Malkinson S, Waldrop TC, Gunsolly JC, Lanning SK, Sabatini R The effect of esthetic crown lengthening on perceptions of a patient's attractiveness, friendliness, trustworthiness, intelligence, and self-confidence. J Periodontol. 2013; 84:(8)1126-1133
Tjan AH, Miller GD, The JG Some esthetic factors in a smile. J Prosthet Dent. 1984; 51:(1)24-28
Konikoff BM, Johnson DC, Schenkein HA, Kwatra N, Waldrop TC Clinical crown length of the maxillary anterior teeth preorthodontics and postorthodontics. J Periodontol. 2007; 78:(4)645-653
Gargiulo AW, Wentz FM, Orban B Dimensions and relations of the dentogingival junction in humans. J Periodontol. 1961; 362:261-267
Coslet JG, Vanarsdall R, Weisgold A Diagnosis and classification of delayed passive eruption of the dentogingival junction in the adult. Alpha Omegan. 1977; 70:(3)24-28
Bozzo L, de Almedia OP, Scully C, Aldred MJ Hereditary gingival fibromatosis. Report of an extensive four-generation pedigree. Oral Surg Oral Med Oral Pathol. 1994; 78:(4)452-454
Fletcher J Gingival abnormalities of genetic origin: a preliminary communication with special reference to hereditary gingival fibromatosis. J Dent Res. 1966; 45:597-612
Singer SL, Goldblatt J, Hallam LA, Winters JC Hereditary gingival fibromatosis with a recessive mode of inheritance. Case reports. Aust Dent J. 1993; 38:(6)427-432
Gorlin R, Cohen M, Levi L, 3rd edn. New York: Oxford Press; 1990
Coletta RD, Graner E Hereditary gingival fibromatosis: a systematic review. J Periodontol. 2006; 77:(5)753-764
Cuestas-Carnero R, Bornancini CA Hereditary generalized gingival fibromatosis associated with hypertrichosis: report of five cases in one family. J Oral Maxillofac Surg. 1988; 46:(5)415-420
Jones JE, Weddell JA, McKown CG Incidence and indications for surgical management of phenytoin-induced gingival overgrowth in a cerebral palsy population. J Oral Maxillofac Surg. 1988; 46:(5)385-390
Dahllof G, Preber H, Eliasson S, Ryden H, Karsten J, Modeer T Periodontal condition of epileptic adults treated long-term with phenytoin or carbamazepine. Epilepsia. 1993; 34:(5)960-964
Dongari A, McDonnell HT, Langlais RP Drug-induced gingival overgrowth. Oral Surg Oral Med Oral Pathol. 1993; 76:(4)543-548
Wise MD Stability of gingival crest after surgery and before anterior crown placement. J Prosthet Dent. 1985; 53:(1)20-23
Mavrogiannis M, Ellis JS, Seymour RA, Thomason JM The efficacy of three different surgical techniques in the management of drug-induced gingival overgrowth. J Clin Periodontol. 2006; 33:(9)677-682
McGuire MK, Scheyer ET Laser-assisted flapless crown lengthening: a case series. Int J Periodont Rest. 2011; 31:(4)357-364
Cunliffe J, Grey N Crown lengthening surgery – indications and techniques. Dent Update. 2008; 35:(1)29-25
This is the first article in a two-part series which aims to provide an overview of the different techniques used to increase clinical crown height. In the first paper, the focus will be on the management of patients who present with gingival tissue excess. The different aetiologies are discussed and illustrated with clinical cases, following which a range of procedures that may be employed in the management of these patients are presented. With an increasingly ageing population, more patients are taking regular medications prescribed from their general medical practitioner, and so having a working knowledge of the specific drugs that may cause gingival enlargement is essential.
Clinical Relevance: When patients with gingival tissue excess present in primary or secondary care, a clinician must have a good knowledge of the possible causes of the condition, as well as an idea of how the patient may be managed.
Article
This is a two-part series of articles that aims to provide an overview of the different techniques used to increase clinical crown height, a procedure known as crown lengthening. The need for increasing clinical crown height falls into two main groups: those that require increased crown length to improve aesthetics (commonly seen in patients with gingival tissue excess); and those that require increased clinical crown height to facilitate restorative treatment of a tooth or multiple teeth.
Smile aesthetics has been shown to play a vital role in the perception of an individual's attractiveness, friendliness and self-confidence.1 In patients where the gingival tissues have not retracted to their full extent during the eruption of teeth, this can have an impact where there is excessive gingival tissue on show. This condition is known as altered passive eruption and is more commonly referred to as a ‘gummy smile’. Similarly, the aesthetics may be affected in patients where normal tooth eruption has occurred but there has been gingival tissue overgrowth due to hereditary conditions, such as hereditary gingival fibromatosis, or secondary to certain types of medication. Gingival overgrowth can be mild, moderate or severe, where the full clinical crown is covered and the gingival tissues encroach upon the occlusal surfaces, making chewing and function difficult. In both groups, patients often become self-conscious of their appearance and often seek help to improve the appearance of their teeth. A key aspect of managing these patients is a thorough assessment of the complaint and their condition to ensure that the intervention offered will address their main concern.
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