Maintaining and enhancing gingival architecture in fixed prosthodontics

The long-term success of fixed prosthodontic restorations is greatly dependent upon the health and stability of the surrounding periodontal structures. This article deals with the interrelationship between fixed prosthodontic procedures and the stability and health of the periodontium. The commonly encountered problem of alterations in gingival architecture is examined in relation to tooth preparation as well as soft tissue preparation. In addition, the ability of the provisional restoration to guide soft tissue form is discussed as well as the role of the final restoration in providing long-term tissue maintenance. Key factors such as margin placement, tissue damage during tooth preparation, the role of the provisional restoration, tissue injury during impression procedures, crown contour, pontic design, and embrasure design are covered in detail.