Abstract
Crown lengthening is the exposure of root structure to function as clinical crown for restorative coverage.1 Indications for crown lengthening include increasing the amount of clinical crown available for attachment of a prosthesis (crown or bridge) following crown fracture, and exposure of a malerupted tooth crown allowing management of any pathologic changes. Types of crown lengthening procedures include simple gingivectomy [type I], apically repositioned flap(s) following bone recontouring [type II], or orthodontic extrusion [type III]. Type I and II crown lengthening procedures involve periodontal surgery requiring maintenance of the biological width of the gingiva composed of the gingival sulcus, junctional epithelium, and connective tissue attachment (Fig. 1). Each of these zones is approximately 1-mm wide in humans, and may be 2 to 3-mm wide in large dogs. In type II crown lengthening procedures in dogs, the apically repositioned flap should maintain a minimum 3-mm biological width of the gingiva coronal to the newly formed alveolar crest to provide space for the three zones to reestablish. Failure to maintain gingival biological width physiology may cause an inflammatory response that results in crestal bone resorption and apical migration of periodontal soft tissues.1 Advanced periodontal disease resulting in the formation of infrabony pockets may jeopardize tooth maintenance.1 Crown preparation may be performed acutely, however a 2 to 3-week interval is recommended between crown lengthening and preparation to allow for accurate assessment of gingival margin location following wound healing. Type II crown lengthening of the mandibular and maxillary canine teeth is described step-by-step.
Published Version
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