Mattos CM, Santana RB A quantitative evaluation of the spatial displacement of the gingival zenith in the maxillary anterior dentition. J Periodontol. 2008; 79:(10)1880-1885
Chu SJ, Tan JH, Stappert CF, Tarnow DP Gingival zenith positions and levels of the maxillary anterior dentition. J Esthet Restor Dent. 2009; 21:(2)113-120
Chu SJ, Tarnow DP, Tan JH Papilla proportions in the maxillary anterior dentition. Int J Periodont Rest Dent. 2009; 29:(4)385-393
Tarnow DP, Magner AW, Fletcher P The effect of the distance from the contact point to the crest of bone on the presence or absence of the interproximal dental papilla. J Periodontol. 1992; 63:(12)995-996
Gargiulo AW, Wentz F, Orban B Dimensions and relations of the dentogingival junction in humans. J Periodontol. 1961; 32:261-267
Wise MD Stability of gingival crest after gingival surgery and before anterior crown placement. J Prosthet Dent. 1985; 53:(1)20-23
Functional crown lengthening surgery in the aesthetic zone; periodontic and prosthodontic considerations Rajiv M Patel Paul Baker Dental Update 2024 42:1, 707-709.
Specialists in Periodontics, Clinical Demonstrators, Department of Periodontology and Preventive Dentistry, Guy's, King's and St Thomas' Dental Institute, Guy's Hospital, London
Crown lengthening surgery aims to increase the amount of supragingival tooth tissue by resection of the soft and/or hard tissues to enable otherwise unrestorable teeth to be restored by increasing the retention and resistance forms of the teeth. Restoration of the worn dentition may require significant prosthodontic knowledge and skill. A prosthodontist should be involved from the beginning of the management of the patient. A number of key stages should be considered for correct management. Although the periodontist may guide the prosthodontist with regards to what may or may not be possible surgically, the overall treatment plan should be prosthodontically driven.
Clinical Relevance: Toothwear of the anterior dentition provides a unique challenge to restore not only function but also to manage the aesthetic demands of the patient. To ensure that the correct outcome is reached, clinicians should be familiar with the normal anatomical proportions and relationships to enable planning and treatment to take place.
Article
Crown lengthening surgery aims to increase the amount of supragingival tooth tissue by resection of the soft and/or hard tissues to enable otherwise unrestorable teeth to be restored by increasing the retention and resistance forms of the teeth.
As restoration of the significantly worn dentition requires significant prosthodontic knowledge and skill; the restoring dentist should be involved from the beginning of the management of the patient and, indeed, lead treatment. Where necessary, the advice of a prosthodontist may also be sought.
Management of a patient with severe toothwear requiring crown lengthening surgery will require a number of planning stages:
The restoring dentist has a number of decisions to make regarding the rehabilitation of the worn dentition based on the extent of toothwear and its distribution, and the general restorative and endodontic status of the whole dentition. The occlusion will also have to be assessed prior to planning restorations. Where the existing intercuspal position (ICP) is unsatisfactory or does not exist due to excessive wear, centric relation may be used as the basis for reconstructing a new ICP. There are two other principles to consider when reorganizing the occlusion in this manner:
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
