crown lengthening

lecture given 10/14/2026

what should you look at to determine if crown lengthening is indicated?

probing depth, ferrule, margin location, keratinized tissue present

why do you suture into the periostium when doing a crown lenghening?

allows you to position the gingiva more apically

biologic width

the dimensions and relations of the dentogingival junctions in humans

their study established that there is a proportionate dimensional relationship between the crest of the alveolar bone, the connective tissue attachment, junctional epithelium, and the sulcus

the zone of root surface coronal to the alveolar crest, to which the connective tissue and junctional epithelium are attached

what are the measurements for biologic width- sulcus depth?

0.69mm

what are the measurements for biologic width- junctional epithelium?

0.97mm

what are the measurements for biologic width- connective tissue attachment?

1.07mm

what is the total average biologic width?

2.73mm

what are indications for crown lengthening?

tooth decay at or below the gingival margin

tooth fracture below the gingival margin, with adequate remaining periodontal support and attachment

teeth with excessive wear

teeth with insufficient interocclusal space

delayed passive eruption

the decision to restore a tooth depends on what?

crown to root ratio

position of tooth in the arch

predictability of treatment procedures

strategic value of tooth

esthetic and phonetic considerations

degree of periodontal support lost from adjacent teeth during crown lengthening procedure

location of furcation relative to biologic width

ability to perform effective plaque control following placement of restoration

endo considerations

root anatomy and morphology as it relates to post placement

restorative requirements

cost/risk/benefit ratio relative to alternative treatment

cost/risk/benefit ratio

what are the costs of each treatment?

what is the length of time involved?

how many visits are involved?

what is the long term prognosis?

how predictable is the procedure?

what are alternative treatments?

extraction- bridge or implant

ortho extrusion

post operative treatment after crown lengthening?

perio packing?

medication- NSAIDs, antibiotic, analgesic

suture removal

completion of restoration

how long do you need to heal after crown lengthening?

6-8-12 weeks or more

0.5mm-1.2mm over 12 mo

what are complications from crown lengthening?

bleeding, pain, swelling, root sensitivity, loss of flap

how much distance from the restorative margin to the crest of bone?

± 4mm

nefly says 3-4mm