Contributors
Matthew R. Anderson, dmd, msd, earned his DMD from the University of Pennsylvania School of Dental Medicine, after which he completed specialty training
in pros­thodontics at the University of Washington School of Dentistry, where heearned his certificate and MSD. While there, Dr Anderson was named the David
L. Wands Fellow and also received a fellowship from the American Dental Association & Dentsply International. His research during his residency earned hima Tylman Grant and award from the American Academy of Fixed Prosthodontics.
Dr Anderson maintains a private practice in Santa Rosa, California.
Sami Dogan, dds, dr med dent, received his dental degrees from the University ofAnkara, Turkey, and from the School of Dentistry at the University of Hannover,Germany. He completed his postgraduate training in prosthodontics at the University of Washington. He is currently an assistant professor at the University ofWashington in Seattle, where he teaches graduate and postgraduate students.
Dr Dogan’s research includes clinical and in vitro studies and focuses on remineralization of teeth and the quality assessment of dental materials. He has published extensively in peer-reviewed journals and holds an intramural practicelimited to prosthodontics at the University of Washington.

Sul-Ki Hong, dds, received his dental degree from the University of São Paulo,
Brazil, where he then entered the postgraduate program in prosthodontics andtaught both prosthodontics and periodontics. He received his certificate in periodontics in 2006 from Nova Southeastern University in Florida. Dr Hong becamea Diplomate of the American Board of Periodontology in 2008. Currently, he is afull-time clinical assistant professor in the Department of Periodontics at theUniversity of Washington. He also maintains a private practice limited to periodontics in Bellevue, Washington.

Motoaki Ishibe, dds, msd, received his DDS degree from Nihon University
School of Dentistry in Tokyo, Japan, where he also completed a 1-year residency in general dentistry and served as a resident in oral and maxillofacial surgery. He further pursued his postgraduate training in prosthodontics at the University of Washington, where he received a certificate with an MSD degree. He
is a certified prosthodontist and is currently an affiliate assistant professor in theDepartment of Restorative Dentistry at the University of Washington. He also
maintains a private practice in Kofu, Yamanashi, Japan.

Jae Seon Kim, dds, msd, received his DDS degree from Yonsei University College of Dentistry in Seoul, Korea, and his MSD degree and certificate in pros­thodontics from the University of Washington School of Dentistry. He is currently an assistant professor in the Oral Rehabilitation Department at Georgia
Regents University College of Dental Medicine in Augusta, Georgia. He is alsopart of the esthetic team in the Ronald Goldstein Center for Esthetic and Implant
Dentistry. Dr Kim is a Diplomate of the American Board of Prosthodontics and aFellow of the American College of Prosthodontists.

viii

Accurate Transferof Soft Tissue
Contours to theDental Laboratory
Ariel J. Raigrodski | Motoaki Ishibe

As described in chapter 4, the primary goal of a master
impression is to accurately capture the tooth preparation
with the finish line as well as its position in the dental arch.
When implant-supported restorations are to be fabricated, the master impression must capture the implant’s tri­­dimensional position in the arch. However, with both toothborne and implant-supported restorations, it is imperative
to facilitate the dental technician’s ability to fabricate restorations that integrate functionally and esthetically with thesupporting tissues in a healthy manner. Once all needed
surgical procedures (eg, implant placement, osseous crownlengthening, hard and soft tissue augmentation) have been
completed and the supporting tissues have healed and matured, shaping and sculpting of the soft tissue is performed
with the provisional restorations for crowns and fixed dental
prosthesis (FDP) retainers,1–5 ovate pontics,6–9 and implantsupported restorations10–13 as a prerequisite for achieving
the desired integration with the supporting tissues.
In terms of soft tissue esthetics, studies have identified
mean gingival zenith locations and levels as well as papillae
heights in the anterior dentition. Such objective data may affect the design of the facial and interproximal topography ofbone and soft tissue during surgical procedures, thus leading to the desired soft tissue contours and a matching cervical and interproximal design for the corresponding restorations. In one study, the location of the gingival zenith wasassessed in a mediolateral position relative to the vertical
tooth axis of the maxillary anterior teeth.14 Gingival zenith
positions were measured from the vertical bisected mid-5line along the long axis of each individual maxillary anterior
tooth. Mean values were 1.1 mm to the distal of the verticalbisected midline for maxillary central incisors, 0.4 mm to
the distal for maxillary lateral incisors, and almost identicalto the vertical bisected midline for maxillary canines. The
gingival zenith levels of maxillary lateral incisors relative tothe adjacent central incisors and canines were more coronal by approximately 1.0 mm. In another study, interdental
papilla length measurements were made from the level ofthe gingival zenith to the coronal tip of the papilla.15 Meanvalues for maxillary anterior teeth were 4.0 mm for mesial
papillae and 4.1 mm for distal papillae. The mean mesial
papilla proportion (mesial papilla height ÷ crown length ×100%) was 42%, and the mean distal papilla proportion(distal papilla height ÷ crown length × 100%) was 43%,
with no significant difference for the maxillary incisors. Canines demonstrated a trend toward increased distal papillaheights. Papillae proportions were approximately 40% for
all tooth groups.
Several studies have evaluated gingival display in different areas of the dentition for different sets of populations.
One study demonstrated visual display of interdental papillae during maximum smiling in 380 (91%) of 420 study
participants.16 Note that 87% of the participants were diagnosed with a low gingival smile line. Another study evaluated soft tissue display during smiling in white people,17
while another looked at soft tissue display during smilingin a Chinese population.18 The first study assessed photographs of 66 participants and measured tooth, gingival, and103