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Crown Lengthening

Crown lengthening is generally performed in order to improve the health of the gum tissue, or to prepare the mouth for restorative or cosmetic procedures.  In addition, crown lengthening procedures can also be used to correct a “gummy” smile, where teeth are covered with excess gum tissue.  Crown lengthening can selectively expose more of the natural tooth by reshaping or recontouring tissues.  This treatment can be performed on a single tooth, many teeth or the entire gum line, to expose a pleasant, aesthetically pleasing smile.

Reasons for crown lengthening

Crown lengthening is a versatile and common procedure that has many effective uses and benefits.  The vast majority of patients who have undergone this type of surgery are highly delighted with the results.

Here are some of the most common reasons for crown lengthening:

  • Restoration of damaged teeth – Periodontal disease can cause severe damage to the teeth, as can trauma and decay.  Where teeth have been broken beneath the gum line, crown lengthening can be used to prepare the area for a new restoration to correct the damaged teeth.

  • Cosmetic uses – Extra gum tissue can make teeth look unnaturally short, and also increase susceptibility to periodontal infections.  Removing excess gum tissue can restore a balanced, healthy look and thus improve the aesthetic appearance of the smile.

  • Dental crowns – Crown lengthening serves to provide more space between the supporting jawbone and dental crown.  This prevents the new crown from damaging gum tissues and bone once it is in place.

Dr. Nattkemper's Personal Guide to Crown Lengthening....

Crown lengthening (or esthetic crown lengthening –see Periodontal Plastic Surgery ) is sometimes needed if a tooth develops decay or a fracture extending below the gum level.   Often, your restorative dentist will be unable to properly and safely restore a tooth if there is extensive tooth structure loss.  On occasion they may recommend removal of the tooth and replacement, with a bridge or implant-supported crown.  In many cases, though, teeth with fractures or decay can be successfully restored (and retained for many years) if your dentist has adequate access to remove decay and place a restoration (filling or crown) on the tooth.

To make this possible, I utilize either the soft tissue laser or a precise flap surgical technique to modify the gum and (if necessary in cases where there is more extensive decay or fracture) bone contour adjacent to the affected area of the tooth.  In some cases, the gum contour will purposely be placed lower on the tooth, exposing the area of tooth structure loss for your dentist to restore.  In many cases though, changes in soft tissue profile following crown lengthening surgery will be fairly subtle—most of what is done being below the gum.  Through use of retraction cord (a tiny string that helps push the gum away from the tooth for the period of time that your dentist is finalizing their preparation of your tooth and taking impressions), only small changes (if any) are noticeable following precise crown lengthening and proper restoration. 

Crown lengthening sometimes requires no sutures or special care, particularly if the laser is used.  In most cases for posterior (back) teeth, sutures will be placed, and a softer diet is appropriate for the first few days.

Crown lengthening is normally performed under local anesthetic, and often with light conscious sedation.  The amount of time this procedure takes will largely depend in how many teeth are involved and whether a small amount of bone needs to be removed, in addition to the soft tissue.  If your restorative dentist has placed temporary crowns on the teeth I am treating, I'll remove them during the procedure and replace (recement) them immediately afterwards.

If you have any questions about crown lengthening, please ask Dr. Nattkemper.

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