Crown lengthing

The crown lenghing

Crown lengthening is a type of dental surgery •
that general dentists and periodontists
perform with the goal of exposing a greater
 .part of the tooth
 Types of crown lengthening
,:There are 3 ways for crown lengthening
Soft tissue remove
Hard tissue reduction
Orthodontics applaince
 ?What is crown lengthening vs Gingivectomy

Crown lengthening procedure will help •

establish more favorable bony architecture,
.leading to normal looking teeth
Gingivectomy refers to the removal of gums •
to expose more tooth structure below the
gum margin. Gingivectomy is often used to
.remove fibrous enlargement of gum tissues
INDICATIONS •
Elimination of suprabony pockets •
Elimination of gingival enlargements •
Exposure of additional clinical crown for • •
restorative and esthetic purposes
Pericoronal flap •
CONTRAINDICATIONS •
Procedures involving bone surgery or •
examination of shape and morphology
When the bottom the pocket is apical to the •
MGJ, which will leave an inadequate width of
gingiva
Anterior teeth -esthetic zone •
 :TYPES •
Surgical gingivectomy .1 •
LASER gingivectomy .2 •
Electrosurgical gingivectomy .3 •
Chemical gingivectomy .4 •
 HARD TISSUE
This type of crown lengthening removes excess gum •
and bone tissue to expose more the “crown” of the
.tooth to allow place for filling or a crown on the tooth
This procedure is needed when the tooth has •
fractured or the decay is very deep and there is not
enough tooth structure or the filling/crown would be
too close to the bone and would cause chronic
.inflammation and future issues
The gum line and bone are sculpted to allow for •
.better access to put the final restoration
 Contraindications to Crown lengthening •
Unrestorable teeth •
Teeth with short roots •
Teeth with inadequate bone support (mobile teeth) •
If furcations would have to be exposed as a result of crown •
lengthening
If adjacent teeth would be destabilized as a result of crown •
lengthening
Teeth with inadequate attached keratinized gingiva (corrective •
grafting can be done in most of these cases, sometimes
.concurrently)
 Indications for crown lengthening •
Complete caries removal: Teeth with extensive, inaccessible subgingival caries, which is •
  .difficult to excavate, restore or treat endodontically
Any type of restoration margins which would violate the biologic width: Margins either •
.submerged deep within pockets or too close to the alveolar bone
Retention: Teeth with inadequate coronal tooth structure, which cannot be built-up •
.sufficiently due to occlusal or other limitations
Teeth with inadequate ferrule: Endodontically treated or severely damaged teeth must have •
an adequate ferrule, in order to be restored with crowns16, 17.  The ferrule corresponds to a
2mm vertical natural tooth structure, at least 1mm thick, which can retain the amalgam,
.composite or cast metal core of the future crown restoration
Aesthetic crown lengthening: Apical relocation of the gingival margin around teeth in the •
aesthetic zone may be required due to other reasons such as lack of altered passive eruption,
orthodontic treatment, prosthetics. Clinical crown-lengthening in most of these cases cannot
be done simply by removal of gingival tissues, since the dimensions of the DGC could be such
.that the final margins will invade the DGC, resulting in chronic inflammation, etc
 ORTHODONTIC CROWN LENGTHENING

?What does tooth extrusion mean •

An extrusion is defined as a displacement of a •
tooth out of its socket. This can make the
tooth appear to be elongated, and it can
.wiggle excessively as a result