Coronally Repositioning the Cemento‐Enamel Junction to Address Gingival Margin Discrepancies

Abstract

Gingival margin discrepancies, especially in the esthetic zone, can pose a challenge for the restorative dentist. Surgical clinical crown lengthening and orthodontic tooth movement are most often used to treat these situations. In this report, an additional surgical technique will be discussed with its indications for use. Three cases are presented, each with a different type of gingival margin discrepancy. The surgical technique used was the same for all cases. It involved establishing a new, more coronally positioned cemento-enamel junction (CEJ) through the use of a finishing bur and curets. The newly exposed root surface was then covered with connective tissue, thus effecting a movement of the gingival margin in a coronal position. Clinical outcomes resulted in a more natural soft tissue relationship between the treated tooth and the adjacent dentition. The three cases presented did not appear to have any negative periodontal or restorative consequences following the procedure. This report presents another technique which can be considered when the clinician is faced with the need to move the gingival margin in a coronal direction. Within the guidelines presented, this technique appears to be predictable, less complicated, and less time consuming to carry out when compared with other available options.