Periodontology

The clinical crown is the fragment of the tooth that is not covered by bone or gingiva and is visible in the oral cavity. The correction of the clinical crown height of the tooth may be necessary before prosthetic, endodontic or after orthodontic treatment.

Patients are referred to the periodontist before prosthetic crowns are made on abutment teeth. Often, the prosthodontist finds a situation in which the abutment tooth is too short as a consequence of carious fracture or destruction. This may result in a poor prosthetic restoration on such a tooth or the planned margin of the restoration is located too close to the edge of the bony process, which can generate recurrent gingival inflammation. Even with such severe damage to the tooth, root canal treatment is necessary before prosthetic reconstruction of the tooth. In order to ensure the root canal treatment is conducted under antiseptic conditions, a rubber dam is placed around the tooth, which is placed with a metal or plastic clamp on the tooth. With a damaged tooth below the edge of the gingiva, it often becomes problematic and also requires prior periodontal intervention.

The clinical crown lengthening procedure is most often performed using the technique of an apically repositioned flap with osseous recontouring (resection). It is the surgical excision of gingival tissue and lowering the border of the alveolar process with a drill, then placing an apical flap, and stabilizing it with sutures.

Sometimes, in short abutment teeth, gingival inflammation causes gingival hyperplasia around the tooth. The cause of such gingival hypertrophy may be incorrect oral hygiene, but also general illnesses of the patient or medications, which is why an accurate medical history, as well as general blood tests, are so important.

The procedure of clinical crown lengthening also applies to improving aesthetics, and you can read more in the Gummy Smile tab.