Functional Crown Lengthening
Functional crown lengthening is usually performed to improve the health of the gum tissue and prepare the surrounding tissue for a restorative procedure. When a tooth is fractured or decay extends below the gum line, this area must be uncovered before it can be restored. In order for the gum to heal against the tooth in a healthy manner, there must be 3 millimeters of healthy tooth between the margin of a filling or crown and the crest of the bone which supports the tooth. This allows space for proper attachment of the gum to the tooth.
A tooth which is broken or decayed below the gum is also difficult, if not impossible, for your dentist to restore correctly, as access and visualization of the area is compromised. In addition, even the best filling or crown will trap bacteria where the restoration meets the tooth. If this area is below the gum where you can not properly clean it, the bacterial accumulation results in both periodontal problems and the formation of a new cavity as the base of the filling. A crown lengthening procedure, which reshapes the gum and supporting tissue, will solve these problems.
Crown lengthening allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It should also provide enough tooth structure so the new restoration will not come loose in the future. This allows you to clean the edge of the restoration when you brush and floss to prevent decay and gum disease.
How is the surgery performed?
Crown lengthening takes approximately one hour but will largely depend on the amount of teeth involved and if any amount of bone will need to be removed. The procedure is usually performed under local anesthetic and involves a series of small incisions around the tissue to separate the gums from the teeth. Even if only one tooth requires the procedure, it will probably be necessary to adjust the surrounding teeth to enable a more even reshaping. In some cases, extraction of a small amount of bone will be necessary as well.
When Dr. Orth is satisfied that the teeth have sufficient exposure and the procedure is completed, the incisions will be cleaned with sterile water. Sutures and a protective bandage are then placed to help secure the new gum-to-tooth relationship. Your teeth will look noticeably longer immediately after surgery because the gums have now been repositioned. You will need to be seen in one or two weeks to remove the sutures and evaluate your healing. The surgical site should be completely healed in approximately two to three months following the procedure.
Functional Crown lengthening Surgery Performed by Dr. Orth
Case 1: Fracture of a tooth below the gum line before and after crown lengthening, and final restoration
Case 2: Full mouth functional crown lengthening used to increase tooth length and final restoration of worn teeth