Soft-tissue considerations in esthetic dentistry

The marriage of periodontics with esthetic/restorative dentistry, or the "perio-esthetic connection," may be the most critical interdisciplinary relationship in contemporary dental practice. The foundation provided by healthy, well-contoured, biologically sound, symmetrical supporting tissues significantly enhances the cosmetic and functional value of restorative and prosthetic reconstruction. Conversely, the finest restorative fabrication can be markedly diminished by unhealthy, poorly maintained gingival and periodontal tissues. The remarkable advances in the materials sciences have enabled us to restore the dentition to natural function and appearance, but, as with a portrait, the esthetic results are either enhanced or diminished by the boundaries of the frame. This paper focuses on the marginal and attached gingival tissues and the relationship of the lip line, without delving into the various surgical modalities currently available.