Case Reports on Surgical Lengthening of the Clinical Crown

The objective of this case report is to demonstrate the importance of a simple method to increase the crown length and thereby facilitating the restoration procedure and esthetics.

Maintenance of periodontal health is critical to the long term success of endodontically treated and restored teeth. Many teeth suffer from significant structural defects that jeopardize coronal reconstruction. Extensive caries, tooth fracture, previous restorations, perforations and external resorption can destroy tooth structure at the level of the periodontal attachment.

Placement of a restoration margin subgingivally may encroach upon the periodontal attachment zone or biologic width. Whenever the biologic width is violated, there is a reaction by the periodontium in the form of gingival inflammation, loss of attachment and alveolar bone resorption. Where orthodontic extrusion cannot be done to provide sufficient tooth structure for a restoration, a clinical crown lengthening can be considered as an alternative.

Discussed here are two cases of short clinical crowns with compromised gingival health. Surgical crown lengthening was done subsequent to which posts were placed followed by fabrication of porcelain fused to metal crowns, all leading to the results that were profoundly satisfying for the patients as well as the clinician. Four years follow-up in one case showed stable gingival margins and excellent esthetics.