Ovidental Editorial Team
hola@ovidentalgo.com
Crown lengthening is a periodontal surgical procedure aimed at increasing the clinical crown height of a tooth for restorative or aesthetic purposes.
This technique involves the removal of gingival tissue, and in some cases, alveolar bone, to expose more of the tooth structure.
It is essential for ensuring proper prosthetic retention, achieving aesthetic harmony, and maintaining periodontal health.
Indications for Crown Lengthening
Crown lengthening is indicated in various clinical scenarios, including:
- Restorative Needs
When subgingival caries, fractures, or perforations are present, crown lengthening provides adequate tooth structure for restorative procedures.
- Biologic Width Violation
To reestablish the biologic width and prevent periodontal inflammation, crown lengthening is performed when restorative margins encroach upon this space.
- Aesthetic Concerns
In cases of excessive gingival display or uneven gingival contours, crown lengthening enhances smile aesthetics by reshaping the gingival architecture.
Surgical Techniques
Several techniques are employed in crown lengthening procedures:
1. Gingivectomy: Removal of excess gingival tissue without involving the bone, suitable when there is sufficient keratinized tissue and the bone level is adequate.
2. Apically Positioned Flap with or without Osseous Resection: This approach involves repositioning the gingival tissue apically and may include bone removal to achieve the desired crown length.
3. Orthodontic Extrusion: Gradual movement of the tooth coronally using orthodontic forces, followed by stabilization and possible gingival recontouring.
Clinical Considerations
A comprehensive assessment is crucial before performing crown lengthening:
- Biologic Width
Maintaining an adequate distance between the alveolar bone crest and the restorative margin is vital to prevent periodontal issues.
- Gingival Phenotype
Thick gingival biotypes are more stable post-surgery, whereas thin biotypes may be prone to recession.
- Crown-to-Root Ratio
An unfavorable ratio may compromise tooth stability; thus, this factor should be evaluated during treatment planning.
Postoperative Outcomes
Clinical studies have shown that crown lengthening can be effective in providing adequate tooth structure for restorative procedures without significantly affecting periodontal parameters.
However, careful case selection and technique are essential to minimize potential complications.
Conclusion
Crown lengthening is a valuable procedure in dentistry, facilitating proper restorative treatments and enhancing aesthetic outcomes.
A thorough understanding of the indications, techniques, and clinical considerations is essential for achieving optimal results and maintaining periodontal health.
References
- Qali, S., Alsaegh, H., Alsaraf, S. (2024). Clinical Considerations for Crown Lengthening: A Comprehensive Review. Cureus.
- de Araújo, L.N.M., dos Santos, M.T., Moura, D.M.D., de Assunção E Souza, R.O., Gurgel, B.C.V. (2024). Influence of Crown-Lengthening Surgery on Teeth Rehabilitated with Ceramic Single Crowns: A 12-Month Prospective Clinical Study. Journal of Dentistry.
- González-Martín, O., Lee, E.A., Chambrone, L., Avila-Ortiz, G., Caiazzo, A., Suárez-López Del Amo, F. (2020). One- Versus Two-Stage Crown Lengthening Surgical Procedure for Aesthetic Restorative Purposes: A Randomized Controlled Trial. Journal of Clinical Periodontology.
- Baghele, Om Nemichand (2021). A Comprehensive Update on Crown-Lengthening Procedures with New Concepts and Inputs. Journal of the International Clinical Dental Research Organization.
