DENTAL SCIENCE - ORIGINAL ARTICLE

Year : 2013  |  Volume : 5  |  Issue : 5  |  Page : 14-16

Three different surgical techniques of crown lengthening: A comparative study

Ramya Nethravathy¹, Santhana Krishnan Vinoth², Ashwin Varghese Thomas^3
1 Department of Periodontics, Vivekanandha Dental College for Women, Elayampalayam, Tiruchengode, Namakkal, Tamil Nadu, India
² Department of Orthodontics, Vivekanandha Dental College for Women, Elayampalayam, Tiruchengode, Namakkal, Tamil Nadu, India
³ Department of Orthodontics, Sree Mookambika Institute of Dental Sciences, Kanyakumari, Tamil Nadu, India

Correspondence Address:
Ramya Nethravathy
Department of Periodontics, Vivekanandha Dental College for Women, Elayampalayam, Tiruchengode, Namakkal, Tamil Nadu
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/0975-7406.113281

Abstract

Introduction: A short clinical crown may lead to poor retention form thereby leading to improper tooth preparation. Surgical crown lengthening procedure is done to increase the clinical crown length without violating the biologic width. Several techniques have been proposed for clinical crown lengthening which includes gingivectomy, apically displaced flap with or without resective osseous surgery, and surgical extrusion using periotome. Objective: The aim of this paper is to compare clinically the three different surgical techniques of crown lengthening procedures. Materials and Methods: Fifteen patients who reported to the department of Periodontology, were included in the study. Patients were randomly divided into three groups, which include patients who underwent gingivectomy (Group A), apically repositioned flap (Group B) and surgical extrusion using periotome (Group C). Clinical measurements such as clinical crown length, gingival zenith, interdental papilla height were taken at baseline and at 3 ^rd month post-operatively. Results: Clinical and radiographic evaluation at 3 ^rd month suggest that surgical extrusion technique offers several advantages over the other conventional surgical techniques such as preservation of the interproximal papilla, gingival margin position and no marginal bone loss. Conclusions: This technique can be used to successfully treat a grossly damaged crown structure as a result of tooth fracture, dental caries and iatrogenic factors especially in the anterior region, where esthetics is of great concern.

Keywords: Biologic width, gingival zenith, gingivectomy, periotome

Objectives for Crown Lengthening

1. Exposure of sufficient sound tooth structure in case of deep subgingival tooth fracture and carious lesion
2. To enhance retention of restoration
3. Correct placement of margins of restorations without violating the biologic width
4. Improved esthetics in patients with uneven gingival margin and excessive gingival display. ^[1]

• 15 patients (nine males and six females) reported to the Department of Periodontology, Vivekanandha Dental College for Women, Thiruchengode were included in the study
• Patients were equally and randomly divided into three groups.

• Length of the clinical crown
• Width of attached gingiva
• Gingival zenith
• Interdental papilla height

Figure 1: Pre-operative photograph Click here to view

Figure 2: immediate post-operative Click here to view

Results

Table 1: Preoperative and postoperative measurements of three different surgical techniques Click here to view

Discussion

Conclusion

References

1.	Sonick M. Esthetic crown lengthening for maxillary anterior teeth. Compend Contin Educ Dent 1997;18:807-12.
2.	Nemcovsky CE, Artzi Z, Moses O. Preprosthetic clinical crown lengthening procedures in the anterior maxilla. Pract Proced Aesthet Dent 2001;13:581-8.
3.	Levine RA. Forced eruption in the esthetic zone. Compend Contin Educ Dent 1997;18:795-803.
4.	Bensimon GC. Surgical crown-lengthening procedure to enhance esthetics. Int J Periodontics Restorative Dent 1999;19:332-41.
5.	Davarpanah M, Jansen CE, Vidjak FM, Etienne D, Kebir M, Martinez H. Restorative and periodontal considerations of short clinical crowns. Int J Periodontics Restorative Dent 1998;18:424-33.
6.	De Waal H, Castellucci G. The importance of restorative margin placement to the biologic width and periodontal health. Part II. Int J Periodontics Restorative Dent 1994;14:70-83.

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