A crown lengthening procedure is necessary when there is insufficient tooth structure remaining clinically visible or accessible for proper retention of a cast restoration (a crown or onlay) or for routine restoration (filling). It is also necessary if the gum tissue has poor position or contour or for improving the cosmetic appearance of the teeth. It may also be required in order to make a successful impression for a cast restoration. The soft gingival tissues will be modified, repositioned, or reshaped so that a restoration can be placed. If the tooth has been severely decayed, crown lengthening may be necessary to more completely expose the decayed area and allow better preparation for the final filling.
Many times, this crown lengthening will be minimal and it can be done in our office. This may involve electrosurgery or a scalpel and suturing procedure. We will select the method based on your individual circumstances. If the modification is extensive, involving many teeth or the supporting bone, you may be referred to a periodontist (gum specialist) for evaluation and treatment. At times, after the crown lengthening is completed and the tissue is healed, the tooth may exhibit temporary sensitivity to thermal changes. With time, the sensitivity decreases. Also, we do not want the tissue that is removed to grow back. If it does grow back, which can happen, it may need to be removed again.
Restorations placed on sound tooth structure will last the longest possible time. One tooth or several teeth may be involved in the lengthening procedure. In many cases, it would be impossible to obtain a satisfactory result if the crown lengthening were not performed. Postoperative discomfort is usually minimal unless the crown lengthening has been extensive, as when the underlying bone must be recontoured. Over-the-counter pain relievers are usually very adequate. Healing time varies, depending on the extent of the procedure. Sometimes we will elect to finish the restoration or make the final impression at the time of the crown lengthening; other times we must wait for the site to heal. Healing time may be 4 to 6 weeks. This will be discussed with you when the crown lengthening procedure is suggested.
If a crown lengthening is recommended, you should have it done, or the final restoration may be compromised and the chance of obtaining a clinically successful restoration would be seriously reduced.