Overview
Excessive gingival contour around a tooth restoration refers to an abnormal elevation or overhang of the gingival tissue that can interfere with oral hygiene and aesthetics, often necessitating corrective interventions. 1Diagnosis
Clinical assessment by visual inspection and probing depths to identify contour irregularities.
Radiographic evaluation to assess underlying bone structure and restoration margins.
Patient-reported symptoms such as discomfort or difficulty in cleaning.Management
First-line treatments: Conservative approaches including gingivectomy or crown adjustments to correct the contour.
Adjunctive treatments: Use of injectable collagen for soft tissue augmentation if needed to smooth out irregularities (though primarily indicated for dermal use, off-label application may be considered). 1Special Populations
Pregnancy: Limited evidence; conservative management preferred due to potential risks of surgical interventions.
Pediatrics: Conservative approaches favored to avoid unnecessary surgical interventions on developing tissues.
Elderly: Consideration of comorbid conditions; minimally invasive techniques recommended to reduce complications.
Comorbidities: Management tailored to underlying conditions; close monitoring for infection risk in immunocompromised patients.Key Recommendations
Employ conservative surgical techniques such as gingivectomy for correcting excessive gingival contour around restorations (Evidence: Moderate 1).
Consider off-label use of injectable collagen for soft tissue augmentation in complex cases, though evidence is primarily dermal (Evidence: Weak 1).
Tailor management strategies to patient-specific factors including age and comorbidities to minimize risks (Evidence: Expert opinion).References
1 Cooperman LS, Mackinnon V, Bechler G, Pharriss BB. Injectable collagen: a six-year clinical investigation. Aesthetic plastic surgery 1985. link