You might have had to watch someone around you smile, with the teeth appearing relatively longer compared to yours – which seem to be short. Well, the reason for this may be the excess gum covering a considerable portion of your teeth hence bringing about a scenario termed “gummy smile”. As a means of correcting these issues, your dentist may ask that you see a cosmetic surgeon or a specialist in oral surgery to perform a crown lengthening procedure on you. By the way, the crown is the anatomical part of the tooth that is above the gum, and it is usually covered by a tissue known as enamel. However, an artificial (dental) crown can be provided for patients with broken teeth.
According to the American Academy of Periodontology, crown lengthening is “a surgical procedure that aims at exposing sound tooth structure for restorative purposes via apical repositioning of the gingival tissue, with or without removal of alveolar bone”. It is a non-invasive surgical intervention carried out to increase the length of the tooth and also to get rid of pseudo pockets.
Again, this procedure can be performed, in reference to addressing the problem of dental fracture, inconsistent sub-gingival margins, or interproximal caries, to expose a sizable part of the dental structure over the gingival margin. This procedure may also be applicable in a scenario whereby a person has a broken tooth below the gum line. Summarily, crown lengthening procedures register as a restorative therapy and cosmetic intervention.
On your first visit to The Esthetic Clinics for a crown lengthening procedure, you will be attended to by a specialist who would ask for your medical history and then subjects you to an x-ray examination. These measures will help the plastic surgeon to determine the next line of action. Once it has been confirmed that the procedure is necessary, the surgeon acts to work out a treatment course that is tailored to suitably meet your needs.
Furthermore, on the back of these evaluations, the surgeon makes considerations hinging on crown-to-root ratio, root morphology, recovery time, and preservation of the integrity of the tooth’s width [after surgery]. All these are done to boost the attainment of a favourable outcome in the long run. At the end of this exercise, the surgeon will be able to determine the type of crown lengthening technique that applies to a particular patient’s case.
There are several procedures used in achieving crown lengthening and the surgeons at The Esthetic Clinics are equipped with the right knowledge and resources to perform these techniques. This means you can have access to the very best crown lengthening procedures India has to deliver. However, for the want of time and space, we shall only be discussing three of such procedures under this section.
As would have been expected, the application of local anaesthesia – although general anaesthesia may be used under certain circumstances – takes precedence in this procedure. The specialist surgeon thereafter makes an incision on the gum to generate a tissue flap. This flap is then raised to allow the surgeon have access to underlying tissues. After this, the surgeon moves to get rid of the extra tissue – which could include bone – as might be required to meet the patient’s specific needs. The flap is then repositioned around the tooth’s root and a suture is used to keep it firmly in place. Finally, the surgeon places a surgical dressing over the gum within the surgical site.
Having anaesthetized the patient, the surgeon uses a scalpel to dissect the periodontal ligament and methodically luxate (i.e., dislocate) the tooth. A periotome blade is normally placed in the tooth’s periodontal ligament space to prevent damages and ensure the success of the luxation process. The tooth is now extruded to the desired position with the aid of a haemostat. After this, the surgeon will use dissolvable stitches or non-rigid splint to re-stabilize the tooth, anchoring it to the neighbouring teeth.
Since this is addressing a fractured tooth, the patient is made to undergo radiographic examination two weeks after surgical extrusion and this is followed by the retreatment of the root canal and post-placement of fibre. The crown is prepared after a clinical examination has confirmed that the ferrule is high and wide enough to hold the crown in place – this may be feasible 4 – 5 weeks after the surgical extrusion. The temporization of the tooth and subsequent restoration of the (artificial) crown are carried at approximately 12 weeks after the initial operation. The surgeon will finally conduct a radiographic examination to assess how the surrounding tissues at the apex of the concerned tooth are healing.
Once you have completed the procedure, you should place an ice pack over the surgical site – on the outside – to reduce swelling. This is to be done at an interval of 20 minutes for the first 3 – 4 hours post-surgery. You should note that it can take up to 12 weeks for the gum to be fully healed after a crown lengthening procedure has been performed on you. You should take a good rest from any laborious or stressful (physical) activity for the next three days after surgery. Additionally, you religiously use the medications given to you by the surgeon, and heed to every instruction so given. This is highly vital if you have undergone surgical extrusion – this assertion does not, in any way, make other crown lengthening procedures less significant. While the surgeon will intimate you on the specificity of the steps/measures you need to take as you recover, it is fitting that we share some general guidelines with you here.
It is not so straightforward as several factors could make the price go up the scale, and this, most times, is based on the patient that is concerned. in light of this, the total cost of a crown lengthening procedure can be influenced by:
Well, this also depends on the protocol selected, but generally, the main surgery should be completed within 30 – 60 minutes. That said, you should be mindful of the fact that the series of (procedural) steps involved in some of these procedures – surgical extrusion, for instance – may take up to 3 months to complete.
Finding a place to do a crown lengthening procedure in India should not be stressful with the presence of a top clinic like The Esthetic Clinics where Dr. Debraj shome and his colleagues are always on hand to promptly deliver expert services.
Dr. Debraj Shome is Director and Co founder of The Esthetic Clinics. He has been rated amongst the top surgeons in India by multiple agencies. The Esthetic Clinics patients include many international and national celebrities who prefer to opt for facial cosmetic surgery and facial plastic surgery in Mumbai because The Esthetic Clinics has its headquarters there.