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What to know about crown lengthening

What to know about crown lengthening Crown lengthening is a procedure to address an excessive gingival display, otherwise known as a gummy smile.

A person with a gummy smile appears to have short teeth. Their teeth are actually the typical size, but excess gum tissue partially covers them.

The crown is the part of the tooth that is visible above the gumline. Some people request crown lengthening for cosmetic purposes, while others need the procedure to expose decayed or broken areas of teeth.

A periodontist — a gum specialist — may perform a crown lengthening to expose more tooth structure before they can fit a bridge or perform another restorative dental procedure.

In this article, we describe what crown lengthening involves, including how a person prepares, what they can expect during the procedure, and what recovery entails.

What is it?

People with gummy smiles typically have more than 3 millimeters of exposed gum.

The procedure involves removing soft tissue and sometimes bone to increase the amount of tooth that is visible.

A periodontist may perform the procedure on one tooth, several teeth, or the entire gumline.

Dentists may perform crown lengthening procedures to:

  • address cosmetic concerns
  • expose cavities beneath the gumline
  • expose fractured areas of tooth
  • expose more tooth structure before they can fit a device such as a bridge

The dentist will be careful to preserve enough gum to maintain the health of oral structures. They may describe this amount of gum as biologic width.

Crown lengthening surgery is not appropriate for everyone. Anyone who is interested in the procedure for cosmetic reasons should discuss it with their dentist.

How to prepare for the procedure

A person who is interested in crown lengthening should see their dentist for a check-up and to discuss the suitability of the procedure.

It is important to have healthy gums and good overall health before the surgery. To support the health of the gums and teeth:

  • brushing the teeth regularly
  • flossing at least once a day
  • using mouthwash
  • visiting the dentist annually for a comprehensive evaluation

Before the procedure, the periodontist performs a presurgical analysis to determine the new location of the gumline.

They will also assess the teeth, gum, and surrounding structures. This information helps them decide upon the most appropriate surgical technique.

The procedure

During a crown lengthening, a periodontist — a dentist who specializes in gum health — removes excess gum tissue. Some general dentists can also perform this procedure.

Certain situations require the dentist to also remove or reshape bone tissue to expose more of the teeth.

The following are different crown lengthening techniques:

  • gingivectomy
  • apically repositioned flap surgery
  • surgical extrusion

We describe each in detail below.

The dentist will choose the most appropriate technique based on the cause of the excess gum tissue and the condition of the person’s mouth.

Some factors that can influence the choice of technique include:

  • aesthetic considerations
  • the length of the tooth’s root, compared with its crown, called the crown to root ratio
  • the proximity of the root
  • the appearance of the root
  • the presence of bone loss
  • the position of the affected tooth or teeth
  • the need for a filling or cap

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