It is always such a pleasure coming to your office. Your entire staff is so knowledgeable, helpful, and caring. They really make me feel comfortable and relaxed.
Judith M., W.Palm Beach, FL.
Functional Crown Lengthening
Sometimes a tooth may fracture or decay beneath the gum line. In order for your dentist to gain access to restore the tooth, periodontal crown lengthening surgery may be required to expose the area of the tooth to be treated. In these cases, the gum needs to be repositioned away from the site of tooth damage. Since the gum position is dependent upon the level of the underlying bone, often the bone must be adjusted as well.
Using a local anesthetic (Novocain) the periodontist gently peels back the gum from around the tooth to the level of the bone. If necessary, the bone is trimmed and reshaped, so that the gum can be repositioned just beyond the fracture or decay. After healing, the patient returns to their dentist for a final restoration or crown.
Before Crown Lengthening. Tooth Decay Below
Gum Line.
X-Ray of Tooth Decay Below Gum Line, to Bone Level.
After Crown Lengthening. Gum Line Lower
to
Expose Firm
Tooth Structure Below Level of
Decay.
Temporary Crown in Place.
X-Ray of Tooth After Crown Lengthening
with
Lower Bone Level.
When completed, the exposed visible part of the tooth will be slightly longer than it was prior to treatment. This is not because the tooth grows In length, but because the portion of the tooth not covered by the gum line has increased. The gum will be higher up on upper teeth, or lower down on lower teeth. Although this will not be noticeable on unseen back teeth, crown lengthening can have either a positive or negative effect on the appearance of front teeth.
If crown lengthening around an upper front tooth will leave it appearing too long, other treatment options must be considered. Sometimes, it is possible to orthodontically draw the tooth downward to expose the area to be treated. Other times, however, it may be better to strategically extract the tooth and replace it with a dental implant. In fact, anytime crown lengthening is deemed necessary to properly restore a decayed or broken tooth, the periodontist must consider the length of the root, and the periodontal status of the adjacent teeth. Crown lengthening can sometimes weaken periodontal support around teeth with short or thin roots, and this can affect adjacent teeth as well. Strategic extraction and replacement of the broken or decayed tooth may be preferable to crown lengthening in this situation.
Cosmetic Crown Lengthening
Occasionally, patients will be dissatisfied with the appearance of their front teeth because they have a “gummy smile” . In these cases, crown lengthening surgery can be performed to reposition the gum line higher up on upper front teeth, or lower down on lower front teeth, to improve a person’s smile esthetics. Other patients may have an uneven smile line on the front teeth. Artistically sculpting the gum line, so that all tooth lengths are in harmony with one another, can enhance smile appearance for these patients.
Before cosmetic crown lengthening
After cosmetic crown lengthening and prosthodontic (crown and bridge) reconstruction
All photographs shown are actual cases treated by Dr. Pechter.
