Crown lengthening involves exposing the tooth crown by surgically excising the excessive gingival tissue surrounding the crown. Such a procedure is usually performed in prosthetic cases to provide enhanced retention area for crowns and bridges.
Local anesthesia is administered around the surgical site. Gingival tissue around the crown to be exposed is incised and retracted to reveal the underlying bone around the tooth. In case the soft tissue treatment not enough, a part of bony tissue around the neck of the tooth may have to be excised to expose more of the tooth crown. The soft tissue or bone must always be excised keeping in mind all the bio-mechanical considerations like the biological width, the ratio of crown to root ratio etc. Any existing temporary crowns must be removed before the surgery. The free ends of the gingival tissue may be sutured if necessary. The sutures are removed after one week.
The procedure can include a number of risk factors:
Bleeding: The surgical site may bleed for long after the surgery. Any prolonged bleeding is usually managed by application of cold or pressure on the wound, followed by a periodontal dressing.
Swelling: Swelling may occur around the surgical wound area and can be prevented by applying cold packs and maintaining proper hygiene.
Longer Crown: The crown of the tooth around which crown lengthening surgery has been performed may look longer as compared to the adjacent teeth in the same arch or the teeth in the contra-lateral arch. Such a condition gets corrected on placement of the crown or bridge on the prepared abutment.
Sensitivity: The treated tooth may become sensitivity to hot and cold after the surgery because of the exposed dentin or cementum. Such a condition is treated by placing a temporary or a permanent crown, besides using de-sensitizers.
The patient must report for a follow up after 7-10 days for the removal of sutures. This is followed by a check-up after 4 weeks. The surgical wound heals completely in 2 months.
The patient must report to the Periodontist in the following conditions:
Prognosis after Crown Lengthening is good if precautions are taken properly and hygiene is meticulously maintained.
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