Esthetic Crown Lengthening: Contemporary Guidelines for Achieving Ideal Gingival Architecture and Stability

Abstract

The achievement and maintenance of ideal gingival margin levels and architecture constitute essential requirements for esthetic crown lengthening procedures. The use of a scalpel blade and ancillary mechanical armamentarium to sculpt the gingival margins may not be the most efficient or accurate surgical method available, and this review will consider the use of contemporary alternatives. Additionally, the fact that gingival margin levels are often not stable following esthetic crown lengthening surgery is a phenomenon that has perplexed clinicians. The purpose of this article is to review the pertinent literature in search of predictable clinical protocols for esthetic crown lengthening. There has been increasing interest in the use of lasers for dental applications, and their potential benefits for gingival sculpting procedures must be considered. Diode lasers may offer an advantageous compromise between surgical efficacy and practicality. Additionally, coronal gingival re-growth is often an undesired sequela of traditional crown lengthening procedures. Recent literature helps to identify potential contributing factors. The establishment of ideal gingival margin architecture requires precise sculpting of the soft tissues. This is often easier to achieve with lasers, particularly diode lasers. Coronal gingival proliferation following esthetic crown lengthening may be prevented by incorporating more current concepts regarding the need for sufficient bone removal and flap management that emphasizes the preservation of gingival complex dimensions.