Crown Lengthening

A dental crown is a tooth-shaped cap that a dentist places over a damaged tooth to protect it and restore the integrity of a person's smile. Dental crowns are typically indicated when a tooth is broken, distorted, or cracked, but a dental crown can also be added after another dental procedure, such as root canal therapy.

Sometimes there's enough intact tooth structure to make dental implants impractical, but not enough for the dentist to bond a crown. That's when you have to undergo a crown lengthening procedure, which involves using surgery to remove gum tissue, bone, or both to expose more of the tooth surface. The more of the tooth's surface that is revealed, the more effectively a crown will fit.

Before the crown lengthening, your dentist will perform an analysis to determine the new length of your gum line. They will also assess the teeth, gums, and surrounding structures to learn how best to proceed and ensure that the surgery will go smoothly. This usually involves reviewing your dental records and X-rays.

Your periodontist may also schedule you for a hygiene appointment. This appointment will ensure that your teeth and gums are as clean as possible to prevent any bacteria, plaque, or tartar from interfering with the procedure or causing an infection.

In some cases, your periodontist may fit you with a temporary crown. This will help protect your tooth before the procedure and allow them to see how a crown may fit after your lengthening.

For the procedure, your periodontist or dentist typically uses a combination of local anesthesia and a sedative. Then, they will use a scalpel, a laser, or both depending on the nature of your surgery. The amount of time your crown lengthening takes will vary depending on how many teeth are being treated. It will also depend on whether tissue and bone need to be shaved down.

There are three different kinds of crown lengthening procedures:

Gingivectomy

A gingivectomy removes gum tissue using a scalpel, a laser, or electrocautery. The patient is given a local anesthetic for this. Healing from a gingivectomy is relatively quick. Following the procedure, any discomfort or pain only lasts a few days to a week, with a full recovery typically within four to six weeks.

Apically Repositioned Flap

This procedure involves making an incision in the gum line to create a flap of tissue. Then, the periodontal surgeon removes excess tissue and possibly bone from within the flap. Once this is done, the flap is repositioned toward the tooth's root and held in place with stitches as it heals.

Surgical Extrusion

For a surgical extrusion, your periodontist will move the tooth to the desired position in the gum line. This method is typically used when a tooth fractures below the gum line. To stabilize the tooth, the periodontist may use stitches. They may also use a wire or a splint to anchor the tooth to the surrounding teeth.

Crown lengthening is often preferred to dental implants because crowns are typically less expensive. Also, depending on how extensive the procedure is, a crown lengthening may be less invasive than an implant. This procedure is permanent, with measures taken to ensure that your gum line does not grow back into its original state.

Crown lengthening can also be done for aesthetic purposes to alter a “gummy” smile. Your teeth may be the appropriate length, but removing extra gum and bone tissue will expose more of your natural smile, which creates a whiter, brighter-looking smile.

At Castlebury Dental, we always look forward to offering you quality dental services. Our state-of-the-art facility allows us to provide the utmost care for our dental patients, surpassing all OSHA (Occupational Safety and Health Administration) and CDC (Center for Disease Control) specifications and standards. At the same time, we focus on ensuring that your experience is as comfortable and positive as possible. Contact us to schedule an appointment or consultation regarding dental crown lengthening with one of our dentists.