DR.

HUSSAIN
AL-SARHAN
Higher diploma periodontology and implantology
Esthetic Crown
lengthening
 Esthetic crown lengthening

Procedure intended for increase the supra-gingival extant of a tooth (clinical crown length )without invading the
biological width
 An other definition

◦ clinical crown lengthening is a surgical procedure that

aims at exposing sound tooth structure for restorative
purposes via apical repositioning of the gingival tissue,
with or without removal of alveolar bone.
 Clinical crown Anatomical crown Biological width

Junctional epithelium
The part of tooth visible in oral +connective tissue
From CEJ to incisal edge
cavity All soft tissue from the crest of
the bone to the base of sulcus
 Clinical
crown Clinical
crown

Recetion

Clinical
Anatomical
crown
crown
 o ut
s ab
h i
t
l wi d
m m
ica
i ol
o g
. 0 4
B 2

Invasion to biological width cause inflammation lead to recession

Anatomy of the gingiva
 Golden proportion
IS A MATHMATICAL CONSTANT RATIO BETWEEN SMALLER AND LONGER LENGTH
WICH IS 1.618
 USE THE RATIO IN
CROWN LENGTHING
OR USE A CHUE GAGE
 HING
T
E NG
N L
OW
Y CR
WH

TO RE-ESTABLISH A BIOLOGICAL
WIDTH MORE APICAL POSITIOND
AND AVOID IT’S VIOLATION THAT
LEAD TO INFLAMATION AND
BONE AND SOFT TISSUE
RECESSION
Surgical crown lengthening can provide additional crown length for restorative procedures on a
severely damaged tooth or for treatment of excessive gingival display (gummy smile )
CONTRAINDCATION FOR ESTHATIC CROWN LENGTHING

TOOTH MOBILITY

INSUFFICIENT ATTACHD GINGIVA

(minimum 3mm remaining )

INADQUITE CROWN ROOT RAITIO

( minimum 1to1)
Gingivectomy Osteotomy
 How to determine if you need osteotomy

Bone sounding is a great method

Under local anesthesia insert the periodontal probe

until the tip of the crest of the alveolar bone
CBCT

Good quality (CBCT) very effective method for measuring soft tissue and
bone level
Distance between alveolar crest and the margin of gingiva 3mm

Bone level

Gingival
margin
More than 3mm gingivectomy
Gingivoplasty
Less than or 3mm and you need more of the crown for
restoration (esthetic ) need osteotomy

Chue gage
 ◦ Surgical procedure to increase the
crown when bone margin is near
Crown lengthening the CEJ we have to do osteotomy
and gingivoplasty
Surgical Approach
 Surgical guide
For crown lengthening
6 months after
Always
smile
Thank
you