Crown Lengthening Surgery for Anterior Esthetic Restoration: Case Report

Abstract

Crown lengthening surgery (CL) is a procedure that aims to reduce periodontal tissue to increase clinical crown height by maintaining the biological width for the placement of the final restoration. CL surgery will also affect the smile line for a better aesthetic appearance. Objective: To explain CL surgery for the aesthetic restoration needs of maxillary anterior teeth with the help of Chu-gauge examination. Case Report and Treatment: A 20-year-old female patient was referred by a Conservation Specialist to Periodontics with complaints of discolored maxillary anterior teeth since 2016 post-trauma. A consultation was conducted due to the need for final restorations considering the smile line and existing design. Clinical examination revealed inadequate restoration of tooth 21, gingival excess of teeth 12 and 22, edema, and plaque score of 10.3% (O’Leary). The use of Chu-gauge in gingivectomy to maintain an ideal crown ratio. Flap surgery was accompanied by osteotomy to maintain biological width. Then the flap was repositioned with a mattress vertical suture. Result: CL surgery to maintain periodontal tissue condition and biological width in final restoration selection. Conclusion: CL aesthetic surgery with osteotomy showed good results in terms of clinical crown dimension, gingival contour, and osseous level.