Crown Lengthening Procedures

By Lawrence Spindel DDS, Sunday, October 18, 2009

Dentist New York

Crown lengthening can be used either when a tooth is decayed too close to the bone and can not be properly restored without trimming the adjacent bone or when insufficient sound tooth structure remains exposed supra gingivally to safely hold a crown.

Sometimes when a tooth is decayed sub gingivally or is badly broken down, a crown lengthening procedure is recommended. Crowns should extend onto sound tooth structure and not finish on restorative material. Also,. If a tooth has had sub gingival decay, sometimes without a crown lengthening procedure a crown margin maybe placed to close to a patients’ bone and cause  a ‘biological width violation’. This violation occurs if a crown margin is placed closer than 1.5 mm the patient’s bone the adjacent gingiva can become chronically inflamed. If bone is trimmed away from this area, prior to placement of a permanent crown, then this inflammation maybe avoided entirely..

Another reason that crown lengthening can be need is to increase the amount of sound tooth structure available to hold a crown.  It is not that unusual for badly broken down teeth that need crowns to have insufficient health tooth structure remaining to reliably retain a crown.. After crown lengthening, teeth can have more tooth structure exposed for a crown to grab onto and the resulting restoration is less likely to fail prematurely, either because the crown became loose or because the underlying tooth structure fractured..

Another reason for crown lengthening is for esthetic reason. If the dentist and the patient want the buccal position of the cervical gingival to be moved apically to achieve a different looking smile. This procedure is sometimes called a ‘Smile Lift’,

In any of these instances, a dentist can recommend crown lengthening as an option. Either the dentist himself, or a more specialized surgeon. such as a periodontist or an oral surgeon, may perform this procedure..