J Korean Acad Periodontol.  2009 Jun;39(2):199-204. 10.5051/jkape.2009.39.2.199.

Case report of esthetic maxillary anterior crown lengthening

• Kim SH
• Park JW
• Suh JY
• Lee JM

• KMID: 1733738
• DOI: http://doi.org/10.5051/jkape.2009.39.2.199

Abstract

PURPOSE: Excessive gingival display and short clinical crowns due to altered passive eruptions are major concerns for a considerable number of patients visiting dental clinics. Altered passive eruptions could be corrected through various types of periodontal surgery conformable to a classification. 3 cases are reported here on the esthetic correction of altered passive eruption to evaluate results of crown lengthening procedure.
METHODS
Three patients whose major complaints were excessive gingival display and short teeth were picked out for this case study. Before treatment, clinical and radiological exam was performed to choose type of surgery. Thickness and width of keratinized gingiva was measured in all three patients then they were treated by surgical methods including flap operation and depigmentation under subsequent diagnosis.
RESULTS
Uneventful healing and stable gingival margin were observed in all three patients except recurrence of gingival pigmentation of one patient.
CONCLUSIONS
The treatment of altered passive eruption requires precise diagnostic procedure and could achieve better esthetic outcomes when it is accompanied by other orthodontic and orthognathic treatment.

Keyword

altered passive eruption; anterior crown lengthening; gummy smile

MeSH Terms

Crown Lengthening
Crowns
Dental Clinics
Gingiva
Humans
Keratins
Pigmentation
Recurrence
Tooth
Keratins

Figure

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  Figure 1 Coslet's classification.

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  Figure 2 Preoperative view which showing short clinical crown and dark gingivae.

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  Figure 3 preoperative view.

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  Figure 4 Sulcular incision with papilla preservation.

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  Figure 5 Flap reflection.

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  Figure 6 View after interrupted suture.

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  Figure 7 gingivoplasty for depigmentation of both jaw anterior area.

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  Figure 8 Postoperative view(2 months).

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  Figure 9 Preoperative view.

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  Figure 10 Preoperative view(short upper lip).

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  Figure 11 Cast analysis.

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  Figure 12 Postoperative view(3 months).

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  Figure 13 Preoperative view.

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  Figure 14 Preoperative view(short upper lip).

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  Figure 15 Stent application.

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  Figure 16 Sulcular incision.

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  Figure 17 osseous reduction.

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  Figure 18 View after sutere.

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  Figure 19 Postoperative view(4 months).

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  Figure 20 Postoperative view(10 months).

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