Since its initial description by Cohen in 1962, the technique has evolved to accommodate both functional and esthetic objectives.
Functional crown lengthening focuses on exposing subgingival caries or fractures, preventing violation of the biologic width, and securing adequate ferrule for prosthetic restorations.
In contrast, esthetic crown lengthening is often indicated in the anterior region to correct short crowns or uneven gingival contours for an improved smile line.
This comprehensive review evaluates the multifaceted considerations essential for successful crown-lengthening procedures
It emphasizes meticulous diagnosis of periodontal conditions, including biologic width, gingival phenotype, keratinized tissue, alveolar bone levels, and adjacent dentition—all of which dictate the choice of technique and surgical approach.
Techniques range from gingivectomy and apically positioned flaps (with or without osseous recontouring) to alternative modalities such as orthodontic extrusion, tailored to preserve periodontal health and achieve predictable outcomes.
Moreover, this review highlights the importance of preserving periodontal architecture while establishing a stable restoration margin.
It discusses the balance between sufficient sound tooth exposure and preservation of the crown-to-root ratio, keratinized tissue, and adjacent bone support—crucial considerations for long-term success.
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Through in-depth exploration of indications, contraindications, surgical planning, technical variations, and biologic rationale, the article empowers clinicians to make evidence-based decisions for both esthetic and functional cases.
Whether the goal is to manage subgingival pathology or enhance smile esthetics, this review offers a methodical framework aligned with current periodontal-restorative principles.
I invite all dental professionals to explore the full article in the provided PDF.
It offers valuable insights and clinical pearls that will enhance your proficiency in crown-lengthening procedures—don’t miss out on this essential resource!
