Clinical Considerations for Crown Lengthening: A Comprehensive Review.

Clinical crown lengthening is a surgical procedure that involves the manipulation of gingival tissue, designed to expose sound tooth structure for restorative purposes by apically repositioning the gingival tissue, with or without the removal of alveolar bone. Crown lengthening may be subdivided as functional or esthetic, according to the purpose of treatment. Functional crown lengthening pertains to the exposure of subgingival caries, fractures, or to avoid invading the biologic width. Whereas esthetic crown lengthening, typically performed in the anterior sextants, aims to lengthen short anterior teeth or refine an uneven gingival contour. Crown lengthening is indicated to address restorative needs, increase clinical crown height, access subgingival caries or perforations, create a ferrule for restorations, or relocate restoration margins. This review manuscript outlines different crown lengthening techniques. Each technique is approached depending on patient-related factors (biologic width, remaining tooth structure, surrounding keratinized tissue, bone, and teeth) and the clinician's perspective. The importance of reaching a correct diagnosis through meticulous examination of the periodontal condition is key in employing the correct procedure to be conducted. This assures both the practitioner and the patient that the treatment plan will achieve the desired outcome.