Eliminate Black Triangles from Anterior Veneers
A very common clinical scenario is the patient who wants to have restorative dentistry done to close black triangles in the esthetic zone. This can be a gratifying but challenging situation. One of the first things to assess is the height of the papilla and how is compares to the adjacent teeth. Do you have papilla symmetry? Or are there varying heights in the esthetic zone? Next is the relative position of the papilla tip to the proposed incisal edge position. Esthetically we like the length of the tooth to be split between the papilla and the contact. If you have this then closing the triangle can be a simple matter of proper prep design and changing the shape of the tooth using the veneer. If you have a short papilla relative to the final tooth length, you will create a long contact when you close the embrasure space, and although most patients find this preferable to the black triangle, it requires creating achievable expectations.
One of the greatest challenges of closing a black triangle, or gingival embrasure with a veneer is avoiding the creating of a ledge interproximally. This is similar to our experience with composite when we try to close a diastema. We need to prepare the tooth and give the ceramist enough room to create a new emergence profile that closes the gingival embrasure form and keeps a smooth contour that maintains proper periodontal health. The preparation must continue through the contact and ideally end at the mesial and distal line angles of the tooth. In addition to give the technician running room to close the space without leaving a ledge the preparation margin must be taken as far subgingivally as you can in the interproximal without violating the biologic attachment. Remember that the gingival margin of the preparation should mimic the ginigval scallop and be higher interproximally then it is on the facial to avoid violating the biologic attachment.