Crown Lengthening Essay

A comprehensive understanding of the periodontal tissues that surround and support the dentition is essential to achieving success with any restorative case. Crown lengthening is a surgical procedure performed by a dentist where bone is resected around a tooth to expose a greater height of tooth structure. Based on where the anticipated restoration margins are to be placed, the dentist aims to expose enough tooth structure circumferentially to facilitate restoration. There are many instances in which crown lengthening can be used as part of a comprehensive treatment approach.
One of the main indications for crown lengthening surgery is the maintenance of biologic width. This concept was developed based on the work of Gargiulo et. al. in which
In this situation, excavating decay and restoring the tooth will violate the biologic width unless crown lengthening is done. Furthermore, crown lengthening can allow for repair of other defects such as crown fracture, endodontic or post perforation, which would otherwise be a lost cause. In a case report conducted by Stratul et. al., a patient presented with the chief complaint that his maxillary anterior teeth were constantly bleeding, inflamed, painful, and he was not pleased with how they looked. Dental history revealed trauma during childhood to these teeth which resulted in subgingival horizontal fracture and subluxation. Following root canal therapy, crowns were placed on these teeth without any consideration for biologic width. The case report documented the results following crown lengthening and replacement with new metal ceramic restorations. The patient’s symptoms resolved and the tissue healed. Immunochemistry also revealed that expression of matrix metalloproteinase 9, which was used as a marker of gingival inflammation was reduced following the surgery. This further supports the importance of crown lengthening surgery in maintaining healthy periodontium, specifically in a case of tooth trauma and