Document Detail

Contemporary crown-lengthening therapy: a review.
MedLine Citation:
PMID:  20516094     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The authors conducted a literature review regarding the rationale, basic surgical principles, contraindications and wound healing associated with periodontal crown-lengthening surgery. They present a report of a clinical case illustrating crown lengthening with osseous resection. TYPES OF STUDIES REVIEWED: The authors evaluated clinical and radiographic studies, as well as literature reviews. They selected only publications that pertained to the surgical exposure of the natural dentition to facilitate restorative therapy, esthetic concerns or both. RESULTS: Periodontal crown lengthening can be used for esthetic enhancement in the presence of delayed passive eruption. Moreover, for teeth with subgingival caries, fractures or both, this treatment can establish a biological width and, if needed, a ferrule length facilitating prosthetic management. Crown-lengthening surgery involves various techniques, including gingivectomy or gingivoplasty or apically positioned flaps, which may include osseous resection. Authors of wound-healing investigations have reported that an average of 3 millimeters of supragingival soft tissue will rebound coronal to the alveolar crest and can take a minimum of three months to complete vertical growth. CLINICAL IMPLICATIONS: Initiation of final prosthetic treatment should wait at least three months and possibly up to six months for esthetically important areas, as the free gingival margin requires a minimum of three months to establish its final vertical position. Dentists must be aware that osseous resection could affect periodontal stability and may pose a contraindication to crown-lengthening therapy.
Timothy J Hempton; John T Dominici
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Journal of the American Dental Association (1939)     Volume:  141     ISSN:  1943-4723     ISO Abbreviation:  J Am Dent Assoc     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-02     Completed Date:  2010-09-28     Revised Date:  2010-10-07    
Medline Journal Info:
Nlm Unique ID:  7503060     Medline TA:  J Am Dent Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  647-55     Citation Subset:  D; IM    
School of Dental Medicine, Tufts University, Boston, MA, USA.
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MeSH Terms
Crown Lengthening / contraindications,  methods*
Esthetics, Dental
Middle Aged
Surgical Flaps
Wound Healing / physiology
Comment In:
J Am Dent Assoc. 2010 Oct;141(10):1182-3; author reply 1184-5   [PMID:  20884919 ]
J Am Dent Assoc. 2010 Oct;141(10):1183-4; author reply 1184-5   [PMID:  20884920 ]

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