Closed Flap Osseous Crown Lengthening Procedure

2020 ◽  
Author(s):  
Aditi Chaudhary
Keyword(s):  
Postoperative Complications ◽  
Healing Process ◽  
Aesthetic Outcome ◽  
Flap Surgery ◽  
Erbium Laser ◽  
Tooth Structure ◽  
Present Technique ◽  
The Aesthetic ◽  
Biologic Width ◽  
Crown Lengthening

Osseous crown-lengthening is often needed to enhance the appearance of a patient’s smile, prevent the violation of biologic width, and/or provide sufficient tooth structure for the placement of final restorations. The present technique for osseous crown lengthening typically involves flap surgery, a procedure that frequently is associated with postoperative complications that can interfere with the aesthetic outcome, such as infection, bleeding, and change in tissue position during the healing process. The erbium laser enables the clinician to offer the patient a minimally invasive alternative to osseous crown lengthening negating the adverse effects associated with conventional treatment. Other advantages of using the laser for osseous crown lengthening includes: hemostasis, improved visualization, fewer postoperative complications and recession.

scholarly journals Biologic Width: Understanding and Its Preservation

2014 ◽  
Vol 3 (1) ◽  
pp. 363
Author(s):  
K. Malathi ◽  
Arjun Singh
Keyword(s):  
Dental Restoration ◽  
Periodontal Health ◽  
Tooth Structure ◽  
Form And Function ◽  
Gingival Health ◽  
Adequate Understanding ◽  
Biologic Width ◽  
And Function ◽  
The Relationship ◽  
Crown Lengthening

The relationship between the periodontal health and the restoration of teeth is intimate and inseparable. Maintenance of gingival health constitutes one of the keys for tooth and dental restoration longevity. An adequate understanding of relationship between the periodontal tissue and restorative dentistry is essential to ensure adequate form and function of dentition and Esthetics and comfort to the patients. Restoration of fractured (traumatized), severely decayed, partially erupted (delayed passive eruption), worn or poorly restorated teeth is often difficult for the dentist without surgical and orthodontic intervention. Surgical crown lengthening of these teeth is necessary to provide adequate tooth structure for restoration or Esthetics enhancement, thus adhering to basic biological principles by preventing impingement on the periodontal attachment apparatus or biological width. Many clinicians have been unable to utilize the concept of biologic width in practical manner. Hence the purpose of this article is to describe the biologic width anatomy, evaluations and correction of its violation by different methods.

scholarly journals Crown Lengthening Procedure: Report of Two Cases

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 2926-2931
Author(s):  
Deepika Masurkar ◽  
Priyanka Jaiswal ◽  
Diksha Agrawal
Keyword(s):  
Case Report ◽  
Root Structure ◽  
Tooth Structure ◽  
Crown Length ◽  
Operative Complications ◽  
Biologic Width ◽  
Forced Eruption ◽  
Crown Lengthening ◽  
Root Location ◽  
Selection Of

Crown lengthening is a surgical procedure designed to increase the extent of the supragingival tooth structure, so that the clinician can restore the tooth. Crown lengthening procedure is done to maintain normal biologic width and increase crown length for retention of prosthesis. Various techniques have been proposed to perform CLP, such as gingivectomy, undisplaced flap with or without osseous reduction, apically repositioned flap with or without bone reduction, and orthodontic forced eruption with or without fibrotomy. Selection of one of this CLP technique depends upon esthetics, clinical ratio of crown to root, structure of root, location of furcation, position of tooth and the capacity of the tooth to be restored. This case report illustrate two different methods of doing crown lengthening procedure the selection of case depends upon various soft tissue and hard tissue parameters. Owing to the various advantages, disadvantages and associated limitation with different methods, we opted for surgical CLP with scalpel method. Uneventful healing was observed in both our cases. No post-operative complications was observed in both cases. Thus to conclude success rate of CLP is high but appropriate selection of case is required. In our case report both the methods of CLP shows significant result in increasing the crown length and maintaining the biological width.

scholarly journals A Comparative Evaluation for Biologic Width following Surgical Crown Lengthening Using Gingivectomy and Ostectomy Procedure

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Kiran Kumar Ganji ◽  
Veena Ashok Patil ◽  
Jiji John
Keyword(s):  
Comparative Evaluation ◽  
Histological Studies ◽  
Tooth Structure ◽  
Periodontal Tissues ◽  
Probing Depth ◽  
Before And After ◽  
Baseline Values ◽  
Biologic Width ◽  
Crown Lengthening ◽  
Caries Tooth

Surgical crown lengthening has been proposed as a means of facilitating restorative procedures and preventing injuries in teeth with structurally inadequate clinical crown or exposing tooth structure in the presence of deep, subgingival pathologies which may hamper the access for proper restorative measures. Histological studies utilizing animal models have shown that postoperative crestal resorption allowed reestablishment of the biologic width. However, very little has been done in humans.Aims. The purpose of the study was to evaluate the potential changes in the periodontal tissues, particularly the biologic width, following surgical crown lengthening by two surgical procedures before and after crown placement.Methods and Material. Twenty (20) patients who needed surgical crown lengthening to gain retention necessary for prosthetic treatment and/or to access caries, tooth fracture, or previous prosthetic margins entered the study. The following parameters were obtained from line angles of treated teeth (teeth requiring surgical crown lengthening) and adjacent sites: Plaque and Gingival Indices (PI) & (GI), Position of Gingival Margin from reference Stent (PGMRS), Probing depth (PD), and Biologic Width (BW).Statistical Analysis Used. Student “t” Test.Results. Initial baseline values of biologic width were 2.55 mm (Gingivectomy procedure B1 Group) and 1.95 mm (Ostectomy procedure B2 Group) and after surgical procedure the values were 1.15 mm and 1.25 mm.Conclusions. Within the limitations of the study the biologic width, at treated sites, was re-established to its original vertical dimension by 3 months. Ostectomy with apically positioned flap can be considered as a more effective procedure than Gingivectomy for Surgical Crown Lengthening.

scholarly journals Minimally Invasive Surgery for Clinical Crown Lengthening Using Piezoelectric Ultrasound

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Ana Carolina Monachini Marcantonio ◽  
Guilherme José Pimentel Lopes de Oliveira ◽  
Cássio Rocha Scardueli ◽  
Camila Chiérici Marcantonio ◽  
Rosemary Adriana Chiérici Marcantonio ◽  
...  
Keyword(s):  
Case Report ◽  
Postoperative Complications ◽  
Minimally Invasive ◽  
Gingival Tissue ◽  
Aesthetic Outcome ◽  
Gingival Margin ◽  
Periodontal Tissues ◽  
Rapid Healing ◽  
Virtual Analysis ◽  
Crown Lengthening

This case report is aimed at describing a flapless, minimally invasive clinical crown lengthening with an osteotomy performed using a piezoelectric ultrasound. A female patient complained about the amount of gum that was exposed when she smiled, which caused aesthetic discomfort. After a clinical examination, it was confirmed that the patient had excessive gum exposure in the upper arch of the dental region for teeth 14 to 24 when she smiled. The tomographic exam showed that bone tissue was at the level of the enamel-cementum junction, and gingival tissue covered a part of the anatomic crown. Virtual analysis using digital smile design (DSD) demonstrated that enlarging the clinical crowns would provide better aesthetics. The excess gingival tissue was removed from the gingival margin region with the aid of a mockup without interference to the interdental papillae. Then, osteotomy was performed using piezoelectric ultrasound until there was a 2.5 mm distance from the top of the bone crest to the new gingival margin. In the postoperative period, good repositioning of the gingival margin, absence of postoperative complications, and rapid healing of the gingival tissue were verified. After 6 months, a good aesthetic outcome was observed with stability in the level of the periodontal tissues obtained via the crown-lengthening technique. It can be concluded that the minimally invasive clinical crown-lengthening technique was effective in repositioning the gingival margin with no postoperative complications.

Designing a Trifoliate Flap for Isolated Congenital Alar Rim Defect in Pediatric Patients

2021 ◽  
pp. 229255032110196
Author(s):  
Shi-Yan Li ◽  
Bao-Fu Yu ◽  
Shu-Yi Wei ◽  
Ning Yin ◽  
Zong-Jiang Yao ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Standard Technique ◽  
Aesthetic Outcome ◽  
Flap Surgery ◽  
Rotation Flap ◽  
Alar Retraction ◽  
Surgical Suture ◽  
The Aesthetic ◽  
Alar Rim

Isolated congenital alar rim defects are extremely rare, and there has been no standard technique for the reconstruction of remarkable aesthetic deformity. Herein, we introduce a trifoliate flap for the correction of isolated congenital alar rim defects in pediatric patients. Fifteen cases undergoing nasal alar sulcus rotation flap surgery were analyzed retrospectively. This rotation flap including 3 triangles was a modified flap based on prior studies. Clinical medical notes and photographs were reviewed. Patients’ (or their parents) reported satisfactions with aesthetic outcome were also evaluated during the post-operative follow-up period. In all patients, the isolated congenital alar rim defects were successfully reconstructed. The rotation flap survived and the wound healed primarily. The follow-up period ranged from 6 to 22 months (average 11 months). There were no incidents of flap loss, step-off deformities, nasal obstruction, or alar retraction. At follow-up of post-operative 3 months, pale red scars were observed in the operative area in few patients (2/15). However, these scars gradually became invisible at post-operative 6 months. All patients (or their parents) were satisfied with the aesthetic outcome of this operation. This newly designed trifoliate flap can be an alternative method for the reconstruction of isolated congenital alar rim defects in pediatric patients. The scars of this procedure can be unobvious with fine surgical suture.

Aesthetic Crown Lengthening for Gummy Smile Treatment Related to Altered Passive Eruption: A Case Report

2020 ◽  
Vol 23 (2) ◽  
pp. 28-33
Author(s):  
Indira Apriantika ◽  
Agung Krismariono
Keyword(s):  
Case Report ◽  
Treatment Plan ◽  
Patient Treatment ◽  
Treatment Results ◽  
Dental Hospital ◽  
Proper Diagnosis ◽  
The Aesthetic ◽  
Smile Aesthetics ◽  
Crown Lengthening ◽  
Gummy Smile

A healthy and beautiful smile can affect appearance and confidence. One of the aesthetic problems in dentistry that is often complained of by patients is excessive gingival display (gummy smile). The excessive gingival display can be caused by several factors, one of which is altered passive eruption (APE). One of the treatments to correct gummy smile related to APE is crown lengthening. Crown lengthening can be with bone reduction (gingivectomy with bone reduction) or without bone reduction (gingivectomy). Crown Lengthening with bone reduction is a surgical procedure that aims to maintain the dentogingival complex and to improve smile aesthetics. The purpose of this case report is to determine the crown lengthening with bone reduction (gingivectomy with bone reduction) procedure as a gummy smile treatment related to APE .A23-year-old female patient, came to Dental Hospital of Universitas Airlangga with complaints of her upper gum which not in the same length and the teeth looked short, she considered her smile was less aesthetic. After conducting analyses relating to aesthetics and periodontal tissue, crown lengthening with bone reduction was chosen for this patient treatment. The treatment results are quite good, visible gingival margins that matched the gingival zenith and improved patient's smile profile. APE as the etiology of patient's gummy smile can be corrected. There are no post-surgical complications such as excessive pain and infection. A proper diagnosis, treatment plan, and good techniques can produce a harmonious smile on the patient.

scholarly journals Does immediate loading of a single implant in the healed anterior maxillary ridge improve the aesthetic outcome compared to conventional loading?

BDJ Open ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Radhika J Baireddy ◽  
Neil Cook ◽  
Siwei Li ◽  
Fadi Barrak
Keyword(s):  
Public Health Practice ◽  
Immediate Loading ◽  
Aesthetic Outcome ◽  
Significant Difference ◽  
Attractive Option ◽  
The Aesthetic ◽  
Randomised Controlled ◽  
Study Designs ◽  
Effective Public Health ◽  
Single Implant

Abstract Background Immediate loading is an attractive option for avoiding secondary surgery. However, it is unclear whether it provides a better aesthetic outcome compared to conventional loading with implants placed in healed ridges. Aims To compare the aesthetic outcomes of immediately and conventionally loaded single implants in healed anterior maxillary ridges. Methodology A systematic review using PICO was conducted. EMBASE, MEDLINE and DoSS databases were searched. The Cochrane Risk of Bias tool for Randomised Controlled Trials and the Effective Public Health Practice Project tool for other study designs were used for quality appraisal. A narrative synthesis was undertaken. Results A total of 622 articles were identified. After screening, a total of five papers were included. Results indicated no statistically significant difference in pink or white aesthetic scores between the immediate and conventional loading groups at 1- and 5-year review and the Papilla Index at the 1-year review. Conclusion Within the limitations of this review, immediate loading of single implants provides a comparable aesthetic outcome to conventional loading in healed ridges of the anterior maxillary.

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