What does the crown lengthening procedure consist of?

Crown lengthening is a procedure used to help a crown (also cap) fit better. If a tooth is tooth short when it is prepared for the crown, a crown lengthening procedure may be needed. The dentist removes a small amount of gum and bone around the tooth, and several weeks are needed for healing. The new "taller" tooth is then prepared for the crown.
Crown lengthening is a dental office surgery that begins with novacaine for good local anesthesia. Then you will feel firm pressure as the area around the tooth is uncovered. A hand piece (drill), a laser, or some combination of the two instruments will be used to reshape the gum and bone around your tooth, and to some extend around the adjacent teeth as well. You experience this like a combination of a filling and a cleaning all rolled into one procedure -- nothing to get excited about. When the area is shaped to good advantage, stitches are placed to enable more rapid healing. Sometimes a "dressing" is placed over the treated area -- kind of like silly putty that sticks to the teeth and protects the site.

You will come back to get the stitches out in about a week, and the area will be achy-sore for a few days. You may take something for pain, and you will prefer to avoid chewing in that area for a while. Eventually (days, weeks, sometimes months -- depends on the situation) the area will settle down and the tooth can be restored (or enjoyed "as is", if treatment was done only for esthetic reasons). Many patients find this procedure to be rewarding and worthwhile.
The crown lengthening procedure starts with anesthesia, and then the periodontist removes excess gum tissue to expose more of your teeth. Sometimes removal of only a little gum tissue is enough to dramatically improve the appearance of your teeth. Sometimes bone may need to be removed from the area surrounding the tooth root or roots.
Crown lengthening is surgery, but it is minor periodontal surgery. The goal is to expose more solid tooth above the gum for the crown to grip. This is important for retention, stability of the crown and resistance to fracture of the crown from the root.

The principle here is to be able to establish a ferrule around the root surface. The definition of ferrule is:
  1. a ring or cap usually of metal put around a slender shaft (as a cane or a tool handle) to strengthen it or prevent splitting
  2. a usually metal sleeve used especially for joining or binding one part to another (as pipe sections or the bristles and handle of a brush)
In this case crown lengthening exposes adequate tooth/root structure for the crown material to grip.
If crown lengthening is indicated it may also be necessary to build up the tooth (often with reinforced composite resin) above the newly exposed tooth structure. This is also important for retention and to be able to fabricate a crown in the usual manner.

If crown lengthening is indicated but not performed, the crown would be seated only on build-up material, and it would not have sufficient grip on solid natural tooth structure to prevent fracture.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.