INFORMATIVE ARTICLES

The desire for esthetic outcomes and cosmetic improvements has become a major objective for patients seeking dental treatment. As a result, many dentists have refocused their practices so that esthetics have become a large part of their delivery of clinical care. With today's state-of-the-art techniques, we are able to routinely provide a predictable result that satisfies the emotional needs of our patients and fulfills us as practitioners. Levine and Shanaman recently describer how being able to successfully translate routine clinical procedures into what patients "value" vs what they "need" has been an obstacle in the past for many patients receiving this electice care.

What we have learned through behavioral studies, clinical practice, ad common sense is that, as clinicians, we are taught to emphasize techniques that can confuse or scare patients into not receiving needed care because they do not understand how the benefits of treatment apply to them specifically. Emphasizing benefits of treatment over procedural techniques and keying into patients' values and beliefs in an environment of mutual trust and respect enables us to achieve not only a high acceptance rate, but also good compliance. Understanding our patients' key motivators is paramount. Self-preservation, improving esthetics, improving function, and limiting costs can motivate patients to receive care. The ability to link the benefits of treatment to these key motivators is what establishes closure and case acceptance. This enables the patient to become a "cotherapist" with shared responsibilities.

Many periodontists also have refocused their practices to ones that are more cosmetic, regenerative, and dental implant-based. As Garber has stated, "One must get the periodontist involved" to achieve optimum results in many restorative procedures. This article reviews forced eruption, an esthetic procedure by which we can predictably achieve the desired result by optimizing what comprehensive treatment planning can do to better fit what our patients value.

Forced Eruption (Vertical Extrusion) for Sound Tooth Structure

Forced eruption for sound tooth structure was first described by Ingber as a way to solve the common problem of inadequate sound tooth structure to allow for the biologic width. It has been the author's experience that at least 4mm of sound tooth structure is needed to provide adequate room for the epithelial and connective-tissue attachments (1mm for each is needed) and for ending a crown margin (1mm to 2mm is needed)...

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