Surgical lengthening of the clinical tooth crown

A variety of dental and periodontal diseases can lead to teeth with small length of clinical crown, which is a common condition in daily practice. The crown lengthening procedure is used in order to increase the length of the clinical crown. This surgical technique can be accomplished with an apically positioned flap in combination with ostectomy and/or osteoplasty. When there is no need for access to the alveolar bone and the soft tissues are sufficient; the desired outcome can be achieved with gingivectomy. The main aim of crown lengthening procedure is to preserve the biologic width; which is the minimum distance from the margin of the restoration to the top of the alveolar ridge so that the periodontal health can be retained. In addition; the crown lengthening procedure can resolve problems of the periodontal tissues; such as drug-induced gingival overgrowth and altered or delayed passive eruption, as well as give satisfactory results in some cases of asymmetries of the soft tissue’s margin, or in “gummy smile”. The aim of this review is the analysis of the surgical technique of crown lengthening procedure and its indications/contra-indications. It will be also discussed: the importance of biologic width, the criteria that define the relation of periodontal tissues-restoration’s margin, and the ideal time of restoration placement.