Crown Lengthening

Badly mutilated teeth or the grossly decayed teeth often pose problems to the restorative dentists during their treatment due to unavailability of sufficient clinical crowns. Hence a crown lengthening procedure prior to restorative treatment is mandatory during management of such teeth. Clinical crown lengthening refers to procedures designed to increase the extent of supragingival tooth structure for restorative or esthetic purposes.

1. Clinicians often encounter the need for crown lengthening in the practice of dentistry and have to make treatment decisions taking into consideration how to best address the biological, functional, and esthetic requirements of each particular case.

2. Presently a procedure that often employs some combination of tissue reduction or removal, osseous surgery, and / or orthodontics for tooth exposure. The amount of tooth structure exposed above the osseous crest (about 4mm) must be enough to provide for a stable dentogingival complex and biologic width to permit proper tooth preparation and account for an adequate marginal placement, thus ensuring a good marginal seal with retention for both provisional and final restorations.

3. This article discusses crown lengthening as one way in which the dentist can address both functional and esthetic demands. The indications for crown lengthening are

• To increase clinical crown height lost due to caries, fracture or wear

• To access subgingival caries

• To produce a „ferrule‟ for restoration

• To access a perforation in the coronal third of the root

• To relocate margins of restorations that are impinging on biological width.

• Aesthetics

• Short teeth

• Uneven gingival contour

• Gummy smile.