Piezosurgery and Burs Showed Similar Gingival Stability After Crown Lengthening

Posted: November 12, 2026

Piezosurgery and Burs Showed Similar Gingival Stability After Crown Lengthening

Edited by Dentaltown staff

Gingival margin stability after aesthetic crown lengthening did not differ significantly whether bone was removed with piezosurgery or with conventional rotary burs, according to a split-mouth randomized controlled trial published Nov. 5 in the Journal of Clinical Periodontology.

The trial enrolled 15 patients with altered passive eruption who underwent aesthetic crown lengthening from maxillary premolar to premolar. Ostectomy was performed with piezosurgery on one side and rotary burs on the other, by random assignment, and patients were followed for six months.

The primary outcome was change in gingival margin position between six weeks and six months. Margins shifted 0.16 ± 0.19 mm on the piezosurgery side and 0.12 ± 0.21 mm on the bur side, a difference that was not significant (P = .170).

Most of the change came early. The greatest reduction in crown height, an average of 0.63 mm, occurred between suturing and day 7, and the authors reported that margins were stable by six weeks.

Bone remodeling was also similar. From surgery to six months, the distance from the cementoenamel junction to the bone crest decreased by 0.22 ± 0.42 mm with piezosurgery and 0.26 ± 0.44 mm with burs (P = .491).

Investigators also collected profilometric, radiographic, and patient-reported outcomes. The abstract does not report the patient-reported results.

Kitichai Janaphan, Thanasak Rakmanee, and colleagues at Thammasat University in Bangkok conducted the trial with researchers from Kyung Hee University in Seoul and the University of Zurich, including Daniel S. Thoma. A Thammasat University Faculty of Dentistry research fund supported the work.

Sources:
Journal of Clinical Periodontology, “A Split-Mouth Randomised Controlled Clinical Trial: Comparing Ostectomy Performed With Piezosurgery Versus Burs for Aesthetic Crown-Lengthening Surgery,” published online Nov. 5, 2026:
doi.org/10.1111/jcpe.70223
PubMed, PMID 42987426:
pubmed.ncbi.nlm.nih.gov/42987426


Piezosurgery and Burs Showed Similar Gingival Stability After Crown Lengthening

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