A comprehensive update on crown-lengthening procedures with new concepts and inputs

Abstract

A majority of periodontal procedures performed today are related with clinical crown extension for esthetic or functional needs related to varied etiologies. The concepts and understanding about any particular treatment keep evolving and further refinements happen with each passing year. The objective of the review is to put forth the various new innovative inputs and concepts regarding crown-lengthening procedures (CLPs) as envisioned by the author and provide a relevant review on various surgical procedures. To the extent possible, a retrospective evaluation of the available literature on CLPs and associated treatment modalities were undertaken. Personal evaluations based on a cumulative understanding of various clinical situations being presented for CLPs across many years were instrumental in writing this review. A new perspective on need-based area-specific CLPs is presented in the review which can be appropriated with any presenting clinical scenario. The review also proposes a new categorization of apically repositioned flaps in multiple types, which may expand our surgical options. A new treatment algorithm based on proposed residual attached gingiva is introduced. The review also deals with a modified proposal for the restorative considerations and a CLP format for record keeping. The scope of CLPs is really wide and refinements in the treatment modalities are need of the hour. The expansion of CLP concept and innovative inputs will definitely appeal to an astute clinician.

Keywords

• apically repositioned flap
• clinical crown extension
• crown-lengthening procedure
• crown-lengthening procedure decision algorithm
• crown-lengthening procedure record sheet format
• new classifications
• periodontal osseous surgery
• periodontal surgery
• stepwise surgical protocol