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This is the second paper in this two-part series. Paper one provided an overview of managing gingival tissue excess and paper two will focus on increasing clinical crown height to facilitate restorative treatment. Crown lengthening is a surgical procedure aimed at the removal of gingival tissue with or without adjunctive bone removal. The different types of procedure undertaken will be discussed over the two papers. In order to provide predictable restorations, care must be taken to ensure the integrity of the margins. If this is not taken into account it can lead to an impingement on the biologic width, which may in turn lead to chronic inflammation resulting in recession or the development of periodontal problems which can be hard to manage.
Clinical Relevance: This paper aims to reinforce the need for thorough diagnosis and treatment planning and provides an overview of the various procedures that can be undertaken.
Article
This second of two papers will focus on increasing clinical crown height to facilitate restorative treatment. This type of procedure is often needed in patients who have subgingival caries or restorative margins that impinge upon the biologic width.
Crown lengthening may be defined as a surgical procedure which is aimed at the removal of gingival tissue to increase clinical crown height. It can be undertaken as part of a restorative treatment plan, following full case assessment and having considered all possible alternatives. There are different types of crown lengthening procedures, some of which require osseous recontouring, and some of which do not. In order to understand which type of procedure is required the operator must consider what the intended outcome is, as well as taking into account the aetiology and the biological parameters. This entails taking a detailed history, examination and clinical assessment which includes exploring patient expectations. If these parameters are not fully considered patients can be left in a more compromised position than they were to start with; this is even more important when working in the aesthetic zone.
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