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Crown Lengthening

The Problem

Crown lengthening is needed prior to restorative treatment in three instances:

1. Teeth with large and older restorations that end at or below the gum line and are in need of new restorations.
2. Teeth with large and older restorations that have fractured or broken off at or below the gum line.
3. Short teeth that need restorative treatment.

Reason for Treatment

Each tooth needs a proper width of gum and bone attachment to maintain health in the mouth. If insufficient tooth is available above the gum line a restoration will go too deep below the gum to get retention for the restoration, and violation of the gum tissue will occur.  A violation of gum width will result in a poor fitting restoration leading to restoration failure or a cavity formation. Violation of the gum tissue will also result in gum disease, bone loss and possible future tooth loss. This violation of gum and bone occurs when fillings or crowns go too far below the gum tissue. Teeth with large fillings that end below the gum line, short teeth that need crowns or bridges, or teeth that have fractured, often need crown lengthening to prevent this problem.

Procedure

During this procedure, gum will be moved away from the teeth to permit better access.  Some gum and bone will be removed to allow repositioning of the gum tissue to a more apical level around the teeth needing lengthening (higher for upper teeth and lower for lower teeth).  The gum tissue will then be placed to this new position to have more tooth exposed above the gum line and a periodontal bandage or dressing will be placed. A local anesthetic will be used so no feeling occurs during treatment.

Benefits

The purpose of this procedure is to reposition the gum and bone around the teeth, or create recession, to allow access for restorative treatment. Following healing teeth will be longer in the surgical area. This includes the teeth in question as well as adjacent teeth.  The surgery is intended to allow the restorative dentist access to the tooth for restorative treatment and to provide exposure for adequate restoration retention.  If the restoration doesn’t have enough tooth to “grab,” the restoration will not hold and may frequently become loose and need to be recemented.  Treatment will provide better access to make oral hygiene more effective and enable professionals to better clean the teeth for a long term result. 

Before Crown Lengthening		After Crown Lengthening

Final Restorations		Final Restorations

Before Crown Lengthening		After Crown Lengthening

Interim Restoration		Final Restoration