Crown lengthening

Crown lengthening is a surgical procedure where the gum tissue and/or bone surrounding the teeth are partially removed to expose more of the tooth structure.

The common indications include:

1) Where a tooth needs a crown (or a filling), but the tooth is too short or not exposed enough for the placement of the crown/filling. During this procedure the periodontist will expose more of the tooth by removing gum and/or bone surrounding the tooth. In some cases, moving a small amount of gum is enough to expose the tooth for a crown placement. But in most cases the periodontist will also need to remove some of the bone to expose the tooth enough for the crown placement.

2) Correction of ‘gummy smile’: Some people are born with what dentists refer to as ‘gummy smile’. In these cases, for a combination of aesthetic and functional purposes the periodontist surgically removes the ‘extra’ gum in order to give the patient a more beautiful smile. Crowns or veneers may also be required as the second step to improve the shape and color of the exposed areas, and this will be done by your own dentist.

The procedure is performed under local anaesthetics and usually takes 1-2 hours, depending on the number of teeth involved. In most cases even though only one tooth needs the procedure, neighboring teeth are also included – this allows for the tissue to be reshaped gradually creating a more natural look.

You will need to make an initial appointment with the periodontist for a consultation. In this appointment the periodontist will assess your teeth and plans a surgical approach to suit your needs. If only soft tissue is removed the surgery is relatively quick. This can also be done with laser in some cases which creates no/minimal bleeding and does not need stitches. If bone removal is necessary, the procedure will take longer and will require stitches.

Once the procedure is complete, you will require a review appointment 1-2 week after surgery to remove the stitches (if any were placed). The area usually takes 2 to 3 months to fully heal and you will need to make a second review appointment at that point. Once the area has fully healed, you will return to your regular dentist for the placement of the crown, veneer or filling.

Crown lengthening has a number of considerations to focus upon for it to be effective. These include:

• Biological width
• Ferrule effect
• Crown-to-root ratio

Crown lengthening techniques include:

• Apically repositioned flap with osseous recontouring
• Forced tooth eruption

Dr Ehsan Mellati’s team at Precision Periodontics can help provide valuable insights into crown lengthening procedures. To know more, call on (02) 8093 2680 or book an appointment with us.