Abstract

Introduction: Patients now days have a greater desire for esthetic treatments. In addition to the anterior teeth itself, the surrounding gingival tissue plays an important role in such treatments. Discrepancies in the symmetry, contour, or color of the gingiva can affect the harmonious appearance of natural or prosthetic teeth. Periodontal surgery comes in handy here. Crown lengthening is a procedure that is undertaken to increase the amount of supragingival tooth structure for esthetic or restorative purposes by apically repositioning the gingival margin, removing bone, or both. Although crown lengthening is primarily undertaken to increase the anatomic length of a tooth to preserve the biological width, esthetic crown lengthening may be undertaken to reduce asymmetry between adjacent anterior teeth, reduce excessive labial gingiva, and to expose anatomical crowns of the tooth for esthetic purposes.

Aim of the Study: The paper aims to discuss the different cases where esthetic crown lengthening may be used, biological width considerations that should be paid attention to while planning such a procedure and the various surgical techniques that can be used to carry out Esthetic Crown Lengthening.

Methodology: The article is a comprehensive research of PUBMED papers from 1961 to 2018.

Conclusion: Esthetic Crown lengthening has now become an integral part of the esthetic dentistry armamentarium and is used regularly to improve the form and retention of restorations that are placed within the esthetic zone.

Case selection and periodontal examinations are very important before planning the procedure. The complete periodontal condition of the patients and their oral hygiene habits should be assessed. It is successful in cases with excessive gingiva, short clinic crowns, and asymmetrical gingival margins. It is important to take into consideration the concept of biological width while planning esthetic crown lengthening. Various surgical treatment protocols are available for performing the procedure, depending on whether or not bone resection is required.

Keywords: Esthetic Crown Lengthening for Anterior Teeth; Periodontal Surgery; Biological Width; Esthetic Dentistry; Gingivectomy

References

1. Assaf M. “Esthetic crown lengthening for upper anterior teeth: indications and surgical techniques”. Journal of International Dental and Medical Research 3 (2014): 86-91.
2. Anoop S. “Crown lengthening surgery: a periodontal makeup for anterior esthetic restoration”. Journal of Interdisciplinary Dentistry3 (2018): 132.
3. American Academy of Periodontology (Edition). “Glossary of periodontal terms”. American Academy of Periodontology (2001).
4. Kokich Jr V O., et al. “Comparing the perception of dentists and lay people to altered dental esthetics”. Journal of Esthetic and Restorative Dentistry6 (1999): 311-324.
5. Allen EP. “Use of mucogingival surgical procedures to enhance esthetics”. Dental Clinics of North America2 (1988): 307-330.
6. Schroeder HE. “Fine structure of the developing epithelial attachment of human teeth”. Monographs in Developmental Biology (1971): 2.
7. Gargiulo A W., et al. “Dimensions and relations of the dentogingival junction in humans”. The Journal of Periodontology3 (1961): 261-267.
8. Ingber JS. “The" biologic width", a concept in periodontics and restorative dentistry”. Alpha Omegan 70 (1977): 62-65.
9. Silness J. “Fixed prosthodontics and periodontal health”. Dental Clinics of North America2 (1980): 317-329.
10. Dragoo MR and Williams GB. “Periodontal tissue reactions to restorative procedures”. The International Journal of Periodontics and Restorative Dentistry1 (1981): 8.
11. Lanning SK., et al. “Surgical crown lengthening: evaluation of the biological width”. Journal of Periodontology4 (2003): 468-474.
12. Sonick M. “Esthetic crown lengthening for maxillary anterior teeth”. Compendium8 (1997): 807-812.
13. Lee EA. “Aesthetic crown lengthening: classification, biologic rationale, and treatment planning considerations”. Practical Procedures and Aesthetic Dentistry 10 (2004): 769-778.
14. Kois JC. “Altering gingival levels: the restorative connection part I: biologic variables”. Journal of Esthetic and Restorative Dentistry1 (1994): 3-7.
15. Lai J Y., et al. “Anterior esthetic crown-lengthening surgery: A case report”. Journal-Canadian Dental Association10 (2001): 600-603.