“I was ready for my restorative dental procedure, once I got to my dentist after several months, he says I will need to have a crown-lengthening. I looked up wondering what is that?”

Most patients know what a dental crown is – but only a few know what crown lengthening is.

The majority of the time, crown lengthening is only required to when your tooth does not have enough tooth structure remaining (known as ferrule effect) to receive a dental crown. This will involve the removal of gum tissue, bone, or both of them to expose more of the tooth structure.

It is a well known procedure for a periodontist. One of the most common goals when performing crown lengthening is to facilitate the reconstruction of the tooth. It is usually a preliminary step in the reconstruction of a tooth.

Situations when Crown Lengthening may be used:

In teeth with cavities that are below the gingiva, very close to or at the bottom of the gingival sulcus.
Endodontic perforations at the bottom of the gingival sulcus
Teeth with reabsorptions at the root
When renovating an old dental bridge because the margins are already below the gum, poorly adjusted.
When it is necessary to increase mechanical retention and have a greater amount of tooth on which to perform dental reconstruction.

The procedure can be performed on one or several teeth depending on the patient and their treatment plan. It is usually performed with local anesthesia but can also be performed with sedation to avoid anxiety during the course of the surgical session. Incisions will be made in the tissue to take off the gingival of the teeth, giving the access to the root and the surrounding bone.

In some cases, removing a little gingiva is enough, although it is usually necessary to remove some bone in order to reestablish what we call the biologic width. When the professional has left enough dental structure exposed, the wound can be covered with special bandages for a up to a week to help the healing. Or the provisional is cemented back until the healing is complete and you visit your dentist for final impression and the construction of the new crown.