Crown lengthening is the practice in periodontics of exposing the teeth to provide a stable base for a new prosthetic crown, correct a gummy smile, or access cavities or perforations under the gum line. There are several methods to achieve this, with some being more invasive than others. Let us explore the procedures available today.
Lengthening a crown or the visible part of a tooth is accomplished by increasing the width or distance between the surface of the gums and the alveolar bone, the structure that holds the teeth in place. This distance varies in each individual, from as little as 0.75 millimeters to 4.33 millimeters.
Exposing more than 3 mm between the restorative margin and the top of the bone can lead to chronic pain, inflammation of the gums, or loss of additional bone. When performing crown lengthening for a prosthetic crown, the dentist or periodontist will ensure that there is enough of the tooth left to leave intact the bands, or ferrules, that help maintain its structure.
The crown-to-root ratio, or the length of the section of a tooth above the alveolar bone relative to what is below the bone, is crucial in determining how crown lengthening is accomplished. If too much of the bone is removed during the procedure, it can weaken the bone's support to adjacent teeth.
In addition, once the bone is removed, it rarely regrows to its previous level. If the patient who is undergoing crown lengthening desires dental implants in that area in the future, there might not be enough bone left to support them. Periodontic crown lengthening is irreversible, so the patient and their dentist must discuss all treatment alternatives thoroughly beforehand.
If performed with other procedures, such as adding a post and core (in which a post is cemented into a root canal to provide additional support for a crown or other types of treatment), the probability of failure of each procedure — not to mention the time, effort, and cost involved — may make tooth extraction a preferable option to crown lengthening. In that case, dental implants may be the ideal restorative option, as long as the surgical site can support them.
Orthodontic forced eruption is a non-invasive alternative to surgery. Braces are installed so the tooth in question is pulled a couple of millimeters farther out of the gums; this is less expensive than surgery and has the advantage of not removing any bone. Fiberotomy, in which connective tissue fibers at the tooth's base are severed, is another non-invasive means of lengthening the crown. All the available options should be explored by the doctor and patient to ensure that they make the right decision.
Our dentist has years of experience performing crown-lengthening treatments. Call or stop by our San Diego clinic to set up a periodontics appointment.
Request an appointment here: https://scrippsranchdentistry.com or call Scripps Ranch Dental at (858) 222-6164 for an appointment in our San Diego office.
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