Chapter 66

Insight: The periodontium has the ability to establish a natural “physiological gap” from the margin of the gingiva to the crest of the alveolar bone. This “gap” consists of the sulcus, the junctional epithelium and the connective tissue and is about 2-3mm in health (See figure to the left).

Clinical Consideration: Surgical crown-lengthening procedures are performed to provide retention form to allow for proper tooth preparation, impression procedures,21 and placement of restorative margin and to adjust gingival levels for esthetics.32,43 It is important that crown-lengthening surgery is done in such a manner that the biologic width is preserved, since infringement on the biologic width by the placement of a restoration within its zone may result in gingival inflammation,19 pocket formation, and alveolar bone loss35.

For details and surgical steps/pictures on crown lengthening surgery see Chapter 66.