Crown Lengthening Procedure
The main indications for clinical crown lengthening are to fulfill the need to:
• Increase tooth length for esthetic reasons
• Eliminate pseudo pockets
• Expose sufficient quantity of healthy dental structure above the gingival margin in case of cervical or interproximal caries, dental fractures, or inconsistent margins of subgingivally placed restorations.
A 29 years old male non-diabetic and non-smoker presented with extensive distruction of the crown on tooth no. 44. The margin of the preparation was below the gingiva and very close to the alveolar crest. In order to provide sound tooth structure and to preserve the natural tooth, an apically positioned flap along with minimal bone resection was carried out.
When clinical crown lengthening is performed on a single tooth requiring prosthetic rehabilitation, the main problems to be addressed are the extent to which the periodontal support has to be removed both in relation to the tooth in question and to the adjacent teeth, and the imbalance between gingival levels that could occur at the completion of the treatment.
In such cases, it may be advisable to consider various therapeutic options such as extraction of the tooth and subsequent implant placement or orthodontic extrusion.
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