Gingival epitheses: forgotten craft or technology with a future? - Case report of a epithesis fabricated with CAD/CAM

The case in this report presents an alternative, partially CAD/CAM-based fabrication of a gingival epithesis in a 48-years-old female patient. The patient suffered from a periodontits stage III, grade C. After a non-surgical periodontal treatment with adjunctive systemic antibiotics, the patient developed severe circumferential gingival recessions on the upper frontal teeth. Due to social discomfort and esthetic concerns, the indication for a gingival epithesis was made. After taking a conventional impression from the upper jaw, the cast model was scanned and the gingival epithesis was designed virtually at the laboratory. The epithesis was then milled from a block of high performance polymer. Minor adjustments of surface details were added manually. The result was a esthetically sufficient and by the patient well-accepted treatment modality. Further research is necessary to prove the feasibility of a full digital workflow and the long-term stability of CAD/CAMbased gingival epitheses.