case_images: PMC4644817_01
case_images: Clinical photograph representing the preoperative facial view with presence of diastemas.
case_images: CRID2015-437412.001.jpg
case_images: PMC4644817_01_CRID2015-437412.001.jpg
case_images: fig1
case_images: The patient presented a good general health and maxillary anterior teeth with short clinical crowns and diastemas (Figures 1 and 2).
case_images: Preoperative intraoral view.
case_images: CRID2015-437412.002.jpg
case_images: PMC4644817_01_CRID2015-437412.002.jpg
case_images: fig2
case_images: The patient presented a good general health and maxillary anterior teeth with short clinical crowns and diastemas (Figures 1 and 2).
case_images: Diagnostic wax-up.
case_images: CRID2015-437412.003.jpg
case_images: PMC4644817_01_CRID2015-437412.003.jpg
case_images: fig3
case_images: Initially, an impression of the maxilla was obtained to realize the diagnosis wax-up (Figure 3), and then a surgical guide in silicone, with the edge tangent to the cervical region of wax-up, was confectioned (Figures 4 and 5).
case_images: Surgical guide manufactured with silicone.
case_images: CRID2015-437412.004.jpg
case_images: PMC4644817_01_CRID2015-437412.004.jpg
case_images: fig4
case_images: Initially, an impression of the maxilla was obtained to realize the diagnosis wax-up (Figure 3), and then a surgical guide in silicone, with the edge tangent to the cervical region of wax-up, was confectioned (Figures 4 and 5).
case_images: Surgical guide installed in the mouth.
case_images: CRID2015-437412.005.jpg
case_images: PMC4644817_01_CRID2015-437412.005.jpg
case_images: fig5
case_images: Initially, an impression of the maxilla was obtained to realize the diagnosis wax-up (Figure 3), and then a surgical guide in silicone, with the edge tangent to the cervical region of wax-up, was confectioned (Figures 4 and 5).
case_images: Register of new gingival margin with scalpel.
case_images: CRID2015-437412.006.jpg
case_images: PMC4644817_01_CRID2015-437412.006.jpg
case_images: fig6
case_images: The guide was inserted in mouth and the new gingival margin was registered with a scalpel (Figure 6).
case_images: Incision in the registered area and elevation of a full-thickness mucoperiosteal flap.
case_images: CRID2015-437412.007.jpg
case_images: PMC4644817_01_CRID2015-437412.007.jpg
case_images: fig7
case_images: Thus, a full-thickness mucoperiosteal flap was elevated (Figure 7) and the gingival collar extracted with a Gracey curette.
case_images: Measurements of the distance between the guide edge and the cervical bone for the osteotomy.
case_images: CRID2015-437412.008.jpg
case_images: PMC4644817_01_CRID2015-437412.008.jpg
case_images: fig8
case_images: For the osteotomy, measurement of the distance between the guide edge and the cervical bone was recorded (Figure 8).
case_images: Removal of bone tissue with manual instrument.
case_images: CRID2015-437412.009.jpg
case_images: PMC4644817_01_CRID2015-437412.009.jpg
case_images: fig9
case_images: The creation of a precise biologic width requires, in addition, a precise osseous contouring, which was performed using manual instruments (surgical chisels) and carbide/diamond burs with adequate irrigation, for preventing bone necrosis (Figures 9 -11); then, the flaps were sutured (Figure 12).
case_images: Bone tissue resection through rotating instrument.
case_images: CRID2015-437412.010.jpg
case_images: PMC4644817_01_CRID2015-437412.010.jpg
case_images: fig10
case_images: The creation of a precise biologic width requires, in addition, a precise osseous contouring, which was performed using manual instruments (surgical chisels) and carbide/diamond burs with adequate irrigation, for preventing bone necrosis (Figures 9 -11); then, the flaps were sutured (Figure 12).
case_images: Clinical aspect after the bone removal.
case_images: CRID2015-437412.011.jpg
case_images: PMC4644817_01_CRID2015-437412.011.jpg
case_images: fig11
case_images: The creation of a precise biologic width requires, in addition, a precise osseous contouring, which was performed using manual instruments (surgical chisels) and carbide/diamond burs with adequate irrigation, for preventing bone necrosis (Figures 9 -11); then, the flaps were sutured (Figure 12).
case_images: Suture of the surgical region.
case_images: CRID2015-437412.012.jpg
case_images: PMC4644817_01_CRID2015-437412.012.jpg
case_images: fig12
case_images: The creation of a precise biologic width requires, in addition, a precise osseous contouring, which was performed using manual instruments (surgical chisels) and carbide/diamond burs with adequate irrigation, for preventing bone necrosis (Figures 9 -11); then, the flaps were sutured (Figure 12).
case_images: Clinical aspect of soft tissues after six-month follow-up.
case_images: CRID2015-437412.013.jpg
case_images: PMC4644817_01_CRID2015-437412.013.jpg
case_images: fig13
case_images: After 6-month healing (Figure 13), the provisional facets were installed for aesthetic test and posterior definitive prostheses were delivered (Figure 14).
case_images: Installation of provisional facets.
case_images: CRID2015-437412.014.jpg
case_images: PMC4644817_01_CRID2015-437412.014.jpg
case_images: fig14
case_images: After 6-month healing (Figure 13), the provisional facets were installed for aesthetic test and posterior definitive prostheses were delivered (Figure 14).