Crown lengthening may be required in two situations. One is to expose healthy tooth structure present under the gum line, to allow your dentist to restore your tooth with a new crown or filling. The second is to improve a “gummy” smile, otherwise known as an esthetic gum lift.
If your teeth are decayed (cavity), fractured at or below the gum line, or have too much gum tissue covering them, your dentist will not have enough tooth structure to hold a new crown or to reach the cavity to clean it out and place a filling. In these situations a crown lengthening is required to expose the necessary amount of tooth structure. Soon after the area heals your dentist will be able to easily place the crown or filling.
Without a crown lengthening your dentist will not be able to repair your tooth or would be forced to place the new crown or filling far under the gum line with much bleeding and difficulty. Fillings placed under the gum line can result in a biologic width invasion. It is called this because the crown or filling is invading the biologic zone where the gum attaches to the tooth.
Biologic width invasion is a very important concept – Our body has skin around it in part to seal our insides against bacteria from the outside. The mouth is no different.
When we are young, the teeth enter into the mouth by breaking the gum barrier. To prevent bacteria from getting in through this break, we form a natural seal or cuff around each and every tooth. This seal is known and the Biologic Width. When the natural seal around a tooth is interrupted or invaded with a filling or crown you end up with an area where bacteria can attack. This results in constant inflammation that will not resolve no matter how much you brush and floss. The effects of biologic width invasion are seen as red or purplish, bleeding gums that bleed easily and bone loss. Essentially, the restoration causes periodontal disease.
The second instance where crown lengthening may be required is for a “gummy” smile. This is also known as a gum lift or crown exposure. A smile that shows a lot of gum is often associated with teeth that appear short or square in shape. Your teeth are most likely the proper length and shape but are covered with too much gum tissue. A crown lengthening surgery can correct this problem by reshaping the excess gum and bone tissue thereby revealing the full, natural shape of your teeth.
An esthetic gum lift may also be necessary prior to getting crowns and veneers on your front teeth. Placing beautifully coloured veneers on short front teeth gives you beautiful but nevertheless, short teeth in your smile. It only makes esthetic sense to get an gum lift first so that your dentist can realized the full potential of your smile.
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