8. Crown Lengthening Flashcards

1
Q

What is crown lengthening

A

procedure to increase the length of the clinical crown

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2
Q

What is the difference between the clinical and anatomic crown

A

Clinical crown= coronal to the alveolar crest

Anatomic crown= coronal to the CEJ

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3
Q

What is ferrule

A

Supra-marginal dentin engaged by the restoration

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4
Q

T/F Can crown lengthening increase ferrule

A

yes

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5
Q

Benefits of ferrule

A

aids in retention by creating a stronger tooth/restoration interfece

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6
Q

Indications for crown lengthening

A
  • Short clinical crown (poor retention)
  • Improve esthetics (anterior teeth gummy smiles)
  • Subgingival caries or root resorption (subgingival margins invading biologic width)
  • Reduce excessive gingival display
  • Root fracture in coronal third
  • Pin or post perforation in coronal third
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7
Q

Causes of excessive gingival display

A
  • Occlusal wear
  • Short upper lip
  • Longer than usual maxila
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8
Q

Contraindications for crown lengthening

A
  • Inadequate treatment plans
  • Poor oral hygiene
  • No strategic value for the tooth
  • Severe peridontitis
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9
Q

Biologic width is _mm

A

2

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10
Q

The biologic width consists of what contents

A

-JE
-Supracrestal CT fiber complex
^^In this order from coronally to more apically

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11
Q

How much tooth structure is needed for retention

A

3-4 mm

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12
Q

T/F Osseous reduction is not usually required around the entire circumference of the tooth

A

t

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13
Q

What happens if the biologic width is violated

A
  • Chronic inflammation
  • Progressive attachment loss
  • Pocket formation
  • Localized bone loss
  • Gingival hyperplasia
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14
Q

Other alternative surgeries for crown lengthening at

A
  • Gingivectomy
  • Flap surgery
  • Ortho extrusion
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15
Q

Purpose of a gingivectomy is

A
  • Eliminated tissues that form the pocket

- Used if overgrown or hyperplastic gingiva is interfering with restorative procedures

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16
Q

T/F Gingivectomy will lengthen the clinical crown

A

f- EXCEPT for a minimal area of supracrestal fiber attachment

17
Q

How much keratinized gingiva is needed for a gingivectomy

A

at least 4 mm

18
Q

Flap surgery utilizes what kind of incision

A

reverbevel or internal bevel incision

19
Q

Buccal flaps and mandibular flaps are typically (marginal/submarginal)

A

either

20
Q

Palatal flaps are (marginal/submarginal)

A

submarginal

21
Q

A min. of _mm of sound tooth structure should be exposed for flap surgery

A

3mm (generally want 3-5mm)

22
Q

Benefits of orthodontic extrusion over crown lengthening

A

-Maintains shape of papilla

23
Q

Disadvantages of ortho extrusion over crown lengthening

A

-Osseous tissues may move with the tooth and supraosseous tooth structure may not change

24
Q

Post- op healing time after CL

A

6 weeks

25
Q

Describe the appearance of the papilla after CL and after 6 weeks healing

A
  • Initially appears flat

- Generally regains contour with healing

26
Q

Final gingival contour is dictated by

A
  • Underlying osseous configuration
  • Surface anatomy of the root
  • Post-op flap placement