Mandibular Molar

This mandibular first molar had subgingival caries extending into the buccal furcation. Caries control had been completed and a temporary restoration placed - but there was not enough tooth structure above the osseous crest to complete the permanent crown.

First, the osseous contouring was completed to expose enough tooth structure for retention, and to preserve biologic width. After four weeks of healing, the permanent crown could be placed. Note that the crown has been well-contoured into the buccal furcation to allow excellent cleaning access for the patient.

Pre-Surgery	At Surgery
Subgingival caries on this lower first molar would be difficult to restore without crown lengthening	Caries had progressed almost to the crest of bone and into the furcation
At Surgery	After Restoration
After osseous contouring, there is now enough tooth structure to place the crown margin and maintain biologic width	With biologic width preserved and excellent crown contours, tissue health is maintained

Crown Lengthening in Conjunction with Improving Anterior Esthetics

This man was concerned about his appearance. He had incomplete exposure of his anterior anatomic crowns, along with diastemas. In addition, there was asymmetry of the gingiva, leading to asymmetry in the lengths of the clinical crowns. The gingival margins had to be altered to bring the lengths of the clinical crowns to match and improve gingival symmetry.

The first step was to complete the crown lengthening to alter the gingival margins and lengthen the clinical crowns. After ten to twelve weeks of healing, the clinical crowns now match and the gingival contours are improved.

The permanent crowns then were constructed. Note the improved appearance of the teeth in the smile "esthetic zone." The spaces between the teeth have been closed, and the new contours of the gingiva enhance the esthetics.

Pre-Surgery
Spaces between his teeth and his “gummy” smile were of concern for this patient	Note asymmetry of gingival tissues make clinical crowns look as if they are different lengths
After Surgery
After gingival contouring and appropriate healing, the gingival contours are improved	Length of clinical crowns now match
After Restoration
New crowns have closed the spaces, and the smile is more esthetic	The new gingival contours enhance the esthetics of the new crowns