Crown Lengthening
What Is Crown Lengthening?
Crown lengthening surgery rearranges gum and, when needed, alveolar bone levels to increase clinical tooth length. It is not only for aesthetic smile correction; it may also be planned for exposing a fractured margin, enabling restoration under deep decay and creating enough tooth wall for a crown or filling.
It may be assessed in Gummy Smile cases with high bone level, but not every Gummy Smile requires crown lengthening.
Indication and Assessment
If a fractured or decayed tooth margin remains below the gum, the margin is exposed before restoration. Surgical support may be needed when crown retention is insufficient because of a short clinical crown. Periapical X-ray is used for bone level and biological width analysis.
Planning should leave adequate tooth tissue without violating biological width.
Surgical Process
Under local anaesthesia, flap elevation, bone reshaping and gum repositioning may be performed. The procedure may include one or multiple teeth. Periodontal dressing may be applied.
Sensitivity and swelling may occur during healing. Restorative treatment is usually planned after tissue healing; timing varies by case.
Difference from Gingivectomy and Contouring
Gingivectomy may remain limited to soft-tissue removal and does not include bone reshaping. Contouring adjusts the aesthetic line. Crown lengthening addresses bone and soft-tissue levels together to increase clinical crown length for functional or aesthetic reasons.
The suitable technique is determined by X-ray and clinical examination.
Restorative Planning and Follow-up
After surgery, crown, bridge or filling restoration may be planned. A temporary restoration may be used in the interim. Regular periodontal review monitors marginal gum health.
The result depends on bone anatomy, hygiene and restoration quality; definite aesthetic or functional results are not promised.
A temporary restoration may protect the tooth after surgery; the final crown is usually planned after healing.
Coordination between the restorative clinician and periodontal surgeon helps determine the correct margin level.
The amount of bone reshaping is limited by biological width and restorative need; excessive bone removal may cause support loss.
Temporary sensitivity may occur after surgery.
Occlusal contacts may need fine adjustment after restoration.
Post-surgical periodontal review monitors marginal gum health.