Gingivectomy & Crown Lengthening Procedures
Excess soft tissue or insufficient tooth structure can impair a final restoration.
When only soft tissue needs to be removed, this is termed a gingivectomy procedure, not a crown lengthening procedure. It is also necessary if the gum tissue has poor position or contour or for improving the cosmetic appearance of the teeth. It may also be required in order to make a successful impression for a cast restoration. The soft gingival tissues will be modified, repositioned, or reshaped so that an impression can be made or a restoration can be placed. If the tooth has been severely decayed, crown lengthening may be necessary to more completely expose the decayed area and allow better preparation for the final filling, (crown lengthening procedure see below). This gingivectomy may involve electrosurgery, a scalpel, or simply a rough diamond abrasion (all using anesthetic). We will select the method based on your individual circumstances. Healing time varies but for a gingivectomy usually is between 3 to 10 days.
A crown lengthening procedure is done by another dental specialist a Periodontist, a specialist in the tissue surrounding and supporting the teeth. A crown lengthening procedure is necessary when there is insufficient tooth structure remaining clinically visible or accessible for proper retention of a cast restoration (a crown or onlay) or routine restoration (filling). In either case it requires both the modification of the soft gingival tissues to reshape and reposition, as well as the removal of some underlying bone surrounding the tooth/root while recontouring the soft tissue at the same time. Many times, this crown lengthening will be minimal, and sometimes modification is extensive, involving many teeth and the supporting bone, but absolutely necessary for a successful restoration(s). At times, after the crown lengthening is completed and the tissue is healed, the tooth may exhibit temporary sensitivity to thermal changes due to increased root exposure, but with time the sensitivity usually decreases. The healing time is usually 6 to 8 weeks.
Restorations placed on sound tooth structure will last the longest possible time. One tooth or several teeth may be involved in the lengthening procedure. In many cases, it would be impossible to obtain a satisfactory result if the crown lengthening were not performed. Postoperative discomfort is usually minimal unless the crown lengthening has been extensive, as when the underlying bone must be recontoured. Over-the-counter pain relievers are usually very adequate. Healing time varies, depending on the extent of the procedure. Sometimes we will elect to finish the restoration or make the final impression at the time of the gingivectomy which heals in a few days to a couple of weeks depending on the amount of tissue removed and area of the mouth; other times we must wait longer for the site to heal, as in the crown lengthening procedure, where the healing time may be 6 to 8 weeks. This will be discussed with you when the crown lengthening procedure is suggested. If a crown lengthening is recommended, you should have it done, or the final restoration may be compromised and the chance of obtaining a clinically successful restoration would be seriously reduced. We will not compromise on procedures clinically necessary for long term success.
If you have any questions about the gingivectomy or crown lengthening procedures, please feel free to ask us.
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