matches the other side perfectly.
Our patient will now proceed with veneers to improve the shade and incisal contours of the teeth. He and his restorative dentist can move forward with confidence that the gingival margins will remain stable and that the proper length-to-width ratio of the teeth can be maintained.
Thanks for reading.
Amy and David