Implant Prosthodontics
Implant Prosthodontics
A forum to share and discuss cases, trends and news in the Implant Prosthodontic community.
Blog By:
Derek Gatta
Derek Gatta

How Do You Know When Your Patient Needs Crown Lengthening?

How Do You Know When Your Patient Needs Crown Lengthening?

6/14/2016 6:09:03 PM   |   Comments: 0   |   Views: 241
     Full Case Photos Here

     How do you know when to crown lengthen? In this case, I document the necessary steps to treatment plan and sequence short teeth syndrome cases. Photographs are crucial when making this determination. You can see in the smile shot how short the anterior si
x appear. They measured about 7.5mm long. The average central is closer to 10.5-11.5mm long. She does not have a gummy smile appearance so you know vertical maxillary excess or short upper lip are not the issues. The occlusion is edge-to-edge with a class III tendency. I did not do a ceph tracing so I can't say for certain but the occlusion combined with bruxism and altered passive eruption is most likely the etiology for this case. If once you do your occlusal reduction and your prep is shorter than 3-4mm, you could definitely benefit from crown lengthening in that scenario. This will help your retention and resistance form. In situations with limited space, metal ceramic restorations are great because the metal requires less clearance than an emax restoration. The patient chose not to have anything done to the mandibular arch at this time. An initial wax up and mock up is performed as a guide for the crown lengthening. After at least 3 months of healing, a second wax up and mock up are performed to confirm the length, contour and proportion.  Hope this helps and would love to hear feedback.  Thank you.  
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