Crown lengthening is generally performed in order to improve the health of the gum tissue, or to prepare the mouth for restorative or cosmetic procedures. In addition, crown lengthening procedures can also be used to correct a “gummy” smile, where teeth are covered with excess gum tissue. Crown lengthening exposes more of the natural tooth by reshaping or recontouring bone and gum tissue. This treatment can be performed on a single tooth, many teeth or the entire gum line, to expose a pleasant, aesthetically pleasing smile.
Reasons for crown lengthening
Crown lengthening is a versatile and common procedure that has many effective uses and benefits. The vast majority of patients who have undergone this type of surgery are highly delighted with the results.
Here are some of the most common reasons for crown lengthening:
Restoration of damaged teeth – Periodontal disease can cause severe damage to the teeth, as can trauma and decay. Where teeth have been broken beneath the gum line, crown lengthening can be used to prepare the area for a new restoration to correct the damaged teeth.
Cosmetic uses – Extra gum tissue can make teeth look unnaturally short, and also increase susceptibility to periodontal infections. Removing excess gum tissue can restore a balanced, healthy look and thus improve the aesthetic appearance of the smile.
Dental crowns – Crown lengthening serves to provide more space between the supporting jawbone and dental crown. This prevents the new crown from damaging gum tissues and bone once it is in place. A crown margin should be 3mm away from the supporting bone. If the margin is closer than this, we have a discussion with our patients regarding the pros and cons of crown lengthening.
What does crown lengthening involve?
Crown lengthening is performed under local anesthetic. The amount of time this procedure takes will largely depend on how many teeth are involved and whether a small amount of bone needs to be removed, in addition to the soft tissue. Any existing dental crowns or restorations will be removed prior to the procedure and a temporary crown or filling will be placed. A permananent crown or filling will then be placed after full healing has occurred, usually in 8 to 12 weeks.
Dr. Kend or Dr. Thunberg will make a series of small incisions around the soft tissue in order to separate the gums away from the teeth. Even if only one tooth requires the re-contour, neighboring teeth are usually treated to provide a more even reshaping. Separating the gums provides them with access to the roots of the teeth and the underlying bone.
In some cases, the removal of a small amount of tissue will provide enough tooth exposure to place a crown. This type of crown lengthening is called a gingivectomy since only gum tissue is removed. In other cases, the doctor will also need to remove a small amount of bone from around the teeth. The bone is usually removed using a combination of special hand instruments, and rotary instruments. The rotary instruments roughly resemble the drill that is used in cavity treatment. When bone is removed, this is considered a true crown lengthening procedure.
When the doctor is satisfied the teeth have sufficient exposure, the wound will be cleaned with sterile water and the gum tissue will be sutured with small stitches. The teeth will look noticeably longer immediately after surgery because the gums have now been repositioned. In some cases the teeth will be more sensitive to hot and cold due to more of the tooth root being exposed. If this happens, our doctors can prescribe fluoride gel to combat the sensitivity.
The doctor will then secure the surgical site using an intraoral (periodontal) bandage, which serves to prevent infection. Prescriptions may be provided for pain medication, and a chlorhexidine (antimicrobial) mouth rinse may be given to help reduce any bacteria attempting to re-colonize. The surgical site will be completely healed in approximately two to three months.
If you have any questions about crown lengthening, please call our office.